Mojo - April 2011

Hospitals: Way More Dangerous Than You Thought

| Thu Apr. 7, 2011 12:16 PM EDT

Under the guise of trying to make health care more affordable, House Republicans this week have been debating a measure that would make it much harder for people injured by the health care system to sue doctors or hospitals. Their timing hasn't been great. A day after a hearing on the medical malpractice bill, the journal Health Affairs released the findings of a new study that found that medical errors are way, way more common than anyone thought.

Ten years ago, the Institute of Medicine reported that preventable medical errors killed 98,000 people a year. But Health Affairs reports that the number is likely far higher, in large part because the data on those errors was collected through a voluntary reporting system. And as anyone who's ever looked at malpractice lawsuits knows, no one in the health care system ever wants to voluntarily admit to making a mistake.

So the researchers started tracking errors at three hospitals themselves. As a result, they found that voluntary reporting missed 90 percent of the errors that took place in those hospitals. The study found that 1 in every 3 hospital admissions resulted in an adverse event, a figure that should make everyone shudder. A mere 10 types of errors made up nearly two-thirds of all the adverse events, conditions that included pressure sores and post-op infections—things that don't take rocket science to prevent. The cost of all these errors is high: as much as $17 billion every year, all from hospital screw ups that could be prevented. Perhaps Republicans looking to reduce health care spending should try going after medical errors rather than the people who suffer because of them.

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So Conservatives Now (Heart) Rationing?

| Thu Apr. 7, 2011 10:16 AM EDT

America spends too much money on health care—this much Republicans and Democrats alike can agree on. Where they differ is on the best way to curb costs and unnecessary, inefficient care. In other words, somebody's got to say "no" to unnecessary spending, and that's not something that most Americans are going to want to hear. Democrats have been more willing to face this reality than their Republican counterparts. When the Dems introduced their own cost-controls in the Affordable Care Act—including research that would compare the effectiveness of different treatments, advice for end-of-life-counseling, and an independent board that would set payments for Medicare—the GOP attacked them for creating "death panels" and a Soviet-era bureaucracy to "ration" care.

That said, a growing number of conservatives have begun to admit that some form of rationing is necessary to prevent America's health care system—and the economy as a whole—from self-destructing. "There's no way out but rationing—either by making seniors pay much more for their healthcare or denying them much more than basic care," writes Andrew Sullivan. Some Republicans are now casting Rep. Paul Ryan's budget plan as a form of "self-rationing" that would place such decisions in the hands of private citizens, rather than cold-hearted bureaucrats. "Rationing is going to go on within the Medicare system. It's a fact of life" given financial constraints, the Cato Institute's Michael Tanner tells Politico. "The question's going to be, is that decision going to be made by government and imposed top down under the current system? Ryan wants to shift that responsibility to individuals and from the bottom up."

But far from creating a nation of empowered individuals free from government constraints, the Ryan plan will simply shift that authority to the private insurance industry. As NPR reports, the Congressional Budget Office says that insurers would have far greater leeway to do things like "limiting benefits, changing co-payment amounts, managing how patients use services" under RyanCare, free from ObamaCare's consumer protections that prohibit exploitative practices. What's more, private insurance is less cost-effective than government-run health care, forcing seniors to pay more and get less. 

So the elderly may be forced to use less health care under Ryan's plan, and government spending on Medicare will go down. But rather than using scientific research and the consensus of experts to make more cost-effective Medicare choices, the Republicans will take a hatchet to Medicare costs and then hand the weapon over to private insurances. Rationing must happen, yes—but it can be done far more intelligently.

The Tea Party vs. "Media Marxism"

| Thu Apr. 7, 2011 9:46 AM EDT

For the past year, tea party groups have been rallying their members to oppose "net neutrality," the rules outlined by the Federal Communications Commission (FCC) that ensure a level playing field on the Internet. The rules prevent big corporate Internet providers like Comcast from discriminating against different types of content and applications, or from trying to force website operators to pay more for their content to be accessible online. That way, Internet providers can't limit users' access to preferred sites (i.e., the ones who pay more). The rules, in effect, ensure that even the smallest, poorest tea party group has the potential to reach a large audience through its website, unimpeded by Comcast and other big companies.

Yet tea partiers inexplicably equate net neutrality with Marxism. Last fall, when activists were organizing around the issue, Jamie Radtke from Virginia Tea Party Patriot Federation and a current Senate candidate, said of net neutrality: "I think the clearest thing is it’s an affront to free speech and free markets." This week, ahead of today's House vote on a measure that would roll back the FCC's net neutrality rules, Tea Party Patriots blasted an urgent alert to activists urging them to call on lawmaker to vote in favor of the move:

Net neutrality is an innocuous sounding term for what is really media Marxism. This is an ideological attempt by those on the left to control the greatest means for the distribution of information ever devised. It provides a playing field which the government does not control, and this is immensely troubling to those on the left.

