Animal Health Care Model for Homo Sapiens?

Congress is full of them. So beware. (See 1 below.)

Charles Krauthammer's article, posted previously, and the one below by a local doctor point the way. There is no need to destory what works. Adjust, correct and fix of course and then seek a practical cost sensible solution for others yes, but tearing the house down to rebuild a government health care jail smacks of control not care.(See 1a below.)

Money makes the world go round and when it runs out in Britain, their universal health care system feels the pain.

Oh to be a dog in Britain. In fact. why not model a health care plan for 'homo sapiens' after the care we give animals in our country?

Most veterinary care is excellent, vets even call to see how the 'pooch'is doing, generally vets take you on time thus, care is immediate and vets get paid virtually their entire charges. You can buy pet insurance across state lines, there is no bureaucracy to deal with just an animal loving receptionist.

Vet care has become preferable to human care - ask any pet owner! That was not always the case but then government stepped in and made care for 'homo sapiens' better and everything has since gone down the bed pan.(See 2 and 2a below.)

Legislators find the climate better outside the U.S. than when meeting with their constituents to talk turkey about health care because:

a) They can take their wives or mistresses along.

b) The scenery is better.

c) Penquins do not disrupt their trip. (See 3, 3a and 3b below.)

So politicians have come up with a solution - avoid the people they represent.

In the final analysis the simplest question to put to any Congressperson is why they are unwilling to subject themselves to the same health care program they are designing for us mortals? (See 4 below.)

Think about it. The 'messiah,' 'the music man' the 'gifted orator' was going to heal, bring the nation together, close the racial gap and move us away from the disaster GW created.

Our budget is busting, our debt is piling up, our casualties in Afghanistan are mounting, our nation's mood has even terrified Peggy Noonan who hated GW,where to
re-house already incarcerated terrorists has become an issue and we are at each other's throats over the race issue and a bottle of beer has not cooled tempers. Now Congresspersons would rather visit penguins than constituents because it is safer to travel to distant lands than go home.

All this in seven months and the best is yet to come.

Perhaps experience does count for something.

Dick



1)One afternoon a lawyer was riding in his limousine when he saw two men along the road-side eating grass.

Disturbed, he ordered his driver to stop and he got out to investigate.

He asked one man, "Why are you eating grass?"

"We don't have any money for food," the poor man replied. "We have to eat grass."

"Well, then, you can come with me to my house and I'll feed you," the lawyer said.

"But sir, I have a wife and two children with me. They are over there, under that tree."

"Bring them along," the lawyer replied.

Turning to the other poor man he stated, "You come with us, also."

The second man, in a pitiful voice, then said, "But sir, I also have a wife and SIX children with me!"

"Bring them all, as well," the lawyer answered.

They all entered the car, which was no easy task, even for a car as large as the limousine was.

Once underway, one of the poor fellows turned to the lawyer and said, "Sir, you are too kind."

"Thank you for taking all of us with you."

The lawyer replied, "Glad to do it.

"You'll really love my place.


"The grass is almost a foot high"

1a) In his letter of July 1, Dr. Richard Dent asks a very important question, "Why competition and the free market will make things better" in American medicine.

I wish to answer this question.

If the market in medicine were truly free - not presently the case - every adult citizen would be able to choose a physician without limitations imposed by government or employer. Patients would have the freedom to accept or reject the judgment and opinion of the physicians whom they consult.

A major burden of fee payment would be the patient's responsibility with insurance coverage for catastrophes. If individuals had the freedom to decide how their health care dollars were spent, I am certain waste and frivolity would be reduced significantly. Health insurance would be an individual responsibility.

One could shop the market for this kind of insurance as one shops for any other service or commodity. The role of government would be limited to licensure of health care providers and insurers. Insurers would be required by government regulation to accept all applicants, irrespective of medical history, with government supplementation of premiums charged to chronically ill persons.

The only patients "rated" for higher premiums would be those with unhealthy habits: smoking, alcohol and substance abuse, dangerous hobbies, and obesity. No one would be forced to accept a government program, to include Medicare. In other words, a free market in medicine should be no different than a free market in any other activity where goods and services are provided in exchange for money.

Do you not think this would "make things better?" It would make things better for persons who value freedom and individual responsibility. It probably would not do much for persons who would be happy to let Big Brother take charge of their lives. It would certainly deprive Big Brother of an excuse to take away our hard-earned money and give it to his cronies, using our welfare as a pretext for promoting his own agenda.



1b) Beware of Bureaucrats' Prescriptions
By Thomas Sowell

As someone who was once rushed to a hospital in the middle of the night, because of taking a medication that millions of people take every day without the slightest problem, I have a special horror of life and death medical decisions being made by bureaucrats in Washington, about patients they have never laid eyes on.

On another occasion, I was told by a doctor that I would have died if I had not gotten to him in time, after an allergic reaction to eating one of the most healthful foods around. On still another occasion, I was treated with a medication that causes many people big problems and was urged to come back to the hospital immediately if I had a really bad reaction. But I had no reaction at all, went home, felt fine and slept soundly through the night.

My point is that everybody is different. Millions of children eat peanut butter sandwiches every day but some children can die from eating peanut butter. Some vaccines and medications that save many lives can also kill some people.

Are decisions made by doctors who have treated the same patient for years to be over-ruled by bureaucrats sitting in front of computer screens in Washington, following guidelines drawn up with the idea of "bringing down the cost of medical care"?

