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Kaiser Kidney Fiasco

If the confusion and miserable performance that has resulted from the Republicans' Prescription Drug giveaway to the HMO's and insurance companies wasn't enough to demonstrate the private sector's incapacity to meet our medical needs, then check out this horrifying investigative report by the Los Angeles Times.

Kaiser Permanente forced more than 1500 patients awaiting kidney transplants to transfer "to a new transplant center run by Kaiser itself -- the first ever opened by the nation's largest HMO."

The patients were moved from established programs into its "fledgling program" in San Francisco with "a waiting list [that] ranked among the longest in the country…. The patients didn't know it, but their odds of getting a kidney had plummeted."

The numbers tell much of the story: in the first year, "Kaiser performed only 56 transplants, while twice that many people on the waiting list died…. In each of the two years before Kaiser opened its program, UC San Francisco and UC Davis medical centers together performed at least 168 transplants on Kaiser patients."

In hundreds of cases Kaiser neglected to record the amount of time patients had already spent on waiting lists at other hospitals. Consequently, many were wrongly placed at the bottom of the new waiting list – even if a patient was close to receiving a transplant at a previous hospital.

Dr. Stephen Tomlanovich, medical director of UC San Francisco's renal transplant service, has tried repeatedly--"by phone, fax and e-mail"--to contact Kaiser about 220 patients who have not been credited with time already spent on its waiting list. He also noted that Kaiser representatives denied 25 patients "the chance for new kidneys that were nearly perfectly matched" because the company would not authorize UC San Francisco to do the transplants. To make matters worse, Kaiser failed to do the paperwork necessary to transfer those same patients into its own program--the patients were "stranded."

67 patients formerly treated by UC Davis inherited another setback due to the transfer: organs are allocated regionally, and the waiting time in the concentrated San Francisco area is nearly double that of the Sacramento area.

The financial motive for Kaiser's decision is readily apparent. "The San Francisco hospital's open-heart surgery program was shrinking as less-invasive procedures became more popular. Kaiser was left with unused beds and operating rooms."

"The timing was perfect," according to Dr. Bruce Blumberg, the chief physician at Kaiser's main San Francisco hospital.

Aside from the statistics on patient care, the personnel records are also revealing: "10 permanent employees have quit or been fired out of a staff of 22."

In January--prior to being placed on administrative leave--kidney specialist Dr. W. James Chon wrote, "On the outside, the program seems to have settled into a reasonably functioning unit. However, a closer look at the program will show that it is suffering from very serious and potentially explosive problems."

Indeed, it is explosive problems such as these that have led an overwhelming majority of Americans to support national health care, as well as The Nation and columnists like Paul Krugman who called for Medicare for all Americans in his Death By Insurance op-ed this week.

The 2006 and 2008 elections must be defined by three issues: The Constitution--DEFEND it; the war in Iraq--END IT; and national health care--PASS IT. The Kaiser kidney fiasco reemphasizes the urgency of taking health care out of the hands of private companies concerned first and foremost with profits not people.

Mission (Really) Not Accomplished

President Bush and his acolytes continually suggest that the occupations of Afghanistan and Iraq are "success stories" that just have not receiving proper attention from the U.S. media.

Unfortunately for the spin doctors who dressed the president up in flight-suit drag and made their Iraq "mission accomplished" declaration three years ago are having a hard time convincing serious observers of global affairs that they have achieved anything but disaster.

According to the The Failed State Index, an authoritative annual analysis produced by Foreign Policy magazine and the Washington, DC, based Fund for Peace, both Iraq and Afghanistan are in serious trouble.

The 2005 index, which ranks 148 states according to 12 social, economic, political, and military indicators based on data from more than 11,000 publicly available sources, ranked Iraq at number four and Afghanistan at number 10 on the list of the most dysfunctional countries on the planet.

According to the analysis, which employs internationally recognized methodology to assess violent internal conflicts and to measure the impact of strategies to create stability, "Despite holding successful elections and ratifying new constitutions, both Iraq (4th) and Afghanistan (10th) saw their scores decline in the 2006 edition of the index. Persistent insurgent violence undermined modest gains in the delivery of public services and establishment of political institutions, placing both nations among the 10 most vulnerable in the world."

Another country in which the Bush administration has been meddling with abandon, Pakistan, finds itself at No. 9 on the list -- although, in fairness, a natural disaster added to that nation's turmoil.

To be sure, there are other troubled countries: Sudan , where the Darfur crisis continues, is the first on the list; the Democratic Republic of the Congo is second, while Ivory Coast ranks third.

