Democrats Explain Senate Rules...

Democrats have recently threatened to pass Health Care Reform v. 2.0 with a 51-vote majority in the Senate.  This has been called the "nuclear option" because it prevents the "extended debate" that the senate is famous for. 

The Founders had in mind a sort of House of Commons (Representatives) that would give voice to the people.  The House of Lords (Senate) would balance the often impulsive vox populi with deliberate consideration of the issues.  The two Houses would then serve to check the power of the Executive. 

Anyway, watch this video where several Democrat leaders articulate the matter much better than I could.  Then remember that it is this same group of people advocating for and threatening to use the "nuclear option" against the current Republican minority and their less liberal Democrat party mates. 

Ann Kirkpatrick Betrays the 1st Arizona Congressional District...

Mrs. Kirkpatrick:

You have revealed yourself to be a true liberal and a turncoat.

How could you have ignored the voice of so many of us, your constituents, with regard to health care reform? We told you loud and clear that we are opposed to this intrusion of government into the private sector.

You acted as if you'd heard us when you were, as Mrs. Clinton so articulately stated, "against it before you were for it."

And now, on the vote that really counted, you turned on us.

Do you understand how this will adversely impact the many senior citizens in your district? If you do, then you are a truly cruel person. If you don't, then you have no business representing us.

Be assured that I will do all I can to ensure that your betrayal is not forgotten and that you are not sent back to Washington for a second term.

Respectfully,

John N. Ellis

A Conversation With My ACLU-Boardmember-Cousin...

Here’s a conversation with my dad’s cousin Terry. Terry works with the ACLU, but strangely is an advocate of the 2nd Amendment….

T: Congress has gotten so polarized and dogmatic that they put the next election ahead of anything that might be good for the country. Both sides of the aisle are guilty of this mentality, but (forgive the bias) the ultra-conservatives don’t have any compunction about checking their brains and honesty at the door in order to present a unified opposition. So who is lying??? Do you believe that:

· There are death panels that will determine which old people get treatment and which ones don’t?
· That Obama wasn’t born in the United States?
· That the world is only 6,000 years old?
· That Obama is a socialist and/or communist and/or nazi?
· That maybe it’s time for some of the states to succeed from the union and that the constitution supports this position?


J: Let me answer your questions first, just so you can get the lay of the political land in my head.

1. "Death Panel" is certainly an exaggeration. The focus of any bureaucratic review of recipients of government healthcare will certainly not be on any individual. Rather the review will be a rational and objective one that compares the economic benefit of the treatment in question with the viability of the patient.
2. I don't know. Do you?
3. I don't care. Why do you?
4. President Obama certainly has expressed views that are not capitalist in nature. He has railed against "profit" and has moved to bring several large companies including banks and manufacturers into government and union ownership. That lies somewhere between socialist (state ownership) and communist (worker ownership). He has supported an ousted would-be socialist dictator in Honduras over the country's legitimate constitution and the actions of its Supreme Court and military. That is at very least tacit endorsement of socialist aggression.
5. While it certainly is the right of states to secede from the Union, I do not believe that is a good idea. States have a long history of yielding their rights under the 10th Amendment, going back at least to Reconstruction. If the States want to, they must understand that teaching the federal government that the 10th Amendment is as important as the 1st or the 14th is going to take time.

T: And CAN you believe that the same Republicans that are opposed to the government interfering with end-of-life decisions are the ones who supported the government intervention in the end-of-life family decision for Terry Schaivo?


J: So, with the Terri Schaivo case, are you saying that government will interfere with end-of-life choices; and we should be okay with that because (and you must forgive me - I was busy that summer and didn't pay much attention to the whole Schaivo thing...) some Republicans thought it was okay? (There are plenty of "Republicans" who think that government is the answer.) Do you think it's okay for government to do that? You see, on one hand I hear liberals protesting that the government will not make those decisions for us, and on the other I hear them saying we shouldn't complain about the government making those decisions for us.

T: I am easily convinced that Democrats can stretch the truth and revise history. But the outrageous allegations made by Republicans who can’t stand being out of power for 8 months outclasses anything I have witnessed before.

