Post Politics Hour

Shailagh Murray
Washington Post National Political Reporter
Monday, September 17, 2007; 11:00 AM

Don't want to miss out on the latest in politics? Start each day with The Post Politics Hour. Join in each weekday morning at 11 a.m. as a member of The Washington Post's team of White House and Congressional reporters answers questions about the latest in buzz in Washington and The Post's coverage of political news.

Washington Post national political reporter Shailagh Murray was online Monday, Sept. 17 at 11 a.m. ET.

The transcript follows.

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Shailagh Murray: Morning, everyone -- thanks for joining today. Let's hear your thoughts about the big news today: a new attorney general, whom Chuck Schumer actually likes; presidential health care politics; the war debate in Congress; and whatever else.


Boulder, Colo.: According to the president in his recent address to the nation, the U.S. was "invited" to make a permanent commitment in Iraq. Who invited us, when did they invite us, and what was the exact wording?

Shailagh Murray: I missed that one too.


MoveOn contributor, Md.: It seems most of (educated) America is comfortable these days admitting that our leaders betrayed us by misleading the public throughout our involvement in Vietnam. Now our leaders are dishing out objectively demonstrable falsehoods on Iraq, and John McCain says we have to leave the country. Is it just not okay to point these things out while they're actually happening?

Shailagh Murray: Lots of people are making this point, including the organization you support. Certainly the Democratic outrage seems to grow each day. Whether it makes a difference is another issue. Not much evidence of Bush bending to critics on the war.


Rolla, Mo.: Is Sen. Webb's approach one way to get around the issue of ending the war through direct funding cuts? I ask because the Dems are in a fix, the American public wants the war to end, but they are against the seemingly only option the Dems have, cutting funding.

Shailagh Murray: Democrats, and not a few Republicans, believe Webb's approach is an effective way to limit the U.S. role in Iraq, in a way that benefits American troops, rather than potentially harms them through a funding cutoff. In particular, it directly addresses a big area of concern for Republicans from large military states, namely the war's toll on troops and their families.


Columbus, Ohio: There are rumors that Ohio Gov. Strickland might be picked by Hillary as a vice presidential partner, if she wins the Democratic nomination. Do you see this happening? Why or why not?

Shailagh Murray: I wrote an item about this for the Sunday Fix a few months back. Strickland is a highly popular governor from a hugely important state and would be on any Democratic nominee's short list for VP. He's said he's not interested, but don't they all?


Princeton, N.J.: Why can't people understand that a single-payer health care system is simply much more efficient than what we have? Forget the immorality of the uninsured, forget the competitive disadvantage of our business community -- other countries get much better health care at much lower cost. The evidence is overwhelming. We can't afford our current mess. We need Medicare for all. Is this a failure of democracy?

Shailagh Murray: Back in another century, I covered health care policy for the Wall Street Journal, and I couldn't believe the complexities. You have huge corporate, political and labor interests, all with their own perfect solutions. Another thing I realized was that none of the other models out there, i.e. in Western Europe, are perfect fits for the U.S., which is much bigger and more diverse, both socially and economically.

That said, if a Democrat wins next year, it will be interesting to see him/her attempt to deliver on some very big promises now on the table (at least from Edwards, Clinton and Obama).


Washington: To the best of your knowledge, have any of the candidates addressed how to solve the supply side issue of health care, specifically how we are going to find doctors to care for the 40 million-plus that (presumably) will have some kind of health insurance in the future? I see lots of rhetoric about making sure that everybody has insurance, but nothing about how to find doctors for everyone. Most of my own MDs rarely or never accept on new patients -- who's going to take care of the newly insured? This seems to be a big unknown.

Shailagh Murray: This goes to my last point -- it's not just about insurance coverage. I know all you liberals and trial lawyers out there groan when a Republican says "tort reform," but this is exactly why the GOP-led Congress tried so many times to change medical malpractice laws -- and why many states already have.


Arlington, Va.: I hear John McCain is Baptist now! Will that help him in South Carolina? Didn't they not like him there last time? Is it like that saying that "there are no atheists in foxholes" -- there are no non-born-agains in Republican primaries?

Shailagh Murray: You know, I saw that and I thought it was from The Onion.


Boston: Okay, Mighty Fred Thompson is already on vacation after a rigorous one-week campaign. Add his need for regular rest with last week's malapropisms and obvious lack of knowledge on the most basic issues, and it is pretty apparent the GOP has found the true heir to the George W. Bush legacy.

Shailagh Murray: A new twist on the "Lazy Thompson" story. But I don't care how long you can sit in front of a TV, no successful White House candidate wins without killing himself.


Re: Strickland for VP: Strickland was one of the most conservative Democrats when he was a Congressman. The NRA supported him over a GOP rival one election. I seriously doubt that he will be a VP nominee. I don't see anyone without a "former" in front of their title getting the nod, simply because the Democrats won't want to take anyone in office out of office if they don't have to...

Shailagh Murray: You raise some good points. I'm just repeating what I'm hearing, which is that several campaigns already have taken notice of Strickland, and there's some buzz out there. I disagree with the idea that his conservative slant makes him less appealing. I think it makes him more appealing -- especially given how far left the candidates have had to lean on the war, and now health care.


Prescott, Ariz.: What makes a bigger splash today, Clinton's health care plan, with its interesting idea of a public-private institute to evaluate drugs, treatment and devices for effectiveness, or Edward proposal to cut off health care to Congress and all political appointees (himself included) until they devise a plan that covers everyone?

Shailagh Murray: That's a tough call. Edwards certainly is turning the volume up to "11" (for you Spinal Tap fans) with his health care threat. Just another reason why Democratic members of Congress growl when you mention his name.


