Kathleen Sebelius on The Huffington Post

George Lakoff: Give Thanks To Kathleen Sebelius For Saving 47,000 Women From Death By Cost-Benefit Analysis

2009-11-24T15:43:32Z

Cost-benefit analysis can kill. The failure to distinguish statistics from arithmetic can kill. In the current debate over mammograms, the number of women projected to be at risk of death due to cost-benefit analysis is about 47,000.

That is the approximate number projected to die by the United States Preventative Task Force if their recommendations on scaling back mammograms had been accepted. It is their number, if you do the arithmetic, which they apparently did not.

Their statistics say that the life of "only" one woman in 1900 will be saved if mammograms start at age 40 instead of age 50. In other words, a 40-year-old woman's "risk" of dying from breast cancer in the next ten years is only 1 in 1900. That seems like no risk at all. 1 divided by 1900 equals .000526. About half a woman per thousand. Miniscule, right?

Now, how many women in America would be affected?

The most recent (July, 2008) census figures say there are about 304,000,000 Americans, of which 50.7 percent are female. That's about 154,000,000 females. Roughly 80,000,000 of them are under forty and about another 20,000,000 between 40 and 50. Of the 80,000,000 under 40, each one, under the proposed guidelines, would not get a mammogram until age 50. If "only" 1 in 1900 die as a result, that would be .000526 times 80,000,000, which equals about 42,000.

In short, moving the mammogram age from 40 to 50 would result in the deaths of 42,000 women now 40 or under, according to the statistics of the United States Preventative Task Force. Of the 20,000,000 between 40 and 50, it could mean the deaths of as many as 10,500 women, though the figure may be somewhat lower because half are more than halfway through the critical period. There might be as few as half, say, 5,000 deaths. Adding 42,000 and 5,000, we get a ballpark figure of 47,000 of currently alive American females who would die needlessly under the proposed task force restriction on mammograms. Of course, as more are born, the absolute numbers would go up.

What is at issue is called "framing." The Preventive Task Force chose the probability of risk frame: only 1 in 1900. But the arithmetic frame reveals the more important truth.

Framing, in this case as in so many others, is a matter of life and death. Take the framing in the NY Times (November 18, 2009) in the front-page news analysis by Kevin Sack and in the op-ed by Robert Aronowitz. Sack frames the mammogram debate as the "science of medicine" versus "medical consumerism." Aronowitz calls it "wishful thinking" that early mammograms could help and speaks of "the very small numbers of lives potentially saved."

You can see why cost-benefit analysis can kill. Its use isn't science. Real scientists do arithmetic as well as statistics. Medical science is about real people, not percentages or statistics, especially when large numbers of real people are involved and small differences in risk can produce large numbers of deaths.

The Preventive Task Force also uses the "harm" frame. The task force observes that more mammograms mean more false positives and claims that false positives do "harm." But no science is presented showing that the "harm" done is greater than the deaths of 47,000 women.

What is the "harm?" Anxiety and unnecessary biopsies from false positives are listed as the "harms." My wife had such a false positive. The anxiety came for economic reasons: she had to wait for a biopsy because no one who could perform one was present when the mammogram was done, due to economic restrictions. The biopsy when it came was simple: a needle inserted to withdraw fluid, like taking a blood sample. No harm. If the biopsy had been done immediately, there would have been no need for anxiety. But the task force does not recommend immediate biopsies as a way to eliminate such "harm."

Aronowitz also claims that the figures show that mammograms haven't helped prevent breast cancer. He observes that the rate of 28 breast cancer deaths per 100,000 people has not changed substantially since the 50's, despite more mammography and better treatments. But that could mean, and probably does mean, that there has been an increase in breast cancer offset by earlier detection and better treatment, saving tens of thousands of lives, but not affecting the overall rate. But he did not consider the possibility that the occurrence of breast cancer might have increased, while the rate of deaths did not change because of earlier detection due to mammograms.

I suspect that the real "harm" intended is economic harm - the costs of the "unnecessary" mammograms and biopsies. But the task force gives no figures weighing the economic costs versus the human "cost" of the deaths of 47,000 women. Now, in cost-benefit analysis, a commonly cited figure for the value of an American life is $6.5 million. 47,000 times 6.5 million is $305, 500,000,000. That is, 305 billion five hundred million dollars. Of course, that would be spread over the next forty years, but it's not clear that such a cost-benefit analysis would make this less than the cost of mammograms and biopsies, all moral issues and human costs aside. Unfortunately, the Preventive Task Force doesn't do the calculation, so my figures may be off. The exact figures are not the point. The point is to go beyond rates to numbers.

In the present debate over health care, economics has become the main issue, but the Preventive Task Force hides it by framing. "Cost-benefit analysis" has been reframed as "risk-benefit analysis," as if the Preventive Task Force were not concerned with "cost" to insurance companies and tax-payers, but rather with "risk" to women. But "risk-benefit analysis" is just cost-benefit analysis, which in turn is what corporations use to maximize profit in the short term. Both cost-benefit analysis and the Preventive Task Force were introduced as government institutions by the Reagan administration. They were right-wing moves - part of the strategy to privatize government.

As the Obama administration shifted the health care debate from morality to economics, cost-benefit analysis entered in the form of "evidence-based medicine," where the "evidence" comes from statistics. This is seen as a major way to reduce the cost of health care. This is where "risk-benefit analysis" is cost-benefit analysis publicly and proudly discussed.

Is such an application of cost-benefit analysis always immoral? Hardly. It can be very useful. But it has to be looked at carefully, as the mammogram example shows. In the mammogram example, low probability events can have major effects!

When is a case of "evidence-based medicine" that uses cost-benefit analysis an instance of low probability events that can have major effects, effects serious enough to far outweigh the cost-benefit analysis? This is a serious and difficult question.

It is also a question of concern in the Obama White House. There are three high-powered experts there committed to such questions. One is Ezekial Emanuel, Rahm Emanuel's brother, who is perhaps the best-known advocate of evidence-based medicine. He is an advisor to Peter Orszag, Budget Director, who sees medicine as an economic problem. The third is Cass Sunstein, Obama's Administrator of the White House Office of Information and Regulatory Affairs, also known as the cost-benefit czar. Sunstein is known for specializing in low probability events that have major effects. Political observers should watch how such issues are handled by the administration as they arise.

The official administration reaction is so far against the Preventive Task Force recommendation. Health and Human Services Secretary Sebelius has rejected it and said to make no change.

Hooray for Kathleen Sebelius! Tens of thousands of women owe her their lives.

The political fallout has been instructive. Business columnist for the Washington Post Steve Pearlstein (November 20, 2009) attacked Sebelius as not wanting to save money, but rather promoting waste. This is pretty much what the NY Times position (both front-page analysis and op-ed) seems to be. Most voices on the right have ignored Sebelius' official response and instead attributed the Reagan-era Preventive Task Force's recommendations to official Obama Health care policy, calling it "rationing" health care, while ignoring the fact that most rationing of health care is actually done by insurance companies. As expected, the most radical conservatives have seen this not only as an Obama move, but have likened it to mythical "death panels."

I stand with Sebelius, and I take it to be the official Obama administration view. When arithmetic is added to statistics, this is a clear case of a low probability event with major life-and-death consequences for tens of thousands of people. The overly simplistic framings -- either accepting or rejecting the cost-benefit analysis without looking further -- are dangerous. Just accepting the task force's recommendation is dangerous to the women of this country, now and in the future. Calling it "rationing" and using it to argue against the health care bills in Congress is dangerous to us all.

As we sit down to Thanksgiving dinner, let us thank Kathleen Sebelius.

Health Care Reform Opponents Stoking Fears Over Breast Cancer Screenings

2009-11-19T15:24:05Z

The latest alarmist claptrap that's emerged in the debate over health care reform involves a study that's been done by the US Preventive Services Task Force (USPSTF) on breast cancer screenings. That study led that agency to formulate a new set of recommendations on when and how often women should receive mammography exams that were subsequently published in the November 17th edition of the Annals Of Internal Medicine, and which are now being debated by the medical community. The recommendations included suggestions that women not receive routine screenings before the age of 50, and adjusting the "screening interval from 1 year to 2 years.

This has led health care reform opponents to screech about how this is an indication that Nancy Pelosi will ration breast cancer treatment, resulting in women getting riddled with tumors. They seem to be confusing this agency's study and subsequent recommendations with a policy decision that impacts the health care reform bills being debated in Congress. In reality, this has nothing to do with policy, or health care reform, or pending legislation, or previews of coming health care apocalypses. There are just some recommendations that have been made and stuck in a scholarly journal.