Given the fact that the Republicans believe that if they defeat health care reform, then it will be “Obama’s Waterloo,” I have no doubt about who is willing to lie in order to accomplish that lofty objective. And… One final question that has been niggling at me for the last couple of weeks… Why are so many Americans, even those on the extreme right, so darned concerned about preserving the fantastic profits of the insurance companies??? They are actually concerned about the company’s well-being if they are faced with… get this… competition. Please explain to me why. I await with bated breath.


J: As for "Obama's Waterloo", this is the first time I've heard healthcare reform called that. But let's look at the context of Waterloo. It was not that Napoleon's enemy was superior. The reason Napoleon lost at Waterloo was a series of mistakes he made. Waterloo is synonymous with a self-inflicted defeat. Napoleon had bad timing, a bad plan, and a set of poor leaders. He failed to execute; failed to exploit his advantages. In short, he overestimated his own forces' capabilities and underestimated his enemy. Further, he failed to see the possibility of 50,000 Prussian reinforcements arriving on the scene. In that context, whoever came up with the "Waterloo" analogy may be right.

President Obama missed the wave of popular support. He used that time to pass a stimulus package that is still largely impossible to track. That was a big withdrawal from the fledgling emotional bank account he had with the American people. It left him trying to paddle up the backside of the wave. President Obama still has not articulated a plan for healthcare reform which leaves many wondering if there is a plan at all. The extraordinarily poor quality of appointees he has made - ranging from tax avoiders to conflicts of interest - has been a distraction.

He has failed to execute; failed to exploit his advantages. In short, he overestimated his own election. Rather than reading it as the rejection of a spineless and double-dealing Republican president he read it as a whole-hearted mandate of his socialist agenda - which was largely hidden from the ignorant voting population that numbs its mind on CNN and the Today Show. That misreading caused him to fail to see the possibility of really upsetting a large number of people who would take time off work and travel long distances to express their disappointment (and some contempt) to their elected representatives.

Anyone who paints those folks (of which I am part) as "astroturf" is living in denial.

Your final niggling question about why we Americans are concerned about preserving the profits of insurance companies has a simple answer that ought to be crystal clear to any of you who are drawing down a 401k, 403b, or IRA. All of our financial futures are tied to the profitability and the future profitability of large companies, not just insurance companies or auto makers. Take away the profit potential for any company and what is the investment value? Zero. Now, go try to cash in your investments so that you can live with dignity in retirement when the profit potential for even a small portion of your portfolio has been taken away. You WILL be eating dog food, as the fearmongers in the 1980s asserted.

Competing with the government never was competition, Terry.

Don't point to UPS and FedEx, either. They are not allowed to play in the first-class postage arena. If they were, we might see some very interesting things happen at the USPS. You see, government writes the rules and, as is the case in parcel post, government writes them in its favor.

If you want to open up competition in healthcare, let's deregulate the market and allow companies to practice in all 50 states. I'd love to have the Kaiser Permanente option here in Arizona, but becaus the market is so tightly regulated Kaiser is locked out. Level the playing field, as the liberals say.

And let's get some tort reform going here. When I try to understand what trial lawyers add to the cost of medical care in the country my head swims. I think back to Tina's OB in Ohio who paid $500,000 per year in malpractice premiums - although she'd never lost a case and was only sued 2 or 3 times per year.

I return to my assertion: We do not understand the root problems of healthcare in this country. Therefore we cannot fix them by addressing the symptoms of cost and availability.

More From the AP on America's Health "Crisis"

By SCOTT HARRINGTON
In his speech to Congress last week, President Barack Obama attempted to sell a reform agenda by demonizing the private health-insurance industry, which many people love to hate. He opened the attack by asserting: "More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the full cost of care. It happens every day."

Clearly, this should never happen to anyone who is in good standing with his insurance company and has abided by the terms of the policy. But the president's examples of people "dropped" by their insurance companies involve the rescission of policies based on misrepresentation or concealment of information in applications for coverage. Private health insurance cannot function if people buy insurance only after they become seriously ill, or if they knowingly conceal health conditions that might affect their policy.

Traditional practice, governed by decades of common law, statute and regulation is for insurers to rely in underwriting and pricing on the truthfulness of the information provided by applicants about their health, without conducting a costly investigation of each applicant's health history. Instead, companies engage in a certain degree of ex post auditing—conducting more detailed and costly reviews of a subset of applications following policy issue—including when expensive treatment is sought soon after a policy is issued.

