Health Policymakers Foresaw, Exploited Care Problems

Written by Andrew Kreig
Published on October 30, 2013

A new controversy about the rollout of the Affordable Care Act (ACA) exploded into view this week because insurers are cancelling hundreds of thousands of consumer policies as of Dec. 31.

“The real problem is that people weren’t told the truth,” said New Jersey Gov. Chris Christie, a Republican, shown at left. “You can remember, they were told that they would be able to keep their policies if they liked them. Now you hear hundreds of thousands of people across the country being told they couldn’t.” Administration officials say better policies will replace the canceled insurance.

Kathleen SebeliusChrist ChristieMeanwhile, the massive website glitches frustrating ACA enrollment prompted an apology to the public Oct. 30 from Secretary Kathleen Sebelius, right. Republicans have called for her resignation.

"Access to HealthCare.gov has been a miserably frustrating experience for way too many Americans," Sebelius told a congressional hearing while vowing to fix the problems. To the American people, she said, "You deserve better. I apologize. I'm accountable to you for fixing these problems." A new study showed that just six people in the entire United States were able to enroll on the opening day of registration, Oct. 1.

The Obama administration and other Democrats have defended the law while also announcing Oct. 23 a six-week delay in enforcement next spring of penalties against those uninsured Americans who fail to enroll in ACA with an insurance provider.

The history of the law shows that government leaders in both parties focused on political posturing from the beginning instead of planning an effective system under ACA, also known as “Obamacare.”

Updates: In a Nov. 14 column on FireDogLake, commentator Jon Walker points out: Obama Basically Admits He Never Really Understood His Own Health Care Law.

Also, his Normal Solomon wrote The Obamacare Disaster and the Poison of Party Loyalty decrying party loyalists who ignore the law's dangers.

My column below and a video by our new Truth Patrol summarize the failure of both parties to address the fundamental problems of the system in a candid manner, thereby creating current problems.

Based in part on my Capitol Hill reporting of the genesis of the law in 2009 and 2010, I link the problems to the powerful private sector forces that control the destinies of both politicians and the public.

Presidential PuppetryThe problems involve not simply mismanagement -- but crony capitalism that benefits insiders. The complicit insiders include supposed watchdog institutions, such as universities that receive grants on a political basis.

Implicated also are media organizations and their affiliates, which depend less on informing readers than on relationships with the power players who can provide news, ads and -- less obviously but very importantly -- lucrative corporate affiliate agreements.

In essence, many so-called news organizations function largely as the PR department of their conglomerate parent. Their loyalty to the parent organization is so pervasive that recent hires or reporters and editors who have survived decades of group-think and staff cutbacks often have difficulty imagining, much less acting upon, a fundamental loyalty to consumers, small businesses, and other health care system users. 

For those reasons, this week's controversies over the health insurance legislation relate directly to my new book, Presidential Puppetry: Obama, Romney and Their Masters. The hearings on Obamacare, the current law and related austerity measures are vital to nearly everyone's future, as described below.


The Problem

The basic problem for policymakers is that United States health care averages two to three times more in cost than similar care in other Western nations. All of the other nations have some version of universal health care in a mix of public and private plans. Independent research shows they deliver results at least as good as those in the United States on average, and often much better at less cost.

But powerful incumbents in the United States -- ranging from health care providers to tort lawyers -- resist significant change in the U.S. system despite its enormous costs and other failures.

Studies show, for instance, that the system Obama sought to reform with ACA has been leaving more than 40 million U.S. uninsured, resulting 25,000 needless deaths per year. Yet wasteful spending has existed in many parts of the system. Republicans focus on huge jury awards for malpractice, resulting in excessive paperwork. Democrats tend to focus on those currently dying with no care, or else seeking treatment for matters larger and small at emergency rooms.

Barack Obama and Kathleen Sibelius with recipients Oct. 13, 2013President Obama deserves credit for at least tackling a problem essentially ignored by his rivals. At left, he and the HHS Secretary Sebelius listen as enrollees in the Affordable Care Act tell their stories in the Oval Office on Oct. 1. The enrollees later joined the President for a statement in the Rose Garden. (Official White House Photo by Pete Souza)

I reported from 2009 to 2010 on Capitol Hill about the law's development and passage. Soon after taking office, President Obama secretly junked his campaign promise to consider the possibility of a public access option. Instead, his team drew on previous Republican ideas to develop a plan based largely on the Massachusetts plan enacted by former Gov. Mitt Romney to rely on private insurers to extend coverage under a complex system of mandates and subsidies.

At the time, neither Obama nor other Democrats realized that the Republican leaders had held a secret meeting on the night of Obama's inauguration in 2009. The scene was The Caucus Room Restaurant (a stone's throw from my office).