But the "failure" ratings for Iraq and Afghanistan stand out, as does the relatively low ranking of the United States.

In a telling measure of the damage done on the homefront by the Bush administration's focus on warmaking abroad, the United States is ranked as more vulberable than Norway, Sweden, Finland, Ireland, Switzerland, New Zealand, Australia, Canada, Belgium, Denmark, Austria, Japan, Netherlands, Singapore, Chile, Portugal, Great Britain and France.

The cost of misguided military adventures abroad is great for the countries that are invaded and occupied. But it is great, as well, for the countries that do the invading and occupying.

Sham Reformers

Yesterday the Washington Post offered a prescient warning about the pathetic lobbying "reform" bill passed by the House 217-213 last night.

Democrats tempted to vote for this sham because they're scared of 30-second ads that accuse them of opposing lobbying reform ought to ask themselves whether they really think so little of their constituents. As for Republicans willing to settle for this legislative fig leaf, they ought to listen to Rep. Christopher Shays (R-Conn). "I happen to believe we are losing our moral authority to lead this place," Mr. Shays said on the House floor last week.

The GOP leadership wanted to claim the mantle of reform without actually enacting any reforms. Sadly, eight Democrats--enough to switch the outcome on a razor thin vote--took the bait. They are:

Barrow, Boren, Boswell, Cuellar, Marshall, Matheson,Melancon,Taylor (MS)

Of the anti-reform eight, seven are conservative Blue Dog Democrats, six voted for the bankruptcy bill, five voted for the GOP energy bill and so-called tort reform and two members (Cueller and Matheson), voted for all three, plus CAFTA. At least Cuellar got a primary challenge this election cycle.

The Democratic leadership tried its best to keep members united. But at the end of the day, the seventeen Republicans voting nay were braver than the eight Democrats voting yea.

Thank You Jack, May I Have Another?

To understand what the sham lobbying "reform" bill that the House will likely pass today will do, you need to understand what it won't do. The only reason Congress is talking about lobbying reform is because of Jack Abramoff and his Fedora-studded guilty plea last January. Yet the so-called reforms in the "Lobbying Accountability and Transparency Act" will do absolutely nothing to prevent the next Abramoff, as this valuable chart from Public Citizen shows.

Moreover, as Public Citizen recognizes: "Corruption by lobbyists and lawmakers does not begin or end with Abramoff; it is a systemic problem. There are many more Jack Abramoffs peddling their wares on the Hill."

Yes. Don't forget about prostitutes at the Watergate servicing Republican members of Congress and CIA aides. Abramoff may be too technical, but hookers everyone can understand.

UPDATE: The final bill passed around 5:30 on a 217-213 vote. Nineteen Republicans voted with the Democrats in opposing the bill. Eight Dems voted with the GOP leadership. Will post their names once I have them. If those eight held the line, sham bill might've failed.

Ney's Day is Coming

At least one GOP lawmaker is paying attention to L'Affair Abramoff: Ohio Rep. Bob Ney. Time is running out for the former "Mayor of Capitol Hill."

Dennis Hastert pushed the Ohio Congressman from his House Administration Committee chairmanship following Abramoff's DC indictment in January. Since then, a game of wait and see has transpired between Ney and the law.

Ney's statute of limitations in the Abramoff Sun Cruz casino fleet investigation expired last Thursday, with the Justice Department opting for an expanded corruption probe. Ney's lawyer says his client will learn in "a month or two" whether he faces criminal charges. Multiple guilty pleas from Abramoff and his aides ID'd Ney as the bribe-taking "Representative #1."

That's probably why $96,500 of Ney's 250,098 campaign dollars last quarter went toward legal fees. Or why Congressional Quarterly recently changed Ney's re-election prospects from "Lean Republican" to a tossup, with internal GOP polling showing Ney losing to either of his Democratic challengers. Or why the pretrial motion in the federal investigation into indicted Bush Administration official David Safavian argues that Ney underreported the cost of his golf trip to Scotland with Abramoff and Safavian by $12,000.

Like his former mentor Tom DeLay, Ney's got some 'splainin to do. With the Ohio primary approaching tonight, National Journal reports that "well-placed Republican strategists say it's time for House Majority Leader John Boehner to tell Ney to resign."

Energy Independence Day

George Bush won't ask Congress for permission for torture or domestic spying. But when it comes to energy policy – he is very, very concerned about the limits of his presidential powers.

According to The Washington Post, he "renewed his call for Congress to give him the authority to ‘raise' mileage standards for all passenger cars." Then perhaps signaling a nod and a wink to his Big Oil friends, "White House officials said later, however, that they didn't know when or how the president would use that authority."

