White House, Big Pharma, We Have a Problem

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In June, I wrote a story that raised big questions about the value of the government’s $80 billion deal with Big Pharma, and wondered if the deal came with the trade-off of killing legislation that would enable the government to negotiate directly with pharmaceutical compannies for lower prices.  Such a trade-off would be indefensible.

That week, I took extraordinary steps to determine if this was the case.  I spoke personally with a White House Deputy Press Secretary twice, followed by multiple emails.  I also spoke, personally, to the press official for the Senate Finance Committee, followed by multiple emails.  There was no doubt as to what I was asking.  I never got a response from either of them.

That Thursday, I asked Gibbs about it at a daily briefing:

Q Thank you, Robert. I have two quick ones on health care. The first one, in the speeches about the $80 billion deal with the pharmaceutical companies, I haven’t heard anything about negotiating price — Medicare negotiating price with the pharmaceutical industry. I wanted to know if that was one of the tradeoffs for getting this $80 billion was that we’re not going to pursue that now.

MR. GIBBS: Well, look, again, the structure of part of that agreement was to use a portion of that $80 billion to pay up to — for the pharmaceutical industry to pay up to 50 percent of the cost for a name brand drug for a senior that falls between the point at which Medicare Part D stops providing help, and when catastrophic coverage — I think it is $6,500, a little bit more than $6,500 — level kicks in. So filling in that — what’s commonly known as — ironically, in health care — the doughnut hole, about — that up to 50 percent of the name brand — the price for that name brand drug would be paid for, and I think that provides a hefty discount that will bear appreciable benefits for seniors all over the country.

Q Has there been an agreement not to pursue a Medicare –

MR. GIBBS: I don’t know the answer.

Q I’m talking about S. 330.

MR. GIBBS: What was that?

Q Senate bill 330?

MR. GIBBS: You’re 330 bills ahead of me on that. (Laughter.) I will check on it.

Of course, now, the New York Times reports that the White House confirms that the deal did include an agreement to kill price negotiation laws:

In response, the industry successfully demanded that the White House explicitly acknowledge for the first time that it had committed to protect drug makers from bearing further costs in the overhaul. The Obama administration had never spelled out the details of the agreement….A deputy White House chief of staff, Jim Messina, confirmed Mr. Tauzin’s account of the deal in an e-mail message on Wednesday night.

“The president encouraged this approach,” Mr. Messina wrote. “He wanted to bring all the parties to the table to discuss health insurance reform.”

This is deeply disturbing on many levels.  If Gibbs didn’t know about this provision after the deal was made, then it stands to reason that the President didn’t know, either.  With the Senate Finance Committe stonewalling me about it, one could conclude that they kept the President in the dark about it until it was already a fait accompli.

The other possibility is that Robert Gibbs was left in the dark, a frightening prospect for a White House reporter, and for any American.

Beneath it all is the fact that the government dealt away our right to negotiate lower drug prices (just like any other large customer), and they did it for peanuts.  This is a disgrace.

I emailed Gibbs and his deputy for an explanation, and am awaiting a reply.

Update: Jake Tapper asked Gibbs about the discrepancy at today’s White House Press Briefing.

TAPPER:  Can I just ask a quick follow up?  In June you were asked about the deal and whether or not the deal with PhRMA implied that the White House signed off on no other legislation, such as allowing Medicare to renegotiate with PhRMA.  And you said you didn’t know the answer to that. Was it because you personally didn’t know or because the Senate Finance Committee hadn’t informed the White House of that aspect of the deal?

GIBBS:  You’re asking me to recall why I didn’t remember something in June.  I — I — that I don’t know the answer to. Obviously, the agreement that we have is — is in the confines of health insurance reform that’s being worked on right now.

DNC “Angry Mob” Ad Spurs Online Uproar, Questions About Accuracy

The Democratic National Committee released a web ad Tuesday that seems to have hit a “Marathon Man”-style nerve town_hall_birtherwith conservatives online.  Entitled “Enough of the Mob,” the ad features clips of recent disruptions at health care town hall meetings, including a “Birther” with what looks like a large wonton wrapper in a Ziploc bag.

The ad has sparked a wave of anger and defiance from conservatives online, who collected their grievances under the hashtag “I am the mob.” The common refrain is that the ad amounts to demonization of dissent, similar to 2007’s “Moveon.org Resolution”, and fearmongering, similar to conservative attempts to convince people that the reform bill mandates euthanasia.

