« Clinton, And Clinton Alone | Main | More Kindle Commentary »

November 20, 2007

The Republicans and Cancer

If anyone from The LA Times would like to come by Ezra Klein World Headquarters, I have a giant gold star for them:

When Rudolph W. Giuliani was diagnosed with prostate cancer in the spring of 2000, one thing he did not have to worry about was a lack of medical insurance.

Today, the former New York mayor joins two other cancer survivors in seeking the Republican presidential nomination: Arizona Sen. John McCain has been treated for melanoma, the most serious type of skin malignancy, and former Tennessee Sen. Fred Thompson had lymphoma, a cancer of the immune system.

All three have offered proposals with the stated aim of helping the 47 million people in the U.S. who have no health insurance, including those with preexisting medical conditions.

But under the plans all three have put forward, cancer survivors such as themselves could not be sure of getting coverage -- especially if they were not already covered by a government or job-related plan and had to seek insurance as individuals.

As you folks already know, the Republican plans do very little to reform the health care system, and absolutely nothing to reform the insurance system. If you're blocked from accessing health insurance now, these plans do nothing to help you. They would, for instance, do nothing to help Susan Brown:

Susan Brown, 53, discovered her melanoma early -- a sore spot on her left shoulder smaller than a pencil eraser. She was successfully treated in 2000. But Brown, who lives in a small town in East Texas, had to give up her job as a medical office manager -- and the healthcare benefits it came with.

Since then, she said, she has been unable to find private coverage that she can afford. One company turned her down. Another wanted a letter from her cancer specialist stating that the disease would not return. Others demanded premiums that would have drained her bank account in return for policies that still would not have covered a recurrence of cancer.

The candidates "can't sit there and say they understand what people are going through, because they've got healthcare," Brown said. "We went through the same illness, however [they] don't understand what it's like not to have health insurance."

Brown remains cancer-free but uninsured. She depends on charity care for her follow-up cancer screenings, she said.

If you have cancer and can't get health insurance, the Republican solution is a tax cut. The Democratic solution is health insurance. So far as health care goes, that's the election's bottom line. What's all the more amazing is that the Republicans offering these inconsequential, insufficient plans are, themselves, cancer survivors, who routinely laud the wonderful health care they were able to access because they had health insurance. Indeed, Giuliani's post-cancer realization was that everybody should have health insurance, and that his legacy would be expanding coverage.

That was before he decided to run for president, of course. Before cruelty became more politically expedient than compassion.

November 20, 2007 in Health Care | Permalink


Democrats good, Republicans bad. We get it, Ezra.

For those interested in successfully reforming our health care system, this was the interesting piece of the article:

"People who advocate the individual market have a lot of work to do to explain how they are going to get better results than we get today," said Paul Ginsburg, president of the Center for Studying Health System Change, a health policy research group. "One of the ironies is that that takes regulation by government, and Republicans running in the primaries don't like to talk about that."

This is the real challenge for this type of solution. But it doesn't fit inside the partisan/ideological boxes neatly, so people don't want to talk about it-- that doesn't get TV ratings or blog hits.

For this type of solution, you'd need a politician who's actually interested in real reform and less interested in scoring political points ("tax cuts" for the right and "public option" for the left).

Any of those politicians exist?

Hmm... oh yeah, Senator Wyden. The guy with the best plan of all of them.

People need to take a serious look at his plan-- Ezra rightfully had a post on it last week. Universal coverage, decent government oversight/regulation of insurers, delinking jobs from insurance coverage, promises of real cost control and competition. And something that actually holds political promise of being passed.

Posted by: wisewon | Nov 20, 2007 2:16:06 PM

This is the real challenge for this type of solution. But it doesn't fit inside the partisan/ideological boxes neatly, so people don't want to talk about it-- that doesn't get TV ratings or blog hits.

I don't know what the political parties are like on your planet, and more importantly I haven't read the article because I don't have a registration to the L.A. Times, but that quoted paragraph sure doesn't seem to support your idea that partisan ideologies don't apply to this.

