While I thank Gramps for the history lesson, I note that she's cited parts of the bill as well as parts of Daschle's book. OTOH, Gramps didn't discuss each of her cites, showing how they're wrong. Perhaps he can, perhaps he can't. But, I'll stick with her interpretation for now because I have a general idea of what BHO and friends want to do.

The real problem that you won't discuss is the dishonest way it was slipped into the bill.

What you're really pissed about is someone is informing the public.

Oh look, it's Blogwhore Day!

Who's paying McCaughey? Simple as that.

The real problem that you won't discuss is the dishonest way it was slipped into the bill.

What you're really pissed about is someone is informing the public.

Who in gods name was editing TNR at the time? Oh yeah, that's right. Thanks Andrew Sullivan!

I know you were, like, 10 years old, but in addition to being "wrong" Betsy McCaughey-Ross's New Republic article also won a National Magazine Award.

Oh, and she was Lt. Governor of New York, which, you know, matters to some people when assessing credibility.

I'm just saying, if you're going to run a hatchet job on someone, you should at least do them the honor of being honest about their qualifications.

Oh, and she was Lt. Governor of New York

And Bush was President of the United States of America. I'm not going to trust his take on policy matters.

You always know Ezra's on to something with the first couple commenters are LV and Lone Dipshit.

Apparently, her references to the bill are to the version originally passed by the House. I don't know if they are in the current version. And I don't have time to page through it to find out.

As for her credibility, I think Ezra has a lot more credibility than someone connected with the Hudson Institute. Of course, right-wingers will have a different opinion about that.

Andrew Sullivan - bad magazine editor, or worst magazine editor?

Bad. For all Sullivan's faults, Marty Peretz is worse than him.

Oh, and she was Lt. Governor of New York, which, you know, matters to some people when assessing credibility.

What the fuck is that even supposed to mean? She was an elected official, hence her word is gold? Tom DeLay was an elected official who also happend to be a lying, untrustworthy scumbag. Christ, what a non-sequitur.

Also, what's with the New Republic hiring late-twentysomething, pseudo-hotshot Harvard assholes to edit their magazine? Beinart and Sullivan- quite the track record those two geniuses have produced.

Peretz is pretty terrible, but Sullivan published the McCaughey hack job, made a national figure out of Camille Paglia, devoted an entire issue to promoting The Bell Curve and gave Stephen Glass his start in journalism, and all within a two-year span. Just awful.

12:44 was me. Damn you comment section!

what's with the New Republic hiring late-twentysomething, pseudo-hotshot Harvard assholes to edit their magazine?

(a) Getting qualified, experienced talent is expensive.

(b) Unqualified, inexperienced, cheap labor doesn't actually affect the goals of the final work-product, which is to "get noticed," not be of high quality or reflect a knowledgeable point of view.

(c) Insofar as there are qualified people willing that aren't too expensive, they're generally doing something else with their lives other than editing a small-market publication that wouldn't advance their policymaking career.

Even Ambinder has gone after her,
http://politics.theatlantic.com/2009/02/lets_stop_this_before_it_goes_any_further.php

Ezra,

My post is focused on the vision of health IT and comparative effectiveness, so this isn't a defense of McGaughey. (Although I do think my point makes your point about her a less powerful.)

There may come a day when that data is used to make coverage decisions, but that day is not today, and nothing in the stimulus brings it any closer. Indeed, doing so would be a question not of data collection but of payment reform (you'd have to change payment rates to reflect the research).