The idea is even more absurd than the idea that you can add millions of people to a government medical care plan without increasing the costs. It is also more dangerous.

What is both dangerous and mindless is rushing a massive new medical care scheme through Congress so fast that members of Congress do not even have time to read it before voting on it. Legislation that is far less sweeping in its effects can get months of hearings before Congressional committees, followed by debates in the Senate and the House of Representatives, with all sorts of people voicing their views in the media and in letters to Congress, while ads from people on both sides of the issue appear in newspapers and on television.

If this new medical scheme is so wonderful, why can't it stand the light of day or a little time to think about it?

The obvious answer is that the administration doesn't want us to know what it is all about or else we would not go along with it. Far better to say that we can't wait, that things are just too urgent. This tactic worked with whizzing the "stimulus" package through Congress, even though the stimulus package itself has not worked.

Any serious discussion of government-run medical care would have to look at other countries where there is government-run medical care. As someone who has done some research on this for my book "Applied Economics,"
I can tell you that the actual consequences of government-controlled medical care is not a pretty picture, however inspiring the rhetoric that accompanies it.

Thirty thousand Canadians are passing up free medical care at home to go to some other country where they have to pay for it. People don't do that without a reason.

But Canadians are better off than people in some other countries with government-controlled medical care, because they have the United States right next door, in case their medical problems get too serious to rely on their own system.

But where are Americans to turn if we become like Canada? Where are we to go when we need better medical treatment than Washington bureaucrats will let us have? Mexico? The Caribbean?

Many people do not understand that it is not just a question of whether government bureaucrats will agree to pay for particular medical treatments. The same government-control mindset that decides what should and should not be paid for can also decide that the medical technology or pharmaceutical drugs that they control should not be for sale to those who are willing to pay their own money.

Right now, medications or treatments that have not been approved by the Food and Drug Administration are medications or treatments that you are not allowed to buy with your own money, no matter how desperate your medical condition, and no matter how many years these medications or treatments may have been used without dire effects in other countries.

The crucial word is not "care" but "control."



2)Care:Behind every story of shortages in the National Health Service lies a much more fundamental problem. The money is running out


There is a truth about modern healthcare that, in the politics of the day, is consistently ignored. Demand will always beat supply. A story could be written every day with the same basic message. There is never enough. The latest instance is that one in twenty NHS posts for doctors and dentists is vacant; the places are filled with exorbitantly expensive agency staff (see page 16).

With the public finances in a serious state of disrepair, we have every right to expect the debate to rise above the iteration of details. But both the main parties have pledged to protect spending on healthcare. Andy Burnham, the Health Secretary, owes his rise precisely to his emollient way with the professionals. His shadow, Andrew Lansley, seems intent on auditioning to be the Tory Frank Dobson, in which all is for the best in the best of all possible worlds.

Back in the real world, the pressure on cost is remorseless. A recent report from the King’s Fund and the Institute for Fiscal Studies (IFS) showed how the NHS cannot provide a comprehensive service on current assumptions after 2011. To freeze the budget again would require an extra £10.6 billion over the next spending review period. Some of the shortfall could, in principle, come from increased productivity, up to 7.7 per cent per annum, according to the IFS. This is an heroic assumption in a service in which, as the Office for National Statistics recently showed, productivity fell 4.3 per cent over the decade from 1997.

This immediate cyclical pressure is bad enough. It will be a major political headache for whichever Andrew inherits it. But the structural deficit in health spending is even more serious. The IFS has concluded that, even if the NHS budget is not cut in real terms over the next spending review period, funding is likely to fall short of the population’s healthcare needs by more than £30 billion.

That is because the demands we have of the service are now out of all alignment with our willingness to pay for them. There are more pensioners than there have been in any previous era and they are living to the ripe old ages at which they contract expensively treatable diseases. The innovative genius of health scientists has made more diseases treatable, usually with new drugs that are, at least initially, very expensive. It is not surprising that citizens demand all that can be done. In a public system, every citizen is sensitive to pain and insensitive to price.

At the same time, healthcare is getting less effective at preventing conditions, such as obesity and its associated links with diabetes, that are the upshot of dietary and lifestyle choices. The National Health Service has never really been that. It is more of a national illness-fixing service. The health of the nation actually has rather little to do with the NHS and that poor correlation is getting worse, to costly effect.

These are serious problems, but the solutions are not hard to enumerate, even if they are difficult to swallow. We cannot afford all that we can do so healthcare will have to be rationed further. We can do this by price, by availability or by time. Patients can be charged for some services that are currently free; some elective and non-catastrophic services may have to be excluded from the core set of NHS interventions; or people will again have to get used to waiting a long time.

The disposable income of the Britain of 2009 is vastly greater than it was in 1948. It makes no sense to pretend that fully comprehensive health provision can all be funded out of general taxation. That is not to impugn the founding idea of the NHS. On the contrary, it is the only way to protect it. The greatest danger to healthcare in Britain comes from those false friends who are still pretending that we do not need to change.

2)Man vs. Mutt: Theodore Dalrymple on who gets the better treatment, and what this means for U.S. health-care reform
By THEODORE DALRYMPLE

In the last few years, I have had the opportunity to compare the human and veterinary health services of Great Britain, and on the whole it is better to be a dog.

