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The stars do seem aligned for much needed change in the US healthcare system. But the organizations with a vested interest in the status quo, their lavishly funded lobbyists, and their tame Congressmen are going to do their damndest to make sure it does not happen.

The Boston Globe has an interesting article today: Held hostage by the health system. The article starts out by mentioning that the Senate Finance Committee (chaired by Max Baucus and Chuck Grassley) held a hearing earlier this month on healthcare reform and did not allow any advocates of a single-payer healthcare system to testify. And it is not as if there weren’t single-payer advocates ready and willing to speak. The Physicians for a National Health Program (which represents 16,000 doctors) asked the Committee to invite Dr. Marcia Angell (a senior lecturer at Harvard Medical School and a former Editor of the New England Journal of Medicine) to speak but the Committee decided to invite industry lobbyists instead.

As Dr. Angel points out, nearly every other developed country (e.g. Britain, France, Germany, Switzerland, Japan, etc.) has some form of single-payer system. All pay less per capita than the US and all have better health statistics than the US. Surely, any debate on meaningful change in our healthcare system should include debate and discussion on single-payer systems. And equally surely, the only reason it isn’t being included is that it represents a financial threat to for-profit insurers, the pharmaceutical companies, and for-profit hospitals and they and their lobbyists will do whatever they can to steer debate and discussion away from single-payer options.

In addition to Dr. Angell’s Globe article (see link above), I would recommend checking out the PBS FrontLine program Sick Around the World which examines the single-payer health plans in Britain, Germany, Switzerland, Taiwan, and Japan.

I run a small business and I currently get my healthcare through the local Chamber of Commerce. Inflation in the US has been running in the single digits for the last few years but each year the health insurance premiums go up by anything from 15% to 25%. There seems to be no real competition between the insurance companies on cost or benefits, no transparency (there are pages of fine print… “Oh, you thought you were covered”), and no real incentive on the part of the insurance companies to control cost.

The irony is that our current “free market”  healthcare system is hurting the ability of US companies to compete globally. Healthcare costs are the fastest growing costs for US firms and are growing much faster than the comparable healthcare costs for their European and Asian competitors.

It will be interesting to see how Obama matches up against McCain.

I do think McCain deserves credit for his military service and the years spent as a POW. But he was a very junior officer and the most useful thing he gained from getting beaten up in the camps was the ability to identify a bit with the prisoners in Abu Ghraib and Dick Cheney’s Gulag.

John Kerry did his bit in Vietnam too but that didn’t stop GW and his handlers from Swiftboating him… And the voters accepted that from a guy that turned National Guard service into a no-show job!

The Presidency of the United States is the most important job in the world and I am afraid the voters should be a bit ruthless in asking any candidate “What have you done for us lately?” and “What are you going to do for us in the future?”

I actually voted for McCain in the 2000 primary and I was appalled and disgusted by the dirty tricks that the GW folks used to defeat him. But I was even more disgusted when McCain then cozied up to GW for the 2004 election. McCain must despise GW… How could he stomach embracing him on stage?

I imagine the RNC must have whispered in his ear…. Gee, John, if you want support from us in 2008, you better get out there and put on a good show.

So what has McCain done for us lately?

He helped us get another 4 years of GW. He has failed to criticize the grotesquely mismanaged occupation of Iraq. He has said nothing about the rampant corruption and incompetence of the Halliburtons and Black Waters all of which has put US soldiers and marines at risk.

He has not criticized the creation of a bloated Homeland Stupidity department staffed by incompetent political cronies like FEMA’s “Helluva job Brownie.”

OK, he supported the troop surge which seems to have been having some positive effect.

But he never said a word about Rumsfeld firing General Shinseki for suggesting that we needed more troops in the first place.

He has, literally within the last week, discovered that we really are experiencing global warming and maybe we ought to do something about it. Even that sounds like a cobbled up attempt to differentiate himself from the most unpopular president in modern history.

It will be interesting to see who he picks as his running mate. Might I suggest…

McCain-Cheney ‘08

I am so relieved that Obama has won the primary.

Both Bill and Hillary are brilliant, determined, and relentless politicians but it is all about their own ambitions and ego. Bill was a mediocre president… It is only the contrast with his dreadful successor that casts him as anything else.

I have, for some time, felt that the 16 years of Bill and GW will be viewed as an awful watershed in US history. Eight years of Bill’s stagnation and eight years of GW’s corrupt, disasterous incompetence.

Sixteen years of lost opportunities and wasted time that could have been spent dealing with global warming, the energy crisis, and the economic changes brought on by globalization.

Eighty percent of Americans feel the country is going in the wrong direction.

Hillary was never going to be the candidate of change. She is the epitome of what we all despise about Washington DC. The schmoozing with lobbyists, the trading Presidential pardons for contributions to her Senatorial campaign, trading Senate bills for campaign contributions.

