Would Be Nice If He Knew What He Was Doing !

Caroline Glick believes Obama needs some hearing aids. (See 1 below.)

The Supreme Court will protect prisoner rights and will ensure they receive humane treatment. Thus, this is not a bad 'tongue in cheek idea.' (See 2 below.)

Dismayed Obama supporter? (See 3 below.)

OOOPS! (See 4 below.)

The Guardian's take on Obama's health care policies reveals a lot about England's failure to control its own corporate power. (See 5 below.)

It might help matters if Obama understood something about the practice of medicine.

It would be even better if Obama knew what he was doing about most everything. (See 6 below)

Mark Steyn discusses immigration. (See 7 below.)

Porky Pig and his relatives dominate Congressional spending - earmarks, a runaway train. (See 8 below.)

Blue Dogs are being chased by both sides but Obama will get a health care bill, the camel's nose will get under the tent and government will eventually intrude itself into our nation's health care system even more than it already is and as it has done in education, safety and every aspect of our way of life. Only a matter of time. The results will also be the same - degradation at an increased cost and failure! (See 9 below.)

Parody sent by a discouraged friend, practicing doctor and fellow memo reader.

The 23rd Psalm updated. (See 10 below.)

Dick


1) Gazan and West Bank ‘leaders’ come clean, but Obama is still playing deaf
By Caroline B. Glick



A central pillar of the Obama administration's Middle East policy paradigm was shattered at the Fatah conference in Bethlehem — but don't expect the White House to notice.

At the conference, Fatah's supposedly feuding old guard and young guard were united in their refusal to reach an accommodation with Israel. Both old and young endorsed the use of terrorism against Israel. Both embraced the Aksa Martyrs Brigade terror group as a full-fledged Fatah organization.

Both demanded that all Jews be expelled from Judea, Samaria and Jerusalem ahead of the establishment of a Jew-free Palestinian state.

Both claimed that any settlement with Israel be preceded by an Israeli withdrawal to the indefensible 1949 armistice lines and by Israel's destruction as a Jewish state through its acceptance of millions of foreign-born hostile Arabs as immigrants within its truncated borders.

Both demanded that all terrorists be released from Israeli prisons as a precondition for "peace" talks with Israel.

Both accused Israel of murdering Yassir Arafat.

Both approved building a strategic alliance with Iran.

In staking out these extremist positions, both Fatah's old guard and its younger generation of leaders demonstrated that Fatah's goal today is the same as it has been since the its founding in 1959: Liberating Palestine (from the river to the sea) by wiping Israel off the map.

Fatah leader Mahmoud Abbas's decision to remove both his own mask and that of his organization should cause the Netanyahu government to reassess its current policies towards the group. For the past four months, Prime Minister Binyamin Netanyahu and his government have quietly barred all Jewish construction in eastern, northern and southern Jerusalem neighborhoods as well as in Judea and Samaria. The government's unofficial policy has been implemented in the hopes of pleasing the Obama administration which argues that by barring Jewish building, Israel will encourage the Fatah-controlled Palestinian Authority to moderate its policies and so engender an atmosphere conducive to a peaceful settlement of the Palestinian conflict with Israel. The Fatah conference put paid that fiction.

Fatah's message to the Netanyahu government is important. But even more important is the message it conveys to the Obama administration. For Netanyahu, the Fatah gathering bore out his prior assessment that the group is a wolf in sheep's clothing. For US President Barack Obama, the message of the Fatah conclave was that his administration's assumptions not only about Fatah, but about terrorists and terror-supporting regimes in general are completely wrong.

For the Obama administration Fatah was supposed to be the poster child for moderate terrorists. Fatah was supposed to be the prototype of the noble terrorist organization that really just wants respect. It was supposed to be the group that proved the central contention of the Obama White House's strategy for dealing with terror, namely, that all terrorists want is to be appeased.

But over the past week in Bethlehem Fatah's leaders said they will not be appeased. To the international community whose billions of dollars in aid money and boundless good will and political support they have pocketed over the past decade and a half they sent a clear message. They remain an implacable terror group devoted to the physical annihilation of Israel.

Unfortunately, the Obama administration is already making clear that it is incapable of accepting this basic truth. As Abbas and his cronies were exposing their true nature in Bethlehem, Obama's counterterrorism advisor John Brennan was giving a speech in Washington where he demonstrated the administration's ideological inflexibility.

Speaking before the Center for Strategic and International Studies last Thursday, Brennan declared that appeasing terrorists and terror supporting regimes and societies by bowing to their political demands is the central plank of the administration's counterterror strategy. As he put it, "Even as we condemn and oppose the illegitimate tactics used by terrorists, we need to acknowledge and address the legitimate needs and grievances of ordinary people those terrorists claim to represent."

To this end, Brennan stressed that for the Obama administration, the now-discredited Fatah model of conferring political legitimacy and funding on terrorists in a bid to transform them into good citizens must be implemented for every terror group in the world except al Qaida. In furtherance of this goal, the US government will no longer refer to America's fight against terror a "war on terror" and it will no longer refer to the enemy it fights as "jihadists" or the cause for which these "violent extremists" fight a "jihad."

As Brennan explained it, referring to terrorists as terrorists is unacceptable because doing so sets the US against terror supporting regimes that the Obama administration believes are all amenable to appeasement. And referring to Islamic terrorists as jihadists gives the jihadists the "right" to define what jihad is. Since the Obama administration perceives itself as a greater authority on Islamic law and tradition than the likes of Osama bin Laden, Ayman Zawahiri, Ayatollah Khomeini, Khaled Mashal and their fellow jihadists worldwide, Brennan unhesitatingly asserted that "'Jihad'… means to purify oneself or to wage a holy struggle for a moral goal."

Building on the false Fatah model of appeasable terrorists, Brennan indicated that the Obama administration believes that Hizbullah is well on its way to becoming a respectable political actor. As he sees it, simply by participating in Lebanon's political process, the Iranian proxy has earned the right to be viewed as a legitimate political force. Brennan cited the fact that in addition to active terrorist elements, Hizbullah members today include "members of parliament, in the cabinet; [and] there are lawyers, doctors, others who are part of the Hizbullah organization" as a reason to celebrate the group. He further claimed that Hizbullah members who are not actively involved in terrorism "are in fact renouncing that type of terrorism and violence and are trying to participate in the political process in a very legitimate fashion."