As a British dog, you get to choose (through an intermediary, I admit) your veterinarian. If you don’t like him, you can pick up your leash and go elsewhere, that very day if necessary. Any vet will see you straight away, there is no delay in such investigations as you may need, and treatment is immediate. There are no waiting lists for dogs, no operations postponed because something more important has come up, no appalling stories of dogs being made to wait for years because other dogs—or hamsters—come first.

The conditions in which you receive your treatment are much more pleasant than British humans have to endure. For one thing, there is no bureaucracy to be negotiated with the skill of a white-water canoeist; above all, the atmosphere is different. There is no tension, no feeling that one more patient will bring the whole system to the point of collapse, and all the staff go off with nervous breakdowns. In the waiting rooms, a perfect calm reigns; the patients’ relatives are not on the verge of hysteria, and do not suspect that the system is cheating their loved one, for economic reasons, of the treatment which he needs. The relatives are united by their concern for the welfare of each other’s loved one. They are not terrified that someone is getting more out of the system than they.

The latter is the fear that also haunts Americans, at least those Americans who think of justice as equality in actual, tangible benefits. That is the ideological driving force of health-care reform in America. Without manifest and undeniable inequalities, the whole question would generate no passion, only dull technical proposals and counterproposals, reported sporadically on the inside pages of newspapers. I have never seen an article on the way veterinary services are arranged in Britain: it is simply not a question.

Nevertheless, there is one drawback to the superior care British dogs receive by comparison with that of British humans: they have to pay for it, there and then. By contrast, British humans receive health care that is free at the point of delivery. Of course, some dogs have had the foresight to take out insurance, but others have to pay out of their savings. Nevertheless, the iron principle holds: cash on delivery.

But what, I hear social philosophers and the shade of the late John Rawls cry, of British dogs that have no savings and cannot afford insurance? What happens to them? Are not British streets littered with canines expiring from preventable and treatable diseases, as American streets are said by Europeans to be littered with the corpses of the uninsured?


Strangely, no. This is not because there are no poor dogs; there are many. The fact is, however, that there is a charitable system of veterinary services, free at the point of delivery, for poor dogs, run by the People’s Dispensary for Sick Animals, the PDSA. This is the dog’s safety net.

Honesty compels me to admit that the atmosphere in the PDSA rather resembles that in the National Health Service for British humans, and no dog would go there if he had the choice to go elsewhere. He has to wait and accept what he’s given; the attendants may be nice, or they may also be nasty, he has to take pot luck; and the other dogs who go there tend to be of a different type or breed, often of the fighting variety whose jaws once closed on, say, a human calf cannot be prised open except by decapitation. There is no denying that the PDSA is not as pleasant as private veterinary services; but even the most ferocious opponents of the National Health Service have not alleged that it fails to be better than nothing.

What is the solution to the problem of some dogs receiving so much better, or at least more pleasant, care than others? Is it not a great injustice that, through no fault of their own, some dogs are treated in Spartan conditions while others, no better or more talented than they, are pampered with all the comforts that commerce can afford?

One solution to the problem of the injustice in the treatment of dogs would be for the government to set up an equalizing fund from which money would be dispensed, when necessary, to sick dogs, purely on the basis of need rather than by their ability to pay, though contributions to the fund would be assessed strictly on ability to pay.

Of course, from the point of view of social justice as equality, it wouldn’t really matter whether the treatment meted out to dogs was good or bad, so long as it was equal. And, oddly enough, one of the things about the British National Health Service for human beings that has persuaded the British over its 60 years of existence that it is socially just is the difficulty and unpleasantness it throws in the way of patients, rich and poor alike: for equality has the connotation not only of justice, but of hardship and suffering. And, as everyone knows, it is easier to spread hardship equally than to disseminate blessings equally.

I hope I shall not be accused of undue asperity towards human nature when I suggest that the comparative efficiency and pleasantness of services for dogs by comparison with those for humans has something, indeed a great deal, to do with the exchange of money. This is not to say that it is only the commercial aspect of veterinary practice that makes it satisfactory: most vets genuinely like dogs at least as much as most doctors like people, and moreover they have a pride in professional standards that is independent of any monetary gain they might secure by maintaining them. But the fact that the money they receive might go elsewhere if they fail to satisfy surely gives a fillip to their resolve to satisfy.

And I mean no disrespect to the proper function of government when I say that government control, especially when highly centralized, can sap the will even of highly motivated people to do their best. No one, therefore, would seriously expect the condition of dogs in Britain to improve if the government took over veterinary care, and laid down what treatment dogs could and could not receive.

It might be objected, however, that Man, pace Professor Singer, is not a dog, and that therefore the veterinary analogy is not strictly a correct or relevant one. Health economics, after all, is an important and very complex science, if a somewhat dull one, indeed the most dismal branch of the dismal science. Who opens the pages of the New England Journal of Medicine to read, with a song in his heart, papers with titles such as ‘Collective Accountability for Medical Care—Toward Bundled Medicare Payments,’ or ‘Universal Coverage One Head at a Time—the Risks and Benefits of Individual Insurance Mandates’? On the whole, I’d as soon settle down to read the 110,000 pages of Medicare rules.

A few simple facts seem established, however, even in this contentious field. The United States spends a greater proportion of its gross domestic product on health care than any other advanced nation, yet the results, as measured by the health of the population overall, are mediocre. Even within the United States, there is no correlation between the amount spent on health care per capita and the actual health of the population upon which it is spent.