The tea party's position on net neutrality has seemed counterintuitive, given just how badly conservative activists could be screwed by the big cable and phone companies should net neutrality rules be repealed. The whole movement has been organized online, making the Internet's level playing field a crucial element to its success. Yet tea partiers claim that net neutrality is just another sign of government overreach. They don't seem to recognize that they are effectively advocating against their own interests—and Comcast is more than happy to have their help in doing so.

A New York Times story this weekend helps to explain the tea party's odd net neutrality fixation. The story focused on a conservative Astroturf group that has cozied up to the tea party movement to advance political causes for various corporate interests, everything from protecting Asian paper companies from US tariffs to—you guessed it—fighting net neutrality.

The Institute for Liberty, as the group is known, is headed by Andrew Langer, a former executive at the National Federation of Independent Business, a lobbying organization that claims to represent small businesses but often walks in lockstep with the US Chamber of Commerce. The Institute has been a regular presence at tea party events for the better part of two years. Langer himself spoke at the Tea Party Patriots "continuing revolution" protest in DC last week. He freely admitted to the Times that various interest groups have given him money to push activists on pet issues (though he declined to disclose the donors):

In a recent interview, he explained how the institute pitched its services to opponents of the Obama health care plan, resulting in a $1 million advertising blitz. "A donor gave us some money, and we went out on the ground in five states in the space of like six weeks," he said.

In a classic Astroturf move, the Times also discovered that the Institute had used the names of dead people on a "grassroots" petition it sent to the US Department of Agriculture supporting efforts by the chemical giant Monsanto to relax restrictions on its pesticide-resistant alfalfa. The paper credits Langer with getting tea partiers to oppose net neutrality. Given just how contrary the tea party position on net neutrality is to the movement's own best interests, Langer should be congratulated on his PR coup.

We're Still at War: Photo of the Day for April 7, 2011

Thu Apr. 7, 2011 4:30 AM EDT

Capt. Donna Buono (left), the commander of Company B, 3rd Battalion, 101st Aviation Regiment, and an AH-64 Apache pilot, introduces Afghan Air Force Maj. Gen. Abdul Razik Sherzai, the commander of the Kandahar Air Wing, to the helicopter during the general's visit with Task Force Thunder here April 2. Sherzai met with Col. Todd Royar - the task force commander - and his subordinate leaders to discuss future partnering opportunities between their two units. Task Force Thunder comprises the 159th Combat Aviation Brigade and its subordinate battalions, which are deployed from Fort Campbell, Ky., along with MEDEVAC additions from Alaska and Germany, Chinook assets from the Hawaii National Guard and Australia, and the 1st Attack Reconnaissance Battalion, 4th Combat Aviation Regiment, from Fort Hood, Texas. Photo via US Army

Kloppenberg Bags Narrow Victory, But Recount Looms

| Wed Apr. 6, 2011 3:45 PM EDT

By the slimmest of margins, liberal JoAnne Kloppenburg, a long-time assistant attorney general, upset conservative sitting justice David Prosser in the race to fill the seventh seat on the Wisconsin Supreme Court. Kloppenburg topped Prosser by a mere 204 votes in a race in which 1.48 million Wisconsinites cast a vote. In a statement declaring herself the winner, Kloppenburg said, "Wisconsin voters have spoken and I am grateful for, and humbled by, their confidence and trust.... I look forward to bringing new blood to the Supreme Court and focusing my energy on the important work Wisconsin residents elect Supreme Court justices to do."

Not so fast, says Prosser's team. It's almost certain that Prosser will demand a recount of the election, which would be the first statewide recount in 20 years. And depending on how the recount goes, Prosser has the option of legally challenging the election results, not unlike former US Sen. Norm Coleman's challenge in his battle against Al Franken, a legal fight Franken ultimately won. And like the Coleman-Franken legal battle, a challenge by Prosser could potentially end up before Wisconsin's Supreme Court on which he currently sits. The election, in other words, is hardly over.

