I added it in. I actually realized I'd forgotten to put it in and was writing it up around the same time you wrote your comment. You're pretty fast!

Thanks.

Brzezinski:

"I don't think the country needs to go back to what we had eight years ago."

Peace, prosperity, budget surpluses, competent government? Yeah, that shit sucks.

I believe the point Hillary was making was "I know there is danger... I know people may die... but... but... but this is supposed to be all about me!!"

I don't think you'd get the opportunity to see her take the oath. I think she's quite defeatable.

Your post is the dumbest thing I've read all day. If you're going to take Brzezinski's quote horribly out of context and try to make it appear that he was talking about the economy, why don't you just make something up completely? It will be exactly as honest.

Clinton's foreign-policy approach is "very conventional," Brzezinski said. "I don't think the country needs to go back to what we had eight years ago."

And by the way, Bill's not running. His wife is.

I already mentioned it on another thread, but Brzezinski gets my vote for the quote of the day:

"Being a former first lady doesn't prepare you to be president."

Heh. I wouldn't have rated your comment, but it was worth a chuckle so I thought I'd balance out your '1'. ;)

With the GOP/RNC war machine ready to pounce at the snap of her fingers . . . How could you not feel safer? On the other hand, her little 'the sky is falling which will make the GOP stronger' rant is her first real SNAFU of the campaign . . .

I mean, other than loving corporations more than human beings, of course . . . Which endears her to the RNC overlords who will provide the lowly USAians protection at the cost of only a little of their freedom . . . When the big bad tayer-er-ists attack . . . Yet again on BUSH43's watch . . . At least we can hock ourselves over our eyeballs shopping to show those ee-val terrorists that they can't stop us.

Is there some snark in this comment I don't get? I'm not an HRC fan at all, but I don't see why being First Lady should disqualify someone from the presidency, I think we can all agree a Eleanor Roosevelt Presidency would have been amazing.

I just don't think HRC did anything particularly great with her time as First Lady. She botched health care, and then moved in baby steps.

A top adviser for Sen. Barack Obama (D-Ill.) said Friday that Sen. Hillary Rodham Clinton (D-N.Y.), the front-runner for her party’s presidential nomination, is obsessed “with what she calls the Republican attack machine.” “I think we need a candidate who is obsessed with unifying this country again,” said Obama adviser David Axelrod.

Oh how I hate to agree with campaign spokesmen, but every once in a long while, even the political hacks hit a nail on the head.   Hillary is indeed obsessed with the "vast Right Wing conspiracy" and seeking revenge for the past and for anticipated future attacks.  We don't need Hillary plotting political attacks from the White House like Nixon, Bush-Atwater and Bush-Rove.

I kinda agree with it should disqualify on the basis of the spirit of the 22nd Amendment was intending. I personally disagree with the 22nd Amendment but it is part of the Constitution. Having one's spouse run for the office is a bit of an endrun around the concept of consolidation of power. The best marriages are not those of convenience but of teamwork between the spouses and after decades of marriage the individual can easily blur into the collective of the marriage.

Brzezinski didn't need to talk to Hillary about her foreign policy plans -- he just assumes that they would take us back eight years. He was never a fan of Bill's. The assumption that Hillary is running for president on the basis of her first ladyship is a position worth discussing. If she hadn't had that experience I would definitely have a different feeling about her ability to do the job. Having Bill as adviser also helps her case in my mind. If Elizabeth Dole were running I don't think that I could keep Bob out of the equation. Let's see, if Susan Collins were running, I don't think I could get Joe Lieberman off my mind.

I assume that the Z-man spoke fairly extensively with Barak, as this is certainly a high profile endorsement. Something must have impressed him. I don't agree with all that I've heard from Brzezinski, but I certainly respect his opinion.

Fun exercise: Google "Hillary Clinton" and "strength and experience".

Every time one of the Clinton Zombies says anything to the press, they use this tagline.

It's "message discipline," doncha know. Helps win elections. The modern master of it was George W. Bush. And it demeans and dumbs down our politics.

I think she is referring to her experience both as First Lady and as Senator with the right-wing attack machine -- the first lesson is to respond quickly to attacks. After dealing with Starr, Rove and the rest, she wants supporters to know that she won't crash and burn like Kerry did. Framing that as an obsession may help Barak. Who knows?

As the comments above and MSM headlines continue to make clear, Hillary is divisive to the Democrats and Unites the Republicans. This is a problem that the best spin doctors cannot fix. Hillary as the Dem candidate is the most likely way to guarantee a Republican renaissance in 2008. I don't yet know if Richardson, Dodd, Biden, Obama, or Edwards is the best candidate for achieving Democratic victory in 2008. But I know for certain that if Hillary becomes our candidate, we will go down to one of the most painful defeats in modern history.

"It's a horrible prospect to ask yourself 'What if? What if?,' " Clinton said. "But if certain things happen between now and the election, particularly with respect to terrorism, that will automatically give the Republicans an advantage again, no matter how badly they have mishandled it, no matter how much more dangerous they have made the world. So I think I'm the best of the Democrats to deal with that as well."

Maybe HRC shouldn't have said it like that, but I'm afraid the responses from our other candidates are mostly bunk too. What's "tasteless" and "deeply troubling" is the fact that the day after another terrorist attack, if not the day of, Bush would say it happend because Democrats and liberals stabbed him and our boys and girls in Iraq in the back, wacko neocons (but I repeat myself) would say that it was just what we needed to be Ein Volk again, and the religious right would attack homosexuals, wiccans, feminnists, the ACLU, and anyone else they consider deviant. Will it work again? Maybe not - things are different from 2001, 2002, and 2004 - but possibly so. I'll gladly vote for any of these guys and gals (add standard Gravel and Kucinich disclaimer here), but whoever our candidate ends up being had better be prepared to deal with the possibility.

"...taking the big fight to Democrats whose crime is disagreeing with her."

Take it easy. I for one don't think you're a criminal. I can't speak for Hillary though.

If Barack Obama has advisers who can read Hillary Clinton's deepest thoughts, why isn't he farther ahead?

Yeah. Let's reward the Reptilians Republicans for all those years of baseless, cynical and malicious prosecutions, smear campaigns and a frivolous impeachment attempt. Shame on Hillary Clinton for... being a target of the far right. And you know that right this minute, she's even breathing Barack Obama's air!

People here are not representative of Democrats, except that they disagree on almost everything.

