Someone Writes Beloved Leader

President George W. Bush

The White House

1600 Pennsylvania Ave., NW

Washington, DC 20500

Dear Mr. President:

The Preamble to our Constitution states that one of our highest duties as public officials is to "provide for the common defence." As an elected Member of Congress, a senior Member of the House Armed Services Committee, and Chairman of the House Permanent Select Committee on Intelligence, I work everyday to ensure that our defense and intelligence capabilities remain strong in the face of serious threats to our national security.

Because I care so deeply about protecting our country, I take strong offense to your suggestion in recent days that the country will be vulnerable to terrorist attack unless Congress immediately enacts legislation giving you broader powers to conduct warrantless surveillance of Americans' communications and provides legal immunity for telecommunications companies that participated in the Administration's warrantless surveillance program.

Today, the National Security Agency (NSA) has authority to conduct surveillance in at least three different ways, all of which provide strong capability to monitor the communications of possible terrorists.

First, NSA can use its authority under Executive Order 12333 to conduct surveillance abroad of any known or suspected terrorist. There is no requirement for a warrant. There is no requirement for probable cause. Most of NSA's collection occurs under this authority.

Second, NSA can use its authority under the Protect America Act, enacted last August, to conduct surveillance here in the U.S of any foreign target. This authority does not "expire" on Saturday, as you have stated. Under the PAA, orders authorizing surveillance may last for one year - until at least August 2008. These orders may cover every terrorist group without limitation. If a new member of the group is identified, or if a new phone number or email address is identified, the NSA may add it to the existing orders, and surveillance can begin immediately. We will not "go dark."

Third, in the remote possibility that a new terrorist organization emerges that we have never previously identified, the NSA could use existing authority under the Foreign Intelligence Surveillance Act (FISA) to monitor those communications. Since its establishment nearly 30 years ago, the FISA Court has approved nearly every application for a warrant from the Department of Justice. In an emergency, NSA or the Federal Bureau of Investigation (FBI) may begin surveillance immediately, and a FISA Court order does not have to be obtained for three days. The former head of FISA operations for the Department of Justice has testified publicly that emergency authorization may be granted in a matter of minutes.

As you know, the 1978 FISA law, which has been modernized and updated numerous times since 9/11, was instrumental in disrupting the terrorist plot in Germany last summer. Those who say that FISA is outdated do not understand the strength of this important tool.

If our nation is left vulnerable in the coming months, it will not be because we don't have enough domestic spying powers. It will be because your Administration has not done enough to defeat terrorist organizations - including al Qaeda -- that have gained strength since 9/11. We do not have nearly enough linguists to translate the reams of information we currently collect. We do not have enough intelligence officers who can penetrate the hardest targets, such as al Qaeda. We have surged so many intelligence resources into Iraq that we have taken our eye off the ball in Afghanistan and Pakistan. As a result, you have allowed al Qaeda to reconstitute itself on your watch.

You have also suggested that Congress must grant retroactive immunity to telecommunications companies. As someone who has been briefed on our most sensitive intelligence programs, I can see no argument why the future security of our country depends on whether past actions of telecommunications companies are immunized.

The issue of telecom liability should be carefully considered based on a full review of the documents that your Administration withheld from Congress for eight months. However, it is an insult to the intelligence of the American people to say that we will be vulnerable unless we grant immunity for actions that happened years ago.

Congress has not been sitting on its hands. Last November, the House passed responsible legislation to authorize the NSA to conduct surveillance of foreign terrorists and to provide clarity and legal protection to our private sector partners who assist in that surveillance.

The proper course is now to conference the House bill with the Senate bill that was passed on Tuesday. There are significant differences between these two bills and a conference, in regular order, is the appropriate mechanism to resolve the differences between these two bills. I urge you, Mr. President, to put partisanship aside and allow Republicans in Congress to arrive at a compromise that will protect America and protect our Constitution.

I, for one, do not intend to back down - not to the terrorists and not to anyone, including a President, who wants Americans to cower in fear.

We are a strong nation. We cannot allow ourselves to be scared into suspending the Constitution. If we do that, we might as well call the terrorists and tell them that they have won.

Sincerely,

Silvestre Reyes

Member of Congress

Chairman, House Permanent Select Committee on Intelligence

Link.

Olbermann Disses Beloved Leader

But he does it so well....

“Who’s to blame?” Mr. Bush also said this afternoon, “Look, these folks in Congress passed a good bill late last summer… The problem is, they let the bill expire. My attitude is: if the bill was good enough then, why not pass the bill again?”

You know, like The Gulf of Tonkin Resolution.

Or Executive Order 90-66.

Or The Alien and Sedition Acts.

Or Slavery.

Mr. Bush, you say that our ability to track terrorist threats will be weakened and our citizens will be in greater danger.

Yet you have weakened that ability!

You have subjected us, your citizens, to that greater danger!

This, Mr. Bush, is simple enough even for you to understand.

For the moment, at least, thanks to some true patriots in the House, and your own stubbornness, you have tabled telecom immunity, and the FISA act.

You.

By your own terms and your definitions — you have just sided with the terrorists.

You got to have this law or we’re all going to die.

But practically speaking, you vetoed this law.

It is bad enough, sir, that you were demanding an Ex Post Facto law, which could still clear the AT&Ts and the Verizons from responsibility for their systematic, aggressive, and blatant collaboration with your illegal and unjustified spying on Americans under this flimsy guise of looking for any terrorists who are stupid enough to make a collect call or send a mass e-mail.

But when you demanded it again during the State of the Union address, you wouldn’t even confirm that they actually did anything for which they deserved to be cleared.

“The Congress must pass liability protection for companies believed to have assisted in the efforts to defend America.” Believed?

Don’t you know?

Don’t you even have the guts Dick Cheney showed in admitting they did collaborate with you?

Does this endless presidency of loopholes and fine print extend even here?

If you believe in the seamless mutuality of government and big business — come out and say it!

There is a dictionary definition, one word that describes that toxic blend.

You’re a fascist — get them to print you a t-shirt with “fascist” on it!

What else is this but fascism?

Did you see Mark Klein on this newscast last November?

Mark Klein was the AT&T Whistleblower, the one who explained in the placid, dull terms of your local neighborhood I-T desk, how he personally attached all AT&T circuits — everything — carrying every one of your phone calls, every one of your e-mails, every bit of your web browsing into a secure room, room number 641-A at the Folsom Street facility in San Francisco, where it was all copied so the government could look at it.

Not some of it, not just the international part of it, certainly not just the stuff some spy — a spy both patriotic and telepathic — might able to divine had been sent or spoken by — or to — a terrorist.

Everything!

Every time you looked at a naked picture.

Every time you bid on eBay.

Every time you phoned in a donation to a Democrat.

“My thought was,” Mr. Klein told us last November, “George Orwell’s 1984. And here I am, forced to connect the big brother machine.”

And if there’s one thing we know about Big Brother, Mr. Bush, is that he is — you are — a liar.

“This Saturday at midnight,” you said today, “legislation authorizing intelligence professionals to quickly and effectively monitor terrorist communications will expire. If Congress does not act by that time, our ability to find out who the terrorists are talking to, what they are saying, and what they are planning, will be compromised…You said that “the lives of countless Americans depend” on you getting your way.

This is crap.

And you sling it, with an audacity and a speed unrivaled even by the greatest political felons of our history.

Richard Clarke — you might remember him, sir, he was one of the counter-terror pro’s you inherited from President Clinton, before you ran the professionals out of government in favor of your unreality-based reality — Richard Clarke wrote in the Philadelphia Inquirer:

“Let me be clear: Our ability to track and monitor terrorists overseas would not cease should the Protect America Act expire. If this were true, the president would not threaten to terminate any temporary extension with his veto pen. All surveillance currently occurring would continue even after legislative provisions lapsed because authorizations issued under the act are in effect up to a full year.”

You are a liar, Mr. Bush, and after showing some skill at it, you have ceased to even be a very good liar.

And your minions like John Boehner — your Republican congressional crash dummies who just happen to decide to walk out of Congress when a podium-full of microphones await them — they should just keep walking, out of Congress and if possible, out of the country.

For they — and you, sir — have no place in a government of the people, by the people, for the people.

The lot of you, are the symbolic descendants of the despotic middle managers of some banana republic, to whom “Freedom” is an ironic brand name, a word you reach for, when you want to get away with its opposite.

Thus, Mr. Bush, your panoramic invasion of privacy is dressed up as “protecting America.”

Thus, Mr. Bush, your indiscriminate domestic spying becomes the focused monitoring, only of “terrorist communications.”

Thus, Mr. Bush, what you and the telecom giants have done, isn’t unlawful, it’s just the kind of perfectly legal, passionately patriotic thing for which you happen to need immunity!

Richard Clarke is on the money, as usual.

That the President was willing to veto this eavesdropping, means there is no threat to the legitimate counter-terror efforts underway.

