Last week a young Florida child sank into a coma. Due to recent cutbacks, he
wasn’t eligible for the state CHIP program and with no health insurance and
precious little money available from her job at Wal-mart, his mother had skipped
on taking him to the ER until it was too late. With a sudden realization that
American health care was in crisis, late last Saturday night Congress passed a
bill completely changing the nation’s health care system. President Bush flew in
from yet another vacation to sign the new law, saying that the health care
system ought to preserve the culture of life. Evangelical religious groups
picketed Congress holding banners denouncing the impact of the lack of health
insurance and the high cost of health care for poor and middle class Americans.
Self-appointed moral values spokesmen denounced the nation’s courts for doing
nothing to improve the infant mortality rate, claiming that it was below that of
Cuba. Finally, all the cable news channels turned their networks over 24 hours a
day to covering the crisis. Even though there were bitterly opposing sides in the dispute and polls seemed
to show that most Americans didn’t agree with Congress or the President, the
politicians insisted that the moral imperatives made their action necessary. Sage editorials in the major newspapers explained that the Florida
tragedy had at least had the virtue of having families in the nation discuss
whether or not they wanted access to health insurance. Sadly the young boy died unaware that his fate had transformed a nation.

It’s incredible what a useless governor Arnie has been. Here was a guy from way outside the political establishment who had the chance to really change politics in California, so what has he done?

1. He ran non-stop adverts all through the recall campaign saying that he would cut the state deficit by having a "full audit" (or in Arnie-speak "Foorl Ordit".  He then increased the deficit by canceling the $4bn increase to the car tax, and when, surprise, surprise, the Foorl Ordit didn’t miraculously find $15bn of waste to get rid of he simply borrowed the money by changing the law and issuing bonds.  Some budget hawk, eh.
2. He ran as an outsider and used at least some of his own money in the campaign. But after  he won he paid his own account back from new political contributions — those are called bribes in less polite society — which came from not "special interests" like the ones from whom that Grey Davis guy used to get his cash from.  Oh no — Arnie’s money came from "powerful interests".  And who might they be?  Well apart from the Spanos real estate family that owns most of central California, it also includes a lot of money from big pharma after Arnie vetoed a bill trying to legalize Canadian imports into California.  No pay-off there
3. And while we’re on the pay-off theme, several of us felt that the most despicable part of the Gray Davis regime was its ownership by the appalling prison guards union.  This is a state where a prison guard earns way, way more than a teacher, and where the CCOA (California Correctional Officers Association) in vehement on insisting that instead of spending money on education now instead of prisons later, we spend on prisons now and prisons later.  So a funny thing happens just before the Nov 2004 election. Arnie takes the prison guards cash, just like Davis did, and then comes out against the modest reform of the worst injustices of the 3-Strikes measure, turning it from a moderate winner to a very close loser — and costing the taxpayer a boatload more in the future.
4. And to confirm his total moral bankruptcy, instead of standing as a decent Republican alternative to the clowns running the nation in DC, he decides to emulate them. While the Bush Administration has been putting out fake news stories and become a laughing stock along the way, now Arnie has decided to copy it.  What does this mean? Yes, you and I the taxpayer are paying for fake news propaganda to oppose the nurse staffing law which was passed with a fair measure of popular support, and was recently reaffirmed by a state judge.  And of course some dumb TV stations have been running the stories, which look like real news (in as much as "real news" is ever seen on local TV station news — I suspect the people who watch that stuff get the "news" they deserve.

There’s more fun stuff from www.Arnoldwatch.org including a fun video of protesters getting thrown out of an Arnie fundraiser.

A long time THCB friend and contributor is back from the big NMHCC show.  He was not impressed at what he heard:

Just got back from NMHCC in DC last night. I was
shocked – shocked! – at the paucity of any kind of original thought at the
conference.  There were a couple of interesting collaborations between payers
and providers (e.g. BCBS of Delaware providing access to its MeDecision database
to allow them to print patient history reports in Christiana Health System’s
ER), but nothing especially compelling or breakthrough to discuss.  No
substanative discussions (beyond CDHP) about the 45 million uninsured (at least
that I heard) or the millions more that will be with the looming Medicaid
cuts.