This practice offers substantial cost savings and lower premiums compared to trying to verify every application before issuing a policy, or simply paying all claims, regardless of the accuracy and completeness of the applicant's disclosure. Some states restrict insurer rescission rights to instances where the misrepresented or concealed information is directly related to the illness that produced the claim. Most states do not.

To highlight abusive practices, Mr. Obama referred to an Illinois man who "lost his coverage in the middle of chemotherapy because his insurer found he hadn't reported gallstones that he didn't even know about." The president continued: "They delayed his treatment, and he died because of it."

Although the president has used this example previously, his conclusion is contradicted by the transcript of a June 16 hearing on industry practices before the Subcommittee of Oversight and Investigation of the House Committee on Energy and Commerce. The deceased's sister testified that the insurer reinstated her brother's coverage following intervention by the Illinois Attorney General's Office. She testified that her brother received a prescribed stem-cell transplant within the desired three- to four-week "window of opportunity" from "one of the most renowned doctors in the whole world on the specific routine," that the procedure "was extremely successful," and that "it extended his life nearly three and a half years."

The president's second example was a Texas woman "about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne." He said that "By the time she had her insurance reinstated, her breast cancer more than doubled in size."

The woman's testimony at the June 16 hearing confirms that her surgery was delayed several months. It also suggests that the dermatologist's chart may have described her skin condition as precancerous, that the insurer also took issue with an apparent failure to disclose an earlier problem with an irregular heartbeat, and that she knowingly underreported her weight on the application.

These two cases are presumably among the most egregious identified by Congressional staffers' analysis of 116,000 pages of documents from three large health insurers, which identified a total of about 20,000 rescissions from millions of policies issued by the insurers over a five-year period. Company representatives testified that less than one half of one percent of policies were rescinded (less than 0.1% for one of the companies).

If existing laws and litigation governing rescission are inadequate, there clearly are a variety of ways that the states or federal government could target abuses without adopting the president's agenda for federal control of health insurance, or the creation of a government health insurer.

Later in his speech, the president used Alabama to buttress his call for a government insurer to enhance competition in health insurance. He asserted that 90% of the Alabama health-insurance market is controlled by one insurer, and that high market concentration "makes it easier for insurance companies to treat their customers badly—by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates."

In fact, the Birmingham News reported immediately following the speech that the state's largest health insurer, the nonprofit Blue Cross and Blue Shield of Alabama, has about a 75% market share. A representative of the company indicated that its "profit" averaged only 0.6% of premiums the past decade, and that its administrative expense ratio is 7% of premiums, the fourth lowest among 39 Blue Cross and Blue Shield plans nationwide.

Similarly, a Dec. 31, 2007, report by the Alabama Department of Insurance indicates that the insurer's ratio of medical-claim costs to premiums for the year was 92%, with an administrative expense ratio (including claims settlement expenses) of 7.5%. Its net income, including investment income, was equivalent to 2% of premiums in that year.

In addition to these consumer friendly numbers, a survey in Consumer Reports this month reported that Blue Cross and Blue Shield of Alabama ranked second nationally in customer satisfaction among 41 preferred provider organization health plans. The insurer's apparent efficiency may explain its dominance, as opposed to a lack of competition—especially since there are no obvious barriers to entry or expansion in Alabama faced by large national health insurers such as United Healthcare and Aetna.

Responsible reform requires careful analysis of the underlying causes of problems in health insurance and informed debate over the benefits and costs of targeted remedies. The president's continued demonization of private health insurance in pursuit of his broad agenda of government expansion is inconsistent with that objective.

Mr. Harrington is professor of health-care management and insurance and risk management at the University of Pennsylvania's Wharton School and an adjunct scholar at the American Enterprise Institute.

Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved

Checking the Facts with AP

FACT CHECK: Obama uses iffy math on deficit pledge
By CALVIN WOODWARD and ERICA WERNER, Associated Press Writers Calvin Woodward And Erica Werner, Associated Press Writers Thu Sep 10, 3:15 am ET
WASHINGTON – President Barack Obama used only-in-Washington accounting Wednesday when he promised to overhaul the nation's health care system without adding "one dime" to the deficit. By conventional arithmetic, Democratic plans would drive up the deficit by billions of dollars.
The president's speech to Congress contained a variety of oversimplifications and omissions in laying out what he wants to do about health insurance.
A look at some of Obama's claims and how they square with the facts or the fuller story:
___
OBAMA: "I will not sign a plan that adds one dime to our deficits either now or in the future. Period."
THE FACTS: Though there's no final plan yet, the White House and congressional Democrats already have shown they're ready to skirt the no-new-deficits pledge.
House Democrats offered a bill that the Congressional Budget Office said would add $220 billion to the deficit over 10 years. But Democrats and Obama administration officials claimed the bill actually was deficit-neutral. They said they simply didn't have to count $245 billion of it — the cost of adjusting Medicare reimbursement rates so physicians don't face big annual pay cuts.
Their reasoning was that they already had decided to exempt this "doc fix" from congressional rules that require new programs to be paid for. In other words, it doesn't have to be paid for because they decided it doesn't have to be paid for.
The administration also said that since Obama already had included the doctor payment in his 10-year budget proposal, it didn't have to be counted again.
That aside, the long-term prognosis for costs of the health care legislation has not been good.
CBO Director Douglas Elmendorf had this to say in July: "We do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount."
___
OBAMA: "Nothing in this plan will require you or your employer to change the coverage or the doctor you have."
THE FACTS: That's correct, as far as it goes. But neither can the plan guarantee that people can keep their current coverage. Employers sponsor coverage for most families, and they'd be free to change their health plans in ways that workers may not like, or drop insurance altogether. The Congressional Budget Office analyzed the health care bill written by House Democrats and said that by 2016 some 3 million people who now have employer-based care would lose it because their employers would decide to stop offering it.
In the past Obama repeatedly said, "If you like your health care plan, you'll be able to keep your health care plan, period." Now he's stopping short of that unconditional guarantee by saying nothing in the plan "requires" any change.
___
OBAMA: "The reforms I'm proposing would not apply to those who are here illegally." One congressman, South Carolina Republican Joe Wilson, shouted "You lie!" from his seat in the House chamber when Obama made this assertion. Wilson later apologized.
THE FACTS: The facts back up Obama. The House version of the health care bill explicitly prohibits spending any federal money to help illegal immigrants get health care coverage. Illegal immigrants could buy private health insurance, as many do now, but wouldn't get tax subsidies to help them. Still, Republicans say there are not sufficient citizenship verification requirements to ensure illegal immigrants are excluded from benefits they are not due.
___
OBAMA: "Don't pay attention to those scary stories about how your benefits will be cut. ... That will never happen on my watch. I will protect Medicare."
THE FACTS: Obama and congressional Democrats want to pay for their health care plans in part by reducing Medicare payments to providers by more than $500 billion over 10 years. The cuts would largely hit hospitals and Medicare Advantage, the part of the Medicare program operated through private insurance companies.
Although wasteful spending in Medicare is widely acknowledged, many experts believe some seniors almost certainly would see reduced benefits from the cuts. That's particularly true for the 25 percent of Medicare users covered through Medicare Advantage.
Supporters contend that providers could absorb the cuts by improving how they operate and wouldn't have to reduce benefits or pass along costs. But there's certainly no guarantee they wouldn't.
___
OBAMA: Requiring insurance companies to cover preventive care like mammograms and colonoscopies "makes sense, it saves money, and it saves lives."
THE FACTS: Studies have shown that much preventive care — particularly tests like the ones Obama mentions — actually costs money instead of saving it. That's because detecting acute diseases like breast cancer in their early stages involves testing many people who would never end up developing the disease. The costs of a large number of tests, even if they're relatively cheap, will outweigh the costs of caring for the minority of people who would have ended up getting sick without the testing.
The Congressional Budget Office wrote in August: "The evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall."
That doesn't mean preventive care doesn't make sense or save lives. It just doesn't save money.
___
OBAMA: "If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage."
THE FACTS: It's not just a matter of being able to get coverage. Most people would have to get coverage under the law, if his plan is adopted.
In his speech, Obama endorsed mandatory coverage for individuals, an approach he did not embrace as a candidate.
He proposed during the campaign — as he does now — that larger businesses be required to offer insurance to workers or else pay into a fund. But he rejected the idea of requiring individuals to obtain insurance. He said people would get insurance without being forced to do so by the law, if coverage were made affordable. And he repeatedly criticized his Democratic primary rival, Hillary Rodham Clinton, for proposing to mandate coverage.
"To force people to get health insurance, you've got to have a very harsh penalty," he said in a February 2008 debate.
Now, he says, "individuals will be required to carry basic health insurance — just as most states require you to carry auto insurance."
He proposes a hardship waiver, exempting from the requirement those who cannot afford coverage despite increased federal aid.
___
OBAMA: "There are now more than 30 million American citizens who cannot get coverage."
THE FACTS: Obama time and again has referred to the number of uninsured as 46 million, a figure based on year-old Census data. The new number is based on an analysis by the Kaiser Commission on Medicaid and the Uninsured, which concluded that about two-thirds of Americans without insurance are poor or near poor. "These individuals are less likely to be offered employer-sponsored coverage or to be able to afford to purchase their own coverage," the report said. By using the new figure, Obama avoids criticism that he is including individuals, particularly healthy young people, who choose not to obtain health insurance.
___
Associated Press writer Jim Kuhnhenn contributed to this report.