How will these recommendations impact your life? Dr. Victor G. Vogel, the national vice president for research at the American Cancer Society, says, "Clinicians should recognize that very few agencies, including the ACS, are altering their screening guidelines based on the USPSTF modeling results, which simply reanalyze previously published data." The ACS recommends, and will continue to recommend "annual mammograms... starting at age 40 years and continuing for as long as a woman is in good health." USPSTF Vice Chair Dr. Diana B. Petiti has said that, "This recommendation is not a recommendation against ever screening women age 40 to 49; it is a recommendation against routine screening of women starting at this age."

And between those two points of view, there is a healthy debate on the merits, based on scientific data. But there's also a lot of confusion, because people like Representative Dave Camp (R-Mich.) go around braying nonsense like this:

"Some people discounted the idea that the government would actually put people to death...And this actually is really showing how the insidious encroachment of government between the patient and their doctor plays out. And it's not a pretty sight."

But the USPSTF has been doing research and making recommendations since 1984! And they've been doing so entirely independent of whatever health care debates have been going on in Congress. There's nothing about their mammography study that involves an "insidious encroachment of government" and they can't force a doctor to do anything to a patient or oblige the government to start "put[ting] people to death." Anyway, Kathleen Sebellius is, I guess, pushing back with what I guess, to Dave Camp, is the equivalent of "reverse insidious encroachment":

"There is no question that the [USPSTF] recommendations have caused a great deal of confusion and worry among women and their families across this country," said US Department of Health and Human Services Secretary Kathleen Sebelius in a statement issued yesterday. "I want to address that confusion head on. The [USPTF] is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don't determine what services are covered by the federal government."

Despite new evidence presented by the USPSTF, Dr. Sebelius noted that "our policies remain unchanged. Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action."

As you might suspect, the media is doing a terrible job at providing clarity. Even as I write this, MSNBC is teasing a segment on this story this afternoon by asking, "Did the government back down on guidelines suggesting mammograms for women at age 50 instead of age 40 because of critics comparing it to rationing and even death panels?" Uhm... no! Because there's nothing to back down from!

This article, from NPR, is pretty typical of the coverage this study has garnered. You get plenty of news on the "political brouhaha" that's flared up, with one side spewing shrill doomspeak and the other side trying to point out that no one's going to be denied breast cancer screenings. What's missing are any of the actual facts: what the study recommends, how cancer care agencies are treating the recommendations, what practical effect the agency has over patient care, and, last but not least, the most vital point, pursuant to the health care reform debate, of all: THAT IT HAS NO BEARING ON THE HEALTH CARE REFORM BILL.

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Sebelius: Women should get mammograms by age 40

2009-11-18T20:28:36Z

WASHINGTON — Women should continue getting regular mammograms starting at age 40, Health and Human Services Secretary Kathleen Sebelius said Wednesday, moving to douse confusion caused by a task-force recommendation two days earlier.

Sebelius issued her statement following a government panel's recommendation on Monday, that said most women don't need mammograms in their 40s and should get one every two years starting at 50.

Jessica Corry: Mrs. Obama, What About Our Boys?

2009-11-16T14:21:05Z

As Michelle Obama touched down in Denver today to promote her efforts to connect America's public school students with professional mentors, she declined to send an invitation to one population who could most benefit: our city's neglected boys.

The First Lady's packed schedule started with a closed "girls mentoring luncheon" at the Governor's Mansion on Logan Street. Next, she'll gather with other state and national figures in meeting with female students from area schools. The high profile list of mentors included actresses Susan Sarandon and Fran Drescher. Also taking part are beltway heavy hitters, including Labor secretary Hilda Solis, Health and Human Services secretary Kathleen Sebelius, and Environmental Protection Agency administrator Lisa Jackson.

The visit comes just days after Obama hosted a "Women of Excellence" outreach event at the White House, where 20 girls were paired with 20 mentors, and participants were treated to appearances by singers Sheryl Crow and Alicia Keys. Obama says she hopes to provide successful female role models to a greater number of students. As the Denver Post reported Friday, "During the launch of the program at the White House 10 days ago, Michelle Obama told the students she felt it important they have mentors who could help them and listen to their concerns."

But what's gender got to do with it?

Especially as Obama lists among her most influential role models her father, a pump operator for the Chicago Water Department, and her brother, Craig. Certainly she's not possibly suggesting that girls need special help in the form of female mentors. That would be both ignorant and sexist.

In Denver today, less than half of all male public school students will ever graduate from high school. Girls, meanwhile, still face discouraging odds, but at least they have almost a 60 percent chance of earning a diploma.

Denver isn't alone in seeing such discouraging outcomes, and the disparities only become more pronounced as students make their way onto our college campuses. According to the National Center For Education Statistics, nearly 57 percent of all college undergraduates are female. For certain racial groups the numbers are even more staggering: just 37 percent of all black college students are male. While feminists like to champion figures concluding that women are drastically underrepresented in some sciences and engineering fields, they neglect statistics demonstrating that women are about half of all medical and law school students today.

The fact is clear: being born a girl today is no longer an impediment to success. To succeed, girls need to hit the books, not rock concerts.

Over the years, I've written frequently about sexism against our boys. Perhaps it seems ironic given that I'm the mother of two girls. I do so, however, knowing that today's girl-power hype sends the wrong message to my own girls. Like professional working moms across the country, I provide my daughters an imperfect but devoted mentor right inside their own home. And gender has nothing to do with it, as they'll also see their father balance life's responsibilities and his own professional ambitions.

To Mrs. Obama, I have this to say. Bring in the rock stars. Bring in the high performing academics. But bring them in for everyone, and after the 3 p.m. bell rings. Don't pat my girls on the head and tell them they need a female mentor to succeed, especially when such help comes at the expense of their male peers.

In an already overly complicated world, I don't need to explain why the First Lady believes that picking winners or losers based on gender is okay. It's not -- never has been and never will be.

Jessica Peck Corry (www.JessicaCorry.com) is a Denver attorney and director of the Independence Institute's Campus Accountability Project.

David Axelrod On H1N1 Vaccines: 'We Overpromised'

2009-11-01T01:37:14Z

David Axelrod, President Obama's senior adviser, says the administration based its predictions about how many doses of the H1N1 vaccine would be available by mid-October on bad information.

Dr. Nancy Snyderman: Paging Dr. Benjamin

2009-10-30T13:23:21Z

Well it's about time. Nine months after the inauguration of President Obama, we finally have our Surgeon General. It couldn't have come soon enough. While her confirmation was unanimously voted on by the members of the Senate Health committee, Regina Benjamin found herself caught in a political pissing match between HHS and conservative senators with strong ties to the insurance industry.

But this column isn't so much about the temporary political hijacking as it is about why we need her now. The role of the Surgeon General is to be America's physician, to hold our collective hands during health crises and emergencies. Some Surgeons General have had quiet tenures. (can you name the Surgeon General under President Bush... either one?) Others have been impulsively vocal and had very short careers. (Think Dr. Joycelyn Elders). Others have been stand-outs and have defined the office. Democrats vilified Dr. C. Everett Koop during the confirmation process because he personally opposed abortion. But when HIV/AIDS was discovered, he was vocal about sexual transmission and spoke openly to the gay community. Then the Republicans were furious. His answer to everyone was simple. "I am a physician".

Let's be clear about the role. The post of Surgeon General is largely ceremonial and comes with a bully pulpit. The job doesn't come with much of a budget or a very big paycheck. It does come with stature, a lot of bureaucracy, and in this case, a woman who looks like she would be a good boss -- Secretary of HHS, Kathleen Sebelius.

Dr. Benjamin assumes her position in the midst of a viral pandemic. H1N1 (swine flu) has now been reported in all fifty states and is robust in 46 of them. While the virus was isolated quickly, the production of vaccine has been hampered with technical delays and the messaging from the pharmaceutical companies and the federal government has led to confusion. While I believe that Dr. Anthony Fauci and Secretary Sebelius have done extraordinary jobs spearheading the communication, the fact is that they have their day jobs to do too. And my concern is that while the messages have been on target most of the time, there have been too many messengers. In one week on MSNBC, I heard vaccine and H1N1 updates from Health and Human Services, Centers for Disease Control, Homeland Security, Department of Defense and Department of Education. The messages were fine but there were too many messengers. The frustration within the medical community is evident and growing anger among patients is palpable.

