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Founded in 1985, Remote Area Medical® is a publicly supported all-volunteer charitable organization. Volunteer doctors, nurses, pilots, veterinarians and support workers participate in expeditions (at their own expense) in some of the world's most exciting places. Medical supplies, medicines, facilities and vehicles are donated.

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A great interview with a CIGNA health insurance executive turned whistle blower.

With almost 20 years inside the health insurance industry, Wendell Potter saw for-profit insurers hijack our health care system and put profits before patients. Now, he speaks with Bill Moyers about how those companies are standing in the way of health care reform.

***

Last month, testimony in front of the U.S. Senate Committee on Commerce, Science and Transportation by a former health insurance insider named Wendell Potter made news even before it occurred: CBS NEWS headlined: "Cigna Whistleblower to Testify." After Potter's testimony the industry scrambled to do damage control: "Insurers defend rescissions, take heat for lack of transparency."

In his first extended television interview since leaving the health insurance industry, Wendell Potter tells Bill Moyers why he left his successful career as the head of Public Relations for CIGNA, one of the nation's largest insurers, and decided to speak out against the industry. "I didn't intend to [speak out], until it became really clear to me that the industry is resorting to the same tactics they've used over the years, and particularly back in the early '90s, when they were leading the effort to kill the Clinton plan."
Potter began his trip from health care spokesperson to reform advocate while back home in Tennessee. Potter attended a "health care expedition," a makeshift health clinic set up at a fairgrounds, and he tells Bill Moyers, "It was absolutely stunning. When I walked through the fairground gates, I saw hundreds of people lined up, in the rain. It was raining that day. Lined up, waiting to get care, in animal stalls. Animal stalls."

Looking back over his long career, Potter sees an industry corrupted by Wall Street expectations and greed. According to Potter, insurers have every incentive to deny coverage — every dollar they don't pay out to a claim is a dollar they can add to their profits, and Wall Street investors demand they pay out less every year. Under these conditions, Potter says, "You don't think about individual people. You think about the numbers, and whether or not you're going to meet Wall Street's expectations."

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Book on The C Street Group by Jeff Sharlet, The Family.

From The Jacket,

They are the Family—fundamentalism’s avant-garde, waging spiritual war in the halls of American power and around the globe. They consider themselves the new chosen, congressmen, generals, and foreign dictators who meet in confidential cells, to pray and plan for a “leadership led by God,” to be won not by force but through “quiet diplomacy.” Their base is a leafy estate overlooking the Potomac in Arlington, Virginia, and Jeff Sharlet is the only journalist to have written from inside its walls.

The Family is about the other half of American fundamentalist power—not its angry masses, but its sophisticated elites. Sharlet follows the story back to Abraham Vereide, an immigrant preacher who in 1935 organized a small group of businessmen sympathetic to European fascism, fusing the Far Right with his own polite but authoritarian faith. From that core, Vereide built an international network of fundamentalists who spoke the language of establishment power, a “family” that thrives to this day. In public, they host prayer breakfasts; in private they preach a gospel of “biblical capitalism,” military might, and American empire. Citing Hitler, Lenin, and Mao, the Family's leader declares, "We work with power where we can, build new power where we can't."

Sharlet’s discoveries dramatically challenge conventional wisdom about American fundamentalism, revealing its crucial role in the unraveling of the New Deal, the waging of the Cold War, and the no-holds-barred economics of globalization. The question Sharlet believes we must ask is not “What do fundamentalists want?” but “What have they already done?”

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Your modern GOP has Lee Atwater to thank for their last run of power, but the future is dank due to demogrpahic changes coming home to roost,

As a member of the Reagan administration in 1981, Atwater gave an anonymous interview to Political Scientist Alexander P. Lamis. Part of this interview was printed in Lamis' book The Two-Party South, then reprinted in Southern Politics in the 1990s with Atwater's name revealed. Bob Herbert reported on the interview in the October 6, 2005 edition of the New York Times. Atwater talked about the GOP's Southern Strategy and Ronald Reagan's version of it:

Atwater: As to the whole Southern strategy that Harry Dent and others put together in 1968, opposition to the Voting Rights Act would have been a central part of keeping the South. Now [the new Southern Strategy of Ronald Reagan] doesn’t have to do that. All you have to do to keep the South is for Reagan to run in place on the issues he’s campaigned on since 1964… and that’s fiscal conservatism, balancing the budget, cut taxes, you know, the whole cluster...