Posted by: Cyrus | Nov 20, 2007 2:49:58 PM


The point Ginsburg is making is that a individual market requires sufficient regulation in order to work. Republicans are pushing individual markets without the regulation, Dems are pushing for more regulation with an aim of single-payer, not individual markets.

Posted by: wisewon | Nov 20, 2007 3:32:39 PM

But it doesn't fit inside the partisan/ideological boxes neatly
Hmm... oh yeah, Senator Wyden. The guy with the best plan of all of them.
- wisewon

And which party is Sen. Wyden in perchance?


If you have cancer and can't get health insurance, the Republican solution is a tax cut. The Democratic solution is health insurance

is a point the Democrats(*) somehow need to drive home. There are still many voters out there who are think

well, there are Democrats who have their heart in the right place and those who are just after getting themselves into gummint and giving the gummint power ... and there are Republicans who are brazen plutocrats, that's true, but many of them really are trying to help the poor in the way they think is best. So even if my church tells me to be concerned about the poor when I vote, I can still vote for the GOP as they want to help the poor as much as the Democrats do -- they just have a different idea of how to go about doing it that's equally valid. And anyway, my church also tells me abortion is teh evil and the GOP is against it while the Democrats want to keep it legal. So I'm gonna vote GOP.

But it isn't the case that the GOP and Democrats just are trying to take different paths to helping the poor, e.g., get health care. One side is proposing ideas that may actually do something while the other side is clearly proposing nonsense.

So how do we communicate this distinction? I dunno, but I reckon that the "we gotta play to the middle and blur all distinctions between us and the GOP" crowd ain't helping.

*and yes, this is about scoring political points -- unlike what the Washington Insiders with their fainting spells would say, politics is the way things happen in a democratic republic ... haven't people read the Federalist Papers? in order to get things done, you need to play the game. Nu? play it.

Posted by: DAS | Nov 20, 2007 4:26:20 PM

I just love sob stories so light on facts they float away. From the article we know she use to work but apparently no longer does. If she is no longer able to work then why isn’t she on Medicare disability? If she is able to work but just doesn’t why isn’t she on Medicaid? Both are supposedly excellent government run programs, why are they failing this women in her time of need?

OMG they asked her physician to write a letter saying her cancer was in remission! How could anyone possibly be asked to do such a thing. I mean that might take all of 2-3 phone calls and a postage stamp, no American should be subjected to such corporate tyranny.

Policies that wouldn’t cover her cancer is a big bunch of BS. Unless LAT is hiding facts from us her cancer would be covered, and I am certain the LAT would never hide facts from its readers.

The Democrat solution is a bunch of empty promises. When you can deliver on your promises to the poor, Medicaid, Public Housing, Welfare and Veterans, poor state of VA healthcare, then try to sell the rest of us on your pipe dreams.

Prescriptions have been a major part of healthcare for what 30+ years? Medicare started covering them when? Ya that great modern government run healthcare.

Just because Liberals are incapable of understanding the intricate details of Health Insurance and how it is delivered doesn’t make Republican plans inconsequential, and insufficient plans, just makes them to complex for Democrats, like most problems we face.

Posted by: Nate O | Nov 20, 2007 5:07:09 PM


Ezra has said the same thing previously. What I wrote then and applies now:

If this blog is purely about health care politics, so be it. But if you are interested in discussing policy, there are some good ideas here. You can say again that you "can't take the politics out of politics"-- but if you never look at the policy ideas outside the context of politics, you can never frame the "ideal plan" that can that be adjusted for the politics. Its exactly what Rove's problem was-- there was never any consideration for the best policy outside the context of the politics. Its a marriage and balance of the two.

Posted by: wisewon | Nov 20, 2007 5:18:02 PM

OMG they asked her physician to write a letter saying her cancer was in remission! How could anyone possibly be asked to do such a thing.

No, they asked her physician to write a letter saying her cancer would never come back, i.e. asked for something they knew they either wouldn't get, or that only Dr Nick of Hollywood Upstairs Medical College would write.

I love heartless bastards who assume that behind every story of Big Insurance doing what it does best -- look after the profit margin -- there's a fraudulent individual. Please, take that position and run for office on the back of it.

Now, if someone could write a letter promising that Nate O wouldn't come back...