The explanation usually given for this is that physicians have perverse incentives: they are paid by service or procedure rather than by results. As Bernard Shaw said, if you pay a man to cut off your leg, he will.

But the same is true in France, which not only spends a lesser proportion of its GDP on health care than the U.S. but has better results, as measured by life expectancy, and is in the unusual situation of allaying most of its citizens’ anxieties about health care. However, the French government is not so happy: chronically in deficit, the health-care system can be sustained only by continued government borrowing, which is already at a dangerously high level. The French government is in the situation, uncomfortable for that of any democracy, of having to reform, and even destroy, a system that everyone likes.

Across the Channel, there is very little that can be said in favor of a health system which is the most ideologically egalitarian in the western world. It supposedly allots health care independently of the ability to pay, and solely on the basis of clinical need; but not only are differences in the health of the rich and poor in Britain among the greatest in the western world, they are as great as they were in 1948, when health care was de facto nationalized precisely to bring about equalization. There are parts of Glasgow that have almost Russian levels of premature male death. Britain’s hospitals have vastly higher rates of methicillin-resistant Staphylococcus aureus (a measurement of the cleanliness of hospitals) than those of any other European country; and survival rates from cancer and cardiovascular disease are the lowest in the western world, and lower even than among the worst-off Americans.

Even here, though, there is a slight paradox. About three quarters of people die of cardiovascular diseases and cancer, and therefore seriously inferior rates of survival ought to affect life expectancy overall. And yet Britons do not have a lower life expectancy than all other Europeans; their life expectancy is very slightly higher than that of Americans, and higher than that of Danes, for example, who might be expected to have a very superior health-care system. Certainly, I would much rather be ill in Denmark than in Britain, whatever the life expectancy statistics.

Perhaps this suggests that there is less at stake in the way health-care systems are organized and funded, at least as far as life expectancy is concerned (not an unimportant measure, after all), than is sometimes supposed. Or perhaps it suggests that the relationship of the health-care system to the actual health of people in societies numbering many millions is so complex that it is difficult to identify factors with any degree of certainty.

In the New England Journal of Medicine for July 3, 2008, we read the bald statement that ‘Medicare’s projected spending growth is unsustainable.’ But in the same journal on Jan. 24, 2008, under the title ‘The Amazing Noncollapsing U.S. Health Care System’ we had read that ‘For roughly 40 years, health care professionals, policy-makers, politicians, and the public have concurred that the system is careening towards collapse because it is indefensible and unsustainable, a study in crisis and chaos. This forecast appeared soon after Medicare and Medicaid were enacted and have never retreated. Such disquieting continuity amid changes raises an intriguing question: If the consensus was so incontestable, why has the system not already collapsed?’

The fact that collapse has not occurred in 40 years does not, of course, mean that it will not collapse tomorrow. The fact that a projection is not a prediction works in all directions: prolonged survival does not mean eternal survival, any more than a growth in the proportion of GDP devoted to health care means that, eventually, the entire GDP must be spent on health care.

Therefore I, who have no solution to my own health-care problems, let alone those of the United States, say only, beware of health-care economists bearing statistics that prove the inevitability of their own solutions. I mistrust the fact that, while those people who work for commercial companies (rightly) have to declare their interests in writing in medical journals, those who work for governmental agencies do not do so: as if government agencies had not interests of their own, and worked only for the common good.

The one kind of reform that America should avoid is one that is imposed uniformly upon the whole country, with a vast central bureaucracy. No nation in the world is more fortunate than America in its suitability for testing various possible solutions. The federal government should concern itself very little in health care arrangements, and leave it almost entirely to the states. I don’t want to provoke a new war of secession but surely this is a matter of states’ rights. All judgment, said Doctor Johnson, is comparative; and while comparisons of systems as complex as those of health care are never definitive or indisputable, it is possible to make reasonable global judgments: that the French system is better than the British or Dutch, for example. Only dictators insist they know all the answers in advance of experience. Let 100—or, in the case of the U.S., 50—flowers bloom.

Selfishly, no doubt, I continue to measure the health-care system where I live by what I want for myself and those about me.

And what I want, at least for that part of my time that I spend in England, is to be a dog. I also want, wherever I am, the Americans to go on paying for the great majority of the world’s progress in medical research and technological innovation by the preposterous expense of their system: for it is a truth universally acknowledged that American clinical research has long reigned supreme, so overall, the American health-care system must have been doing something right. The rest of the world soon adopts the progress, without the pain of having had to pay for it.

—Theodore Dalrymple is the pen name of Anthony Daniels, a British physician.

3)Lawmakers' Global-Warming Trip Hit Tourist Hot Spots: Penguins, a Rocket-Propelled Airplane (and Tax Dollars) Also Involved.
By BRODY MULLINS and T.W. FARNAM

When 10 members of Congress wanted to study climate change, they did more than just dip their toes into the subject: They went diving and snorkeling at the Great Barrier Reef. They also rode a cable car through the Australian rain forest, visited a penguin rookery and flew to the South Pole.


The 11-day trip -- with six spouses traveling along as well -- took place over New Year's 2008. Details are only now coming to light as part of a Wall Street Journal analysis piecing together the specifics of the excursion.