As Senator Kennedy reminded us in December:

“The President has said that American lives will be sacrificed if Congress does not change FISA. But he has also said that he will veto any FISA bill that does not grant retroactive immunity.

No immunity, no FISA bill. So if we take the President at his word, he’s willing to let Americans die to protect the phone companies.”

And that literally cannot be.

Even Mr. Bush could not overtly take a step that actually aids the terrorists.

I am not talking about ethics here.

I am talking about blame.

If the President seems to be throwing the baby out with the bathwater, it means we can safely conclude… there is no baby.

Because if there were, sir, now that you have vetoed an extension of this eavesdropping, if some terrorist attack were to follow…

You would not merely be guilty of siding with the terrorists…

You would not merely be guilty of prioritizing the telecoms over the people…

You would not merely be guilty of stupidity…

You would not merely be guilty of treason, sir…

You would be personally, and eternally, responsible.

And if there is one thing we know about you, Mr. Bush, one thing that you have proved time and time again… it is that you are never responsible.

As recently ago as 2006, we spoke words like these with trepidation.

The idea that even the most cynical and untrustworthy of politicians in our history — George W. Bush — would use the literal form of terrorism against his own people — was dangerous territory. It seemed to tempt fate, to heighten fear.

We will not fear any longer.

We will not fear the international terrorists — we will thwart them.

We will not fear the recognition of the manipulation of our yearning for safety — we will call it what it is: terrorism.

We will not fear identifying the vulgar hypocrites in our government — we will name them.

And we will not fear George W. Bush.

Nor will we fear because George W. Bush wants us to fear.

How McCain Will Run And Govern

Four more years. That's it. Got it??


Link.

Beloved Leader, Still Lying

Beloved Leader's claim below is an utter and complete lie. (Yeah, yeah, just like everything that comes out of his mouth.)

Bush spoke at some length about torture in his Fox News interview. All in all, it sounded like he was walking back spokesman Tony Fratto's assertion last week that the president might approve more waterboarding. Bush sided in the interview with CIA director Michael Hayden's view that waterboarding was legal when it was conducted in 2002 and 2003, but may no longer be legal.

Said Bush: "First of all, whatever we have done was legal, and whatever decision I will make will be reviewed by the Justice Department to determine whether or not the legality is there. And the reason why there is a difference between what happened in the past and today, there is a new law."

Then, however, Bush made an unsupported claim, and issued a challenge that the media and his critics should pick up with vigor: "The American people have got to know that what we did in the past gained information that prevented an attack. And for those who criticize what we did in the past, I ask them, which attack would they rather have not permitted -- stopped? Which attack on America did they -- would they have said, well, you know, maybe it wasn't all that important that we stop those attacks."

But if the American people have "got to know" that torture gained information that prevented an attack, Bush needs to start making a better case. As I've written repeatedly, he has yet to offer any evidence that intelligence produced by torture thwarted a single plot or saved a single life.

The media should demand that he back it up or take it back.

Link.

More Straight Talk: The Politics Of Home

Straight Talk: The Video

Earth-Shattering News

Watch this and feel the earth shake.

Today's Straight Talk

We report, you decide. Our Next Leader explains Iraq to us (subject, I suppose, to change at his next straight-talking flip-flop).

Our Leaders' Success At Making Our Nation Safer

American Samoa's delegate to the U.S. Congress is calling for an investigation into the death of a baby at Honolulu International Airport.

Delegate Eni Faleomavaega has asked the Department of Homeland Security to begin an investigation into death of 14-day-old Michael Tony Futi last Friday.

The baby had been flown to Honolulu for emergency heart surgery. He died while detained inside a customs' room at the Honolulu airport with his mother and a nurse.

A lawyer for the family announced plans to sue the federal government over the baby's death.

Faleomavaega called for the probe in a letter issued to Homeland Security chief Michael Chertoff.

Link.

Video Of The Day: Just Some Guy Doing Something To Make Senior Home Shut-ins Happy

It Must Be A Historical Financial Crisis; A Conservative Capitalist Says It Is

I mean, this isn't an anti-capitalist or some weird rightist wingnut. This is an experienced, knowledgeable businessman. My favorite part is the dis of these robotic interest rate cuts. Of course, in this case, the problem came from an excess of loose capital used for speculation so, of course, throwing oil on the flames is a good idea (not).

ONE OF THE GRANDEST OF THINKERS AND MOST ELOQUENT of oracles, Jeremy Grantham has long been the voice of reason in an industry prone to excesses and embellishment. By taking the long view, blending quantitative strategies and technical analysis with sound and experienced judgment, Grantham, chairman of Boston-based GMO, consistently uncovers with his team the best values among a wide range of global asset classes.

The payoff is outstanding performance and risk management. In return, clients have entrusted the firm with about $150 billion. As the man who warned early of a worldwide bubble forming, we turned to him as that bubble has started bursting.

"It was late '06 when [Fed Chairman Benjamin] Bernanke said he thought the high prices of homes in the U.S. merely reflected a strong U.S. economy. Was he not looking at the data?" -- Jeremy Grantham

Barron's: You, along with George Soros, have called this the worst financial crisis we've had in the post-war era.

Grantham: This is much more global than, say, the savings-and-loan crisis was. The world is obviously much more globalized than at any time since the late 19th century and much more interrelated in almost every way, certainly financially. To have the leading economy and the reserve currency having a major-league credit crisis would by itself make it more important than earlier ones.

Secondly, this occurred at a time of what I believe is the first global bubble in pretty well all asset prices, so there is a much greater degree of broad-based vulnerability. Then it is a question of degree, and how carried away the sloppy lending was: It was very carried away. Not just in the design of needlessly complicated instruments, but in the enthusiasm -- recklessness one might say -- with which they were sold.

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Can these bubbles burst if the Fed is easing the way they are?

Well, this is an amazing little tidbit. People think the Federal Reserve can stop a bear market because they can throw money at it and lower interest rates. It is even more certain we can collectively stop a bear market if some fiscal stimulus is thrown in. To which I say, 'Oh, you mean like 2000 and 2002?' -- when they threw what I call the greatest stimulus in American history, an unparalleled series of interest-rate cuts, cumulating in two, almost three, years of negative real returns, real interest rates coupled with a really substantial tax cut, which would never have happened without 9/11.

The combination would have gotten the dead to walk, and it stopped the bear market eventually. But the Standard & Poor's 500 was down 50% and the Nasdaq -- which was all anyone talked about back then -- went down 78%. And a puny five to six years later, people are saying there is not going to be a bear market because the Fed is going to lower rates and because the government is going to have a stimulus package. But we have just been there, done that, and we had a nice bear market.

What about places to hide?

That isn't something we can laugh off. Last time, there were plenty of opportunities: Bonds were cheap and TIPS (Treasury-inflation protective securities) were brilliant; real estate was cheap and REITs were brilliant. Even within equities, emerging markets were much cheaper than U.S. equities, and within U.S. equities, value stocks were only a little expensive and small-caps were only a little expensive and small-cap value was actually a little bit cheap. So you could really hide and could reasonably expect to make money, which we did in each of the three years of the bear market.

Since then, all those areas appear to have read the book on mean-reversion. Ten years would be a perfectly normal period of time to go from a peak of a great bubble [like the one in 2000], based on the history of bubbles and their aftermath, to the low. I have long thought that 2010 would be when we hit the biggest discount to fair value. Trend-line value on the S&P, by the way, in 2010 is 1100. (The S&P 500 traded at 1334 late last week.)

What should we expect from the market between now and 2010?

In the fourth year of a presidential cycle, where you have a lame-duck president, the typical pattern of S&P 500 performance has been something like 10% below the normal long-term average (a 5.2% gain, inflation-adjusted), and worse if it is an overpriced market. A first year is never very pleasant: They average about 3% below normal. If they are overpriced, they do four points worse than that.

But if the party in power changes, first years tend to be eight points below normal. The following year is ugly, too. The average year two, since 1932, has been 10 points below normal and, if the market is overpriced, 15 points below normal. This is unpleasant. By a nice coincidence, those averages suggest the market will decline to 1100 in 2010, which is exactly the number we get to from a completely different technique -- building it from the grass roots through fundamental value. We do that by taking average corporate-profit margins, actually a generous average, assigning a normal market price/earnings ratio, and that gives you 1100 in 2010. This year, next year and the year after will all be uncomfortable years. One of them might be up, but my guess is it won't be up by much.

What exactly will make them more uncomfortable?

Profit margins, the great prop to the market, surprisingly defied the laws of gravity for three years in the developed world and, particularly, in the emerging world and even in Japan. That was because the global economy was stronger than any corporation counted on and, in the U.S., consumption was always higher and our savings rate was always lower than any corporate economist would have suggested, going into negative territory. But there are a few near certainties in this business -- not many, but a few -- and one of them is that abnormally high profit margins will go back to normal. The timing is unfortunately shrouded in fog. The other near certainty is that house prices will go back to a normal multiple of family income. In the end, we, the people, have to be able to afford the houses and they are affordable at something around 2.8 times family income. When they peak in Boston at 6 times and nationally at 3.9 times, you know you are in for tough times.