Questioner: But the fact is, isn’t it, that Reagan does get to the Wallace voter and to the racist side of the Wallace voter by doing away with legal services, by cutting down on food stamps...?

Atwater: You start out in 1954 by saying, “Nigger, nigger, nigger.” By 1968 you can't say “nigger”—that hurts you. Backfires. So you say stuff like forced busing, states' rights and all that stuff. You're getting so abstract now [that] you're talking about cutting taxes, and all these things you're talking about are totally economic things and a byproduct of them is [that] blacks get hurt worse than whites.

And subconsciously maybe that is part of it. I'm not saying that. But I'm saying that if it is getting that abstract, and that coded, that we are doing away with the racial problem one way or the other. You follow me—because obviously sitting around saying, “We want to cut this,” is much more abstract than even the busing thing, and a hell of a lot more abstract than “Nigger, nigger.”

That wins you power in 32 of the last 50 years, but going forward, the United States is going to be a minority majority nation with the internet access to look up modern GOP party fathers like Lee Atwater. Never forget that it wasn't only electoral convenience that caused the GOP to be racists, that's what they believe in, white racial superiority.

Live, currently on C-Span 3 is the mark-up of the House Energy and Commerce Committee version of the Health bill. They're debating and voting on Republican amendments to the bill.

At the base, our inability to progress is not only the fault of lobbyists and the campaign finance system, there's a large degree of ignorance mingled with "I've got mine" apathy",

This tease from the forthcoming New York Times/CBS News poll shows the difficulties lawmakers face when dealing with the nation's problems.

"Most Americans continue to want the federal government to focus on reducing the budget deficit rather than spending money to stimulate the national economy... Yet at the same time, most oppose some proposed solution for decreasing it."

"Fifty-six percent of respondents said that they were not willing to pay more in taxes in order to reduce the deficit, and nearly as many said they were not willing for the government to provide fewer services in areas such as health care, education and defense spending."

If anyone has a solution to our long national policy retardation, I'd love to hear it.

Rep. Earl Blumenhauer breaks down the break down,

Three or four times a month I will preside over House proceedings. While this can occasionally be repetitious, I find it to be a fascinating window into House operations. There is no better seat to watch the interactions of Members - who is talking to whom; who pays attention when someone else speaks. When there are large numbers of people on the floor you can watch patterns develop. It is a great way to understand House-dynamics.

Occasionally, you get more than you bargained for. Today, my two hour stint in the Chair was made up entirely of one-minute speeches. This is a House procedure where Members from both parties come to the floor, and the two sides take alternating one-minute shots talking about everything from critical issues to commemorating a championship high school softball team, to an announcement of legislation that a Member is introducing.

Sometimes, however, it isn't pretty. Today, I literally watched Republicans become unhinged as they attempted to outdo one another on the "evils" of programs being considered by President Obama and the Democrats in Congress. As the Republicans took advantage of the unlimited opportunities for one-minute speeches, dozens of them headed to the floor with competing tales of horror that are allegedly in the Democratic approach to health reform.

I listened as people, theoretically speaking from the same talking points, variously claimed that 4, 5, 6 and even 7 million jobs would be lost as a result of the health care plan. A colleague from Oregon claimed that 114 million Americans would lose their health insurance; that Democrats want to socialize 20% of the economy. In as much as healthcare currently is only 16% of the economy, this is quite a trick. Another Republican talked about how extending health insurance to more than 40 million Americans who currently don't have coverage was somehow going to put government bureaucrats in charge?!

It increasingly became more and more surreal. The Democratic plan would leave Americans no choice but to go to emergency rooms (?). Don't they remember George Bush suggesting that's why we had universal coverage now?

Rep. Todd Akin suggested that there would be a 50% chance that he would be dead if he lived in Great Britain because of their failure to meaningfully treat cancer patients. McClintock from California questioned how the same government that operates FEMA could possibly be efficient. I'm shocked that any Republican would bring up FEMA and the disaster of the Bush Administration for an agency that, until the Republicans got a hold of it, was doing a great job in the Clinton years.

Rep. Broun from Georgia demanded to see the bill, "Show us the bill", "don't hide the bill," at exactly the same time that his colleagues were waving the bill and misreading what was in it. Rep. Buck McKeon admonished people to read the bill and then specifically cited Section 1233. Actually, I know a little bit about this section because it's a bill that I wrote which was incorporated into the overall legislation. His statement was a complete fabrication (check out my myth vs. fact sheet). At least he didn't get to the point that Rep. Virginia Foxx of North Carolina did when she claimed that the Republican approach would be more pro-life because it, "would not put seniors in the position of being put to death by their government!"!

