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» Hatrack River Forum » Active Forums » Books, Films, Food and Culture » President Obama and the Proposal for Health Care (Page 5)

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Author Topic: President Obama and the Proposal for Health Care
ClaudiaTherese
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Thanks, fugu13. I corrected that and another spelling typo.

---
quote:
Originally posted by Amka:
A lot of people don't get that opposing this bill isn't the same as opposing health care reform.

This is why I referenced the professional organizations' statements which named the bill they were supporting, not just reform in general. There is specific support for the current bill as endorsed by Obama. (see above)
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ClaudiaTherese
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Samprimary, there was this study from Sept 2009 (which was published in the NEJM): Doctors on Coverage — Physicians’ Views on a New Public Insurance Option and Medicare Expansion. Unlike the Medicus Firm private study [Dec 2009], this was a peer-reviewed publication of a study with explicit and valid design. There may be something more recent -- but again, I linked to specific policy statements [about this specific bill] with updates within the last few days in the quotations above.

quote:
Overall, a majority of physicians (62.9%) supported public and private options (see Panel A of graph). Only 27.3% supported offering private options only. Respondents — across all demographic subgroups, specialties, practice locations, and practice types — showed majority support (>57.4%) for the inclusion of a public option (see Table 1). Primary care providers were the most likely to support a public option (65.2%); among the other specialty groups, the “other” physicians — those in fields that generally have less regular direct contact with patients, such as radiology, anesthesiology, and nuclear medicine — were the least likely to support a public option, though 57.4% did so.


[ March 17, 2010, 08:04 PM: Message edited by: ClaudiaTherese ]

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ClaudiaTherese
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Last post from me for awhile. [Smile] My apologies for the incessant updating.

I just want to be clear about this: I care very deeply about my profession being represented accurately and with integrity. Sometimes I disagree with my professional colleagues, but in this case, I think the medical profession as a whole is doing a great job of being clear, thoughtful, and responsible. That just mustn't be misrepresented.

Sometimes I disagree with my friends here, too, but I have no doubt we are all trying to be clear, thoughtful, and responsible as well. We may have different sources of information, different short-term goals or values, and certainly different perspectives, but I can acknowledge both of those positions simultaneously. They don't cancel out.

So please take my disagreement, such as it is, as a passionate searching for making sense, not as a critique of any individuals here. I am still convinced my friends and I are working toward the same eventual ends: better lives, better care, better medicine. Disagreement about how to get there does not negate that.

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Amka
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Well, I went and read the critique.

In fact, I had clicked through to the survey through the NEJM website because I was verifying things, but I understand one no longer can. I certainly concede that it wasn't published in the NEJM. But the critique simply detailed how it was reported. It also talked about where the sample came from. I'm not sure how I see how that particular sample would be biased, except for self selection bias. But self selection bias could also be present in the NEJM survey as well with response rate of 43.2%. Of course, we don't even have the response rate of the other survey.

There is actually a lot of other data we'd need to do a good comparison of the two, and the question is in fact only about a public option.

As for professional organizations, statements are usually drafted by a board of directors (that may or may not be practicing, that may or may not have industry connections) and aren't always indicators of how the individuals part of that organization feel.

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Amka
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And I think, CT, that we disagree on particulars and not in general. Because the truth of it is, I really do want a lot done to fix health care. In fact, I would like some form of universal health care. Health care is as much a right as education is.

Still, there are problems with the public education system. I wonder if, in implementing a true universal health care, we could learn from the mistakes in public education?

But this just doesn't do it well in my opinion. Please note my earlier objections that this bill doesn't resemble health care in the army or VA, or Canada. It is about making sure everyone is insured by (mostly) private corporations seeking profit.

But even if we did disagree in general, that's okay. I agree with you that we're both just searching for the right way to make sure everyone gets what they need.

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natural_mystic
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quote:
Originally posted by Amka:

But this just doesn't do it well in my opinion. Please note my earlier objections that this bill doesn't resemble health care in the army or VA, or Canada. It is about making sure everyone is insured by (mostly) private corporations seeking profit.

Do you think that nothing is better than this bill?
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Amka
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I would rather be patient, and I would rather do it piece by piece. In the year we've wasted with partisan politics, we could have come up with something phenomenal. We could have already passed a couple of bills.

The idea that we must pass THIS bill NOW could result in damage that is far worse than if we did nothing. I'm actually confused about why this bloated thing is what the dems hung it all on.