John McCainThe result was a GOP leadership plan to fight all of Obama's major initiatives. The Republican Alabama Sen. Dick Shelby took a lead in the process in February 2009 by putting a hold for weeks on every nomination by the new administration unless he received guarantees of fairness for several major defense contracts he supported. They in turn supported him and other leading Republicans, including defeated 2008 GOP nominee and Arizona Sen. John McCain, right.

The overall Republican goal? To prevent Obama's success despite the election results, thereby paving the way for the Tea Party victories in 2010 elections that returned House control to Republicans and many state governments to Republican governance. The states then used the once-per-decade census results to further gerrymander congressional districts for the next decade so that even when Republicans lose both the nationwide House overall totals and statewide votes in Ohio, Pennsylvania and Virginia, they control overwhelming majorities in both key states and in the House.

In response, the Obama team relied on a host of public relations tricks to eke out a narrow win on the health insurance law, which remains the administration’s proudest domestic policy achievement.

Yet the plan was deeply flawed at the outset. Its claims of cost containment and of extending insurance to more than 40 million uninsured Americans by 2014 are well-known by now.

I reported on the ACA law’s debate and passage for such publications as the Huffington Post, OpEd News and Connecticut Watchdog.

Amid the vast spending and speech-making by powerful corporations and other incumbents such as unions and think tanks, I found particularly revealing what was reputed to be the only congressional hearing focused on the stories of patients. It did not even have the status of an official hearing. Instead, it was part of a more informal hearing process convened by Democratic Congresswoman Sheila Jackson Lee of Texas and House Judiciary Committee Chairman John Conyers of Michigan.  

John ConyersI observed at close hand how traditional liberals such as Conyers, left, and John Dingell, also of Michigan, can be eloquent in advocating simpler, cheaper, and fairer solutions, but were totally ineffective at Congress. Why?

As described in Presidential Puppetry, the hearing produced powerful testimony, which I arranged to be filmed in view of the near-total lack of coverage by traditional news media.

Among the witnesses from different vantage points was cancer survivor Harriet Fulbright, widow of the Arkansas Senator J. William Fulbright, whose televised Vietnam War hearings helped to change the national opinion about the war four decades ago. “I can think of no subject more important,” she testified, “than health care for every citizen of this country.”

Independent-film-maker Natalie Noel, another witness, showed her work with Robert Corsini portraying the ravaged health care services in New Orleans and the helplessness of officials post-Katrina. She and Corsini began work in 2007 on their film “Reinventing Paradise.” The movie was about post-Katrina recovery problems in Gulf of Mexico states.

An Alabama native, Noel recounted how she later discovered that she had Stage Three cancer, which exhausted her ability to pay for treatments or even to continue to pay her insurer, which was Alabama’s dominant carrier. With no options for life-saving care in Alabama and without the ability to work, she moved to Pennsylvania, where the state provided twice-weekly treatments toward her full recovery. Noel concluded her testimony by asking those present to consider: “What would happen if you were suddenly struck by your own personal Katrina?”

At the hearing’s conclusion, the Rev. Walter Fauntroy, a former congressman and an organizer of iconic Civil Rights marches in the 1960s, made an eloquent call for action.

Fauntroy sought to put the issue of health care for those who might otherwise die into perspective. In the style of old-time preachers, he spoke of the curse of subjugation, the blessing of hard work and abundance, and the cycle of apathy and renewed subjugation in the rise and fall of civilizations.

On that day in 2009, he sought to rekindle the passion that inspired his generation five decades ago at a time now often praised but seldom imitated. Immediately afterward, Conyers described his career-long fight for a “public option” and single-payer health care system in a video interview by Noel, recorded by Corsini. Links are at bottom to powerful video excerpts from the hearing.

The Pressure

The Conyers hearing had no impact on the larger debate, and scant follow up. The powerful industry players opposed any discussion of a public option, as did the Obama administration. Health care inevitably involves sickness, death, costs. The leadership of both parties wanted to keep the focus away from such topics.

Instead, they kow-towed to major lobbying groups, enabled cronies to profiteer, and pacified  the public with public relations.

Mike LeavittAt the beginning of Obama's term, Republican obstruction led to a slow transition and installation of Democratic appointees carrying out his programs, shifting as they were. Holdover Republicans ran HHS for months in 2009 as Obama struggled to find a secretary who could win confirmation before settling on Sebelius, a popular, Democratic, two-term governor of Kansas and daughter of a former governor of Ohio.

Meanwhile, Bush administration HHS Secretary Mike Leavitt -- son of the founder of The Leavitt Group, the nation's third largest insurance brokerage and thus a major health insurance player -- saw his longtime aide Charles Johnson running HHS as interim secretary in April 2009 after Leavitt left at the end of 2008 to operate a health consultancy.

