Another Democratic "Compromise" . . .

. . .that's a total cave. Yeah, Congress is apparently going to pass an extension of the payroll tax cut -- which was a terrible idea in the first place but it's the only economic stimulus Obama could get through Congress. And they're going to pass the so-called "doc fix" without threatening to shut down the government first. This has to do with an arcane statutory provision called the Medicare Sustainable Growth Rate, which basically requires a periodic vote to prevent reimbursement to physicians from being deeply slashed, kind of like the debt limit problem. What really needs to happen is that reimbursement rates for specialists should indeed be reduced, and more support should go to primary care, but that's a fight for another day.

But how are they going to pay for this? Funny you should ask. They're going to rip $5 billion out of the Prevention and Public Health Fund, one of the signature achievements of the health care reform act. We spend about 5% as much on preventing disease as we do on treating it once it's already happened. That makes no sense. But Republicans hate the idea of preventing disease -- they call the PPHF a "slush fund," whatever the heck they mean by that.

Why do they hate the idea of preventing disease? I'm not entirely sure, but maybe it's partly because a major way of doing that is to counteract corporate marketing of tobacco and junk food. Anyway, here's how Pennsylvania, for example, is spending its share.

It is not a win to slash spending on public health and give the money to highly paid medical specialists to try to fix the damage that could have been prevented. It's a massive surrender.

We need better Democrats.