Now, if it doesn't pass, (and y'all can tell by now I hope it doesn't) then that is the time to put forth something better. Not give up. There are other options out there. And there are pieces of the bill that are pretty decent. Please, can't we just break it down into more manageable bills?

But it is being pegged as "if you aren't for this, you aren't for health care reform".

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Blayne Bradley
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It needs to be passed now or otherwise it will never be passed and healthcare agenda will die again for another 12 years.

The idea is wedge in something not so good but better then nothing NOW see its overwhelming success and then built ontop of it with an even more dominated Democrat congress.

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rivka
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quote:
Originally posted by Amka:
I would rather be patient, and I would rather do it piece by piece.

If I actually thought that had a hope in heck of happening, I would completely agree. But if this past year has proven anything, it has proven that piece by piece is not going to happen -- not any time in the next 10 years, not if this bill gets shot down.
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sinflower
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quote:
But if this past year has proven anything, it has proven that piece by piece is not going to happen
How has this year proven that exactly? As far as I know, we haven't BEEN trying to pass it piece by piece this year. Just in one bloated chunk. Maybe if we did it in pieces, there would be parts that Democrats and Republicans could both agree on. I think someone earlier made a good point in that whatever gets passed will likely become an entitlement program sort of thing like Medicare and Social Security-- something untouchable. So if we're going to pass healthcare reform, we should do it right.
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natural_mystic
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quote:
Originally posted by Amka:
Now, if it doesn't pass, (and y'all can tell by now I hope it doesn't) then that is the time to put forth something better. Not give up. There are other options out there. And there are pieces of the bill that are pretty decent. Please, can't we just break it down into more manageable bills?

I'd be interested in hearing your proposals on how to break it up. I'm skeptical. For example, if you want to stop insurance companies from denying coverage for pre-existing conditions you've got to have a mandate otherwise people would just wait until they get sick before getting insurance. If you have a mandate you've got to provide subsidies for people of lower income. And, voila, you have a sizable bill.
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MattP
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quote:
How has this year proven that exactly?
The Republicans in congress have shown that they are willing to form a united front against virtually anything that Obama and the Democrats try to pass. This is why Obama made the comment in the SOTU about requiring a super majority to pass any legislation.

The other problem is that some pieces don't work without other pieces. You can't eliminate pre-existing conditions clauses unless you simultaneously add a mandate. Those two pieces represent the majority of the impact of the current bill. Much of what's left is noncontroversial issues like plans to evaluate quality and improve efficiency.

[ March 18, 2010, 02:37 AM: Message edited by: MattP ]

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rivka
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quote:
Originally posted by MattP:
quote:
How has this year proven that exactly?
The Republicans in congress have shown that they are willing to form a united front against virtually anything that Obama and the Democrats try to pass.
Bingo!

quote:
Originally posted by MattP:
The other problem is that some pieces don't work without other pieces. You can't eliminate pre-existing conditions clauses unless you simultaneously add a mandate. Those two pieces represent the majority of the impact of the current bill. Much of what's left is noncontroversial issues like plans to evaluate quality and improve efficiency.

Also true.
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AvidReader
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quote:
Originally posted by MattP:
Much of what's left is noncontroversial issues like plans to evaluate quality and improve efficiency.

Wouldn't it makes sense to pass that first so it happens regardless?

The arguement seems like it's being presented as a "we need everything now" or "everything will stay exactly the same" dichotomy. Why can't we improve the way we handle what's already there, then expand coverage?

I still say some of the anger at the current bill is trying to force people into a product they feel is a rip off. Yes, I get death spirals. Yes, we're going to need mandatory insurance. But shouldn't we make the people who don't have it now feel like it's a good thing to have before we cram it down their throats?

I just feel the whole debate could have used a bit more carrot and a lot less stick. Trying to convince us to change stuff we already like because people we don't know got screwed doesn't sound like a very psychological argument to me. Compassion makes us want to change other people's stuff, not ours.