The media, meanwhile, continues to debate the authenticity of these protests as grassroots movement vs. special interest-funded astroturf.

Mary Katherine Ham, however, has broken one of the spokes in the DNC’s ad.  She reports at The Weekly Standard that the Right Principlesplaybook” featured in the ad doesn’t actually spring from “high-level Republican political operatives” at all:

Right Principles has a Facebook group with 23 members and a Twitter account with five followers. MacGuffie describes himself as an “opponent of leftist thinking in America,” and told me he’s “never pulled a lever” for a Republican or Democrat on a federal level. Yet this Connecticut libertarian’s influence over a national, orchestrated Republican health-care push-back is strong, indeed, if you listen to liberal pundits and the Democratic National Committee, who have crafted a nefarious web out of refutable evidence.

It would be hard to characterize these folks as high-level, even in today’s Republican Party.

Ham goes on to deconstruct the route between Think Progress’ story, MSNBC’s reporting of it, and the DNC ad.

This is a great example of the pitfalls of taking shortcuts.  The DNC would have been better served by laying out the funding sources of healthcare reform opposition, a difficult concept to fit into a 2-second graphic.

As for attacking the protesters themselves, the wisdom is questionable.  The White House has avoided this so far, drawing a line between the protesters and the special interests behind them.  The risk is that ordinary Americans will identify with the protesters, and see this as bullying.

On the other hand, the anger of the right at this ad might play right into the DNC’s hands, making opposition to healthcare reform seem unattractive.

A less risky, but tough to fit into 60 seconds, strategy might be to engage the protesters.  Keith Olbermann reported last night on just such an example, a town hall meeting by Texas Democrat Gene Green that seemed to go pretty well.  Given a fair hearing, it’s tough to relate to the fact that almost all of them have adequate healthcare, yet they oppose extending it to those who don’t.

In any case, it’s obvious that what the healthcare debate needs is less fearmongering, and more factmongering.

John Stossel’s Stupid/Idiotic/Dumbass/Moronic Health Care Report

See?  I can string together even MORE adjectives!

In this clip, catchily entitled “ABC’s John Stossel Destroys/Pulverizes/Crushes Obama’s anti-American ‘Health Care’ Plan,” Stossel actually doesn’t talk at all about the health care reform that’s currently being gutted by ball-deficient Blue Dogs.  Instead, he opts to throw together the same bunch of anecdotal propaganda about Canada’s healthcare system that you’ve all seen debunked a hundred times.

The piece hits the idiotic ground running with a healthcare “expert” who wisely points out that the only way to control healthcare costs is to reduce the amount of money spent on health care.  Genius.  It goes downhill from there.

Without even fact-checking the bullshit claims here, their central premise is bogus.  Stossel & company are saying that there just aren’t enough doctors to treat everyone.  So, 47 million uninsured, I guess you can all drop dead no matter what kind of system we adopt.  Unless we continue to lavish insurance companies with record profits, we’re all gonna die.

Plus, the idea that a public healthcare plan will kill innovation doesn’t make any sense.  You know what other technology America rules at?  Weapons.  Yeah, must be that free-market Army we have.

I imagine that, like most opponents of health care reform, Stossel probably has great insurance, making it easier to narrate talking points as if he were speaking to 3 year-olds.  I wonder how he would feel if he couldn’t afford to go see a doctor after something like this.

Public Option the True Test of President Obama’s Game

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This has seemed like a bad week for healthcare reform.  Congressional Blue Dogs are doing their damnedest to kill the public option, and the White House seeming to backtrack on their support of it.  While expressing strong support for it, Gibbs has consistently refused to draw a line in the sand on the public option, and this week, inched back a little.

If this were any other politician, I’d be throwing my hands up in disgust, because this is how these backslides start.  The obvious interpretation is that the White House is innoculating itself from the public option’s defeat.

In Barack Obama’s case, though, this isn’t so obvious.  I’ve spoken before about his unique political MO, likening it to the “rope-a-dope.”  In this case, I hope, he’s being more of a chess player.  Since I’m more of a Gnip-Gnop player, I haven’t got it all figured out yet.

It is important to note that my confidence in the President, to this point, is based on past performance, not magical thinking.  He’s a progressive in triangulator’s clothing.  I’ve been sure he was blowing it before, only to be proven wrong.

This time may be different, however.  He was right to determine that momentum was key to passing strong reform.  Already, this week, one poll is being used deceptively to claim support for a public option is slipping.  The spineless sellout Blue Dogs think they’re in the driver’s seat.  Opponents of the public option continue to pound the public with lies.  Now, it seems like the White House is sounding the retreat.