Here ya go:

August 23, 2007

HEALTH CARE QUALITY:
Speech at the Dartmouth-Hitchcock Medical Center

Thank you all very much. Thank you Nancy for your introduction and for your leadership of this great medical center, and to Frank McDoogle who has also helped very much in putting this event together. I also want to thank Dr. Susan Lynch for being here. Some of you know that Dr. Lynch did her residency at Dartmouth-Hitchcock and she's a pediatrician who works as a pediatric lipid specialist at the cholesterol treatment center at Concord Hospital in Concord.

It would be interesting to know just as historic fact when the first pediatric lipid specialist was certified because one thinks about cholesterol as a problem of us, the adult world. And now we know, as Dr. Lynch too well knows, with her advocacy on behalf of physical activity and trying to stem the tide of obesity among our children, how significant this is and I'm just absolutely delighted that she could be here today. It's also a pleasure being back here. I just had the opportunity to say hello to some of the physicians and nurses and staff members who run this great center. And a number of them reminded me that I was here in 1993, I actually met some of them before this occasion and I am thrilled to be back because I cannot imagine a more fitting place to talk about improving health care quality in America than at this institution which has helped to set the standard for excellence for more than 200 years.

As I travel across New Hampshire -- and certainly around our country -- I talk with people from all walks of life, it is really one of the great privileges of being in public life; I see the speaker here, and others who are involved in the day-to-day life of New Hampshire. You get to meet people you would have never otherwise met; you are invited into their lives, somewhat similar to what you do here, as you take care of them in very significant points of their life's journey. Well in the political arena we also have that privilege and no matter where I go, or with whom I talk -- whether it's a CEO or a small business owner or a doctor or a nurse or patient or a hospital administrator -- everyone tells me the same thing: "Our health care system isn't working and what can we do about it?" The costs are too high, the coverage too thin -- or in some cases non-existent -- the care not what it should be.

Now I have worked on health care, like Nancy said, for more years than I care to recount. Going back to 1979 and 80 in Arkansas, where I led an effort to try too bring more health care into rural areas, a problem we still have in Northern New Hampshire just as in Eastern Arkansas. And of course most memorably, during the eight years as First Lady.

Now despite the scars I carry from that, I also have learned some valuable lessons. And most importantly, that in order to answer any question about what we can do better to provide health care for all of our citizens in a cost effective quality driven way, we first have to establish a consensus in America. That this is a goal we intend to achieve together. We have to reach that consensus among providers, employers, employees, citizens, those who pay for, depend upon, and actually deliver health care services. And this consensus has to be strong enough to persuade decision makers in Washington and to overcome entrenched opposition among the forces that oppose change for ideological and corporate reasons.

Now the good news is that I think we are finally reaching consensus. I see businesses, labor, government and other stakeholders increasingly investing in quality care because they realize that it's not only good for individuals and families that it's also goof or our economy. We've begun to agree that there is an economic as well as a moral imperative to reign in costs and to extend coverage to all Americans. There's a practical imperative to improve quality -- to promote wellness and prevent illness wherever possible. And these are the key components of my health care plan -- lowering costs for everyone, improving quality for everyone, and providing coverage for everyone. I list them as three interlocking goals because I think we cannot do one without doing all of them.

A few months ago, I outlined my agenda to reduce health care costs and today, I want to talk about health care quality. And next month, I will announce my plan for universal coverage. My order here is deliberate. In order to forge a consensus on universal health care, we need to assure people they'll get the quality they expect at a price they can afford. And my recommendations to control costs and ensure quality lay the groundwork for insuring everyone.

Now, by all accounts, we should already have the highest quality health care in the world. Our doctors, nurses and other health care practitioners are among the best in the world. They have access to the most cutting-edge drugs, and treatments and medical technologies. And we spend more money per capita on health care, almost $5,700, than any country in the world.

But we are far from having the best care. We're ranked 23rd in infant mortality and 42nd in life expectancy. According to the 2006 survey by the Kaiser Family Foundation and the Agency for health care Research and Quality, 51% of Americans were dissatisfied with the quality of our health care system. According to a RAND study, adults in the United States on average fail to receive about one half the medical care they need. More than one in ten patients may receive care that isn't recommended -- and may be potentially harmful. And the Institute of Medicine estimates that as many as 98,000 Americans are killed each year by preventable medical errors.

Now in short, too often and in too may places, our health care system hurts us instead of helping us. It hurts doctors, who aren't rewarded for providing the best care -- and are often punished for it, financially at least. It hurts nurses, who are asked to work longer hours caring for more patients with fewer resources. And it hurts patients, who are forced to make complicated medical decisions without basic information about their conditions and options.

Now I'm hoping that we're getting to a point where the quality of our health care is not a partisan issue. Whether you're a Democrat or Republican, a liberal or a conservative, none of us wants to rush our child to an emergency room only to receive the wrong treatment. None of us wants to bring our spouse in for surgery only to see them next in the ICU with a preventable infection. None of us wants our loved one cared for by nurses who are juggling too many patients and too many medications with too little support.

And any of us could become seriously ill injured such that we won't have a second chance to get the right diagnosis and treatment. And when that day comes, why should we settle for less than the best?

But that is exactly what we're doing right now. When you buy a TV for your living room, or a tire for your car, or a toy for your child, you want to know you're getting the best value -- and these days, especially with toys, the greatest safety. So you compare prices, you ask questions, you check the consumer reports and you rely on your government to establish and enforce basic guarantees of safety and reliability.

But too often, with the product we care most about --that can mean the difference between life and death, and between billions of dollars wasted and saved -- we don't compare prices or quality we wind up stuck with something whether we think it's best for us or not.

And until recently, government at all levels did not use its enormous buying power to empower providers and patients to demand and deliver quality. We plod along with a twentieth century health care system, unable to take full advantage of 21st century medical advances, stuck in the same rut of fatalistic thinking that's defined our health care debate for more than a decade. If we try to cover everyone, the argument goes -- we'll lower quality. If we try to improve quality -- we'll break the bank. Our health care problems are too big, too deep, too complicated, the argument continues, for us to solve.

Well, I reject that and I think all of you here at this exemplary institution do as well. America is not a nation that settles. We don't wring our hands and make excuses. We roll up our sleeves. We invent. We innovate. We come up with solutions. And that's exactly what hospitals and nursing homes and providers across America have been doing with very little support. Many are improving the care they offer and lowering costs.

Take the example of Kaiser Permanente. Their management came together with 40 unions representing 90,000 health care workers and staff and formed a Labor Management Partnership. The Partnership works to solve problems, improve patient care and give everyone a seat at the table.

One example of their work involved a patient complaint that nurses often did their shift handover without input from the patient -- so union nurses worked with management to come up with a solution: doing the handover in the patient's room, where the patient could join in the conversation. As a result, patients better understand their care, nurses spend more time with patients, and information is being shared more efficiently.

