Democrats Maintain Murtha’s Seat

CNN is projecting that Democrat Mark Critz has defeated Republican Tim Burns in the battle to replace John Murtha, and the returns thus far suggest it will be a comfortable win. Early indications are that the competitive Democratic Senate primary between Joe Sestak and Arlen Specter (and the lack of a competitive primary on the Republican side) boosted Democratic turnout to Critz’s benefit. But still, this represents the third straight Republican loss in a House special election, and it comes in the exact type of swing district that Republicans need to win if they are going to take over the House in November. Expect this result to trigger a “Are Republicans Overconfident?” narrative among the political class.

Bye, Bye Arlen

The Associated Press has just called the Pennsylvania Senate primary for Joe Sestak, putting an end to Sen. Arlen Specter’s political career. It’s good to see that Specter’s craven political maneuverings have finally caught up with him. Sestak will likely present a more difficult challenge for Republican Pat Toomey in the general election (by significantly weakening the anti-incumbent argument), but it will be refreshing to watch a race that will present a clear ideological contrast. If Toomey wins the race, it will be very hard to portray it as anything other than a rejection of Obama’s agenda in a state that has trended Democrat in recent election cycles. 

Clintonian Blumenthal Digs In

In one of the most shameless political performances since the days of Bill Clinton during the Monica Lewinsky scandal, Connecticut Attorney General Richard Blumenthal just gave a press conference in which he blamed “misplaced words” for the fact that he was caught lying about having served in Vietnam.

A New York Times report published today found that on numerous occasions, Blumenthal either directly said he served in Vietnam, or phrased things in such a way as to leave his audiences with that impression — even though he received at least five deferments.

This afternoon, a defiant Blumenthal appeared at a Veterans of Foreign Wars hall to respond to the story. He was introduced by a friend who said he was a Marine Corps veteran and called the charges against Blumenthal “malicious” and “deceptive.” During his own remarks, Blumenthal emphasized that he served in the Marine reserves during the Vietnam War and said he “misspoke” about his service on a few occasions completely unintentionally.

“Unlike many of my peers, I chose to join the military and serve my country,” he said. “I am proud of my service in the United States Marine Corps.”

While he said that he usually described serving “during the Vietnam era,” he accidently misspoke in one quote when he substituted “in” for “during.”

“On a few occasions, I have misspoken about my service, and I regret that, and I take full responsibility,” he said. “But I will not allow anyone to take a few misplaced words and impugn my record of service to our country.”

When asked directly by a reporter whether he would apologize, his supporters in the room shouted “Noooooo!” and he refused. Instead, he reiterated that he “regrets” misspeaking.

This sort of lawyerly posturing created a lot of fodder for late night comics during the Clinton era, but politically speaking, it worked, and he was able to survive numerous scandals. We’ll have to see if Connecticut voters are as forgiving of Blumenthal after this laughable performance. 

Blumenthal’s Blues

Connecticut Attorney General Richard Blumenthal had been viewed as a virtual shoe-in to win the Senate seat of retiring Chris Dodd, but now the Democratic candidate finds himself on the ropes after a report in the New York Times that exposes him for lying about having served in Vietnam. What makes it more difficult for him to wiggle out of is that not just once, but on numerous occasions, Blumenthal either directly said he served in Vietnam, or phrased things in such a way as to leave the audience with that impression — even though he received at least five deferments. (I’ve posted a video of the appearance at which he explicitly claimed to have served.) It’s still early in the election cycle, so he’ll have plenty of time to dig himself out of this mess. And given that in most polls he leads all Republican candidates by 20 points or more in a very Democratic state, he has a large margin of error. My guess is that as damaging as this is, on its own, it won’t be enough to sink Blumenthal. But if Republicans are able to establish this sort of lying as being part of a larger pattern, then that’s when he’ll run into even bigger problems. Either way, it certainly reshuffled the deck in a race that was seen as a safe Democratic seat. 

For more on Blumenthal, check out Jim Antle’s piece on his record as an overzealous prosecutor and shameless self-promoter.

UPDATE: Nate Silver makes the case that the Democrats should draft a new candidate.

Harold & Kumar, Meet ObamaCare

Burger chain White Castle says that one provision in the new national health care law could cut it’s earnings in half, causing it to curtail expansion plans and slow hiring.

At issue is a measure that would slap employers with a $3,000 penalty when a worker’s contribution to health insurance premiums exceeds 9.5 percent of household income. The problem for a fast food chain such as White Castle is that many of their workers are on the lower end of the pay scale, so insurance premium payments will tend to eat up a higher percentage of a worker’s earnings, slaming them with the penalty.