Obama Health Czar Tied to Corrupt and Illegal Practices

Here's another example of President Obama's judgment. Or lack thereof.

I found this article on MSNBC today. Unfortunately, the popular press is reporting the issue 4 months after the information was relevant.

Nancy-Ann DeParle has been serving as Health Czar since March and is earning $158,000 per year. She has links to and has earned millions of dollars from companies that were being investigated by the US Government during her tenure with them.

When will this stop?

Obama health czar directed firms in trouble:
DeParle made millions from companies under federal investigation
By Fred Schulte
Investigative Reporting Workshop, American University
updated 6:18 a.m. MT, Thurs., July 2, 2009
Nancy-Ann DeParle, President Barack Obama’s health policy czar, served as a director of corporations that faced scores of federal investigations, whistleblower lawsuits and other regulatory actions, according to government records reviewed by the Investigative Reporting Workshop at American University.

Several of the companies were investigated for alleged kickbacks or engaging in other illegal billing schemes, while others were accused of serious violations of federal quality standards, including one company that failed to warn patients of deadly problems with an implanted heart defibrillator. Several of the cases ended with substantial fines paid to the federal government, even though the companies admitted no wrongdoing.

Since leaving her government job running Medicare for the Clinton administration, DeParle built a lucrative private-sector career. Records show she earned more than $6.6 million since early 2001, according to a tally by the Investigative Reporting Workshop.

Much of that corporate career was built at companies that have frequently had to defend themselves against federal investigations. After leaving government, DeParle accepted director positions at half a dozen companies suspected of violating the very laws and regulations she had enforced for Medicare. Those companies got into further trouble on her watch as a director.

Now she’s back in government as a leading voice in deciding the shape of health care reform. Named by Obama in March as director of the White House Office of Health Reform, making $158,000 a year, DeParle is the point person in pushing for the administration's plans for changing health care and the ways Americans pay for it — changes in which her former companies have a great deal at stake.

Critics see DeParle’s re-emergence as a classic case of Washington “revolving door” syndrome, despite Obama’s suggestions that he would shut that door.

The administration faces a “balancing act,” said Steve Ellis of the nonpartisan Taxpayers for Common Sense. Obama must find leaders with the proper expertise, but who are “not so conflicted that they cannot engage in all facets of the debate.”

Advocates of a “single-payer” coverage plan say that DeParle may be indebted to the companies she served, and more broadly to the health care industry.

“This woman owes her fortune to the corporations that she is making decisions about,” said Dr. David Himmelstein, an associate professor of medicine at Harvard University and a co-founder of Physicians for a National Health Program.

“She cashed in really big on her previous role in government and made millions and millions of dollars. Then she divests and all of a sudden she’s Snow White. It’s ridiculous.”