There is spin, and there are out right lies. The GOP has found it acceptable to make insane statements, they know are false. So write, call, make it clear that this is unacceptable.

Earl is a serious member who is fighting for the best interests of working families,

Congressman Earl Blumenauer (Ore-3) has devoted his entire career to public service. He first served in the Oregon House of Representatives in 1972. From there Congressman Blumenauer went on to be a Multnomah County Commissioner and spent ten years on the Portland City Council as Commissioner of Public Works. His innovative accomplishments in transportation, planning, environmental programs and public participation have helped Portland earn an international reputation as one of America’s most livable cities – places where people are safe, healthy and economically secure.

Elected to the US House of Representatives in 1996, Congressman Blumenauer is committed to promoting livable communities at the federal level. A member of the Ways and Means Committee, the Budget Committee and the new Select Committee on Energy Independence and Climate Change, he is a strong and creative voice both at home and abroad for the environment, sustainable development, and economic opportunity. Congressman Blumenauer has authored and co-sponsored legislation to preserve and protect public lands, shift the nation’s energy policy towards renewable energy and energy efficiency, curb global warming and clean our nation’s water bodies, among many others.

Congressman Blumenauer was named a German Marshall Fellow in 1995 and has won numerous awards from environmental, education, community, and civic organizations, including 1999 Legislator of the Year from the American Planning Association, the National Building Museum's Apgar Award in 2000, the Public Radio Leadership Award from National Public Radio in 2005, One of “The Top 25 Change Agents in Bicycling History,” from the League of American Bicyclists in 2005, and the Public Official’s Award from the Water Environment Federation in 2006.

So what's the deal with Health Care Reform as we move into recess?

The battle over health care reform "is all but paralyzed" as everyone awaits the outcome of Senate Finance Committee negotiations. If a bipartisan deal is possible, it will come from the talks between six senators who have been meeting multiple times a day since mid-June.

New York Times: "Still, if the three Democrats and three Republicans can pull off a grand bargain, it will have to be more conservative than the measures proposed by the House or the left-leaning Senate health committee. And that could force Mr. Obama to choose between backing the bipartisan deal or rank-and-file Democrats who want a bill that more closely reflects their liberal ideals."

Indeed, the AP confirms the group is dropping elements of the more liberal House plan, noting "participants were on track to exclude a requirement many congressional Democrats seek for businesses to offer coverage to their workers. Nor would there be a provision for a government insurance option, despite President Barack Obama's support for such a plan."

The big question today: Will liberals in the House and Senate attempt to block a plan without these provisions?

So tell the Congress what you want, now, because we're getting to the point where the cement is about to pour.

Paul Krugman todays attempts to divine if The Blue Dogs are in fact even aware of their interests in today's must read op-ed.

Right now the fate of health care reform seems to rest in the hands of relatively conservative Democrats — mainly members of the Blue Dog Coalition, created in 1995. And you might be tempted to say that President Obama needs to give those Democrats what they want.

But he can’t — because the Blue Dogs aren’t making sense.

To grasp the problem, you need to understand the outline of the proposed reform (all of the Democratic plans on the table agree on the essentials.)

Reform, if it happens, will rest on four main pillars: regulation, mandates, subsidies and competition.

By regulation I mean the nationwide imposition of rules that would prevent insurance companies from denying coverage based on your medical history, or dropping your coverage when you get sick. This would stop insurers from gaming the system by covering only healthy people.

On the other side, individuals would also be prevented from gaming the system: Americans would be required to buy insurance even if they’re currently healthy, rather than signing up only when they need care. And all but the smallest businesses would be required either to provide their employees with insurance, or to pay fees that help cover the cost of subsidies — subsidies that would make insurance affordable for lower-income American families.

Finally, there would be a public option: a government-run insurance plan competing with private insurers, which would help hold down costs.

The subsidy portion of health reform would cost around a trillion dollars over the next decade. In all the plans currently on the table, this expense would be offset with a combination of cost savings elsewhere and additional taxes, so that there would be no overall effect on the federal deficit.

So what are the objections of the Blue Dogs?

Well, they talk a lot about fiscal responsibility, which basically boils down to worrying about the cost of those subsidies. And it’s tempting to stop right there, and cry foul. After all, where were those concerns about fiscal responsibility back in 2001, when most conservative Democrats voted enthusiastically for that year’s big Bush tax cut — a tax cut that added $1.35 trillion to the deficit?