If Barack Obama is the chess player I think he is, he’s got a plan to rescue the public option from the Blue Dogs.  If I’m right, it will involve Rahm Emanuel and some blunt conversations about mid-term elections.

I don’t think that Barack Obama is a bad enough politician to take the disastrous hit of no public option when he’s got airtight majorities in both houses of Congress.  On the other hand, he likes for it to look like the other guy’s idea.

Either way, I hope the President knows that defying his base, and 76% of Americans, is not an option.  Time to use that powder.

In other news…

….a double dog dare from Representative Weiner-D-NY:

Billie’s Quickies?

bllieddoseWell, after two days of no quickies because of unforeseen circumstances, I was quite excited to post some today.

However, today’s quickies will be replaced with:  annoyance that the “majority (using this term lightly)” are acting like doormats or fully being jackasses re healthcare/health insurance reform, and indignation that the last two news cycles have been dominated by conspiracy theorists with regard to Obama’s citizenship and allegations that the President is racist.  May as well bring back Speidi if the news is gonna be this stupid.  Think of it this way, ENews banned Heidi and Spencer Pratt for God’s sake…..ENEWS!

Surprise! Anti-Healthcare Reform Horror Story is a Lie

Update: So, that Canadian lady in the commercial, the one who wants to keep at least 20 million Americans without healthcare?  The one with the life-threatening brain tumor?  Yeah, not so much.

Still, I found Holmes tale both compelling and troubling. So I decided to check a little further. On the Mayo Clinic’s website, Shona Holmes is a success story. But it’s somewhat different story than all the headlines might have implied. Holmes’ “brain tumour” was actually a Rathke’s Cleft Cyst on her pituitary gland. To quote an American source, the John Wayne Cancer Center, “Rathke’s Cleft Cysts are not true tumors or neoplasms; instead they are benign cysts.”

Well, surely, a Rathke cleft cyst can be life-threatening, right?

Mortality associated with RCCs is extremely rare. In a study conducted by Shin and colleagues, the mortality rate was 0%, and the recurrence rate was 19%.2 In the literature, recurrence rates typically are lower, commonly 5-10%; however, Mukherjee co-authors reported a recurrence rate of 33%.

So, there you have it.  The Republicans want you to put the future of your healthcare in the hands of a Canadian hypochondriac.  I suppose that’s marginally better than letting the Republicans handle it, but I think we’ll stick with the public option.

Healthcare PWN-age Video of the Day

This clip is actually a few weeks old, but it was emailed to me by a conservative who was in an apoplectic lather over Jane Hamsher’s attempted PWNing of Townhall’s Jillian Bandes.

As it turns out, Jillian PWNed herself. Check it out.

Hamsher plays a little bit of dirty pool here, using her own cancer survivorship to try and taze Bandes into submission,but in doing so, misses a better opportunity. Everybody’s got a story, and when you rest your argument on one, you legitimize whatever sob story the right wants to dig up. Since all the right really has are anecdotes and speculative fiction, this is a bad strategy.

In fact, she’s responding to an ad in which another cancer survivor does the same thing. We could trade horror stories all day long, and it wouldn’t do a thing to illuminate this issue for people.

Hamsher misses the big kill here, as Jillian Bandes delivers the perfect setup. When Shuster asks her who represents the “50 million uninsured,” Bandes torturously haggles him down to 20 million people.

20 million people? Using the best math available to the right, generously granting all of Bandes’ assumptions, that is the best they can do? Why didn’t Hamsher zero in on that? Who is representing the at least twenty million people who cannot get health insurance?

That is the real shame in this.

She misses another chance, as well, to challenge the contradictory assumptions of the right. They say that the public plan will be a deadly morass, yet they are convinced that private insurance companies will be unable to compete with it. What sense does that make? That’s like saying that cheap cans of shit will drive beef stew out of the market. It’s nonsense. Bandes also gets away without answering to the overwhelming public support for a government option.

There may be some grassroots opposition to the public option, but it seems to be coming from insurance companies and their best customers. Take it with a grain of salt, then get your blood pressure checked, if you can.

That History Book on the Shelf

alex01thumbOkay, I know this is a little behind the times – practically eons ago in news-cycle reckoning. But this little turn of phrase has been sticking in my head like an earworm.