Leavitt founded Leavitt Partners, which provided among its major services advice -- mostly sought by conservative state governors opposed to Obamacare -- on how to approach the issues involved in whatever law HHS would administer.

Johnson later joined The Leavitt Group. That level of cross-pollination and revolving-door conflict is a huge part of Washington and law-making, but is rarely noted in news stories or in Leavitt's many op-ed columns commenting on health care issues.

The top levels of the Obama administration's health care team and leading congressional players are similarly taking leading roles in implementing the plan. They are making fortunes out of what many privately predicted would be a disaster.

In August 2009, Conyers told a gathering of the Progressive Democrats of America that he had warned Obama that Obamacare would be a disaster that would tarnish his presidency. I covered the talk in which Conyers made extremely blunt comments that disconcerted Democrats eager to believe in the hopeful words of the new president.

A half year later, I covered also an informal gathering at the House Rayburn Building just after House progressives caved in to White House demands to support the complex, flawed, corporate-friendly compromise Obamacare legislation.

Howard DeanFormer candidate Howard Dean, now a lobbyist as well as a leader in good-government civic bodies, tried to console the single-payer advocates in the audience by touting the Obama administration's wisdom in enacting the ACA instead of using his 2008 election momentum from the start to advocate a lower-cost, simpler solution.

Dean, shown at right in a Wikipedia file photo, predicted that the bill would have so many problems upon implementation that the public would seek a better solution after getting a taste of the benefits.

Dean is a medical doctor and former Vermont governor married to a physician. He has advocated major health care reform. He left the hearing room before taking my question.

Shortly afterward, I queried Conyers:

"Why would the public trust Democrats to create a better solution to health care," I said, "if Obamacare proves to be flawed?"

Conyers, with a small smile, replied, "Ask Howard Dean."

The Legislative Fix

To finesse the congressional battle and sustain support among major corporations, the Obama administration from the secretly discarded its 2008 campaign theme of an open mind for any resembling a "public option" or Medicare for all in a plan similar to the other Western nations that keep costs lower by reducing middlemen companies, paperwork, and payment responsibilities. In retrospect, we now know that the administration gave a parade of centrist Democrats freedom to steer the legislation towards its current shape and then enforced passage by draconian threats against Democrats to support the administration bill.

Rep. Eric Massa, a freshman Democrat from Upstate New York who resigned in March 2010 after what appears to be a highly unfair whispering campaign against him by a staffer, ascribes part of the reason to his resistance to the administration bill as too cumbersome and not congruent enough with the Obama campaign promises.  

As another tactic, the administration secretly used HHS funds to support an MIT scholar, Jonathan Gruber, who provided supposedly independent analysis predicting the ACA's eventual success. We are today seeing the results of that kind of duplicity from the administration and its supporters.

Yet is clear also Republicans have not yet offered an alternative view of how to handle the vastly greater suffering and death of those tens of millions of uninsured.

The HHS Website, Broken Promises and Other Torments

HHS has long had problems with its major websites, including the www.grants.gov site it administers for most federal contracts much like the current ACA website. These sites are run through a combination of holdover career employees and outside contractors, all supervised by political appointees. The grants.gov site, as the portal to federal grants throughout government, should be a model of smooth functioning but it has not been.

The person directly responsible for the HHS site for ACA is Marilyn Taverenner, administrator for the Centers for Medicare and Medicare Services within HHS. She apologized to the public at an Oct. 29 congressional hearing, much as Sebelius would do the following day, and defended the program's overall goals. She blamed some setbacks on the main contractor, CGI Federal.

The Washington Post reported on the cancelled policies this week:
 
If the accusations of broken promises stick, they could ultimately be more damaging than the glitchy Web site. Although some people are signing up and benefiting from federal subsidies to buy private insurance, the number is unknown because the administration has not revealed enrollment figures.
 
Meanwhile, insurance companies have sent hundreds of thousands of termination notices in recent months to previously insured Americans, telling them that their health insurance plans are changing to meet the requirements of the health-care law. Under the Affordable Care Act, beginning Jan. 1 insurers must offer renewal policies that cover a core group of essential health benefits, such as maternity care and prescription drug coverage. Policies that don’t offers such benefits can’t be sold after this year.
 
As a result, many insurers are discontinuing policies that do not comply with these new standards. If insurers discontinue a policy, they are required to give the policyholder 90 days’ notice and offer the option of enrolling in an alternative policy. Florida Blue Cross Blue Shield chief executive Patrick J. Geraghty said Sunday that the company is dropping about 300,000 policies. Customers are being informed that they can’t keep their current plans but that their new options might be better because of new benefits and government subsidies available to low- and middle-income people. While Republicans are insisting that the president misled the public about the effects of the law, others who are sympathetic to the administration said the seeming contradiction shows the difference between political talking points intended to sell a controversial law and the intricacies of the health policies that underlie it.
 