But it’s actually much worse than that — because even as they complain about the plan’s cost, the Blue Dogs are making demands that would greatly increase that cost.

There has been a lot of publicity about Blue Dog opposition to the public option, and rightly so: a plan without a public option to hold down insurance premiums would cost taxpayers more than a plan with such an option.

But Blue Dogs have also been complaining about the employer mandate, which is even more at odds with their supposed concern about spending. The Congressional Budget Office has already weighed in on this issue: without an employer mandate, health care reform would be undermined as many companies dropped their existing insurance plans, forcing workers to seek federal aid — and causing the cost of subsidies to balloon. It makes no sense at all to complain about the cost of subsidies and at the same time oppose an employer mandate.

So what do the Blue Dogs want?

Maybe they’re just being complete hypocrites. It’s worth remembering the history of one of the Blue Dog Coalition’s founders: former Representative Billy Tauzin of Louisiana. Mr. Tauzin switched to the Republicans soon after the group’s creation; eight years later he pushed through the 2003 Medicare Modernization Act, a deeply irresponsible bill that included huge giveaways to drug and insurance companies. And then he left Congress to become, yes, the lavishly paid president of PhRMA, the pharmaceutical industry lobby.

One interpretation, then, is that the Blue Dogs are basically following in Mr. Tauzin’s footsteps: if their position is incoherent, it’s because they’re nothing but corporate tools, defending special interests. And as the Center for Responsive Politics pointed out in a recent report, drug and insurance companies have lately been pouring money into Blue Dog coffers.

But I guess I’m not quite that cynical. After all, today’s Blue Dogs are politicians who didn’t go the Tauzin route — they didn’t switch parties even when the G.O.P. seemed to hold all the cards and pundits were declaring the Republican majority permanent. So these are Democrats who, despite their relative conservatism, have shown some commitment to their party and its values.

The argument that Democrats are fighting Democrats and that's not good for the Party is wrong up until the point when it becomes self-defeating, because if you promise to be more efficient, competent, and effective then the GOP, when you layout a platform and you have sufficient majorities in the Congress, the party as a whole will take the blame and the members concerned about retaining their seats will lose by cutting off their noses to spite their faces. It's this dynamic, big tent party, that isn't afraid to debate amongst themselves that gives us an advantage over the monolithic GOP. Up until the point when the debate is over and we must stand firm together so we can actually pass legislation. This is exactly why I think The Democrats gave to do a better job of reducing the costs of elections, the need to raise money, and therefor access to the lobbyists who are refracting public opinion not reflecting it, serving the lobbyists interests and not their constituents interests is only because of the cost of elections.

As we go into the recess, members will go home and explain to their constituents the intended effects of the bill. If you want change, the squeakiest wheel does get the oil. This is the time to hand write letters, e-mails are too easy to ignore, call the members of the Blue Dog Coalition, (there positions on committees that have national scope makes you their constituent as well as their local constituents), multiply your efforts by encouraging like minded friends and family to multiply their efforts, or we're not going to achieve our central party plank, real substantive health reform that covers everyone, improves health outcomes, and reduces wastes like reducing medical errors and surgical infection rates while retaining and enhancing value, (value is where cost meets quality.)

When dealing with the polling, remember there are two types of respondents, those who have never had to access their health insurance for a chronic illness and/or horrible accident, and those who have. Most healthy people believe they like their insurance, but have never really had to exercise it to its capacity. Those who are in the medical system due too prolonged illness, will tell you a different story then those who haven't. It's much like reviewing a train you don't ride everyday and comparing that with the review of someone who takes the train daily. The daily train rider's review is much more relevant and helpful in improving the train.

Like any reform with doing, the opposition will always try to confuse the voter by defining the proposed reform in a manner that is purposefully confusing to the voter. So with one month to either pass health reform in our lifetime, it's incumbent that everyone who voted for Obama follow through and stand firm for reform.

I'll be the first to tell you that the legislative process in a democratic republic is a sausage factory. Winning passage will be determined by our ability to help swing voters in the Congress from rural districts that health reform will come to their district in the same positive manner that it comes to all districts.

The legislative process is about understand the interests of each member and then showing the member how your proposal serves the interests of the member's people, and the member can thereby retain power. This confluence makes it possible for establishmentarians to realistic in the debate but not real.