Meanwhile, the GOP Congress is scrambling to flex some 11th hour Election Year muscle of its own by reviewing oil company tax returns and "reaffirming authority for state and federal officials to fight price gouging."

No surprise that they are also attempting to exploit an increasingly squeezed middle-class by once again calling for drilling in the Arctic National Wildlife Refuge under the false pretense that it will provide economic relief at the gas pump. The truth, as the US Geological Service estimates, is that ANWR drilling would likely produce a total amount insufficient to fill the need for even one year of US domestic consumption and it wouldn't even hit the market for 10 years!

President Bush, too, offered his own rendition of Johnny Law in pursuit of any evildoer oil companies: "We'll make sure that the energy companies are pricing their product fairly. If we catch them gouging, if we catch them -- unfair trade practices, we'll deal with them at the federal government. That's what you expect the federal government to do."

Indeed, many citizens and Democrats have been asking -– if not expecting -– the formerly well-oiled, oil-friendly White House to do that for quite some time. Senators Maria Cantwell, Jeff Bingaman, and Bill Nelson all introduced legislation that would have cracked down on price gouging, as has Rep. Bart Stupak and even Republican Rep. Heather Wilson. In fact, lawmakers have repeatedly called on Bush over the past year to investigate and punish price gouging. But Oil man Bush--head of an administration loaded with ex-oil and gas executives-- is just walking the walk. If he actually talked the talk he'd be calling for subpoenas and public testimony from his oil industry cronies; he'd be calling for an all-out investigation of the industry's pricing practices-- from the wells to the gas pumps.

Even if the GOP does finally crack down on price manipulation, greed and collusion in the oil industry (while also pursuing more drilling and a roll-back of environmental protections) as a result of the public's "we're mad as hell and we're not going to take it anymore" outrage – there is a more important long-range issue: when will we unite around a sane policy to achieve real and lasting energy independence for our nation?

The Apollo Alliance has provided a blueprint for doing just that. This coalition of labor, environmentalists, (enlightened) business people, lawmakers, and social justice activists offers best practices already implemented in states across the nation, as well as its own innovative ideas for achieving energy independence in the next decade (the name comes from JFK's goal to land a man on the moon within 10 years).

Founded in 2003, the group's 10-point plan includes: promoting renewables; upgrading existing energy infrastructure; improving efficiency in transportation, industry, and buildings; research in new clean technology; and Smart Growth for cities and suburbs.

Joel Rogers, Chair of Apollo's National Steering Committee and Director of the Center on Wisconsin Strategy, says of the plan, "We estimate that $300 billion spent on our plan, would generate about 3 million new jobs…. It would generate a little over $1 trillion in additional GDP over its ten-year development. And, most important, probably, it would reduce our energy costs by better than $300 billion annually. That would effectively…. eliminate our dependence on the Middle East… [and] it should reestablish the American position in what is clearly going to be a gigantic world market for clean-energy technology…. Our plan has been out there for about two years now, and nobody has seriously questioned any of these numbers."

What is –- and has been –- lacking is the political will to challenge the status quo and, in the case of many politicians, to bite the hand that feeds them. But helped along by skyrocketing gas prices, an unpopular war, growing concern about global warming, and an overwhelming majority of Americans who now think that sustainable energy independence should be a top national priority, it's becoming increasingly more difficult to argue with Apollo's message of good jobs and energy independence.

One current proposal that would take an important step is Rep. Dennis Kucinich's Gas Price Spike Act. It would tax oil companies for excessive profits; transfer those revenues to tax credits for Americans who purchase fuel-efficient cars; and establish a program to promote inter- and intra-city mass rail transit.

Other important measures have been recently proposed by Ohio Senate candidate Sherrod Brown, who has made alternative energy a core component of his economic platform. Foremost among his proposals is the transitioning to bio-fuels, hybrid technology, and other alternative energy sources.

Ralph Nader -- whose best work has been as a consumer crusader taking on the oil companies -- has also weighed in with a series of smart proposals . It is high time, he argues, to use antitrust action to break up the oil industrial cartel. "The claim by the oil barons that they're just responding to the marketplace of supply and demand is laughable," Nader argues. "A competitive domestic oil industry would not be so able to close down scores of refineries and then turn 'refinery shortages' into higher gas prices at the pump."

The kind of transformative thinking represented most clearly by the Apollo Alliance is exactly what is needed if we are to work our way out of this mess. Election year grandstanding will provide some good theater and a cathartic public shaming of some oil executives. But, after that, let's not find ourselves exactly where we are today – hostage to the oil industry and wondering why we let things get so bad.