Incidentally, it was late in '06 when [Fed Chairman Benjamin] Bernanke said he thought the high prices of homes in the U.S. merely reflected a strong U.S. economy. Was he not looking at the data? Did he not measure long-term house prices? Had he not seen how they ebbed and flowed as a multiple of family income, which they do here and in the U.K. and everywhere else? And with it being so obviously a bubble, how could he have said that?

He was taking his cue from Alan Greenspan, who said we should all be taking out adjustable-rate mortgages.

Greenspan and Bernanke have taken a hands-off approach for two consecutive great bubbles, first in TMT -- telecommunications, media and technology -- and second, in housing. A hands-off approach is a polite way of saying they facilitated this. And what is the point of a 125-basis-point rate reduction, other than to provide reinforcement for the people who borrow short and lend long? From bankers who have committed every crime you could possibly accuse a banker of, to hedge funds who borrow short, leverage, and invest long in the stock market -- that's who really benefits from the interest-rate reduction. The economy, broadly defined, does not.

I have an exhibit that shows the 30 years prior to 1982 when the debt-to-gross domestic product ratio was completely flat at 1.2 times. Total debt is defined as government debt, personal debt, corporate debt and financial debt. Then in the 25 years after 1982, the flat line goes up at a 45 degrees angle from 1.2 times to 3.1 times GDP. Massive. In the first 30 years, when debt is flat, annual GDP growth is its usual battleship, growing at 3.5% and hardly twitching. After the massive increase in debt, GDP, far from accelerating, grew at 3%. So debt in the aggregate does not drive the economy. The economy is driven by education, man-hours worked, capital investment and technology. It is not driven by what I owe you and you owe me.

So the Fed's actions won't stave off a slowdown?

Since when did the thought of an economic slowdown induce such hysteria? That was a response to the decline in global markets. It was aimed at the stock market. It was aimed at banking disorder and banking profits. It doesn't have that much of a powerful effect on the economy. If it had any more profound effect, there would be a positive relationship between debt increasing and GDP growth, and there is none.

But it is driving down the dollar.

It drives down the dollar, which is inflationary, and, eventually, it could be seriously inflationary.

I understand you are most concerned with further fallout in the private-equity arena?

Yes. I have yet to meet a private-equity firm that put into its spreadsheet the assumption that system-wide profit margins could decline by 20% to 30%. They have taken the current, abnormally high profit margins as a given and then determined to improve them by, let's say, 15% and assume everything works out pretty well.

But if the base declines by 20%, even if they end up improving margins by 15%, they are going backwards. And if they pay the 25% premium up front, which was normal, and if they leverage 4-to-1, which was normal, then they almost precisely wipe out all of the clients' money, all of the 20% in equity and if, perish the thought, they don't add 15%, but add perhaps zero to 5%, then they do more than wipe out the equity, they leave the underlying debt in ragged disarray. That is the next shoe to drop on the credit side.

Where else does this housing crisis lead us?

It has a lot to go. It still has to drop 20% to 25% to reach more normal levels, or if you prefer, it could wait five years for income to catch up, barring no big recessions. With the housing market gone, people turned to credit cards and with economic times slowing down -- whether there's a recession or not -- consumers are going to slow down a lot, are slowing down or have slowed down a lot.

What about the dollar?

Currency is a real problem, I've got to admit. There was a time not that many years ago when we had a huge high-confidence bet against the dollar. It was technically overpriced, and we were running a huge trade deficit. Now, it is technically substantially cheap. But we are running an even bigger deficit. It is a conundrum. I don't think it should be a major, major bet. We are reasonably happy owning emerging currencies as a packet against the dollar for a several-year time horizon. I'm not particularly happy owning a packet of other developed currencies against the dollar.

Personally, I'm long the yen, the Singapore dollar and the Swiss franc. I'm certainly not long the pound: shorting the pound is a better bet than shorting the dollar.

What other bets would you take here?

My favorite bet on Jan. 1 and today, for that matter, is going long very-high-quality U.S. blue chips with 50% of my dough, and long emerging markets for 50%, and shorting the Russell 2000 for 100%, or a complete hedge. In that bet, I'm long value because both of those components are cheaper than the Russell 2000. I'm long liquidity on average. I'm long momentum on average.

What about growth stocks? Isn't there value there?

Growth stocks are expensive, but not quite as expensive as value stocks or low-growth stocks. Quality stocks are expensive but substantially less so than anything else. Emerging is expensive, but less so than anything less, and the fundamentals are so much superior to the rest of the world. Everything is expensive. All we are trying to do is extract some relative money, or by going short, actually make some real money.

But how do you define quality these days?

We always defined high-quality companies as those with high and stable returns and low debt. Recently, we had to override, and exclude several banks from that list. Whether you like it or not, you have got to treat banks separately.

What about the deal market, will that provide any lift to stocks? Microsoft's bid for Yahoo! hasn't done much for the market.

You might say that is a company in serious trouble being acquired by a company that is worried, maybe desperate. And that doesn't sound like a very strong deal to anybody.

Link (sub. required, that's why I ran nearly the whole piece).

The Fear Of An Islamofascist Victory

Image Of The Day

Unsolicited plug but a message is a message.

Important Video

When the election is over and some poor son of a bitch or whatever is elected to clean up Our Leaders' messes, this will live on. It's about priorities.

Trailer Of The Day

Shown: Our Leaders' Love For Their Vets

The Department of Veterans Affairs (VA) will treat about 333,000 sick and injured veterans of the Iraq and Afghanistan wars in 2009, according to VA statistics released last week. That number is a 14 percent increase over this year's casualty total. Yet, despite the Bush administration's promises to prioritize the VA even as other domestic departments' funds are cut, its annual budget request for next year places more financial burdens than ever on many returning soldiers.

At first glance, Bush's 2009 budget may seem like a boon to veterans: It would increase the VA budget by $3.4 billion.

"The President's ongoing commitment to those who have faithfully served this country in uniform is clearly demonstrated through this budget request for VA," said VA Secretary James B. Peake at a budget hearing last Thursday. "Resources requested for discretionary programs in 2009 are more than double the funding level in effect when the president took office seven years ago."

However, veterans' advocates argue the budget's growth has not kept pace with the skyrocketing size of the veteran community - or the increasing cost of servicing them.

"Bush only provides the news on the increased budget without providing full facts on the increased demands and costs," said Paul Sullivan, executive director of Veterans for Common Sense.

Although the "discretionary spending" Peake mentions has indeed doubled since Bush entered office, the VA budget as a whole has only increased by about a third - roughly in proportion to the growth of the veteran population, according to VA statistics.

Peake's comparison of today's VA budget to that of seven years ago also sidesteps the reality of changing market values. Congressman Bob Filner, chairman of the House Veterans Affairs' Committee, says that regardless of the administration's sweeping claims, the 2009 VA budget is not much improvement over last year's. According to Filner, the budget's much-touted 5.5 percent increase for veteran health care "barely covers the cost of medical inflation."

"The service and sacrifice of our veterans is real, and the budget for the VA must provide realistic funding levels to meet these needs," Filner said in a statement upon the budget's release. "I am concerned that this budget proposal contains only modest increases for veterans' health care while paying for this slight increase with cuts in other veterans' programs below the historic levels this Congress provided for in this fiscal year."

For example, the new budget would require veterans to pay more out-of-pocket expenses, such as pharmacy co-pays and annual enrollment fees. Also, under Bush's plan, the VA's medical research budget would drop below 2007 levels, with the expectation the department would outsource its research needs.

"The VA reduces its research budget [in 2009] and sets sights on coordinating with other agency research activities, agencies such as the Institute of Medicine," said Rick Jones, legislative director of the National Association for Uniformed Services. "With so much unknown on traumatic brain injury and post-traumatic stress disorder, it seems ill-advised to depend on outside-agency coordination when these issues are veteran-centric."

The administration's proposal cuts the VA medical and prosthetic research budget by 8 percent and veterans' rehabilitation research by 7 percent.

It also slashes construction funds for new medical facilities by about 44 percent, with grants for construction of extended care facilities losing 49 percent.

Moreover, after the 2009 VA budget increase, the Bush plan calls for billions of dollars in budget cuts over the next four years, according to Filner. For a system already playing a losing game of catch-up, the reductions could be devastating.

"The VA's backlog of claims and appeals has been exacerbated by funding shortfalls," said Jay Agg, national communications director for American Veterans (AMVETS). "Currently, 870,000 veterans are awaiting decisions from the VA, a process that may take many months or even years. That's about the same size as 15 Yankee Stadiums full of veterans."

The administration has shown no signs of altering its 2009 VA request; in fact, it is currently immersed in a lawsuit defending its right to deny health care to Iraq and Afghanistan veterans.