As the Jerusalem Post's Barry Rubin argued, Brennan's assessment of Hizbullah is not merely factually wrong. It also exposes a deep misunderstanding of why Hizbullah entered the Lebanese political fray — and why Hamas entered the Palestinian political fray — in the first place. Brennan's analysis is factually wrong because at no point has any Hizbullah member ever condemned or in any way criticized its paramilitary or terror cadres. To the contrary, Hizbullah's non-military personnel have gone on record repeatedly praising their terror brethren and have expressed disappointment that they are not among the movement's fighters.

Like Hamas — which Brennan in the past has expressed support for recognizing — Hizbullah entered Lebanese politics with the intention of taking over the country. It wishes to control Lebanon both to protect its military forces, and to advance its jihadist aim of spreading the Iranian revolution and destroying Israel. Like Hamas, Hizbullah's political empowerment has not moderated it. It has strengthened its military arm and made it politically impossible for its domestic rivals to oppose its war against Israel, its ties to Iran and Syria and its independent military force.

Unfortunately, as Brennan made clear last Thursday, the Obama administration is intellectually wed to the notion that terrorists like Hassan Nasrallah, and terror supporting regimes like Bashar Assad's Syria and his overlords in Iran just want to be accepted by the West. They cannot accept any evidence to the contrary.

This week the Obama administration dispatched senior military officials to Damascus for yet another round of friendly talks with the Iranian satellite. According to media citations of Pentagon and State Department officials, the administration is looking to cut a deal where in exchange for Syrian agreement to curtail its support for jihadists in Iraq, the US will put pressure on Israel to surrender the Golan Heights to Syria.

As for Iran, the administration has officially given the mullahs until next month to decide whether they are interested in negotiating a deal with the US regarding their nuclear program. Although Secretary of State Hillary Clinton and her colleagues in the administration are beginning to acknowledge that Iran will not meet their deadline, the administration has no Plan B.

The White House continues to oppose placing additional sanctions on Iran. State Department officials said this week that they fear that additional sanctions — including widely supported Congressional bills that would limit refined petroleum imports to Iran — would cause the Iranian public to rally around the regime. The fact that the Iranian public is in large part now begging Western countries to reject the legitimacy of the regime has made no impact on the Obama administration. Indeed, top US officials are unanimous in their willingness to accept Mahmoud Ahmadinejad as the legitimate president of Iran. Appeasement remains the only option the administration is willing to consider.

The Obama administration's unswerving efforts to accommodate terrorists and terror supporting regimes wherever they are to be found demonstrates that for the administration, appeasement is not a tactic for achieving US policy aims. Appeasing terrorists and regimes that support them is the aim of US policy.

All of this makes clear that in spite of its reasonable desire to reach a deal with the Obama White House, the Netanyahu government must abandon any plans to do so. The Jerusalem Post reported this week that the government is now negotiating a six-month extension of its unofficial ban on Jewish construction in Jerusalem, Judea and Samaria with US officials. These negotiations must be ended immediately. Indeed, the proper response to the Fatah conference is for the government to announce that it is approving all building requests it has held up for the past four months. It should also declare that from now on it will treat all requests for building permits in Judea and Samaria and Jerusalem in the same manner that it treats such requests from everywhere else in the country.

The Obama administration's devotion to appeasement shows that even if it wished to reward Israel in some way for going along with a construction freeze, it has nothing to offer. The only play in its game book is further concessions to terrorists and regimes that sponsor them. A settlement freeze will lead to a demand to accept a Lebanese "unity" government where Hizbullah reigns supreme, or a Palestinian "unity" government that paves the way for Hamas's international legitimization. An Israeli willingness to discriminate against Jews in Jerusalem will lead to a further demand that Israel cede the Golan Heights to Damascus, and accept Iran as a nuclear power.

For the Obama administration there is but one way of looking at terrorists: Just as Fatah can be appeased, so the mullahs can be accommodated.

Fatah's message that it will not be appeased is a message the Obama administration will never receive.

2)The Perfect Solution to Senior Health Care: Pass the ammunition Sr. healthcare.


While discussing the upcoming Universal Health Care Program with my sister-in-law the
other day, I think we have found the solution. I am sure you have heard the ideas
that if you’re a senior you need to suck it up and give up the idea that you need any
health care. A new hip? Unheard of. We simply can’t afford to take care of you
anymore. You don’t need any medications for your high blood pressure, diabetes,
heart problems, etc. Let’s take care of the young people. After all, they will be ruling the world very soon.

So here is the solution. When you turn 70, you get a gun and 4 bullets. You are allowedto shoot 2 senators and 2 representatives. Of course, you will be sent to prison where you will get 3 meals a day, a roof over your head and all the health care you need!!!

New teeth, great!!! Need glasses, no problem. New hip, knee, kidney, lung, heart?
Well bring it on. And who will be paying for all of this. The same government that just told you that you are too old for health care. And, since you are a prisoner, you don’t have to pay any income tax.

I really think we have a Perfect Solution!!!

3) The New Iran Sanctions: Worse Than the Old Ones
BY GAL LUFT/Foreign Policy Magazine

In an effort to prevent Iran from becoming a nuclear power, the U.S.
Congress has set its sights on the Islamic Republic's foreign gasoline
dependence. The logic is straightforward: Iran, it has been widely reported,
is an oil giant that nonetheless imports 40 percent of its gasoline;
internationally coordinated sanctions stopping it from obtaining enough
could pain the regime into rethinking its nuclear ambitions. Little wonder
the bipartisan Iran Refined Petroleum Sanctions Act, introduced in both the
Senate and the House, enjoys the support of at least 74 senators and 294
representatives.

There is just one problem: Iran is much less vulnerable to gasoline
sanctions than is commonly believed on Capitol Hill, and its foreign
gasoline dependence is dropping by the day.

The little-known reason is that President Mahmoud Ahmadinejad has imposed
dramatic measures to eliminate this strategic vulnerability. He has
massively expanded the country's refinery infrastructure. Seven of Iran's
nine existing refineries are undergoing expansion projects; seven new
refineries are on the drawing board or already under construction. In three
to five years, these projects will double Iran's refining capacity, putting
it on par with Saudi Arabia.

