Whenever conservatives start telling me what a great healthcare system we have, I say, "Yes, and we make very nice yachts, too. What's your point?" Because what earthly difference does it make to you when you're priced out of that system?

I've known Americans who've gone to Costa Rica, Venezuela, Peru, Mexico and Austria for medical and dental treatment they couldn't afford here. (In fact, Logan wrote about this a few weeks ago.) If people are getting on a plane to go somewhere to get treatment, that's got to tell you something:

MEXICO CITY — It sounds almost too good to be true: a health care plan with no limits, no deductibles, free medicines, tests, X-rays, eyeglasses, even dental work — all for a flat fee of $250 or less a year.

To get it, you just have to move to Mexico.

As the United States debates an overhaul of its health care system, thousands of American retirees in Mexico have quietly found a solution of their own, signing up for the health care plan run by the Mexican Social Security Institute.

The system has flaws, the facilities aren't cutting-edge, and the deal may not last long because the Mexican government said in a recent report that it is "notorious" for losing money. But for now, retirees say they're getting a bargain.

"It was one of the primary reasons I moved here," said Judy Harvey of Prescott Valley, who now lives in Alamos, Sonora. "I couldn't afford health care in the United States. … To me, this is the best system that there is."

It's unclear how many Americans use IMSS, but with between 40,000 and 80,000 U.S. retirees living in Mexico, the number probably runs "well into the thousands," said David Warner, a public policy professor at the University of Texas.

"They take very good care of us," said Jessica Moyal, 59, of Hollywood, Fla., who now lives in San Miguel de Allende, Mexico, a popular retirement enclave for Americans.

The IMSS plan is primarily designed to support Mexican taxpayers who have been paying into the system for decades, and officials say they don't want to be overrun by bargain-hunting foreigners.

"If they started flooding down here for this, it wouldn't be sustainable," said Javier Lopez Ortiz, IMSS director in San Miguel de Allende.

The New Yorker has a great profile of Sheila Bair, the populist Republican who's at the helm of the FDIC. (h/t Riverdaughter)

As you may already know, Bair is not well liked by the Wall St. crowd that's running the White House show. (Apparently she has this bizarre idea that her job is to look out for working folk. Crazy talk!) Well, she's very popular with regular people - the administration wouldn't get rid of her, it would make a stink. Instead, they've just neutered her:

These debates entered into the Administration’s discussions about building a new regulatory architecture. In late March, Geithner previewed for Congress some of the key concepts that Treasury wanted. The outline seemed to match the Bair camp’s ideas. [Ladies, has this ever happened to you?] A new authority with the power to take over large financial institutions that posed a systemic risk to the economy was modeled on the F.D.I.C., which, Geithner suggested in his testimony, would be an equal partner with Treasury in resolving such firms if they failed. He seemed to be saying that although he and Bair may have disagreed about how to handle the current crisis, there was much more consensus about how to deal with a future one.

But in the white paper detailing the new legislation, which the Administration released on June 17th, all the new authority to regulate firms that posed systemic risk was vested in the Federal Reserve. During Geithner’s testimony before the Senate, Jim Bunning, of Kentucky, echoing Bair, was incredulous. “It took fourteen years for the Fed to write one regulation on mortgages after we gave it the power to do that,” he said. “What makes you think that the Fed will do better this time around?” In addition, while the March plan said that the “Secretary and the FDIC would decide” how to resolve a failing firm, the new plan said such power should “be vested in Treasury.” Geithner could appoint the F.D.I.C. to do the technical work of cleaning up the firm, but between late March and mid-June — when Bair’s aggressive ideas about how to handle Citigroup leaked to the press — Bair’s agency had been downgraded from Treasury’s equal partner to a sidekick.

The senior Treasury official said that stripping authority from the F.D.I.C. had nothing to do with pressure from the banks. “Making a group decision on something that must be done really quickly is not easy,” he said. “At the end of the day, someone has to have the ability to make a call, and it’s better to have that authority vested in one person.”

When I asked Bair about the plan, she said, “I think it reflected a lot of input from a lot of different agencies, and the private sector, and insurance and consumer groups. It’s a very difficult task to try to balance all the different perspectives and come up with a package, and every compromise is going to have people who are unhappy about various parts of it. So I think it’s a starting point.” I said that she sounded disappointed. “I don’t know if ‘disappointed’ is the right word,” she replied.