You are actually missing a piece of the puzzle-- health IT and comparative effectiveness are linked heavily in two ways, contrary to what you suggested: 1) heavy use of EMRs would make it possible to do retrospective comparative effectiveness studies at a fraction of the cost and time. Think going to the library vs. Google. If government started a comparative effectiveness group, once health IT had taken hold, its influence would dramatically increase in a very short period of time. 2) The holy grail is not actual payment reform (this really isn't nearly as powerful as you think), but clinical decision support (CDS) linked to P4P incentives. CDS, is a platform used as part of a health IT package, that basically tells doctors what the right course of action when they are conducting a patient visit on the office computer. Think: spell-check when writing a paper. You write up the chief complaint, symptoms, exam, potentially lab results, and CDS will pop up with a box saying what the appropriate options would be. This is all good, of course, but its fair to point out that CDS linked to performance incentives that are provided from payers (whether its single-payer or not doesn't really matter, a government comparative effectiveness group would end up providing all of the data) would lead the "pop-up" boxes all being based on government recommendations. Again-- think spell-check. If you were paid based on ensuring your blog posts were spelled correctly-- and "correct" meant following the "official government dictionary"-- there's no doubt that bloggers would all have spell-checkers based on the government dictionary. You can argue that this is all good-- that's a debate for another time-- but there's no doubt that this is the Democratic vision-- a vision that requires widespread implementation of health IT. That's what the real "cost-savings" that are currently being espoused are based on. Better adherence to the "right" treatment.

National health care will be the topic of News Talk Online on Paltalk.com Monday February 16 at 5 PM New York time.

Please go to http://www.garybaumgarten.com and click on the Enter The Chatroom button to join in the conversation.

Thanks,

Gary

I think Ms. McCaughey’s article is well thought out, but a bit alarmist and missing the gigantic point, which is that electronic health records will save lives. This is a technology that will give public health officials the single strongest tool imaginable to bring life-saving epidemiological information to the attention of the public in near real-time. If this had been in place, we would’ve known about the peanut butter salmonella outbreak weeks sooner by seeing an anomalous spike in clinical data from the various pockets around the country. If we would’ve had this with HIV, or with cryptosporidium outbreaks, or even with potential bioterrorism, well, the benefits are vast.

And it is going to happen. The electronic format has already been designed by the national standard setting organization HL7 and there are already tools in development by Microsoft (Amalga), IBM/Google and Epic using this format (and the codification of these standards already popped up in the federal register on 1/21/09: http://edocket.access.gpo.gov/2009/pdf/E9-1068.pdf). The only question is deployment and penetrance. And by ‘penetrance’, I mean, will it be just for Medicare, Medicaid, VA, and SCHIP? Or will it be all of us, in a nationwide effort like the standardization of electronic transactions under the HIPAA legislation? The language referenced in the proposed HR 1 EH seems to suggest the latter. Indeed, the infrastructure is already being put into place with regional workgroups (Workgroup for Electronic Date Interchange and Ehealth Initiative) working on the gap analysis and figuring out the transition.

There are two distinct things at play here; the consolidating of health care information electronically, and the specter of someone ‘managing care’ via electronic information (which already happens, by the way). Personally, I think there’s a strong argument that the benefits of the former outweigh the concerns of the latter, but I don’t even think that’s an argument that needs to be made. Managing care electronically is really about managing cost. This is a good thing. For example, a CT scan is a frequently used diagnostic tool but it is a test that is unnecessarily repeated as patients go from ER to ER. A CT scan costs around $1500-$3000. Say one hospital does one less CT scan every other day, even at $2000 a test, that’s a savings to that one hospital of $365,000 per year. So yes, someone might tell your doctor not to do a CT scan, but if your doctor sees that one was done 2 days ago and he/she has access to electronic records with the image report, your doctor will not be ordering one anyway. This is something doctors want. They want baseline lab values. They want to reduce redundant tests and wasted time so they can focus more on patient care.

I do agree with Ms. McCaughey’s criticism of Daschle’s “board.” Though, in his book, note that he compares his board both to the UK model, and the Federal Reserve. These are very different entities and I think his idea works better if it is closer to the Federal Reserve model, and not a clinical decision-support group (or what is called a Utilization Management or Utilization Review Committee in the HMO world) as it is in the UK. The Federal Reserve model speaks more to the need for a board that can cut through bureaucracy in the interest of public health. The UK model is more a clinical decision support group. The Federal Reserve model also is a rough parallel to the Connector Board in Massachusetts, which would most likely be the eventual model for universal health care (with many tweaks). Daschle’s book gets ahead of itself and basically thinks it is a foregone conclusion that the national model will be just like the Massachusetts model, and that, you know, it would be passed by Congress. Quite an assumption.