These efforts, in addition to an effective petrol rationing scheme, have
slashed Iran's need to import petroleum products. As of this fall, Iran's
daily gasoline dependence will stand below 25 percent. This figure is
expected to decline even further to roughly 15 percent over the next year as
new refining capacity comes online. By 2012 Iran is projected to be gasoline
self-sufficient; shortly after that, the Islamic Republic is likely to
become a net gasoline exporter.

In expanding its refining capacity, Iran worked with French, British,
German, Swiss, Korean, Romanian, Italian, Danish, Japanese, Chinese, and
even American firms (working through shell companies set up overseas).
Vigorous enforcement of the Iran Refined Petroleum Sanctions Act might cause
some of these companies to reconsider their relations with Iran. But the
idea that the new U.S. sanctions on gasoline imports
-- widely thought in Washington to be a "drastic" measure -- would derail
Iran's progress toward energy independence or inflict more than a pin prick
on the mullahs' regime is overly optimistic.

First, the foreign companies that have been involved in Iran's refinery
expansion projects have done so in the early phases of licensing,
consulting, financing, design and engineering. For the most part these
services have already been performed; the Iranians do the construction
themselves. Even if the foreign partners responded to the sanctions, it
would have little impact on the projects.

Second, Iran is becoming increasingly reliant on China for its refinery
expansion program -- and Beijing has shown little interest in abiding by any
sanctions regime initiated by the United States. In recent months, Chinese
companies have greatly expanded their presence in Iran's oil sector. In the
coming months, Sinopec, the state-owned Chinese oil company, is scheduled to
complete the expansion of the Tabriz and Shazand refineries -- adding 3.3
million gallons of gasoline per day. Iran has also secured agreements to
take part in three overseas refining joint ventures, in Malaysia, Indonesia,
and Syria.
The chances those governments would annul these projects are nil.

Simultaneously, Iran is ambitiously pushing alternative fuels to reduce its
gasoline consumption. Three years ago, Ahmadinejad initiated a program to
convert Iran's vehicles to run on natural gas rather than gasoline. Iran has
the world's third-largest natural gas reserves (around 16 percent of the
world's total). Now, the government is subsidizing retrofitting cars for
natural gas; an Iranian version of "cash for clunkers" is phasing out old
gas guzzlers; and domestic automakers now must enable all new cars to run on
natural gas, which hundreds of refueling stations are being renovated to
serve. The government also provides financial incentives for drivers to
prefer natural gas over gasoline. A gallon of gasoline costs 53 cents while
the natural gas equivalent only costs 15 cents. Since the initiation of the
program, gas has replaced 10 percent of Iran's total gasoline consumption
for transport fuel.

Furthermore, Iran is one of the world's largest producers of methanol
-- a cousin to ethanol that can be made from not just agricultural products,
but also coal and natural gas. The country has four major methanol plants
and is building two massive new ones, among the largest in the world, which
will increase Iran's production capacity by more than 60 percent. These
factories, built with the aid of a Danish company, will enable Iran to blend
alcohol into its fuel, just as the United States does with gas and ethanol,
and lower its gasoline consumption by at least 5 percent without any need
for vehicle retrofitting. Finally, the Iranian government is encouraging its
citizens to use public buses by subsidizing diesel to the tune of 100%.

All of these measures show that the chance a U.S. sanctions policy will
inflict economic pain and trigger a change in the regime's behavior is slim.
The focus on such sanctions would be warranted if Iran's petroleum-products
dependence were deep. But it is no longer the case.
The wheels of Washington's bureaucracy have turned too slowly to keep pace
with Iran's wiliness.

And in their fixation with sanctions, U.S. lawmakers have been distracted
from some tectonic changes in the Iranian energy security landscape. In May,
the Islamic Republic signed a pipeline deal with Pakistan that will provide
Iranian natural gas access to the Asian market. India's petroleum minister
announced that New Delhi will not bow to any external pressure against
extending the pipeline into India; this means that millions of Indians might
soon be relying on Iran for their electricity (in a deal Russian gas giant
Gazprom has shown interest in financing). Last month, Iran concluded a deal
to connect with Turkmenistan as European countries moved forward toward
building the Nabucco pipeline, which could bring Iranian gas into the heart
of Europe.

Derailing each of these moves would have much lasting impact on Iran's plans
for regional hegemony than the gasoline sanctions. If the congressional
activism directed toward this feel-good solution were directed toward
efforts to block Iran from developing new economic lifelines, Tehran would
have a real reason to worry.