It's tough to calculate the travel bills racked up by members of Congress, but one thing's for sure: They use a lot of airplanes. In recent days, House of Representatives members allocated $550 million to upgrade the fleet of luxury Air Force jets used for trips like these -- even though the Defense Department says it doesn't need all the planes.

The South Pole trip, led by Rep. Brian Baird (D., Wash.), ranks among the priciest. The lawmakers reported a cost to taxpayers of $103,000.

That figure, however, doesn't include the actual flying, because the trip used the Air Force planes, not commercial carriers. Flight costs would lift the total tab to more than $500,000, based on Defense Department figures for aircraft per-hour operating costs.

Lawmakers say the trip offered them a valuable chance to learn about global warming and to monitor how federal funds are spent. "The trip we made was more valuable than 100 hearings," said Rep. Baird, its leader. "Are there members of Congress who take trips somewhat recreationally? Perhaps. Is this what this trip was about? Absolutely not."

The knowledge gained is "profoundly important to how I do this job," added Mr. Baird, who at the time headed the House Science Committee's subcommittee on research and science education.

Other legislators agree it wasn't all fun and games. "There are a lot more glamorous things to do than hang out on the South Pole," said Rep. Frank Lucas, an Oklahoma Republican who traveled as well. "I never want to wear that many clothes again."

Taxpayer-funded travel for Congress is booming. Legislators and aides reported spending about $13 million on overseas trips last year, a Journal analysis has shown, a nearly 10-fold jump since 1995.

For Mr. Baird, the trip was one of two such excursions in six months. Last summer, he went to the Galapagos Islands with several lawmakers, also to gain expertise in climate change.

Other lawmakers have taken big-ticket trips. In June 2007, Ted Stevens, then a Republican senator from Alaska, and four other senators went to the Paris Air Show, costing the government $121,000 for hotels, meals and other expenses. Information needed to estimate their flight costs wasn't available.

Mr. Stevens said the purpose was to learn more about developments in aviation. "My state is very dependent on the industry" because many cities can be reached only by air, he said.

The 10 members of Congress gathered at Andrews Air Force Base in Maryland on the morning of Dec. 29, 2007, along with several of their staff. Those who brought spouses were four Democrats (Rep. Mike Ross of Arkansas, Rep. Russ Carnahan of Missouri, Rep. Charlie Melancon of Louisiana and Rep. John Tanner of Tennessee) and two Republicans (Rep. Randy Neugebauer of Texas and Mr. Lucas of Oklahoma). Spouses must pay for their own meals, but they don't have to pay for lodging and travel.

Asked about his wife's participation, Mr. Lucas cited a busy congressional schedule that often keeps families separated, even on weekends. If spouses couldn't go along on trips abroad, "then you couldn't travel -- simple as that," he said.

A spokeswoman for Mr. Melancon said the representative's wife of 37 years, Peachy Melancon, added "insight and perspective" that "only amplified the educational benefit he gained as a lawmaker."

Representatives for the other four who brought spouses declined to comment on doing so. Lawmakers said the trip offered them a valuable chance to learn about global warming and to monitor how federal funds are spent on scientific projects.

The party boarded a C-40, the military's business-class version of a Boeing 737. It is designed to be an "office in the sky" for government leaders, according to the Air Force Web site.

The lawmakers touched down at their first destination, Christchurch, New Zealand, a few hours before sunset on New Year's Eve. Mr. Baird watched the town's fireworks at midnight, his spokesman said.

The next day, Jan. 1, 2008, preparing for their South Pole trip, the lawmakers were provided clothing for extreme cold weather, including thermal underwear, according to the National Science Foundation.


Only lawmakers and staff were allowed to visit Antarctica; spouses stayed in New Zealand. The government doesn't pay for spouses' accommodations when the lawmakers aren't present.

On Jan. 2, the lawmakers and four aides flew to McMurdo Station in Antarctica on a supply flight, about 800 miles from the South Pole. "Take your camera to dinner," the itinerary reminded the travelers, for a post-meal tour of Discovery Hut, an outpost that was the launching pad for early South Pole expeditions.

The next day, the group left for the South Pole itself aboard a C-130 Hercules making a previously scheduled supply run. The aircraft was specially equipped with takeoff-boosting rockets and also skis for use on ice runways. The lawmakers toured the South Pole Station, including its post office. "Pre-address and pre-stamp any mail you wish to send from the South Pole," the itinerary reminded them. Scientists briefed them on research projects including a $271 million telescope buried in the ice that detects elementary particles passing through the Earth.

After flying back to McMurdo, they visited a penguin rookery to see the "threats to the wildlife," said a spokeswoman for the National Science Foundation.

They also spoke with National Aeronautics and Space Administration scientists there who hope to use the South Pole's frigid and hostile environment to test inflatable moon dwellings. "Some of the most important science in the world is being done down there," Mr. Baird said.

Next stop: Australia. The group took a boat trip to the Great Barrier Reef, where lawmakers spoke with scientists about research showing its vulnerability to climate change, according to the Science Committee's report.

Mr. Baird, a certified scuba diver, said he went on two shallow reef dives with scientists. Rep. Loretta Sanchez, a California Democrat, said she preferred to snorkel. Mr. Lucas said he didn't enjoy the boat trip because he hasn't spent much time on the water. The reef is one of the world's premier diving destinations.