However, veterans' advocacy groups aren't giving up. During last Thursday's testimony, Jones and representatives from several other organizations, including AMVETS, presented "The Independent Budget" (IB): their own proposal for next year's VA spending. It would up the Bush budget by almost $3 billion, emphasizing mental health research and medical facility construction.

"The IB is by veterans, for veterans, and provides a full picture of veterans' needs and how our government can meet them," Agg said. "Our position is that the administration and Congress, having authorized funding for war, must now be prepared to provide sufficient, timely and predictable funding to meet the needs of our war fighters."

Despite the Bush administration's firm stance on the VA budget, some advocates see signs of hope. Last Thursday's hearing was not a battle, according to Sullivan; in fact, administration officials appeared interested in listening to what the "other side" had to say.

"While Secretary Peake and VA's top political appointees testified first, they broke their usual pattern of quickly departing the hearing room," Sullivan said. "Instead of bolting for the door, Peake asked Under Secretary Kussman and Under Secretary Cooper to remain, and they all remained and listened to the testimony of ten different [veteran] groups."

As casualties mount and the end of the Bush administration draws nearer, Congress will take up the VA request and, likely by this summer, propose its own version of the budget.

Link.

And watch this:

Continuing: More Love For Our Troops From Our Leaders Who Sent Them To Patently Unnecessary Wars

The four tours in Iraq served by the Second Brigade at Fort Drum here have created an unusual level of stress, especially after the standard Iraq tour was increased to 15 months from 12. Yet according to a new report on the shortcomings of mental health care at the base, a soldier’s wait to be seen for psychological help can take more than a month.

The draft report, “Fort Drum: A Great Burden, Inadequate Assistance,” which was given to The New York Times last week, was done by Veterans for America, a nonprofit advocacy organization for wounded members of the armed forces. It also uncovered several other problems with the mental health services on the post, which is north of Syracuse.

Based on interviews with a dozen soldiers and the mental health providers on the base, the report describes problems with understaffing, a reliance on questionnaires to identify soldiers in need of treatment and a sometimes dismissive view at the company level of post-traumatic stress disorder.

“The system is very much overburdened,” said Jason W. Forrester, director of policy for Veterans for America, in a telephone interview last week. “These problems are going to continue as long as we have units, such as the Second Brigade Combat Team, that have seen high-intensity combat, extended deployments and inadequate time between deployments.”

Maj. Gen. Michael Oates, the commander of the 10th Mountain Division, which includes the Second Brigade, acknowledged the shortcomings of the mental health care on the base, and said the problems were being addressed. “We recognize that there is stress on the force and our families from this conflict,” General Oates said. “But until recently we have not fully appreciated the extent of some of the mental stresses and injuries or how best to identify them”

In particular, he said, the providers of psychological services on the base have been expanding their effort to interview “those who are most at risk,” though “the screening process is not where we want it to be.”

Indeed, the report said that the wait for an appointment has eased since three Army psychiatrists were reassigned last month from Walter Reed Army Medical Center, joining three psychiatrists already on the base, to address the needs of 3,500 Second Brigade soldiers recently back from Iraq. But, the report noted, the reassignment was “only a temporary fix” since the psychiatrists from Walter Reed would probably return to Washington in a few weeks.

Fort Drum lacks its own hospital, so any soldier needing inpatient treatment has to be sent to Samaritan Medical Center in Watertown, which recently increased the number of beds in its psychiatric unit to 32 from 24.

But the report said that when the psychological facilities at the base have closed for the day, some soldiers have bypassed Samaritan and driven more than an hour to Syracuse for treatment. The Veterans for America report said the soldiers fear that doctors at Samaritan will side with some base leaders, who had, “in some cases, cast doubt on the legitimacy of combat-related mental health wounds.”

“The Department of Defense itself has recognized that with every tour you increase the likelihood of post-traumatic stress disorder,” said Adrienne Willis, spokeswoman for Veterans for America. “Here we have a brigade that has served four tours.”

Nor is the heavy service the only problem at Fort Drum. In the last two weeks, it has been at the center of a controversy over whether the Army instructed the Department of Veterans Affairs last March to stop helping soldiers there with their disability claims. At first, the Army surgeon general, Eric B. Schoomaker, denied that the Army had told Veterans Affairs to do so.

But after National Public Radio reported on a memorandum from the March meeting in Buffalo in which a colonel was quoted as directing Veterans Affairs to discontinue counseling, the surgeon general apologized for his denial and said it was based on a “miscommunication.”

In the report issued by Veterans for America, one soldier, Eli Wright, 26, who was a medic in Iraq in 2003 and 2004 and remains on active duty while awaiting a medical discharge, said his symptoms of post-traumatic stress disorder began after his tour ended and have worsened since then.

“My nerves are basically shot,” Mr. Wright said in a recent interview at the Different Drummer Cafe downtown. “I have flashbacks if I hear loud noises, especially if weapons are being fired. Sometimes just putting on my uniform can bring me right back to my experience in Iraq.”

He said that when he was in Iraq, he treated more civilians than American soldiers, and that two in particular stood out in his mind: an old woman and a child who were shot through a door as soldiers were “going door to door, tearing apart entire neighborhoods” searching for insurgents.

Mr. Wright said he waited weeks at Fort Drum to see a mental health professional, who diagnosed post-traumatic stress disorder. He was prescribed medication and pointed toward group therapy, where, he said, “half the time the group is staring at the floor.” At times, he was taking two pills at once. “I couldn’t stay awake,” he said.

But his chief complaint with the Army is the long wait for treatment. “The average wait time is five to six weeks,” he said. “When a soldier is having a mental breakdown, he has to wait over a month to see a counselor about his problems.”

Mr. Forrester of Veterans for America said that while the top brass at Fort Drum, especially General Oates, have spoken passionately about the need for soldiers to seek psychological treatment, others have not.

“There’s a trickle-down problem with the message, and that is that there’s still a pervasive stigma around mental health treatment in the military, along with a lack of confidentiality,” he said. “For those who still doubt the legitimacy of these wounds, they often are quite abusive of fellow soldiers or people in their units.”

While Fort Drum has two dozen psychologists, social workers and substance-abuse counselors, the low number of psychiatrists is worrisome because psychiatric medication is common, Ms. Willis said. “They’re heavily medicated, and it’s not something a social worker can deal with,” she said. “You really need a psychiatrist to manage that.”

Link.

America On The March!

What's the matter with Kansas?

It's fucked up, same as it always has been.

A woman can't referee a boys' basketball game 'cause no woman can be in an authoritative position over males.

Kansas activities officials are investigating a religious school's refusal to let a female referee call a boys' high school basketball game.

The Kansas State High School Activities Association said referees reported that Michelle Campbell was preparing to officiate at St. Mary's Academy near Topeka on Feb. 2 when a school official insisted that Campbell could not call the game.

The reason given, according to the referees: Campbell, as a woman, could not be put in a position of authority over boys because of the academy's beliefs.

Campbell then walked off the court along with Darin Putthoff, the referee who was to work the game with her.

"I said, 'If Michelle has to leave, then I'm leaving with her,"' Putthoff said Wednesday. "I was disappointed that it happened to Michelle. I've never heard of anything like that."

Fred Shockey, who was getting ready to leave the gym after officiating two junior high games, said he was told there had been an emergency and was asked to stay and officiate two more games.

"When I found out what the emergency was, I said there was no way I was going to work those games," said Shockey, who spent 12 years in the Army and became a ref about three years ago. "I have been led by some of the finest women this nation has to offer, and there was no way I was going to go along with that."

Shockey noted that referees normally don't work Saturday games, but he agreed to officiate because his daughter's basketball game slated for that day was canceled.

The Activities Association said it is considering whether to take action against the private religious school. St. Mary's Academy, about 25 miles northwest of Topeka, is owned and operated by the Society of St. Pius X, which follows older Roman Catholic laws. The society's world leader, the late Archbishop Marcel Lefebvre, was excommunicated by Pope John Paul II in the late 1980s.

Gary Musselman, the association's executive director, said the organization will not make a decision until it confirms whether St. Mary's Academy has a policy of not allowing female referees to work boys basketball games.

If that is indeed the school's written policy, Musselman said, the association could decide to remove St. Mary's Academy from the list of approved schools and take away its ability to compete against the association's more than 300 member schools.

St. Mary's Academy officials declined comment when contacted by The Associated Press on Wednesday.

St. Mary's Academy is among 30 schools on the list that are not full association members but compete against schools that are. Musselman said St. Mary's Academy plays one or two games per season against member schools but has no more scheduled this school year.

He said if removed from the approved list for next school year, St. Mary's Academy still would be able to compete against approved schools that are not members of the association.

Musselman said the association hopes to resolve the matter sometime this week. He said he sent a letter to the school's principal, Vicente A. Griego, the day of the incident but has not heard back from him.

