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Health Care Tyranny by 13 Obstructionists

Posted on Jul 31, 2009

By David Sirota

For those still clinging to quaint notions of the American ideal, these have been a faith-shaking 10 years. Just as evolutionary science once got in the way of creationists’ catechism, so has politics now undermined patriots’ naive belief that the United States is a functioning democracy.

The 21st century opened with a handful of Supreme Court puppets appointing George W. Bush president after he lost the popular vote—and we all know the costs in blood and treasure that insult wrought. Now, the decade closes with another cabal of stooges assaulting the “one person, one vote” principle—and potentially bringing about another disaster.

Here we have a major congressional push to fix a health care system that leaves one-sixth of the country without coverage. Here we have 535 House and Senate delegates elected to give all 300 million of us a voice in the solution. And here we have just 13 of those delegates holding the initiative hostage.

In the Senate, both parties have outsourced health care legislation to six Finance Committee lawmakers: Max Baucus, D-Mont.; Kent Conrad, D-N.D.; Jeff Bingaman, D-N.M.; Mike Enzi, R-Wyo.; Charles Grassley, R-Iowa, and Olympia Snowe, R-Maine. The group recently announced it is rejecting essential provisions like a public insurance option that surveys show the public supports. Meanwhile, seven mostly Southern House Democrats have been threatening to use their Commerce Committee votes to gut any health care bill, regardless of what the American majority wants.

This, however, isn’t about the majority. These lawmakers, hailing mostly from small states and rural areas, together represent only 13 million people, meaning those speaking for just 4 percent of America are maneuvering to impose their health care will on the other 96 percent of us.

Census figures show that the poverty rates are far higher and per capita incomes far lower in the 13 legislators’ specific districts than in the nation as a whole. Put another way, these politicians represent exactly the kinds of districts whose constituents would most benefit from universal health care. So why are they leading the fight to stop—rather than pass—reform?

Because when tyranny mixes with legalized bribery, constituents’ economic concerns stop mattering.

Thanks to our undemocratic system and our corrupt campaign finance laws, the health care industry doesn’t have to fight a 50-state battle. It can simply buy a tiny group of congresspeople, which is what it’s done. According to the Center for Responsive Politics, health interests have given these 13 members of Congress $12 million in campaign contributions—a massive sum further enhanced by geography.

Remember, politicians trade favors for re-election support—and the best way to ensure re-election is to raise money for TV airtime (read: commercials). In rural America, that airtime is comparatively cheap because the audience is relatively small. Thus, campaign contributions to rural politicians like these 13 buy more commercials—and, consequently, more political loyalty.

The end result is an amplifier of tyranny: Precisely because the undemocratic system unduly empowers legislators from sparsely populated (and hence cheap) media markets, industry cash can more easily purchase tyrannical obstruction from those same legislators. In this case, that means congresspeople blocking health care reform that would most help their own voters.

Of course, there is talk of circumventing the 13 obstructionists and forcing a vote of the full Congress that cannot be filibustered. Inside the Washington palace, the media court jesters and political aides-de-camp have reacted to such plans by raising predictable charges of improper procedure, poor manners, bad etiquette and other Versailles transgressions.

But the real crime would be letting the tyrants block that vote, trample democracy and kill health care reform in the process.

David Sirota is the best-selling author of the books “Hostile Takeover” (2006) and “The Uprising” (2008). Find his blog at or e-mail him at

© 2009


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driving bear's avatar

By driving bear, July 31, 2009 at 11:25 am Link to this comment

Sprit girl

Read section 1401 of the bill. Under this part of the bill what health care procedures are covered is determined by the so called “center for comparative effectiveness research” . One of the factors the body takes into account is the patient’s age. Also the decisions of the body are not subject to appeal or review.

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By KDelphi, July 31, 2009 at 11:19 am Link to this comment

Since Dodd (and most other Dems) do not want single payer, I wonder if Dodd, Kennedy, etc would like to come here to my Medicaid Clinic for their cancers…they dont deserve any better care than you or I…

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By KDelphi, July 31, 2009 at 11:12 am Link to this comment

tmullins—RAM is fine, as far as it goes, but for some reason the guy who runs it is rabidly against universal coverage, saying it would “make drs into slaves of the state”.