Posted by: pseudonymous in nc | Nov 20, 2007 5:44:58 PM

NateO wrote: "If she is no longer able to work then why isn’t she on Medicare disability?"

Try this statement from Medicare, "You will automatically be enrolled in Medicare after you get Social Security disability benefits for two years." Jerk.

Posted by: SteveH | Nov 20, 2007 5:54:33 PM

DAS is right on the money. Republicans have "principles" i.e. small government and Democrats have "policy" i.e. ALL citizens should have efficient and effective health care (given that this is, for a little while still, the most prosperous country in the history of the world). For the Republicans, if some people can't get adequate (or any) health care because of small government, well, that's the way it goes. For the Democrats, if we can't have small government because of getting everyone adequate health care, well, then that's the way it goes. That's a pretty clear distinction.

Posted by: BlueStreak | Nov 20, 2007 6:04:09 PM

To follow up on what SteveH said, AFAIK, Medicaid is only for the destitute: i.e. you need to spend all your money on things before you qualify -- then, when you are having to choose whether to have cheap dog food and go out to eat (i.e. dumpster diving), do you qualify.

I have an aquaintance in a somewhat similar situation: she is not mentally quite stable enough or physically healthy enough to hold a real job. But since she can't get a good job, she can't get the quality of health care she needs in order to actually be well enough to work. And how is she gonna afford health care that'd really deal with her problems?

Posted by: DAS | Nov 20, 2007 6:14:02 PM

I just love sob stories so light on facts they float away.

So that explains why you post comments so often!

Posted by: DMonteith | Nov 20, 2007 6:31:10 PM

Let's think out of the box here. As far as I can tell, neither the Ds nor the Rs have anything at all likely to work. The Ds want to make a bad system mandatory and the Rs don't have a clue.

We can only get to meaningful reform by getting health care away from the political parties and the Beltway, and work together with other nonpartisan nonprofits to create a system that works for us not against us.

I have lived through the civil rights movement, the women's movement and Vietnam antiwar movement. Effective change is only going to happen when we the people take matters into our own hands.

There is far more consensus out there then the politicians, pundits and the press lead us to believe. We have done work in three states now. We need to build on the consensus that exists and get something done. We certainly can't leave it to the candidates!

Keep up the good work! This is some of the most refreshing health policy discussions I have heard in my 30+ years of following reform.

For a really cheery thought, health care reform has failed since 1932! The one constant--the public has been held at arm's length when it comes to reform. We must change this. Now.

Cheers and more later. Kathleen

Posted by: Kathleen O'Connor | Nov 20, 2007 6:44:38 PM

DAS is right on the money. Republicans have "principles" i.e. small government and Democrats have "policy" i.e. ALL citizens should have efficient and effective health care

Huh? What you described is the Republicans having what could be described as either a "principle" or a "policy," ("small government," which could be a principle that government should be small, or policy of small government for whatever reason), and the Democrats as having a "principle." ("ALL citizens should have efficient and effective health care," with the normative "should" indicating a principle) Which is good. Having principles is good. "All citizens should have efficient and effective health care" is a principle, rather than a policy, but a number of good policies could follow from that principle (community rate + subsidize + mandate schemes, single payer, etc).

Posted by: Julian Elson | Nov 20, 2007 9:03:28 PM

pseudonymous in nc, this is why people that have no clue what they are talking about should not be allowed to propose policy or call themselves journalist. Ask ANYONE in insurance and they will say the Insurance Company asked the doctor for her prognosis to verify it was in remission. It’s standard procedure and happens hundreds of times a day. You get some half wit LA Times writer trying to make the story sound worse then it is or is just plain stupid and you end up with a factual incorrect sob story for clueless sheep to bah over. Any insurance company employee, nurse, doctor, or UR person that deals with these daily will tell you the exact same thing.

Do you ever stop to wonder what other lies and misconceptions you have fallen for? Liberal comprehension and ideology of insurance and how it works day to day is so detached from reality you would fall for anything. We could write the LAT and ask them to verify the fact but they have a habit of not hearing people when they question their accuracy, there are entire blogs dedicated to the LAT and how poor their reporting is.