Among DeParle’s corporate connections:
• DaVita Inc., which owns and operates kidney dialysis centers, has been the subject of several government probes into its billing and drug-prescribing practices, most recently in December by Justice Department investigators in Georgia. DeParle joined the DaVita board in May 2001 and resigned in July 2008 “to devote more time to her other business activities,” according to the company. She earned more than $2 million in compensation and stock sales, according to records at the Securities and Exchange Commission.
• Boston Scientific Corp. reported to the SEC that it received five state or federal subpoenas during 2008, including ones from the Justice Department and Health and Human Services, which oversees the Medicare agency. In addition, Defense Department criminal investigators are looking into the company’s “marketing interactions” with doctors at a U.S. Army hospital in Tacoma, Wash. DeParle joined the Boston Scientific board in April 2006 and resigned on March 4 of this year, two days after she was appointed to the White House post. She earned more than $1.4 million in compensation and stock sales from her years at Boston Scientific and a company it bought, the Guidant Corp.
• Guidant, which already was in legal trouble for failing to disclose 12 patient deaths when DeParle joined the board in 2001, has since then faced new problems. After a college student died in 2005 when his implanted defibrillator failed on a biking trip, his doctor told Congress that Guidant officials had known of similar problems for three years, but failed to tell the public.
•
Five of the corporations whose boards DeParle served on have paid a total of $566 million since 2003 to settle fraud or product liability cases, often involving tax dollars paid by Medicare.


Four signed “corporate integrity agreements” in which they promised to tighten oversight of their billing practices in exchange for the government agreeing not to take legal action to kick them out of the Medicare program.

“These raise eyebrows,” said Ellis, of Taxpayers for Common Sense. “These are things that have to be considered and evaluated.”

The White House did not make DeParle available for an interview about her corporate ties. Her spokeswoman, Linda Douglass, said the White House would not have time to answer questions about DeParle’s actions as a director. DeParle also declined interview requests from msnbc.com, which is co-publishing this article with the Investigative Reporting Workshop.

A director's responsibility
There is no reason to think that DeParle was directly involved in any of the actions that led to the investigations and sanctions. DeParle was a member of the board of directors of these companies, not the chief executive officer managing day-to-day operations. It is rare for directors to be held legally accountable for illegal dealings by management.

However, the 2002 Sarbanes-Oxley law, passed by Congress after the scandals at Enron and other companies, requires directors to be more aware of what is happening inside companies. Federal guidelines tell directors they should exercise even more oversight in health care firms.

Michael W. Peregrine, a corporate compliance lawyer in Chicago, said that while board members aren’t obligated to “ferret out wrongdoing,” they need to question management once they learn of regulatory problems and to “make sure something is being done about it. The board has to ask, ‘What the hell’s going on here?’”

At three companies — Guidant, DaVita and Specialty Laboratories — DeParle was not only a director but also served on board committees responsible for monitoring the companies' compliance with laws and regulations.


Publicly traded companies must disclose to shareholders the existence of investigations, enforcement actions or lawsuits that could affect their earnings. These filings, made with the Securities and Exchange Commission, often are short on specifics, including when the conduct that’s under investigation allegedly occurred. These investigations typically drag on for years.

It's therefore difficult to say in some cases whether DeParle's board service coincided with the company's suspicious conduct, or whether some of the conduct preceded her service but only came to light during her service.

In a few additional cases, DeParle joined companies that had already gotten into trouble.

For example, DeParle agreed to join the board of Guidant just days after it acknowledged it had covered up the deaths of 12 patients and more than 2,000 injuries caused by a faulty surgical device. She was on the board when the company pleaded guilty to 10 felony charges in the case, and paid $92 million in fines. The apparent cover-up in the separate case involving the implanted defibrillator came to light when DeParle had been on the board for two years.

And she joined the board of Boston Scientific about a year after it had paid $74 million to settle a federal criminal investigation into the company's delay in recalling a faulty heart device. No charges were brought, and the company no longer sells the product, called a stent. It also denied wrongdoing as part of the settlement with prosecutors.

Peregrine, the regulatory compliance lawyer, said potential directors should be “cautious” about joining the boards of companies with a history of clashing with regulators. Board members need to satisfy themselves that the organization has developed “a culture of compliance” with laws, he said.

‘A dedicated public servant’
DeParle resigned her corporate board positions upon taking the White House position, according to a financial disclosure form dated May 13 but only released by the White House on June 12. A handwritten note on the first page says that, as of June 4, “all conflicting assets have been divested.”

Her spokeswoman said DeParle has recused herself from any matters that might affect these companies, and has sold her stock in them at a “fairly substantial financial loss to herself and her family.” DeParle has “come into government with the understanding it would require a financial sacrifice. She is in complete compliance with all ethical requirements of the administration," Douglass said.

“She gave it all up to come and work in a tiny cramped office on one of the most important issues the country is dealing with,” Douglass said. “She’s working seven days a week, not seeing her children and working incredibly long hours. She’s doing this because she is a dedicated public servant.”