LA's Two May Day Marches

On May Day, hundreds of thousands of people demanding rights forundocumented immigrants marched down Wilshire Boulevard in Los Angeles,the epicenter of this burgeoning national movement. The sky was clearand blue and the breeze was mercifully cool as it took more than twohours for all the marchers to make their way down the office-towercanyon of Wilshire Blvd. to the rally site, packing the six-lane streetfrom curb to curb and making lots of cheerful noise. It was athrilling afternoon; in many ways the most overwhelming demonstrationI've ever seen.

The marchers, estimated by the police at 400,000 people, were almostall Mexican-American and mostly young. The advance guard consisted ofa brigade of adolescent boys on short bicycles doing wheelies whilethey shouted the march slogan, "Si se puede!" ("Yes we can!"). Thencame the seemingly endless throngs of kids, families, and groups, manycarrying handmade signs: "We may be immigrants/But we are hardworkers"; "You might hate us/But you need us"; "This land is yourland/This land is my land"; a guy in a Dodger cap held a sign thatsaid "Let our people stay!", and another young guy's sign said, "DeportArnold/Not my homies."

The key organizing groups carried huge banners: "Hotel Workers Rising", UNITE-HERE, plus the Garment Workers Center, the Instituto de Educacion Popular, the Day Laborer Project, Pacific Islanders for Immigrants' Rights, Columbianos por una Reforma Migratoria Justa, the Organization of Hot Dog Vendors in Solidarity, and the LA Taxi Workers Alliance, who rode in three yellow cabs. People for the American Way had a big banner and six people behind it, three of them talking on cell phones.

This was one of two competing immigration May Day protests held in LosAngeles, with different organizers and different politics. Themonumental Wilshire Boulevard march had been called by labor unions,immigrant rights groups, the pro-immigrant Cardinal Roger Mahony, andthe new Latino mayor AntonioVillaraigosa, as an alternative to another march held at noondowntown, the "Boycott" march, which called on immigrant Angelinos toboycott school and work to show what would happen to LA on a "daywithout immigrants"--although more of the signs called it "Un Dia SinLatinos," or the admirably bilingual "Primero de Mayo, A Day without aMexican." The "boycott" march, which demanded "nothing less than fullamnesty" and "full rights for all immigrants," had virtually noinstitutional support, except for small left-wing groups likeANSWER-LA.

The unions, the immigrant rights organizations, the cardinal and themayor opposed the boycott out of a concern that it would alienatemainstream voters and members of Congress. As an alternative theyorganized an after-school, after work, afternoon march, with much lessradical demands than "full amnesty." This "We Are America"coalition instead calls for "legalization with a path to citizenshipfor hard-working immigrants," plus "an effective visa program forfuture immigrants that protects their rights and includes a path tocitizenship" - basically the McCain-Kennedy bill.

The all-important Spanish language radio DJs, whoproved to be the secret force behind the massive March 25 demonstrationthat stunned Anglo LA with its size and intensity, did not support theboycotts. Instead they joined the mayor and the cardinal in calling onkids to stay in school today and come to the afternoon march.

But the hundreds of thousands marching in LA today probably didn't caremuch about the different politics of the two marches, as Marc Cooper has argued. (See his report and photos here.) And when the mayor and the cardinal tell kids not to boycott school forthe day, many find it hard to resist defying authority, especially forthis cause.

The downtown march four hours earlier had an estimated 250,000 people.As the march stepped off at noon, the side streets were full of vendorsgrilling sausages, peppers and onions. These marchers were alsocheerful, peaceful, and mostly young--many very young, alongside theirparents. The signs showed that marchers know about the keylegislation, a lot more than the great majority of Anglos. "Alto a laHR 4437" was apopular sign, and many young women wore tank tops that said "Contra4437" - referring to the bill passed recently by the House, officially"HR 4437," that would make undocumented aliens into felons.

When hundreds of thousands take to the streets on a day like today, weare witnessing the birth of a movement for social justice of historicproportions. What I remember best is a somber ten-year old girl whomarched by with her Mexican-American family, carrying a sign that read"We Are Not Criminals." That summed it up for me.

The Pain Game

Apparently when Republicans were urging Americans to get tough on crime they were doing it to protect us from themselves. Just last week, Karl Rove went back to testify to the grand jury for the fifth time; we learned that the FBI is investigating the possible bribing by two defense contractor of Rep. Duke Cunningham and other unnamed lawmakers with free prostitutes, and then there was my old nemesis, Rush Limbaugh.