Later, Mr. Baird made a third reef dive at his own expense to see first-hand the damage to coral reefs caused by tourism. Mr. Baird said he wanted to see evidence of coral bleaching, which some scientists say is caused by higher levels of carbon dioxide in the atmosphere. Mr. Baird blames increased carbon levels for a decline of shellfish in the Pacific Ocean near his district.

The tab for two days in Australia was more than $50,000, according to the travel-disclosure form. According to the document, the lawmakers spent $32,000 on hotels and meals, $7,000 on transportation and $10,000 for "other purposes." As on all such oversees trips, each lawmaker gets a daily stipend of $350 for incidentals, according to the form.

Mr. Baird said the travel report for Australia was inaccurate. His spokesman didn't respond to requests for details.

The trip ended with a layover in Hawaii to refuel the Air Force plane. There, lawmakers visited troops based at Hickman Air Force Base.

On the last night of their 11-day trip, the lawmakers stayed at the Royal Hawaiian Hotel in Waikiki. The spokesman for Mr. Baird said he would have been "every bit as happy camping as staying in a hotel."

3a) A Town-Hall Protest in Maryland:The audience was loud but civil—and their anxiety over health reform was very real
By MAX SCHULZ

Mardela Springs, Md.

As he entered the auditorium of the Mardela Middle and High School on Tuesday, a surprised Frank Kratovil waded through a sea of constituents. The first-term Democratic congressman had been told by aides that maybe two or three dozen residents would attend the “Congress in Your Corner” town-hall event in this Eastern Shore town of about 360 people. Instead, more than 250 people showed up.

The crowd repeatedly burst into wild cheering, but not for Mr. Kratovil. The cheers were for residents who gave the congressman a piece of their mind over what’s happening in Washington.

Scenes such as this are occurring across the country. As congressmen return home for the August recess, many are facing a barrage of fury over proposals to create a government-run health-care program that many believe risks undermining private health insurance. Voters are also upset about runaway government spending, and a cap-and-trade bill that will lead to higher energy prices. The discontent is giving rise to a new political phenomenon: the town-hall protest.

By tradition, town-hall meetings are sedate, boring, sparsely attended affairs. Now large, hostile crowds of voters give their guy in Washington an earful about government run amok. Videos of embattled lawmakers are posted on YouTube, and the meetings are turning into events that resemble last April’s Tea Party protests. The targets are mostly Democrats in districts where a majority of voters are more conservative than Democratic leaders in Washington—many of these districts voted for John McCain or George W. Bush in recent presidential elections.

Mr. McCain won Maryland’s First Congressional District by 18 percentage points last year; Mr. Kratovil, a county prosecutor, defeated his Republican opponent by fewer than 3,000 votes out of 360,000 cast to become the first Democrat to win the seat in 18 years. He describes himself as a Blue Dog and is considered vulnerable in next year’s election.

Mr. Kratovil is an attractive, polished, likable guy, but his seeming support for President Barack Obama’s health-care proposals and his vote for cap-and-trade legislation put him out of step with many constituents. “You don’t get it,” one told him after he argued that increasing government’s role in health care would be a good thing if only Congress crafts the legislation language properly. “We don’t want it. We don’t want your help.”

The audience erupted in huge applause when a retired naval chief petty officer brought up government-run health care on Indian reservations and at Veterans Administration hospitals and then asked, “Why would we want that?” The audience booed when Mr. Kratovil said he voted for cap-and-trade because he thought it would actually lower Marylanders’ electricity rates.

The meeting was contentious, though civilized. Those at the meeting politely allowed Mr. Kratovil to make his points before responding, and the audience applauded when he noted that he voted against various spending bills, including the president’s budget. Many questioners thanked him for having the courage to show up.

That doesn’t fit the story line Democrats and many in the media are trying to peddle. Asked on Tuesday if the town-hall protests were grass-roots efforts by voters, House Speaker Nancy Pelosi told a reporter, “I think they’re Astroturf,” i.e., orchestrated by political pressure groups. In an online ad, the Democratic National Committee has called the protests “mobs” of bitter Republicans. On July 31, MSNBC’s Richard Wolffe tried to buck up spooked Democrats by claiming, “Those angry protestors who will disrupt your attempts to talk to your voters—and trust us they will—are being coordinated and coached by industry-funded right wing operatives. Their stated goal will be to rattle you, not to have an intelligent debate. And there’s a good chance they don’t even live in your district.”

The protestors can misbehave. At a town hall he hosted in the Napa Valley on Monday, California Democratic Rep. Mike Thompson watched some in the crowd of 500 people shout down panelists. A spokesman for North Carolina Democrat Rep. Brad Miller has told reporters that his boss won’t be holding town hall meetings this month after receiving a death threat.

But the discontent is neither faked nor staged by the GOP. At the Mardela Springs event I attended, the parking lot was filled with Maryland license plates, the speakers made references to local areas and events, and everyone of the several people I spoke with lived in the congressman’s district. They were just upset and worried that the reforms Democrats were bent on enacting would hurt the economy and their ability to get the health care they needed.

This crowd was probably far more representative of the national mood than Mrs. Pelosi realizes. Mardela Springs is about 100 miles from the nation’s capital, on a strip of land that sits between the Atlantic Ocean to the east and the Chesapeake Bay to the west. The district is filled with farms and is populated by farmers, mariners and retired beach bums. “We are not very political people. We are just ordinary people with ordinary concerns,” said Salisbury businessman Earl Nelson, who told me he voted for Mr. Kratovil. “But we are very concerned. I just hope he understands that.”