There are a host of other problems that can arise when a government tries to solve complex problems, especially without full disclosure of all goals, methods and ripple effects. 

Michael DaughertyThis week, I met Michael J. Daugherty, right, president and CEO of LabMD, a cancer detection facility based in Atlanta, GA. He is a fellow member of the National Press Club, where we encountered one another in the library. He is currently releasing his first book, The Devil Inside the Beltway, which made the cover of Publisher's Weekly earlier this month.He calls it a "non-fiction thriller with themes of cyber security, government overreach, and American small business."

He wrote the book to describe his experience as a quasi-insider in the health care system who uncovered "an extraordinary government surveillance story that compromised national security and invaded the privacy of tens of millions of online users worldwide." His concerns stemmed from how an aggressive security surveillance company "magically acquires the private health information of thousands of LabMD's patients." This occurred, he says, government employees and contractors for such non-health bodies as the Federal Trade Commission and Department of Homeland Security sought cancer patient records, in part via "illicit and unapproved file sharing" for non-medical purposes. He alleges this could pose "a chilling effect on Americans and their businesses for years."

This kind of allegation is increasingly common in the post-Snowden era and is similar to my own themes in Puppetry.

Daugherty is an engaging entrepreneur who still plays Pro-Am tennis events at mid-life, and otherwise seems healthy. Not so for many millions for whom the health care debate is a matter of life and death --or at the minimum a grim choice between money for medicine or food, or other extreme hardship (as in care of critically ill relatives).

The Future

Presidential Puppetry Black HandI wrote Puppetry, which is separate but overlapping from the Project here, because of the appalling practices that are destroying our country and imposing needless hardship on the public, including in health care services.

Only by exposing the Puppet Masters, their government operatives, and their secrets can the public reassert the power that rightfully belongs to the American people.

One of my book's themes is that national security relationships have a hidden impact on much of our news coverage on a host of topics, including health care but also involving a wide variety of other business and government issues. Surveillance, with its potential to reward or punish players seemingly uninvolved in national security, is a part of the problem that must be revealed and discussed.

To advance that process, I'm launching today a new video on YouTube to provide a forum for such discussions. Also, I am scheduled to be a featured speaker at the Million Mask March Nov. 5 at the Washington Monument in the nation's capital. The latter, whose Facebook site is here, is coordinated with similar demonstrations in more than 400 locales around the world.

Please get informed and get involved. Your future depends on your understanding the new realities.

 

 

Contact the author This email address is being protected from spambots. You need JavaScript enabled to view it.">Andrew Kreig or comment

Related News Coverage

Updates:

FireDogLake, Competence Matters Above All Else, Jon Walker, Nov. 20, 2013. It was simply unrealistic to put the success of Obamacare in the hands of GOP governors who opposed it. What is more important than ideology, good ideas or smart plans in a leader is basic competence. This is why the terrible roll out of the Affordable Care Act has been so damaging to President Obama. Democrats had free reign to write any health care law without needing to make any concession to Republicans. The Obama administration then had over three years to work on implementing their plan. Yet they failed miserably. Obama is either such a bad manager he really didn’t bother to learn about these problems with his signature law until after it launched or he knowingly lied to the American people about the Healthcare.gov being ready. Neither looks good. Some Democrats have tried to shift the blame to Republican governors for not helping Obama implement his law, but even that is an indirect admission of Obama’s incompetence. Republicans made it very clear in 2010 that they adamantly opposed the law.

FireDogLake, The Obamacare Disaster and the Poison of Party Loyalty, Norman Solomon, Nov. 18, 2013. Four years ago, countless Democratic leaders and allies pushed for passage of Barack Obama’s complex healthcare act while arguing that his entire presidency was at stake. The party hierarchy whipped the Congressional Progressive Caucus into line, while MoveOn and other loyal groups stayed in step along with many liberal pundits. Today, in terms of healthcare policy, the merits and downsides of Obamacare deserve progressive debate. But at this point there’s no doubt it’s a disaster in political terms — igniting the Mad Hatter Tea Party’s phony populism, heightening prospects for major right-wing electoral gains next year and propagating the rancid notion that the government should stay out of healthcare. At this pivotal, historic, teachable moment, progressives should not leave the messaging battle about the ACA to right wingers and Obama loyalists. While critiquing the law for its entanglement with the profit-voracious insurance industry, we should fight for quality healthcare for everyone — definitely including the people who live in states where right-wing officials are blocking expansion of Medicaid coverage.Washington Post, Health-care site contractor tied to firm that botched other IT projects, Jerry Markon and Alice Crites, Nov. 15, 2013. More than 100 of the main contractor’s employees and executives once worked at a company with a history of problems with at least 20 government projects.

