Wednesday, December 2, 2009

What are our expectations?

(Read a transcript of President Obama's address on the 30,000 troops to be deployed in Afghanistan)

If President Obama is serious about generating a credible Afghan government that is capable of holding back the Taliban, do we believe that the one now in place will suffice?

I just watched the Presidential Address on C-Span's website... it is a long speech, but one of Obama's better ones. I admit to having been somewhat swayed early on by the picture that he painted of a world united behind the effort to address the threat to security posed by the 9/11 attacks on the United States.

Nevertheless, I hold reservations about the idea that we will be able to produce an Afghan government that will be strong enough to resist this insurgency. Increasing our troop presence may aid our ability to fight the foe. But will this fighting indeed preserve an Afghan state worth keeping? Or will it, like other frail Asian governments we have sought to prop up with our blood and treasure, fold like a proverbial cheap suit once we leave?

I remain unconvinced that Karzai's Afghanistan is a viable country, or that we can make it so with another couple of years, a few tens of thousands more troops, and some billions more dollars. If our president's pronouncements are to be believed, our security is already under threat from al Qaeda in its current "safe havens" (one might credibly call them "strongholds") within the Afghanistan-Pakistan border area. If my recollection serves and the maps I have seen are accurate, this "border area" has come to include a hefty percentage of both Afghanistan and Pakistan. Even "hopeful" Obama makes no claim now that we will be able to eradicate these existing strongholds completely. So I wonder how much First World security will benefit from this troop increase.

If the fighting further intensifies, it would seem possible that more infrastructure will be destroyed than will be built in Afghanistan during the next two years. And if the history and "personality" of the Afghan people is any indication, then our most desired objective, to bolster the Afghan morale and willingness to continue this fight, may prove most elusive of all.

Sunday, November 29, 2009

Feeding the Poor

Food is perhaps the most basic right a man, woman, or child can have in a civilized society. Take a look at an article from The New York Times on the growing use of food stamps in the United States of America.

This article is disturbing in that it reflects the growing acceptance of widespread poverty. Programs to help people purchase food are good; the economic disparity between rich and poor, and the lack of provision for the needs of all people, that necessitates such programs is a serious problem, and one that seems increasingly accepted.

Saturday, November 28, 2009

Two First-Hand Reports from Guantanamo Bay

(The following is a sketch for a piece written by Maia Goodell, who was one of five non-government observers at the pre-trial hearing of Mohammed Kamin, an Afghan who has been charged with material support to terrorism and is being held in the Guantanamo Bay detention camps.)

On November 18, 2009, at 9:00 a.m., the Military Commissions Trial Judiciary held a pre-trial hearing for Mohamed Kamin, who has been held in U.S. custody since 2003. In April 2008, the Military Commissions’ Convening Authority, the Honorable Susan Crawford, referred a charge against Kamin for material support to terrorism. According to the government, Kamin conducted surveillance, planted explosives, and launched missiles against U.S. Military forces in Afghanistan.

Kamin is one of over 200 detainees still being held in Guantanamo; he is one of only __ who have been charged.

I was one of five non-governmental organization observers invited to be present and observe the proceedings. A single military judge presided; two government and two defense lawyers, all military officers, argued various motions. Two rows of spectators were sparsely populated: Kamin, not being one of the more notorious prisoners, had motivated few reporters to make the 4-day trek for a two-hour hearing on discovery motions.

An Absent Defendant

A distinctive aspect of Kamin’s case, reported by prior observers, is his refusal to attend any of the proceedings. Once again he was not present; Assistant Staff Judge Advocate for the Joint Task Force - Guantanamo (“JTF”), Keleigh Biggins, whose job is to be the primary point of contact for both prosecution and defense counsel for the commissions, took the stand at the center of the courtroom to testify that she went to Kamin’s cell to inform him of his right to attend the hearing. According to her testimony, he was lying on the bed; he told her through an interpreter that he was aware of the court hearing but didn’t want to go, and that he already knew what the statement of his rights said and didn’t want to hear it again. She read it anyway through the interpreter, and said he responded by putting in earplugs and pulling his blanket over his head. When she was done, he made a “shooing” gesture. She testified without objection that it was her opinion he understood his rights.