3)By Camille Paglia
Buyer's remorse? Not me. At the North American summit in Guadalajara this week, President Obama resumed the role he is best at -- representing the U.S. with dignity and authority abroad. This is why I, for one, voted for Obama and continue to support him. The damage done to U.S. prestige by the feckless, buffoonish George W. Bush will take years to repair. Obama has barely begun the crucial mission that he was elected to do.
Having said that, I must confess my dismay bordering on horror at the amateurism of the White House apparatus for domestic policy. When will heads start to roll? I was glad to see the White House counsel booted, as well as Michelle Obama's chief of staff, and hope it's a harbinger of things to come. Except for that wily fox, David Axelrod, who could charm gold threads out of moonbeams, Obama seems to be surrounded by juvenile tinhorns, bumbling mediocrities and crass bully boys.
Case in point: the administration's grotesque mishandling of healthcare reform, one of the most vital issues facing the nation. Ever since Hillary Clinton's megalomaniacal annihilation of our last best chance at reform in 1993 (all of which was suppressed by the mainstream media when she was running for president), Democrats have been longing for that happy day when this issue would once again be front and center.
But who would have thought that the sober, deliberative Barrack Obama would have nothing to propose but vague and slippery promises -- or that he would so easily cede the leadership clout of the executive branch to a chaotic, rapacious, solipsistic Congress? House Speaker Nancy Pelosi, whom I used to admire for her smooth aplomb under pressure, has clearly gone off the deep end with her bizarre rants about legitimate town-hall protests by American citizens. She is doing grievous damage to the party and should immediately step down.
There is plenty of blame to go around. Obama's aggressive endorsement of a healthcare plan that does not even exist yet, except in five competing, fluctuating drafts, makes Washington seem like Cloud Cuckoo Land. The president is promoting the most colossal, brazen bait-and-switch operation since the Bush administration snookered the country into invading Iraq with apocalyptic visions of mushroom clouds over American cities.
You can keep your doctor; you can keep your insurance, if you're happy with it, Obama keeps assuring us in soothing, lullaby tones. Oh, really? And what if my doctor is not the one appointed by the new government medical boards for ruling on my access to tests and specialists? And what if my insurance company goes belly up because of undercutting by its government-bankrolled competitor? Face it: Virtually all nationalized health systems, neither nourished nor updated by profit-driven private investment, eventually lead to rationing.
I just don't get it. Why the insane rush to pass a bill, any bill, in three weeks? And why such an abject failure by the Obama administration to present the issues to the public in a rational, detailed, informational way? The U.S. is gigantic; many of our states are bigger than whole European nations. The bureaucracy required to institute and manage a nationalized health system here would be Byzantine beyond belief and would vampirically absorb whatever savings Obama thinks could be made. And the transition period would be a nightmare of red tape and mammoth screw-ups, which we can ill afford with a faltering economy.
As with the massive boondoggle of the stimulus package, which Obama foolishly let Congress turn into a pork rut, too much has been attempted all at once; focused, targeted initiatives would, instead, have won wide public support. How is it possible that Democrats, through their own clumsiness and arrogance, have sabotaged healthcare reform yet again? Blaming obstructionist Republicans is nonsensical because Democrats control all three branches of government. It isn't conservative rumors or lies that are stopping healthcare legislation; it's the justifiable alarm of an electorate that has been cut out of the loop and is watching its representatives construct a tangled labyrinth for others but not for themselves. No, the airheads of Congress will keep their own plush healthcare plan -- it's the rest of us guinea pigs who will be thrown to the wolves.
With the Republican party leaderless and in backbiting disarray following its destruction by the ideologically incoherent George W. Bush, Democrats are apparently eager to join the hara-kiri brigade. What looked like smooth coasting to the 2010 election has now become a nail-biter. Both major parties have become a rats' nest of hypocrisy and incompetence. That, combined with our stratospheric, near-criminal indebtedness to China (which could destroy the dollar overnight), should raise signal flags. Are we like late Rome, infatuated with past glories, ruled by a complacent, greedy elite, and hopelessly powerless to respond to changing conditions?
What does either party stand for these days? Republican politicians, with their endless scandals, are hardly exemplars of traditional moral values. Nor have they generated new ideas for healthcare, except for medical savings accounts, which would be pathetically inadequate in a major crisis for anyone earning at or below a median income.
And what do Democrats stand for, if they are so ready to defame concerned citizens as the "mob" -- a word betraying a Marie Antoinette delusion of superiority to ordinary mortals. I thought my party was populist, attentive to the needs and wishes of those outside the power structure. And as a product of the 1960s, I thought the Democratic party was passionately committed to freedom of thought and speech.
But somehow liberals have drifted into a strange servility toward big government, which they revere as a godlike foster father-mother who can dispense all bounty and magically heal all ills. The ethical collapse of the left was nowhere more evident than in the near total silence of liberal media and Web sites at the Obama administration's outrageous solicitation to private citizens to report "unacceptable "casual conversations" to the White House. If Republicans had done this, there would have been an angry explosion by Democrats from coast to coast. I was stunned at the failure of liberals to see the blatant totalitarianism in this incident, which the president should have immediately denounced. His failure to do so implicates him in it.
As a libertarian and refugee from the authoritarian Roman Catholic church of my youth, I simply do not understand the drift of my party toward a soulless collectivism. This is in fact what Sarah Palin hit on in her shocking image of a "death panel" under Obamacare that would make irrevocable decisions about the disabled and elderly. When I first saw that phrase, headlined on the Drudge Report, I burst out laughing. It seemed so over the top! But on reflection, I realized that Palin's shrewdly timed metaphor spoke directly to the electorate's unease with the prospect of shadowy, unelected government figures controlling our lives. A death panel not only has the power of life and death but is itself a symptom of a Kafkaesque brave new world where authority has become remote, arbitrary and spectral. And as in the Spanish Inquisition, dissidence is heresy, persecuted and punished.
Surely, the basic rule in comprehensive legislation should be: First, do no harm. The present proposals are full of noble aims, but the biggest danger always comes from unforeseen and unintended consequences. Example: the American incursion into Iraq, which destabilized the region by neutralizing Iran's rival and thus enormously enhancing Iran's power and nuclear ambitions.
What was needed for reform was an in-depth analysis, buttressed by documentary evidence, of waste, fraud and profiteering in the healthcare, pharmaceutical and insurance industries. Instead what we've gotten is a series of facile, vulgar innuendoes about how doctors conduct their practice, as if their primary motive is money. Quite frankly, the president gives little sense of direct knowledge of medical protocols; it's as if his views are a tissue of hearsay and scattershot worst-case scenarios.

4)Japan: Secret Syrian-Iranian-NKorean missile-test fails, kills 20 Syrians

Japanese intelligence has learned that in late May, Iran, Syria and North Korea secretly test-launched in southern Syria a new short-range ballistic missile developed jointly by Pyongyang, Tehran and Damascus as a substitute for the outdated Scuds still in use in their armed forces, military sources report. In May, several new missiles were flown from North Korea and Iran to the Damascus military airfield and thence to Syria's southeastern missile-testing site at Jebel Druze near the small town of Salakhand.

After two weeks' preparation, two of the new projectiles had their first trial-launch - and failed with disastrous results.

Sources report that they targeted an uninhabited desert area in the North, 500 kilometers away, just south of Ayn Diwar and east of Al Qamishli not far from the Syrian-Turkish-Iraqi border intersection.

(It was here that Syria and Iraq, with Russian help, interred Saddam Hussein's weapons of mass destruction in 2001.)

However, one of the missiles strayed 350-400 km west of its projected course, indicating a problem with its guidance system. It exploded in the center of the small town of Manbij north of Aleppo near the Turkish border, killing at least 20 people, injuring 60 and badly damaging the market town.

The second missile exploded in mid-course in the South, over the north of the town of Abu Kamal and 200 kilometers from its launching site. Syrian military authorities closed the area around the stricken town of Manbij for more than a month, attributing the disaster to a gas explosion.

Japanese intelligence sources, who are anxiously tracking the growing missile collaboration between North Korea, Iran and Syria, do not name the failed new missile, but military sources suggest it was a short-range ballistic missile (SRBM) propelled by solid fuel with a range of 800-1,000 kilometers and fitted with a warhead containing between 800 kilos and one ton of explosives. This would be an improvement on most of the three nations' short-range missiles which are powered with liquid fuel.