FireDogLake, Obama Basically Admits He Never Really Understood His Own Health Care Law, Jon Walker, Nov. 14, 2013. President Obama delivered a very apologetic presser today on the problems with the Affordable Care Act, but the most remarkable moment was when Obama basically admitted he never really understood how his signature law would actually work. He claims to have only realized in the past few weeks that buying insurance on an exchange is an inherently complicated and often confusing process. One of Obama’s big promises in selling his law to the public was that it would make buying insurance insanely easy. It is a promise he repeated all the time and seemed to really believe. For example, just six weeks ago Obama was still claiming the exchange would make buying insurance basically as easy as getting a song on iTunes. One of the main reasons I had so little faith in the supposed promise of these exchanges is because I know ACA wouldn’t make this process simple enough. This is why even in countries that use a system that appears to resemble the basic design of ACA, such as Switzerland, they require extreme plan standardization. Obama didn’t just admit he never fully understood his signature law, he seems to indirectly acknowledge that the whole thing is conceptually flawed.

Washington Post, Health-care law has changed game for Democrats in 2014, Ed O’Keefe and Paul Kane, Nov. 16, 2013. The party had hoped to capitalize on the political fallout for Republicans from the government shutdown, but the health-care law has taken center stage.

Barack Obama and Health CEOsAt left, President Barack Obama holds an Affordable Care Act meeting with health insurance company CEOs in the Roosevelt Room of the White House, Nov. 15, 2013. (Official White House Photo by Pete Souza.)

Washington Post, 1 in 5 may not be able to enroll on HealthCare.gov, Amy Goldstein and Juliet Eilperin, Nov. 16, 2013. The administration is hoping 80 percent of people going to HealthCare.gov will manage to enroll electronically by a Nov. 30 deadline for fixing the Web site.

Washington Post, Game over? Obama’s health-care fumble could be decisive, Nov. 16, 2013. There may well be enough time to salvage Obamacare.  But on the broader question of whether Obama can rebuild an effective presidency after this debacle, it’s starting to look as if it may be game over.

Washington Post, Obama relying more on insurers to fix Web site, Juliet Eilperin and Amy Goldstein, Nov. 9, 2013. Health insurance companies are helping to repair HealthCare.gov, the problem-ridden online marketplace, as the administration prioritizes consumers’ ability to buy plans directly from carriers.

Washington Post, What Obama forgot to apologize for, Kathleen Parker, Nov. 8, 2013. President Obama is sorry that some people have been inconvenienced by HealthCare.gov’s computer disaster. He’s sorry that some people have lost the policies he promised they could keep. He’s sorry that the Affordable Care Act (ACA) wasn’t adequately “crafted.” But is he sorry that he intentionally misled people? I must have missed that part.

Washington Post, Obamacare’s launch looked even worse from the inside. Sarah Kliff, Oct. 31, 2013. Obamacare’s launch looked even worse from the inside. Healthcare.gov had tallied exactly six successful enrollments by the morning of October 2, new documents released by the House Oversight Committee show.

Washington Post, The sin of omission in Obamacare, Kathleen Parker, Nov. 5, 2013. How much dishonesty from a president is tolerable? Now the White House tells us that Obama always meant you could keep the insurance policy you like if it met the standards of the ACA. To sum up, the American people were duped; the administration did not misspeak, as the New York Times editorialized. The administration knowingly misled with a false promise and a deliberate omission. Worse, it did so for your own good because you might be confused by the truth. Call it what you will.

The Hill, Conflict-of-interest concerns raised as Obama races to implement health reform, Alexander Bolton, Nov. 3, 2012. The Obama administration is relying heavily on outside contractors to implement a core component of healthcare reform as it races to set up a federal health insurance marketplace before 2014. The fast-approaching deadline gives the administration little time to scrutinize private-sector partners for conflicts of interest. The purchase of one of these contractors, Quality Software Services, Inc. (QSSI), by UnitedHealth Group, a major healthcare conglomerate, has sparked concerns about a potentially uneven playing field. QSSI, a Maryland-based contractor, in January won a large contract to build a federal data services hub to help run the complex federal health insurance exchange. It will be working with several other contractors, including CGI Federal, Inc., to create the technological architecture for the exchange. The quiet nature of the transaction, which was not disclosed to the Securities and Exchange Commission (SEC), has fueled suspicion among industry insiders that UnitedHealth Group may be gaining an advantage for its subsidiary, UnitedHealthcare. UnitedHealth Group’s acquisition has caught the attention of Sen. Orrin Hatch (R-Utah), the ranking member on the Senate Finance Committee. He has expressed alarm over what he calls a lack of transparency in setting up a national insurance marketplace covering more than 30 states. He asked Health and Human Services (HHS) Secretary Kathleen Sebelius in an Oct. 19 letter for a full account of contractors hired to set up the national exchange and a list of administration officials who signed off on those awards.