So, welcome Dr. Benjamin. We are so glad you are here. Your job is probably more complex than it has been for any of your predecessors. You enter in the midst of a viral pandemic and a news cycle that won't give you much of a break. We will call on you to respond to the American public and those of us in the press at any time. You have dedicated your life to sitting at patients' bedsides and holding people's hands, making complicated situations easier to understand and always telling the truth. We expect you to do the same with us.

GOP, Democratic Senators Agree: Get Swine Flu Vaccination

2009-10-18T19:30:08Z

Right-wing pundits like Glenn Beck and Rush Limbaugh have recently spoken out against government direction on the H1N1 vaccine, saying that individuals should make up their own minds whether to get vaccinated or not. Some left-wing pundits, such as Bill Maher, have made similar statements.

In the Senate, the topic has accomplished the rare feat of uniting Democrats and Republicans -- members of both parties are promoting vaccinations regardless of the rhetoric.

2morrowknight: Debbie Wasserman Schultz for President/Vice-President in 2016?

2009-10-13T17:44:21Z

It almost happened in 2008. It could happen in 2016. At some point, and some point soon, we'll see a woman in the White House. And her name might not necessarily be Hillary or Sarah. How's Debbie Wasserman Schultz sound? I know, I know, you're saying, "I've never heard of her. She doesn't have the name recognition of Sarah Palin or the major public policy buzz of Kathleen Sebelius. And while she doesn't have the baggage of a Michelle Bachman, she's not a Governor or U.S. Senator." All true. But listen up: Wasserman Schultz is riding a wave that will only get bigger, and she's got a few advantages that few others in the field -- woman or man -- can match.

Here are five reasons she could be on the Democratic ticket in 2016:

Democratic Unifier
Throughout the 2007 and 2008 primary season, Wasserman Schultz was resolute in her support for Hillary Clinton. Whether on TV, radio, or in the blogosphere, Wasserman Schultz was unflappable. But when Barack Obama won the nomination, Wasserman Schultz quickly endorsed him and campaigned vigorously. None of this has been lost on Democratic leaders. Her tireless efforts to unify the Obama and Clinton camps won her kudos from the party faithful, and instantly made her a power player in national politics.

Florida. Florida. Florida.
Wasserman Schultz represents the Sunshine State in the U.S. Congress; having her on the ticket would give the Democrats the upper hand in the infamous I-4 corridor connecting Daytona Beach, Orlando and Tampa. Grab the middle and you win the state -- Wasserman Schultz could be the Dems' surest bet.

Her Jewish Heritage
Before last fall, nobody thought a Jewish-American would ever have a legitimate chance at the White House. But with the tolerant views of 80 million politically involved millennials who helped elect President Obama, Wasserman Schultz's Jewish heritage won't be a liability. How she weighs in on the Israeli-Palestinian conflict between now and then will have a real impact on her standing in the Jewish community, but if she can find a way to please those folks while maintaining cred with younger voters, she could bring far more voters to the polls than Joe Lieberman did for Al Gore in 2000.

She's Tough ... Seriously!
By all accounts, she's funny, engaging and benevolent. But if you've seen her on cable and network shows, you'll know she's also very skilled at dismantling nonsensical arguments, and, leaving unprepared opponents picking their faces up off the ground. And she has used her tenacity, and tirelessness, to fight for the rights of families, women and children.

The 2016 and 2020 Anniversaries
2016 isn't just a presidential election year, it's also the 100th anniversary of Jeannette Rankin being the first woman elected to the Congress. Her victory was all the more remarkable because women couldn't vote -- that didn't come until four years later. The 2016 and 2020 elections promise to be reflective, euphoric and celebratory periods -- and with her considerable political gifts, Wasserman Schultz could take full advantage of the great national mood.

And yes, I know, it's still very, very early. A day in politics is like an eternity, and one day's worth of political earthquakes could shake up or diminish any predictions. I know. But don't tell me that a woman won't be either president of vice-president seven years from now. I just wouldn't bet against it. And I wouldn't bet against Rep. Debbie Wasserman Schultz being that woman.

David Kirby: Do You Believe that One In 60 American Males Has Autism?

2009-10-09T17:06:59Z

It amazes me to see that the Obama Administration and mainstream media have been rather nonchalant about the startling news that 1-in-100 American children - and perhaps around 1-in-60 boys - have an autism spectrum disorder.

On Friday, Health and Human Services Secretary Kathleen Sebelius told listeners on a conference call about an upcoming CDC study showing that the estimated rate of autism increased by about 50% among children living in study locations who were born in 1994, compared with those born in 1996.

Among children studied in select areas around the country, the CDC found an average ASD rate of 66-per-10,000 (1-in-150) in the 1994 cohort, but this jumped to somewhere "around one percent," or 100-per-10,000 (1-in-100), in children born just two years later. (Keep in mind that the 1996 data pertain to 13-year-olds today; officials say they cannot tell us the rate among children younger than that).

Males are four times more likely to have an ASD. So extrapolating from the CDC data, among 15-year-old boys, the estiimated US rate is 102-per-10,000 (1-in-98), but among 13-year-old boys, it would appear to be somewhere around 167-per-10,000, or 1-in-60.

Sebelius said the government does not know if the actual rate has gone up, "and we are hoping to unlock these mysteries."

Meanwhile, some experts seemingly want to brush this increase off as a mere artifact of better reporting, wider diagnostic criteria, greater awareness and early intervention programs among younger children. They don't seem to feel that rising levels of environmental toxic exposures in genetically susceptible children might also be at play here. Some have called it "good news" that doctors are now so proficient at diagnosing the milder forms of ASD.

But these children were diagnosed, on average, in 1999 and 2001, respectively - which was quite a bit after the ASD classification was expanded (in the public schools and in the DSM-IV) to include Asperger syndrome and pervasive developmental disorder - not otherwise specified, or PDD-NOS.

Moreover, these boys were 8 years old when they were studied, so early intervention might not be a major reason for the increase. And while greater awareness and better reporting and record keeping have undoubtedly boosted the numbers, it is hard to see how this could explain the entire increase over the years.

We must wait until the final study is published, of course. Unfortunately, the CDC has not always tracked the exact same sites every study cycle. But among the six sites that were included in the 1992 and 1994 cohorts, the reported rate increased by 10 percent. It bears watching to see what happened in those same six sites among the 1996 cohort.

In order to accept that actual ASD rates have not gone up at all, one must also now acknowledge that the ASD rate among US males has always been at or around 167-per-10,000, and that all lower estimates were mistaken and all of those missing people went undiagnosed or misdiagnosed.

But how is it possible that tens of thousands of parents - not to mention relatives, teachers, schools, nurses, counselors, clinicians and pediatricians - could miss so many of the 15-year-old boys with ASD in their midst, but can detect ASD in more 13-year olds? It is hard to understand why more parents of the 1994 cohort would fail to get autism services for their children, compared with parents of children born just two years later.

In my opinion, to shrug and treat this story as if things have probably always been this way is, frankly, wishful thinking and unsettling.

Officlals who say the numbers have not gone up are, in effect, telling pregnant women that if they are having a boy, there is a 1-in-60 chance he will have ASD - but not to worry, because it has probably always been this way, we just never noticed. Autism is very common; it is just part of the human condition.

Many will call me an alarmist, but I believe that 1-in-60 boys with an autism spectrum disorder is a national crisis - and not just a reassuring confirmation of how things have always been.

So, if you believe that autism rates are not increasing, then you must also believe that roughly 1-in-60 American males - of all ages -- have an ASD.

Do you really believe that 1 in 60 American men are autistic?

That would mean some 2.55 million American males with autism, which is roughly the size of Nevada.

I have lived in many different cities, worked at nine different jobs, and met thousands of men and women throughout my years. I cannot recall people who showed the characteristics of high-functioning autism, though I must have met some along the way, at least in passing. But there were not 1-in-60 boys with ASD in my schools and there are not 1-in-60 men with ASD in my area. I think I would have noticed them by now.

I also spend time speaking with teachers and special education administrators who have been in the business for decades. One of them said she had surveyed every single long-term teacher she had worked with (those with 20, 30, or even 40 years on the job), "and every single one of them said that these kids just weren't there in anywhere near these numbers when they started teaching - under any diagnosis."

And Anne Dachel, a Wisconsin mother of an autistic son, a national advocate, and a teacher who works extensively with ASD students, said it was "an insult to thousands of teachers and counselors and doctors - who apparently 'stupidly' ignored these kids in the past. If they were always here, but we just called them something else, then what did we do with them? We would have had to provide services even if the kids weren't called 'autistic.' So why are there waiting lists for services and more and more of a demand for special education teachers?"