Since Kaiser's partnership began, costs have fallen, workplace injuries have fallen -- and patient satisfaction and employee retention have improved. And this is just one example of how, across America, workers and management can improve health care quality.

Or take the example of Ascension Health, America's largest non-profit hospital system. Back in 2002, they began a system-wide effort to improve their quality of care -- to meet best practices and provide better treatments. Today, their rate of certain hospital infections is 62% lower than the national average. Serious patient falls are 86% lower. Rates of bedsores are 93% lower.

But in the end, quality health care isn't just about savings or statistics. It's about something much more fundamental: the relationship between physicians and patients, between nurses and patients, between physicians, nurses and hospital administrators. That's what's at the heart of our quality, how we get along with one another, what our relationships are. The moment when someone in need seeks you out, they're scared and vulnerable, they want you to do what can get them better, but too often our health care system stands in the way, blocking that relationship, preventing physicians and nurses from doing what they would want to do. So therefore, we have to change the system.

Well, I'm here today because I believe it's time we had a health care system that lived up to the Hippocratic Oath. A system that empowers doctors, nurses and hospitals to give the best care. That empowers patients to make the best decisions. And that ensures that payers -- governments and private payers-- value, reward and promote the best results: longer, healthier lives, and money saved in lowering and unproductive and unnecessary hospital and nursing home costs.

That is what my Health Care Quality Plan tries to do. We have come to these recommendations in consultation with doctors, nurses and others across the country. We've developed a plan to raise standards, support health care providers, educate patients, realign the reimbursement systems to reward quality, recruit and retain more nurses, and address the health disparities that continue to plague our system.

I want to start by talking about how we ensure that our health care providers -- doctors, nurses and others -- provide the best possible care.

That starts with providing federal support for doctors' own quality certification standards.

Now, most doctors stay current on their own -- reading up on the latest advances, studying the latest techniques. But changes are coming so fast these days, many tell us they just can't keep up. Some might not even realize they're no longer using the latest protocols or the best systems. This may explain the dramatic variations in cost and quality from state to state, town to town -- even from hospital to hospital in the same town. Now some of these variations have been discovered and publicized right here at Dartmouth, the studies conducted by Jack Weinberg and his colleagues here have revolutionized how many people think about quality of care. They found that the quality of care for patients with terminal illnesses, just to pick one example, varied greatly. The percentage of patients who died as hospital inpatients instead of at home or in a hospice, range from 32% to more than 52% despite the fact that the overwhelming number of Americans would prefer not to die in a hospital.

Part of the solution to these disparities can be found in doctors' own voluntary Maintenance of Certification programs, so called MOC programs. They provide lifelong learning opportunities to help doctors stay up to date. They're generally run by the boards of the various specialties -- so cardiology runs the MOC for cardiologists, or the pediatrics runs the MOC for pediatricians, and so on.

Doctors who participate in certification programs have better outcomes. Heart attack patients treated by board certified doctors were 15% less likely to die than those treated by non-certified doctors. Doctors who scored higher on MOC examinations had better outcomes in treating patients with diabetes, and they were more likely to ensure that their patients received mammograms.

So as President, I want to lend the support of the federal government to MOC process to help our doctors stay on the top of their game. I will offer higher Medicare reimbursement rates to doctors who participate in qualified MOC programs. And to ensure that the MOCs are sufficiently rigorous -- I'll ask that the Secretary of HHS to invest $125 million to recognize and help fund the work of a public-private Quality Trust to certify the MOCs. This Trust will bring together people from across the health care system -- doctors, patients, nurses and others -- who will rigorously review MOCs to ensure they are up to the highest standards.

If you have any doubt about whether we need to do this, I'd refer you to an article from this week's New York Times indicating that just 7% of diabetics are getting all of the treatment they need -- often because their doctors are not versed in the latest developments. Now, imagine if instead, these doctors participated in certification programs that kept them up to date on nationally recognized standards for diabetic care. The most revealing conclusion in the very long article was that most doctors were vigilant about blood sugar, but not about blood pressure and cholesterol monitoring. Think of how many more lives could be saved and how much more money could be saved if they were.

I'll also support doctors by creating a Best Care Practices Institute, a public-private partnership to fund comparative effectiveness research and disseminate it across the country. Right now so much of the information on which drugs, devices, surgeries and treatments work best, either isn't researched, it isn't compared, it isn't published, and it isn't circulated. It takes years for an agreed upon treatment that a medical center like this one knows is the best practice to be disseminated across our country. So this Best Practices Institute will serve as a central national clearinghouse so no matter where you are, you and your doctor can access information on what the best treatments should be.

In addition to helping doctors provide the best care, I plan to finally implement medical malpractice reforms that work for doctors and patients alike. Many of the physicians that I meet say that high malpractice premiums force them to alter their practice-- and even consider leaving the profession altogether. I've also heard first hand from families who've experienced serious medical errors and have trouble getting the relief that they deserve. The current political stalemate on this issue leaves both patients and physicians in the lurch.

Earlier before I came in I was speaking to the head of anesthesiology and I really give the anesthesiologists a lot of credit because for the last ten years they have moved toward standards of practice that have not only helped patients but dramatically lowered malpractice premiums and I believe there's a lot we can do within the specialties, following the example of anesthesiology, coming up with new approaches.

I've offered one solution based on a successful program at the University of Michigan Hospital system. It's called the National Medical Error Disclosure and Compensation Act. In the Congress you have to come up with acronyms so you search for days to try to name a piece of legislation with something that if you take the first letter it spells a word -- so that is the MEDiC act for those of you who were wondering.

It's a novel approach to improving patient safety and the quality of care while protecting patients' rights, reducing medical errors and lowering malpractice costs. The bill that I have introduced based on the University of Michigan Hospital system would proved liability protections for physicians who disclose medical errors to patients and offer to enter into negotiations for fair compensation backed up by their hospital and their practice. At the University of Michigan, these policies have already resulted in greater patient trust and satisfaction, more patients being compensated for injuries, fewer malpractice suits, significantly reduced administrative costs, and between one and three million dollars in litigation cost savings.

But when I talk about supporting providers, I'm not just talking about doctors -- but about nurses as well. And that's the third step in my plan -- to immediately address our nursing shortage and to give nurses the training and educational and support that they need to provide the care patients deserve.