The details of how the President's health reform principles are written into law and the ends to which they law will serve over time will depend on continual improving the legislation with critical analysis and because the average voter is not a lawyer it's easy to confuse the issue. So let's define what Obama and The Democrats want to do in the face of an election in November where Obama won in states like Florida, North Carolina, Virginia, Ohio, Iowa, New Hampshire, with the most exposure of any person possible Obama won in states that Al Gore and John Kerry had difficulty in and/or lost. I strongly believe that a mandate was democratically issued and that Obama and The Democrats have the consent of the governed to inact the following principles,

President Obama is committed to working with Congress to pass comprehensive health reform in his first year in order to control rising health care costs, guarantee choice of doctor, and assure high-quality, affordable health care for all Americans.

Comprehensive health care reform can no longer wait. Rapidly escalating health care costs are crushing family, business, and government budgets. Employer-sponsored health insurance premiums have doubled in the last 9 years, a rate 3 times faster than cumulative wage increases. This forces families to sit around the kitchen table to make impossible choices between paying rent or paying health premiums. Given all that we spend on health care, American families should not be presented with that choice. The United States spent approximately $2.2 trillion on health care in 2007, or $7,421 per person – nearly twice the average of other developed nations. Americans spend more on health care than on housing or food. If rapid health cost growth persists, the Congressional Budget Office estimates that by 2025, one out of every four dollars in our national economy will be tied up in the health system. This growing burden will limit other investments and priorities that are needed to grow our economy. Rising health care costs also affect our economic competitiveness in the global economy, as American companies compete against companies in other countries that have dramatically lower health care costs.

The President has vowed that the health reform process will be different in his Administration – an open, inclusive, and transparent process where all ideas are encouraged and all parties work together to find a solution to the health care crisis. Working together with members of Congress, doctors and hospitals, businesses and unions, and other key health care stakeholders, the President is committed to making sure we finally enact comprehensive health care reform.

The Administration believes that comprehensive health reform should:

Reduce long-term growth of health care costs for businesses and government
Protect families from bankruptcy or debt because of health care costs
Guarantee choice of doctors and health plans
Invest in prevention and wellness
Improve patient safety and quality of care
Assure affordable, quality health coverage for all Americans
Maintain coverage when you change or lose your job
End barriers to coverage for people with pre-existing medical conditions
Please visit www.HealthReform.gov to learn more about the President’s commitment to enacting comprehensive health reform this year.

When people try to argue that the legislation currently pending in Congress is anything but the above stated, they're either ignorant or misleading. Call them on it. This debate will be won like the 2008 election, in the trenches of public opinion. Don't blow this golden opportunity to in-act the change you voted for. You don't vote in November and set the nation on autopilot. We don't have that luxury. Until we have comprehensive campaign finance reform that get's the lobbyists out of the way between you and your Congress, we have to make do with what we have and give Obama the benefit of the doubt. Democrats have to behave as if it's two weeks before the 2008 Presidential election and focus on hand writing letters to the members of the Senate Finance Committee, The House Commerce Committee and all of the six committees who are responsible for engineering this reform engine. If we don't you're not going to like the next three years as much as Obama will have failed to deliver on the central tenet of his campaign. Focus on what the bill is, not what you wish it was, or don't wish it was.

This issue is as important as the Civil Rights struggle for the 50 million Americans with no health insurance and the 137 million Americans with inadequate or junk insurance. This bill must be funded correctly so that States use Medicaid dollars for Medicaid and not some other desire, and all the reforms must reach the rural districts where Blue Dogs provide our majority so we can even set the agenda. This bill must be budget neutral and save money over time providing more quality health outcomes, like lower surgical infection rates or other surgical complications that can be avoided like electronic medicine labeling in the hospital for blood thinner and other commonly confused, poorly labeled hospital setting medications. We have to adopt the ideas of places like the Cleveland Clinic and the Mayo Clinic. Often saving money and improving health are not mutually exclusive. We spend 1/3 of all health dollars on private insurance overhead, and that's not helping to heal one patient.

If you're down for Obama, this is the time to act. Or, Do we hand a victory to the GOP with our dominate election to the White House, and our historic majority of both Houses? Hell no! You have to act, and you have got to get your friends to get their friends to write letters with a stamps, not e-mails, and make multiple calls to Congress. The members to target are right here to see. You may not be sick now, but when you need the health system you need it, don't waste good Americans who die each year from inadequate or no health insurance. Half of all personal bankruptcies are Health Bill related. We have this short window to pass historic legislation, fairly and democratically. Don't let this pass us by.