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Remember this? This is Rachel Maddow's stellar segment on the "Swiftboat Veterans for Unaffordable Insurance", aka Rick Scott's organization, Conservatives for Patients Rights, the AstroTurf anti-health care reform group who led the opposition to any and all efforts to reform the health care system last year. As Rachel opined, "Having Rick Scott as your spokesman for health care reform is like having the eColi bacterium as your spokesman against handwashing."

Scott's involvement in Conservatives for Patients' Rights is just his latest venture. The real reason Floridians would be insane to even consider electing this man? His leadership of the Columbia/HCA hospital chain.

Columbia/HCA didn't just scheme to defraud Medicare a little bit. They schemed to commit fraud on a mega-fraud basis. And it wasn't just insurance companies they tried to rip off. It was Medicare, Medicaid, and even TRICARE, the health plan that covers our veterans. It wasn't only overbilling, either. Here's a partial list:

• Intentional year-end record fraud alleging payments from the government less than actually received, leaving the government with the burden of overpaying them.
• Payment of kickbacks to providers to inflate claims billed to Medicare, Medicaid and TRICARE.
• Billing costs to the government which were not allowed.
• Inflating the cost of transferring patients from HCA facilities to other, non-HCA facilities.
• Inflating claims for indigent patients.
• Paying kickbacks for diabetes patients.
• Overbilling states for Medicaid patients.

The entire list and summary of the case is on the DOJ website.

Columbia/HCA settled the morass of fraud claims for $1.7 billion, the largest-ever settlement of a Medicare fraud investigation.

Scott will be quick to jump in and remind anyone who raises the Columbia/HCA fraud settlement as an issue that he personally was not charged with any crime. While that may be true, it is also true that the company was under HIS leadership, and it was a publicly-owned corporation at the time.

Not only was the government taken for a ride, shareholders were, too. When Scott resigned, he took his multi-million dollar golden parachute and waved goodbye to the mess he left behind. The only ones holding the bag at that point were the shareholders. After a painful cleanup and stock buyout making the company privately-held again, Hospital Corporation of America (HCA) is poised for another $4.6 billion public offering.

This is the man who thinks he can lead Florida. The man who led a company while that company was busy defrauding the federal government now wants to lead a state. Even more concerning, his candidacy is actually getting some traction, leading me to once again ask this question:

Why is Rick Scott running for governor in Florida?

Read more about Rick Scott at Media Matters. They have a rich treasure trove of information there. And if you are in Florida, I hope you'll ask, and then repeat, my question above.

Bonus: Since "outsider" status seems to be some kind of political magic shield right now, Floridians should also ask themselves why billionaire Jeff Greene was a Republican until he became a Democrat and decided to run for the Senate.

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Conservative humor is alive and well. Harry Reid's challenger in Nevada, Sue Lowden, strikes comedy gold with her silly "livestock barter" program for doctors:

Sue Lowden (R), the leading Republican Senate candidate in Nevada, recently articulated her vision of how the American health-care system should work. At a local candidate forum, Lowden, a former state senator and chair of the Nevada Republican Party, encouraged Nevadans to "go ahead and barter with your doctor." It would, she insisted, "get get prices down in a hurry."

-

"I'm telling you that this works," the Republican candidate explained. "You know, before we all started having health care, in the olden days, our grandparents, they would bring a chicken to the doctor. They would say, 'I'll paint your house.' I mean, that's the old days of what people would do to get health care with your doctors. Doctors are very sympathetic people. I'm not backing down from that system."

It's a permanent credibility-killer. It's one thing to be a confused, far-right candidate. It's another to be a laughingstock.

Talk about channeling Michael Landon and "Little House on the Prairie." It was a pretty good show at the time, but it did take place in the late 1800s.

If you have a serious illness you might get away with this idea, not with chickens, but by giving up a new BMW or a Rolex, maybe.

Greg Sargent reports that the DCCC has a new website dedicated to Reid's challenger.

That’s the name of a new Web site the DSCC is planning to unveil today in an effort to draw national attention to GOP Senate candidate Sue Lowden, who doubled down this week on her assertion that people should barter with doctors to reduce health care prices, a DSCC spox tells me.