Posted by: Nate O | Nov 20, 2007 9:20:18 PM

SteveH, maybe before you resort to calling names you should learn to read? Take your fingers out of your ears and try to follow along, it really is simple. She was treated in 2000 and stopped working, it is now 2007, that would be up to 7 years. If she has been unable to work for 7 years why does she not have Medicare? Why is she not on SS Disability?

BlueStreak, what if Democrats promise healthcare for all, tax us to ^&($#, and fail to deliver? Just because their “Plan” says everyone will be covered that doesn’t mean it will work. 6.6 million kids are eligible for Medicaid or SCHIP yet are not enrolled. The SCHIP “plan” was that all kids living in households with incomes under 200% would have insurance yet here we are with 6.6 million that still don’t. Think about this math, of the 9 million uninsured kids 74% are eligible for top of the line government provided healthcare at little to no cost yet don’t have it. 90% of the 9 million live in households where at least one parent works. 50% both parents work. Mandating employers offer insurance and offering subsidies for the poor would be far more effective then the current government program you all laud. Granted it’s a very simple solution, won’t cost a fortune in taxes or shift major resource to government control but isn’t the purpose to cover the kids….or is it? Someone needs to sit Liberal Policy makers in a classroom and explain Occam’s razor to them…repeatedly.


Kathleen, I have posted here before that it is government reform that created the mess we have today. I’ve been trying to get any one here to even acknowledge the HMO Act of 1973 even exist let alone discuss how it created most of what they complain about today. As long as we look to government for solutions we’ll continue to digress.

Posted by: Nate O | Nov 20, 2007 9:41:00 PM

I was wondering how long it would take Nate O to show up and whine about anecdotes about people in need. Your mix of selective reading, arrogance and ad hominem is truly special.

The article doesn't say she is disabled and can't work; it says that she had to give up the job that gave her insurance. Now, with a preexisting condition, she can't get coverage except at a prohibitive cost.

For the rest of us, take the Lawyers, Guns, and Money pledge to ignore people like Nate O; we will all be happier for it.

Posted by: jmack | Nov 20, 2007 11:24:46 PM

What is the prohibitive cost? By who's measure is it prohibitive? Does she work now? Does her new job not offer benefits?

What is it with Liberals and the Media, if you read something in the LAT, NYT, or see it on CBS, NBC, or ABC you believe it 100% without any questions. You then take these "facts" you are so certain of and develope this distorted impression of the world. You would reform our health system based no more fact then what your told by the MSM.

Your ideology is built on lies! Most stories your feed about healthcare and insurance by your media and policy wonks are factually inaccurate. Your base of knowledge comes from a group that also has no idea what they are talking about.

Posted by: Nate O | Nov 20, 2007 11:48:38 PM

"What is it with Liberals and the Media, if you read something in the LAT, NYT, or see it on CBS, NBC, or ABC you believe it 100% without any questions. You then take these "facts" you are so certain of and develope this distorted impression of the world. You would reform our health system based no more fact then what your told by the MSM."

Your ability to sum up the entire basis of my beliefs is astounding! I keep trying to think for myself, but I keep getting bamboozled by every single mainstream media outlet! Combine this with your complete inability to read and you have a winning combination.

Whether she can find a job with benefits is completely fucking irrelevant if "Eleven [insurance] companies said they would deny coverage, and six said they would issue a policy at standard rates. One company said it would charge double the usual premium. Another said it would issue a policy but exclude future cancer treatment. Three insurers did not respond." The fact that we don't know the precise costs for this case doesn't change the fact that this case is representative a common problem.

But I am sure you are right, I am sure that everyone involved in this story made it up. I'll bet that they are all on the Democrats' payroll to invent stuff like this so that we can all live under the Democrats' ideal of a socialist paradise. Beat it guys, Nate O is on to us!

Now, I will officially take the pledge.

Posted by: jmack | Nov 21, 2007 7:37:29 AM


"Are there no prisons? Are there no poor houses?"

Scrooge had it right!

Posted by: A Canadian Reader | Nov 21, 2007 11:12:04 AM

What people like Nate O are saying, without actually coming out and saying it, is that people who have cancer and might get it again don't deserve to have health insurance because it might become too costly for the insurance company.