Anne also frets that the new ASD numbers are "being presented as good news," in some media, she said. "Autism hasn't increased--we just never realized how common it really is. No official ever calls autism a crisis, no matter how bad the numbers get."

Finally, if you can explain away an increase in autism, you can also ignore the mounting evidence and growing belief among some scientists that autism likely has an environmental component, and that certain environmental exposores have been on the increase in recent years. You can also ignore the growing clinical, animal and epidemiological evidence to suggest that mercury, other heavy metals and other environmental toxins might increase the risk of ASD in genetically susceptible subpopulations.

Consider mercury. Rising levels have been documented in rivers, lakes and waterways nationwide, and rising levels in humans is now a sad and terrifying fact as well. A new study has shown that inorganic mercury was detected in the blood of 30 percent of US women in the CDC's most recent National Health and Nutrition Examination Survey (NHANES). That figure was 1,500 percent higher than what was reported in the 1999-2000 survey, when only 2% of women had inorganic mercury in their blood. And though these figures post-date the 1996 birth cohort, they do indicate steadily rising levels of background mercury over the years.

Other studies have shown an association between exposures to heavy metals and other toxins and autism risk. A paper published this year in Neurotoxocology showed a higher rate of ASD in schools located near Minnesota superfund sites, which typically contain high levels of "lead, mercury, cadmium, chromium and arsenic."

Another CDC-funded study found that children born in the most polluted tracts of the San Francisco Bay Area were 50% more likely to have an ASD. "The individual compounds that contributed most to these associations included mercury, cadmium, nickel, trichloroethylene, and vinyl chloride," the study concluded.

Mercury has been shown to cause immune disorders, oxidative stress, mitochondrial dysfunction, neuro-inflammation and other physical problems. These symptoms can also be found in at least some children with autism. And research on the brains of people with autism show markers that are associated with heavy metal exposure.

I personally believe that toxins like mercury can trigger ASD in children. These toxic exposures are on the rise, and so is the incidence of ASD.

An estimated 1-in-60 13-year-old boys has an ASD, but I don't believe the same is true for 43-year-old men. It is time to stop pretending that the autism crisis is not happening.
--------------------

PLEASE NOTE - I was interviewed this week by Sharyl Attkisson of CBS News for the "Washington Unplugged" webcast, which may be viewed here.

David Kirby: Kathleen Sebelius: Autism Now Hits 1 In 100 Children, We Have No Idea Why

2009-10-04T18:05:21Z

Washington loves to dump its bad news on a Friday afternoon, and on October 2 it confirmed that 1 percent of American children (and by extension, perhaps 1-in-58 boys) has an autism spectrum disorder.

On a hastily arranged telephone "visit" with US Health and Human Services Secretary Kathleen Sebelius and the autism community, the health chief announced that "the prevalence of autism might be even higher than previously thought." But, she added, "We don't know if it has gone up, and we are hoping to unlock these mysteries."

The Secretary then declared autism "An urgent public health challenge," proclaimed that President Obama was "right to make it one of our top health priorities," including research into "treatments and a cure" for the disorder, and then promptly ended her visit.

Helping to fill in some of the details was Dr. Thomas R. Insel, Director of the National Institute of Mental Health (NIMH), and Chair of the Interagency Autism Coordinating Committee, who confirmed that CDC data to be published later this year will estimate the current childhood ASD rate at 100-per-10,000 children.

The data, collected from the Center for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring (ADDM) Network, shows a significant uptick in ASD prevalence estimates in just two years.

According to ADDM, the average rate of autism among eight-year-olds across all study sites was 67-per-10,000 in 2000 (the 1992 birth cohort), and 66-per-10,000 in 2002 (the 1994 birth cohort). Only six sites were included in both studies, and their average prevalence rate increased by 10%, from 67-per-10,000 to 74-per-10,000.

Now, CDC has announced that among the 1996 birth cohort, the estimated rate of ASD is 100-per-10,000 -- a staggering 50% increase over the 1994 birth cohort.

It is easy to understand why the Feds would call autism an "urgent" issue, but any sense of urgency by the officials on the phone was clearly absent, at least from my perspective. In fact, much of the discussion was centered around providing services and education to the growing ranks of Americans with ASD, an entirely laudable goal, to be sure.

But no one expressed any alarm that up to 1-in-58 boys in this country is now on the autism spectrum. The officials on the call seemed to think that wider diagnostic criteria - such as adding Asperger Syndrome and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) -- to the concept of an "autism spectrum disorder" vastly inflated the rate of ASD in the United States.

There was no alarm, and little time for questions from the community that was invited to "visit." After about 15 minutes, questioning was cut off, and the call abruptly ended. I tried three times to ask a question (via a telephone switching system) and so did many other people on the call, which lasted a total of 39 minutes.

And so, here is my (expanded) question, directed to Dr. Insel:

Dr. Insel, thank you for arranging this call. I understand that the estimated average ASD rate increased from 66-per-10,000 to 100-per-10,000 between the 1994 and 1996 birth cohorts. Officials on this call believe this increase could be attributed purely to expanding diagnostic criteria and greater awareness, though they don't know for sure.

But how could you attribute a 50% increase in just two years to wider diagnostics, especially when the 1994 cohort would have been diagnosed, on average, in 1999 and the latter cohort in 2001? The expansion of the ASD definition to include Asperger and PDD-NOS occurred in the early 1990s, so how can you explain this sudden and delayed explosion in the numbers?

Also, you have declared that the vaccine-autism link has been disproven, yet all the studies you cite have only looked at MMR and thimerosal. But why is the IACC, which you chair, not investigating the possible role of Hep-B vaccine, given the following facts?:

1) An abstract just published in the Annals of Epidemiology said that giving Hepatitis B vaccine to newborn baby boys more than triples the risk of ASD.

2) A study just published in Neurotoxicology reported that infant male primates who received one dose of the Hepatitis-B were far more likely to display developmental delays than unvaccinated controls.

3) A study last year in Toxicological and Environmental Chemistry showed that boys getting the 3-shot HepB vaccine series were eight times more likely to require early intervention services than boys who did not have the series.

4) A study in the journal Neurology found that children who received Merck's Engerix B brand Hepatitis B vaccine series were 74% more likely to develop "central nervous system inflammatory demyelination" than children who did not receive the vaccine.

Finally, why did you jettison the vaccinated-vs.-unvaccinated study that your own committee had previously voted to recommend, and why are you spending only 39 minutes speaking with the community that represents, according to your boss, one of the nation's "top health priorities?"

I am also sending this question to HHS, to see if I can get a proper response. But I am not holding my breath.

Sebelius, Whitehouse Hold White House Live Chat

2009-10-01T15:08:52Z

The White House has announced that it will hold a live chat with Secretary Kathleen Sebelius and Sen. Sheldon Whitehouse (D-R.I.) today at 5:30 PM ET, as part of a larger effort to reach out to Americans on the country's pressing health care debate. The administration hopes that the chat will be the first of many sessions allowing Americans from across the country to share their perspectives and have their questions answered.

The session is an administration first and will stream live at WhiteHouse.gov.

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Kathleen Sebelius Lectures Chuck Todd For Not Sneezing Correctly During Briefing (VIDEO)

2009-09-17T20:32:22Z

Health and Human Services Secretary Kathleen Sebelius was outraged when NBC political correspondent Chuck Todd had the temerity to sneeze during her briefing without properly covering his nose with his elbow. The press corps erupted in laughter as Sebelius made funny faces and lectured Todd on controlling the spread of his germs.

Todd smiled sheepishly as Sebelius playfully admonished him: "I mean what is that about? Jeez, who's got some Purell? Give that to Mr. Todd right away. We'll have Elmo give Chuck a special briefing."

WATCH:

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Pawlenty Called Out On Undocumented Immigrant Claim

2009-09-14T08:18:24Z

Today on ABC's This Week, Minnesota Gov. Tim Pawlenty (R) defended Rep. Joe "You Lie!" Wilson's (R-SC) concern that undocumented immigrants would be able to get federal health care benefits. Although Health and Human Services Secretary Kathleen Sebelius stated that President Obama and Congress have made it clear that undocumented immigrants shouldn't have access to the new health insurance exchange, Pawlenty claimed that they will still will "show up" and get the services because no one checks their citizenship status. When Stephanopoulos called out his inaccurate claim, Pawlenty stumbled for a response.