 

The chain crunched the numbers, and in a statement to House Minority Leader John Boehner’s office, says:

In present form, this provision alone would lead to approximate increased costs equal to over 55% of what we earn annually in net income (based on past 4-year average). Effectively cutting our net income in half would have [a] devastating impact on the business – cutting future expansion and more job creation at least in half. Sadly, it makes it difficult to justify growing where jobs are needed most – in lower income areas.

Via Jeffrey Anderson.

How Liberal Jews Are Enabling the Second Holocaust

In the past, I’ve remarked to friends that the difference between a Jewish liberal and a Jewish conservative is that when a Jewish liberal walks out of the Holocaust Museum, he feels, “This shows why we need to have more tolerance and multiculturalism.” The Jewish conservative feels, “We should have killed a lot more Nazis, and sooner.”

I thought of this as I read Peter Beinart’s new essay, “The Failure of the American Jewish Establishment,” which argues that “liberal Zionism” is in danger unless groups such as AIPAC start to take a more critical view of Israel’s actions. Beinart, using a Frank Luntz survey of young American Jews as a jumping off point, writes:

Particularly in the younger generations, fewer and fewer American Jewish liberals are Zionists; fewer and fewer American Jewish Zionists are liberal. One reason is that the leading institutions of American Jewry have refused to foster — indeed, have actively opposed — a Zionism that challenges Israel’s behavior in the West Bank and Gaza Strip and toward its own Arab citizens. For several decades, the Jewish establishment has asked American Jews to check their liberalism at Zionism’s door, and now, to their horror, they are finding that many young Jews have checked their Zionism instead.

The problem, however, isn’t with leading Jewish organizations that defend Israel, but with liberalism. As sickening as it sounds, Jewish liberals see their fellow Jews as noble when they are victims being led helplessly into the gas chambers, but recoil at the thought of Jews who refuse to be victims, and actually take actions to defend themselves. It isn’t too different from American liberal attitudes toward criminal justice or terrorism, where morality is turned upside down and the lines between criminals and victims become blurred, and in certain cases, even reversed.

In the case of Israel, what changed over time was that Israel went from a state that exemplified Jewish victimhood (a role that Jewish liberals are comfortable with) to one in which Jews were actually in a position of power, which liberals are not comfortable with. Meanwhile, Palestinians, aided by the media, effectively exploited Jewish liberals by portraying themselves as the real victims, and Israel as the oppressors. I experienced this first hand once when I went on a Birthright Israel trip (which is a paid trip for American Jews to travel to Israel). At one point, we went to the cemetery at Mount Herzl, which is sort of Israel’s equivalent of Arlington National Cemetery, and is located by Yad Vashem, Israel’s main Holocaust Museum. While stopping at the cemetery, we were asked to offer our feelings standing in a cemetery honoring fallen Israeli soldiers, and the first American Jew who commented was this liberal girl who reflected, “All I can think about is how many Palestinian graves there are.”

Israel, right now, is surrounded by terorrist groups dedicated to the nation’s destruction. Palestinian society teaches its children to aspire to slaughter Jews much in the same fashion as the Nazis indoctrinated their young. Suicide bombers who die in the act of killing Jewish civilians are celebrated as heroes. It’s a culture that glorifies death and uses women and children as human shields to gain sympathy from the international community — and especially liberal Jews. And the terrorists are receiving aid from Iran, a radical nation that vows to wipe Israel off the map within the context of seeking a nuclear weapon.

Yet against this backdrop, all liberal Jews want to do is to pin the blame on Israel’s efforts to defend itself, and engage in the magical thinking that more Jewish concessions will create peace and security. By doing so, they are helping the enemies of the Jews who are intent on finishing the job that Hitler started. While Israel has no shortage of critics, when Jewish liberals attack Israel, it’s that much more damaging, because Israel’s enemies can say, “See, even Jews admit that Israel is the oppressor.”

While I would never suggest that Jews who happen to be politically liberal would want a second Holocaust to happen, I do think that by participating in a campaign to defang Israel and prevent it from taking the actions necessary to defend itself, that Jewish liberals are making things significantly easier for those who do want to carry out a second Holocaust.

Luckily, though, there are a lot of Jews in Israel who are determined not to let that happen.

Obama’s Rationing Man

While much of Washington is focused on President Obama’s Supreme Court pick, Republicans are gearing up for a confirmation battle over another Obama nominee who promises to put health care back in the spotlight.

At issue is Obama’s choice to head the Centers for Medicare and Medicaid Services, Donald Berwick, a Harvard professor with a self-professed love affair with Britain’s socialized health care system. In his writings and speeches, Berwick has defended government rationing and advocated centralized budget caps on health care spending.