5)Big health flexes its lobbying muscle. Democracy quiversIn finance as in health, public interest is tamed by unaccountable corporate interest. It was meant to be the other way round
By Peter Wilby


No American who voted for Barack Obama last November could have been in much doubt that he supported healthcare reform, that it would include a public scheme, and that he would make it a priority of his presidency. So why is the fate of the bill to realise his campaign promises now in such doubt, and why does it no longer, according to polls, command support from a majority of Americans?

The answer tells us a great deal not just about American politics, but about our own. The most determined, coherent and organised voices in any contemporary political debate are those of the corporate sector and its allies. It can afford the PR and advertising to change the terms of public discourse and it well knows that lies and half-truths – for example, that the NHS leaves the old and chronically ill to die, that 40% of British cancer patients don't see an oncologist, that Edward Kennedy would be left untreated in Britain for his brain tumour – can sow doubt in people's minds even if they are easily disproved. The corporate sector can also intimidate and compromise elected politicians.

In the first three months of 2009, healthcare companies donated $5.4m to the political funds of members of Congress, 60% of it to Democrats. Over the past six years, Max Baucus, head of the crucial Senate finance committee – which has not so far looked kindly on Obama's proposal for a public insurance option – has received $3.9m from the health industry. Though Baucus said in June that he would refuse further such contributions while the bill was going through, he still takes donations from lobbyists who represent healthcare firms.

Against such lobbying muscle, democracy is overwhelmed, as the former US labour secretary Robert Reich argued in his book Supercapitalism. Washington crawls with corporate money, and a politician or public official may turn out to be just a future lobbyist making contacts. According to Reich, more than 30% of retiring Congress members – as many Democrats as Republicans – become lobbyists. More than half the senior officials of Bill Clinton's 1993-2001 administrations became corporate lobbyists, including his deputy chief of staff.

In Britain, too, we are increasingly familiar with corporate donations to political parties, and with ministers, officials and aides becoming "consultants", "advisers" or company directors. Former health secretary Alan Milburn became a director of Covidien, a healthcare product provider, and adviser to Bridgepoint Central, a venture capital firm involved with financing private health firms. Patricia Hewitt, another former health secretary, became "special consultant" to Alliance Boots and adviser to Cinven, a private hospital and healthcare group. Sally Morgan, a Tony Blair aide, was subsequently a director of Southern Cross, the UK's largest care home operator, and an adviser to Lloyds Pharmacy. Is it any surprise that the arguments for greater private-sector involvement in the NHS get a better hearing in Westminster and Whitehall than most voters would wish?

Also, former home secretary John Reid is a consultant to private security firm G4S. Stephen Byers, a former trade and industry secretary, has advised Consolidated Contractors, a multinational oil and construction company. Anji Hunter, another Blair aide, later became director of communications for BP. Sir Michael Barber, head of Blair's public services "delivery unit", is now an "expert partner" with McKinsey. Sir Kevin Tebbit, Ministry of Defence permanent secretary until 2005, later joined the boards of two companies that make helicopters for the MoD.

In office, they and others may honestly claim they are acting in the public interest. But, to a remarkable extent, politicians now identify the public interest with the corporate interest. Taking on powerful corporations is a thankless task at the best of times; to do so when a corner of your mind must know the implications for your future career prospects requires exceptional courage and determination.

Whether present Labour ministers look forward to richly remunerated positions in the financial services industry I cannot say, but Jonathan Powell, Blair's former chief of staff, now works for Morgan Stanley. Given an unprecedented opportunity, ministers have utterly failed to bring the industry to heel. They have tolerated, with weak protests, the return of multimillion-pound bonuses for bankers. They have not acted on proposals to separate risk-taking investment banks from retail banks handling savings and mortgages.

Peter Mandelson let it be known that, during his week in charge, he would lobby the European commission to modify a directive forcing hedge funds to maintain higher levels of capital, cap debts and disclose more information.

As Reich puts it, "Democracy and capitalism have been turned upside down." Our democratic institutions do not regulate capitalism; rather, market institutions regulate democracy, setting the limits of the possible.

The point of democracy is to tame unaccountable concentrations of power. Yet, while governments are under constant scrutiny, banks can wreck the economy (and then demand taxpayer bailouts), supermarkets can kill town centres, oil companies can pollute the planet and, it seems, there is little we can do about it.


The failure to contain corporate power – or even, apparently, to want to do so – is New Labour's greatest failure. Mandelson can talk all he likes about trying to get more state schoolchildren from poor homes into university, but he remains – as his easy socialising with the Rothschilds and their set shows – intensely relaxed not only about the wealth of the filthy rich but also about their unaccountable power.

Now that nationalisation has been rejected, even as an aspiration, the left has no language and no ideas for dealing with corporate power.

For the sake of the 47 million Americans who lack health insurance, and the millions more who find their policies do not cover the most serious conditions, we should hope Obama gets his way. But there is no cause for complacency on this side of the Atlantic. As the chairman of the British Medical Association council put it in a letter to this paper yesterday, while Obama tries to move America towards the British system (albeit by a mere fraction), we risk "marching steadily away from a system of free, state-provided healthcare" towards the US model. The price of democracy is eternal vigilance against the encroachment of corporate interests.


6)Obama and the Practice of Medicine: Why is the president convinced so many doctors and patients are making irrational decisions
By SCOTT GOTTLIEB

On the defensive because of an increasingly skeptical public, President Barack Obama has recently spoken extemporaneously about his health plan. In doing so, he has revealed his lack of understanding about aspects of medical practice and the reasons for rising health-care costs.

One theme the president has focused on is doctors' motives. During a prime-time press conference on July 22, the president referred to a doctor who muses that she makes "a lot more money if I take this kid's tonsils out"—even if the child might not need surgery. Responding to a woman whose spry 100-year-old mother was given a needed pacemaker despite her age, the president said a few weeks earlier (at an ABC News town-hall event at the White House) that doctors should let patients know that sometimes "you're better off not having the surgery, but taking the painkiller."

Mr. Obama's clinical scenarios represent an excessive—if not erroneous—take on how doctors are influenced by financial incentives. This jaundiced view on medical decision-making may explain why programs the White House is proposing to lower health-care costs rely on the direct regulation of medical decisions. If Mr. Obama is serious about lowering costs, he'll need to reform the economic structures in medicine—especially programs like Medicare.

