Irrelevant small states with no people in them that exist by an accident of history are chronically over-represented in this country — both in the electoral college and most obviously in the Senate. And those states are much more conservative than metro areas where people actually live, which means that even if they send Democrats to DC, they’re not exactly raging Trotskyites.
Hence we get Max Baucus, representing less than 1 million people, or one-sixth of an average state’s population, pushing moderate reform and saying that single-payer is a political non-starter. He’s right, but it’s only because of the political structure that guarantees him his power. If San Francisco, which has roughly the same population as Montana, sent a Senator to Congress I think the result would be somewhat different.
Meanwhile the same issue means that, as it stands, the stimulus bill which apparently is our only hope doesn’t have enough votes to pass, while a moderate Republican (yes, they found one) from Maine and a conservative Democrat from Nebraska (yes, they don’t just shoot them all there) are basically charging themselves with being “responsible” and scaling it back.
But don't worry, in health care the story remains the same. What are they trying to scale back?
Among the items that the Collins-Nelson initiative is targeting: $1.1 billion for comparative medical research <SNIP>. The medical research measure, aimed at developing uniform treatment protocols, is an Obama priority and part of the foundation he is trying to build for health-care reform
So the most sensible thing in the whole darn package gets cut. But just in case you were worried that we’re just going to cut comparative effectiveness research which any moron every health policy wonk will tell you is something we desperately need more of, here’s something to really make you despair:
And the chamber ended the night by unanimously accepting an additional $6.5 billion for research at the National Institutes of Health, pushing the cost of the Senate legislation — for now — to more than $900 billion.
We already spend nearly $30 billionish on research via NIH, and we spend a bucket of cold spit assessing what actually happens in the real world at AHRQ. And we wonder why we have so many ineffective widely used treatments.
Stalin would never have put up with this!
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