Definitive Proof That Obama Wants Socialized Medicine

Very subtly -- yet surely -- proof has arrived to demonstrate that President Obama wants socialized medicine. The Tea Party folk and "professional" Republican politicians have made this argument incessantly, and it now appears that they are absolutely correct.

Obama just had his first physical as president, and rather than going to one of the many private hospitals in the country, he went to the National Navy Medical Center --a (gasp) government-run hospital. Not only is the hospital government-run, but it also takes many patients on government-run health plans, like TRICARE -- the socialized plan of choice for Joe "You Lie" Wilson and his family. TRICARE, like all other health plans, only pays for allowed procedures; in other words, it "rations" care. How Bolshevik!

Shame on you, Obama. And shame on the other people who utilize socialized medicine!

Note: Sarcasm to the extreme.

Media Is More Interested in Rightwing Racism Than Rightwing Distortion, Deception, Lies, and Hypocrisy

I am a law professor who teaches Constitutional Law, Civil Rights, Race and the Law and other areas related to equality. I have spent nearly two decades researching and writing about race relations and public policy. With respect to the rightwing attacks on President Obama, however, I find the issue of race largely uninteresting.

I think it is safe to say that most Tea Party marchers, rightwingers, Joe Wilson, and many other anti-Obama types are not progressive on issues of race. Indeed, many of the participants in the protest marches have carried signs or made statements that show racial hostility. So -- yes -- some of Obama's critics harbor racial bias.

Nevertheless, it is impossible to psychoanalyze the entire opposition to Obama. Discussing this issue will do nothing but take the public's attention away from more important public policy concerns. Race is definitely an important social, political and legal concern, and the issue of race and access to healthcare is extremely important. But in this setting, there are far more pressing matters than the racial motivation of Obama's opponents.

Furthermore, even though racism informs some of the opposition to Obama, rightwingers have exhibited lunactic opposition to liberal and even moderate policies in the past (think Bill Clinton). Glenn Greenwald (of Salon) and I have both analyzed this topic.

What to Talk About Instead of Race
For over a month, conservatives have advanced gross distortions regarding healthcare reform. They have described it as socialism, Nazism, and totalitarianism, and they have argued that it would establish "death panels" to decide whether to "pull the plug on grandma." They have portrayed healthcare reform as an effort to harm seniors -- even though Republican John McCain proposed the very same cuts to Medicare that Obama has proposed. They have also condemned "government-run" healthcare, while pretending to support Medicare and TRICARE; these two programs, however, are forms of government-run healthcare.

Moreover, many of Obama's opponents have blasted "big government," but they want the federal government to reform tort laws in every state and to veto a doctor and patient's decision regarding abortion. Many of them also supported the unnecessary war in Iraq and the increasingly unpopular war in Afghanistan. They also endorse governmental regulation of some of the most intimate human relations, such as sex among consenting adults.

Conservatives blame Obama for the financial sector and auto industry bailouts -- even though the Bush administration proposed both bailouts and ushered the legislation through Congress. Bush also sharply increased the rate of government spending -- while cutting taxes. That disastrous fiscal policy turned a surplus into a record deficit.

I am not even intrigued by Joe "You Lie" Wilson's racial mindset. His prior work for Strom Thurmond and his reaction to the "unseemly" possibility that Thurmond had a "black" daughter indicate that Wilson is not the most advanced mind on issues of race and sex. But focusing on this obvious fact detracts from the content of Wilson's own "lies."

Wilson, for example, has rallied his conservative constituents against the inclusion of a public plan option in healthcare reform. Wilson makes typical Republican arguments regarding this issue, claiming that a public plan would interfere with doctor and patient relationships and reduce the level and quality of care. Wilson, however, has spoken quite fondly of TRICARE -- the government-run health system for military personnel, veterans and their families. Wilson and his children and their families are all on TRICARE. Wilson has said that TRICARE delivers "world class" medical care. Wilson has also noted that TRICARE receives high marks from participants.

TRICARE also establishes treatment options (just like private insurance) that define the contours of a doctor-patient relationship for patients who lack private insurance or the ability to self-pay. Wilson's contradictory positions on this subject are far more important than whether he hates Obama because he is black.