The nursing shortage has become a nursing crisis. And that means it's a crisis for everyone, because nurses are critical to delivering and improving quality. Our nurses are truly the eyes and ears --and in many ways, the heart and soul -- of our health care system. And when we've got fewer nurses, working longer hours, serving more patients -- the result can be worse outcomes. We currently face a shortfall of 118,000 nurses. If we don't take action now, by the year 2020, the estimate is that we will be short as many as one million nurses. In addition to the shortage, nurses are aging. On average a nurse is over 45 in America. So we need a comprehensive solution.

According to the American Association of Colleges of Nursing, in 2005, American nursing programs turned away nearly 32,000 qualified bachelor and masters degree applicants. They just didn't have the slots. So when I'm President, I will provide funding to nursing schools to allow them to admit and train more nurses and to recruit and retain more faculty. And I'll give first priority to schools with a record of sending graduates to serve in underserved areas -- from rural communities, to inner-cities, to low-income neighborhoods.

I'll also work to recruit more nurses to the profession in the first place -- reaching out to communities of color that are traditionally underrepresented, providing scholarships and loan forgiveness so we can have a more diverse, culturally competent nursing workforce.

But we know that the problem isn't just recruiting-- it's retaining nurses. Roughly 50% of new nurses leave their jobs within the first year -- all too often because they're not getting the support they need to do their jobs. I will address that by funding innovative mentoring and residency programs with a proven track record of helping to keep nurses in the profession.

Programs like the RN Residency program that was launched five years ago at Children's Hospital Los Angeles. This 22-week program provides new nursing school graduates with a comprehensive clinical experience to prepare them for careers in acute care environments. Prior to this program, turnover for new graduates during their first year was 36%. Graduates of the RN Residency program have a first-year turnover rate of just 11%, and a 24 month turnover rate that has dropped from 56 to 22%. Given that it costs roughly $50,000 to replace each nurse -- and thousands more to pay temporary nurses to fill in -- you can see the kinds of savings that Children's is experiencing.

I also want to do more to empower advanced practice nurses. We're going to have to change the practice, acts, and protocols that govern what nurses can do -- nurse practitioners, nurse midwives, physician's assistants, advanced practice professionals. Because it's clear that we will not be able to reach our goals for preventive care if we don't have better utilization of nurses.

We need to empower patients. And that means giving them the information they need to make the right choices. Today even the savviest, best informed patients struggle to choose providers and treatment options and it is easy to feel helpless and overwhelmed about these decisions.

Now some people will tell you the best way to provide consumer choice is to give everyone a Health Savings Account -- and leave them to find the least expensive, most effective providers on their own. If they're in good health, chances are that they'll be able to navigate this. But if they get seriously ill, or have an accident that is serious, well I don't think that there's much hope there.

The idea is that we have to really empower patients -- not shift costs on to them under the guise of so called "consumer-driven" care. So when I talk about informed consumer choice, I mean no one should have to guess their way through this maze.

That's why we need a comprehensive, patient-friendly quality database. With the click of a mouse, patients should be able to see which hospitals have the best care, the best specialists, the lowest infection rates, the most efficient discharge policies, the shortest emergency room waiting times, and more.

And that is exactly what you're doing here at Dartmouth-Hitchcock, publishing comprehensive public reports on everything from the quality of your cancer treatments and pneumonia care to your infection prevention rates. I'm so impressed by what you've done here and the difference that it is making that I have teamed up with Senator Judd Gregg and introduced bipartisan legislation to create this kind of system on a national scale using Medicare claims data to make risk-adjusted quality reports publicly available.

I also empower patients by making sure that the information that they get is understandable. The Center for Shared Decision Making here at Dartmouth Hitchcock is another perfect example. This center approaches medical decisions as a collaboration between patients and doctors. Doctors take the time to talk with patients, discuss their concerns and their goals -- and then help them reach the outcomes they desire. And once again the results speak for themselves. 98% of patients report they understood their treatment choices. 96% said they realized which treatment risks and benefits mattered most to them as they made their decisions.

We cannot do this however if we don't invest in electronic medical records. I've already proposed this as legislation, a bipartisan piece of legislation that I have worked on for four and a half years, passed the Senate last year, it died in the house. But we're back with bipartisan legislation again.

It is essential that we begin to do this. Institutions like this have electronic medical records as do other of our medical centers and fine hospitals around the country but we're not creating a seamless system. We're not creating one where if you're a patient here and you're visiting family in Florida or if you're on a business trip to LA, your record can be easily transmitted. And while Amazon.com knows exactly which books you've bought and what music you like -- an emergency room doctor may have no way of knowing what medications you're taking, what you're allergic to -- or even what your blood type is.

Electronic medical records will change that. They'll ensure that patients can have secure, confidential access to their medical history wherever and whenever they need it. This will save, according to a RAND study, approximately 77 billion dollars a year. And it will also save lives.

The VA is a great example of a health care system that has dramatically improved the quality of patient care. The American Consumer Satisfaction Index Survey shows that VA patients were significantly more satisfied with both inpatient and outpatient care than patients in the private medical system. The New England Journal of Medicine found that VA health care ranked higher than Medicare in 12 out of 13 measurements of quality and the VA system achieves better rates of quality care for diabetics than commercial managed care organizations.

Now what made this success possible? Well, in part the use of information technology. During the Clinton Administration, a transition to a paperless system was accelerated and today the VA maintains electronic health records in 1,300 facilities for over 5 million veterans. And this enables someone to go from VA hospital to VA hospital and have that record be seamlessly delivered wherever it is needed.

The VA medical records system supports the use of advanced technology including mobile devices, wireless interfaces, and a barcode medication administration system in which patients are given a bar-coded ID tag. Nurses scan this tag when providing medications allowing them to confirm that the right person receives the right medicine at the right time. So the VA is doing it, there's no reason we can't do it across our health care system,

And through my coverage recommendations which I will be making next month, I want to come up with ideas to incentivize patients and potential patients which includes all of us to make better decisions about our own health. Information alone about behaviors like smoking or obesity does not automatically result in change. We need both a renewed public health effort, that I think should be lead by the president, stressing better health outcomes and financial benefits to motivate such changes through the way we pay for public and private insurance.

I want to emphasize that when I talk about empowering patients -- I mean all patients -- from all backgrounds and all walks of life. We are far from that goal now. Our health care system unfortunately is still plagued with racial, ethnic, socioeconomic and gender disparities at every level. And my goal is to eliminate those disparities once and for all.

Right now, African American infant mortality rates are more than double those for whites. More than one-fifth of American Indians do not have a reliable source of health care, as compared to 15 percent of whites. Asian-Americans are less likely to receive critical screening tests like mammograms and pap smears. Hispanics living with diabetes are almost 20 percent less likely to receive recommended diabetes treatments. And women are more likely than men to be hospitalized for high blood pressure -- a manageable chronic condition.