Putthoff and other supporters of Campbell said they believe state activities officials will handle the situation properly.

Campbell did not return phone calls seeking comment Wednesday.

However, she told The Kansas City Star that she was "dumbfounded" by the incident but that she is not angry at the school. She said she does not want the situation to go any further than it already has.

"This issue was going to come up eventually," said Campbell, 49, a retired Albuquerque, N.M., police officer who now lives in Ozawkie, Kan. "I just happened to be the person who was there this time.

"It's kind of a sticky situation. It needs to be looked at carefully, slowly, with all the facts."

Putthoff said he has called games at St. Mary's Academy off and on for 10 or 12 years, but doubts he will officiate at the school again.

"Out of defense to Michelle, I'm probably going to decline to go back there," he said. "We have to support our fellow officials."

Campbell, one of about five female referees in the Topeka Officials Association, has been officiating games for about two years.

"We don't support any institutions that would discriminate against any of our officials," said Steve Bradley, president of the Topeka group. "We support Michelle 100 percent.

"Michelle works hard. She cares about what she does. She is not a person who's on a crusade. She's a good person. She's a good official. You will not find a person who's more serious about doing a good job than Michelle."

Musselman said this was his first time dealing with a situation in which a school turned away a referee because of gender.

"We view officials not as male or female, Hispanic or African-American or Asian-American. We view officials as officials," Musselman said. "Discrimination against our officials is something we can't be party to."

Still, he said, the association wants to be fair to everyone involved and gather all the information before taking action.

Link. And after you read this and click on the link, you may search the website and look for the swimsuit pix.

The Spies Who Loved YOU

Link.

American Justice

Big cop beats on little scrawny punk 17 year old. Look!



And the story continues from there to here.

FISA For Dummies

Greenwald spells it all out, nice and simply.

FISA was not enacted in 1842. If we are "forced" to live under that law for a few weeks or even longer, we are not "going dark." We are not "more vulnerable" to the Terrorists Who Want to Kill Us. Even under FISA, the Government is fully able to eavesdrop on all of the Terrorists and suspected Terrorists their hearts desire.
FISA was enacted in 1978 and updated multiple times since then to accommodate all the modern technologies Terrorists use, including cell phones and computers. It was even amended in October, 2001, when a Congress that was even more compliant than it is now gave the President every change he wanted to that law.
No need to take my word for it. Here is what the Leader himself said about FISA -- the law he is now attempting (with a drooling, eager assist from our press corps) to depict as some dangerous relic from the obsolete era of telegraphs -- once it was amended in October, 2001 by the Congress, during the ceremony where he signed those amendments into law:

The changes, effective today, will help counter a threat like no other our Nation has ever faced. . . .
We're dealing with terrorists who operate by highly sophisticated methods and technologies, some of which were not even available when our existing laws were written. The bill before me takes account of the new realities and dangers posed by modern terrorists. It will help law enforcement to identify, to dismantle, to disrupt, and to punish terrorists before they strike. . . .
Surveillance of communications is another essential tool to pursue and stop terrorists. The existing law was written in the era of rotary telephones. This new law I sign today will allow surveillance of all communications used by terrorists, including e-mails, the Internet, and cell phones. As of today, we'll be able to better meet the technological challenges posed by this proliferation of communications technology. . .

In his radio address the following week, this is the lavish praise the Commander-in-Chief heaped on the newly amended FISA law:

The bill I signed yesterday gives intelligence and law enforcement officials additional tools they need to hunt and capture and punish terrorists. Our enemies operate by highly sophisticated methods and technologies, using the latest means of communication and the new weapon of bioterrorism.
When earlier laws were written, some of these methods did not even exist. The new law recognizes the realities and dangers posed by the modern terrorist. It will help us to prosecute terrorist organizations -- and also to detect them before they strike. . . .
Surveillance of communications is another essential method of law enforcement. But for a long time, we have been working under laws written in the era of rotary telephones. Under the new law, officials may conduct court-ordered surveillance of all modern forms of communication used by terrorists.

Every President until George Bush was able to defend the nation by engaging in surveillance under FISA. That even includes the Great and Powerful Warrior Ronald Reagan, who vanquished the incomparably nefarious Soviet Union while adhering to FISA. It was only George Bush who claimed that we would All Die unless FISA was modernized, and it was modernized -- repeatedly, to his satisfaction and at his direction.
FISA and the Protect America Act both equally allow eavesdropping on the Terrorists Who Want to Kill Us. The material difference is that FISA requires warrants for eavesdropping on Americans (after the fact, if necessary) while the Protect America Act allows the President to eavesdrop on any Americans without having any oversight at all. The difference does not relate to the ability to eavesdrop on the Terrorists but on the nature and level of oversight from that eavsdropping. Moreover, the FISA Court is and always has been a rubber-stamping tribunal that does not ever block any surveillance on any suspected Terrorists.
Thus, we're not all going to die under FISA. We're not "going dark." FISA is a modern law that was re-written at George Bush's direction and which he himself said allowed for full surveillance on all of the evil Terrorists and all of their complex, super-modern means of communications. None of this has anything to do with the Government's ability to listen in When Osama Calls. It is only about whether the nation's largest telecoms will have pending lawsuits, brought by their customers for breaking the law, dismissed by Congress. Is that really so hard to understand and explain?

UPDATE: One of the tortures I endured yesterday was watching the House hearing involving Roger Clemens and the trainer who claims to have injected him with steroids. The press could not have been any more riveted and was fully knowledgable of every relevant detail. Almost every House Committee member came to the hearing thoroughly prepared, grilled the witnesses with the expertise of an experienced litigator, and thundered about the grave seriousness -- and consequences -- of lying to Congress.
The drama was high, the gravity palpable, and the interest level intense. Ponder how much better our country would be if even a fraction of all of that were conjured up for acts of chronic lawbreaking and serial lying by our highest government officials, rather than our baseball stars.
On a not unreleated note, David Broder wrote his latest paean to "bipartisanship" today and made clear what he -- and most others -- mean by that (h/t Denning):

The voters' message is getting through, not only in settling the fights for the Republican and Democratic nominations but in changing the mind-set of Washington.
The clearest evidence of the change is what happened last week on the economic stimulus bill. A week ahead of their self-imposed deadline, the House and Senate, by overwhelming votes, sent to President Bush almost exactly the kind of relief measure he had sought for the staggering economy.

In Broderian Beltway World, when Democrats join the Republicans to give the Leader "exactly" what "he has sought," that is "bipartisanship." When they refuse to carry out the Leader's instructions, that's "partisan bickering."

Current And Future Beloved Leaders' Valentine To You

And more GOP love is here.

Progress!

-- as in, Our Leaders succeed in dragging America even further down, in this case turning the clock way back on civil rights:

"Noose" incidents on the rise.

Video Of The Day

God Bless Our Wonderful Legal System!

But let me tell you about our suit with the owner of a chicken-processing plant. We are suing for his workers, under the so-called WARN Act, which requires a notice before a plant closing. In this case, the owner did not give the required sixty days' notice before he closed the plant. "But the Department of Agriculture shut me down," the owner argues. "How could I foresee that?" He argues that year, he may have done bad things, and let rats run wild, and let rats shit on the chicken meat. And yes, it is even true that the inspectors of the Department of Agriculture gave him write-ups.

But here is the issue: Was it reasonable for the owner to foresee that the Department of Agriculture would enforce its own regulations?

He had an argument: "I'm in the business, and they never enfore the law." Never. That was his claim. The Department of Agriculture is more or less a joke. Under Bush I, then Clinton, and then Bush II, it' gotten worse. "Everyone knows!" Nows comes the ruling of the district judge, who is a liberal, a Clinton appointee: Yes, he says, it was unforeseeable. It was as if he took judicial notice that as a matter of common knowledge, the government does not enforce the laws.

Case dismissed!

I'm still in shock that the employer got away with such an argument. But he had a point. We cut back on inspectors. We don't impose fines. So he had no way of knowing that the Department of Agriculture would shut him down.

In other words, the application of the Rule of Law is the equivalent of an act of God. Completely arbitrary. Like a hurricane.

Yes, we appealed. I helped edit the brief. It was not my case, but my colleague's. All I did was strike out the word "rodent" and put in the word "rat." And the word "rat" came up a lot because the plant was filthy: fill of rats and rat droppings all over the meat. The scary part was that the plant had gone on like this for years. The more we deregulate, and the more the inspectors are told not to threaten but to work in a "cooperative spirit," the more the rodents, and the rats, are free to go on dropping on our chicken wings and nuggets.

So what happened on appeal? Well, of course we argued that a judge cannot assume that it is "unforeseeable" for the laws ever to be enforced. In the United States, has the Rule of Law really come to this? Even though we got the District Court judgment reversed, we did not really win the point.

Instead, we have to go to trial. We have to have a trial to determine whether the owner of the chicken-processing plan has to believe the government when it says to him they're going to enforce the law.

Link.