Conclusion
The issue of race has become the latest nonpolicy distraction for the media. Earlier, the media covered violence and mayhem at healthcare town hall discussions -- rather than the substance of reform. It then covered the conflicts between moderate and liberal Democrats (rather than the substance of reform). Now, it is exploring whether the opposition to Obama is racist (rather than the substance of reform).

Here's a thought: Analyze the substance of reform -- rather than the subjective emotions that shape its opposition. The media cannot tell us whether most of Obama's opponents are racist, but it can certainly unveil the hypocritical and deceitful nature of that opposition.

Hypocrisy Alert: Protesting "Big Government" While Using "Socialized" Transportation and Medicine

Representative Kevin Brady (R-Tex) wrote a letter to the DC Metro system complaining about what he describes as less than a "basic level of transit":

These individuals came all the way from Southeast Texas to protest the excessive spending and growing government intrusion by the 111th Congress and the new Obama administration. . . .These participants, whose tax dollars were used to create and maintain this public transit system, were frustrated and disappointed that our nation’s capital did not make a great effort to simply provide a basic level of transit for them.

Oh, boo hoo. Rapid transit is a wonderful service "up here" in Northern cities. But this isn't really the hotbed of Tea Party activity challenging government programs that improve society -- rather than those which start unnecessary wars.

Hypocrisy Alert: Protesting "Big Government" While Using "Socialized" Subway Transportation and Medicine
Brady also laments the fact that elderly marchers -- including veterans -- had to take taxis. But isn't this better than using socialized subway transportation? As David Kurtz at TPM observes, the taxi users were simply relying on "free market solutions." I guess the personal isn't political after all.

Also, why are elderly people who are (very likely) on Medicare and TRICARE (government healthcare for seniors and veterans) protesting government-sponsored healthcare while demanding more services from a government-run transportation system? Perhaps they oppose big government unless they need big government.

Finally, Brady voted against the stimulus, which included money to make improvements to the DC Metro system. The irony, contradictions and hypocrisy continue!

Joe Wilson: Healthcare Hypocrite

Two words -- You Lie! -- have brought Representative Joe Wilson greater national scrutiny than anything he has previously said or done. Wilson, a South Carolina Republican, shouted disagreement with President Obama during his recent speech to Congress regarding healthcare reform.



Healthcare Hypocrisy: Wilson's Contradictory Stances on Governmental Health Plans

The most intriguing and relevant news regarding Wilson surrounds his hypocritical stances on "government-run" healthcare. Wilson argues that "[a] government-controlled system would limit choice and quality by letting politicians and bureaucrats determine your level of care in order to bring down costs. That is unnecessary and unacceptable."



In July 2009, however, Wilson spoke very glowingly and intimately about TRICARE, the government-administered and funded health plan for military personnel, veterans and their dependants:

As a 31-year Army Guard and Reserve veteran, I know the importance of TRICARE. I know it is important for the military personnel and families at the bases I represent . . . .I am grateful to have four sons now serving in the military, and I know that their families appreciate the availability of TRICARE.



Currently, TRICARE provides world class health care to 9.4 million beneficiaries. . . .TRICARE. . .is a low cost, comprehensive health plan. . . .[I]n 2008 TRICARE was rated the best health care insurer in the nation according to the Wilson Health Information survey of customer satisfaction. TRICARE also received stellar marks on the 2007 annual federal government report from the 2007 American Customer Satisfaction Index. . . .



I believe that TRICARE is one part of our health care system that’s working. . . . I believe that our military personnel and their families. . .like what they have. . . .

As a veteran, Wilson qualifies for TRICARE. According to his own words, his four sons and their families and many of his constituents rely upon TRICARE. Although Wilson offers high praise for TRICARE, he argues that allowing "politicians and bureaucrats" to determine the level of care in order to lower costs is "unnecessary and unacceptable." Politicians and bureaucrats, however, administer TRICARE and determine the level of care for participants. Also, federal law makes cost-effectiveness a primary goal of TRICARE administration.



Earth to Wilson: TRICARE = Public Plan = Government-Run Health Program = Government-Sponsored Health Plan

Congress created and funds TRICARE. The Secretary of Defense administers TRICARE. Although Congress has mandated that TRICARE cover certain broad categories of medical services, the Secretary of Defense issues the specific plan materials, which establish covered and excluded treatments under the various available plans as well as the obligations of participants. Like all other federal regulations, TRICARE policies are contained in the Code of Federal Regulations (or CFR).