Minority populations aren't just sicker -- they also get lower-quality care. According to the annual National health care Disparities Report released by HHS, African Americans and Hispanics received worse care than whites on more than 70 percent of the criteria used to measure quality.

This is simply unacceptable in our country. The quality of your care should have nothing to do with your ethnicity, skin color, or gender. And when I'm President, I will see to it that it doesn't. I will start by directing the Department of Health and Human Services to collect detailed, up-to-date information on health care disparities, so we actually can know the full extent of the .

I'll also invest in developing culturally competent health care for minority population. That means ensuring health care providers have access to the language skills they need to communicate with their patients -- and that patient information is appropriately translated into the many languages that a hospital often has to deal with.

Finally, I want to discuss the role of payers -- insurance companies and state and federal governments -- in providing quality health care.

I want to start with our reimbursement system. We have to completely re-haul this system. We need a system that actually encourages -- instead of discourages -- quality care. Right now, the incentives in our reimbursement system are upside-down and backwards. They often punish doctors are trying to do the right thing -- like spend time with their patients, trying to prevent, not just treat illness. Doing what's best for patients is sometimes bad for business.

Hospitals are paid for each episode of care, each hospitalization. Doctors are paid for each office visit, each procedure. People aren't paid to coordinate patients' treatments to ensure they get the best quality care. So let's say you are a diabetic with high blood pressure. Your doctor won't be reimbursed for hiring a nutritionist to track your weight and help you understand what you can and can't eat. Your hospital won't be reimbursed for hiring a nurse assistant to ensure you have regular appointments to get your feet and eyes checked. Or to make sure your blood pressure doctor and your diabetes doctor communicate with each other about your care. And health care providers who wish to work in teams to coordinate services and treat patients holistically receive lower reimbursements than if they all worked separately.

So we wind up treating patients like walking collections of symptoms and diseases -- each to be treated discretely. But that is not how illness works, that's not how the body or the mind works. For example, if you are a diabetic with high blood pressure, your high blood pressure obviously affects your diabetes, and vice versa. So there's incredible value to coordinating care and in having doctors, nurses, social workers, nutritionists and other professionals working together as a team.

That's exactly how it's done at the Mayo Clinic, one of the most respected health care institutions in America, actually probably in the world. Under their integrated health care system, primary care physicians work together with specialists to develop a comprehensive approach to treat each patient. The result is better care, lower costs, and fewer hospitalizations and doctor visits. The result is better care, lower costs, and fewer hospitalizations and doctor visits. In fact, if hospitalizations and doctor visits across America mirrored the numbers at Mayo, for certain conditions, inpatient Medicare spending would decrease 20%, Medicare costs for doctor visits would decrease 35%. That's billions of dollars in savings. But at the same time physicians salaries are above the national average. So when I'm President, I'll support federal reimbursements for precisely this kind of team approach to medicine. We know it saves money -- and saves lives.

I'll also ensure that the federal reimbursement system rewards care based on how effective it is. Today, we often do just the opposite. In a Pennsylvania government survey of the state's 60 hospitals performing heart bypass surgery, the best-paid hospital received nearly $100,000, on average for the operation, while the least-paid got less than $20,000. But at both hospitals, patients had comparable lengths of stay and death rates. And among the 20 hospitals serving metropolitan Philadelphia, two of the highest paid actually had higher-than-expected death rates. Now, we know we have to adjust for risk, and we know that very often the most difficult cases end up at the hospitals that have the greatest capacity. But I think we could do a better job in actually figuring out what we should be paying for -- work that has also been pioneered here at Dartmouth-Hitchcock.

With the right incentives, we can make a difference. Take the example of the Marshfield Clinic, in Wisconsin, where doctors are paid based on the quality of care they provide for common diseases like diabetes and heart disease. They could earn up to 80% of the Medicare savings that result from their good treatment. Preliminary results revealed a 50% increase in electronically documented foot exams for diabetes -- and a 29% decrease in hospitalization.

Another excellent example of incentivizing good care with smart reimbursement policies is the Bush Administration's recent decision to refuse Medicare payments for preventable infections, injuries and errors sustained during hospital stays. A sponge accidentally left inside a patient during surgery, a broken arm sustained when a patient is improperly handled. They're known as "never events," because they never should have happened. It's not often that I offer praise for the Bush Administration, but it is well deserved for this decision.

Now Michigan has had great success with systematic efforts to reduce infection rates in intensive care units. Hospitals in that state have reduced blood stream infections related to catheters, as reported in the New England Journal of Medicine. The hospitals did not use expensive new technology, but followed well-established infection control practices, like covering doctors and patients with sterile gowns and sheets when catheters were inserted.

So, As President, I won't just sustain these good policies at the federal and the state level-- I'll take it one step further. I'll insist that any insurance company wishing to provide coverage through the Federal Employees Health Benefits Program, which is all of them, has to also refuse to cover these costs. And I'll encourage private plans to follow suit. I believe we could not only save billions of dollars but thousands of lives over time.

Finally, ensuring that our reimbursement system rewards quality care also means ending insurance company discrimination against people with pre-existing conditions. Right now, insurance companies have free reign to cherry pick the healthiest patients and shut out everyone who seems like a "bad risk." In fact, they spend $50 billion a year on elaborate underwriting calculations and schemes to figure out how not to cover people or that not to pay you for what you do once you've delivered the service. As President, I'll put an end to that. I believe we should examine the patchwork nature of regulation of the insurance system. And I believe we have to end insurance discrimination.

Now, will all of this be easy? We just elect a new president? Will it just happen? Of course not. But let's remember, we're gathered today at the school that introduced the stethoscope to the American Medical School curriculum, took the first clinical X-Ray, established the first ICU. The institution that has always been pushing the boundaries, and looking toward that next horizon. Oliver Wendell Holmes, who served as a professor in this school back in the 19th century, put it best when he said, "I find the great thing in this world is not so much where we stand, as in what direction we are moving."

We may have a long road ahead of us, but I believe we're finally moving in the right direction. That we can empower patients to make the right decisions for themselves. We can empower doctors and nurses to deliver the best care that they want to, and are often prevented from doing so. We can have the highest quality health care system in the world and we can do it in a cost-effective manner. That's the direction that I'm headed in. And I'm proud to be at this institution, which has pioneered so many of the changes that benefit us today, and I hope that you'll all join me on this journey to better quality health care.

Thank you all very much.

While I disagree with the majority of her point of view . . . I think she is all TOO electable. No Dems are voting for any folk not a Dem this time around AND she is the best liked Republican candidate . . . She even beats her male twin-separated at birth RUDE-y.