Defense counsel also questioned Biggins about the defense motion to move Kamin to a different detention block on Guantanamo. According to defense counsel, prior government statements indicate the government is aware that there is pressure to display “solidarity” in Kamin’s cell block, by refusing to participate. Defense counsel asked for him to be moved to another location where "compliant" detainees are housed.

Defense counsel had made this request on November 2 and asked for a response by November 4. Biggins responded by saying the government was considering the request. Questioned on the stand about the delay, she explained that the official she normally communicated with had been “off island” until the day before. Was he the one who had to make the decision? No, his supervisor did. Defense counsel asked the court to order JTF to provide a response -- one way or the other.

The government responded that no order was necessary; a response was forthcoming. They just had to consider a number of factors to consider whether the transfer “When?”, asked the judge. “Hopefully soon.”

That, said the judge, has been the “mantra” in this case from the government -- “it’s in the mail.” A mantra, said the judge, that the government has repeated for the duration of the proceeding – it's on it's way, but it never arrives. After a recess, the judge ordered the government to respond to the request by December 8.

Ultimately, the judge determined that Kamin was aware of his rights and the proceeding could advance, but stated that he had asked defense counsel, who apparently now have some limited communication with Kamin, to advise him that there would come a time when Kamin would be required to be present, voluntarily or not.

An Unclear Future

As of the date of the hearing, Kamin was charged only with “material support for terrorism.” The judge noted at the outset that, at a non-public conference the day before, the government had confirmed that it was plotting new charges against Kamin, which would be sworn and submitted to the Convening Authority by Friday.

Defense counsel opened by noting that the government had received 300 days of successive stays in the case, expiring on November 16, the Friday prior to this Wednesday’s hearing. That day was also, of course, the day that the Obama Administration had announced that it would make a final decision on whether to continue to prosecute the cases currently charged in the military commissions in Guantanamo. When that decision was announced, however, it included only about eleven of the thirty cases pending. Defense counsel -- and the judge -- said they were surprised at not having a resolution for Kamin. The government lawyer said that the inter-agency Department of Defense-Department of Justice task force recommended Kamin’s case proceed under the military commissions rubric, but that the Department of Defense had not yet made a final decision -- other than to give him authority to proceed with today’s hearing.

As an example that seemed to be raised mostly for show, the Military Commissions Act of 2009 now gives the commission jurisdiction over any “alien unprivileged enemy belligerent.” Kamin, the defense argued, was charged under the old Act, as an “unlawful enemy combatant.” Defense counsel brought a new motion under Rule 907(b)(1) arguing that the charges thus failed to allege jurisdiction. The government protested that it was unprepared to argue this issue, and the judge ordered briefs from both sides.

Non-disclosure of Statements of the Accused

Defense next argued a motion to compel disclosure of statements the accused had made. The government, defense counsel noted, had turned over 2000 pages of discovery two weeks before a prior hearing in July; that discovery included the interrogation log for Kamin. By matching the log dates on which interrogations were recorded with the intelligence reports of Kamin’s statements that had been provided, the defense said it had identified seventeen dates for which an interrogation was recorded but it had no report. This, said the defense, vindicated the argument it had been making since December 2008, that the government was not turning over the statements of the accused. The government, given these seventeen instance on October 26, had made no response. Trial counsel responded that the government had found three reports that would be “promptly” provided, and had determined that five of the dates reflected interviews that JTF had not conducted. They were still looking to the rest.

The judge, noting that the charges had been referred in April 2008, expressed frustration with the continued response, “We’re looking into it.” He ruled that by December 15, the government must provide either Kamin’s statement or a detailed explanation of why it was not available for every one of the seventeen dates identified by the defense. Otherwise, the judge warned, sanctions -- including not allowing reliance on the statement -- would be considered.

Prosecution Unprepared to Argue Unscheduled Discovery Motion

The defense then attempted to raise a discovery motion that had been filed concerning unlawful command influence. Trial counsel protested that the motion was “not on the docketing order” and that the government was not prepared to argue it. Given that trial counsel was new, the judge said, he accepted this position and declined to consider the motion.