Arlington, Va.: Hi, Shailagh. Where does the McCain campaign stand now, especially in view of last week's heavy focus on the war? Analysis: Another Entry, But Still a Jumbled GOP Race (Post, Sept. 16)

Shailagh Murray: Let's see in a couple of weeks how much money McCain has raised. I have a hard time believing that the voter base McCain is speaking to is digging deep to put him back in the game.


Margate, N.J.: Re: Health Care, I appreciate your insights regarding the complexity of the issue. Nevertheless, I think it's highly significant that we're the only highly industrialized democracy in the world without universal health care of some sort, nor do I think it a coincidence that we lag behind our peers on life-span expectancy and infant mortality. I was sharply reminded yesterday that at least some members of our medical profession remain willfully blind about this pressing concern. I'm delighted that all the Democratic candidates are committed to addressing the issue.

Shailagh Murray: I think our society is a little more complex than, say, Belgium's or Italy's. Access to health care, I would bet, is just one reason that we lag in infant mortality and life expectancy. In fact, our health care system for poor people -- Medicaid and SCHIP -- isn't that different from what lower-income Europeans would receive.


Re: Princeton, N.J.: Any plan that simply moves more people into private insurance is a subsidy to those companies that will take in more premiums and thus make more profit. It's also a subsidy to their advertising agencies and lobbyists, because the insurance industry spends billions on marketing and lobbying. Why should our health care dollars go for advertising and lobbyists?

Shailagh Murray: You are right, cost containment is not getting much attention.


Re: Washington: About finding doctors for the uninsured, wouldn't part of it mean shifting their care from emergency rooms to primary care? Didn't Bush basically say the same thing, that the uninsured get care, they just go to the emergency rooms? Short term it may be a problem but is that problem worse than the current situation?

Shailagh Murray: Part of the challenge is that a whole bunch of issues more or less have to be addressed at the same time: access, cost, coverage. It's got to be the toughest nut to crack in politics.


Re: Health Care Debate: I think we saw in the '90s what "cost containment" entailed with HMOs and "denial care." For all that we rail about socialized medicine, and not to belabor the point, but England's health care system spends less than 1 percent of total costs on administration/bureaucracy, whereas private companies spend 10 percent to 15 percent. The debate shouldn't begin with how to cut costs, but what we as a nation want out of our system. Can we hold our noses at socialized medicine, or do we want to pay people seven-figure salaries to tell us we have to get pre-approval before breaking our legs?

Shailagh Murray: I'm going to post some of these health care comments to give a flavor of what I'm hearing from all of you...


More on supply side of health care: It is not just a shortage of doctors -- there is a huge shortage of nurses. Plus we need to find a way to shift the health-care delivery paradigm to make more and better use of nurse practitioners, physicians assistants and midwives to provide wellness and prevention care as well as some specialized services.

Shailagh Murray: My mother is a nurse, so I am pro-nurse. In fact, she was a public health nurse when I was a kid in Charlottesville, Va., and I would drive with her up into the mountains to visit folks who lived in dirt-floor shacks -- new mothers, diabetics, men with black lung disease, etc. She'd make sure they were taking their medications, feeding their kids properly, that kind of thing. There aren't many public health nurses any more, and that's part of the problem.


Washington: After the Clinton campaign has denied that Norman Hsu was a well-known contributor and activist, it now turns out there are reports that he paid for junkets to Las Vegas for four Clinton staffers. Are these people just lying about Hsu from start to finish?

Shailagh Murray: Vegas on a donor's dime ... hmmm. I think we can all agree that's a bad idea.


Prescott, Ariz.: The lack of doctors isn't because of malpractice laws, it is because there are the same number of medical school acceptances as in the 1970s.

Shailagh Murray: Another perspective on the doctors shortage. My MD claims that everyone is going to dental school now because it's so much more profitable.


Malpractice Costs are not the issue: Hi, Shailagh ... the Congressional Budget Office disagrees with you about the costs of malpractice, to wit: "The nonpartisan Congressional Budget Office finds that the costs associated with malpractice -- buying insurance and paying out damage awards -- amounts to less than two percent of America's skyrocketing healthcare expenses. 'Even a reduction of 25 percent to 30 percent in malpractice costs would lower healthcare costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small,' the CBO determined." Limiting Tort Liability for Medical Malpractice (Congressional Budget Office, Jan. 8, 2004)

Shailagh Murray: Did everyone catch that ... "disagrees with you..."

I don't remember arguing my personal opinion, just offering the opinion that about half the population, the Republican half, shares.


Princeton, N.J.: You say "in fact, our health care system for poor people, Medicaid and SCHIP, isn't that different from what lower-income Europeans would receive." It's obvious you have not tried to deal with the Medicaid and SCHIP bureaucracy. What percentage of eligible children are covered under SCHIP? And that's under the old rules, not Bush's new rules.

Shailagh Murray: Have you ever lived in Europe? I have -- and I had two kids there, with private insurance. I stand by my statement, both in terms of access and quality of care.


Arlington, Va.: I am surprised at how often I see the pro-war propaganda commercials on TV. Somebody must have some really deep pockets to afford all that air time. I read somewhere that Ari Fleischer is behind them. Do we know where the money is coming from? Is the Pentagon funding this organization? Why do you suppose there are no antiwar counter commercials? A list of major donors can be seen here: Left, Right Proxies Push on Iraq (Post, Aug. 23)

Shailagh Murray: Am I the only one who finds it rather depressing that the two sides of the war debate are now battling each other through advertisements? The war has become the health care debate ... polarized and intractable.

And more to come this week!

So stay tuned. Thanks to all of you for joining in.


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