The DSCC’s new Chickens for Checkups Web site — a name that first appeared below on this blog — will allow people to send Lowden a “personalized message asking for her help in finding a doctor for their 19th century illness,” DSCC spox Deirdre Murphy says. It will include a menu of stuff you can choose to barter for treatment.

“You can’t make this stuff up,” Murphy says. “Sue Lowden is completely out of touch with reality if she thinks trading chickens for checkups is smart health care reform.”

She just tripled down on the idea and said doctors do support her "chickens for checkups" idea. Lowden certainly has made this a national story now. And I predict there will be some teabagging doctors who will adopt this for awhile, just to back her up as long as they have enough money in the bank to do it.

Is she just cuckoo for cocoa puffs? Sure looks like it.

This isn't a new idea, and it's not limited to Massachusetts. (When I first read about it, it was called "tiered" coverage.) I expect we're going to see it spread, though, because the just-passed federal legislation doesn't actually reform the health care system, and much of the much-vaunted "access" is in name only.

Which means the fight isn't over. Because if you have a serious health problem and your coverage will send you to the facility that doesn't have such a great track record, you're out of luck:

Health insurers are starting to sell policies that largely bar consumers from receiving medical care at popular but expensive hospitals such as Massachusetts General and Brigham and Women’s — a once radical idea that is gaining traction as a way to control soaring health care costs.

Governor Deval Patrick and Senate President Therese Murray have included such restricted provider networks in their recent legislative proposals to control rising insurance rates. And the state this month began offering limited-network plans to 300,000 state employees, retirees, and their families, promising 20 percent discounts on premiums if they are willing to give up access to some of the Boston area’s most renowned hospitals.

Dolores Mitchell, executive director of the agency that oversees health insurance for state employees, said she wants “to send a message to the more expensive [provider] organizations that, ‘Hey, we’re not going to just sit still and do nothing’" as medical costs climb year after year.

But even as state officials promote the idea, there are obstacles to its wide adoption. Some of the state’s largest insurers have contracts with powerful teaching hospitals and doctors’ groups that could make it difficult to exclude them. And Massachusetts consumers and employers have long cherished choosing from a broad range of providers.

In a yearlong investigation into rising health care costs completed last month, Attorney General Martha Coakley cited "distorted" contracting practices as one factor. She found that providers with market clout have negotiated clauses in their contracts that prohibit or inhibit insurers from creating plans intended to steer patients away from them. She did not name the companies involved, but said regulators and lawmakers should move to discourage or forbid these practices.

Certain providers “are strong enough to dictate which products get into the market," agreed Rick Weisblatt, senior vice president for health services at Harvard Pilgrim Health Care, the state’s second largest insurer.

The American people were once again treated to the sight of the obstructionist Republicans dragging their feet and playing party politics with the people's business - on a bill that's constructed mostly with Republican ideas.

I wonder if this means Sen. Michael Bennet will bring up the public option amendment he promised?

Senate Republicans have successfully identified two minor violations of reconciliation rules in the final piece of the health-care package. The violations will force the Senate to change the reconciliation bill and ship it to the House of Representatives for final passage.

But Democratic leaders said the provisions that will be struck -- from the part of the bill dealing with Pell Grants for college students -- do not significantly affect the student loan program or the health care bill overall.

The corrected legislation most likely will not be subjected to additional challenges when it is sent back to the House, Democratic staffers said, and is expected to receive final approval before the weekend.

"The parliamentarian struck two minor provisions tonight from in the Health Care and Education Reconciliation Act. But this bill's passage in the Senate is a big win for the American people," said Jim Manley, spokesman for Senate Majority Leader Harry Reid.

For much of Wednesday and into Thursday morning, Senate Republicans offered dozens of amendments to the bill President Obama signed into law Tuesday. Their goal was to force the legislation that will launch an overhaul of the nation's health-care system back to the House for another vote. But when the Senate began voting shortly after 5 p.m., all 29 amendments were easily rejected.

That means the health-care package survived essentially intact, save for the deletion of the two clauses in the reconciliation bill that were found to violate reconciliation rules, the complicated set of procedures that protected the bill from filibuster.