Sebelius: No Public Abortion Funding In Health Care Bill

2009-09-14T01:57:01Z

WASHINGTON -- Health and Human Services Secretary Kathleen Sebelius pledged Sunday that President Barack Obama will support barring public funding for abortion in any health care overhaul legislation.

Swine Flu Vaccine Shots May Start In Early October: Sebelius

2009-09-13T11:08:23Z

WASHINGTON — The nation's first round of swine flu shots could begin sooner than expected, with some vaccine available as early as the first week of October, Health and Human Services Secretary Kathleen Sebelius said Sunday.

Sebelius said she is confident the vaccine will be available early enough to beat the peak of the expected flu season this fall and that early doses are intended for health care workers and other high-priority groups.

Obama Doesn't Want Abortion Money In Health Care Reform: Sebelius

2009-09-13T10:55:33Z

WASHINGTON — Health and Human Services Secretary Kathleen Sebelius says the president supports language in health overhaul legislation that explicitly prohibits money for abortions.

Sebelius says President Barack Obama has made it clear that his health care goals do not include using public money to pay for abortions.

Elin Suleymanov: Making History in Person: A view from Azerbaijan

2009-09-11T14:51:25Z

A year has passed since both major parties in United States politics held their nominating conventions. Looking back on the rancorous, contentious presidential election last year with the benefit of hindsight being 20-20, among the factors that made it truly special and the most important in recent memory, is the diversity of both tickets. And while the nation is now wrapped up in debates over health care reform, how to stimulate the sluggish economy and what the best course of action is in Afghanistan, we should take a moment to reflect on the truly historic nature of last year's election.

Regardless of political views and opinions, the fact that an African-American stood as the Democratic presidential nominee and now sits as the President, while a woman was the vice presidential choice for the Republican Party, embodies important symbolism for the entire world. Such symbolism should not be underestimated or overlooked. After all, if specific policies change or if they are forgotten years from now, the changing dynamic of who can become the leader of this powerful nation will be nothing less than historic.

Even today it is clear that the most outstanding characteristic of politics in 2008 and 2009 is the prominent role of women's leadership. Beginning with Senator Hillary Clinton's run for the White House and later appointment as the senior most diplomat in the U.S., women have energized and enriched America's political process. Women have finally become full partners in the American political process. This resonates far beyond America's borders because the world is watching the U.S. political process very carefully. Some are watching because the United States is a global power, which has an impact on many nations; others watch because the diversity makes the election so much more interesting.

For the people of the Republic of Azerbaijan, the prominent role of women in the American election followed by the appointment of so many women to President Obama's cabinet, 7 in all, has an added significance. The reason is that the Azerbaijanis recently celebrated the 91st anniversary of establishing the first democratic parliamentary republic in the Muslim world. It was also more than 90 years ago that the Azerbaijan Democratic Republic, which soon afterward was annexed and abolished by the Bolsheviks, granted equal voting rights for men and women alike. In so doing, Azerbaijan had pioneered a fundamental principle of equality for the region and beyond. Building on this tradition, Azerbaijan's First Lady Mehriban Aliyeva initiated an international forum on expanding the role of women in cross-cultural dialogue in 2008. The event organized jointly with the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the Islamic Educational, Scientific and Cultural Organization (ISESCO) in Azerbaijan's capital of Baku brought together leaders of diverse backgrounds, including many women who serve in Azerbaijan's parliament and government to brainstorm how to promote global understanding through making women leaders more vocal.

It is hard to say whether the Forum participants would agree with Sarah Palin's political views or those of Hillary Clinton or Janet Napolitano or Kathleen Sebelius, and others, but they, most likely, can relate to the challenge of being a working mother and would appreciate their strong leadership skills. That alone lays the foundation for a different tone of a global conversation. Today, I am not sure what the specific political positions of the first voters in Azerbaijan in 1918 were, nor who they voted for. One thing is certain: more than 90 years ago, they made history by personally pioneering change. Almost a century later, that still matters a lot.

Elin Suleymanov is Azerbaijan's first Consul General to Los Angeles and 13 Western States, including the State of Alaska. For more information on the Consulate General of Azerbaijan in Los Angeles, please visit www.azconsulatela.org.

Mike Papantonio: The Hysteria Factor: Obama and the Swine Flu

2009-09-11T09:20:55Z

In the past week, the cable talk lunatics have turned their attention to the swine flu conspiracy. Their newest storyline is that Obama is going to use the flu season threat to authorize a forceful entry into people's homes to administer vaccines. As you might imagine, all those delusional "We the People" town hall patriots now have another reason to arm themselves. Nothing like a good pandemic to bring the villagers out with their pitchforks. Another variation of the Obama swine flu conspiracy is that U.S. Secretary of Homeland Security Janet Napolitano is using swine flu hype to distract the terrified villagers while Obama promotes health care reform.

For the past eight years, we have seen how successfully the hysteria factor works. After 9-11, "W" kept the terrorist danger meter burning bright red to take America's focus off issues like war, a floundering economy, and domestic spying. It worked well. But it wasn't just the terrorist meter that helped America lose their good sense. It was also the Bird Flu epidemic that supposedly was threatening our democracy. And remember the hyped up 2003 SARS pandemic that arrived just in time to get our minds off the fact that the Iraq WMD scare was a hoax? Then there was the Anthrax scare promoted by the "W" gang. It terrified our most impressionable crowd to the point that some homemakers were out buying gas masks and chemical protective suits. "W" had middle America so terrified that 20 thousand Americans were taking the medicine Cipro. "W" was always crying wolf. But don't forget that in the end of that children's story, there really was a wolf who ate all the sheep and gobbled up the goofy little boy who loved to scare the villagers.

Because of that, Napolitano can't afford to understate the seriousness of the swine flu, even though America has been abused by politically motivated scare tactics for eight years. The truth is that H1N1 is a legitimate public health concern. It is more likely to cause illness in healthy young people than in an even a less healthy, elderly population. That is not a typical scenario for a flu virus. It is still mutating and is now showing signs possibly of being transmitted to other animals besides pigs. It is more contagious than most flus, and it spreads rapidly. Because of the way it effects the respiratory system, it is probable that the need for hospitalization will be greater than what we see with a typical seasonal flu. Napolitano cannot afford to show the Katrina caliber of unpreparedness and incompetence that we grew accustomed to with the "W" gang.

The pitchfork villager crazies naturally will create political hysteria around this issue. Terrified Americans will stockpile TamaFlu and surgical masks. The survivalist crowd will restock their survival bunkers.

But I'm sure Napolitano's hope is that the rest of us simply get vaccinated and wash our hands regularly; show common sense by keeping our kids out of school when they are ill and isolate ourselves when we show symptoms.

But above all else, stay as far away as possible from that village clown car infected with "crazy" as it pulls into town.

Karin Tanabe: The Seven Unsung Heroes of Washington Fashion

2009-09-01T07:52:05Z

"Welcome to Washington, Hollywood for ugly people!" The fabled moniker held tried and true through Jimmy Carter cardigans and George W. Bush suits and cowboy boots. Then all of a sudden fashion plate Michelle Obama and her well-dressed entourage came to town and Washingtonians aren't likened to burlap-clad trolls anymore. We have women like Desiré e Rogers, Valerie Jarrett, and la belle Michelle who grace the covers of Vogue and make Anna Wintour salivate. Did these three graces manage to reverse years of fashion faux pas on the part of the capital city? Or maybe, just maybe we weren't that bad before the Obama runway show came to town. After all, some Washingtonians have quietly been making fashion splashes for decades, but sadly have gone unsung. Until now!

Gary Ackerman - The former junior high school teacher and current Democratic congressman from New York's 5th district has been wearing a white carnation in his suit lapel since the late sixties. No fresh white flowers in sunny Tajikistan? No problem! The blossom-loving rep carries a few days supply of carnations in dry ice when he travels to third world countries. When he is on American soil, Ackerman doesn't take any old roadside dandelion and staple it to his breast. No, no, no. He always wears a carnation, it's always white and he makes sure to buy a fresh one every day. Now it might sound a tad odd to our modern ears to have the Oldsmobile of flowers worn day in and day out by a thirteen term congressman, but how many politicians care about making a fashion statement?

Ackerman isn't exactly a Rhett Butler look-alike and I have no current plans to wander over to the Rayburn Office Building and try to woo him. But in a sea of identical suits and the unsightly casual wear that comes with the August recess, the congressman from Long Island's flower power adds an old fashioned charm to Capitol Hill.