Discovery of Opinion Memos About Validity of Material Support for Terrorism Charge

Defense counsel next asked for discovery of government memoranda of opinion about whether material support for terrorism is a charge that reflects a traditional violation of the law of war and thus properly prosecutable by a military commission. Narrowing the written request, defense limited the relief sought to memos by the Department of Justice Office of Legal Counsel and Department of Defense General Counsel, which, defense counsel argued, would be binding on the Convening Authority. This would allow the defense, averred counsel, to have a more meaningful exchange with the Convening Authority when they renewed their request to drop the prosecution.

Relying on congressional testimony by administration officials that prosecuting material support for terrorism in the military commissions would probably not survive constitutional review, defense counsel argued that the existence of such memos was likely The government, and the judge, however, noted that since that time Congress had passed, and the President had signed into law, a statute making material support for terrorism one of the offenses that was within the military commission’s purview. Defense counsel responded that the Supreme Court in Chada had specifically ruled that a president can sign a multi-provisional statute while recognizing that parts of it were unconstitutional -- particularly likely here, where the statue was the very large National Defense Authorization Act.

The government characterized the debate about whether material support for terrorism was a charge that was legally cognizable by the military commission as “unimportant and irrelevant to Mr. Kamin’s guilt or innocence.” It noted that the defense had already made two motions to the court and to the Convening Authority. The Convening Authority had stated she was aware of and would follow her obligations and there was no reason to believe that was not the case. Defense counsel, however, noted that the Convening Authority, unlike the court, had to consider the expenditure of resources in deciding whether to continue to prosecute the case. While making no ruling the judge appeared sympathetic to the government’s perspective, noting repeatedly that testimony concerning pending legislation had little weight after that legislation was passed and signed into law, without direction to refrain from enforcing it. Oddly, the government only made reference to attorney-client privilege and work product protection in passing, arguing that even if one “set aside” those considerations, the motion should fail.

Notice to Defense Counsel if Defendant is Transferred

Defense next argued that it was entitled to fourteen days’ notice if the government intended to transfer Kamin, to allow counsel to meet their ethical obligation to assist Kamin in any way possible, and particularly to arrange for travel to be at the new location when Kamin arrived. The government argued that there was nothing defense counsel could do with the information because it would be condition that it not be disclosed to Kamin, that trial counsel was unlikely to have fourteen days’ notice, and that defense counsel should be able to arrange for travel in a much shorter time. The judge did not rule.

Discovery of Witnesses

Defense made two motions concerning witnesses. The first, resolved at a closed-door conference between the judge and counsel pursuant to Rule 802, concerned a military witness who was not responding to defense requests to speak with the witness. The government agreed to direct the witness to contact defense counsel for an interview within ten days.

The second concerned discovery of contact information for two witnesses in Afghanistan involved in the initial detention of Kamin. According to the defense, Kamin was captured by U.S. forces, then transferred to Afghan forces for a short period -- perhaps, defense suggested, to “soften him up” -- then returned to U.S. custody. The defense claimed the witnesses had knowledge of interrogations during that period of Afghan custody, which might taint future statements made to U.S. interrogators.

Further, defense counsel argued, the government could not claim that it could not locate the witnesses given that the United States occupies Afghanistan and the government therefore has “actual and effective control” over most institutions in Afghanistan.

The government disagreed with the defense’s recitation of the sequence of events surrounding Kamin’s capture. Trial counsel said that Kamin had been captured by US and Afghan forces, then released, then brought back to the US forces when evidence was discovered. Thus, no interrogation was conducted outside the presence of US forces. However, the government did not deny that the two witnesses’ involvement was discoverable; it just couldn't find them. The judge questioned how actively the government was looking, and trial counsel stated their investigator was actively seeking out leads, and that the information would be provided to the defense if the government learned it – provided immediately, he added on the judge’s prompt.

Defense counsel countered that if the witnesses still could not be found, the government should suffer sanctions because it was the government that had delayed five years in referring charges, so it should suffer the consequences of the delay.