Also:

And I read Daschle's book too and I don't think McCaughey and I read the same book. First of all, Medicare does make coverage determinations already. And age is already in the criteria formula. If a claim comes through for a 25 year old girl (let's say she's disabled, thus how she's on Medicare) to get a mammogram, unless the claim comes through with the proper coding indicating there was some cause for concern, Medicare would spit back out a denial. Which it should as that is outside the standard of care.

I think McCaughey is trying to intimate that Daschle's philosophy towards the elderly was, "just let 'em die", which, though I'm no Daschle apologist, really wasn't the case at all.

Daschle's point is that the current model for coverage determinations is corrupt already which is why probably 1/3 of all advanced imaging tests aren't necessary. The pharmaceutical and biotechnology lobbies have a lot of say over what is covered in the public-payer world and he wants to carve out those decision makers and insulate them like the Federal Reserve or the FAA where they will, presumably, be less likely to be influenced by politics. Whether or not that will work is certainly up for debate.

Also, the people making the Medicare coverage determinations are decentralized. I happen to have his book in my office so let me quote, "Under Medicare, national coverage decisions are made by the Centers for Medicare and Medicaid Service (CMS). But CMS, which doesn't weigh cost effectiveness, only hands down about two dozen decisions a year. The remaining 90 percent of Medicare coverage decisions are issued by roughly 50 fiscal intermediaries and insurance carriers scattered around the country."

So no, he's not saying we should just let grandma die. He might be saying grandma doesn't need a $3000 PET scan at the ER we take her to when we're on vacation, and if we had electronic health records, we probably wouldn't order one anyway.

Oh, and she was Lt. Governor of New York, which, you know, matters to some people when assessing credibility.

What the fuck is that even supposed to mean? She was an elected official, hence her word is gold? Tom DeLay was an elected official who also happend to be a lying, untrustworthy scumbag. Christ, what a non-sequitur.

To me, this article and especially this comment really highlight left-wing journalism (and it's fans) at their worst.

Whether or not you voted for or whether or not you think they're worth listening to, someone voted for them and someone is probably listening to them.

The idea that dismissing someone you know only through politics as a "lying, untrustworthy scumbag" is comically inappropriate. In fact, it's people like that guy that prevent Republicans from working co-operatively.

Back home in some gerrymanderingly-perfect conservative district there are guys, just like that commenter, threatening to mount a primary challenge if their representative dares work constructively with that "lying, untrustworthy scumbag" Nancy Pelosi.

These opinions are all relative. Until we start dropping the hate-on things aren't going to change. I'm jsut glad Obama gets it.

I've been trying to point out, for years, that the problem with selling health care reforms is that the general public has not been brought into the discussion. McCaughey succeeds, in no small part, with her fear mongering because the field is relatively empty: few people exist to take on her claims, and there's an assumption by many progressives that things don't need explaining because everyone gets them. They don't.

McCaughey's success also has everything to do with the fact that she prepares: she succeeded in 1994 precisely because so few people - especially the congresspeople meant to vote on it - had actually done the deep dive into the bill's text. Then, as now, she wasn't entirely wrong: her quoted passages were accurate, and her interpretations, bombastic though they were, were grounded in the text. But what was needed then, and is still needed, was someone equally well informed to push back. What she represents most is a basic concern of some folks - that there will be excessive control of healthcare by some beaurocratic entity, and doctors will have less say in providing care. Never mind that, right now, that situation exists for many patients anyway... and more to the point, most patients wouldn't know their own best treatment regardless. But you can't expect people to get that... if you never explain it.

Electronic records are in themselves benign, but wisewon's right: it's absurd to think that with the availability of data, people won't build databases to start determining best practices, and cost effective ones. That is, in fact, what you want to have happen. We need more standardization of care, not less. And we need to get people out of the habit of thinking that any and every "new thing" in medical care is vitally necessary. Some are simply more expensive, and less effective. And again, people don't get that... and no one explains it.