If she is the nominee of the Democratic Party, she will be President . . . Much to our detriment.

Let's select a candidate obsessed with uniting the country, who approaches things in a truly non-partisan fashion, who can attract Republican votes!

What do you mean you never thought I was talking about Joe Lieberman?

The level of discourse is grim.

Why not cut the quick and pass an amendment that disallows any faux DLC Democrats like the Clintons from ever holding any elective office again? :-)

Best, Terry

Terry, I've seen you being much better on some threads, but again with me you totally mis-understand me.

How can I make it clearer? It's not about Hillary, It's about nepotism. I hate Hillary's corporatism, anti-small-d-democratism, and her imperialism -- but I think she's be great to have three glasses of wine with, and wake up to in the morning. And she has been the most take-charge, think-on-her-feet performer in the early debates.

But while she's taken more than her share of limp-dicked wingnut vitriol, to quote another commenter, she's also gotten a huge leg up on other candidates in cheap publicity, nepotistic publicity, and we've got to put a stop to that kind of institutionalized nepotism.

So Terry, do I have to ask you send me a private message before you respond to my comments, asking if you are correctly understanding my meaning?

RonK, it's not an issue of Republican accusations, the White House visitors log was clear on this. The Clintons ran a Lincoln Bedroom "B&B" for deep-pocketed contributors to their campaigns and the DNC.

A big part of the well-documented Clinton legacy, to which Hillary claims to be a full heir, is some pretty dirty baggage. The strategy of trying to portray Hillary as untainted by influence peddling to big donors is a no win, as is blaming any criticism of her on the "Republican attack machine." From my perspective, it's like passing out buckets on the Titanic.

Shame on Hillary Clinton for... being a target of the far right.

Your proposition seems to be that the only people who oppose Hillary are Republicans and people dumb enough to believe baseless right wing attacks.

But not all ciriticisms of Hillary and the Clintons are baseless.  My opposition to Hillary has NOTHING to do with the "Republican attack machine." I have followed her career closely, and feel she is a dishonest opportunist. Her vote for the Iraq War alone shows she does not have the quality of judgment necessary to lead the nation and the world. Few statesmen face that sort of historic dilemma and test. Hillary, in my opinion, faced it and failed it.

Getting even with evil Republicans is a terrible reason to elect Hillary Clinton president, if you care about the future of the nation.

FYI: Geroge W Bush, also used the Lincoln Bedroom as a high priced hotel for fundraisers.

It's a Simpsons reference.

Americans of every type came together after 9-11 and invested their trust in a president they assumed would have the best interests of the nation at heart. We were betrayed in that trust. Hillary's analysis of the need to respond to another attack as an opportunity to drive another partisan wedge into the heart of the nation is from my perspective despicable. We need to find a leader who has the vision, ideas and capacity to unite a large majority of the nation. Hillary simply can't do it.

just to watch wingnuts have aneurysms when she takes the oath of office.

I appreciate your sense of humor, but I also realize the danger in this outlook. I see an attitude on both sides of the political divide that has put our nation in a ditich: "Us and them", anything to get even. 

We need a president with at least a desire and the capacity to inspire and to lead a substantial majority of the nation.   We know from her "proud" record of intense battle with Republicans, her high negatives, and the great suspicion with which she is held by many Democrats and independents, that Hillary is not that leader.

So, you suggest that we should elect Hillary anyway because it will make the wingnuts crazy?  Sounds like the recipe for four more years of acrimony, gridlock and disaster.

I second the thanks to you, hwc, for providing this text of Hillary's speech on Health Care Quality.

A few months ago, I outlined my agenda to reduce health care costs and today, I want to talk about health care quality. And next month, I will announce my plan for universal coverage. My order here is deliberate. In order to forge a consensus on universal health care, we need to assure people they'll get the quality they expect at a price they can afford. And my recommendations to control costs and ensure quality lay the groundwork for insuring everyone.

The speech had 73 paragraphs, and the above paragraph is the only one which mentions the problem of 40,000,000+ Americans left out of the system: 1]"And, next month, I will announce my plan for universal coverage."; 2]"And my recommendations to control costs and ensure quality lay the groundwork for insuring everyone."

So, we all must wait for 'next month' to hear how Hillary's recommendations to a] control costs and to b] ensure quality somehow 'lay the groundwork' for insuring everyone. Notice that she says insure everyone rather than saying provide health care to everyone.

I did read every line of this speech. The scene that developed in my mind as I finished reading was this:

Hillary meets at a banquet hall to discuss the food service industry with conference participants who are restaurant owners, restaurant management, or restaurant employees. Interspersing her deliver with kudos and anecdotes about specific successes within the industry, she offers her views of and recommendations about the quality of the food, the quality of the delivery of that food, and the need to assure adequate menu diversity and palate satisfaction for restaurant customers.
Outside the banquet hall, there are untold numbers of folks drawn by the smells of food. They stand there with empty bellies, but hopeful nontheless, because someone told them that, after the quality of the food is assured, they will be invited into the hall to sit at the table.

featherfamily,

do I have to ask you send me a private message before you respond to my comments, asking if you are correctly understanding my meaning?

Nawwww.

Your implication that the election of Hillary Clinton would just continue the family tradition was quite clear.

Fans of Hillary would deny the past blemishes while glorifying accomplishments of the Clinton Administration and yet claim that Hillary is somehow a woman in a lonely fight against the establishment to overturn the old boy network instead of a continuation of what was.

I have expressed my undiluted admiration for Bill Clinton's accomplishment in making a breakthrough in ending the ancient warfare in Ireland.

Truly that was a shining accomplishments but the war against the working class in our own country that the Clintons deepened and accelerated while turning the Democratic Party into little more than an auxiliary of the Republican Party was a black mark that the reign of Hillary I would only worsen IMO.

Not a single Clinton fan will acknowledge the facts while falsifying the record.

I think she's be great to have three glasses of wine with, and wake up to in the morning. And she has been the most take-charge, think-on-her-feet performer in the early debates.

We have a slightly different appraisal.

A bottle or two of thunderbird in a cheap dive might have made the experience bearable in the past while a hangover in the morning would be distracting enough to help forget.

I saw a debater that avoided, obfuscated and attacked - and in fact lied outrageously. That I thought the performance was slickly done and even surprisingly professional, I have stated plainly. If there was anything of importance that was announced or elucidated, I missed it entirely.

Compare to the horrendous blunders and astonishingly poor preparation of Richardson. Despite everything, there has been much revealed about the man's ideas, both good and bad. Technically the man was atrocious but I would yet give him an A+ for imparting information.