Trial Schedule

The judge set the following schedule:

December 2 - deadline for submission of law motions
December 9 - responses due
Week of December 16 - hearing to resolve all pending issues, including law motions

Defense counsel noted that the continued uncertainty in the procedure, including the conceded pending revision of the manual governing the commissions, made further delay inevitable in a case in which the accused had already been held more than six years. Defense was put in the position of needing a continuance of the proceedings because they did not know what the rules were going to be; however, the delay was already extreme and not the defendant‘s fault. Therefore, he said, defense would be asking the court to consider abatement of the proceedings as a remedy. The government, and the judge, were of the view that the proceedings could continue under the current rules, subject to reconsideration if something changed.

Apparently, therefore, Kamin’s case is headed for a military commission trial within a few months, unless the government changes course. Whether that will be in Guantanamo or at a new location within the U.S. remains unclear, particularly in light of President Obama’s statement that Guantanamo may remain open into the next year.

(Here is a link to an article written for the Huffington Post by one of the other civilian observers:

Wednesday, November 4, 2009

A long-delayed editorial: Now There Really IS a "War on Terror"

Though this subject is probably beyond my abilities or resources to do justice to, the facts of international events in the past decade and the emerging reality of a multi-front, global war waged by the United States and the other European and predominantly white, formerly Christian nations against a network of terror-friendly organizations in majority Muslim countries cry out for an acknowledgment the "War on Terror," though imaginary in its inception, is now a reality.

A recent New York Times Article on the international funding sources for the Taliban crystalized, for me, the fact that what the George W. Bush Administration decided to bill as a "War on Terror," and which consisted of a tissue-paper erection of easy-to-hate enemies, has become a real conflict with no end in sight. Our "Axis of Evil" goons, friendly and familiar faces like "Saddam Insane" who looked in pictures like the "evil dictators" we have been taught we need to send our troops to dethrone, have been replaced by a real enemy that is not so easy to depict in straw dummy form.

So desperate was the Bush Administration to heroize itself that it deluded itself into believing that this was World War II America, an America beset with powerful, freedom-hating fascistic foes, that it set up a puppet-theater of its own, a stage on which the United States was always right.

We may have, in conducting an endless, faceless, edited-for-internet-video war whose casualties, in Muslim countries, now number in the hundreds of thousands, created the very thing which we once deluded ourselves into believing existed: an alliance of America-hating international terrorists strengthened and funded and perpetuated by terror-friendly or weak governments.

Americans believed we had to destroy a network of determined foes propped up by  political regimes. In practice, by toppling those regimes and destroying regional stability, we have created a radical Islamist alliance even extensive and determined.

Thursday, September 24, 2009

President Barack Obama's Speech on Health Care Reform, September 9, 2009: Full Transcript from CBS News

Madam Speaker, Vice President Biden, members of Congress, and the American people:

When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression. We were losing an average of 700,000 jobs per month. Credit was frozen. And our financial system was on the verge of collapse.

As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods. A full and vibrant recovery is still many months away. And I will not let up until those Americans who seek jobs can find them -- (applause) -- until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes. That is our ultimate goal. But thanks to the bold and decisive action we've taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink. (Applause.)

I want to thank the members of this body for your efforts and your support in these last several months, and especially those who've taken the difficult votes that have put us on a path to recovery. I also want to thank the American people for their patience and resolve during this trying time for our nation.

But we did not come here just to clean up crises. We came here to build a future. (Applause.) So tonight, I return to speak to all of you about an issue that is central to that future -- and that is the issue of health care.

I am not the first President to take up this cause, but I am determined to be the last. (Applause.) It has now been nearly a century since Theodore Roosevelt first called for health care reform. And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way. A bill for comprehensive health reform was first introduced by John Dingell Sr. in 1943. Sixty-five years later, his son continues to introduce that same bill at the beginning of each session. (Applause.)

Our collective failure to meet this challenge -- year after year, decade after decade -- has led us to the breaking point. Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy. These are not primarily people on welfare. These are middle-class Americans. Some can't get insurance on the job. Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer. Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or too expensive to cover.