However, where I think Daschle's plan is wrong - and was wrong, and was a bigger part of his downfall than many realize - is creating a government panel to determine best practices, comprised mainly of docs. Part of the input into determining cost effectiveness is talking to payers, and giving them input as well. Let docs make these decisions... and you shouldn't be surprised how much they'll like giving the final say to... other docs. And this too, highlights a problem on the left: for all of our progressive ideas, many lefties are just as easily willing to let big players who need to change go unchallenged: including doctors, and hospitals as central to how healthcare is provided. These, too, are ideas that need challenging.

Finally, McCaughey touches on a basic fear here that shouldn't be ignored: adequate care for seniors. Almost everyone wonders, I think, where we will let decisions fall when at a certain point prolonging life may not make the most sense - when a condition is terminal, when only minimal quality of life improvements can be made. These are very hard questions, and we've largely tried to evade them, as a society. Any reassessment of how we provide care, really, will have to face them. And often, in talking about the changes a new system will have to address, we pretend that this is not an issue, when it is.

And in the fear mongering, I think it's a mistake to demonize McCaughey - she's informed, and she backs up her assertions; she deserves, and indeed her writing insists upon, being challenged. That's different from the cheap fear-mongering being sold on Fox News, whose anchors are really no better informed, and probably less informed, than many viewers (including the fact that many of them, I bet, are part of the healthy cohort of white collar workers who think their insurance is just great).

That, it strikes me, is where the anger should be directed... but responding, in a thoughtful way, to all of this can't really be focused until some progressive advocates for health care reform start doing the work of bringing the explanations to the people who need the information; for now, I don't think we can entirely blame the right for succeeding at scaring the public, when we offer little as an alternative.

These opinions are all relative.

No, not really, they aren't. Either McCaughey is correct is her assertions and research, or she's not. Her mistakes were either misreadings or willful distortions, or they are not. It's not relative.

If she really doesn't know what she's talking about and/or if she really did distort characterizations of various Democrats' health care plans then, no, it doesn't actually matter that she was elected to anything. This is a ridiculous attitude you have whereby we have to show some sort of deference to the talking points and ridiculous assertions of politicians, no matter what they're saying, simply because someone, somewhere elected them.

Ezra is absolutely right about Betsy McCaughey Ross. I remember her lies from Clinton health reform and it was not surprising to see her rise again now to distort the current stimulus efforts. Please read Wikipedia's biography of Betsy McCaughey. Included in it is a description of how she got the issues in the stimulus bill wrong -- http://en.wikipedia.org/wiki/Betsy_McCaughey_Ross

If you look at the language in the current Senate stimulus bill, you will see funding for health IT and for clinical effectiveness research, but the application of the research that will flow from this funding will in NO way affect coverage decisions by Medicare or Medicaid. In fact, the bill (in my mind, unfortunately) forbids the government from using information from this research to make coverage decisions or even to issue guidelines for medical practice. The following language is from a Senate Finance Committee's Q and A about this provision:

Q: Will this bill allow the government to apply the results of comparative effectiveness research to deny me end-of-life care or medicines that I choose?

A: Absolutely not. In fact, the Senate bill specifically prohibits the government from making any coverage decisions based on this research, or even from issuing guidelines that would suggest how to interpret the research results. The sole aim is to disseminate the results of the research to the public, so that patients and their doctors can make the best decisions for their specific situations, together.

Yesterday, one of the Bay ARea radio hosts allowed Ms. McCaughey to spout her inaccuracies all over the air and inflamed listeners with warnings of the collapse of the American health care system. I called in and did my best to present some facts, but no one was interested in facts. What a shame.

One note to add to this conversation (and thanks Ezra, for a good post): everyone seems to think putting HIT in the stimulus is a) sneaky and b) a Democratic plot. That's funny, since Congress has been holding hearing and markups almost constantly since May on this exact topic, including three major HIT bills (two significantly bipartisan) in 2007-2008 alone. Almost every word in this bill is taken from those previous congressional efforts, all done very much in the open, and way before anyone in Congress decided that Daschle's book was a critical read.