Medicare data shows that for the most part, major surgeries aren't the source of waste in health care. These kinds of procedures are typically guided by clear clinical criteria and are closely scrutinized by doctors and patients alike. Rather it is in routine procedures and treatments that economic incentives factor heavily into doctors' decisions.

The use of branded over cheaper generic drugs until recently fell into this category. Doctors would regularly prescribe the more expensive option. Today this is far less prevalent, since patients with private plans realized that they were being saddled with higher co-pays when they opted for the brand-name drugs over generic alternatives.

Other areas where doctors have been accused of excessive utilization include radiology scans and home medical equipment. In the absence of financial incentives to restrain excess use, relatively safe diagnostic procedures can often be justified—even if their benefits are slim.

Instead of addressing the distorted financial incentives that influence these kinds of routine tests and treatments, Mr. Obama's policies seek to directly regulate doctors and their decisions.

The Obama administration has proposed establishing an "Independent Medicare Advisory Committee" to set binding rules on Medicare reimbursement policies. Mr. Obama has also called for the creation of a new federal entity that would conduct "comparative" research on the cost-effectiveness of various treatments in order to establish federal "guidelines." The House health reform bill calls for "health information tools" that would enable Medicare to deny payment for a particular treatment right in the doctor's office.

Regulating medical decisions should not be the responsibility of a remote Washington bureaucracy. The only way to instill more reflection at the point of medical decision making is to give doctors and patients reasons to consider the cost of various options.

For doctors whom Medicare pays per intervention, the problem isn't the fee-for-service model, but the way that the government program sets the fees. Fees are set according to a fixed price schedule with no tie to the physician's quality, experience level, or the outcome of the service.

A more rational system would pay doctors for entire "episodes of care," rather than individual procedures. Private health systems like the Geisinger Clinic and some Blue Cross plans have adopted this model and pay doctors for taking care of an entire illness.

Medicare doesn't have the ability to track episodes of care. It has struggled to adopt even modest payment reforms such as restricted panels of providers, value-based insurance, and account-based coverage, where consumers control their own spending—all techniques used by private insurers to improve efficiency.

Medicare's size demands that it keep payment systems simple. Thus it relies on fixed prices for checklists of services tied to discrete billing codes. These uniform payment rules reward low and high quality care the same. What's troubling is that the heart of the president's plan—a government-run "public" insurance program—is modeled directly on Medicare.

Medicare compounds its shortcomings by insulating patients from costs. This causes a total lack of financial restraint at the point of care. Cost-sharing in Medicare has actually declined over time as a percent of patients' total health bill.

My colleague at the American Enterprise Institute, Tom Miller, estimates that U.S. patients have the lowest out-of-pocket costs as a percent of total national health spending of any developed country except France, Luxembourg, the Czech Republic and Ireland. They're even lower than the single-payer health system in Canada. Mr. Miller calculates that out-of-pocket spending on physician and clinical services in the U.S. was about 60% of total real per capita spending on health care in 1960. By 2002 it had fallen to 10%.

Unsurprisingly, Medicare data show that over the past two decades Medicare's costs for care have sharply outpaced spending in private plans, where co-pays and cost sharing are standard. While these estimates are confounded by factors such as the age of Medicare's population, Medicare certainly hasn't been austere.

Mr. Obama says as much as one-third of medical spending is wasted on services that provide little or no benefit. But closer scrutiny of these kinds of marginal medical decisions can't be imposed by government regulation. Cost consideration must be internalized at the point of care by patients and doctors with a stake in the price, as well as the outcome.

Dr. Gottlieb, a former official at the Centers for Medicare and Medicaid Services, is a fellow at the American Enterprise Institute and a practicing internist. He's partner to a firm that invests in health-care companies.

7) We can’t talk about immigration
By Mark Steyn


Christopher Caldwell’s new book is called: "Reflections on the Revolution in Europe." And, if you don’t quite get the Burkean allusion, his subtitle spells out his real concerns: “Immigration, Islam and the West.” Given my own obsessions in recent years, you’d expect me to be favourably disposed to it. And I am, my enthusiasm only slightly tempered by the instant conventional wisdom that, if you’re only going to buy one Islamophobic Euro-doom-mongering diatribe this summer, Caldwell’s is the sober and respectable one, in striking contrast to certain others we could mention. “Unlike [Oriana] Fallaci and Mark Steyn, Caldwell does not rant or sneer,” writes Matt Carr of Britain’s Institute of Race Relations. Caldwell, says The Atlantic’s Andrew Sullivan, is not a “Steynian hysteric.” Oh, dear. I think I prefer the droll Irish commentator “P O’Neill”: “Someone has to say it,” he smirked. “Caldwell is the thinking man’s Mark Steyn.”

But enough about me. On to the book . . . actually, hold on a minute. One more thing about me. Let us put Islam aside for the moment, as my views have been well aired in these pages, and consider the author’s other theme. As it happens, for all his non-ranting, non-hysterical sobriety, Mr. Caldwell is somewhat more “extreme” than I am on immigration. For a notorious blowhard, I can go a bit cryptic or (according to taste) wimpy when invited to confront that particular subject head on. On the CBC last year, I was tap dancing around various socio-cultural generalities when the host, George Stroumboulopoulos, leaned in in that way he has and cut to the chase: “You mean [pause and knowing glance to camera] immigration?”
I thought of bolting for the nearest exit, but, at such moments, I usually take refuge in the formulation that a dependence on mass immigration is always a structural weakness and it would be prudent to address it as such. But in the end my line’s a bit of a dodge. As Christopher Caldwell sees it, no country truly “depends” on mass immigration. Ultimately, it’s a choice, or a fetish, or a fit of absentmindedness for which, in the event that one is called upon to justify it, there is no rationale. Indeed, it’s the defining irrationale of the age: a hitherto all but unknown phenomenon that is now regarded either as inevitable or the essential moral component of an advanced society.

To be sure, the green eyeshade types never cease trying to sell it on more prosaic grounds. “Sober-minded economists reckon that the potential gains from freer global migration are huge,” writes Philippe Legrain in Immigrants: Your Country Needs Them. “The World Bank reckons that if rich countries allowed their workforce to swell by a mere three per cent by letting in an extra 14 million workers from developing countries between 2001 and 2025, the world would be $356 billion a year better off, with the new migrants themselves gaining $162 billion a year, people who remain in poor countries $143 billion, and natives in rich countries $139 billion.”