Because the government has the exclusive authority to determine the treatments covered by TRICARE:



Unless TRICARE participants have other health plans or the money to self-pay, then the scope of their allowable medical treatment is determined by "politicians and bureaucrats" -- not by doctors and patients. The government does not mandate that individuals participate in TRICARE, but if they do, they can only receive services authorized by the federal government (unless they have another plan or elect to self-pay).



Government health plans, however, are typically very comprehensive and usually less expensive than private insurance plans. Wilson does not explain why only military personnel (or seniors) should benefit from comprehensive and relatively inexpensive medical services.



TRICARE "Death Panels" and "Interference With the Doctor and Patient" Relationship

The CFR contains TRICARE plan materials. A review of the regulations demonstrates the close involvement of the federal government in the medical services of plan participants. The discussion below provides examples of some areas of covered and excluded services.



1. Federal regulations allow reimbursement of costs associated with the provision of counseling to terminally ill patients, including counseling "for the purpose of helping the individual and those caring for him or her to adjust to the individual's approaching death" (see pg. 137).



2. Federal regulations, however, disallow reimbursement for "unnecessary diagnostic tests," which the government defines as "X-ray, laboratory, and pathological services and machine diagnostic tests [except for certain cancer screenings] not related to a specific illness or injury or a definitive set of symptoms."



3. Federal regulations do not permit reimbursement for "unnecessary postpartum inpatient" treatment of a mother or newborn -- when only one of the two needs extended hospitalization (e.g., will not pay for mom to stay in hospital when newborn needs hospitalization). This includes stays to allow the mother to breastfeed the infant (see pg. 147).



4. Federal law does not permit TRICARE to pay for the use of an "unproven" "drug, device, or medical treatment or procedure." This prohibition covers any drug or device that lacks FDA approval or clearance (see pg. 148) and any treatment or procedure that has not been subjected to a sufficient number of well controlled clinical studies (see pg. 149).



The multiple-page partial list of excluded drugs, devices, procedures and treatments includes in utro fetal surgery, treatment of chronic fatigue syndrome, gastric wrapping/banding, intestinal bypass, and "high dose chemotherapy with stem cell rescue" to treat breast cancer (with limited exceptions), ovarian cancer, or testicular cancer (see pp. 149-151).



5. Federal regulations provide that "[TRICARE] benefits for rare diseases are reviewed on a case-by-case basis" (see pg. 149).



6. Federal law requires participating medical providers to accept as full payment for TRICARE-covered services the co-pay and/or deductible, plus the amount that the government establishes an allowable expense for the particular service category (see pg. 167).



This short list represents just a few ways in which the government shapes the terms of the doctor-patient relationship for people who choose TRICARE as a service payer. For example, doctors cannot cannot collect more than the allowed amount for any services. Also, psatients cannot elect to undergo excluded services -- unless of course the individual has supplemental coverage or can self-pay.



Furthermore, as the statute and administering regulations state, cost-effectiveness is a central goal of the program. Conservatives, however, argue that cost-effectiveness is impossible without compromising care. If that is the case, then to the extent that TRICARE is cost-effective, it does so by compromising the care of participants.



Finally, the Democrats' reform proposals would not curtail services covered in private health insurance policies. Instead, the proposals would augment the rights of policyholders by prohibiting denial of coverage for preexisting conditions, the cessation of coverage after the insured has reached a lifetime maximum level of benefits, and the canelation of policies if individuals develop a particular illness. The government would determine the specifics of a public plan option, but Medicare and TRICARE demonstrate that the government can perform this function and maintain comprehensive coverage. If Wilson wants to challenge liars, he can start at home.

GOP's "Pack of Lies for Seniors"

Apparently, the Republicans believe that they can make a run for seniors by continuing to scare the hell out of them. It all started with Sarah Palin's "death panels" lie. Now, they are fueling the notion that the Democrats are a threat to Medicare -- even the conservatives have blasted Medicare and the notion of "public plans" for decades.