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(Claude Pepper - D-Florida - Governor Harold Stassen - R-Minnesota - The relentless jangle of The Bogey Man)

The never ending debate in a National Health plan and another dig in the archives for some perspective. Seems the one thing the debates had in common (the ones I've come up with from 1947, 1949, 1951, 1961) is the fear factor, trotted out almost verbatim by spokespeople for the AMA - all following the dreaded bogey man. It seems this overriding fear was the biggest factor in sinking any useful legislation in health care. And always the fear card is played by the Republicans. This debate features Senator Claude Pepper (D-Florida) and former Governor Harold Stassen (R-Minn.) from the program "American Forum Of The Air" on January 29, 1950.

It's interesting to note that one of the arguments made against the British system of Health care was the reported "dramatic rise in gravesites" after it was enacted in 1943, eluding to the notion that British National Health care became inept. Trouble was, there was that little thing called World War 2 that seemed to escape the radar and that all this sudden rise in dead people came not from a flawed health system, but rather bullets and shrapnel.

In the argument against a decent National Health care plan - reality doesn't seem to play much of a role.

As you've probably noticed, I've been very upset with the way the health-care debate is headed. Kathleen Sibelius did a good job defending the public option and of exposing some of the lies being used the medical industry and their cohorts in Congress.

I think we can all agree that single payer is the way to go, but since it was never made a priority by our representatives, we are left to fight for a solid and robust public option. We know that the obstructionist Republican Party will never get behind any meaningful reforms so Blue America has to go after members of the Democratic Party in the Senate and call them out for selling Americans health care down the drain.

For weeks I've been working on an action so we could get busy defending the best option we have and I think we've come up with a great idea. We are going to target Blanche Lincoln first with TV ads, with the help of Robert Greenwald's Brave New Films, and expose her actions to her constituents in Arkansas. This will be the first play because she is up for re-election in 2010 and has already received the second most money from the HIC of any Senator.

Digby writes:

Watching the health care debate unfold is frustrating and predictably enervating. These kinds of debates are often followed by a deepening of public apathy and a sense that government can't help solve the big problems. And this plays into conservative hands since they are the ones who want to stoke that belief so that the citizens don't get it into their heads that they can get an equal shake with those who think they own this country.

We can't let that happen with health care. It is just too important on every level, for individuals, business and the country at large. It's time to get involved. To that end Blue America is launching a campaign to raise money to run some television ads. We've got to get these wavering Democrats off the fence about a public plan choice or this thing is going to fall completely apart before it even starts.

Perhaps it's not surprising that Lincoln is showing so much compassion for the poor insurance companies. She's taken hundreds of thousands of dollars from them over the years. In fact, she's already received $14,500 from insurance companies for her 2010 campaign, the second highest of any senator up for re-election next year. And the only reform they support is reform that will get the taxpayers to pay the overpriced premiums for the 47 million uninsured without having to change their ways. The fact is that insurance companies are not in any danger of going out of business because of the public plan choice unless they continue the kind of practices that have brought us to this crisis.

Please go to our Blue America Act Blue Page a to give what you can

Howie Klein writes:

Digby's been writing TV scripts for a whole week to try to salvage health care reform from the tender mercies of Democrats who have grown worthless to working families after millions and millions of dollars in legalized bribes from the Medical-Industrial Complex and the Insurance Giants. Robert Greenwald is standing by with a camera crew ready to start shooting. The first batch of ads are going up on TV in Arkansas and, man, do we need help. We have a new Blue America Page that I want to urge you to visit today.

Perhaps it's not surprising that Lincoln is showing so much compassion for the poor insurance companies. She's taken hundreds of thousands of dollars from them over the years. In fact, she's already received $14,500 from insurance companies for her 2010 campaign, the second highest of any senator up for re-election next year. And the only reform they support is reform that will get the taxpayers to pay the overpriced premiums for the 47 million uninsured without having to change their ways. The fact is that insurance companies are not in any danger of going out of business because of the public plan choice unless they continue the kind of practices that have brought us to this crisis.

Digby has finished several excellent scripts and we've begun the casting process. Please join us and support Blue America in its fight to save the public option. Idiots like Joe Lieberman are saying the fight over health insurance is for "universal access," but that's a lie.

Access doesn't do anything if the health care sucks. Lieberman should have said the fight is for universal health care for all if he was a human being instead of a shill for the HIC. We will not let them get away with this garbage.

Blanche Lincoln is the first one up on our radar, but we're sending a signal to the rest of the cowardly, corporate influenced Democrats that we are coming. Please help us save health care.