While playing the Christian in the lions’ den is nobody’s idea of a good time, Mr. Kratovil took his ordeal in stride. He knew that he didn’t change anyone’s mind about supporting ObamaCare or other items on the agenda in Washington, but he did gain a few grudging admirers merely for facing the onslaught. “Listening to constituents is a big part of my job,” Mr. Kratovil told me. “This is part of the democratic process.”

Of course, so are elections, and Mr. Kravotil and his colleagues face the voters again in 15 months. Just how long the anger from this summer of discontent will fester remains to be seen.

Mr. Schulz is a senior fellow at the Manhattan Institute.

3b) You Are Terrifying Us’
By PEGGY NOONAN


We have entered uncharted territory in the fight over national health care. There’s a new tone in the debate, and it’s ugly. At the moment the Democrats are looking like something they haven’t looked like in years, and that is: desperate.

They must know at this point they should not have pushed a national health-care plan. A Democratic operative the other day called it “Hillary’s revenge.” When Mrs. Clinton started losing to Barack Obama in the primaries 18 months ago, she began to give new and sharper emphasis to her health-care plan. Mr. Obama responded by talking about his health-care vision. He won. Now he would push what he had been forced to highlight: Health care would be a priority initiative. The net result is falling support for his leadership on the issue, falling personal polls, and the angry town-hall meetings that have electrified YouTube.

In his first five months in office, Mr. Obama had racked up big wins—the stimulus, children’s health insurance, House approval of cap-and-trade. But he stayed too long at the hot table. All the Democrats in Washington did. They overinterpreted the meaning of the 2008 election, and didn’t fully take into account how the great recession changed the national mood and atmosphere.

And so the shock on the faces of Congressmen who’ve faced the grillings back home. And really, their shock is the first thing you see in the videos. They had no idea how people were feeling. Their 2008 win left them thinking an election that had been shaped by anti-Bush, anti-Republican, and pro-change feeling was really a mandate without context; they thought that in the middle of a historic recession featuring horrific deficits, they could assume support for the invention of a huge new entitlement carrying huge new costs.

The passions of the protesters, on the other hand, are not a surprise. They hired a man to represent them in Washington. They give him a big office, a huge staff and the power to tell people what to do. They give him a car and a driver, sometimes a security detail, and a special pin showing he’s a congressman. And all they ask in return is that he see to their interests and not terrify them too much. Really, that’s all people ask. Expectations are very low. What the protesters are saying is, “You are terrifying us.”

What has been most unsettling is not the congressmen’s surprise but a hard new tone that emerged this week. The leftosphere and the liberal commentariat charged that the town-hall meetings weren’t authentic, the crowds were ginned up by insurance companies, lobbyists and the Republican National Committee. But you can’t get people to leave their homes and go to a meeting with a congressman (of all people) unless they are engaged to the point of passion. And what tends to agitate people most is the idea of loss—loss of money hard earned, loss of autonomy, loss of the few things that work in a great sweeping away of those that don’t.

People are not automatons. They show up only if they care.

What the town-hall meetings represent is a feeling of rebellion, an uprising against change they do not believe in. And the Democratic response has been stunningly crude and aggressive. It has been to attack. Nancy Pelosi, the speaker of the United States House of Representatives, accused the people at the meetings of “carrying swastikas and symbols like that.” (Apparently one protester held a hand-lettered sign with a “no” slash over a swastika.) But they are not Nazis, they’re Americans. Some of them looked like they’d actually spent some time fighting Nazis.

Then came the Democratic Party charge that the people at the meetings were suspiciously well-dressed, in jackets and ties from Brooks Brothers. They must be Republican rent-a-mobs. Sen. Barbara Boxer said on MSNBC’s “Hardball” that people are “storming these town-hall meetings,” that they were “well dressed,” that “this is all organized,” “all planned,” to “hurt our president.” Here she was projecting. For normal people, it’s not all about Barack Obama.

The Democratic National Committee chimed in with an incendiary Web video whose script reads, “The right wing extremist Republican base is back.” DNC communications director Brad Woodhouse issued a statement that said the Republicans “are inciting angry mobs of . . . right wing extremists” who are “not reflective of where the American people are.”

But most damagingly to political civility, and even our political tradition, was the new White House email address to which citizens are asked to report instances of “disinformation” in the health-care debate: If you receive an email or see something on the Web about health-care reform that seems “fishy,” you can send it to flag@whitehouse.gov. The White House said it was merely trying to fight “intentionally misleading” information.

Sen. John Cornyn of Texas on Wednesday wrote to the president saying he feared that citizens’ engagement could be “chilled” by the effort. He’s right, it could. He also accused the White House of compiling an “enemies list.” If so, they’re being awfully public about it, but as Byron York at the Washington Examiner pointed, the emails collected could become a “dissident database.”

All of this is unnecessarily and unhelpfully divisive and provocative. They are mocking and menacing concerned citizens. This only makes a hot situation hotter. Is this what the president wants? It couldn’t be. But then in an odd way he sometimes seems not to have fully absorbed the awesome stature of his office. You really, if you’re president, can’t call an individual American stupid, if for no other reason than that you’re too big. You cannot allow your allies to call people protesting a health-care plan “extremists” and “right wing,” or bought, or Nazi-like, either. They’re citizens. They’re concerned. They deserve respect.