Nonetheless, Kloppenburg's unofficial victory marks a momentous win for the labor unions and progressive groups that galvanized her campaign and propelled her from an also-ran to a competitive candidate. The Prosser-Kloppenburg race was seen as a proxy fight pitting unions and progressives against Republican Governor Scott Walker and his Republican colleagues who want to kneecap public-sector unions in Wisconsin. Heading into election day, the stakes were high: A Kloppenburg win would prove that unions are still a force to be reckoned with on election day. But if Kloppenburg lost, the movement sparked by the Wisconsin protests would undoubtedly lose some of its momentum, and conservatives would dismiss the uprising in Wisconsin as a flash in the pan.

Mind you, the fact that Kloppenburg was even competitive in the race was a victory for unions and progressives. As I reported yesterday,

Before the votes are counted, Wisconsin progressives have considered the race a victory. Months ago, no one thought Kloppenburg had a chance of toppling Prosser. That she became a competitive challenger indicates that energy from Wisconsin's protests can be funneled into electoral politics. "Had the protests not happened, Prosser would've skated to victory with an easy victory," says Robert Kraig. "Even if she comes up short, a very powerful message has been sent."

Now, it looks like Prosser's the one who could come up short. If a recount confirms Kloppenburg as the winner, it would seal one of the most momentous election upsets in years.

Will the Public Blame Paul Ryan if There's a Shutdown?

| Wed Apr. 6, 2011 12:14 PM EDT

The countdown to a government shutdown has begun. House Speaker John Boehner (R-Ohio) and Senate Democrats have still not reached an agreement on funding the government, much of which will stop functioning on Friday if no deal is struck. Recent polling indicates that voters are slightly more inclined to blame Democrats than Republicans for a government shutdown, though an earlier poll showed they'd be split. But the GOP may have just shot itself in the foot by deciding to introduce Paul Ryan's controversial, entitlement-slashing budget plan for next year the very same week they move towards a shutdown. Though Ryan's 2012 budget isn't germane to the current negotiations—which concern funding the government for rest of 2011, using a bill known as a "Continuing Resolution"  (CR)—people who aren't familiar with the intricacies of the budget negotiations may be inclined to lump both proposals together.  

Even House Republicans admitted as much on Tuesday. As I reported in my story today, some GOPers seem outright baffled by Boehner's decision to tackle both 2011 and 2012 budgets simultaneously. Rep. Lee Terry (R-Idaho) admitted as much when I spoke with him on Tuesday, after Ryan officially released his plan. "A lot of people back home are confusing the CR with the [2012] budget," he said. Terry appeared confident that voters would ultimately figure out the difference—and credit the GOP for being bold enough to tackle both. But I'm not so sure that will happen.

What's more, Democrats may even try to encourage this confusion in the public's mind, at least indirectly. They've already pointed to Ryan's budget as just more evidence of GOP extremism. And, in fact, Boehner may have pushed Ryan's plan this week in hopes of appeasing his party's right-wing if and when he finally comes to a CR deal with the Democrats. Certainly, if there's a shutdown, Democrats will try to drive the Ryan connection home to the public. 

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Huckabee: No Love for Wiped-Out Hard Drive Story

| Wed Apr. 6, 2011 11:20 AM EDT

Mike Huckabee read the Mother Jones story on the destruction of the records from his time as governor of Arkansas. He didn't like it.

Speaking to US News and World Report yesterday, Huckabee slammed Mother Jones. "[Mother Jones] doesn't pretend to be a real news outlet, but a highly polarized opinion-driven vehicle for all things to the far left," he said. "You expect that wolves will eat meat."

Here's part of Huckabee's defense:

The absurd insinuation that my office "destroyed" state records or that records are "missing" is the same old political canard that was attempted years ago and failed then for the same reason it will fail now—it's factually challenged.

As we reported, these are not "absurd insinuations." What happened to Huckabee's gubernatorial records was documented in this memo from the Arkansas Department of Information Systems. It confirms that the hard drives containing the records were erased and then destroyed. Copies of the records were placed in the hands of former Huckabee staffer Brenda Turner, who is now the communications director for a Christian greeting card company. Turner has not said what she did with the backups. She refused to talk to us. Here's the relevant part of the 2007 document, which was addressed to the outgoing Gov. Huckabee:

We also reported that the state of Arkansas had to shell out $335,000 to replace the hardware that the Huckabee administration had destroyed. Huckabee doesn’t deny this. But he blames the decision to spend that money on his Democratic successor, Gov. Mike Beebe, who "wanted all new equipment, even though the existing hardware was operable and modern." Again, Huckabee is contradicted by the above mentioned memo, which notes that "the drives have been subsequently crushed under the supervison of a designee of your office." That is, the drives were destroyed on Huckabee's watch, not Beebe's.