I asked him some questions about how he would spread his “fairgrounds charity care” nationwide and got stuff like “cant give you any real good answers on that”..blah, blah..I cannot understand how someone can work within the “systeM” like he does (and as I did—not as a dr) and be against universal coverage. (I guess he cant tell me either!)

If you think those pics are graphic, stop into a Medicaid Clinic in almost azy state. Except for being withint a building, its not much different.

Expanding Medicaid (while cutting both Medicaid and Medicare) while subsidizing the insurance industry will just continue the old pattern which everyone admits is not working. “If we could start from scratch” (why cant we, and in the meantime, continue as usual?) and the “only way to cover everyone is single payer”—then that is what we must do.

We could go with Sen Sanders or Rep Kucinich (Conyers, etc) idea of starting with universal, state-based care, which could be expanded to federal—-that is what canada did.

The people on Fox were so coached and SAID that they “wish they had US health care”—-let them try it for a couple of years. I’ve been treated in Canada and these people were full of shit. (they could be treated in US—if they pay cash—you think that Fox would do that for thme??)

HR 676 , folks…if the US survives as the uS, we will eventually come to that…the question is whether you or I will live to see it.

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By Susan Griffin, July 31, 2009 at 10:44 am Link to this comment
(Unregistered commenter)

This is a great, clear, very valuable article (the second on the same subject I have read by Sirota) but I suggest in future versions that he refrain from referring to the normal Congressional practice of sending a bill to committee as “outsourcing.” That is silly and creates the false impression of ignorance, or worse, unfairness.

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By Spiritgirl, July 31, 2009 at 10:30 am Link to this comment

Dear Driving Bear,
  Can you please explain how a public health-care option similar to Medicare is “killing seniors”?  I really don’t understand why allowing people to choose not just from private insurance but to include a public option would be an anathema to seniors.  Seniors would probably even benefit because a measure would have to include something to control drug costs which currently Medicare doesn’t do that well!  Please help to enlighten me?

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By Shenonymous, July 31, 2009 at 10:22 am Link to this comment

You mean ObamaCongressCare since he has left up the devilled details to Congress. 

Perhaps most doctors are the way Recovering Historian calls it, though I’ve never made a survey.  I know a country doctor or two who are extraordinary and provide excellent health care to the countryfolks.  Their incentive, even though fiscally conservative, as most doctors appear to be, is not self-serving, but is to provide good health care regardless of ability to pay.  So it is not a given that doctors are without pity and incapable of altruistic motives.

So getting rid of the Nazi democratic party, you would replace it with the Nazi republican party?  Oh yeah, that will solve everything all right.  Especially for the poor and not so well off middle class who the Republicans have always cared for, oh yeah.  And I suppose you speak for ALL southerns?  Well pardon me, if a choice is between two evils, I will go with the evil Democrats every time.  Well…maybe.

I listened very carefully to Ira Flatow interview with Dr. Arnold Relman.  His argument is quite sound.  Not-for-profit health care is the only way to solve this almost Gordian Knot.  It would not be a predicament if the not-for-profit system were made law.  The interview is easy to follow the Doctor’s logic and his reasoning doesn’t have any flaws that I can see.  If anyone else can see it differently, please say so.  So if there are no sound objections to Relman’s assessment, huge write-in and call-in campaigns to all congressmen, reps and senators alike, that only says NOT-FOR-PROFIT IS THE SOLUTION is the public’s way of affecting change….maybe.

It seems ridiculous to keep pointing out how corrupt our government is.  They all are, they always were, and always will be.  How’s that for pessimism.  So the people need to get their poopy together and force their corrupt politicians to do their will.  Ohhhhh how messy.

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By glider, July 31, 2009 at 10:16 am Link to this comment

Driving Bear,
I am definitely curious to understand your reasoning. Most here would like to essentially see an expansion of Medicare. Do old people in the South not like Medicare, or do you perceive there to be a big difference with what Progressive Dems are pushing today verse their push for Medicare in the past?

Seriously am trying to understand your stance.

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driving bear's avatar

By driving bear, July 31, 2009 at 9:55 am Link to this comment

As a proud rural southerner let me set you Nazi’s straight.

Southerns are not willing to go along with the so called progressive democrats plans to deny treatment to old people and thereby killing them. So hopefully in 2010 the Nazi democrat party will be out of power for good.