We are the only democracy -- the only advanced democracy on Earth -- the only wealthy nation -- that allows such hardship for millions of its people. There are now more than 30 million American citizens who cannot get coverage. In just a two-year period, one in every three Americans goes without health care coverage at some point. And every day, 14,000 Americans lose their coverage. In other words, it can happen to anyone.

But the problem that plagues the health care system is not just a problem for the uninsured. Those who do have insurance have never had less security and stability than they do today. More and more Americans worry that if you move, lose your job, or change your job, you'll lose your health insurance too. More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the full cost of care. It happens every day.

One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn't reported gallstones that he didn't even know about. They delayed his treatment, and he died because of it. Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne. By the time she had her insurance reinstated, her breast cancer had more than doubled in size. That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America. (Applause.)

Then there's the problem of rising cost. We spend one and a half times more per person on health care than any other country, but we aren't any healthier for it. This is one of the reasons that insurance premiums have gone up three times faster than wages. It's why so many employers -- especially small businesses -- are forcing their employees to pay more for insurance, or are dropping their coverage entirely. It's why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally -- like our automakers -- are at a huge disadvantage. And it's why those of us with health insurance are also paying a hidden and growing tax for those without it -- about $1,000 per year that pays for somebody else's emergency room and charitable care.

Finally, our health care system is placing an unsustainable burden on taxpayers. When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid. If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined. Put simply, our health care problem is our deficit problem. Nothing else even comes close. Nothing else. (Applause.)

Now, these are the facts. Nobody disputes them. We know we must reform this system. The question is how.

There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's -- (applause) -- where we would severely restrict the private insurance market and have the government provide coverage for everybody. On the right, there are those who argue that we should end employer-based systems and leave individuals to buy health insurance on their own.

I've said -- I have to say that there are arguments to be made for both these approaches. But either one would represent a radical shift that would disrupt the health care most people currently have. Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch. (Applause.) And that is precisely what those of you in Congress have tried to do over the past several months.

During that time, we've seen Washington at its best and at its worst.

We've seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform. Of the five committees asked to develop bills, four have completed their work, and the Senate Finance Committee announced today that it will move forward next week. That has never happened before. Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups, and even drug companies -- many of whom opposed reform in the past. And there is agreement in this chamber on about 80 percent of what needs to be done, putting us closer to the goal of reform than we have ever been.

But what we've also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have towards their own government. Instead of honest debate, we've seen scare tactics. Some have dug into unyielding ideological camps that offer no hope of compromise. Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge. And out of this blizzard of charges and counter-charges, confusion has reigned.

Well, the time for bickering is over. The time for games has passed. (Applause.) Now is the season for action. Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Now is the time to deliver on health care. Now is the time to deliver on health care.

The plan I'm announcing tonight would meet three basic goals. It will provide more security and stability to those who have health insurance. It will provide insurance for those who don't. And it will slow the growth of health care costs for our families, our businesses, and our government. (Applause.) It's a plan that asks everyone to take responsibility for meeting this challenge -- not just government, not just insurance companies, but everybody including employers and individuals. And it's a plan that incorporates ideas from senators and congressmen, from Democrats and Republicans -- and yes, from some of my opponents in both the primary and general election.

Here are the details that every American needs to know about this plan. First, if you are among the hundreds of millions of Americans who already have health insurance through your job, or Medicare, or Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. (Applause.) Let me repeat this: Nothing in our plan requires you to change what you have.

What this plan will do is make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a preexisting condition. (Applause.) As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it the most. (Applause.) They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime. (Applause.) We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. (Applause.) And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies -- (applause) -- because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives. (Applause.)

Now, that's what Americans who have health insurance can expect from this plan -- more security and more stability.

Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. (Applause.) If you lose your job or you change your job, you'll be able to get coverage. If you strike out on your own and start a small business, you'll be able to get coverage. We'll do this by creating a new insurance exchange -- a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance. It's how everyone in this Congress gets affordable insurance. And it's time to give every American the same opportunity that we give ourselves. (Applause.)