Consumer Reports, That Florida woman's canceled Blue Cross policy? It's junk insurance. She can get a real plan for only $165 a month, Nancy Metcalf, Oct. 29, 2013. Did you recently get a notice saying that your insurance company is canceling your policy because it doesn't meet the new health law's higher standards? Thousands of people are, and many are angry about it. But before you rush to judgement, it might not be as bad as it seems. Consider the case of Diane Barrette, a 56-year-old woman from Winter Haven, Fla. Her story was featured in this CBS News report and endlessly echoed on the Internet. She was upset because Blue Cross Blue Shield of Florida was canceling her $54-a-month “GoBlue plan 91” and offering to replace it with a $591-a-month “Blue Options Essential plan.” Sounds terrible—except that Barrette’s expiring policy is a textbook example of a junk plan that isn’t real health insurance at all. If she had ever tried to use it for anything more than an occasional doctor visit or inexpensive prescription, she would have ended up with tens or hundreds of thousands of dollars of medical debt.

Washington Post, HealthCare.gov: How a start-up failed to launch, Amy Goldstein and Juliet Eilperin, Nov. 2, 2013. Fear of political blowback and a lack of central oversight since 2010 have contributed to the troubled rollout of President Obama’s health-care plan.

Presidential Puppetry Truth Patrol: Health Policymakers Foresaw, Exploited Care Problems. The controversial the rollout of the Affordable Care Act (ACA) exploded into view this week because insurers are cancelling hundreds of thousands of consumer policies as of Dec. 31. The Truth Patrol explains the real story in a brief video by author and health care commentator Andrew Kreig.

AP via Huffington Post, White House, Lawmakers Rejecting Edward Snowden's Plea For Clemency, Kimberly Dozier, Nov. 3, 2013. The White House and the leaders of the intelligence committee in Congress are rejecting National Security Agency-contractor Edward Snowden's plea for clemency. "Mr. Snowden violated U.S. law," White House adviser Dan Pfeiffer said about the former systems-analyst-turned-fugitive who has temporary asylum in Russia. "He should return to the U.S. and face justice," Pfeiffer said, adding when pressed that no offers for clemency were being discussed.

Washington Post, Backlash grows over higher costs under health law, Ariana Eunjung Cha and Lena H. Sun, Nov. 3, 2013. If the poor, sick and uninsured are the winners under the new health-care law, the losers seem to include some healthy middle-income workers who buy their own insurance and face rising premiums.

Fox News, Sebelius apologizes for ObamaCare site failures during Hill hearing, Oct. 30, 2013. Health and Human Services Secretary Kathleen Sebelius personally apologized Wednesday for the failures of the ObamaCare website, saying during a Capitol Hill hearing that the American people "deserve better." The secretary faced of her biggest critics Wednesday as she testified for the first time on the troubled ObamaCare rollout -- amid mounting calls for her resignation. "The news seems to get worse by the day," Rep. Fred Upton, R-Mich., chairman of the House Energy and Commerce Committee, said at the start of the hearing before his committee. Not only was the secretary facing questions about the glitch-ridden exchange website, but the administration as a whole is being challenged as consumers on the individual market receive a wave of cancellation notices.

Barack Obama Meets Doctors Oct. 13, 2013Washington Post, Canceled policies spur furor over health-care law, Lena H. Sun and Sandhya Somashekhar, Oct. 29, 2013. President Obama is accused of breaking a promise as hundreds of thousands of insured Americans are told that their non-qualifying policies won’t be renewed.

Washington Post, Firm picked to fix HealthCare.gov faced Hill queries, Jia Lynn Yang, Oct. 25, 2013. Lawmakers questioned whether QSSI’s first contract to work on the site was a conflict of interest because it is owned by the nation’s largest health insurer.

Forbes, Obamacare's Website Is Crashing Because It Doesn't Want You To Know How Costly Its Plans Are, Avik Roy, Oct. 14, 2013. The Healthcare.gov website requires that individuals looking for coverage enter personal information before comparing plans. IT experts believe that this requirement is causing the website to crash. A growing consensus of IT experts, outside and inside the government, have figured out a principal reason why the website for Obamacare’s federally-sponsored insurance exchange is crashing. Healthcare.gov forces you to create an account and enter detailed personal information before you can start shopping. This, in turn, creates a massive traffic bottleneck, as the government verifies your information and decides whether or not you’re eligible for subsidies. HHS bureaucrats knew this would make the website run more slowly. But they were more afraid that letting people see the underlying cost of Obamacare’s insurance plans would scare people away.

