We've been rather kind to Senator Charles (Chuck) Grassley in the past. Yes, he's a right wing Republican with some really odious ideas, ideas for which he deserves to be criticized. But he's also been a champion of the Federal False Claims Act which has encouraged and protected whistleblowers to reveal how corporations have taken the taxpayer for a ride, something for which he deserves credit. Lately he has been on a tear about the ways Big Pharma has been buying influence with high profile medical professionals, with the direct implication that this has skewed their practice, their research and their publications (example here), if not resulted in outright falsification and fraud. He may be right in a number of these cases. His method is to publicize that academic researchers publishing on particular drugs or medical devices also receive undisclosed or unpublicized consultant fees or grants from the companies whose drugs or devices they publish favorable research about. We agree with him this is a conflict of interest. It's not illegal but it does violate ethical principles. And for Chuck Grassley, the principle is the main issue.
Or so he said last night on PBS's NewsHour. So it is with regret that we have to call out Senator Grassley as an unprincipled, corrupt and duplicitous self-righteous charlatan. Did we forget "deranged and stupid sounding?" Grassley is the ranking Republican member (most seniority) of the Senate Finance Committee, who with Committee Chair Max Baucus ("Democrat", MT) is working his little tail off to gut the attempt to bring private health insurers to heel and prevent their continued profiteering at the expense of the old and sick and just about everyone except for Senator Grassley and his colleagues who have excellent government run health care. I guess Chuck wants to keep that privilege for himself while publicly claiming it isn't worth a farthing (so why doesn't he give it up?). Take this piece of nonsense about his colleague, Ted Kennedy, who suffers from a brain tumor:
[E]arlier today during a radio interview with Iowa City’s KCJJ, Grassley steered the conversation with a caller toward rationing health care services among the elderly, one of the right wing’s favorite fearmongering tactics when it comes to health care reform. And as an example, Grassley cited Sen. Ted Kennedy’s (D-MA) brain tumor. Grassley said that in countries with government-run health care, Kennedy "would not get the care he gets here because of his age." Instead, the government would decide to spend health care resources on younger people "who can contribute to the economy":
GRASSLEY: In countries that have government-run health care, just to give you an example, I’ve been told that the brain tumor that Sen. Kennedy has — because he’s 77 years old — would not be treated the way it’s treated in the United States. In other words, he would not get the care he gets here because of his age. In other words, they’d say ‘well he doesn’t have long to live even if he lived another four to five years.’ They’d say ‘well, we gotta spend money on people who can contribute more to economy.’ It’s a little like people saying when somebody gets to be 85 their life is worth less than when they were 35 and you pull the tubes on them. (mcjoan, dKos)
Outside of the fact that what Grassley says is a lie and that both he and Kennedy actually have a government run health plan, Grassley has been going around claiming any competition from public health insurance would automatically lead to a government take-over of health care and put bureaucrats between patients and doctors. First, I wish he were right about the public option automatically leading to a single payer Canadian type system. It won't. That's too bad, because if you ask most Canadians they wouldn't trade their system for ours. If a public option emerges at all after Senators Grassley and Baucus are through neutering it, it will be one that will help make private insurers rich by allowing them to dump all the high risk patients on the public plan and skim the cream from the rest. Just like they are doing now. That will wipe out the savings of the public plan and make private insurance all the more profitable. At least many more people will be covered that have no coverage now, although at a much greater cost than necessary.
This is all typical right wing, pro insurance industry crapola, but it's not the main reason Grassley is a corrupt unprincipled hypocrite. The main reason can be summed up with this; What's sauce for the goose is sauce for the gander:
As the debate over health care reform legislation has heated up over the spring and summer months, the Senate Finance Committee has found itself at the center of the debate. Leading this debate has been the duo of Max Baucus, committee chair, and Chuck Grassley, committee ranking member. According to campaign finance records filed with the FEC, the duo raised $219,000 from health and insurance political action committees (PACs) from April to June of this year.
The majority of that money was raised by Sen. Grassley, who is up for reelection in 2010 and could face a Republican primary battle. During the height of the debate over health care, Grassley pulled in $165,100 from health and insurance PACs. At the same time, Grassley’s language turned from the cautious but open words about reform in 2008 to the abrasive Twitter rants of 2009.