Now, for those individuals and small businesses who still can't afford the lower-priced insurance available in the exchange, we'll provide tax credits, the size of which will be based on your need. And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned. This exchange will take effect in four years, which will give us time to do it right. In the meantime, for those Americans who can't get insurance today because they have preexisting medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill. (Applause.) This was a good idea when Senator John McCain proposed it in the campaign, it's a good idea now, and we should all embrace it. (Applause.)

Now, even if we provide these affordable options, there may be those -- especially the young and the healthy -- who still want to take the risk and go without coverage. There may still be companies that refuse to do right by their workers by giving them coverage. The problem is, such irresponsible behavior costs all the rest of us money. If there are affordable options and people still don't sign up for health insurance, it means we pay for these people's expensive emergency room visits. If some businesses don't provide workers health care, it forces the rest of us to pick up the tab when their workers get sick, and gives those businesses an unfair advantage over their competitors. And unless everybody does their part, many of the insurance reforms we seek -- especially requiring insurance companies to cover preexisting conditions -- just can't be achieved.

And that's why under my plan, individuals will be required to carry basic health insurance -- just as most states require you to carry auto insurance. (Applause.) Likewise -- likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still can't afford coverage, and 95 percent of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements. (Applause.) But we can't have large businesses and individuals who can afford coverage game the system by avoiding responsibility to themselves or their employees. Improving our health care system only works if everybody does their part.

And while there remain some significant details to be ironed out, I believe -- (laughter) -- I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses to purchase affordable coverage, and a requirement that people who can afford insurance get insurance.

And I have no doubt that these reforms would greatly benefit Americans from all walks of life, as well as the economy as a whole. Still, given all the misinformation that's been spread over the past few months, I realize -- (applause) -- I realize that many Americans have grown nervous about reform. So tonight I want to address some of the key controversies that are still out there.

Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim made not just by radio and cable talk show hosts, but by prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens. Now, such a charge would be laughable if it weren't so cynical and irresponsible. It is a lie, plain and simple. (Applause.)

There are also those who claim that our reform efforts would insure illegal immigrants. This, too, is false. The reforms -- the reforms I'm proposing would not apply to those who are here illegally.

AUDIENCE MEMBER: You lie! (Boos.)

THE PRESIDENT: It's not true. And one more misunderstanding I want to clear up -- under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place. (Applause.)

Now, my health care proposal has also been attacked by some who oppose reform as a "government takeover" of the entire health care system. As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly sponsored insurance option, administered by the government just like Medicaid or Medicare. (Applause.)

So let me set the record straight here. My guiding principle is, and always has been, that consumers do better when there is choice and competition. That's how the market works. (Applause.) Unfortunately, in 34 states, 75 percent of the insurance market is controlled by five or fewer companies. In Alabama, almost 90 percent is controlled by just one company. And without competition, the price of insurance goes up and quality goes down. And it makes it easier for insurance companies to treat their customers badly -- by cherry-picking the healthiest individuals and trying to drop the sickest, by overcharging small businesses who have no leverage, and by jacking up rates.

Insurance executives don't do this because they're bad people; they do it because it's profitable. As one former insurance executive testified before Congress, insurance companies are not only encouraged to find reasons to drop the seriously ill, they are rewarded for it. All of this is in service of meeting what this former executive called "Wall Street's relentless profit expectations."

Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. (Applause.) And the insurance reforms that I've already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. (Applause.) Now, let me be clear. Let me be clear. It would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5 percent of Americans would sign up.

Despite all this, the insurance companies and their allies don't like this idea. They argue that these private companies can't fairly compete with the government. And they'd be right if taxpayers were subsidizing this public insurance option. But they won't be. I've insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits and excessive administrative costs and executive salaries, it could provide a good deal for consumers, and would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities. (Applause.)

Now, it is -- it's worth noting that a strong majority of Americans still favor a public insurance option of the sort I've proposed tonight. But its impact shouldn't be exaggerated -- by the left or the right or the media. It is only one part of my plan, and shouldn't be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage available for those without it. (Applause.) The public option -- the public option is only a means to that end -- and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have. (Applause.)