Good point Brian. HL7 has been working on the format for electronic medical records since 2005, and the whole initiative was an un-official 'part two' to the standardization of the HIPAA transactions (which was, it could be argued, the more valuable detritus of the Hilary plan)

Where do I address my angry letter?

And so it begins.

The smears and the lies to try to scare the American people against any improvements to our health care "system."

Fact is, we don't have a "system." We have a mess that is the result of half a century of tinkering around the edges of achieving the goal of universal coverage and access, affordability, high quality, equitable health care system.

Other commenters are correct. Health IT makes a patients entire medical record available to their health care provider and to them. The possibilities for coordinating care, reducing errors, and delivering the best treatments are enhanced enormously through electronic records. This will require a huge investment and coordination and funding at the federal level to achieve. That is the purpose of this funding in the stimulus. It is an investment in a better health care system for the US in the future.

True, the privacy concerns are enormous. And they will have to be addressed. But these concerns should not prevent us from moving forward.

Our health care system is not only the most expensive, it offers relatively poor quality, and our populations health status suffers as a result. We do not have the best health care system in the world. We need to face this head on and not pretend that changes to the system will ruin it. The opposite is true. It will continue to decline if we do nothing.

Are readers aware that for about 80% of what medicine does there is NO evidence that there is any health benefit to the patient. We don't know which treatments work better than others and which drugs work better than others. Given rising health care costs, one of the best ways to get a handle on them is to try to pay for only for what works. This is called evidence based medicine and health IT will help make this possible too.

But first we need to know the relative effectiveness of different treatments. Knowledge is power. The problem with the comparative effectiveness part of the bill is that is only looks at clinical effectiveness. We also need to look at VALUE. We need to know relative costs and cost-effectiveness and we need to know the contribution of a treatment to the overall health of the US population. The comparative effectiveness section is so watered down and so inadequate that it is of limited value. Part of me thinks they should take it out (particularly because the bill says we can't use the information for decision making) and put stronger provisions in the actual health care reform bill Congress will craft.

This debate has only begun.

Well HelenAnn, I think Obama learned the primary lesson from the defeat of the Clinton plan's failure, and the subsequent solution from his observation, that I think will be the antidote to the smear peddlers whom will inevitably come out of the dark recesses of right-wing manure factories. Make the entire process of debate and formulation, open to the public. I doing this, as Obama proposed, there will be no doubt who represents what perspective, and what their intention for or against universal access are. Just as there have been many debunkings regarding lies peddled by the right in regard to what is in the jobs bill, the internet, and c-span will play a significant role in pushing back against their usual silliness.

To me, this article and especially this comment really highlight left-wing journalism (and it's fans) at their worst.

The idea that dismissing someone you know only through politics as a "lying, untrustworthy scumbag" is comically inappropriate. In fact, it's people like that guy that prevent Republicans from working co-operatively.

Hey 'not-angry left'- I'll continue my horrible behavior and suggest that you go fuck yourself, you pearl-clutching git.

Betsy McCaughey discredited herself years ago with a load of bullshit that's been repeatedly and thoroughly debunked. Tom DeLay has finally been fucking indicted after a well-documented career of scumbaggery. The only thing "comically inappropriate" here is people who enjoy having Lucy repeatedly yank the football away from them time after time.

In a healthy political culture there are consequences for not operating in good faith. That faux high-minded wankfest you produced above is the type of middlebrow horseshit that prevents those consequences.

Wisewon,

Isn't the "right treatment" what YOU'd want from YOUR doctor? Assuming of course that the "right treatment" was based on statistical outcome analysis?

I think you're trying to imply that the government would have an interest in killing off the voters. Do you really believe that? Or is it a subtle red herring?

There is absolutely no benefit to the an elected government to advocate any but the most effective treatment for any particular symptomology. EVEN IF IT PAYS THE BILL. It makes no sense to waste money on ineffective efforts.

Now, the government statistics might conclude that use of a generic substitute is the right course. Or if not it might favor the cheapest of available non-generic drugs. BUT SO DO THE INSURANCE COMPANIES! No change there.