Little Valentine's Day Link

Go here and just look....

A Sign Of The Forthcoming Apocalypse And Complete And Utter Collapse Of Civilization

Link.

The Truth About Canadian Healthcare?

In the universal health care debate, Canada is once again getting dragged into the fracas, shoved around by both sides as either an exemplar or a warning — and, along the way, getting coated with the obfuscating dust of so many willful misconceptions that the actual facts about How Canada Does It are completely obscured in the melee. As a health-care-card-carrying Canadian resident and an uninsured American citizen who regularly sees doctors on both sides of the border, I'm in a unique position to address the pros and cons of both systems first-hand.

2008 is shaping up to be the election year that we finally get to have the Great American Healthcare Debate again. Harry and Louise are back with a vengeance. Conservatives are rumbling around the talk show circuit bellowing about the socialist threat to the (literal) American body politic. And, as usual, Canada is once again getting dragged into the fracas, shoved around by both sides as either an exemplar or a warning -- and, along the way, getting coated with the obfuscating dust of so many willful misconceptions that the actual facts about How Canada Does It are completely lost in the melee.

I'm both a health-care-card-carrying Canadian resident and an uninsured American citizen who regularly sees doctors on both sides of the border. As such, I'm in a unique position to address the pros and cons of both systems first-hand. If we're going to have this conversation, it would be great if we could start out (for once) with actual facts, instead of ideological posturing, wishful thinking, hearsay, and random guessing about how things get done up here.

To that end, here's the first of a two-part series aimed at busting the common myths Americans routinely tell each other about Canadian health care. When the right-wing hysterics drag out these hoary old bogeymen, this time, we need to be armed and ready to blast them into straw. Because, mostly, straw is all they're made of.

1. Canada's health care system is "socialized medicine."
False. In socialized medical systems, the doctors work directly for the state. In Canada (and many other countries with universal care), doctors run their own private practices, just like they do in the US. The only difference is that every doctor deals with one insurer, instead of 150. And that insurer is the provincial government, which is accountable to the legislature and the voters if the quality of coverage is allowed to slide.

The proper term for this is "single-payer insurance." In talking to Americans about it, the better phrase is "Medicare for all."

2. Doctors are hurt financially by single-payer health care.
True and False. Doctors in Canada do make less than their US counterparts. But they also have lower overhead, and usually much better working conditions. A few reasons for this:

First, as noted, they don't have to charge higher fees to cover the salary of a full-time staffer to deal with over a hundred different insurers, all of whom are bent on denying care whenever possible. In fact, most Canadian doctors get by quite nicely with just one assistant, who cheerfully handles the phones, mail, scheduling, patient reception, stocking, filing, and billing all by herself in the course of a standard workday.

Second, they don't have to spend several hours every day on the phone cajoling insurance company bean counters into doing the right thing by their patients. My doctor in California worked a 70-hour week: 35 hours seeing patients, and another 35 hours on the phone arguing with insurance companies. My Canadian doctor, on the other hand, works a 35-hour week, period. She files her invoices online, and the vast majority are simply paid -- quietly, quickly, and without hassle. There is no runaround. There are no fights. Appointments aren't interrupted by vexing phone calls. Care is seldom denied (because everybody knows the rules). She gets her checks on time, sees her patients on schedule, takes Thursdays off, and gets home in time for dinner.

One unsurprising side effect of all this is that the doctors I see here are, to a person, more focused, more relaxed, more generous with their time, more up-to-date in their specialties, and overall much less distracted from the real work of doctoring. You don't realize how much stress the American doctor-insurer fights put on the day-to-day quality of care until you see doctors who don't operate under that stress, because they never have to fight those battles at all. Amazingly: they seem to enjoy their jobs.

Third: The average American medical student graduates $140,000 in hock. The average Canadian doctor's debt is roughly half that.

Finally, Canadian doctors pay lower malpractice insurance fees. When paying for health care constitutes a one of a family's major expenses, expectations tend to run very high. A doctor's mistake not only damages the body; it may very well throw a middle-class family permanently into the ranks of the working poor, and render the victim uninsurable for life. With so much at stake, it's no wonder people are quick to rush to court for redress.

Canadians are far less likely to sue in the first place, since they're not having to absorb devastating financial losses in addition to any physical losses when something goes awry. The cost of the damaging treatment will be covered. So will the cost of fixing it. And, no matter what happens, the victim will remain insured for life. When lawsuits do occur, the awards don't have to include coverage for future medical costs, which reduces the insurance company's liability.

3. Wait times in Canada are horrendous.
True and False again -- it depends on which province you live in, and what's wrong with you. Canada's health care system runs on federal guidelines that ensure uniform standards of care, but each territory and province administers its own program. Some provinces don't plan their facilities well enough; in those, you can have waits. Some do better. As a general rule, the farther north you live, the harder it is to get to care, simply because the doctors and hospitals are concentrated in the south. But that's just as true in any rural county in the U.S.

You can hear the bitching about it no matter where you live, though. The percentage of Canadians who'd consider giving up their beloved system consistently languishes in the single digits. A few years ago, a TV show asked Canadians to name the Greatest Canadian in history; and in a broad national consensus, they gave the honor to Tommy Douglas, the Saskatchewan premier who is considered the father of the country's health care system. (And no, it had nothing to do with the fact that he was also Kiefer Sutherland's grandfather.). In spite of that, though, grousing about health care is still unofficially Canada's third national sport after curling and hockey.

And for the country's newspapers, it's a prime watchdogging opportunity. Any little thing goes sideways at the local hospital, and it's on the front pages the next day. Those kinds of stories sell papers, because everyone is invested in that system and has a personal stake in how well it functions. The American system might benefit from this kind of constant scrutiny, because it's certainly one of the things that keeps the quality high. But it also makes people think it's far worse than it is.

Critics should be reminded that the American system is not exactly instant-on, either. When I lived in California, I had excellent insurance, and got my care through one of the best university-based systems in the nation. Yet I routinely had to wait anywhere from six to twelve weeks to get in to see a specialist. Non-emergency surgical waits could be anywhere from four weeks to four months. After two years in the BC system, I'm finding the experience to be pretty much comparable, and often better. The notable exception is MRIs, which were easy in California, but can take many months to get here. (It's the number one thing people go over the border for.) Other than that, urban Canadians get care about as fast as urban Americans do.

4. You have to wait forever to get a family doctor.
False for the vast majority of Canadians, but True for a few. Again, it all depends on where you live. I live in suburban Vancouver, and there are any number of first-rate GPs in my neighborhood who are taking new patients. If you don't have a working relationship with one, but need to see a doctor now, there are 24-hour urgent care clinics in most neighborhoods that will usually get you in and out on the minor stuff in under an hour.

It is, absolutely, harder to get to a doctor if you live out in a small town, or up in the territories. But that's just as true in the U.S. -- and in America, the government won't cover the airfare for rural folk to come down to the city for needed treatment, which all the provincial plans do.

5. You don't get to choose your own doctor.
Scurrilously False. Somebody, somewhere, is getting paid a lot of money to make this kind of stuff up. The cons love to scare the kids with stories about the government picking your doctor for you, and you don't get a choice. Be afraid! Be very afraid!

For the record: Canadians pick their own doctors, just like Americans do. And not only that: since it all pays the same, poor Canadians have exactly the same access to the country's top specialists that rich ones do.

6. Canada's care plan only covers the basics. You're still on your own for any extras, including prescription drugs. And you still have to pay for it.
True -- but not as big an issue as you might think. The province does charge a small monthly premium (ours is $108/month for a family of four) for the basic coverage. However, most people never even have to write that check: almost all employers pick up the tab for their employees' premiums as part of the standard benefits package; and the province covers it for people on public assistance or disability.

"The basics" covered by this plan include 100% of all doctor's fees, ambulance fares, tests, and everything that happens in a hospital -- in other words, the really big-ticket items that routinely drive American families into bankruptcy. In BC, it doesn't include "extras" like medical equipment, prescriptions, physical therapy or chiropractic care, dental, vision, and so on; and if you want a private or semi-private room with TV and phone, that costs extra (about what you'd pay for a room in a middling hotel). That other stuff does add up; but it's far easier to afford if you're not having to cover the big expenses, too. Furthermore: you can deduct any out-of-pocket health expenses you do have to pay off your income taxes. And, as every American knows by now, drugs aren't nearly as expensive here, either.

Filling the gap between the basics and the extras is the job of the country's remaining private health insurers. Since they're off the hook for the ruinously expensive big-ticket items that can put their own profits at risk, the insurance companies make a tidy business out of offering inexpensive policies that cover all those smaller, more predictable expenses. Top-quality add-on policies typically run in the ballpark of $75 per person in a family per month -- about $300 for a family of four -- if you're stuck buying an individual plan. Group plans are cheap enough that even small employers can afford to offer them as a routine benefit. An average working Canadian with employer-paid basic care and supplemental insurance gets free coverage equal to the best policies now only offered at a few of America's largest corporations. And that employer is probably only paying a couple hundred dollars a month to provide that benefit.