$139 billion? From “a mere” 14 million extra immigrants? Wow! As Caldwell writes, “The aggregate gross domestic product of the advanced economies for the year 2008 is estimated by the International Monetary Fund at close to $40 trillion.” So an extra $139 billion works out to an extra, er, 0.0035 per cent. He compares M. Legrain to Dr. Evil excitedly holding the world hostage for one million dollars! “Sacrificing 0.0035 of your economy would be a pittance to pay for starting to get your country back.”

Okay, forget economic growth. With Europe’s population aging and the worker/retiree ratio shrivelling remorselessly, we need more immigrants to come in and prop up the welfare state. Johnny Frenchman may get a bit tetchy at the end of an agreeable evening with his mistress when he glances out the window just before heading back to the missus and sees une bande de jeunes (in the preferred designation) lighting up his Citroën. But when he’s 53 and retired he’ll be grateful to have those jeunes in the workforce paying in to keep his benefit cheques coming. That, at any rate, is the theory. The reality is encapsulated in this remarkable statistic from the Bundesausländerbeauftragte: between 1971 and 2000, the number of foreign residents in Germany rose from three million to about 7.5 million. Yet the number of foreigners in work stayed more or less exactly the same at about two million. Four decades ago, two-thirds of German immigrants were in the workforce. By the turn of the century, barely a quarter were. These days, Germany’s Gastarbeiter (“guest workers”) are heavy on the Gast, ever lighter on the Beiter.

Turks in Germany have three times the rate of welfare dependency as ethnic Germans, and their average retirement age is 50. In the Stockholm suburb of Tensta, where immigrants and their children make up 85 per cent of the population, one-fifth of women in their late 40s collect disability benefits. Foreigners didn’t so much game the system as discover, thanks to family “reunification” and other lollipops, that it demanded nothing of them. Indeed, entire industries were signed up for public subsidy. Two-thirds of French imams are on the dole. Does M. Legrain set their welfare cheques on the debit side of that spectacular 0.0035 per cent economic growth? Or does that count as valuable long-term investment in the critical economic growth sector of fire-breathing mullahs?

Across the decades, one self-delusion of the political class succeeds another: “temporary workers” are now political “refugees”; the urgent need for mill workers and janitors is now an urgent need for millions of Somali software engineers who’ll help Europe stay competitive in the “high-tech” “knowledge economy.” The policy changes but the traffic is remorseless. Recoiling from the logic of tightly argued books like Caldwell’s, sophisticates protest that “it is hard to generalize about Europe.” And it’s true that, if you take a stamp collector’s approach to immigration issues, there are many fascinating differences: the French blame their immigration woes on the bitter legacy of colonialism; Germans blame theirs on a lack of colonial experience at dealing with these exotic chappies. But, if you’re in some decrepit housing project on the edge of almost any Continental city from Malmö to Marseilles, it makes little difference in practice. “If you understand how immigration, Islam, and native European culture interact in any western European country,” writes Caldwell, “you can predict roughly how they will interact in any other—no matter what its national character, no matter whether it conquered an empire, no matter what its role in World War II, and no matter what the provenance of its Muslim immigrants.”

How does one express one’s, ah, concerns about these issues? Caldwell cites a headline from his own newspaper, the Financial Times: “The Uneasy Cosmopolitan: How Migrants Are Enriching An Ever More Anxious Host.”

The “unease” seems principally on the part of the FT’s sub-editor: as his linguistic tiptoeing suggests, decades of multiculti squeamishness have stripped us even of a language with which to discuss the subject. What benefit is it to France or French taxpayers to fund Islamic welfare imams? To pose the question is to miss the point. If you believe in mass immigration, you do so because it’s a talisman of your own moral virtue. If the economic argument for immigration is reductive even when it’s not plain deluded, the psychological one is not to be disdained. On the one hand, mass immigration is the price posterity levies on old-school imperialists: “They are here because we were there,” as they say in the Netherlands. But, if like Sweden you never had an imperialist bone in your body, they’re still here: “They are poor because we are rich.” And, if you’re a small urbanized nation like the Netherlands, the “challenge” of immigration is just the usual frictions that occur when people from the countryside—in this case, the Moroccan countryside—move to the cities.

So it’s the consequence of your urban planning, or your colonialism, or your wealth, or just plain you. We’ll blame anything rather than confront the central truth—that when an old, relatively unicultural society admits in a short space of time a large, young, fecund population from somewhere else, you are setting in motion a process of transformation. Caldwell asks the obvious question—“Can you have the same Europe with different people?” and gives the obvious answer: no. “Europe is not welcoming its newest residents but making way for them.”

In the end, that coy French euphemism for the, um, rioters of no particular socio-religious persuasion—“youths”—gets to the heart of the matter: youths are youthful, and ethnic Europeans aren’t. In the heavily North African Paris suburb of Montfermeil, the Muslim children from the housing projects pass on their way to school each morning a neighbourhood of detached houses still occupied by French natives: they call it “la ville des vieux”—the old people’s town.


8) Pork-barrel spending increases in 2009
By Walter Alarkon

The cost of earmarks increased this year despite lawmakers' claims they're working to reduce pork-barrel spending.

Earmarks, which are inserted in appropriations bills by members in order to fund specific projects, added up to $19.9 billion in 2009, according to an analysis by the Taxpayers for Common Sense and Center for Responsive Politics. Earmarks in 2008 spending bills were worth $18.3 billion.


Earmark critics have said that the practice increases pork-barrel spending and takes funds away from national priorities.

"At a minimum, earmarks granted to lawmakers' friends and supporters merit scrutiny and indicate potential conflicts of interest," said Sheila Krumholz, the executive director of the Center for Responsive Politics.

But earmark defenders have argued that the practice is one way they can directly help their constituents. Earmarks accounted for 1.5 percent of the $1.3 trillion federal budget in 2009.

Amid criticism, lawmakers have sought to reduce earmarks and shed more light on how they're requested and awarded. House Appropriations Chairman David Obey (D-Wis.) and Senate Appropriations Chairman Daniel Inouye (D-Hawaii) said they reduced earmark spending in 2008 to below their 2006 level.