You can't really talk about serious health care reform without looking at major changes in the American way of childbirth. The L.A. Times this morning points out that one of the things driving costs ever upward is the U.S. Cesarean rate, a major surgical procedure now performed in almost one-third of hospital births:

Once reserved for cases in which the life of the baby or mother was in danger, the cesarean is now routine. The most common operation in the U.S., it is performed in 31% of births, up from 4.5% in 1965.

With that surge has come an explosion in medical bills, an increase in complications -- and a reconsideration of the cesarean as a sometimes unnecessary risk.

It is a big reason childbirth often is held up in healthcare reform debates as an example of how the intensive and expensive U.S. brand of medicine has failed to deliver better results and may, in fact, be doing more harm than good.

"We're going in the wrong direction," said Dr. Roger A. Rosenblatt, a University of Washington professor of family medicine who has written about what he calls the "perinatal paradox," in which more intervention, such as cesareans, is linked with declining outcomes, such as neonatal intensive care admissions. Maternity care, he said, "is a microcosm of the entire medical enterprise."

As the No. 1 cause of hospital admissions, childbirth is a huge part of the nation's $2.4-trillion annual healthcare expenditure, accounting in hospital charges alone for more than $79 billion.

Because spending on the average uncomplicated cesarean for all patients runs about $4,500, nearly twice as much as a comparable vaginal birth, cesareans account for a disproportionate amount (45%) of delivery costs. (Among privately insured patients, uncomplicated cesareans run about $13,000.)

Pregnancy is the most expensive condition for both private insurers and Medicaid, according to a 2008 report by the Childbirth Connection, a New York think tank.

"The financial toll of maternity care on private [insurers]/employers and Medicaid/taxpayers is especially large," the report said. "Maternity care thus plays a considerable role in escalating healthcare costs, which increasingly threaten the financial stability of families, employers, and federal and state budgets."

Are there other options, other solutions? Yes. Off-site birthing centers and home deliveries have lower C-section rates and healthier outcomes for mothers and babies. For decades, the all-powerful American College of Obstetricians and Gynecologists has managed to prevent any truly rigorous review of statistics here (preferring to use data that counts miscarriages as home deliveries), but the Netherlands have done it for us.

They found that births where women actually prepared to deliver at home (as opposed to precipitous labors where sudden complications forced them to deliver there) were just as likely to have a safe delivery and healthy baby as those who delivered in a hospital under the care of a midwife.

The group who chose to give birth in hospital rather than at home were more likely to be first-time mothers or of an ethnic minority background - the risk of complications is higher in both these groups.

[...] But Professor Buitendijk said the study did have relevance for other countries like the UK with a highly developed health infrastructure and well-trained midwives.

In the UK, the government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was "a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place.

Here are just some of the things you can avoid in a home delivery: Hospital "supergerms"; birthing positions that actually make fetal distress (and thus, a C-section) more likely; the use of powerful labor-inducing drugs that not only increase the likelihood of a C-section, but also of uterine rupture; and an episiotomy that may be painful for years.

I did it both ways: A hospital birth with a doctor and nurse-midwife, and a home delivery attended by lay midwives. (I told my then-husband I would "never" have another child in a hospital after they almost killed my first-born and then bragged about how they "saved" him.) Not only did I give birth at home with my youngest, I was up cooking breakfast for everyone just a few hours later. It was an experience I wouldn't trade for the world. It was better in every possible way.

For more info on home deliveries, see Rikki Lake's documentary "The Business of Being Born" on YouTube.

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I'm a little late with this because we put so many videos up Tuesday and Wednesday, but Frank Luntz on the FOX News post debate show ran another one of his focus groups with swing voters in Arlington VA, and they resoundingly picked Obama.

He communicated his message and he got to me.

He spoke to the person, the voter, myself instead of the intangible things he actually said this is how I'm going to help you and this is how much it's going to cost.

He wasn't snide, he answered his questions. There was seven different times where McCain just didn't answer the question, but when a head and answered something else. And McCain kept making snide comments about Obama himself.

When Luntz said that the group thought McCain was better on the economy, Brit Hume was flabbergasted.

Hume: But they agree that McCain did better on the economy?

Luntz takes another hand count.

Frank: Half of them...

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Senator Biden took to the stage today in Tampa, Florida to defend his running mate from John McCain's pathetic character assault. Reminding voters that McCain has permitted his running mate to raise the most vile of innuendos and that he's hired the same people who personally destroyed him in 2000, Biden knocks it out of the park.