What you are missing is that there is a genuine issue of WHAT is to be covered. I'm not for covering plastic surgery. But neither are the insurance companies.

The Oregon Health Plan has a list of recognized "diseases" (really symptomologies) and it decides what it will cover each year by starting at the top of a list arranged in order of a combination of lethality and frequency and goes down the list until it runs out of money. The cost of each symptomology is the product of the expected frequency times the expected cost per patient. Pretty straightforward.

Now, I personally think that they are missing the boat by not including an age factor in the formula. That is, if something is fairly rare and highly lethal but can be treated by an expensive transplant (e.g. liver disease), the age of the patient should be a prime decider of treatment. I'm old, so I'd be at risk for exclusion; eventually everyone would.

Since Obama's plan explicitly states that a patient can go outside the plan and pay her or his own money for care, then an old rich cirrhotic patient could still pay for a transplant, assuming an organ could be obtained. There are of course other laws that would make that unlikely, but they already do so.

As far as Betsy McCaughey's credentials, yes, she was LT. Gov. for Pataki's first term. She was an unknown, picked entirely for that article. (This was the Gingrich revolution, remember?). Her and Pataki became completely estranged when he realized she was, uh, batshit insane (you can look it up). She then recanted the entire article, and ran for governor herself, on her new rich husband's dime.
After losing horribly, she divorced the husband, and became a Democrat. She also started a progressive healthcare advocacy. I see she's now seen the GOP light, just in time to kneecap another healthcare reform. Sometimes people are calles 'lying, untrustworthy scumbags' because they're lying, untrustworthy scumbags.

For accuracy's sake, this post attributed to Mark Ambinder, http://politics.theatlantic.com/2009/02/lets_stop_this_before_it_goes_any_further.php, is actually by James Fallows (though it appears at Ambinder's site).

typical liberal name calling personal attacks ...

you people are a bunch of small minded ignorant fools ...

The system is broken. The 1,100 page bill was printed Thursday night, will be voted on today and signed into law on Monday. No Senator or Representative will have read it. Neither Mr. Ezra Klein or Ms. Betsy McCaughey can know the details. We do know it is supposed to be a stimulus bill. It may authorize euthanizing everyone over 35. No one knows, or is responsible for knowing. Thus charges of lying, or just being mistaken have no meaning.
The system is broken.

Who on earth is this Ezra? I came across him at rcp.com What utter nonsense. Typical Obama worshipper trying lift up a smoke screen of half truths to confuse and divert attention away from this ludicrous rushed LARGEST pork bill and away from the FACT that very few (and Ezra's not one) know what is in this enormous secretive bill. They finally put it out (8 inches thick) a few hours before they claim they have to vote for it. Amazing. I thought this was supposed to be the most transparent, open and trustworthy government in history. It's proven to be quite the opposite. 99% of those voting for this, don't have a clue what is in it. This is a new level of irresponsibility never before seen in this country. "Change" (for the worse) we can believe in. Believe it! Open your eyes!

This is my third attempt to submit this comment. What is the problem. I am sure I'm typing the correct captcha

I realize Betsey McCaughey writes from a pro-markets stance, but I was startled to read that there are articles in the stimulus bill related to Medicare that have received no public discussion--esp among health care reform advocates. Negotiations behind closed doors doomed the Clinton bill. We had hoped for transparency this time round. I am also sorry to see Daschle's prints on this, since his lack of objectivity--his alliance with the health care industry--has been revealed.

It is not Medicare that needs cost-trimming and increased oversight. Medicare holds admin costs to an est 3 percent. If anything, Medicare needs increased funding, and fair compensation to physicians. Let's do some real trimming--the bloated health insurance industry needs to be eliminated. In this economic crisis, how can we afford to waste 20 to 20 cents on every health care dollar on the admin costs of HMOs, including exec salaries and profits?

I believe most physicians try to do right by their patients, and to keep up with eveidence and research in their field, but now they are also required to dance to the insurers' tune: shortened consultations, duking it out to get treatment approvals, higher staffing costs, and lower compensation.