Maria Cantwell - The junior senator from Washington always wins "sexiest senator on Capitol Hill," in polls on Huff Post and the like, but it's not just her baby blues and shiny locks that help maintain her Miss Washington status. One of the senate's bachelorettes, Cantwell can't get enough of fashionable layered looks like brightly-colored wide-collared shirts with tweed blazers, pencil skirts, and a turtleneck for good measure. While she may not strut down Pennsylvania Avenue in stilettos or wear head-to-toe Chanel, Cantwell always looks feminine and polished, which is certainly "sexy," in its own right.

David Dreier - For many here, the Republican rep from California's 26th may be fighting for the enemy, but a rather well-dressed enemy he is. With a wardrobe reminiscent of a young John Warner, Dreier often wears bright, almost electric blue ties against starched white wing collar shirts. Sometimes he looks like he should be running a Skull and Bones meeting at Yale, and sometimes he comes off rather Reaganesque in elegant beige and brown suits, but whatever he wears, he always looks powerfully put together.

Jane Harman - The spiky-haired congresswoman sometimes looks like she just scampered off to have a few martinis with Joan Jett, but Harman in her embellished black evening wear and impeccably tailored tweed and pinstriped suits is probably Nancy Pelosi's main rival for best dressed in the House. Sure, she certainly has the coinage to buy the best as the most monied member of congress, but Harman appears perfectly outfitted without looking like she raided a starlet's closet.

John Kerry - Can we ever associate French-speaking, windsurf-loving John Kerry with anything other than those headline-making floral swim trunks? Whether we can or not, we definitely should because the stylish man from Massachusetts sports one of the best wardrobes on the Senate floor. Perhaps Teresa Heinz helps with his attire, or maybe he's just a closeted fashionista, either way, he takes the classic navy blue blazer-wearing, red tie-sporting politician look to new heights. Opting for patterned ties with Hermès-like prints and classic New England khakis and barn jackets on weekends, Kerry is very much the Ivy League gentleman. As we all know, his champagne and sailboats look may have hurt him in 2004, but no longer!

Kathleen Sebelius - She may be a new arrival to Washington, but the silver fox of health and human services has already made her fashion stamp on the city. Like Michelle Obama, she has proven her right to bare arms repeatedly wearing sleeveless evening wear, and wearing it well. She also loves jewel tones donning purple, turquoise, and green like other politicians wear red, white, and blue. Sebelius is a great example of a woman who knows how to dress for her body and sticks with the classics.

John Thune - Whether you agree with his politics or not, it's hard not to admit that John Thune is easy on the eye. Sure, his cleaned up cowboy looks certainly help, but his physical appearance is also aided by classic gray suits that look Jermyn Street rather than K Street and his ability to dress very Washington in red and blue ties, and navy or gray suits, without appearing terribly boring. When the junior senator goes casual, he gives a nod to his home state of South Dakota leaving the preppy politician behind and dressing rancher chic in weathered leather jackets, twill shirts, and boots.

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Sebelius Now Says Public Option Remains Obama's Goal

2009-08-21T20:18:41Z

In a visit to the Ohio State University Medical Center today, Health and Human Services Secretary Kathleen Sebelius reasserted the Obama Administration's strong support for government-run insurance as part of a new health-care system.

Although she did not rule out a compromise that excludes a public insurance option, Sebelius today avoided repeating her comment on CNN Sunday that a government-run alternative to private insurance is "not the essential element" of the administration's health reform effort.

Chris Weigant: Friday Talking Points [90] -- Obama To Switch Parties

2009-08-21T19:05:37Z

President Obama stunned the political world today by announcing he will switch political parties, and soon become a Republican. "It seems the only way we're going to get bipartisanship in this town is if I lead the way," he said, in brief remarks before leaving for vacation. "The Republicans have refused to work with me because I'm a Democrat, and Republicans' biggest strength has always been the ability to fall into line with whatever their leaders tell them, unlike other certain unnamed political parties in America..." (the president appeared to cough several times at this point, although one of his coughs sounded suspiciously like the word "Democrats," if truth be told...). The president, clear-throated now, continued, "So I will now be the leader of the Republican Party, and they will fall in line with what I tell them to we're going to do. The Democrats who are interested in bipartisanship can join us to pass Medicare-for-all, instead of the Rube Goldberg machine which they have been attempting to construct."

Well, actually, that whole preceding paragraph was a lie. Complete and utter fiction. But what the hey -- it seems to be the time of year when fiction is taken seriously, so I thought I'd toss this into the silly season mix. It's certainly no more of a whopper than some of the other stories circulating and being given credibility by the media these days.

Ahem.

Of course, all these important rumors and falsehoods make for much better television than stories about how Tom Ridge is admitting that politics played a big part in the "terrorist attack color alert level" (which would, under George W. Bush and Tom Ridge's leadership, increase every time it was politically advantageous for the Republicans). Imagine that! What a surprise! A few bloggers even took this to its logical conclusion -- that there's a word for people who use the threat of terrorism to advance political gains, and that word is: "terrorist."

But screaming idiocy is so much more fun to cover. Much more fun than, say, a report that the CIA was outsourcing assassination to Blackwater -- a concept so fraught with potential for serious problems (to say nothing of the moral relativism which condones the idea in the first place) that it should have been headline news everywhere, but (sadly) was not.

Which led me to my decision to offer up this sprig of catnip to the mainstream media, since these days it seems they'll believe (or at least, obsess over for weeks on end) just about anything. So, if you know any professional news guys or gals, pass the word along to them, in the hopes of this complete nonsense going viral -- "Obama's going to become a Republican!" Odds are, they'll buy it. And then turn around and use it to sell dogfood and breakfast cereal.

After our recent hiatus in the awards-giving department, we are back and ready to hand out a few Most Impressive Democrat Of The Week awards. Woo hoo!

Senate Majority Leader Harry Reid actually said some strong words this week. In this stunning development of backbone-itude, Reid (and the White House, as well) began darkly intimating that Democrats were just about ready to completely ignore both the Republicans and the corporatist bastard (oh, excuse me, that's a typo, it should read "centrist") Democrats on health care reform, and instead just go ahead and use the budget reconciliation they set up earlier this year to pass the damn thing already -- meaning they'd only need 50 votes (plus Joe Biden) to approve it, and the Republicans would be blocked from mounting a filibuster.

Holy jeepers! Harry Reid, getting tough? On members of his own party, no less? I know -- you could have knocked me over with a feather! But the jury's still out on Reid, since he has, in the past, shown a propensity for talking tough, and then folding like a cheap road map (badly, in other words), when it comes time for action. So Harry only gets a "Maybe Later, If You Actually Do It..." Honorable Mention this week. We'll see, Harry, we'll see. You've talked the talk, now walk the walk.

We have two MIDOTW winners this week. First up, Speaker of the House Nancy Pelosi, for responding to -- and getting out in front of -- the progressive Democrats in her chamber. There is a bloc of House Democrats who may wind up being the ultimate leaders in the health care battle, because they are big enough -- and, crucially, they appear united enough -- to draw their own lines in the sand on the debate. When the White House wobbled and waffled on the public option last weekend (see next section), progressive response was swift and strong. Pelosi reacted to the powerful numbers of the group (variously pegged at anywhere from 60-100 House members, depending on whom you believe) and said herself "nothing's going to pass the House unless it has a public option in it," or words to that effect (this is literary shorthand for "I'm too lazy to look up the actual quote right now," sorry). Right on, Nancy! Get up, stand up! Obama has all but abdicated the role of Public Option Champion, so thank you for stepping into the empty shoes this week. It is looking more and more like the real showdown at the OK Corral over health care is going to be a cage match between the House Progressives and the Senate Blue Dogs, so watch for that in the new fall television season.

But the really impressive Democrat this week was, without question, Representative Barney Frank. While his response to a woman (frothing "Nazi" at the mouth in a town hall meeting) will probably not go down in history as the equivalent to the "Have you no sense of decency, sir?" moment in the McCarthy hearings -- for this generation, it'll have to do. Even Fox News ran it with the headline: "Frank Speaks Truth To Crazy," which is some indication of how stunning a performance it was. Frank's words (Huffington Post has the video, as well) were long overdue for someone to say, that's for sure. When the woman questioning him asked him why he supported a "Nazi policy," Frank shot back with:

"When you ask me that question, I am going to revert to my ethnic heritage and answer your question with a question: On what planet do you spend most of your time? You want me to answer the question? Yes, you stand there with a picture of the president defaced to look like Hitler and compare the effort to increase health care to the Nazis. My answer to you is, as I've said before, it is a tribute to the First Amendment that this kind of vile, contemptible nonsense is so freely propagated. Ma'am, trying to have a conversation with you would be like trying to argue with a dining room table. I have no interest in doing it."