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TomDavidson
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quote:
Wouldn't it makes sense to pass that first so it happens regardless?
No. Why?

quote:
Trying to convince us to change stuff we already like because people we don't know got screwed doesn't sound like a very psychological argument to me.
This is, of course, an argument from political convenience and not one that speaks to the utility of the bill.
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Week-Dead Possum
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Avid, we would not be any sort of democracy if the needs of the many did not weigh upon the actions of the few. The fact that *you* like the current system is immaterial to the millions of people who don't. And since they are majority, and they are duly represented in government by the current majority party, whom they voted for, they get a say, and it's an important say. Since when did citizens of democracies gain individual veto powers? Since when exactly did the Republicans actually start believing that the will of the majority could not be served by a majority of votes in congress? There exist checks against the majority- and they are fair and usually very effective. You, individually, are not one.
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Samprimary
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this year has proven outside of the healthcare debate that the filibuster is broken and is being used (successfully!) to game the system.
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BlackBlade
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Obama's Waterloo

Bear in mind this is way back in July of 2009. As soon as Obama got serious about Health Care, the Republicans started talking to their strategists who said in essence, "Hey remember when Bill Clinton was saying this stuff, and how we totally stopped him and gained a butt load of seats in the house and senate? Why can't we do it again?"

The Republicans as well as Democrats both know the American people don't like one party in control of two branches of the government. Instead of being genuinely forthright and cooperative, the Republicans decided to sulk because they don't have their super-majority anymore, and dug in, stopping everything they could until the American people equalized the equation.

Here's a pretty good summation of what went on when Clinton took a stab at health care. My favorite part if true,
"April 30, 1993 - Hillary Clinton meets behind closed doors with Republican and Democratic senators. She implores them to tell her what she is doing wrong and tells them she is having trouble meeting with Republicans. It is common knowledge among many of those present that the staff of Senate Minority Leader Bob Dole has told Republicans they are not to meet with the First Lady."

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Mucus
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Bah, Waterloos are overrated.
I drive to and from Waterloo everyday [Wink]

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AvidReader
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quote:
Originally posted by Week-Dead Possum:
Avid, we would not be any sort of democracy if the needs of the many did not weigh upon the actions of the few. The fact that *you* like the current system is immaterial to the millions of people who don't. And since they are majority, and they are duly represented in government by the current majority party, whom they voted for, they get a say, and it's an important say. Since when did citizens of democracies gain individual veto powers? Since when exactly did the Republicans actually start believing that the will of the majority could not be served by a majority of votes in congress? There exist checks against the majority- and they are fair and usually very effective. You, individually, are not one.

I support plenty of change to the current system, thank you very much. And last I checked, the majority of the country didn't support this plan. Hence the problems trying to get it passed as the House heads into campaign mode.

But let me ask it as an honest question. How many people do you know who've changed their behavior based on its impact on random strangers? I read about people like that from time to time, but I don't know any. I've only ever witnessed people change their behavior for their own ends, not to make life better for people they don't know.

Based on that, I would think convincing us to let Congress mess with our personal insurance to help some random stranger with a good sob story would not be an effective argument. I am open to data that would show otherwise.

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Orincoro
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Where did you check? That's not a piece of information that can easily be quantified.

And hey, your horribly selfish attitude aside, fixing the health care crisis is not about reaching out to help people with "sob stories."

In fact it's almost the opposite of that. We *already* involuntarily pay huge amounts of money patching up what you might call "sob stories." But the health care crisis is effecting our entire economy and workforce. That is not helping "random strangers," that is fixing a systemic problem, not just patching it in individual cases, because if we don't, the whole thing is poised to fall down around us, and leave us with nothing when we get sick. How you keep latching onto the idea of voluntarily helping strangers I don't know. Fixing health care is about fixing day to day problems that *you* are being affected by because *everyone* is affected by them.

Now the fact that the status quo is good for you personally in the short term is neither here nor there. If you can't recognize the inherent danger in such large systemic failures, and how that *can* affect you, then you're not really worth much as a member of society, in my opinion.

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Blayne Bradley
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quote:
Originally posted by Week-Dead Possum:
Avid, we would not be any sort of democracy if the needs of the many did not weigh upon the actions of the few. The fact that *you* like the current system is immaterial to the millions of people who don't. And since they are majority, and they are duly represented in government by the current majority party, whom they voted for, they get a say, and it's an important say. Since when did citizens of democracies gain individual veto powers? Since when exactly did the Republicans actually start believing that the will of the majority could not be served by a majority of votes in congress? There exist checks against the majority- and they are fair and usually very effective. You, individually, are not one.

No no no Republicans don't believe in that they only believe that while they are the minority, once they're the majority they then believe they should be allowed as much power as they want.
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Lisa
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quote:
Originally posted by Week-Dead Possum:
Avid, we would not be any sort of democracy if the needs of the many did not weigh upon the actions of the few.