“Cynics beware, I am romantic about the (British) National Health Service; I love it,” Berwick said in a July 2008 speech at England’s Wembley stadium. “All I need to do to rediscover the romance is to look at health care in my own country.”

While Berwick would not have the authority to impose a British health care system on the United States in one fell swoop, as head of CMS, he would be running both Medicare and Medicaid. Given that the two programs alone account for more than one out of every three dollars spent on health care in America (all government programs combined account for 47 percent), private players tend to follow CMS’s lead. Berwick himself has made this point.

“(G)overnment is an extraordinarily important player in the American health care scene, and it has inescapable duties with respect to improvement of care, or we’re not going to get improved care,” he said in a January 2005 interview with Health Affairs. “Government remains a major purchaser.â€_ So as CMS goes and as Medicaid goes, so goes the system.”

There are two basic visions for how to contain the growth of health care spending. The free market approach would give individuals control over their health care dollars, with the idea that it would encourage more shopping that will drive down costs and increase quality as has happened in every other aspect of the consumer-based economy. But the other approach, employed by nations such as Britain, is to have the government ration care to meet a global budget.

President Obama rejected the market-based approach, and sought to drastically expand insurance coverage while reducing health care costs. But according to a report by CMS’s chief actuary, the new law will actually increase health care costs. That leaves rationing of care based on a bureaucratic notion of the common good as the remaining option for containing skyrocketing spending, and it’s an outcome that Berwick himself once predicted would be necessary to achieve universal coverage.

“(T)he Holy Grail of universal coverage in the United States may remain out of reach unless, through rational collective action overriding some individual self-interest, we can reduce per capita costs,” Berwick wrote in an article for Health Affairs he co-authored in 2008.

He went on to write that, “The hallmarks of proper financial management in a systemâ€_ are government policies, purchasing contracts, or market mechanisms that lead to a cap on total spending, with strictly limited year-on-year growth targets.”

On a number of occasions, Berwick has praised Britain’s National Institute for Clinical Excellence (NICE), a body of experts that advises the government-run health care system on how to allocate medical spending based on cost-benefit analysis. Among other decisions, they have ruled against the use of cancer-treating drugs and put a dollar value on the final six months of human life.

“NICE is extremely effective and a conscientious, valuable, and — importantly — knowledge-building system,” Berwick said in an interview last June in Biotechnology Healthcare. “The fact that it’s a bogeyman in this country is a political fact, not a technical one.”

The national health care law that President Obama signed in March will greatly expand the role of CMS by adding an estimated 15 million beneficiaries to Medicaid. In addition, the law contains a number of initiatives, to be spearheaded by the Secretary of Health and Human Services in conjunction with the head of CMS, to provide incentive-based pay to doctors and hospitals based on performance. This builds on the comparative effectiveness research provision of last year’s economic stimulus package. While none of these measures will have the same sway as NICE does in Britain, taken together, they will move America in a NICE-like direction, especially with Berwick at the helm.

In 2003, Berwick signed on to an open letter in Health Affairs, called “Paying for Performance: Medicare Should Lead.” (Among his co-signers was Nancy-Ann DeParle, the current White House health care czar.) “Our recommendation-to the executive branch; to Congress; to employers and health plans; and to hospitals, physicians, nurses, and other health professionals — is that payment for performance should become a top national priority and that Medicare payments should lead in this effort, with an immediate priority for hospital care,” the letter read. It went on to say that the CMS administrator’s successors must continue to show “aggressiveness and commitment” to the cause, noting that, “A major initiative by Medicare to pay for performance can be expected to stimulate similar efforts by private payersâ€_”

The idea of paying doctors and hospitals for delivering better quality health care and of offering guidance on best practices seems benign enough. As the letter put it, “Quality is not an issue for partisanship.” The problem arises when government bureaucrats or expert panels are in the position of judging quality, performance, and best practices which get applied across a broad and diverse population.

As cardiologist Sandeep Jauhar argued in a September 2008 New York Times op-ed, pay for performance initiatives can cause unintended consequences such as doctors overprescribing certain medications that are deemed effective and carry bonuses. He also recounted how an initiative in the early 1990s to give report cards to doctors performing coronary bypass surgery prompted doctors to cherry pick patients to avoid the most severely ill cases that could jeopardize their grades.

The problem with any uniform medical guidance is that what’s good for the “average” patient may not be right for any given patient.