This response was interrupted several times for cheers and applause from the audience, and by more incoherent ramblings from the questioner. But for that quote alone, Frank more than earned his Most Impressive Democrat Of The Week award. Shipping the award will be easy, because I live on the same planet as Congressman Frank.

[Congratulate Speaker Nancy Pelosi on her Speaker contact page, and Congressman Frank at his House phone number: (202) 225-5931 (since Frank's House page discourages those from outside his district from emailing him), to let them know you appreciate their efforts.]

We had a few candidates for Most Disappointing Democrat Of The Week this week, I have to say. And, unfortunately, some of the highest-ranking Democrats were among them.

Leading the pack were none other than President Obama himself, and his Health and Human Services Secretary, Kathleen Sebelius. Last weekend, both Sebelius and Obama got pounced on by the media for appearing to back off on strong support for a public option in the health care debate. They both (through Obama's press secretary) tried to "walk back" these remarks in the following days, rather unconvincingly.

I suspect there is more to this story than has so far been reported. Not on the public option front, but on the insider's-view of Obama's White House. Up until now, the Obama White House has been remarkably tight in messaging. Very little leaks out into the press about "who's up and who's down" in the Obama administration. To contrast, consider the stories about Cheney, Rumsfeld, Rice, and Rove which we heard from the Bush White House -- stories of power struggles, infighting, and who had more access and leverage with the president. I, for one, have not read a whole lot of these stories from the Obama White House.

But that doesn't mean the struggles aren't taking place, just that I'm not hearing about them. However, sometimes you can read between the lines a bit, even if you can't identify the players by name. In the midst of last weekend's fray over what was said about the public option and what it meant, there was an article in the Washington Post full of some rather snarky comments from unnamed, but "senior" and "top" sources in the White House about what "the left of the left" thinks. To a large degree, these advisors appeared to support undermining the public option and Obama's support of it. This, to me, looks like a tactical move (leak it to the press!) in a power struggle within the White House itself. Now, it's impossible to know which side Rahm Emanuel is on (but one could guess), or David Axelrod, or any of the other top advisors to the president. But it looks to me like the battle that needs to be won (in order for the president to draw some lines in the sand on health care legislation) is taking place not so very far from the Oval Office itself.

But Sebelius, Obama, and certain senior administration advisors (who have cravenly chosen to remain nameless) didn't rise to the MDDOTW award this week, so they'll have to settle for the "With Friends Like These..." (Dis-)Honorable Mention instead.

The winner of the MDDOTW, it pains me to say, was none other than Senator Ted Kennedy from Massachusetts. Kennedy released a letter he wrote to the top state officials, where he advocated changing the law which governs succession of senators. The letter itself, and the proposed change in the law, seems entirely reasonable when first read.

But it isn't. The media frenzy which was launched by the letter's release has -- almost without exception -- gotten the facts totally wrong. This was due to two major causes: not doing their homework, and Kennedy himself. Because Kennedy's premise itself (that there will be a guaranteed five-month gap where The Bay State will only have one senator representing it) is completely wrong. Well, not completely wrong -- this gap would indeed exist if the senator in question died in office, or otherwise vacated the office unexpectedly. But Kennedy himself has the power to guarantee a smooth succession, with no gap at all (or one of a few days when Congress isn't even in session) -- if he chooses to. This is the fact the media missed, because none of them went and read the actual law itself. I devoted yesterday's column to this subject, if you'd like further details (including the full text of Kennedy's letter, and the relevant Massachusetts law).

Kennedy, by his proposed change in the law, is demanding the right to die in office -- free of political consequences -- instead of realizing that he will soon be medically unfit to fulfill the duties he has been elected to perform. This is about his legacy and about his sense of entitlement to his office, and about him putting both before the interests of his constituents.

As I said, it pains me to write this, because I have so much respect for the man, but Senator Kennedy has to be awarded this week's Most Disappointing Democrat Of The Week.

[Contact Senator Edward Kennedy on his Senate contact page to let him know what you think of his actions.]

Volume 90 (8/21/09)

Kurt Vonnegut, Jr. explained once (via the words of his main character in Cat's Cradle), what being a writer is supposed to mean:

"When a man becomes a writer, I think he takes on a sacred obligation to produce beauty and enlightenment and comfort at top speed."

That's a pretty tall order, especially from a writer whose books often end (as does Cat's Cradle) with the entire world and the human race itself dying out. On the best of Fridays, I only reach for enlightenment, personally. You're going to have to find beauty and comfort elsewhere, is what I'm saying. However, "top speed" has always been a requirement for these Friday columns (this stuff just doesn't type itself, folks!).

But here we are in the depths of the silly season, and I have to say I'm going to chuck out even the goal of enlightenment this week. I've already written my thoughts on how Democrats should be addressing health care reform so many times, even I'm getting bored with the exercise. All the Democrats are on vacation anyway, and even the town hall meeting stories are dying down in the media. Besides, this week I couldn't hope to top Barney Frank's words.

So instead of the normal Talking Points this week, we're going to offer up random thoughts on the media's prioritizing storylines. These kind of go in all directions, so you'll have to excuse me. I blame the silliness of the season, personally.

In no particular order, here are some suggestions for the bored August media (but definitely not "august" media), in the hopes of tickling their fancy.

Remember Iraq?

We've still got around 130,000 soldiers in Iraq. The media determined long ago that this story wasn't "newsworthy," but this week's coordinated bombings deserved more attention than they got. Plus, the American generals are pushing Maliki's government to be allowed in to areas in the north where Kurdish tensions still have not been addressed, which would be a significant reversal of the U.S. pullout from the cities. In the background, the Iraqis are considering whether to put a referendum on the ballot in their next election which would give their citizens a chance to vote on a speeded-up withdrawal timeline for Americans to leave. Any of these are stories worth digging out, if we didn't have to cover war "with the journalists we have" (to paraphrase that well-known military genius, Don Rumsfeld).

Remember Afghanistan?

Reports are that the American generals in Afghanistan may ask for an increase in U.S. troops from the current level (around 70,000) to well over 100,000 by next year. This is an enormous escalation, and deserves to be investigated. The Afghan elections just held were actually covered by the American media, in a cursory way, but little or no context was provided. What does it mean if Karzai is forced into a runoff election? What do the parties opposing Karzai stand for? These would be good questions to answer if we're going to double down on this war.

Naked guy on a plane!

OK, those were a bit serious. How about some media catnip instead? A Southwest flight had to return to Oakland California because a guy took all his clothes off and got violent. Naked guy on a plane! I haven't seen the evening news yet, but I would be willing to wager this story makes the cut.

Sigh.

"Hee-ee-ee-re, media media media... heeere media... want some catnip, furry media-kitten?"

Double-sigh.

Obama's switching parties!

If we're going to flood the airwaves with silliness, then how about my flavor of silliness? Call it Weigant Brand Media Catnip -- the fake news story that wouldn't die!

Barack Obama will, at some point before his vacation ends, announce he is sick of Democratic squabbling and will be switching to the Republicans instead, who quite obviously don't care what species of nonsense they parrot, as long as they're all speaking with one voice.

No, seriously, I read it on the Intertubes... it must be true!

Heh heh.

Mexico legalizes personal drug use

Speaking of August, did you know the month used to be called (by the Anglo-Saxons) "Weedmonth"? Far out, man. Oh, excuse me, I must have been spacing out or something...

I can't believe the media has been slacking on this story. I mean, Mexico is RIGHT NEXT DOOR! The fear-mongering should have begun by now, but maybe I just haven't noticed it yet. Mexico is decriminalizing personal amounts of not just marijuana; but also cocaine, heroin, methamphetamine, LSD, and (one is left to assume) just about everything else. The American media yawned. The nativist anti-immigrant fanatics yawned. The American government (even Republican politicians) have so far yawned, as well. Is the Drug War finally coming to an end? One is left to wonder. This sort of thing would have caused Nancy Reagan to invade Mexico within 24 hours, not so very long ago. How things change, eh?

Who cares who wears short shorts?

You've got to be kidding me. Michelle Obama descends from an airplane (well, OK, it was Air Force One) wearing shorts, and the media swoons? What is this, 1890? Especially when the media who first swooned seems to be a certain liberal blogging site who shall remain nameless. Get the smelling salts, I caught a glimpse of the First Ankle!