And God knows what Bill would get up to if we let him loose in the White House for another four or, I shudder, eight years.

What did he actually do to earn the $109 million dollars he has received since he was last in office? Who are the secret donors that paid for his Presidential library…

And Hillary’s latest performance… “I won’t concede and endorse you unless you offer me the VP slot?”

And all this crap about winning the popular vote if you count Michigan and Florida?

Bill and Hillary have been the two most powerful Democratic politicians for the last 20 years. If they didn’t like the way the primaries were structured or the rules by which the nomination was decided, they had lots of time and certainly the clout to have changes made. They had no problem with any of the rules or procedures… Until they found that Hillary was going to lose according to those rules and procedures. And then suddenly they are weeping over the disenfranchised voters of Florida and Michigan.

This isn’t Al Gore having the election stolen by a bunch of Bush Supreme Court appointees. This was rules and procedures that were created and interpreted by other Democrats.

Hillary is tough. Hillary is intelligent. Hillary is determined. But she is also totally self serving, lacks any integrity, and will do anything to win whatever contest she is in.

I am sorry for the many decent well meaning people who became so invested in her candidacy. Quite bluntly, she is, and always was, unworthy of their support. I can only hope that her churlish behavior of the last few days will make them realize that and that they will come to recognize that they will actually have a much better candidate in Obama come November.

It’s hard to decide which Federal agency is the most corrupt these days but Interior is certainly in the running for that prize.

Today’s New York Times (24 March 2007) has a front page article Ex-Interior Aide is Guilty of Lying in Lobbying Case. The second highest official in the Dept. of Interior, J. Steven Griles, pleaded guilty to lying before a Senate committee about his ties to Jack Abramoff, the Republican lobbyist who is now in prison.

According to the article, Mr. Griles told the Senate committee he had “no special relationship” with Jack Abramoff even though Abramoff routinely sought and received advice from Mr. Griles. He also failed to mention that he had a sexual relationship with one Italia Federici. Ms. Federici is the president of the Council of Republicans for Environmental Advocacy which received $500,000 from Mr. Abramoff. As Mr. Giles may have said, “Advocate this, honey!”…

The article also mentions that Mr. Griles had teamed up with a top ConocoPhillips lobbyist to buy a $980,000 vacation home. This purchase was approved by Sue Ellen Wooldridge, a top official in the Dept. of the Interior at the time. She also ended up as a co-owner of the vacation home. Conflict of Interest? What conflict of interest? Ms. Wooldridge is now, erh, “living in sin” with Mr. Griles in Falls Church, VA. (I know, I know… nobody gets married these days but heck, these are Republicans! Where’s their family values!?)

Ms. Wooldridge a former solicitor (No, not that kind!… a lawyer!) and senior aide to Secretary of the Interior, Gail Norton, ended up as a lawyer at the Justice Dept. prosecuting environmental cases… Including one against Conoco Phillips which she, erh, dropped.

Just how does the Food and Drug Administration decide what drugs or devices to approve for use by the public?

These decisions are made by FDA Advisory Committees made up of experts in the field.

Today’s New York Times (22 March, 2007) has an article F.D.A. Rule Limits Role of Advisors Tied to Industry which says that advisory committee members will (for the first time) be barred from voting on approval for a company’s product if they have received money from that company or a competitor. And if they have received more than $50,000 from that company or a competitor within the last 12 months then they cannot serve on a committee judging that company’s products (less than $50k is just hunky dory ).

FDA Acting Deputy Commissioner Randall W. Lutter stated that a “signficant number” of the agency’s current advisers would be affected by this policy.

What that means, of course, is that up until now, many of the people responsible for approving drugs and medical devices have been routinely accepting tens of thousands of dollars a year from the company’s whose products they were approving. Smells a just a bit, don’t you think?

The article describes a situation in 2005 where 10 of the advisers who voted for Bextra to remain on the market and Vioxx to return to the market had accepted tens of thousands of dollars from the manufacturers. If the tainted advisors had not been allowed to vote, the products would not have been allowed back on the market since the majority of advisers who had not accepted money had voted against approval.

Other little tidbits from the article; under FDA rules an adviser cannot vote if they hold more than $100,000 in stock in the manufacturer (but holding $99,000 or less is hunky dory ).

One needs to remember that the previous FDA Commissioner, Lester Crawford, recently pleaded guilty to charges of filing false financial disclosure forms and conflicts of interest. The government had charged that Crawford and his wife owned stock in several companies that fell under FDA regulation, and failed to fully disclose that information as required by federal law. The court papers also charge that Crawford assured federal ethics officers that he and his wife had sold stock in those companies, when they had not.

Crawford’s attorney, Barbara Van Gelder, said that under a plea agreement, her client would not dispute the government’s charges, and would likely face fines and a possible prison term of up to two years.

Click here to read the Department of Justice news release on the case’s outcome.