Washington Post, Terror case will use evidence gathered through warrantless surveillance, Robert Barnes and Ellen Nakashima, Oct. 25, 2013. This sort of evidence is expected to bring a challenge to the law allowing it to be collected.

Washington Post, Medicare chief to testify about troubled HealthCare.gov, Sarah Kliff, Oct. 28, 2013. Marilyn Tavenner will be the first Obama administration official to appear before Congress on the issue.

Washington Post, Health site fixes expected to take until end of Nov., Sandhya Somashekhar and Lena H. Sun, Oct. 25, 2013. A private contracting firm is managing the effort to correct “dozens” of problems with HealthCare.gov, the administration says.

Washington Post, Full testing of HealthCare.gov began too late, contractors say, Sandhya Somashekhar and Amy Goldstein, Oct. 24, 2013. Private contractors in charge of building the federal online health insurance marketplace testified Thursday that the administration went ahead with the Oct. 1 launch of HealthCare.gov despite insufficient testing.

Darrell Issa FlickrFireDogLake, Oversight Committee Finds White House May Have Directly Exacerbated Exchange Problems, Jon Walker, Oct. 22, 2013. /According to the House Oversight Committee the “White House” may have played an important role in exacerbating the problems with the Healthcare.gov rollout. From the committee: The letter, signed by Committee Chairman Darrell Issa, R-Calif., right, cites January 9, 2013 and October 16, 2013 briefings with CGI Federal Inc., one of the major contractors tasked with building the federal health insurance exchange website.  “Although, CGI officials were not able to identify who within the Administration made the decision to disable the anonymous shopping feature, evidence is mounting that political considerations motivated the decision,” the letter finds. Forcing everyone to create accounts before shopping would significantly increased the load on the system.

Washington Post, Americans will have an extra six weeks to buy health coverage before facing penalty, Sandhya Somashekhar, Amy Goldstein and Juliet Eilperin, Oct. 23, 2013.  Americans will now have until March 31 to sign up for coverage through the new online insurance marketplaces before they face a financial penalty.

Huffington Post, SNL' Troubleshoots Obamacare Website Problems, Katla McGlynn, Oct. 27, 2013. "Saturday Night Live" wasted no time getting to President Obama's biggest problem of the week with a cold open sketch about the devastating Obamacare website glitches. Watch the clip from the Ed Norton-hosted above to hear some hot tips on how to better navigate healthcare.gov courtesy of the Secretary of Health (Kate McKinnon). She's full of great ideas, such as "restarting your computer," and even provides links to other websites that can help you, such as Kayak.com (so you can buy a plane ticket to Canada).
 
Politico, Kathleen Sebelius: Obamacare delay wasn’t an option, Paige Winfield Cunningham, Oct. 22, 2013. Health and Human Services Secretary Kathleen Sebelius said delaying the launch of the insurance exchanges was “not really an option” — even though those building the federal website knew about major problems days in advance. “There are people in this country who have waited decades for affordable health coverage, people who are so eager for this to happen,” Sebelius told CNN’s Sanjay Gupta on Tuesday night. “Waiting is not really an option.” She also said President Barack Obama was told about the major problems with the website in the first couple of days after it launched. Before the launch, she said, the president only knew about testing that officials were doing on the website.

Washington Post, Health law’s insurance co-ops are in danger, Jerry Markon, Oct. 22, 2013. The network of nonprofits was created to foster competition among plans and lower insurance costs, and their failure could cost taxpayers $1 billion.

Washington Post, HealthCare.gov launched despite signs of serious problems, Lena H. Sun and Scott Wilson, Oct. 21, 2013. The site failed some tests, people familiar with the project say, and testing wasn’t done early enough.  Days before the launch of President Obama’s online health ­insurance marketplace, government officials and contractors tested a key part of the Web site to see whether it could handle tens of thousands of consumers at the same time. It crashed after a simulation in which just a few hundred people tried to log on simultaneously. Despite the failed test, federal health officials plowed ahead. When the Web site went live Oct. 1, it locked up shortly after midnight as about 2,000 users attempted to complete the first step, according to two people familiar with the project.

Huffington Post, Chuck Todd: Officials 'Made It Seem' Like Obamacare Site Was Under Control (VIDEO), Oct. 21, 2013.

Daily Howler, As heard on Fox: Eric Stern debunks Hannity show! Bob Somerby, Oct. 21, 2013. Silence from the Times: According to Eric Stern, he watched the Hannity program on Fox on Friday evening, October 11. Stern has a large advantage on most cable viewers; he understands the basic workings of the Affordable Care Act. In a subsequent piece at Salon, Stern says he worked as a senior adviser to Montana governor Brian Schweitzer. He says he helped Schweitzer deal with the new federal rules in the ACA. We watched Hannity’s program that evening too. We saw and heard the same things Stern did. Being less knowledgeable than Stern, we didn’t know what to think about various things which were said that night. And we didn’t proceed as Stern did.