A senior Democratic aide said one of the problematic items is a "hold-harmless provision," which was designed to prevent reductions in individual student grants if appropriated funds for Pell Grants declines. The second adjustment was described as "a conforming change, to strike obsolete language."

You don't suppose they're doing this for political reasons, do you?

Sen. Ron Wyden (D-Ore.) has a message for all the attorneys general and Republican lawmakers who are threatening lawsuits and claiming that an individual mandate for insurance coverage is unconstitutional: You don't have to abide by it -- just set up your own plan.

The Oregon Democrat isn't inviting opponents to defy the newly-enacted health care law. Instead, he's pointing out a provision in the bill that makes moot the argument over the legality of the individual mandate.

Speaking to the Huffington Post on Tuesday, Wyden discussed -- for one of the first times in public -- legislative language he authored which "allows a state to go out and do its own bill, including having no individual mandate."

It's called the "Empowering States to be Innovative" amendment. And it would, quite literally, give states the right to set up their own health care system -- with or without an individual mandate or, for that matter, with or without a public option -- provided that, as Wyden puts it, "they can meet the coverage requirements of the bill."

"Why don't you use the waiver provision to let you go set up your own plan?" the senator asked those who threaten health-care-related lawsuits. "Why would you just say you are going to sue everybody, when this bill gives you the authority and the legal counsel is on record as saying you can do it without an individual mandate?"

Jon Walker at FDL accuses Wyden of being disingenuous:

This is not accurate. You see, the problem is that the individual mandate starts in 2014, but states can’t get a waiver to try a different system, potentially one without an individual mandate, until 2017. So, there is nothing states can do to stop the individual mandate from being in effect for at least three years.

Whether you agree with an individual mandate or not, it is just wrong to say people shouldn’t complain because, at some point in the future, they might possibly have a way for states to opt out of it. If the state waiver started in 2014, Wyden’s argument would be perfectly valid, but as the law currently stands, his statement is pure baloney.

Wyden also seems to be glossing over the serious problem of system entrenchment. While it would be easy for a state to experiment with a new health care system in 2014 if they could get a waiver right away, trying to start a new system in 2017 would be much more difficult. The law requires them to put all the effort into setting up this exchange system. Expecting a state to start all over by uprooting this new system and putting up a whole different system after only three years is a huge hurdle.

Obviously, Wyden's provision wasn't meant to make it easy for states to opt out. But it does make it possible, and that's probably all it needs to do to meet any legal challenges.

As to motive? My guess is, they probably did it this way to hit their CBO targets.

If the Republicans were operating in good faith, it would be a lot simpler to consider reconciliation amendments like the one Jon suggests. Instead, they're doing what they do best: obstructing the process. No no no!

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Jake Tapper on This Week interviews David Axelrod on the healthcare bill, pushing the right-wing narrative that people don't want this bill. Axelrod responds that when you push on into the details, the public supports the things this bill does:

TAPPER: David, pluralities, if not majorities of the American people do oppose this bill. Doesn't he have a point?

AXELROD: Well, first, let me note that Senator Brown comes from a state that has a health care plan that is similar to one that we are trying to enact here, and that people in his state are overwhelmingly in support of it. He voted for it and said he wouldn't repeal it. So we're just trying to give the rest of America the same opportunities that the people of Massachusetts have to get health insurance at a price they can afford.

This bill is important to the American people, Jake, and when you get underneath the numbers and you ask people, do you support giving people more leverage against insurance companies so that they -- if they have preexisting conditions, they can get coverage, so if they get sick, they don't get thrown off, so they don't have these huge premium increases of the sort we've just seen announced in states around the country, they say yes. When you say, do you want to give small businesses and people who don't have insurance through the job the chance to get insurance in a competitive marketplace where they can get it at a price they can afford and give them tax credits to help them do that, they say yes. And when you say, should we reduce the overall costs of the health care system over time, they say yes.

But that's the program. That's the plan. And it is important to the American people that we have the fortitude to go ahead against it, to leave the politics aside, to leave the partisanship aside, to resist the special interests and get the job done.