That's one of the most ridiculous things I've ever heard anyone say.
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Orincoro
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Well, you have a ridiculous haircut, and you smell funny.
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Samprimary
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you're stupid. substantiation of statement on hold until further notice.
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Orincoro
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Samp I'm of a mind to start a thread so that I can provide a link to something that explains my viewpoint about this particular situation, and then not comment on it until I get a chance to react harshly to what others say, and which I will perceive as an attack.
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The Rabbit
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quote:
Originally posted by Lisa:
quote:
Originally posted by Week-Dead Possum:
Avid, we would not be any sort of democracy if the needs of the many did not weigh upon the actions of the few.

That's one of the most ridiculous things I've ever heard anyone say.
I'm curious as to why you find that ridiculous. I see that as an inescapable fact of community life in general, and not just democracy. Living as a community, even a community as small as two people requires compromise and compromise inevitably means sacrifice on the part of some persons for the benefit of others.
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Blayne Bradley
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quote:
Originally posted by Lisa:
quote:
Originally posted by Week-Dead Possum:
Avid, we would not be any sort of democracy if the needs of the many did not weigh upon the actions of the few.

That's one of the most ridiculous things I've ever heard anyone say.
Its a fact, the needs of the many outweigh the needs of the few, wisdom is recognizing that the minority have some rights ie Liberty.

Democracy is 3 wolves and a sheep voting whats for dinner.

Liberty is a well armed sheep contesting the vote.

Franklin Delano Roosevelt.

[ March 19, 2010, 04:13 PM: Message edited by: Blayne Bradley ]

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kmbboots
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Delano
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Lyrhawn
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Maybe he was combining Delano and Eleanor. Like Brangelina.
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kmbboots
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I considered that.
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Blayne Bradley
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We were always at war with Eurasia.
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kmbboots
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Which has what to do with President Roosevelt's middle name?
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Orincoro
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The fact that he edited.
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The Rabbit
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I'm still not seeing the connection.
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BlackBlade
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So...do you folks think the Democrats have the votes?
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kmbboots
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Ah. Thanks, Orincoro.

The Rabbit, Blayne has always been correct.

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Samprimary
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quote:
Originally posted by BlackBlade:
So...do you folks think the Democrats have the votes?

Eh, I'd be surprised if this didn't get pulled through some way or another.
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BlackBlade
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quote:
Originally posted by Samprimary:
quote:
Originally posted by BlackBlade:
So...do you folks think the Democrats have the votes?

Eh, I'd be surprised if this didn't get pulled through some way or another.
I dunno, they still need to get some affirmatives from Democrats in the House. Those hold outs have immense bargaining power.
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T_Smith
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//As a formal statement if anything I say comes off as an opinion, do keep in mind that it is solely my opinion, and not the opinion of my employers, in any form, and all that wonderful stuff that they've told me to make sure when talking about my job on the internet.//

As a general note, I am enjoying reading this thread. Through a various chain of 'contracted by' and 'subsidiary of' I am considered an employee of Wellpoint. We get a good deal of "here are the stats we've run" and "according to this survey" from up above and I enjoy hearing well thought out discussions on the subject.

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rollainm
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So...has there been a huge to-do here over this violation of the 10th amendment stuff yet? I'm surprised it doesn't have its own thread.
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Samprimary
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quote:
Originally posted by BlackBlade:
quote:
Originally posted by Samprimary:
quote:
Originally posted by BlackBlade:
So...do you folks think the Democrats have the votes?

Eh, I'd be surprised if this didn't get pulled through some way or another.
I dunno, they still need to get some affirmatives from Democrats in the House. Those hold outs have immense bargaining power.
To a point. At this juncture, they know that they can either take what they can get over this, or cede victory to the republicans and get this called the democratic Waterloo or something.

so they will have the votes OR WAIT NEVERMIND they already have the votes right now OR WAIT NEVERMIND it's back to a ballet

http://www.huffingtonpost.com/2010/03/21/health-care-debate-live-u_n_507426.html#s75014

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Samprimary
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Oh and remember the whole issue over whether it was really fair to say the tea party had a racist image?

well congratulations, it's time for some last-minute ugliness.