For fiscal year 2010 spending bills, Obey and Inouye said that all members must post their requests and explain on their websites why they're important before the requests are considered by appropriators.

President Barack Obama persuaded Congress to keep the $787 billion stimulus free of earmarks, but he signed a $410 billion spending measure in March that included $7.7 billion in earmarks. Obama, when he signed the bill, called for stricter earmark disclosure rules that would require lawmakers to post all their earmark requests on their web sites and direct federal agencies to hold a competitive bidding process for earmarks to private companies.

The earmark study, released Thursday, found that states with smaller populations, and members of Congress on the appropriations panels, were big earmark winners.

Alaska, home of a former appropriator, Sen. Ted Stevens (R), and a current appropriator, Sen. Lisa Murkowski (R), received more than $331 per person in earmark funds, the most for any state. The states with the next two highest levels of per capita earmark money were Mississippi, home of Sen. Thad Cochran, the top Senate GOP appropriator, and North Dakota, home of Sen. Byron Dorgan, a senior Democratic appropriator.

The member of Congress to win the most earmark money was Cochran, whose earmarks added up to $1.22 billion. They included funds for repairs to hurricane damage at an Army ammunition plant and for construction at the University of Mississippi School of Pharmacy.

The House member with the most earmark money was Rep. Dave Loebsack (D-Iowa), whose earmarks totaled $217 million. Many of Loebsack's earmarks were also requested by Iowa's two senators, Tom Harkin (D) and Chuck Grassley (R).

9)Health Bill Hinges On Blue Dogs' Vote But Few Bite So Far
By DAVID HOGBERG AND SEAN HIGGINS , INVESTOR'S BUSINESS DAILY
Posted 08/14/2009 07:13 PM ET



President Obama shakes hands with House Majority Leader Steny Hoyer as Blue Dog Coalition Co-Chair Rep. Stephanie Herseth Sandlin, Sen. Claire McCaskill, House Budget Committee Chairman John Spratt, and other members of Congress gather in Washington after Obama delivered remarks about PAYGO on June 9. Getty Images View Enlarged Image
Blue Dog Democrats are being chased by both sides in the health care debate. But the opposition may have the inside track, based on an IBD survey of these moderate-to-conservative House lawmakers.

There are 256 Democrats in the House, 52 of whom are Blue Dogs.

Rep. Artur Davis of Alabama, who's not a member of the pack, has said he won't support HR 3200 in its present form. That means Democrats need the support of at least 15 Blue Dogs to reach the 218 votes required to pass the health care bill. So far, no Republicans have come out in favor of the measure.

An IBD survey, combined with news reports, of all the Blue Dogs reveals only four definite supporters: John Salazar of Colorado, Ohio's Zack Space, and Mike Thompson and Adam Schiff, both from California.

Based on the survey and previous press reports, at least 13 Blue Dogs are opposed to the bill as it now stands.

Many of those who are undecided or did not respond have expressed reservations about various aspects of the bill, including the public plan option, the cost and tax increases.

Summer Of Discontent

That's bad news for the Democratic leadership, which was counting on the August recess to firm up support for House passage of the bill.

A Gallup poll released Tuesday found public opinion on the plan almost equally divided, with 35% in favor of the congressional health care reform bill, 36% opposed and 29% unsure. A poll released Wednesday said a plurality disapproved of the way President Obama was handling the health care debate, 49%-43%.

In a month when many Democrats have faced angry groups back home, Blue Dogs have been at the center of some of the most raucous town halls.

With the heat on them, many are trying to keep a lower profile. Rep. Dennis Moore of Kansas announced last week he would no longer hold town hall meetings.

"It would be naive to think this month and what you've seen across the country will not have an effect on Blue Dogs," said Jason Altmire, a Pennsylvania Blue Dog who opposes the current bill. "I would expand that beyond Blue Dogs to newly elected members who represent moderate to conservative districts. Spending a few weeks back home and seeing the level of displeasure, it will be tough."

He remains optimistic that reform will happen but will not resemble the House bill.

Sympathy For The Protesters

The protests also seem to be winning public opinion. A Gallup poll released Wednesday found that 34% said the town hall protests have made them more sympathetic to the protesters. Only 21% were less sympathetic. For independents, 35% were more likely to sympathize with the protesters now vs. 16% who weren't.

Rep. Frank Kratovil, D-Md., was one of the Democrats who pushed to have the final vote after the August recess. Spokesman Kevin Lawler says the time back home with constituents hasn't made Kratovil see the bill in any better light.

"He said that if he had been made to vote on the bill before the August recess, he would have voted against it. He remains that way," Lawler said. "He thinks there needs to be some reform to the system. He doesn't think this bill is it."

Even Blue Dogs who may be in safe districts may be concerned about their future electoral safety.

"Those Blue Dog members who are not hearing lots of raised voices, they see what's going on across the nation," said J. Mark Wrighton, associate dean and professor of political science at the University of Southern Mississippi. "Some members who are not even in marginal districts, a vote for this bill could lead to serious opposition and create difficulty."

Other members who have not expressed outright opposition to the bill but voted against it in the Energy and Commerce Committee include John Barrow of Georgia, Jim Matheson of Utah and Charlie Melancon of Louisiana. Tennessee's John Tanner opposed it in the Ways and Means.

The news is not all bad for the reform supporters.

Nine Blue Dogs who did not respond have expressed at least some support for a public option, according to news reports. Three of those from California — Joe Baca, Jane Harman and Loretta Sanchez — had previously signed a letter, along with backers Mike Thompson and Adam Schiff, signaling strong support for health care reform.

Colorado's Salazar, one of the few Blue Dogs openly in favor of the health bill, planned to join President Obama at a town hall Saturday.

"He's pretty comfortable with where we are at" on the bill, said spokesman Eric Wortman. Unlike others, Salazar hasn't had to deal with angry crowds at his meetings.

10)Obama is the shepherd I did not want.
He leadeth me beside the still factories.
He restoreth my faith in the Republican party.
He guideth me in the path of unemployment for his party's sake.
Yea, though I walk through the valley of the bread line,
I shall fear no hunger, for his bailouts are with me.
He has anointed my income with taxes,
My expenses runneth over.
Surely, poverty and hard living will follow me all the days of my life,
And I will live in a mortgaged home forever.
I am glad I am American,
I am glad that I am free.
But I wish I was a dog ...
And Obama was a tree.