The US News and World Report reports says the Mother Jones story "suggests a sinister motive," which may well be true, to the extent that signing off on the destruction of political history seems a little shady. Can Huckabee—a potential presidential contender who extols the cleansing virtue of transparency—explain why these records were destroyed, and what happened to the backups handed to his aide? He's scheduled to appear on The Daily Show tonight. Perhaps he ought to show up with Brenda Turner and tell all—whether it's funny or not.

British Royal Family Submits to Sharia

| Wed Apr. 6, 2011 9:30 AM EDT

Right-wing opponents of the non-existent threat of Sharia law frequently warn that, if we don't act now, the United States will quickly turn into Western Europe—which, they say, has succumbed to the slow creep of Islamic law. I thought that sounded like a lot of empty fearmongering, but then I saw this:

[The] Duke of York, Prince Andrew Albert Christian Edward, who is well known by the name Prince Andrew calls on Indonesia to plot sharia financing in the country.

During the meeting between Prince Andrew and Indonesian Finance Minister Agus Martowardojo on Wednesday, both parties are planning to discuss several policies on financial services including future sharia financing in Indonesia and partnership between UK and Indonesia in the development of financial market and protection toward customers' assets.

Sound the horn of Gondor! It's worse than we thought.

Well, that, or maybe permitting Sharia-compliant finance is really just a smart business decision, allowing UK companies to stay competitive in new markets. Just throwing that out there.

The Elderly: Paying the Price for Ryan's Plan

| Wed Apr. 6, 2011 8:30 AM EDT

Though it's been billed as a courageous feat of fiscal responsibility, Paul Ryan's 2012 budget ultimately isn't a cost-control plan for the nation's health-care system. It's a cost-shifting plan that simply moves the burden of paying for health care from the government to the backs of the elderly, poor, and disabled beneficiaries of government programs. How much more will seniors and the disabled have to pay for their Medicare coverage under Ryan's plan? According to the Congressional Budget Office, a lot more. Kaiser Health News has the details

For example, by 2030, under the plan, typical 65 year olds would be required to pay 68 percent of the total cost of their coverage, which includes premiums, deductibles, and other out-of-pocket costs, according to CBO. That compares with the 25 percent they would pay under current law, CBO said. 

Why would they have to pay so much more? Under Ryan's plan, Medicare essentially cease to function as an insurance system for beneficiaries. Instead, seniors would given a set amount of money from the government to purchase insurance on their own, meaning they would pay a higher percentage of the overall cost of coverage. 

What's more, Kaiser News continues, traditional government-run Medicare is cheaper than private plans, partly because its payment rates to doctors and hospitals are lower and because the government has lower administrative costs. Experiments in privatization have demonstrated as much: Medicare Advantage, a version of Medicare run by private insurers, has been riddled with waste, overspending, and inefficiencies. So seniors would essentially be hit twice under Ryan's plan, paying more out of pocket for a product that costs more.

Nail-Biter Wisconsin Supreme Court Race Too Close to Call

| Wed Apr. 6, 2011 7:53 AM EDT

The slugfest between liberal JoAnne Kloppenburg and conservative David Prosser to claim the swing seat on Wisconsin's Supreme Court, viewed by many as proxy fight pitting progressives and labor unions against Republican Governor Scott Walker, was still too close to call this morning. With 99 percent of precincts reporting, Prosser leads by a razor-thin 835-vote margin as of 8:51 a.m. Eastern time.

On Tuesday evening, as election officials tallied the nearly 1.5 million ballots cast throughout the state, the two candidates traded the lead, but the race never looked close to finished. Prosser, a sitting justice on the court, dominated conservative areas like Washington and Waukesha Counties, the latter the home turf of Governor Walker. But Kloppenburg, a long-time assistant attorney general, fared well in urban counties like Dane, which includes the liberal capital Madison, and Milwaukee, home to the state's most populous city.

There are still 24 precincts yet to be recorded by the Associated Press, which keeps a running tally. Of those, 22 precincts are in districts where Kloppenburg has won the majority of votes already cast, including urban areas like Milwaukee (2 to be counted) and Dane (1 left). In other words, the stragglers left to be tallied in this race could very well tip the scale to Kloppenburg.

Now, with such a tight race, there will no doubt be legal challenges to the results, and possibly a recount. That challenge could even end up before the state Supreme Court itself, at which point Prosser would no doubt have to recuse himself from the decision. But even if Kloppenburg ends up falling short, progressives and unions can call the race a victory for them. A few months ago, Prosser, who beat Kloppenburg in the four-way primary by 30 point, was expected to coast to victory. "Even if she comes up short, a very powerful message has been sent," says Robert Kraig, executive director of Citizen Action of Wisconsin.