Then again think of the excellent performance of John Edwards. A pair of live bloggers on the Huffington Post only deigned to take time out to say the man was insincere and dishonest and make a snide remark or two about his hair.

I apologize for what you take as distorting what you said.

It wasn't meant to do anything of the kind.

Best, Terry

That betrayal is precisely at the heart of what Hillary was trying to immunize us against.

9/11 resuscitated Bush's presidency precisely because Americans tend to unite around those in power when there is a disaster. Should another diaster occur - or Bush claim that Iran attacked us - Americans will unite behind him unless we have sorted it out beforehand.

If the Dems are being patriots and being ono-partisan and are unifying in support of the President and if the Rethugs are playing politics by saying the only way to be a patriot is to vote for us warmongers, Rethugs win. Hillary is alert to this danger and is warning us against it and stating that she would effectively oppose this.

The other candidates are maintaining that they don't get it and that Hillary is just playing politics. I would like to know what their plans are to prevent the Rethugs from gainnig political ground if America should come under attack real or phony?

The kudos to the audience are standard political fare and the attention span of an audience is limited so how much longer do you think she should have spoken rather than state that she would provide the next installment of what she thinks will be politically doable next month?

The starving people outside the banquet imagery is tearjerking but fallacious: nothing Hillary can do at this time will help them so it doesn't matter to them when Hillary reveals her ideas.

Both Obama and Hillary do not believe that single payer universal health care is obtainable any time soon and both intend to leave the insurance companies in the mix.

Baloney. Don't let facts get in the way. If you look at the list of guests the Clinton's entertained, it includes everyone from Andrew Young to Howard Dean to Nancy Bekavac (Pres of Scripps College/Yale Law friend of Hillary's) to Steven Spielberg.

The Clinton's traveled in an intellectually stimulating circle dating back to their college days and nurtured relationships with a lot of high power friends.

Are there campaign contributors included? Sure. Hello. That's politics. Network over the years. Go to your network for campaign fundraising. Hello.

How do you expect the first family to stay sane in the White House? It's not like they can just go meet some old college friends at TGI Fridays for a casual dinner. Having any kind of social life or conversation outside of government requires, more often than not, inviting friends to the White House. Going over to Steven Speilberg's house for the weekend would cost the taxpayer god knows how many millions of dollars, to fuel up Air Force One, etc.

That's the whole problem with these "smear campaigns". They take things that are perfectly reasonable and turn them into accepted travesties. Like, oh my god, can you imagine that they had to nerve to reward long time supporters with a visit to the White House! Never stopping to think that, if you bought a beach house, you'd probably invite people who have been friends and a part of your career to come visit. It's a perfectly normal thing to do.

Both Obama and Hillary do not believe that single payer universal health care is obtainable any time soon

True enough and such an attitude ensures that a presidency by either of them will not advance the cause.

There is a huge difference in Obama recognizing the only goal worth aiming for and Hillary's health care plan that ignores the reality of an expensive relic from the past that kills and disables more in a day than Bush and Cheney can manage in a lifetime.

Best, Terry

[Hillary] has consistently worked for liberal causes

Is that why she denies being a liberal at all?

I believe her in that instance.

I am not real taken with the Iraq occupation that Hillary supports. Is that a liberal cause you think?

I think the corporate lobbyists that support Hillary are not plain folks like you and I as Hillary thinks. Is it illiberal of me to think that?

Are you sure increasing the wealth and privilege of the upper classes and further impoverishment of the working classes that Hillary advocates is a liberal cause?

For sure Hillary is rather liberal with the truth of matters.

Maybe that's what you mean.

Best, Terry

The starving people outside the banquet imagery is tearjerking but fallacious

Fallacious means deceptive or erroneous. What deception or error could there possibly be in noting that millions of Americans are locked out of the health care system while Hillary, herself a system insider, discusses with others inside the system matters of quality products?

As I said, you're a lot smarter than we average Joes are. We're just dumb enough to be able to distinguish between an occupation and an invasion. Luckily, there are a lot more of us than there are of you. And we just don't get those "failed in her judgment and leadership" talking points.

Actually, I read Obama did great before the AFL-CIO, and, what's more, I believe you're incorrect about "vouchers", and are confusing it for "merit pay". Interesting that you'd get that wrong (I believe--the political "firestorm" was all about merit pay). Are you focusing on the politics, or the policy?

Has Edwards sent out an email fundraiser yet on his cheap shot about the Lincoln bedroom?

No, we are not all misogynists. There are many progressive women who would be thrilled to see a woman as president -- just not a woman who shamelessly conflates her experience with her husband's and is running her campaign based on fear of change. There is no compelling reason to vote for Hillary beyond the Clinton name and her husband's popularity. We have a better choice --I am supporting Obama.

I too read this 'healthcare' speech by Hillary and while it sounds substantive, it actually is not.  It is a lot of words and very short on action or proposals or policies that would be impactful. It was like offering a pacifier to an infant to stop them from whinning...an effective non-nutrient tactic. Baby shuts up but they do not get anything to relieve their hunger, they just work hard sucking for nothing..

Let's think about what Hillary outlined broadly. Was there anything there that has not been the case since she became a US Senator?  No.  All those hospital policies, innovations and insurer payments have been status quo since she was first elected to the Senate.

Hillary has not taken an leadership role nor worked to build any consensus that she stresses is essential during her tenure in the Senate. She has not advocated for change nationally in terms of how health care is delivered that would follow the prototype of Kaiser, MarshfieldClinic, or Mayo...or even Dartmouth.  Hillary has not done squat on this issue.  Had she done so, then this country might be close to having universal health care.  Hillary has simply sat back and become the largest recipient of heathcare industry lobbyist money and capitualated to their influence and interests.  This talk is nothing but more of that.

Allhotairandnosubstance. A speech replete with 'what I'll do and a dearth of HOW to do so. No plan, no details. Just lots of structure details of the existing system with great sounding words like 'ensuring, sustaining, empowering' riiiight...sounds good but no specifics on how to create change along with the usual disclaimers for why nothing has been done.

She gave the same type of speech prior to voting 'with conviction' for the AUMF....

I also find the posting of this longwinded nebulous healthcare speech in a thread on Hillary's lack of foreign policy to be diversionary.