The public may never get a full accounting of her actions on corporate boards. Although DeParle is the point person on Obama's effort to overhaul health care for all Americans, she didn’t have to face questions at a Senate confirmation hearing, because she's a White House staffer, not a Cabinet official.

DeParle, 52, was the first woman to be president of the student body at the University of Tennessee, a Rhodes Scholar, and graduated from Harvard Law School. She ran the Medicaid program in Tennessee before going to Washington. Since leaving the Clinton administration, in addition to serving on corporate boards she was a managing director of a private equity firm that invested in health care companies, a trustee of the Robert Wood Johnson Foundation, and held fellowships at two universities.

'Makes you more valuable'
Growing concern over fraud in the health care industry has led federal officials in recent years to warn directors that they must make “good faith” inquiries into business practices, particularly when there’s reason to suspect wrongdoing. Federal officials are requiring more rigorous oversight by board members of the effectiveness of a company’s formal plan for complying with federal laws and regulations.

“Having government experience is a plus. It is one of the things that make you more valuable,” said Lynn Shapiro Snyder, a Washington lawyer and corporate defense counsel.

In DeParle’s case, four corporations paid her a total of $533,189 last year for serving as a director, according to SEC filings. The year before, she made $549,322 from three board positions. Of the $6.6 million she made from 2001 to 2009, about $2.2 million came from directors’ fees, and $4.4 million from stock options and trades. Her DaVita shares made her at least $1.8 million, and she made $1 million when Triad Hospitals Inc., a Texas company, was sold in 2007.

DeParle’s White House financial disclosure form shows that in 2008 she received $1 million in salary and bonus from CCMP Capital Advisors, LLC, a private equity firm she joined in August 2006 as a managing director helping oversee health care investments. Those interests included a Medicare managed care plan and a start-up hospital chain. She resigned from the firm in March.


Her White House biography mentions that she had served on corporate boards, but doesn’t name any of them. Though it dwells on her government career, it states that she “also brings a unique industry perspective from her work in the private sector.”

The investigations and lawsuits are at odds with DeParle’s reputation in Washington as a progressive, highly respected health policy analyst. During the late 1990s, when she ran Medicare, she pushed hard to raise medical quality standards and to clamp down on fraud and waste in the massive federal health plan for the elderly.

“In my experience, she’s the one administrator who really was tuned into the fraud issue,” said William J. Mahon, a former director of the National Health Care Anti-Fraud Association. “She distinguished herself in putting fraud on the agenda.”

Other companies with much to gain
Whether DeParle’s time in the private sector will influence the shape of health care reform remains to be seen. But there’s no doubt that the decisions will have significant impact on the corporations she formerly served. The Obama administration’s decision to spend billions of dollars promoting the use of electronic medical records offers an example.



In an April 15 media briefing in Washington, DeParle mentioned electronic medical records twice, first saying that an electronic system will help prevent medical errors and ensure that patients get “the right treatments.”

In response to a question, she added: “We want to incentivize physicians to use electronic medical records in a meaningful way for better treatment, better care, more convenience, better administration in their offices.”

Nobody mentioned her lengthy relationship with the Cerner Corporation, a major manufacturer of electronic medical records software based in Kansas City. From May 2001 until the day after her White House appointment, DeParle served on the board at Cerner, which has not reported any investigations into its finances or business dealings in recent years.

DeParle earned at least $680,000 from director’s compensation and stock options while she was on the Cerner board.

Reform "Now or Never" ... Really?

I’ll give you that there are people hurting without healthcare.

Reform has been ignored by every administration prior to President Obama.

In response to the President's urging outlined below, I ask, “Why does the President insist that this ‘reform’ be made this year? Why does he believe that failure this year will result in ‘never’ reforming healthcare in America?”

If healthcare reform is a good thing, and the President’s plan or idea is the best one, why will people realize that in 2009, but not in 2010 or future years? Is it a problem with the public schools? Are we teaching our children less effective critical reasoning skills every year? Will they not be able to understand the complexities of the issue? Is the electorate’s collective intelligence really decaying that rapidly?

Come on! Reasonable people will agree that, ceteris paribus, a good idea today will still be a good idea tomorrow.