What if the doctor had replied, "Sorry, but it's quite likely this cancer will recur within five years"? The insurance company would then say, "Okay, then--no health policy for you!" or, equally bad, "We'll cover your flu shots, but no health policy covering cancer treatment for you!"

That is what it has come down to, ladies and gentlemen. It is a moral and ethical disgrace that the United States, ostensibly the richest and most powerful country on Earth, can brook such institutionalized evildoing.

It goes without saying, though I'll say it anyway, that the Dems' watery proposals are still far to the right of the most conservative health policies (and politicians) in other developed nations. Far to the right. Wake the hell up!

And if you've been supporting such unconscionable Scroogedom toward Americans whose only sin was to fall ill, then you, like Scottie McClellan, should hang your head in shame today.

Posted by: litbrit | Nov 21, 2007 12:11:43 PM

litbrit, let me say it again for you. I work in Inusrance, every year when my clients renew I send these exact same letters to Doctors for any members with large claims. The doctors return them to me and I review them. I also sell Individual policies, when friends make me, so again I see the actual letters the Insurance carrier sends out and what the doctor sends back. I have worked with these letters for about 15 years. How many letters have you even seen? How about any of the other clueless liberals on this blog that have never worked a single day in Insurance or Healthcare? How about the LAT journalist how many letters has he reviewed.

Your assumetions based on erronous facts shows you as the uninformed ass you are. Before you going trashing an industry and suggesting it be overhauled maybe you should take 5 minutes to learn what your talking about? Maybe when someone points out your errors you should be thankful for someone correcting your errors instead of deny the truth. You destroy your own argument when you blindly push lies. If your so rightous and your ideology is correct why is it always supported by false anscedotes? If things in Iraq are so bad why did you trot out McBeath and Beaucamp. If HC in America is so bad why can't you show real problems instead of making them up.

Posted by: Nate O | Nov 22, 2007 12:01:44 PM

Hey NateO,

Trust me, as an employer as well as a mother of three learning-disabled children and the daughter of a woman who runs medical offices and deals with your industry--trying to get paid, that is--every day, I know your letters all too well.

That's why I can confidently state they, like you, are unconscionable.

And you can shove your red herrings and thread-derailings up your nether regions, hard. Perhaps if you code things correctly and ask really nicely, your company might even reimburse you 60% of the cost of having them surgically removed, if not the pain-killers you'll need afterwards.

Posted by: litbrit | Nov 23, 2007 7:55:30 PM

litbrit, you would make an excellent reporter for the LAT. We know learn your mother might work with similar letters on a regular basis, I’m willing the bet the first question everyone wants you to ask is;

Has your mom ever received a letter asking the doctor to certify a patient will never get cancer again?

But instead we get a personal attack for daring to ask the question. What would any reasonable intelligent person think when you support sob stories with questionable anecdotes and when presented with the opportunity to show unequivocally how bad the situation is you bring up your children? What do your children have to do with anything? They are a shield so someone wouldn’t dare question you, who’s going to question the hard working mother of three learning challenged children, only an unconscionable bastard right? So you have now managed to protect your lies and further the dogma that insurance companies are evil without presenting a single fact.

Call me bastard because I’ll say it again, you and the LAT story are full of BS. Didn’t happen that way in the story and doesn’t happen that way in real life.

PS you seemed to group me in with the insurance company in your ranting, if you knew the industry you would be aware that TPAs are employed by the employer, usually, and thus would be fighting against the insurance company to get them to view the medical records favorably. I try to get the lowest reinsurance rates for my clients and that usually entails convincing the insurer that the guy in the hospital that just had a transplant is doing great and they don’t need to worry about them. When I sell individual policies I obviously want the person to get accepted for the policy so I can get paid and thus am again on the side of the little man. Are you sure you’re in the industry? Or does being honest automatically make you an insurance company shill?

Posted by: NateO | Nov 24, 2007 4:51:21 PM

Take the pledge, litbrit...

Posted by: jmack | Nov 24, 2007 8:10:09 PM

The comments to this entry are closed.