http://www.salon.com/news/healthcare_reform/index.html?story=/opinion/walsh/politics/2010/03/20/tea_party_racism

quote:
A year later, though, it's worth more of my time to say what many resist: The tea party movement is disturbingly racist and reactionary, from its roots to its highest branches. On Saturday, as a small group of protesters jammed the Capitol and the streets around it, the movement's origins in white resistance to the Civil Rights Movement was impossible to ignore. Here's only what the mainstream media is reporting, ignoring what I'm seeing on Twitter and left wing blogs:

Civil rights hero Rep. John Lewis was taunted by tea partiers who chanted "nigger" at least 15 times, according to the Associated Press (we are not cleaning up language and using "the N-word" here because it's really important to understand what was said.) First reported on The Hill blog (no hotbed of left-wing fervor), the stories of Lewis being called "nigger" were confirmed by Lewis spokeswoman Brenda Jones and Democratic Rep. Andre Carson, who was walking with Lewis. "It was like going into the time machine with John Lewis," said Carson, a former police officer. "He said it reminded him of another time."
Another Congressional Black Caucus leader, Rep. Emanuel Cleaver, was spat upon by protesters. The culprit was arrested, but Cleaver declined to press charges.
House Majority Whip James Clybourn told reporters: "I heard people saying things today that I have not heard since March 15, 1960, when I was marching to try to get off the back of the bus."
There were many reports that Rep. Barney Frank was called a "faggot" by protesters, but the one I saw personally was by CNN's Dana Bash, who seemed rattled by the tea party fury. Frank told AP: "It's a mob mentality that doesn't work politically."
Meanwhile, a brick came through the window at Rep. Louise Slaughter's Niagara Falls office on Saturday (the day she argued for her "Slaughter solution" to pass health care reform, though it was rejected by other Democrats on the House Rules Committee).


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Dan_Frank
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That's interesting. I've seen a couple pieces of footage of Lewis passing through the crowd, and all I heard was people shouting Kill the Bill.

I'm not saying it's impossible. Certainly perhaps one or two people near him could have been yelling it, and their cries were drowned out in the footage I've seen. But I'm definitely skeptical that it was a whole crowd of tea partiers shouting it over and over. I've tried to find footage of the incident, no luck yet though.

Edited to add: They also booed him. And one guy shouted "let him pass" when he approached. Oh, and someone else called him a liar and a crook.

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Lisa
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It's a claim that's being made with no substantiation whatsoever. There was video of the whole thing, and there's no question but that we'd be seeing video of them shouting those things if they really had. This is a bunch of bull.
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Lisa
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quote:
Originally posted by rollainm:
So...has there been a huge to-do here over this violation of the 10th amendment stuff yet? I'm surprised it doesn't have its own thread.

The 9th and 10th Amendments have been effectively repealed for a long, long time.
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Samprimary
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quote:
There was video of the whole thing, and there's no question but that we'd be seeing video of them shouting those things if they really had.
there's no question that we'd be seeing video of them shouting those things if the position of the video cameras in question had at that time been in a place to pick them up.
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Humean316
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quote:
Originally posted by Lisa:
It's a claim that's being made with no substantiation whatsoever. There was video of the whole thing, and there's no question but that we'd be seeing video of them shouting those things if they really had. This is a bunch of bull.

Since the campaign, the hatred and virulence of parts of the tea party movement and the far right wing have well been on display. From a group that proudly rallies behind signs that threaten physical violence, bloody revolution, and racist images of Obama as the Joker, I have no doubt that these congressmen and women were not lying when they claimed racial and anti-gay slurs were hurled at them. For goodness sakes, they call it Obamacare for a reason...

My incredulity is stoked when Republicans distance themselves from these acts like they did this morning on Sunday talk shows. They have stoked the hatred, they have thrown their lot in with the fringe groups, they have cheered civil unrest even on the floor of congress itself, and they have the nerve to distance themselves from this. What they don't understand is that they ARE that which they try to distance themselves from, and the worst part, is that Republicans had an opportunity to mount a principled objection built upon the facts. Instead, they relied on fear, they built lie upon lie, they refused to compromise or work towards a better health bill, and they embraced the worst parts of their own party and this country in order to win in November.

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Samprimary
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quote:
Originally posted by Humean316:
Since the campaign, the hatred and virulence of parts of the tea party movement and the far right wing have well been on display. From a group that proudly rallies behind signs that threaten physical violence,

http://farm3.static.flickr.com/2716/4448018629_56d56b2f90_b.jpg
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Humean316
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And it gets even uglier...

Politico Reports...

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