The irony in all of this is that Berwick, at times, has eloquently argued for what he called an “extremist” patient-centered approach to health care, in which hospitals wouldn’t restrict visiting hours or force patients to wear gowns. As he said in a speech to the American Board of Internal Medicine in 2008 of the experience of a patient at a hospital: “That’s what scares me: to be made helpless before my time, to be made ignorant when I want to know, to be made to sit when I wish to stand, to be alone when I need to hold my wife’s hand, to eat what I do not wish to eat, to be named what I do not wish to be named, to be told when I wish to be asked, to be awoken when I wish to sleep.”

Yet the term “patient-centered” is typically used by supporters of a free market approach to health care who argue for more individual choice and consumer empowerment. It’s hard to think of a health care system in the world that dehumanizes patients more than Berwick’s beloved British system.

In March 2009, a report found that up to 1,200 died as a result of “appalling standards of care” at just one hospital in Britain’s NHS. The Telegraph reported that “patients (were) left for hours in soiled bedclothes.â€_” In addition, “Patients described one ward as a ‘war zone’ and said people were often left in Stafford’s A&E (Accident and Emergency) for hours covered in blood and without pain relief, even though they had serious injuries. Others were left without food or drink, leading some to reportedly drink from vases when thirsty.”

In November, another report estimated that up to 400 patients a year died at two other hospitals, with similar conditions that included, according to the Telegraph, “lack of basic nursing skills, curtains spattered with blood on wards, mould in vital equipment and patients being left in A&E for up to ten hours.”

During the health care debate, Obama dismissed any attempt by Republicans to liken his vision to the British system. But Berwick’s nomination, which will have to be approved by the Senate, provides Republicans with ample fodder to make the connection.

On Wednesday night, Sen. Minority Leader Mitch McConnell took to the floor for a half-hour along with fellow Republican Sens. Pat Roberts and John Barrasso to rip into Berwick’s positions, in what could be seen as the opening salvo in the nomination battle.

“Many of us are alarmed by the nominee’s focus on the British health care system,” McConnell said, and criticized Berwick for “applauding a system where care is denied, delayed, or rationed.”

McConnell also suggested that Obama intentionally delayed the Berwick appointment until after the passage of the health care law, because announcing his CMS pick during the debate would have confirmed Republican charges that Democrats were intent on rationing care.

Berwick will have to first pass muster with the Finance Committee, which oversees Medicare and Medicaid. A hearing has yet to be scheduled.

Though the nomination of Elena Kagan to the Supreme Court is likely to garner more attention, the Berwick pick could produce more fireworks. In Berwick’s case,  there’s a long paper trail detailing his disturbing views on a wide range of matters relevant to the position he’s seeking.

CBO Sees $115 Billion in Added ObamaCare Costs

The Congressional Budget Office on Tuesday released  a new estimate attributing $115 billion in additional spending to the new national health care law, driving the full cost over the first decade to over $1 trillion.

But the CBO cautioned that it didn’t have enough information to project all of the additional costs.

The discrepancy between the new figures and the oft-cited $938 billion ObamaCare cost estimate comes because during the health care debate, the media only focused on the cost of the spending provisions aimed at expanding insurance coverage.

But the health care law also had all sorts of other discretionary spending costs, and implementation expenses, that were never calculated into a total figure. These include spending such as $39 billion for the Indian health improvement act; $34 billion in Federal Qualified Health Center grants; $9.1 billion in funding for the National Health Service Corps; and $5 billion to $10 billion in increased costs to the Internal Revenue service.

Add it all up, and it brings the cost of ObamaCare to $1.053 trillion from 2010 to 2019.

However, the way in which the law was drafted left the actual amount to be appropriated up in the air, merely writing “such sums as may be necessary,” which prevented the CBO from performing a full cost analysis:

For those activities, the lack of guidance in the legislation about how new activities should be conducted means that, in many cases, CBO does not have a sufficient basis for estimating what the “necessary” amounts might be over the 2010-2020 period.

H/t the Politico.

UPDATE: To clarify, the CBO earlier estimated $55 billion in discretionary costs, so this new estimate adds $60 million to that figure. However, it’s still true that discretionary spending was not included in the headline $938 billion number that deals only with the cost of expanding coverage. Therefore, combined spending easily tops $1 trillion.

Kagan and Partial Birth Abortion

In my column on Elena Kagan for the main site, I wrote:

On Monday, documents surfaced revealing that while working in the Clinton White House, Kagan advised President Clinton to support a compromise bill on banning late-term abortions. But it’s unclear whether such advice tells us anything about her personal views on the issue. 

But Life News reminds us that the measure she supported (being pushed by Tom Daschle) really wasn’t a ban on partial birth abortions because it included a health exception that was broad enough to render any ban effectively meaningless, which is why it was strongly opposed by pro-life groups at the time.