The woman was visiting the Grand Canyon, fer cryin' out loud! In August! Do you know how hot it is there? You don't? Let me enlighten you: it's HOT! Really hot! This is because it is in the desert! And if the First Lady wants to wear shorts, it is not exactly newsworthy, in my humble opinion.

Elizabeth Snead, of the Los Angeles Times, summed it up nicely for me: "What should she have worn to the Grand Canyon? A tweed pantsuit? A ballgown? What do you wear on your summer vacation?"

Now if Barack appeared in Daisy Dukes, that might qualify as news. This, quite simply, does not.

Enjoy your vacation, Mr. President

Likewise, the media appears to be going faint over the news that Barack Obama is taking ten days off (maybe we'll see that paparazzi shot of him in Daisy Dukes yet!). I have to respectfully serve up a big helping of "OH, PUH-LEEZE!!" to those "reporting" this "story." George W. Bush set the all-time record for vacation days while in office, shattering Ronald Reagan's old mark. Bush took the entire month of August off every single year he was in office. This is not-so-long-ago historical fact, folks. Bush was reluctant to cut his vacation short by even a few days when Hurricane Katrina hit.

So Obama taking 10 days off is showing comparative restraint, responsibility, and respect for the duties of his office. But I bet that's not how I'm going to hear it portrayed in the next few days.

Sigh.

Until next week... the forecast is for heavy-duty silliness... and continued scattered media catnip....

Chris Weigant blogs at: ChrisWeigant.com

Full archives of FTP columns: FridayTalkingPoints.com

Cross-posted at: Democratic Underground

Biden To Announce Almost $1.2B For Medical Records

2009-08-20T10:18:56Z

CHICAGO — Vice President Joe Biden said Thursday the nation has never been closer to substantial health care overhaul despite "all the shouting and all the political turmoil" of recent weeks.

Biden said restraining costs and insuring more people should unite fiscal conservatives and advocates for the poor behind the Obama administration's efforts to fix what Biden called a broken system.

Dems May Split Health Care Reform Bill In Two

2009-08-19T22:17:24Z

The White House and Senate Democratic leaders, seeing little chance of bipartisan support for their health-care overhaul, are considering a strategy shift that would break the legislation into two parts and pass the most expensive provisions solely with Democratic votes.

The idea is the latest effort by Democrats to escape the morass caused by delays in Congress, as well as voter discontent crystallized in angry town-hall meetings. Polls suggest the public is losing support for the overhaul plans, giving Republicans less incentive to go along.

Earl Ofari Hutchinson: President Obama Will Likely Dump the Public Option, and Here's Why

2009-08-19T11:02:28Z

Health and Human Services Secretary Kathleen Sebelius found out the hard way that when you say what your boss may really be thinking, or worse, end up doing so on a crucial piece of legislation, you get quickly smacked down. Sebelius, in an unscripted and unvetted moment, said that President Obama's public option in the health care reform war could go by the wayside if that's what it takes to get Senate obstructionists to back a reform bill. Sebelius didn't say anything that Obama's point man Rahm Emanuel didn't hint at weeks earlier -- and that Obama himself has hinted at. The public option is not only expendable, but likely will go.

Even if Sebelius, Emanuel, and Obama hadn't dropped the hint that it can be tossed, it would still likely go. This has much less to do with angry town hall loudmouths, the drum beat of Fox Network, Limbaugh, and the legion of right shrill blogger attacks, and GOP orchestrated Senate attacks on the public option, than Obama the politician. Obama wants -- no desperately needs -- to win a big victory on health care, or at least the appearance of a victory, even if the victory means scrapping the only thing in the health care reform package that really represents true health care reform. Put another way, a government health insurance option is the only real lever to make the pharmaceuticals and health care insurers lower drug costs, reduce their obscene profit rake-offs, deliver better services, eliminate the endless dodges that insurers use to cherry pick only the most healthy and profitable patients, and make some dent in the 45 to 50 million uninsured.

If private health insurers and the pharmaceuticals had done that decades ago without a government lever, the whole health care debate and crisis would have long since been a moot point. Obama well knows this, and has said as much in his earlier political days. But that was then, and now it must be said again, and again, that Obama quickly morphed into the archtypical Hollywood casting lot moderate, centrist Democrat who will cut a political deal with legislation to get something -- anything -- out of it that can be sold as a win. This is nothing new, let alone a sign of duplicity, with Obama.

A cursory read of his record, as well as a fine comb of his speeches, statements, and interviews, confirms that the talk during the campaign of Obama as an unreconstructed far-out liberal was mostly just talk; first by Hillary Clinton, and later by conservative talk jocks, Sarah Palin and the GOP attack teams.

If he even remotely resembled what the attack hounds claimed he was he could never have gotten the stamp of approval from top Democrats, beat down the Clinton machine, gotten the parade of endorsements from former Reagan and Bush Sr., and even W. Bush officials. And most imortant, broken the cash registers on fund raising. That included a a generous plop of more than $2 million into the Obama campaign till. Republican rival John McCain got a relatively paltry $600,000 and some change.

Obama's centrist bent was plainly evident during the campaign when he and McCain at times sounded like they were more agreement than not on the issues of expansion of stem-cell research, immigration, faith-based social services, expanded government wiretapping, building more nuclear power plants, global warming, fair trade, and the death penalty. The similarity between the two was more glaring when Obama edged closer to McCain on their plans on health care and taxes and the Iraq War. This also was no surprise.

The truism in American presidential politics is that liberals and even one-time progressives always run to the political left in the early stages of a campaign. They then move quickly to the center or even rightward as victory becomes a real possibility.

Even when Obama spoke most passionately about change he kept the door wide open to reshape, massage, and contour policy issues to conform to what was pragmatic, doable and acceptable. Obama's voting record in the Illinois state legislature gave a strong hint that his liberal record was hazier than it appeared. He got high marks from liberal groups on votes on environmental, gun control, abortion, civil liberties protections, and ethics reform. But he also deftly ducked taking positions on some of the same issues when they could stir rancor and were potentially polarizing. During his stint in the legislature, Obama used the tactic more often than most senators and rarely gave a reason why.

Whatever Obama's motive for not taking a firm stand on these issues, and not spelling out the reason why, it helped burnish his credentials with conservative Republicans and right leaning Democrats as a man willing to compromise -- even conciliate -- on big ticket issues that conservatives routinely support or oppose.

That hasn't changed. And all signs past and present point to the public option as the latest casualty in the routine compromises that politicians make in playing the political game. And Obama has played the game far better than most.

Earl Ofari Hutchinson is an author and political analyst. His weekly radio show, "The Hutchinson Report" can be heard weekly in Los Angeles, Fridays on KTYM Radio 1460 AM and live streamed nationally on ktym.com.

Press Can't Wait For Public Option To Die

2009-08-18T15:11:37Z

Over at Mediaite, Tommy Christopher notes the panting way the media has dug into reporting on the demise of the public option. See, now that the media believes the public option to be dead, they can finally do what they do best -- ride in and start shooting the corpse.

But was it really news when Secretary Of Health and Human Services Kathleen Sebelius put forth that the public option is not essential to health care reform? Says Christopher, who has actually been paying attention: Not really!

Ex-sueeze me? That's the big news? This is one of those questions that come up so often at White House briefings, we can all recite the answer like a well-dressed Rocky Horror audience. "The President strongly supports a public health insurance option, but the main goal is to provide health care reform that results in quality, affordable care for every American." (throw toast at Gibbs)

Christopher notes that the press has been spoiling to declare the public option extinct from minute one. All along, the White House has been alternately floating trial balloons marked, "maybe not" and just as quickly, and reliably, walking them back. The White House, today, is once again doing this very thing: Walking back the notion that they aren't firmly committed to the public option.

Christopher notes that the battle for a public option is essentially the White House's to lose, and that the "question is whether or not they realize what's at stake."

I really can't fault any of that! And I think Christopher is spot on here, as well:

An even bigger question is, why is the media so ready to eulogize the public option? While recent polls have reflected slipping support for health care reform as it is being debated, those same polls either show overwhelming support for the public option, or they simply don't ask.

I've often remarked that the media has worked hard to avoid mentioning those polls that indicate consistent and strong public support for the public option. It has been a truth to which the media seems to have strong allergy.

That said, I'll offer a prediction. If the public option ends up off the table in a final bill, you can bet your sweet bippy that the media will suddenly rediscover those polls, loudly questioning how the White House and the Democratic majorities could have possibly failed to give their constituents the very thing for which they have loudly clamored. And this will be a very good question, asked months after it would have mattered.

MORE:
Media Eager to Report Death of Public Option [Mediaite]

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