TAPPER: But according to polls, the American people do not agree with what you think--

AXELROD: The polls are split, Jake. I mean, one of the interesting things that has happened in the last four or five weeks is that if you look at -- if you average together the public polls, what you find is that the American people are split on the top line, do you support the plan? But again, when you go underneath, they support the elements of the plan. When you ask them, does the health care system need reform, three quarters of them say yes. When you ask them, do you want Congress to move forward and deal with this issue, three quarters of them say yes. So we're not going to walk away from this issue.

Please discuss as the President announces his final plan for health-care reform.

Some excerpts, sent in advance:

“I don’t believe we should give government bureaucrats or insurance company bureaucrats more control over health care in America. I believe it’s time to give the American people more control over their own health insurance. I don’t believe we can afford to leave life-and-death decisions about health care to the discretion of insurance company executives alone. I believe that doctors and nurses like the ones in this room should be free to decide what’s best for their patients.

The proposal I’ve put forward gives Americans more control over their health care by holding insurance companies more accountable. It builds on the current system where most Americans get their health insurance from their employer. If you like your plan, you can keep your plan. If you like your doctor, you can keep your doctor. Because I can tell you that as the father of two young girls, I wouldn’t want any plan that interferes with the relationship between a family and their doctor.”

***

“So this is our proposal. This is where we’ve ended up. It’s an approach that has been debated and changed and I believe improved over the last year. It incorporates the best ideas from Democrats and Republicans – including some of the ideas that Republicans offered during the health care summit, like funding state grants on medical malpractice reform and curbing waste, fraud, and abuse in the health care system. My proposal also gets rid of many of the provisions that had no place in health care reform – provisions that were more about winning individual votes in Congress than improving health care for all Americans.”

***

“At stake right now is not just our ability to solve this problem, but our ability to solve any problem. The American people want to know if it’s still possible for Washington to look out for their interests and their future. They are waiting for us to act. They are waiting for us to lead. And as long as I hold this office, I intend to provide that leadership. I don’t know how this plays politically, but I know it’s right. And so I ask Congress to finish its work, and I look forward to signing this reform into law.”

The White House has put the proposal up for you to read.

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The obsession Republicans have with lawsuits and the amount of money someone should receive if they win a case is very perplexing and disingenuous to me. I mean, they are the first people to use lawyers and sue you, like Fox News did to Al Franken over a book. But during the Obama health-care summit, I heard more garbage about "tort reform" from the Republicans as if it will cure our ailing health-care system. (Sen. Dick Durbin dispelled that myth perfectly, by the way.)

But that was just a drop in the bucket compared to the garbage we get served up on a daily basis from the media elite pundits who take to our airwaves and say the most insipid things to defend their positions. Fox News' Megyn Kelly earlier this week gave probably the most ludicrous argument against trial lawyers and for tort reform than anyone I've ever seen. She sacrificed her arm for the cause. For some reason, if malpractice cases disappeared, suddenly health care premiums would majestically be reduced.

Kelly was discussing tort reform with Debbie Wassermann-Schultz and dove into the twilight zone by arguing that if her arm was cut off, it really wasn't worth all that much as long as you can still function. And what the hell? It's only an arm. I mean how much of an impact does it have on your life if you lose one arm, because you have a back up, right?

Kelly: this is a CNN poll and thy ask people about tort reform and 66% of those asked said they favor limiting the amount of money patients can get if they win a medical malpractice lawsuit. 66 % want that. 33 % don't want that. Why can't there be an agreement on tort reform?

Schultz: They support that until it's them or their family member that is injured in a medical malpractice suit and then the poll numbers change.

Kelly: You just have to limit the economic damage, in other words you, if a doctor cuts my arm off. I can get the money back from what my life is to live like without this arm so I can function. You can't get punitive damages.

WTF? How does a person figure out how much one of my limbs is worth? And then I'm not allowed to get punitive damages because I don't deserve it? Are you confused?

You know, if some moron of a doctor cut off my arm through incompetence, not only would I want to get enough money to make my life whole, I would want to make sure the doctor paid a price too, just to try to assure it didn't happen to anyone else. It might not put him out of business, but it would take a piece out of his hide that he would never forget.