Salon, Inside the Fox News lie machine: I fact-checked Sean Hannity on Obamacare, Eric Stern, Oct 18, 2013. I re-reported a Fox News segment on Obamacare -- it was appallingly easy to see how it misleads the audience. I happened to turn on the Hannity show on Fox News last Friday evening [October 11]. “Average Americans are feeling the pain of Obamacare and the healthcare overhaul train wreck,” Hannity announced, “and six of them are here tonight to tell us their stories.” Three married couples were neatly arranged in his studio, the wives seated and the men standing behind them, like game show contestants. As Hannity called on each of them, the guests recounted their “Obamacare” horror stories: canceled policies, premium hikes, restrictions on the freedom to see a doctor of their choice, financial burdens upon their small businesses and so on. “These are the stories that the media refuses to cover,” Hannity interjected. But none of it smelled right to me. Nothing these folks were saying jibed with the basic facts of the Affordable Care Act as I understand them.Oct. 16

Huffington Post, Government Shutdown: Congress Votes To End Funding, Debt Standoff, Michael McAuliff and Sabrina Siddiqui, Oct. 16, 2013. The government shutdown is dead. Obamacare is alive. The Senate voted 81 to 18 Wednesday night to reopen the federal government and raise the nation's borrowing limit, hours before the Treasury Department faced the possibility of being unable to pay all of America's bills for the first time in modern history. The House followed suit, voting 285-144, to end the latest damaging battle of divided government in a polarized Congress. President Barack Obama said he would reopen the government immediately to "lift this cloud of uncertainty and unease" that settled on the nation and start fixing the damage.

New York Times, More On Jon Gruber, Paul Krugman, Jan. 15, 2010.

New York Times, The Source’s Stake In the News, Clark Hoyt, Jan. 17, 2010; and Glenn Greenwald, Krugman, Gruber And Non-Disclosure Issues, Salon, Jan. 16, 2010,

House Special Hearing: “Costs of Broken Health Care System, Benefits of Public Option,” Robert Corsini via Aboriginal Media, Oct. 27, 2009. U.S. Rep. Sheila Jackson Lee opened the proceedings:  (Video: 4:43 minutes).

Huffington Post, Fans of House Health Option Cite Rights, Hopes, But Risk Big Defeat, Andrew Kreig, Nov. 4, 2009. See also, Aboriginal Media and Goddess Strides Productions, Video interview of House Judiciary Chairman John Conyers, Robert Corsini and Natalie Noel, Oct. 27, 2009. Video:Part I, ; and Part II,

Catching Our Attention on other Justice, Media & Integrity Issues

Washington Times, Families suspect SEAL Team 6 crash was inside job on worst day in Afghanistan, Rowan Scarborough, Oct. 20, 2013. Questions haunt the families of Extortion 17, the 2011 helicopter mission in Afghanistan that suffered the most U.S. military deaths in a single day in the war on terrorism. The investigative file made available to the Washington Times shows that the helicopter’s landing zone was not properly vetted for threats nor protected by gunships, while commanders criticized the mission as too rushed and the conventional Chinook chopper as ill-suited for  a dangerous troop infiltration. Not all families believe the fact-finding investigation, conducted by Army Brig. Gen. Jeffrey Colt covered all issues. Gen. Colt, who has since been promoted to major general, told commanders that his job was not to find fault and his report did not criticize any person or decision. “I want people held accountable,” said Mr. Strange, a former union construction worker who deals blackjack in a Philadelphia casino.

Angela MerkelWashington Post, Germany summons U.S. envoy over allegations Merkel’s phone targeted, Michael Birnbaum and Ellen Nakashima, Oct. 24, 2013. Outrage over possible NSA spying could hurt collaboration with one of America’s staunchest allies. Other senior German officials said that, if the accusations are true, the United States had gone too far with one of its closest allies. Merkel is shown at right in a file photo via Wikipedia.

Huffington Post, Angela Merkel's Cell Phone Tapped By NSA? U.S. Accused Of Spying On German Chancellor, John-Thor Dahlburg and Lori Hinnant, Oct. 23, 2013. The German government says Chancellor Angela Merkel has called President Barack Obama after receiving information that U.S. intelligence may have targeted her mobile phone. Merkel spokesman Steffen Seibert said Merkel made clear in Wednesday's call that "she views such practices, if the indications are confirmed ... as completely unacceptable" and called for U.S. authorities to clarify the extent of surveillance in Germany. A statement from Seibert said the German government "has received information that the chancellor's cellphone may be monitored by American intelligence."