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By jmr, July 31, 2009 at 9:34 am Link to this comment

Despite the corrupt motives of the obstructionists, there is a legitimate, liberal/progressive argument against Obamacare in its present form.

Please listen to Dr. Arnold Relman of Harvard, past editor-in-chief of the New England Journal of Medicine.  He’s a wise man and a liberal.

The audio is to the left of the headline, “Reforming Healthcare Reform”.

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By P. T., July 31, 2009 at 9:31 am Link to this comment

It is a paradox of politics that politicians from poor districts are cheaper for rich interests to buy off, thereby undermining the interests of poor constituents.

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By Shenonymous, July 31, 2009 at 8:05 am Link to this comment

xypher I think at bottom you are correct.  Your thoughts go along with a few others here, go to the people.  Yet the problem remains of how to galvanize the entire body of people who voted for Obama to make the changes he promised.  We have a lot of complaints, a g.d. excessive number of them that in reality are nothing but wishful thinking.  Timidity does have something to do with it, but impotence seems to eclipse timidity.  The ‘us’ of whom you speak are also impotent as a rabble group.  ‘We’ are disorganized and there is no one on the horizon to regiment us.  There are too many distractions, not the least of which is eking out a living.  But moreover, the words the public hears consistently and no less from the residents of the TD forums is cacophony.  Nothing coherent enough to spur them into positive action.  They are simply re-acting in their own personal corners and not collectivizing.  The people must also take extreme care not to listen to demagogues, and there is no shortage of these on the TD forums as well.

How do you propose to solve this existential riddle?

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By glider, July 31, 2009 at 8:04 am Link to this comment

Fat Freddy
“And the bigger question, would you be willing to pay higher taxes for a public campaign finance Constitutional Amendment?”

Your joking?, ...include lobby reform and election reform that equalizes the playing field for 3rd party candidates, and the question becomes can you think of a single better use of tax dollars?  That our so called democratic elections are for sale is a joke.  It is our form of having the Grand Ayatollah selecting which candidates are allowed to run.

And really why would it be expensive?  Outlaw political soundbite advertisements, mandate free air time on the networks for debates and policy presentations (or charge them for it just as the NFL charges to broadcast the Superbowl).  Seems to me it would be far cheaper in terms of dollars spent.

The problem is our government appears to be irretrievably corrupted.  Getting a self enriching government to reform itself, like a police internal affairs investigation, is a Catch-22.  Our founding fathers clearly had a lot of experience with corrupt governments in Europe and did their best to protect us with the framework they provided but it may just of been an impossible task.

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By Recovering Historian, July 31, 2009 at 7:59 am Link to this comment
(Unregistered commenter)

The irony is that many people in rural areas wouldn’t have health care without government intervention. Most doctors aren’t interested in serving in Billings, let alone the villages that dot the interior of the country. Only through government programs are doctors incentivized to provide health care there. It’s a wonder that activists don’t drive that home more often. Not just on health care, but on agriculture, on infrastructure, on education.

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By xypher, July 31, 2009 at 7:49 am Link to this comment

The unfortunate fact is until we rise up and take our country back nothing will change. Obama and the Dems in power are too timid to fight for the values they allegedly uphold. This makes them part of the problem and not the solution. It’s up to us and we are not going to win by posting comments online. We are going to win by marching in the streets. IF everyone that went to Obama’s Inauguration went back to Washington and demand the Change Obama ran on…we’d win OVERWHELMINGLY that day!

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By Rodger Lemonde, July 31, 2009 at 7:08 am Link to this comment
(Unregistered commenter)

Our health care system doesn’t need reform, it needs a revolution.
Start with billing. What other major expense is as difficult to put a price on before the work proceeds?
Is this the market forces providing the best for America?
Does any one know the ratio of finance related personnel to health care personnel in the health care industry? Or the break down of a dollar spent on health care?
Methinks the wolves have been guarding the sheep too long.

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Shenonymous's avatar

By Shenonymous, July 31, 2009 at 6:59 am Link to this comment

Unfortunately Sirota is right.  But what makes anyone think those 13 are Democrats and not Republicans in bluecoats?  The Southern Democrats have always been Republican under the skin.  This is the crucial time to stop the insurance cartel.  What Obama ought to do is to not let Congress take their August break until they pound out a public option program!  But I doubt he has the fist to do that.