7. Canadian drugs are not the same.
More preposterious bogosity. They are exactly the same drugs, made by the same pharmaceutical companies, often in the same factories. The Canadian drug distribution system, however, has much tighter oversight; and pharmacies and pharmacists are more closely regulated. If there is a difference in Canadian drugs at all, they're actually likely to be safer.

Also: pharmacists here dispense what the doctors tell them to dispense, the first time, without moralizing. I know. It's amazing.

8. Publicly-funded programs will inevitably lead to rationed health care, particularly for the elderly.
False. And bogglingly so. The papers would have a field day if there was the barest hint that this might be true.

One of the things that constantly amazes me here is how well-cared-for the elderly and disabled you see on the streets here are. No, these people are not being thrown out on the curb. In fact, they live longer, healthier, and more productive lives because they're getting a constant level of care that ensures small things get treated before they become big problems.

The health care system also makes it easier on their caregiving adult children, who have more time to look in on Mom and take her on outings because they aren't working 60-hour weeks trying to hold onto a job that gives them insurance.

9. People won't be responsible for their own health if they're not being forced to pay for the consequences.
False. The philosophical basis of America's privatized health care system might best be characterized as medical Calvinism. It's fascinating to watch well-educated secularists who recoil at the Protestant obsession with personal virtue, prosperity as a cardinal sign of election by God, and total responsibility for one's own salvation turn into fire-eyed, moralizing True Believers when it comes to the subject of Taking Responsibility For One's Own Health.

They'll insist that health, like salvation, is entirely in our own hands. If you just have the character and self-discipline to stick to an abstemious regime of careful diet, clean living, and frequent sweat offerings to the Great Treadmill God, you'll never get sick. (Like all good theologies, there's even an unspoken promise of immortality: f you do it really really right, they imply, you might even live forever.) The virtuous Elect can be discerned by their svelte figures and low cholesterol numbers. From here, it's a short leap to the conviction that those who suffer from chronic conditions are victims of their own weaknesses, and simply getting what they deserve. Part of their punishment is being forced to pay for the expensive, heavily marketed pharmaceuticals needed to alleviate these avoidable illnesses. They can't complain. It was their own damned fault; and it's not our responsibility to pay for their sins. In fact, it's recently been suggested that they be shunned, lest they lead the virtuous into sin [1].

Of course, this is bad theology whether you're applying it to the state of one's soul or one's arteries. The fact is that bad genes, bad luck, and the ravages of age eventually take their toll on all of us -- even the most careful of us. The economics of the Canadian system reflect this very different philosophy: it's built on the belief that maintaining health is not an individual responsibility, but a collective one. Since none of us controls fate, the least we can do is be there for each other as our numbers come up.

This difference is expressed in a few different ways. First: Canadians tend to think of tending to one's health as one of your duties as a citizen. You do what's right because you don't want to take up space in the system, or put that burden on your fellow taxpayers. Second, "taking care of yourself" has a slightly expanded definition here, which includes a greater emphasis on public health. Canadians are serious about not coming to work if you're contagious, and seeing a doctor ASAP if you need to. Staying healthy includes not only diet and exercise; but also taking care to keep your germs to yourself, avoiding stress, and getting things treated while they're still small and cheap to fix.

Third, there's a somewhat larger awareness that stress leads to big-ticket illnesses -- and a somewhat lower cultural tolerance for employers who put people in high-stress situations. Nobody wants to pick up the tab for their greed. And finally, there's a generally greater acceptance on the part of both the elderly and their families that end-of-life heroics may be drawing resources away from people who might put them to better use. You can have them if you want them; but reasonable and compassionate people should be able to take the larger view.

The bottom line: When it comes to getting people to make healthy choices, appealing to their sense of the common good seems to work at least as well as Calvinist moralizing.

10. This all sounds great -- but the taxes to cover it are just unaffordable. And besides, isn't the system in bad financial shape?
False. On one hand, our annual Canadian tax bite runs about 10% higher than our U.S. taxes did. On the other, we're not paying out the equivalent of two new car payments every month to keep the family insured here. When you balance out the difference, we're actually money ahead. When you factor in the greatly increased social stability that follows when everybody's getting their necessary health care, the impact on our quality of life becomes even more signficant.

And True -- but only because this is a universal truth that we need to make our peace with. Yes, the provincial plans are always struggling. So is every single publicly-funded health care system in the world, including the VA and Medicare. There's always tension between what the users of the system want, and what the taxpayers are willing to pay. The balance of power ebbs and flows between them; but no matter where it lies at any given moment, at least one of the pair is always going to be at least somewhat unhappy.

But, as many of us know all too well, there's also constant tension between what patients want and what private insurers are willing to pay. At least when it's in government hands, we can demand some accountability. And my experience in Canada has convinced me that this accountability is what makes all the difference between the two systems.

It is true that Canada's system is not the same as the U.S. system. It's designed to deliver a somewhat different product, to a population that has somewhat different expectations. But the end result is that the vast majority of Canadians get the vast majority of what they need the vast majority of the time. It'll be a good day when when Americans can hold their heads high and proudly make that same declaration.Link.

Part II

Government-run health care is inherently less efficient -- because governments themselves are inherently less efficient.
If anything could finally put the lie to this old conservative canard, the disaster that is our health care system is Exhibit A.

America spends about 15% of its GDP on health care. Most other industrialized countries (all of whom have some form of universal care, either single-payer or entirely government-run) spend about 11-12%. Canada spends about 8-9% -- and most of the problems within their system come out of the fact that it's chronically underfunded compared to those other nations. If they spent what the UK or Germany do, those problems would mostly vanish.

Any system that has people spending more and getting less is, by definition, not efficient. And these efficiency leaks are, almost entirely, due to private greed. There is no logical way that a private system can pay eight-figure CEO compensation packages, turn a handsome a profit for shareholders, and still be "efficient." In fact, in order to deliver those profits and salaries, the American system has built up a vast, Kafkaesque administrative machinery of approval, denial, and fraud management, which inflates the US system's administrative costs to well over double that seen in other countries -- or even in our own public systems, including Medicare and the VA system.

Not incidentally: one of the benefits of single-payer health care is that it largely eliminates the entire issue of "fraud." You can only "cheat" a system that already views its primary business as rationing and withholding care. In Canada, where the system is set up to deliver health care instead of profits, and medical access is considered a right, this whole oversight machinery is far cheaper and more compact. In general, the system trusts doctors and patients to make the right choices the first time. As a result, people generally don't have to lie, cheat, and grovel to get the system to deliver the care they need. They just go and get it -- and walk out without a moment's dread about the bills.

Shareholder profit, inflated CEO salaries, and top-heavy administration -- all of which serve to work against the delivery of care, not facilitate it -- are anti-efficiencies that siphon off 20-25% of America's total health care spending. These are huge sums; yet it's mostly money down a gold-plated rathole. In the end, it doesn't provide a single bed, pay a single nurse or doctor, or treat a single patient.

We'll have rationed care
Don't look now: but America does ration care. And it does it in the most capricious, draconian, and often dishonest way possible.

Mostly, the US system rations care by simply eliminating large numbers of people from the system due to an inability to pay. Last year, one-quarter of all Americans didn't go to a doctor when they needed one because they couldn't afford it. Nearly that many skipped getting a test, treatment, prescription, or follow-up appointment recommended by a doctor. In Canada, those same numbers are in the 4-5% range; in the UK, 2-3%. Also: nearly 20% of all Americans had a hard time paying a medical bill last year; and these stresses now trigger over half of all personal bankruptcies in the country.

Furthermore, nominally having health insurance is no guarantee against financial ruin, as Sicko amply illustrated. Being cut off or denied by your insurance company is rationing, too. And there are vast numbers of fairly well-off Americans -- many of them middle-aged, and too young for Medicare -- who have pre-existing conditions that render them uninsurable at any price. They're one heart attack, one diabetic event, or one bad turn away from financial disaster. Please don't insult these people by telling them that the American system doesn't ration care.

Another persistent (and ridiculously mendacious) rationing myth about the Canadian system is that old people are cut off from treatment and left to die. I've never heard about a single case of this in Canada; but it happens routinely to Americans on Medicare and many private policies, which have strict limits on how long you can stay in the hospital with an acute illness. When the benefits run out, ready or not, they send you home. If you die, you die. The Canadian plan has no such limits: you stay for as long as you need to. But in the US, these limits fit the very definition of "rationed care."