On Monday, the Republicans released a Bill of Rights for Seniors. RNC Chair Michael Steele also published an op-ed in the Washington Post that analyzes the Republicans' platform for seniors. Steele's op-ed simply regurgitates deceptive talking points that conservatives have circulated around the Internet since the beginning of healthcare reform debates. The GOP's "Bill of Rights for Seniors" is nothing but a "List of Lies."

Steele makes 5 broad points in his essay. Each one tells a different lie.

Lie #1: Democrats Want to Raid Medicare; Republicans Want to Save It
Steele argues that "[Obama] and congressional Democrats are planning to raid, not aid, Medicare by cutting $500 billion from the program to fund his health-care experiment." Steele's argument that Democrats are the opponents of Medicare while Republicans are fans of the plan is absolutely bogus.

Republicans have for a long time opposed Medicare. Ronald Reagan joined the American Medical Association's campaign against Medicare during the 1960s, describing the idea as "socialized medicine." Republicans have a long history of opposing "public plans" and describing them as socialism. Although Steele's op-ed does not admit this point, medicare is a public plan.

With respect to Medicare cuts, every major presidential candidate -- Democrat and Republican -- who proposed healthcare reform also advocated cutting Medicare costs. John McCain, for example, wanted to slash $1.3 trillion dollars from Medicare and Medicare over a ten-year period. Mitt Romney also frequently discussed the need to cut spending on entitlement programs, including Medicare.

Furthermore, Steele argues that the Democrats want to cut $500 billion from Medicare, but he neglects to discuss additional funding to the program that they have proposed. The Congressional Budget Office estimates that taking into consideration both cost cutting and increased spending, Obama's plan would trim $219 billion from Medicare over 10 years -- which is much less than Steele's figure and than what McCain proposed. Steele's analysis of this issue is hypocritical and factually inaccurate.

Lie #2: Healthcare Reform Gets in the Way of Seniors and Their Doctors
Steele shamelessly argues that: "The government-run health-care experiment that Obama and the Democrats propose will give seniors less power to control their own medical decisions and create government boards that would decide what treatments would or would not be funded."
Although Steele paints a picture of a scary "government-run health-care experiment," he neglects to describe Medicare as a government-run health program. Under Medicare (and Medicaid and Veterans health plans), the government already determines what types of treatments are covered and the reimbursement for those procedures. Steele's argument describes a fantasy world where Medicare is presumably a private entity where doctors and patients can do whatever they want, unconstrained by governmental coverage decisions. Private insurance does not operate this way either. Steele is either ignorant or a liar. Neither option is good.

Also, Republicans strongly support the Hyde Amendment, which bans coverage of abortion for Medicaid recipients. Republicans, have in fact, demonized proposed healthcare reform by falsely stating that it would fund abortion services. This type of governmental intrusion into the doctor-patient relationship is apparently fine for Republicans. So, in addition to being ignorant or a liar, Steele is a hypocrite.

Lie #3: Obama Wants to Ration Care Based on Age
Steele says that care should not be rationed based on age. No version of healthcare reform proposed by any Democrat would do this. Steele is lying yet again.

Lie #4: Democrats Will Dictate End of Life Care for Seniors
Steele repeats the discredited "death panel" lie told by Sarah Palin and Charles Grassley. He claims that end-of-life care "becomes troublesome when the government gets involved." Perhaps that is true, but Steele's description of the Democrats' proposals is intentionally deceptive. The proposals would only compensate doctors who provide end-of-life counseling to patients. The proposals do not mandate the care.

This is the same thing as a governmental decision to pay for mammograms or a heart surgeries (which government insurance plans already do). Paying for treatment or counseling does not mandate it, nor does it get the government "involved" in the treatment. Steele is lying yet again.

Lie #5: Democrats Are Ending Veterans' Benefits
Steele argues that "we need to protect our veterans by preserving Tricare and other benefit programs for military families." He leaves the impression that Democrats want to discontinue these programs, but he can only state that some Democrats proposed raising premiums for Tricare -- which are far less than insurance premiums on the open market. Why? Tricare is a public plan -- the kind of government-sponsored plan that Republicans claim will lead to socialism, communism, and Armageddon.

Perhaps seniors could benefit from a "Bill of Rights." Unfortunately, the Republicans have only given them a pack of lies.