"Last week I had a debate with Governor Palin. Well, at least I think it was a debate. And last night Senator Obama had his second with John McCain. I know I'm prejudiced abut my ticket, but if this were a best of five series, it would be over.

We want a leader, an optimist. Not an angry man lurching from one position to another.

When you vote with George Bush 90% of the time, you're best hope is attacking your opponent 100% of the time."

Robert Gibbs, Senator Obama's communication director and senior spokesman called out Sean Hannity for using the likes of Andy Martin as a source that appeared on his own show to attack Obama with. Good for him and that's how it's done. (rough transcript)

Gibbs: Let me ask you a question. Are you anti-Semitic?
Hannity: Not at all.

Gibbs: On your show on Sunday, the show that's named after you, right? The center piece of that show was a guy named Andy Martin.

Hannity: I know you're reading your talking points.

When I interviewed Al Sharpton, when I interviewed all these controversial figures, you see on FOX we actually interview people of all points of view whether we agree or disagree.

Gibbs: Andy Martin called a judge a crooked, slimy Jew, who has a history of lying and thieving common to....Martin when on to write that he understood better why the Holocaust took place given that Jew survivors are acting like a wolf pack...

Hannity:I find those comments despicable...

Gibbs: You put him on your show. It's the Hannity Show...Why am I not to believe that your'e anti-Semitic, why am I not to believe that everybody that works for the network is anti-Semitic cause Sean Hannity gives somebody a platform that thinks Jews are slimy?

Hannity: I'm a journalist that gives...

Gibbs: You put your whole show around him...

Gibbs:I don't think your Jewish viewers are going to take it very well that you had somebody like that on your show.

Hannity: I'm the biggest supporter of Israel and I've got a thirty year history of, a , on the record....

There you go. Hannity went on about the Ayers nonsense and brought up every slimy thing he could think of. Gibbs actually had Hannity defending his own record on Israel.
Hannity's a journalist too? Wow, who knew.

Holy Jeebus, is the McCrankypants going to yell at him to get off his lawn next?

UPDATE: And he won't shake Obama's hand at the end of the debate either. Afraid of cooties?

UPDATE #2: You gotta love the entrepreneurial spirit of Obama supporters

Second Presidential Debate
Belmont University
Nashville, TN
Town hall format; domestic/foreign policy

How long will it take McCain to pivot from tax policy to William Ayers? Will Obama respond in kind and bring up McCain's much more controversial associations? Will Brokaw make up facts again to help McCain? Will either candidate get thrown a curveball from an audience member? We're about to find out.

Consider this another open thread. You can find the "McLiar Bingo" drinking game here.

***

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There's a whole lot of rationalizing going on in media circles over the laughable and admitted stump-speech-disguised-as-a-Vice-Presidential-debate last week. Moderator Gwen Ifill apparently thinks that if the candidates themselves weren't worried about staying on topic or engaging one another, it wasn't her job to make them do so.

The understanding was that we were going to have a debate. And one of the interesting things about debates, that people forget -- especially with this one, there was so much obsession about Sarah Palin -- is that there are two people on stage. And their job – you know this, you’re doing this Tuesday night – are to debate each other. The moderator’s job is to control their debate. If they have decided, as Joe Biden decided, that he was going to debate John McCain and she decided she was going to give a stump speech to the American people, there’s very little a moderator can do, other than say, “No, no, no, listen, I ask the questions! Please, please answer!” So I guess I knew going in that they all had their goals for that debate.

I was taken, going in, it can now be said, by how many of the questions that people volunteered to me were all about her. There was 99%, I would say, was all about her. 99% of the analysis afterward were about her. It was as if Joe Biden wasn’t part of this deal. And if she wasn’t challenged on the things she said that were not completely correct, or if she wasn’t challenged on changing the subject and answering the questions, by her competitor, I had another job to do at the table.

By her own admission, Ifill recognizes that it's the moderator's job to control the debate--and says that Palin "blew her off"--but since neither of the candidates called out the other for not following the debate rules, she has "another job at the table". Um, huh?

Why bother having a moderator at that point, Ifill? What other job was monopolizing your time?