For example -- for example, some have suggested that the public option go into effect only in those markets where insurance companies are not providing affordable policies. Others have proposed a co-op or another non-profit entity to administer the plan. These are all constructive ideas worth exploring. But I will not back down on the basic principle that if Americans can't find affordable coverage, we will provide you with a choice. (Applause.) And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the care that you need. (Applause.)

Finally, let me discuss an issue that is a great concern to me, to members of this chamber, and to the public -- and that's how we pay for this plan.

And here's what you need to know. First, I will not sign a plan that adds one dime to our deficits -- either now or in the future. (Applause.) I will not sign it if it adds one dime to the deficit, now or in the future, period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize. (Applause.) Now, part of the reason I faced a trillion-dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for -- from the Iraq war to tax breaks for the wealthy. (Applause.) I will not make that same mistake with health care.

Second, we've estimated that most of this plan can be paid for by finding savings within the existing health care system, a system that is currently full of waste and abuse. Right now, too much of the hard-earned savings and tax dollars we spend on health care don't make us any healthier. That's not my judgment -- it's the judgment of medical professionals across this country. And this is also true when it comes to Medicare and Medicaid.

In fact, I want to speak directly to seniors for a moment, because Medicare is another issue that's been subjected to demagoguery and distortion during the course of this debate.

More than four decades ago, this nation stood up for the principle that after a lifetime of hard work, our seniors should not be left to struggle with a pile of medical bills in their later years. That's how Medicare was born. And it remains a sacred trust that must be passed down from one generation to the next. (Applause.) And that is why not a dollar of the Medicare trust fund will be used to pay for this plan. (Applause.)

The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies -- subsidies that do everything to pad their profits but don't improve the care of seniors. And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead. (Applause.)

Now, these steps will ensure that you -- America's seniors -- get the benefits you've been promised. They will ensure that Medicare is there for future generations. And we can use some of the savings to fill the gap in coverage that forces too many seniors to pay thousands of dollars a year out of their own pockets for prescription drugs. (Applause.) That's what this plan will do for you. So don't pay attention to those scary stories about how your benefits will be cut, especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past and just this year supported a budget that would essentially have turned Medicare into a privatized voucher program. That will not happen on my watch. I will protect Medicare. (Applause.)

Now, because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody. We have long known that some places -- like the Intermountain Healthcare in Utah or the Geisinger Health System in rural Pennsylvania -- offer high-quality care at costs below average. So the commission can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system -- everything from reducing hospital infection rates to encouraging better coordination between teams of doctors.

Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan. (Applause.) Now, much of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers. And this reform will charge insurance companies a fee for their most expensive policies, which will encourage them to provide greater value for the money -- an idea which has the support of Democratic and Republican experts. And according to these same experts, this modest change could help hold down the cost of health care for all of us in the long run.

Now, finally, many in this chamber -- particularly on the Republican side of the aisle -- have long insisted that reforming our medical malpractice laws can help bring down the cost of health care. (Applause.) Now -- there you go. There you go. Now, I don't believe malpractice reform is a silver bullet, but I've talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. (Applause.) So I'm proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine. (Applause.) I know that the Bush administration considered authorizing demonstration projects in individual states to test these ideas. I think it's a good idea, and I'm directing my Secretary of Health and Human Services to move forward on this initiative today. (Applause.)

Now, add it all up, and the plan I'm proposing will cost around $900 billion over 10 years -- less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress passed at the beginning of the previous administration. (Applause.) Now, most of these costs will be paid for with money already being spent -- but spent badly -- in the existing health care system. The plan will not add to our deficit. The middle class will realize greater security, not higher taxes. And if we are able to slow the growth of health care costs by just one-tenth of 1 percent each year -- one-tenth of 1 percent -- it will actually reduce the deficit by $4 trillion over the long term.

Now, this is the plan I'm proposing. It's a plan that incorporates ideas from many of the people in this room tonight -- Democrats and Republicans. And I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen. My door is always open.

But know this: I will not waste time with those who have made the calculation that it's better politics to kill this plan than to improve it. (Applause.) I won't stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what's in this plan, we will call you out. (Applause.) And I will not -- and I will not accept the status quo as a solution. Not this time. Not now.