It's time for single payer. Get your legislator to co-sponsor HR 676 (Go to thomas.loc.gov to read the bill). The Lewin Group has reported that trillions of dollars will be saved. Now there's a stimulus package that patients, families, clinicians, employers, states and municipalities will benefit from.

(Go to thomas.loc.gov to read the bill),/i>

Why start reading bills now?

The rush of the stimulus bill is such that no one will have read it, and it's the biggest spending bill in history.

What this article fails to note is that this "nationwide implementation of interoperable health information technology" has nothing to do with stimulating the economy, especially if it isn't due to be implemented for 10 years. It has no place in this spendulous bill just like most of the junk in this package.

First the quote is supposed to be "Lies, Damn Lies and Statistics." We should be carefully scrutinizing the data purveyors who are guiding our legislators and "misinforming" our politics and laws.

I'm a primary care physician and a geriatrician and I'm perfectly capable of sharing information when permitted to do so by the patient with any other provider already. Young physicians such as myself need more freedom to innovate and experiment with tools and technologies. This legislation will only bring more restrictions and likely more proprietary, copyright and patents to this area of healthcare. Certainly that will drive up costs as all government mandates tend to do.

This bill is an attempt by big corporations who skew the data being used to prop-up "the problem" so they can sell proprietary and restrictive solutions to tax payors (or physicians) and to gain full access to data behind the scenes.

It's that plain and simple.
Already we have Free Software (GNU Public Licensed) that permits the secure (encrypted) exchange of data via any medium, any operating system and give the greatest freedom with the least coercion.

Obama is wrong and I can't trust him because is is also a smooth liar who employs criminals to lead us and advise him.

Want to stimulate the economy... then give back and waive taxes on the people so they can pay off their high interest rate credit card debt. End the Federal Reserve and phase in a reintroduction of the Gold Standard to back our currency. That would be tangible confidence instead of more Council for Foreign Relations, and Trilateral Commission parlor games.

I think independently and do not follow the fallacy of the left and right paradigm your helping to sell Mr. Ezra. I'm also 10 years your senior and have been studying health care formally and informally non-stop since I was half your age!

I welcome you to join me any day of the week to see what type of "acid-tipped spiky" probe the government has been in health care.

Obama is wrong and I can't trust him because is is also a smooth liar who employs criminals to lead us and advise him.
We've been saying the same about Bush/Cheney/Rove for over 8 yrs...get it? and you trusted Bush. Thanks Mr.care physician and a geriatrician Give us your business name and I'm sure you will get lots of Patients

http://www.gamegoldme.com

Betsy McCaughey has gone on a real tear. Betsy McCaughey, a journalist of distinction and former Lieutenant Governor of New York state, has taken aim at Obamacare and especially Dr. Ezekiel Emanuel, MD, brother to White House Chief of Staff Rahm Emanuel, and in her op-ed piece that's being billed as New York Post Deadly Doctors, she claims that the public health care plan will deny care to the mentally disabled and elderly. However, nothing in the bill has come to light that would indicate she's correct, and the oversight agency for the program would be only be staffed by physicians. Regardless of criticism by Betsy McCaughey and others, most still need payday loans for the most basic of care.

Ezra: bad link in 3rd paragraph about The New Republic's recanting McCaughey's hack job on Clinton's attempt at health reform.

A better link to Franklin Foer's statement would be greatly appreciated. Thank you.

thanks for you information The rush of the stimulus bill is such that no one will have read it, and it's the biggest spending bill in history

So... meh. this blog post is the first I've heard about the issue, and based on it and reading the Politico article I'd say it's the kind of thing to ask questions about (if Calderone didn't already know that there are a lot of off-the-record list servs around DC like you say, which come to think of it would be a big thing to be ignorant of), but the answers aren't newsworthy. Smoke but no fire.
I just hate seeing "leftists" act like William F Buckley and the National fucking Review. This is why the left has gone to shit, too many damn rich kids and their summer-camp habits brought into the political arena, instead of actual organizing.

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