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By James Keener, July 31, 2009 at 6:35 am Link to this comment
(Unregistered commenter)

Since when has bribery been legalized? Politicians are still guilty of accepting a bribe if it can be shown by a preponderance of statistical evidence that they voted a certain way because someone paid them to do so. Let the investigations (and subsequent prosecutions) begin.

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By Leefeller, July 31, 2009 at 6:24 am Link to this comment

In the words of a great leader (In his mind only), when asked the question. Most (meaning the majority) people in the USA are against the war, his answer stated with feeling and emotion, “so”! And so it goes, nothing has changed, opportunism survives, accountability is absent, if you can find integrity anywhere in the the room, what a surprise.

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By cat, July 31, 2009 at 6:04 am Link to this comment
(Unregistered commenter)

If the Europeans dont like their system ask them if they want a system like ours, let them take a vote. How many of them do you think would vote their system out for a free market captialism system like ours dening coverage hiking prices and pocking profits. If they are honest they will not want to trade, Anyway besides the point, we dont need to up root our free market costly insurance plans we just need to add an option that is public friendly, will cover anyone who wants and needs insurance with NO RESTRICTIONS. Once the new plans is presented let us see from their how much support and how great of a membership it will have. I hope our government just works on the one plan and get the other insurance agents of doom opinions out of here.

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By Purple Girl, July 31, 2009 at 5:15 am Link to this comment

Without Healthcare, citizens are Unable to enjoy the Rights to “Life, Liberty and the pursuit of happiness”
What difference does it make if it is a Imperialistic nation hindering these Rights or a Corp? Family Crest or Logo? Nothing!
I consider this obstructionism a grave act of treason.

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By ardee, July 31, 2009 at 4:57 am Link to this comment

oldhip, July 31 at 6:11 am #

R-i-g-h-t. . .


When one notes the tens of thousands risking life and limb in Iran, protesting an apparently rigged election, one cannot help but feel ashamed for our own democracy.

Amy Goodman wrote an interesting piece about the devaluation of protest here in America, it was posted here as well I believe. You can find it in the archives of Democracy Now I suspect.
tmullins, July 31 at 6:35 am #

This morning on Fox & Friends they were interviewing a couple from England about their lousy European health care. 

One can always find critics, especially when one is paying for that criticism.

I wonder how many here know that, under the Canadian Health Plan, any condition untreatable by Canadian sources is eligible for free transfer to American hospital treatment?

I wonder how many here know the way our health care fiasco is wrecking our economy and killing people daily?

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By Inherit The Wind, July 31, 2009 at 4:42 am Link to this comment

I think it’s the Senators that matter.  If the Senate was solid with 60 votes for the public option, the Blue Dogs in the House would be easy to get around—Pelosi WANTS this bill and would strong-arm them.

I like the idea of enlisting Bill Clinton to jaw-bone, schmooze, drum up public support and arm-twist these guys—he’s the best to do it since Lyndon Johnson.

I ESPECIALLY liked the idea “Remember when failing at health care lost us BOTH houses in 1994?  Do you LIKE being in the majority or the minority?”

Enough of Democrats’ circular firing squad!  The ONE thing the Dims have failed to learn from the Re-Thugs, is when you are in the majority, you MUST enforce party discipline if you want to get things done.  And OH!, did they get things done-and we are all suffering from it.

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By tmullins, July 31, 2009 at 3:35 am Link to this comment

This morning on Fox & Friends they were interviewing a couple from England about their lousy European health care.  This isn’t about European’s or Canadian’s.  It’s about our health care.  I used to work in health care and am ashamed of what is called quality health care in this area.  My father had good insurance, went to what I thought was THE best health care facility in the tri-cities for a three day stay that turned into a ten month long nightmare.  His care was rationed.  He was bleeding to death and the nurse who was taking care of him was practicing medicine as a physician without a physician’s license.  He was going into shock.  Their excuse was the room temperature could have caused him to bleed to death.  The status quo could sure learn a few things on compassionate, efficient, safe and concerned about the patient’s care from Remote Area Medical .  We could start some free preventative care by having the state and local health departments require hospitals and emergency rooms to clean up their act and stop spreading MRSA into our communities.  I would like to know where Rick Boucher and Tim Kaine have been knowing the quality of care here in comparison to what’s being sold by the snake oil merchants.  I know where Bredesen stands unless Bill O’Reilly was fibbing again, which was not surprising after seeing his concern for the people of East Tennessee over the past several years of contacting him and hearing nothing except to be passed on to the agency I started with five years ago.  I was told by Randi Blair of the East Tennessee Facility Licensing board the health care my father got was “horrifying” yet perfectly within the parameters of what the state of Tennessee and the health care system calls “the acceptable standards of health care”.  The status quo is doing more harm than good.  If you care to see what is really their high quality health care just copy/paste (I warn you ahead of time there are some graphic and shocking photos.)  But it is the truth.