Transcripts below the fold:

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Saturday Night Live offers yet another instant classic with their take on last week's Vice Presidential Debate:

IFILL: Now, tonight’s discussion will cover a wide range of topics, including domestic and foreign policy matters. Each candidate will have 90 seconds to respond to a direct question and then an additional two minutes to for rebuttal and follow up. As moderator, I will not ask any follow up questions beyond, “Do you agree?” or “Your response?” So as to not appear biased for Barack Obama in light of my new book, The Breakthrough: Politics of Race in the Age of Obama, coming out on Inauguration Day and available for pre-order on Amazon.com. And finally, we would like to remind our audience that , due to the historically low expectations for Gov. Palin, were she simply to do an adequate job tonight, and at no point cry, faint, run out of the building or vomit, you should consider the debate a tie. All right, let’s begin. Sen. Biden, how as Vice President would you work to shrink the gap of polarization that has sprung up in Washington?

BIDEN: Well, I would do what I’ve done my whole career , whether it’s been dealing with violence against women or putting 100,000 police officers on the streets. I would reach across the aisle. Like I’ve done with so many members of the other party. Members like John McCain. Because look, I love John McCain. He is one of my dearest friends. But at the same time, he is also dangerously unbalanced. I mean, let’s be frank. John McCain – and again, this is a man I would take a bullet for – is bad at his job and mentally unstable. As my mother would say, God love him, but he’s a raging maniac. And a dear, dear friend.

IFILL: Gov. Palin, how would your administration deal with the current financial crisis?

PALIN: Well, first of all , let me say how nice it is to meet Joe Biden. And may I say, up close, your hair plugs don’t look nearly as bad as everyone says. You know, John McCain and I, we’re a couple of mavericks, and gosh darn it, we’re gonna take that maverick energy right to Washington and we’re gonna use it to fix this financial crisis and everything else that’s plaguin’ this great country of ours.

IFILL: How would you solve the financial crisis by being a maverick?

PALIN: You know, we’re gonna take every aspect of the crisis and look at it and then we’re gonna ask ourselves, “what would a maverick do in this situation?” and then, you know, we’ll do that.

  Pat Buchanan gets laughed off the Hardball stage by Tweety and Bob Shrum for saying that Palin won the debate because she topped Biden on the Drudge and AOL polls. Forget CBS and CNN, you know, the real pollsters. If non-scientific polls on sites primarily frequented by right-wing nutjobs say Palin won, then dammit, she won.

Download | play   Download | play  

Buchanan: "Well, I mean Drudge found it 70-30, AOL found it 500,000 split."

Matthews: But those aren't polls. Those are people emailing in on conservative blog sites. We can do those! [laughter]

Shrum: "For Pat to be citing, like, the AOL poll or the Drudge poll which is set up, shows us how much he wants to do cartwheels because she didn't commit a pratfall on stage."

Download | play    Download | play   (h/t Heather)

MSNBC goes to the strange bedfellows tag team of Rachel Maddow and Pat Buchanan to give the post-mortem on the performance of the Vice Presidential candidate Sarah Palin.  I'm reminded of my reaction to the first presidential debate.  I had been disappointed in Obama's performance, noting far too many opportunities to score points not taken by Obama.  John Amato reminded me that it's not the decideds like me for whom Obama performed; it was the undecideds.  Similarly, Maddow's and Buchanan's perceptions mirror exactly how the Palin's performance will strike the decideds on both sides of the fence:  Maddow found her scripted, lacking in genuine emotion and light on substance.  Buchanan responded to her viscerally, caring neither for her flubs nor her lack of details, but just finding her stimulating through her attractiveness.

But will it sway the undecideds?  According to the CNN poll, it looks like substance won over folksiness: 

Fifty-one percent of those polled thought Biden did the best job in Thursday night's debate, while 36 percent thought Palin did the best job.

But respondents said the folksy Palin was more likable, scoring 54 percent to Biden's 36 percent.

Both candidates exceeded expectations - 84 percent of the people polled said Palin did a better job than they expected, while 64 percent said Biden also exceeded expectations.

But on the question of the candidates' qualifications to assume the presidency, 87 percent of the people polled said Biden is qualified while only 42 percent said Palin is qualified.

So perhaps Rachel wrapped it up correctly:  "Boring, But Right" versus "Exciting, But Wrong."   That’s America’s choice.

Transcripts below the fold

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The Obama campaign has already released an ad using footage from last night's VP debate and they've scored another direct hit.

The ad targets Sarah Palin from last night's debate as she proudly announced John McCain's disastrous health care plan that allows a $5000 tax credit for Americans to purchase health care -- and then strikes right back with Joe Biden's brilliant response, reminding people that in order to offset the credit McCain's plan would tax American's health insurance premiums for the first time in American history. The ULTIMATE bridge to nowhere.  Brilliant! (h/t Jamie)