Like most bullies, Limbaugh, who still finds it funny to refer to Hurricane Katrina as Hurricane Katrina vanden Heuvel, is better at dishing out the pain than taking it. He was arrested on Friday and charged with prescription drug fraud, a felony, for buying 2,000 painkillers prescribed by four different doctors in a six-month period.

But oh what a difference an arrest makes.

In the past, Rush argued that drug users "ought to be accused and they ought to be convicted and they ought to be sent up." Instead of going to jail, however, Limbaugh accepted a deal that requires him to pay a $30,000 fine and serve eighteen months of supervised probation to make certain he continues his treatment for drug addiction.

Some have expressed sympathy for Limbaugh, but before anyone writes a check to his defense fund think about the distraught person who draws the short straw and is stuck supervising the blowhard for 18 months. Talk about a job no American wants.

Walk-outs, Rallies and Other Strategies

In the hours before the kick-off the Day Without Immigrants activities,it feels like today's protests are going to be once again of historicproportions.

Here in Los Angeles, the probable epicenter among the 60 or cities inwhich events are planned, officials are expecting crowds that couldsurpass the half-millon who rocked the city on March 25. Several majorthoroughfares are scheduled to be shut down. Numerous employers arealso shuttering for the day.

As the case in other venues, there are mixed views here about whatstrategy should best be pursued. The local Catholic cardinal, theMayor, organized labor and the most prominent among immigrant advocategroups are supporting an after-work rally and march (a position thatoverlaps with mine). A coalition of smaller groups are advocating awalkout from jobs and schools and a noontime rally. Beneath thesurface of that disagreement is a mostly un-reported struggle forleadership over the mushrooming movement.

Most likely, however, these differences will be over-ridden by sheer,massive numbers. The media is not very likely to make much of adistinction between the two camps (nor will most of the participants).That's OK. And rather inevitable, given what I also think will be abreathtaking turnout both here and Los Angeles and nationwide.

This next wave of demonstrations--a movement way and I mean way beyondthe control of any single force--comes as new polls show continuingevolution of public opinion in favor of comprehensive immigrationreform. That shift raises the stakes of the May Day demos. My fingersare crossed that they will go off as peacefully and as effectively asthe big demos of the past weeks. Some wild cards are students who arelikely to ignore the calls of the Cardinal and of Mayor AntonioVillaraigosa to not blow off school. As a former young person myself, Ican readily attest to youthful impetuousness!

There's also a fringe of "revolutionary" sects who traditionallycelebrate May Day by trying to wrestle with the LAPD. These groupletshave attached themselves to today's events--but let's hope they don'twreck it for others (as masterful they are in the fine art ofwrecking).

There's no question in my mind that we are in the midst of an historic,new social movement. It's taken decades to build and reach criticalmass and it is still going to take years to mature and fully pay off.So far, the cool-headed long-term strategists have dominated. My wishis they continue in the leadership of the movement.

The political establishment is still, for the most part, clueless.Entrenched hypocrisy has so long been the official policy that fewpolitical leaders are fully prepared to deal with this emgergingreality. And not just the establishment, I might add. Much of theliberal and progressive left is having difficulty getting their armsaround all this. The ignorance and confusion, for example, surroundingthe notion of a guest worker program is simply stunning. A whole loadof lefties are stuck believing that this is a proposal for a newbracero program. Their ideological stiffness has blocked them fromdoing any real research on the matter and learning, it should bestressed, that liberals from Ted Kennendy to Raul Grijalva have beentoiling away to make these program proposals smart, comprehensive andguarantors of labor rights (Oh well, I'm not gonna go on about this. Ifyou haven't read enough of this elsewhere to understand what'shappening, I'm not about to convince you with one blog past). I willnote in passing that at this weekend's past state Democratic Partyconvention the issue of immigration never came up! During his numerousconvention appearances, the words immigration and immigrant didn'tcross the lips of Phil Angelides, the state treasurer and gubernatorialcandidate officially endorsed by the Party (his rival, Steve Westly,however, forthrightly endorsed legalization of the undocumented alreadyhere).

In short, if there are no severe disruptions or provocations, today'scoast-to-coast demonstrations should be more compelling, undeniableevidence of the integral role that "illegal aliens" play in our veryvibrant economy and societal fabric. With some luck they will help moveforward some concrete, achievable, practical and sensible measures thatwill help legalize those whom we allow to work for us but whom werefuse to recognize or acknowledge.

P.S. The always wonderful-to-read Gustavo Arellano weighs in with thismini-profile of self-proclaimed boycott leader Nativo Lopez. Required reading.