I disagree. I know several registered Republicans who voted for Kerry and who would vote for a democrat again if they hated the republican nominee. These folks are obviously not the evangelical base -- they became republicans for reasons of economic and foreign policy. They have been completely betrayed by Bush. These folks liked Bill Clinton's economic policies and maybe that would translate into votes for Hillary -- but only if the republican candidate was a bible thumper and/or war-monger. They'd prefer Biden over Hillary and probably Biden over Guiliani. As for Obama, these voters don't agree with everything he says and have concerns about his experience, but he does get a lot of respect for being very intelligent and reasonable. Only Edwards has really lost any possible support from these cross-over voters because he is perceived as using a class warfare scenario to score political points.

I am NOT a republican -- I am a progressive democrat who supports Obama. I have just been listening to a lot of people in my travels and this what I am hearing.

Baloney. Don't let facts get in the way.

Good advice, take it.  No one is suggesting that the Clintons did not or should not have had friends and family as guests at the White House.  What you fail to hightlight is that the Lincoln Room guest list of more than 900 also includes celebraties and deep-pocket donors whose ONLY connection to the Clintons were contributions to their campaigns (including Hillary's first Senate campaign) or the DNC in ways that benefited the Clintons. 

The facts aren't pretty.  Here's one specific anecdote among hundreds: 

In March of 1996, the chairman of Occidental Petroleum, an 18 billion dollar oil company, was an overnight guest in the Lincoln bedroom of the White House. Two days after the sleepover, Occidental's Political Action Committee (PAC) gave $100,000 to the Democratic National Committee. In 1997, the Washington Post revealed that the Clinton administration created an exception to a law that stood in the way of a business venture that Occidental wanted to pursue in the country of Sudan. Further investigation has uncovered additional information on this matter.  

In 1996, Congress passed and Bill Clinton signed what became Public Law 104-132. This law prohibits anyone in the United States from doing business with countries who are classified as state sponsors of terrorism. At the time, Occidental was pursuing an oil exploration deal with the country of Sudan, which is classified as a state sponsor of terrorism. There was a 6 week period between when Congress passed this legislation and when Bill Clinton signed it into law. It was during this window of time that the chairman of Occidental stayed at the White House and Occidental's PAC gave $100,000 to the Democratic National Committee. In addition to the timing of the sleepover and the donation, a 9 year review of Occidental's political contributions found the amount of this particular donation is unprecedented, doubling the size of any other donation they have made during this period. http://www.justfacts.com/news.lincolnbedroom.asp

Does Kaiser have a political action committee? How much did Hillary receive during her Senate campaigns. How much did Bill receive? My sense is Kaiser has been working with the Clintons in a big way for a long time.

A real concern. I hope we are far enough from the downside of the Carter economy and the frustration of the Iranian hostage crisis to give Carter credit where it is due. On international issues generally and particularly with regard to the Middle East, Carter's policies seem well informed and strategic for the long-term.

Reference: Simpsons episode 2F31, "A Star is Burns"
http://www.snpp.com/episodes/2F31.html
Situation: Premiere of "A Burns for All Seasons", starring Montgomery Burns as Montgomery Burns:

Audience: Boo! Boo!
Burns: Smithers...are they booing me?
Smithers: Uh, no, they're saying "Boo-urns! Boo-urns!"

Indicative of a mammoth whopper, in conjunction with the credulity to believe it (or to believe someone will believe it).

Your response suggests that you have either a financial or emotional need to join Hillary is slaying evil Republicans forever. Idealistic, unrealistic, naive or whatever, I want change and am feed-up with intense partisan strife and a nation divided into constantly warring camps. The Clinton machine is every bit as mean, divisive and attack prone as the Republicans. And contrary to Hillary's assertions, she does not win against the Republicans, she simply perpetuates the retalitory conflict.

Obama has a new ideas and a life experience that helps him see differently. He does have the capacity to inspire. I at very least want to hear his ideas and perspective. Edwards, too, at least talks about a different future for the nation.

Both Obama and Edwards contrast starkly with Hillary's quest to return to the vengeful 1990s complete with all the needless Clinton baggage. We know that with Hillary we will have the corporate-friendly status quo and legislative gridlock for four more years. Enough of that, turn the page. With Edwards or Obama there is at least some chance for constructive change.

Hillary went on Armed Services in 2003.

On international issues generally and particularly with regard to the Middle East, Carter's policies seem well informed and strategic for the long-term.

Which ones?

As president, Carter was the kind of fellow that toasted Marcos while his friendship with the Shah of Iran led to Carter's own overthrow. Carter also initiated efforts to have the U.S. show concern for human rights in other countries while not quite as exercised about the failings of his own country.

Carter is a wonderful ex-president. Too bad he couldn't have always been an ex-president.

I don't see how some amorphous "Carter-haters" will even have an effect on the elections. Few understand that Carter was the instigator of the reign of the monetarists who have created the huge gulf between privileged and working classes. Bush is the culmination of the fine work begun by that intrepid economic and international explorer: Jimmy Carter.

But Carter didn't mean to be so bad.

Truly.

He wanted so bad to be good.

Best, Terry

Wow! ... and the ratings confirm it.

Obama was against the War in Iraq until he was for Lieberman.

Obama endorsed Lieberman in the Connecticut primary and then provided weak support in the general for Lamont.

Will you acknowledge that there was the teeniest bit of 'compromising on principles'
involved in that choice?

I'd love to have that quality in a legislator -- I have yet to be convinced that Obama has it.

Or at least who has a sense of humor.

Poor analogy. Obsession would be better equated with something etched in stone, than something written on a "blank slate" in "disappearing ink." You should really get yourself a good dictionary.

Most of the problems we've got with our government right now aren't the result of too little unity or too little getting done in Washington.

Golleeee, sometimes even you winger types make statements right on the money.

Congratulations.

On Obama:

I happen to think is a pretty great guy too, BTW

Wouldn't be because of his conservative leanings would it?

or his ideas (also pretty good, although not in fact terribly different from any other Democrat's

Vastly different on their face.

But it gets very muddy when you try to examine Obama's ideas up close.

Today Obama has abandoned his support of the absurdity of "clean coal" that Hillary thinks is mighty fine. While Obama admits that one-payer health care is what this country should have, as most notably championed by Kucinich, Obama deems it impractical to even attempt a rational health care system to replace our shoddy, expensive, bureaucratic anachronism that leaves millions without decent health care. Hillary will never make such an admission with her plain folk lobbyist paymasters looking over her shoulder. Even Edwards proposes much less.

You can pretend all you want that the Republicans are the black hats and that Hillary wears the white hat but they both wear the same hats that are bought and paid for by the same people.

Best, Terry

Winger. LOL! (Probably your favorite band.)

Pretty rich though, coming from a closeted Naderite troll like yourself. I sir am a true blue Donkey. You're just an ass.

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