Effectively shutting one-quarter of the population out of the medical system entirely, and putting many of the rest on short rations, certainly does make things so much nicer for those happy few who are still in it. In fact, Americans have these missing millions to thank for their system's impressively short wait times. Only 4% of American have to wait more than six months for non-elective surgeries, while 14-15% of Canadian and Britons do. (Don't blame this on government care, though: in Germany and the Netherlands, the number is closer to 2%.) When conservatives start bellowing about Canada's terrifying wait times (which, by the way, are carefully triaged: it's rare for people to die waiting, though it happens), we need to remind them that there are 75 million Americans who have been wait-listed forever. If my friend's Aunt Millie gets her emergency hip surgery today because I'm willing to hobble along for an extra couple months before getting my knee surgery -- well, for any morally serious person, that choice should be a complete no-brainer.

You can't have medical innovation without the incentives provided by the free market.
As in the US, Canada's government funds major medical research that has led to a continuous stream of new medical breakthroughs [1]. (And as this link shows, the rate of innovation didn't slow down in the least when Canada moved to single-payer in the 1960s.) All of the country's medical schools are located within public research universities. The university that houses my local medical school, the University of British Columbia, ranked ninth in North America last year -- in league with UC, Stanford, and other powerhouses -- in total public and private research grants received by its labs. Among other things, it leads the way in genetics (David Suzuki is emeritus faculty), and stem-cell research (having attracted a handsome roster of American scientists whose research was thwarted by the political situation at home).

Because the Canadian health care system is driven by delivering care instead of profits, the focus of research is sometimes different -- and often wider-ranging. While there's plenty of pursuit of patents and innovations, there's also considerable research put into questioning whether new treatments are really more effective than older ones; and in pursuing possible treatments that may not be patentable by anyone. The system is focused first on what works; and after that, on what might make someone some money.

Single-payer health care will make America less competitive.
I can't believe people still have the gall to argue this point, but apparently, they do. There are several reasons this is flat-out wrong:

Jobs, Jobs, Jobs -- It's no secret that public health care is making Canada a more attractive business environment for large manufacturers, who typically have very high insurance overhead. Toyota and GM have both moved plants to Canada in recent years, in large part to avoid the spiraling costs of insuring American workers. (Toyota also cited Canada's better-educated workers, but that's another issue for another day.) As long as $900 of every car GM makes is going to supply health care to the people who make it, the US's current system of employer-based health care is going to continue to drive skilled jobs out of the country.

A Smarter, More Entreprenurial Workforce -- Being relieved of insurance worries also makes individual citizens more competitive. How would your life choices change if you didn't have to worry about health care? Would you go back to school and get your PhD in lepidoptery? Start a blog -- or a small business? Work part-time and travel? Tell your boss where he can stick it? Spend a few years at home with your kids?

Countries with universal coverage free up their citizens to take advantage of personal development opportunities that, in the long run, stimulate the economy and create a more skilled, traveled, educated, and fulfilled workforce. Americans, on the other hand, routinely stay chained to jobs they hate -- and are forced to pass up on chances to expand their horizons and their fortunes -- because they can't afford to jeopardize their health care coverage. Our health care mess has reached a point where it jeopardizes not only our lives, but also our liberty and our ability to pursue happiness -- as well as the long-term strength of the economy as a whole.

Increased Financial and Social Capital -- When families are bankrupted by medical bills, or are thrown into poverty when a working member is disabled because they can't afford proper care, or simply break down and fall apart under the stress of debt and illness, it's not long before the country's entire social fabric begins to show the wear and tear -- along with the sense of optimism and the common good required for a democracy to function.

Part of what makes a country competitive is its own commitment to the common good. I've often been impressed by the very tangible sense of civic pride and shared effort my Canadian neighbors have in the fact that they're taking the best possible care of their own, regardless of status, age, or ethnicity. Every encounter with the medical system reminds them that they're all in this together. A medical system that routinely drives families into bankruptcy or divorce court is actively destroying, rather than adding to, the essential social capital that makes the whole society function.

No Deferred Maintenance -- Decades of foregone medical care are starting to catch up with Americans. We're seeing serious declines on many fronts: infant mortality, lifespan, cancer rates, heart disease rates, and increased diabetes. On most of the major markers of public health, America is nowhere near the top tier anymore. In some areas, there are a few small former Communist countries doing better than we are.

Business relies on healthy workers who aren't distracted by their own illness or that of a family member. America's uninsured, increasingly unhealthy workforce is in no position to compete on equal terms with the strong, healthy workers of other countries who are getting the care they deserve.

We have more important matters to tend to -- like national security and the war.
Getting everyone insured is, unequivocally, a clear matter of national security.

Our every-man-for-himself attitude toward health care is a security threat on a par with unsecured ports. In Canada, people go see the doctor if they're sick for more than a day or two. It was this easy access to early treatment, along with the much tighter public health matrix that enables doctors to share information quickly, that allowed the country's health care system to detect the 2003 SARS epidemics in Toronto and Vancouver while they were still very localized, act within hours to stop them before the disease spread any further, and track down and treat exposed people before they got too sick to be helped. In both cases, the system worked flawlessly. The epidemic was stopped within days and quashed entirely in under a month, potentially saving of millions of lives.

In the U.S., that same epidemic might easily have gone unnoticed for critical days and weeks. If the first people to get sick were among those 75 million without adequate insurance, they probably would have toughed it out a few extra days before finally dragging their half-dead carcasses into an ER somewhere. Not only would they be much farther along in the course of the disease -- and thus at greater risk of death themselves -- every one of them could have infected dozens or even hundreds of other people in the meantime, accelerating the spread of the epidemic.

Worse: America's underfunded public health system might have taken several days to piece together the whole picture of an epidemic; and perhaps another week or two might have passed before the E. Coli conservatives in charge (having thrown out the science-based management plans thoughtfully developed by the bureaucracy) cooked up some kind of half-assed ideology-driven decision about how to proceed. (It would, of course, involve spectacular amounts of lying to the public.) By that point, tens of millions could have been infected, leading to a death toll that would make 9/11 and Katrina look like minor statistical blips.

Think about superbugs and the ongoing waves of immunological imports from the world's swamps and jungles. Think about terrorists with bioweapons. And then think again about the undeniable fact that every single underinsured American is a gaping hole in the safety net that protects us all from a catastrophic epidemic. This really is one of those cases in which none of us are safe as long as even one of us is left at risk. And from a purely economic standpoint: would you want to invest in a country where there was a significant risk that an epidemic or a bio-attack, managed by incompetent officials, might force you to shut down your business at a moment's notice?

As for the war: Bush's Folly will generate upwards of half a million veterans, many of whom will require some kind of sustaining care for the rest of their lives. VA funding ebbs and flows with the national political will, and veterans often fall behind other priorities. But if they can enter the same health care system every other American depends on, then we can only forget their interests by forgetting our own as well.

I feel a lot better knowing my taxes are taking care of my fellow Canadians rather than buying bombs to drop on Iraqi towns, supporting a fully-equipped CIA gulag, or funding Baghdad pizza deliveries via Halliburton. It's hard to become a worldwide empire when you're putting half your tax revenue into hospitals and doctors, as Canada does. But, on the other hand, it's hard to insure your citizens when half your tax revenue is going to feed your war machine.

In a very real sense, America has chosen to secure its oil supply at the cost of its own citizens' health. The more we spend on the former, the less we have for the latter. And our own relative health -- both physical and economic -- is starting to show the consequences of that choice. Ultimately, all these things are connected: by making ourselves energy independent, we might not only make ourselves more secure, we'll also finally be able to invest in the kind of health care that will make us truly competitive in the world community.

The Bottom Line
In America, a lucky employee with gold-plated employer-based coverage may well get access to A-level care (though that level of coverage becoming rarer by the month, even among the professional classes). On the other hand, about 50 million under-insured Americans are barely scraping by with C or D-level care; and the nearly 50 million with no insurance at all get next to no care whatsoever. Worst of all: 18,000 Americans die every year due to lack of access to healthcare. That's one every 30 minutes, around the clock, every day of the year -- the equivalent death toll of six 9/11s every single year that passes.

In Canada, everybody gets at least B-level care, pretty consistently across the board -- and, on occasion, quite a bit better than that. You might not like those odds if you're one of the shrinking handful of Americans who's used to A-level care; but if that's not you, you'd be getting a much better deal in Canada.

The private sector has had 20 years to prove that it could deliver low-cost, quality care using those vaunted business-style efficiencies; and it has failed us utterly and completely. This fact should be the ultimate nail in the coffin of the old conservative canard that "the free market always does it better." If that was true, privatizing health care would have been the shining example that proved it once and for all. Instead, all we got was a colossally expensive national disaster that's denying full coverage to a third of the country --- and putting our health, competitiveness, financial and social capital, and national security at risk in the process. It's also devastating the aspirations of our entire middle class, which is being hollowed out by our current health policies.

A famous Hebrew prophet once advised his followers to take the log out of their own eyes before trying to remove the splinter from someone else's. As much as it hurts American pride to admit it, Canada and the rest of the industrialized world has us roundly beat on this one. Those who are so quick to criticize the Canadian system might be better off holding their fire until they've shown us they can do better. America, and the world, is waiting.

Link.