Map of life expectancy at birth from Global Education Project.

Monday, October 23, 2006

Big changes ahead?

With the polls now indicating that the party of Warrior Jesus may lose control of the House, and conceivably the Senate as well, I'm naturally inclined to wonder what the impact might be on public health and health care policy. The Unseen Powers strictly enforce the requirement that political analysts state that the Democrats don't have any agenda of their own, and reporters are required to quote them to that effect in news stories. Of course, like everything else said by pundits and quoted by reporters, it isn't exactly true.

Nancy Pelosi, presumptively the next Speaker of the House, has offered her short list. Now, actually making any of this law depends on the Senate, and should legislation get through both chambers, whether the White House occupant decides to veto it, or sign it and issue a signing statement to the effect that he intends to ignore it, in which case it will be "law" but not the law. Or something. Anyhow, for what it's worth, Ms. Pelosi wants to:

  1. "Put new rules in place to "break the link between lobbyists and legislation." That sounds great Nancy! In fact, it will be necessary to get most of the other stuff done. However, it's a) a little vague; and b) ignores the painful reality that your Democratic colleagues, and you, are dependent on the same corporate funders as your colleagues on the other side of the aisle, and you might have trouble rounding up the votes to do anything substantial. We'll see.
  2. "Allow the government to negotiate directly with the pharmaceutical companies for lower drug prices for Medicare patients." This seems like a good idea, but it's not very specific. Does it mean eliminating the intermediaries from Medicare Part D and folding it into regular Medicare? That would be the right thing to do but it means going up against a now-powerful vested interest created by the original legislation, i.e. the insurance companies that manage the program now; as well as going up against the drug companies. Any real prospect of this happening would depend on Item One, above.
  3. "Raise the minimum wage to $7.25 an hour, maybe in one step." And then override the veto with 2/3 of the vote in both houses. Okaaaaaayyyy.
  4. "Broaden the types of stem cell research allowed with federal funds" -- "I hope with a veto-proof majority," she added in an Associated Press interview Thursday." Again, not very specific but let's assume she's talking about having legislators walk in the light of reason and stipulate that a blastocyst is not a human being, which would mean, pretty much, any research that is scientifically sound and holds promise for benefitting humanity should be judged on its merits. This is not by a very long way the most pressing problem facing the country, but I'm not seeing the veto-proof majority.
  5. And now, the pièce de résistance: "All the days after that: "Pay as you go," meaning no increasing the deficit, whether the issue is middle class tax relief, health care or some other priority."

In other words, Grover Norquist has already won. The billionaire tax relief policies of the past 5 years have led Nancy Pelosi to solemnly swear not to make any effort to solve the horrendous problems facing the country. Thanks Nancy, you've shown us all the true meaning of courage.

ADDENDUM: Here are a couple of suggestions of mine for stuff the Dems might actually be able to accomplish. 1) FDA reform. Fix the drug approval process according to the recommendations we've endorsed here, including establishing effective post-marketing surveillance systems and requiring that the companies fund them and use them; requiring that all trial data be posted publicly, and that results of all trials (not just the ones the companies cherry pick) be included in new drug applications; requiring trials against current best treatment; ban on all advertising, not only direct to consumer but marketing to M.D.s as well, for the first 18 months after approval. 2) Eliminate the cap on income subject to social security taxes. 3) Make the Ryan White Care Act authorization and appropriations increase in proportion to the number of people living with HIV in the U.S., plus inflation. 4) Transfer funding from the DEA to the Center for Substance Abuse Treatment. Subsidize state initiatives to provide treatment on demand, and particularly treatment for released convicts, including a seamless transition from incarceration to the community.

You got any nominees?

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