[snip]
The majority of the money to the two senators comes from health professionals and pharmaceutical companies. The biggest contributors include Aetna, American Academy of Family Physicians, National Health Underwriters and Healthsouth Corporation. (Paul Blumenthal, Sunlight Foundation)
So Chuck Grassley needs money and has changed his tune from a moderate right winger to a wingnut whackjob, coinciding with getting a lot of money from the health insurance industry. That looks corrupt, on its face. From the hypocrisy angle it's just as bad. Because Grassley not only opines publicly on the subject (see below) but when he does he never discloses he's taking millions ($2.7 million, give or take a few hundred thousand) from the people who will benefit from legislation he is shaping. Like the medical professionals he so self-righteously criticizes it's not illegal. But it sure smells bad. Too bad there's no Chuck Grassley in the Senate to stick it to Chuck Grassley.
Grassley is a Republican in a State (Iowa) where his party has been taken over by a radical fringe group of "birthers" (Obama was born in Kenya) and "deathers" (health reform means euthanasia for the elderly). Instead of being governed by principle, he is being governed by fear of the crazies in his own party:
Petrified of a challenge from radical right extremists back home, Grassley has moved further and further right over the last year. Once considered a mainstream conservative who could usually be counted on to put America first and not his party's crazy power struggles and obstructionist strategies, he was widely expected to join other mainstream conservatives like his old friends Dick Lugar (R-IN) and Lamar Alexander (R-TN) in voting to confirm Sonia Sotomayor to the Supreme Court. Instead he ran for the microphones to pledge allegiance to a bizarre Rush Limbaugh/Ann Coulter/Glenn Beck brand of Republicanism. His last term is widely viewed in Iowa as an almost complete failure and if the Democrats field a strong challenger in 2010, it's by no means a guarantee that Grassley will get another term.
Let's hope Grassley is indeed finished in 2010. We've had enough of corrupt politicians on the take. Did we forget "deranged and stupid sounding"?
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I agree Kennedy would likely be dead by now in the UK or other socialist countries if he was a regular Joe and not rich or a member of parliament. Although it sounds harsh we all know what he is going to die from--Brain cancer--and nothing is going to cure his cancer--it is just a matter of time. The main question is: is it quality time or is it just quantity of time that is important in human life? For Kennedy I believe he is still active and participates in life so keeping him alive is justified. On the other hand I believe that we keep too many people alive who should be left to letting nature takes it's course. This is neither cruel or heartless--it is reality that I live everyday at work. I personally think it is creul to keep someone alive who stays in bed 23 hrs of the day, wearing a diaper and doesnt know there name from Adam. These folks show up all the time to the ER for dehydration, UTI etc and get admitted 10-25 times a year. Is this justified use of public money? Are they enjoying life or is the refusal of making them a DNH (do not hospitalize) a function of a maladjusted family with unrealistic expectations and perhaps a little guilt sprinkled on top?
I agree Kennedy would likely be dead by now in the UK or other socialist countries if he was a regular Joe and not rich or a member of parliament.
You believe this based on WHAT???
Sir, if you have the slightest shred of evidence for such a thing occurring in the UK, Australia, or any wealthy industrialised nation (ALL of which (apart from the US) are "socialist" if using UHC is the criteria), I guarantee you will spark a massive scandal that would bring down governments.
Please, share.
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And it might be a touch hypocritical for me of all people to criticise typos (my fingers are possessed by the souls of a thousand poets, so I don't have time to spellcheck), but I find it hard to believe that an ER doc misuses "it's" and "there / their" or writes a trainwreck like "who should be left to letting nature takes it's course".
Yeah, picking on typos is pretty lame, but you're claiming a level of expertise here that such typos might call into question (I, for example, am carefully silent on my area of expertise, if any, and rely on my (poorly written) arguments to stand on their own merits), so I think it's valid.
...if I'm wrong, I apologise. Maybe stardards are lower in your part of the world...
To be fair, BostonERDoc makes a good point. Our current system does not do a good job of ensuring quality of life, especially for persons whose lives are painfully prolonged.
Would it be fair to allocate some care based upon DALYs or similar measures?
(Side note: Thank you for the enlightening posts, Revere - I've been following for quite a while, and this is a superb blog.)
(I'd like to give a quick apology for being so uncivil on Effect Measure yesterday. Must have had the decaf mistake).
Magpie: Apologies are not required here. Argument can be sharp and at times snarky, but at least we hope sticks to the subject. We are very lenient and there have been times when people have not acted in the most gracious or gentle way (that includes us), but it's the internet. We have banned people but usually for behavior that is disruptive, troll-like or otherwise not meant to advance the conversation on a consistent basis. Usually they are warned and it is very rare. In our view, you haven't gotten anywhere near that and we had no concern about anything you said here.