HHS Sec’y Leavitt outlined 12 strategies for Medicaid
(I wandered off during number 8, I think: his diatribe about how big a problem
lawyers cause helping seniors who are above the poverty level give their assets to
their kids so that they can qualify for Medicaid coverage of LTC).  His
mandate is clearly to eviscerate Medicaid as we know it… I’m all for progress
(i.e. a better Medicaid that covers more people at fewer cost with less waste,
fraud and abuse and chronic disease) but not for removing a vital safety net for
the indigent and working poor (especially children)…

Today’s story about California hospitals suing Medi-cal comes on the heels of a
week of meetings between state governors and the Bush administration about
Medicaid. Medicaid has long been a dog’s breakfast of American health policy
with all types of programs thrown together. It’s a health insurer for the very
poor, it’s a long-term care plan for some of the elderly, it’s a subsidy program
for large inner city hospitals (the DiSH program), and it even pays Medicare
Part B premiums for those "dual eligibles" too poor to afford them. In addition,
in many states the CHIP program for near-poor children is rolled into Medicaid
too. Furthermore, many states use what are now called by HHS secretary Leavitt
"accounting gimmicks" to get more of their program on the Feds’ tab.

The problem is that all these programs tend to be underfunded anyway, and in
a time of state and federal budget squeezes, they come severely under fire.
Taking even another $6 billion per year out of the program, as the
Administration proposes, feels to the states like getting blood out of an
already over-squeezed stone–even if the GAO says its only $5bn a year. A rational system would somehow fold Medicaid into
some type of universal insurance system. But we are not getting that any time
soon, and right now many poor Americans and their safety net providers rely on
Medicaid to keep them from toppling into the abyss. So expect the politics of
desperation to play out in that sector over the next few months.

This is not going to be a fun time to be either a Medicaid recipient, or worse someone who would like to be.  And that includes a lot of young and poor children.  It’s also not going to be fun to be a safety-net provider who relies on Medicaid as one of their better payers.

Not that anyone can be in the least surprised, but it’s clear from the tapes secretly recorded by one of his henchmen that in 1999 Bush privately admitted to both taking marijuana and cocaine in his period of "youthful indiscretion". There’s been a surprising lack of comment about this other than this one article in the Chicago Tribune called the Disappointing presidential silence about illicit drugs. The incredible hypocrisy in which Bush feels that his drug use was a "wild, youthful indiscretion" but that any current drug use by a young person is a seriously punishable offense leads to two terrible consequences for society.

First, Bush has presided over an Administration which has dramatically gone after anyone who remotely disagrees with it on the drug issue, including medical marijuana advocates and pain doctors, with the full force of draconian drug laws. It has also left more than 33,000 young people unable to attend college because of the heinous HEA amendment than bans anyone with a drug offense of any kind getting a Federal loan.  Let’s not forget that has this law been in place in the 1970s that number ought to have included Bush and former Eli Lilly exec, and current Indiana governor Mitch Daniels who was convicted of low level drug dealing at Princeton. The hypocrisy and lack of contrition from those holding this position is unspeakable.

Second and much more seriously, the ridiculous head-in-the-sand antics of the government (and this includes both Republican and Democratic Administrations and Congresses over the last 30 years — although the Republicans are clearly worse) on drugs means that the appalling social and health impacts of drug abuse are essentially allowed to go unchecked, leaving the taxpayer and the health system to deal with them. There are some very interesting models in harm reduction, and drug maintenance programs that have enabled addicts in Switzerland, the UK, Germany and now Canada to live relatively normal lives at little cost to the taxpayer and with minimal impact on society — as opposed to the huge amount of crime and personal cost seen in the unregulated activities of addicts here. But no one in the US will even discuss these models.  Instead
we allow the war on drugs to continue to fill the coffers of law enforcement departments and criminals and dictators across the world, and force taxpayers and health care workers to keep paying for it.  That no fuss is made about the fact that the current President essentially admitted to drug use in his twenties, shows how we’ve accepted this appalling situation as being only too normal.

No you probably don’t.  And this is why.

While Social Security reform/privitization/dismantlement has become the biggest policy issue of the 2nd term, now that the word is out and people understand what the Administration’s goal is, the impact is hitting the President’s poll numbers hard.:

"Adults were evenly divided on Bush’s job performance in January, but now 54 percent disapprove and 45 percent approve. The number who think the country is headed down the wrong track increased from 51 percent to 58 percent in the past month."

Of course the real conspiracy theorists amongst us might have felt that they knew messing with social security was always going to be very tough, but that raising the issue, particularly with the vast shortfall it would leave in the budget, would allow or even force Congress to be more active in cutting other areas.

Or it might be just that there are enough honest conservatives left who cannot countenace a Medicare bill that busts the budget so badly. It’s a pity that there don’t seem to be enough as perturbed about the huge and unmentioned scandal of war profiteering, even as Bush asks for another $80bn a year for Iraq’s reconstruction–an amount that could eliminate uninsurance here at home.