“Senators and Congressmen will come back in September afraid to vote against the American people,” [South Carolina Senator Jim] DeMint predicted, adding that “this health care issue Is D-Day for freedom in America.”

“If we’re able to stop Obama on this it will be his Waterloo. It will break him,” he said.

Okay, but what kind of Waterloo do you mean? Continue reading

Healthcare PWN-age Video of the Day

This clip is actually a few weeks old, but it was emailed to me by a conservative who was in an apoplectic lather over Jane Hamsher’s attempted PWNing of Townhall’s Jillian Bandes.

As it turns out, Jillian PWNed herself.  Check it out.

Hamsher plays a little bit of dirty pool here, using her own cancer survivorship to try and taze Bandes into submission,but in doing so, misses a better opportunity.  Everybody’s got a story, and when you rest your argument on one, you legitimize whatever sob story the right wants to dig up.  Since all the right really has are anecdotes and speculative fiction, this is a bad strategy.

In fact, she’s responding to an ad in which another cancer survivor does the same thing.  We could trade horror stories all day long, and it wouldn’t do a thing to illuminate this issue for people.

Hamsher misses the big kill here, as Jillian Bandes delivers the perfect setup.  When Shuster asks her who represents the “50 million uninsured,” Bandes torturously haggles him down to 20 million people.

20 million people?  Using the best math available to the right, generously granting all of Bandes’ assumptions, that is the best they can do?  Why didn’t Hamsher zero in on that?  Who is representing the at least twenty million people who cannot get health insurance?

That is the real shame in this.

She misses another chance, as well, to challenge the contradictory assumptions of the right.  They say that the public plan will be a deadly morass, yet they are convinced that private insurance companies will be unable to compete with it.  What sense does that make?  That’s like saying that cheap cans of shit will drive beef stew out of the market.  It’s nonsense.  Bandes also gets away without answering to the overwhelming public support for a government option.

There may be some grassroots opposition to the public option, but it seems to be coming from insurance companies and their best customers.  Take it with a grain of salt, then get your blood pressure checked, if you can.

Updated:Duh! Healthcare Bill Doesn’t ‘Outlaw Private Insurance’

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Earlier today, Twitter was all a-Itself with news, courtesy of Investor’s Business Daily, that the House healthcare reform bill “outlaws private insurance.”  I knew, without knowing, that they were misreading the thing, but haven’t had the chance to run through it yet.  Luckily, the Heritage Foundation debunks them, while ladling on their own false alarmism.

To sum it up, IBD reads a passage, from page 16 of the bill, that describes a grandfather provision which they interpret as “making private health insurance illegal,” but fail to read a paragraph on page 19 that explains it further.  Non-grandfathered policies would be required to compete in health exchanges, alongside the public option.

The Heritage article still thinks this is going to ruin everything because of “teh regulations!”

In order to qualify as an “Exchange-participating health benefits plan,” all health insurance plans must confirm to a slew of new regulations, including community rating and guaranteed issue. These will all drive up the cost of health insurance. Furthermore, all these new regs would not apply just to individual insurance plans, but to all insurance plans.

The irony here is that the health exchange fixes a major flaw in John McCain’s plan from the 2008 campaign.  McCain wanted people to be able to purchased insurance across state lines, but that would have meant trashing or weakening important protections for consumers.  Without them, there would simply be a race to the bottom to provide the cheapest, crummiest insurance to those who can’t afford more.  From my story on the subject:

Saying that all McCain wants to do is “erase artificial boundaries” between states is like saying, “I don’t want criminals to roam the countryside, I just want to unlock their cells so they can compete for the best one.”

In order to allow such “competition,” companies would need to be exempt from state regulations, regulations that protect consumers from being denied coverage, or being canceled if they get sick, or from being sold worthless insurance that doesn’t cover anything once you read the fine print.

The notion that insurance companies can’t compete while consumers are protected is a frightening one.  There may be some that can’t hack it, but maybe they’re the ones who need to go out of business.

Update: I finally found a complete copy of the bill that my crummy connection would let me download, and it turns out that the IBD headline is even dumber than I thought.  On page 15, immediately prior to their “Oh, noes!” paragraph, is a clearly labeled intro that states that the section is simply a definition of “grandfathered coverage,” which is then referenced on page 19:

GRANDFATHERED HEALTH INSURANCE COVERAGE DEFINED.—Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term ‘‘grandfathered health insurance coverage’’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 (as defined in section 100(c)) if the following conditions are met:

That’s where IBD started reading, and stopped before they got to page 19.

More on this later.