The Democrats should not be attacking, they should be attempting to persuade, to argue for their case. After all, they have the big mic. Which is what the presidency is, the big mic.

And frankly they ought to think about backing off. The president should call in his troops and his Congress and announce a rethinking. There are too many different bills, they’re all a thousand pages long, no one has time to read them, no one knows what’s going to be in the final one, the public is agitated, the nation’s in crisis, the timing is wrong, we’ll turn to it again—but not now. We’ll take a little longer, ponder every aspect, and make clear every complication.

You know what would happen if he did this? His numbers would go up. Even Congress’s would. Because they’d look responsive, deliberative and even wise. Discretion is the better part of valor.

Absent that, and let’s assume that won’t happen, the health-care protesters have to make sure they don’t get too hot, or get out of hand. They haven’t so far, they’ve been burly and full of debate, with plenty of booing. This is democracy’s great barbaric yawp. But every day the meetings seem just a little angrier, and people who are afraid—who have been made afraid, and left to be afraid—can get swept up. As this column is written, there comes word that John Sweeney of the AFL-CIO has announced he’ll be sending in union members to the meetings to counter health care’s critics.

Somehow that doesn’t sound like a peace initiative.

It’s going to be a long August, isn’t it? Let’s hope the uncharted territory we’re in doesn’t turn dark.


4) Lawmakers Rethink Town Halls
By JANET ADAMY and NAFTALI BENDAVID


The health-care debate was supposed to play out at rallies and inside gymnasiums when lawmakers headed home for the August recess.

But after a series of contentious town-hall meetings, some Democratic lawmakers are thinking twice about holding large public gatherings. Instead, they are opting for smaller sessions, holding meetings by phone or inviting constituents for one-on-one office hours.

Democrats have accused Republicans of manufacturing the opposition by organizing groups to attend the events and encouraging disruptive behavior. Republican organizers say the unrest reflects genuine anger about the proposed health-care changes.

Dan Thompson of Canton, Mich., center, speaks out against health-care reform and yells at others during Democratic Rep. John Dingell's town-hall meeting in Romulus, Mich. this week. Contentious meetings across the country are forcing lawmakers to scale back gatherings to discuss the issue.

Lawmakers Opt For Smaller Health Care Meetings1:18Many lawmakers are now opting for smaller, more intimate meetings to hear from their constituents on issues such as health care, instead of town-hall meetings that have left them open to heckling and other distractions, health care reporter Janet Adamy discusses.

"Democrats may think that attacking or ignoring this growing chorus of Americans is a smart strategy, but they are obviously forgetting that these concerned citizens are voters as well," said Paul Lindsay, a spokesman for the National Republican Congressional Committee, the House GOP's campaign arm.

Rick Scott, who leads Conservatives for Patients' Rights, a group that has helped publicize the local meetings, said: "The polls reveal the real picture of what is happening across the country -- people are genuinely concerned, some are genuinely angry, and they are expressing themselves."

The Senate on Friday headed home for a monthlong break after progress stalled on passing sweeping health-care legislation. House members, whose break started a week ago, have been hit with a flood of inquiries about the legislation since they arrived home.

Rep. Ann Kirkpatrick (D., Ariz.) on Thursday canceled her public schedule for the day after a "Chat with Ann" session at a Safeway grocery store in Holbrook, Ariz., turned rowdy.

A video of the meeting showed a woman shouting, "You don't appreciate our frustration!" Ms. Kirkpatrick cut the session short after 15 minutes and headed to her car, trailed by a jeer of "What a nitwit!"

Rep. Tim Bishop (D., N.Y.) stopped holding town-hall meetings after a June event. Footage of the meeting showed participants screaming questions at Mr. Bishop, then repeatedly shouting him down when he tried to respond. At times, Mr. Bishop would begin to respond to a question and a participant would yell, "Answer the question!" At one point Mr. Bishop yelled back, "I'm trying to!"

Police were summoned as several dozen protesters followed Mr. Bishop to his car. Now Mr. Bishop, who has held 100 town-hall meetings during his tenure, has just one scheduled for the August recess, and his office is wrestling with how to ensure it will be civil and orderly.

"I'm seeing the same clips everyone else is of these meetings that are turning into near-riots," said Jon Schneider, Mr. Bishop's district director. "Obviously we don't want that to happen." He added that the congressman is talking to voters in other ways.

Rep. Brian Baird (D., Wash.) also said the raucous nature of recent meetings about health care caused him to steer away from the events, if only because they aren't productive when so many people are shouting.

"I'm not a coward, but neither am I a fool," said Mr. Baird. "There is a real concern right now about this nationwide campaign of intimidation and disruption that I think is troubling," he said. "It's getting dangerous."

Several lawmakers said they aren't canceling large, public events that have already been planned.

Some Democrats who have seen the sharpest attacks say that has made them more determined not to back away from public meetings. Rep. Lloyd Doggett (D., Texas), who was recently heckled over health care at a supermarket, said he would attend a veterans-center opening, a community-health event and a meeting with Austin public school teachers in coming days.

"The apparent focus was to kind of create this impression that you could run me [and] supporters of this out of Dodge," he said. "That's not what is going to happen."