Everyone in this room knows what will happen if we do nothing. Our deficit will grow. More families will go bankrupt. More businesses will close. More Americans will lose their coverage when they are sick and need it the most. And more will die as a result. We know these things to be true.

That is why we cannot fail. Because there are too many Americans counting on us to succeed -- the ones who suffer silently, and the ones who shared their stories with us at town halls, in e-mails, and in letters.

I received one of those letters a few days ago. It was from our beloved friend and colleague, Ted Kennedy. He had written it back in May, shortly after he was told that his illness was terminal. He asked that it be delivered upon his death.

In it, he spoke about what a happy time his last months were, thanks to the love and support of family and friends, his wife, Vicki, his amazing children, who are all here tonight. And he expressed confidence that this would be the year that health care reform -- "that great unfinished business of our society," he called it -- would finally pass. He repeated the truth that health care is decisive for our future prosperity, but he also reminded me that "it concerns more than material things." "What we face," he wrote, "is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."

I've thought about that phrase quite a bit in recent days -- the character of our country. One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government. And figuring out the appropriate size and role of government has always been a source of rigorous and, yes, sometimes angry debate. That's our history.

For some of Ted Kennedy's critics, his brand of liberalism represented an affront to American liberty. In their minds, his passion for universal health care was nothing more than a passion for big government.

But those of us who knew Teddy and worked with him here -- people of both parties -- know that what drove him was something more. His friend Orrin Hatch -- he knows that. They worked together to provide children with health insurance. His friend John McCain knows that. They worked together on a Patient's Bill of Rights. His friend Chuck Grassley knows that. They worked together to provide health care to children with disabilities.

On issues like these, Ted Kennedy's passion was born not of some rigid ideology, but of his own experience. It was the experience of having two children stricken with cancer. He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick. And he was able to imagine what it must be like for those without insurance, what it would be like to have to say to a wife or a child or an aging parent, there is something that could make you better, but I just can't afford it.

That large-heartedness -- that concern and regard for the plight of others -- is not a partisan feeling. It's not a Republican or a Democratic feeling. It, too, is part of the American character -- our ability to stand in other people's shoes; a recognition that we are all in this together, and when fortune turns against one of us, others are there to lend a helping hand; a belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgment that sometimes government has to step in to help deliver on that promise.

This has always been the history of our progress. In 1935, when over half of our seniors could not support themselves and millions had seen their savings wiped away, there were those who argued that Social Security would lead to socialism, but the men and women of Congress stood fast, and we are all the better for it. In 1965, when some argued that Medicare represented a government takeover of health care, members of Congress -- Democrats and Republicans -- did not back down. They joined together so that all of us could enter our golden years with some basic peace of mind.

You see, our predecessors understood that government could not, and should not, solve every problem. They understood that there are instances when the gains in security from government action are not worth the added constraints on our freedom. But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, the vulnerable can be exploited. And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity passes for wisdom, and we can no longer even engage in a civil conversation with each other over the things that truly matter -- that at that point we don't merely lose our capacity to solve big challenges. We lose something essential about ourselves.

That was true then. It remains true today. I understand how difficult this health care debate has been. I know that many in this country are deeply skeptical that government is looking out for them. I understand that the politically safe move would be to kick the can further down the road -- to defer reform one more year, or one more election, or one more term.

But that is not what the moment calls for. That's not what we came here to do. We did not come to fear the future. We came here to shape it. I still believe we can act even when it's hard. (Applause.) I still believe -- I still believe that we can act when it's hard. I still believe we can replace acrimony with civility, and gridlock with progress. I still believe we can do great things, and that here and now we will meet history's test.

Because that's who we are. That is our calling. That is our character. Thank you, God bless you, and may God bless the United States of America. (Applause.)

Friday, September 18, 2009

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When We Don't Know Our Right Hand From Our Left

 article from Politico

It is early days yet, but in recent months, Republicans seem to have turned around and become the most successful out-of-power party in recent memory.

Here's an article on how the Right is using techniques made famous by liberal movements to stir opposition to the Democratic federal government.

What would Ann Coulter say about the Right using "liberal" techniques? Probably something so profane we couldn't post it on this blog!