I have to agree that those Congressrats (both houses) who decry Publicly Financed Healthcare should start by giving up theirs. Then, they could drop their yearly salaries to the National median, $32388.97 (May 2008 National Occupational Employment and Wage Estimates http://www.bls.gov/oes/2008/may/oes_nat.htm#b00-0000 ) from their current $174000, and then let them pay Blue Cross $504 a month (based my demographics, male, 59, non-smoker and 20 lbs overweight and Chuck Grassley's office address. https://www.ehealthinsurance.com/ehi/Quote.fs;jsessionid=BB577D2E803841… ) This gets you a HMO with no deductable, no co-insurance (co-pay) and a $25 office visit charge (but the insurance company gets to pick your doctor and what they will cover.) If you want to pick your physician and what they will cover (sort of) you need a PPO, which only costs $476 a month, but includes a $750 deductible, a 20% co-pay and $25 per office visit. Of course, this only covers Grassley, not his wife and kids. (I forget, is he the one with the special needs kid? No insurance for him at any price...) Take his $5712 out of his $32389 and he's got nearly $27K to pay his rent (average in D.C. is $1100 a month for a one bedroom flat http://www.rent.com/rentals/washington-dc/ ), leaving him nearly $13500 for utilities and groceries with lots left over for a little single malt scotch.
Thanks Revere - I know it wasn't beyond Effect Measure tolerances (something I appreciate), but that chunk about doubting ERDoc's credentials was one I highlighted to delete before posting, but went ahead with anyway. I meant what I said, but feel a bit embarrassed for posting it.
...and then I ruined the effect of my apology anyway by going to the Turbulence thread with the intention of copy-pasting, but instead read stuff that lead me on more of a screed - one which, again, I meant, but will make people feel bad and achieve nothing at all.
Oh well. Magpie's ongoing quest to achieve tranquility continues.
I watched a segment of the Lehrer Report in which Judy Woodruff pretended to interview Grassley on health care reform. I say pretended because her questions were simply inane and Grassley was allowed to hold forth about 'principles' and 'values', etc etc etc. She didn't raise any questions about his move to the right, the effect of a rightwing challenger in the upcoming primary, the need to fundraise, none of that got mentioned. So Grassley was free to sound as though he were trying hard to work for comity with Baucus on something they were calling a public option. He did not have to provide any solid details about this option.
I'm just saying, here, that the media has been extremely deficient in covering this issue. They haven't even been decent in covering the politics of the issue.
I am always amazed that the media just doesn't go get the facts about coverage in other countries. Instead, they trot out all the rightwing charges about 'socialized' medicine and then ...nothin'. But hey! Why should I expect them to find out about other countries' systems when they can't even be bothered to find out about the realities of Medicare and Medicaid? Let alone for-profit insurance.
VassarLiberal writes: Would it be fair to allocate some care based upon DALYs or similar measures?
Cost-effectiveness studies estimate cost/QALY for various treatments/interventions, but the real issue here is that (a) many of these are ignored, and (b) for someone who has just a few months, maybe a year to live, the CE numbers always look bad. So if you use CE for end-of-life issues, you aren't going to get very far. Palliative care may be a better way to go here, but when I have a few weeks left to go I'll tell you if it's a good idea.
Sen Grassley is now getting written up in the British newspapers, as we get the impression from what he says that our National Health Service (NHS) is his worse nightmare.
Not, of course, that there is any chance of anything like the NHS in the US. But we obviously make a good scare.
Europeans actually tend to find the myths about our healthcare systems that get waved about in the US pretty funny. Germany has an insurance system with multiple providers which resembles the US rather more than it does the UK, but I get the impression no-one in the States ever gets told this.
BTW, the only people in Britain who would swap our health system for a mainly private provider US-like one are: (i) the very rich; (ii) the small minority of doctors who do only or mainly private (i.e. for direct fee) medicine; (iii) some of the more rabid free-marketeers in our Tory party; and (iv) various large multinational / US insurers and healthcare companies who are eyeing the UK market hungrily now that they have screwed almost every last possible cent out of the US set-up.
It will come as no surprise, I guess, that at least groups (ii) (iii) and (iv) have a lot of overlap, in the Venn diagram sense.