I believe that, when someone gives a “now or never” ultimatum, it is because they are trying to hide something that others may find more objectionable than the status quo. Think back on every decision that someone has tried to rush you into making and see if that does not hold true.

This article was at Politico.com in late May 2009.

Since it’s primarily quoting the President’s conference call comments, there’s not much room for bias; and I don’t sense an overly active slant either way on the part of the writer.

"Obama: it's now or never"
By AMIE PARNES
05/28/09 2:13 PM
On a conference call with Organizing for America volunteers
Thursday, Obama urged thousands of callers to “work in your communities” to help
pass health care reform this year.

“If we don’t get it done this year, we’re not going to get it done,” Obama cautioned.

Obama urged volunteers to build on their experiences from the campaign and
“remobilize” to pass health care reform, calling it “one of our biggest priorities.”

“This is our big chance to prove that the movement that started during the campaign isn’t over,” he said. “We know what’s at stake. We know we need reforms. Businesses and families are just getting hammered… Millions of Americans have lost their health care.”

The president argued to supporters that Americans “want action.”

“Inaction on health care leads to unsustainable lives…everywhere,” he said. “If we want to cut our deficits…the most important thing we can do to close our budget gap is to rein in health care costs.”

This was interesting on a personal level.

The title raised an emotional – almost visceral – reaction in me.

I once had a girlfriend who wanted to marry me when we were 17 years old. I thought it was a good idea at the time, but (by the grace of God) the realities of life struck me and I asked her to wait for just a few months while I got established and settled in a career (read “finished Army Basic Training).

This thought was based on my uncle Dick’s advice that, “If you’re in love and it’s right now, you’ll be in love and it’ll be right in 6 months, so give it some time.” That was wisdom from a man who’d been there and (hadn’t) done that.

When I posited the idea, her emotional response was VERY similar to President Obama’s appeal below. It was “now or never”.

In the end, I avoided a REALLY bad mistake because I chose the more reflective path and insisted on waiting.

It wasn’t that I didn’t want to marry her! After all, when you are young and naïve, you know exactly what you want in life.

Within weeks we realized that we were not right for each other (read "got mad and broke up") and went our separate ways.If healthcare reform is really the best thing, and approaching it in the President’s proposed manner is really the best way, wouldn’t time bear that out, rather than threaten its chances of success?

There is far too much rushing and pushing and scaring in politics today.

We see it from our knee-jerk reaction to Afghanistan’s harboring Bin Laden, to our calculated and misguided invasion of Iraq, to the bailout of the banking industry, to the election of Barack Obama to the presidency, to closing Guantanamo Bay, to confirming Sonia Sotomayor as a Supreme Court Justice, to “reforming” healthcare.

Do we really understand the causes of the problems we see with healthcare?

Costs are high. Other than that, availability is excellent as compared to that in other countries and as compared to the population of the US.

The hospital I worked at in Cleveland had the same sign in the ER as every other hospital in America. It let everyone know that NO PERSON WOULD BE DENIED TREATMENT BECAUSE OF AN INABILITY TO PAY.

Quality is excellent by any standard.

So, we need to understand why healthcare is so expensive to the consumer. Above I cited one reason. You and I, who have the ability to pay for care, are subsidizing those who do not.

Another reason is anecdotal, but I believe it is common and would bear out under empirical scrutiny. About 5 years ago, I asked Tina’s OB/Gyn what her malpractice insurance premiums were on an annual basis. She paused briefly and matter-of-factly answered, “About $500,000.” I was stunned. She was telling me that before she paid a penny for medical office rent, utilities, continuing education, medical supplies, office staff, licensing fees, student loans, groceries, mortgage, car, insurances, her OWN healthcare, she had to earn HALF A MILLION DOLLARS. That is a LOT of pap smears!

If she is just one physician, imagine what the insurance costs are to “big pharma” or to hospitals themselves, or to medical device manufacturers, or to anyone else involved in your and my medical care!I don’t know much, but that could be a major factor in the cost of medicine in America.

John Edwards would probably have us look at greedy insurance companies, fat-cat hospital administrators, or doctors who drive BMWs. Small potatoes, if we did the math, I’ll bet. But then, John Edwards and his ilk make fortunes off of the “high cost of healthcare” in America.

If REFORM is a good thing today, then it will still be a good thing when we've had the chance to talk through it and come up with a well-reasoned solution to the problem.