Buyer beware, get a second opinion and if you get the flu stay out of emergency rooms, you could come out worse off than before you went in.

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By oldhip, July 31, 2009 at 3:11 am Link to this comment

R-i-g-h-t. . .

A nation whose citizens allowed corporations to become “citizens” - Who allowed three straight proven to be purposefully corrupted national elections to pass without real protests or revolt - Who allowed torture, that resulted in the death of over 100 humans, to be accepted, and “defined” as legal - Who have allowed their nation to become the most incarcerated nation in history, in raw numbers, and percentage of its own population - Who continues to allow over half of it wealth to be spent on a fiscally out of control military-industrial-congressional-complex, more than all of the other nations’ spending - combined - Who remains the only 1st or 2nd world nation without universal health care, the only one controlled by corporations that blatantly let people die, rather than pay for the needed care those peoples’ physicians stated they needed… to live - Who allowed the largest criminal wealth-transfer in written history to succeed, and which is still being accomplished as I write this - Citizens who continue to allow, allow, allow, allow. . .

All of it without real protests, without hitting the streets in anger, without even a weak revolt - Do you think they will not continue to allow. . . Until their own self-destruction results in our destruction also?

In a nation who allows 47% of its adult citizens to not know how long it takes the Earth to orbit the sun, or allow 41% of its adult citizens to believe that humans and dinosaurs coexisted?

Do you think they, the citizens of this nation, aren’t going to continue to allow, even in the face of all the exposed facts concerning their own self-destruction?  Do you really?  Seriously?

The fact that none of the previous administration, outside of one scapegoat, and none of the corporate officers of the banks, et al are not in prison right now, and none of whom are under, at this time, any serious investigation. . .  And that there are no real protests, nor any in the streets righteous anger, nor a revolt of any kind in the face of it all. . .  Kind of says it all right?

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By ardee, July 31, 2009 at 2:47 am Link to this comment

Lest we forget…..

The reform we are wrangling about is insufficient, retains a for-profit slant that will always put profit over care, shuts millions out of health care and is still far more expensive than it needs to be.

While Mr. Sirota may lay the blame on thirteen democrats, forgetting that damn few Republicans will vote for any health care reform bill at all in order to diminish Obama, we should not lose sight of the fact that we are not going to get single payer health care unless we focus and fight.

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By ChaoticGood, July 31, 2009 at 2:30 am Link to this comment

These “Blue Dogs” will not have to worry about being re-elected in 2010 if they stop or severely damage our chances for real reform in healthcare. The people will be so angry and looking to blame someone if the initiative fails because of “Blue Dogs” intransigence.  Unfortunately, they will hand those seats over to Republicans.  The only way they can win is if they help the rest of us.  I hope for everyones sake that they don’t let ideology and self importance blind them.  But I have been disappointed many times before with Democrats timidity.

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By Fat Freddy, July 31, 2009 at 1:40 am Link to this comment

Thanks to our undemocratic system and our corrupt campaign finance laws…

It’s not just the law(s), it’s SCOTUS that ruled that donating money to a campaign is protected “free speech”. As if money caries the same weight in influence as words. Personally, I feel that “donating” to a politician’s campaign is the same as say, giving him a new house or a couple hookers and a bag of meth. It’s corruption, plain and simple. But how can anyone expect the people that directly benefit from it, change it? And the bigger question, would you be willing to pay higher taxes for a public campaign finance Constitutional Amendment?

How many other important issues are determined by campaign contributions? Tax code, defense contacts, research grants, war, education? And yes, it’s not just “big business”, it’s also “big labor”. When I watch a debate on C-SPAN, I get the feeling that I’m not watching an open, honest debate on what is best for the American people, I’m watching attorneys arguing a case for their client(s).

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