Maybe we should have Kelly draw up a diagram of a body and then monetize each part as it relates to how a person functions. She could then pass it on to Michael Steele, Sarah Palin and the teabaggers, because I'm sure they would argue that one foot is only worth about thirty three hundred dollars and sixteen cents.

Why would anyone care if I won $10 million dollars from a f*&king doctor if he cut my leg off and I sued his ass because he was supposed to only drain a little fluid out of my knee? This is the kind of crap Republicans argue for on Fox News every day, and conservative pundits on all the channels spew regularly. They really are ethically bankrupt.

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Head. Bangs. Desk.

Reason #2,348,293,297 why Americans are so tragically misinformed about the issues facing us today. CNN cut away from the Health Care Summit today to give us the oh-so-important musings of former Nixon speechwriter and D-list actor Ben Stein and Democratic strategist Donna Brazile. What? We need to cut away to get more unsubstantiated talking points?

But it gets even better. Stein launches into his socio-economic theories of why health care reform is unpopular with the Republican Party, and it's not because they're beholden to corporations and worship at the altar of the "free markets". It's not because their bank accounts are busting from donations by the health care industry. It's not even because they reflexively obstruct and are against anything the Obama administration is for. Oh no, it's because Republicans pay more taxes than Democrats do:

You asked one of the most brilliant questions I have ever heard anyone ask on TV, which is why are so many Republicans against more government interference in the health care system, and so many Democrats in favor of it? And the answer is much higher percentage of Republicans are taxpayers than Democrats and the Republicans are the people paying for it, and the Democrats are the people receiving it. So that has a lot to explain there.

There are a tremendous number of wealthy Democrats and wealthy Republicans, but as a general matter, Republicans as a group pay income tax at a much higher rate than Democrats, and I think that has a lot to do with everything. They also have a much higher rate, and are paying members of the insurance pools, and they realize that the insurance premiums are going up so that people who otherwise would not get insurance are going to get insurance and it has a lot to do with the fact that Republicans are a different group of people than Democrats.

You have to ask yourself why CNN felt that Ben Stein's opinion on anything (let us not forget that he also rejects evolution) is at all informative to the American public.

In fact, feel free to ask them directly: http://www.cnn.com/feedback/

This will be controversial, to say the least. I wonder on what legal grounds this will be asserted - and how long it will be before the insurance companies lobbyists stop it. (I also wonder why he didn't support the public option, which would have been less directly interventionist than this, and thus, less politically risky.)

You can read the details here:

President Obama will propose on Monday giving the federal government new power to block excessive rate increases by health insurance companies, as he rolls out comprehensive legislation to revamp the nation’s health care system, White House officials said.

[...] The president’s bill would grant the federal health and human services secretary new authority to review, and to block, premium increases by private insurers, and it would create a new Health Insurance Rate Authority, comprised of health industry experts that would issue an annual report setting the parameters for reasonable rate increases based on conditions in the market.

The legislation would call on the secretary of health and human services to work with state regulators to develop an annual review of rate increases, and if increases are deemed “unjustified” the secretary or the state could block the increase, order the insurer to change it, or even issue a rebate to beneficiaries. States would be eligible for a portion of $250 million in grants to finance premium review and approval.

The new rate board would be composed of seven members, including consumer representatives, an insurance industry representative, a physician, and other experts such health economists and actuaries, the White House said. The board’s annual report would offer guidance to the public and states on whether rate increases should be approved.

The corporatist-friendly RAND think tank issued a 2004 report on a similar proposal in California, warning of unintended consequences:

This issue brief evaluates why health insurance premiums are rising and examines the potential long-term consequences of regulating premium costs, using examples from other insurance products such as automobile coverage and workers compensation. The findings underscore that if health care costs continue to rise while premiums are frozen, stringent rate regulation could lead to undesired consequences. These include:

* In the short term, insurers could balance their losses by reducing the quality or quantity of care -- or both.

* Insurers could discourage unhealthy consumers from enrolling in plans, thus increasing the number of uninsured over time.

* If costs continue to rise and premiums are fixed, insurers may exit the market entirely.

* Over the longer term, regulation could discourage expensive treatments and technologies, no matter how beneficial, from coming to market. (A desirable related consequence is that premium regulation could motivate the introduction of cost-saving technologies.)