Seems like Lt. Governor Peter Kinder has got his dander up because members of the Obama administration think they have better things to do than respond to his publicity stunt suit challenging the Affordable Care Act. I mean, it’s been four whole month already and the defendants named in the suit, Kathleen Sebelius, Eric Holder, Hilda Solis, and Tim Geither, haven’t yet snapped to it. To be fair, federal rules specify that government employees named in a lawsuit respond within 60 days and it has now been more than two months since Kinder amended his suit in the wake of the Proposition C victory.

It’s got the volatile Kinder all worked up and now he’s stamping his figurative feet by filing a “motion to compel” while huffing and puffing in the press about the slight – which he characterizes as a “further expression of contempt and arrogance against the people of our state.” Comtempt for penny-ante opportunists like Kinder more likely.

Previously: Senator Claire McCaskill (D): town hall in Concordia, Missouri

Senator Claire McCaskill (D) speaking with a constituent immediately after the town hall in Concordia, Missouri.

After yesterday’s town hall in Concordia, Missouri Senator Claire McCaskill briefly took questions from media.

Senator Claire McCaskill (D) (left) with the “second questioner” (center) and “first questioner” (right) at the media availability immediately after the town hall in Concordia.

[….]

Question: Drove down to say hi.

Senator Claire McCaskill: Yes, look at you all the way down here. You must have something controversial [crosstalk] to ask me.

Question: Nah, nah, nah, not at all, not at all, want to hear what people are saying.

Senator Claire McCaskill (D): Yeah, good.

Aide: Go ahead.

Question: First, let me ask, did, how did you vote on Proposition [inaudible].

Senator McCaskill: Uh, I voted no.

Question: You voted no.

Senator McCaskill: Um, hm.

Question: And it was the right vote?

Senator McCaskill: I think it was. Well, uh…

…Question: You like the individual mandate?

Senator McCaskill: Uh, I mean, the mandate obviously is the most unpopular part, but, um, when you ask people if they want to do away with preexisting conditions they say, well of course, that’s so unfair. Well, who’s gonna buy insurance before they’re sick. You can’t do away with preexisting conditions unless you set up an environment where everyone has insurance. The nice thing about this is it’s not gonna be government run, it’s not gonna be government policies. People are gonna be able to shop, make choices. And if they can’t afford it we’re gonna help ’em by making it more affordable with some help from the government. So I think it’s, is it a perfect solution? No. But it’s the best solution I think that anybody’s come up with to an untenable spiral of healthcare costs in this country.

Question: Let me change, que, and he’s got, um, you did get a couple questions that I saw on immigration. [inaudible] a huge issue in Kansas in the Republican primary. Chris Kobach is now the nominee for [Kansas] Secretary of State, I’m sure you’ve heard of his name, Claire. Give me some sense of whether you think immigration is going to, it was a big issue in oh-six, then not so much in oh-eight, now back in ten it looks like a huge issue [crosstalk]…

Senator McCaskill: Well [crosstalk]…

Question: …that people are really worried about.

Senator McCaskill: …I think people want the laws to be enforced. I think it’s just that simple.  And I think we, um, need to make a priority. What I have tried to do since the day I’ve gotten here is be consistent with what I’ve said during the campaign. I’m gonna go to Washington and do everything I can [inaudible] the laws we have in place enforced and to go after employers who knowingly hire [crosstalk]…

Question: Right.

Senator McCaskill: …illegal immigrants.

Question: Which is kind of the Democratic approach.

Senator McCaskill: well, and, I think it’s a republican approach, too, by some people who now realize [crosstalk]…

Question: Their deal is build the wall. And the Arizona law.

Senator McCaskill: Yeah, well, first of all. [crosstalk]

Question: Which you don’t support.

Senator McCaskill: First of all, people aren’t coming across the border for vacation. They’re coming to try and feed their families. If they don’t think that they can get a job, this reminds me of when we were trying to deter crime. We had a hard time deterring meth cooks, but we could deter the businessmen that were selling the ingredients for meth. And that turned the tide. This is the same kind of thing. We can deter businessmen from hiring illegal immigrants if we come down like a load of bricks on ’em.

Question: Better than wall, better than Arizona in your view, I mean you told [crosstalk]…

Senator McCaskill: Better. [crosstalk]

Question: …these folks you’re not a supporter of the Arizona law.

Senator McCaskill: Better. I said parts of it I support, parts of it I don’t support.

Question: But the idea of Arizona taking it on their own is something [crosstalk]…

Senator McCaskill: I think we have to be careful of having fifty different immigration policies in this country…

Question:  Yeah.

Senator McCaskill: …that the federal government ultimately is gonna bear the cost for. But I get their frustration. I think border has to be part of it, that’s why I did the border [crosstalk] security bill…

Question:  Yeah, right.

Senator McCaskill: That’s why I’ve continued to vote for more border security. That’s part of it, but employer enforcement is also part of it. Once we get those two things better handled, uh, then we can maybe talk about something else. But I’m not interested in talking about anything else until we do a better job [crosstalk] on those two subjects.

Question:  Do you think that plays into the, into the, these midterms? [crosstalk]

Senator McCaskill: I don’t know whether it, I [crosstalk]…

Question:  Immigration, I mean is it [crosstalk]…

Senator McCaskill: …don’t know if it plays or not. It just is my opinion [crosstalk].

Question:  Bigger than hea, no, but it, is immigration more important to people now than say health care, Claire? Is, or, or the deficit, uh, because it seems like it comes up. I went to a Moran [Kansas Republican U.S. Senate nominee] town hall, first five questions were on immigration.

Senator McCaskill: Yeah, I think people, um, people are uncertain and, and antsy about the economic conditions right now.  And when you feel uncertain about economic conditions then it, it, it’s more likely that you focus on well, who’s here that shouldn’t be here. Who’s taking part of the pie that doesn’t deserve it, because it feels like my part of the pie is shrinking and I’m playing by the rules. [crosstalk]

Question:  Particularly if their skin color is different?

Senator McCaskill: I don’t know about skin color, because I, I, I, I’m not gonna go there. I, I think this is more about a frustration that I’m playing by the rules, how come everybody else [crosstalk]…

Question:  Yeah.

Senator McCaskill: …doesn’t have to play by the rules?

Question:  All Right.

Senator McCaskill: I think it’s that simple.

Question:  That’s all I need to know. [laughter] [crosstalk]

Question [second questioner]:  Claire, getting back to Prop. C, you talked about the largely symbolic import, but. But what about the political ramifications, including the midterm elections as well as, perhaps, uh, your own reelection campaign in two years?

Senator McCaskill: Well, I’m, look, you know, I’m, I’m not, I’m not deaf, dumb, and blind. I’m sure there, there’ll be some political ramifications. I’m hopeful that as time goes on and people begin to realize the positive things that are in the bill and realize that some of the things they’ve heard are just not true, um, that, that it won’t be as unpopular as it was in the primary election. And, and the split in the primary election was very close to Democrat versus Republican. And, and in that regard it was a fairly unusual election in Missouri ’cause typically in, in primaries we
have a more fifty-fifty split, we certainly usually have a more fifty-fifty split in general elections.

Question [first questioner]:  But, but you had Democrats voting for Prop. C [inaudible].

Senator McCaskill: We had some Republicans voting against it [crosstalk], but…

Question [first questioner]:  Right, but you had lots [crosstalk]…

Senator McCaskill: Absolutely, absolutely. This is an, let me state unequivocally this is an unpopular piece of legislation. Um, but it’s really hard to fix a hard problem in this country, uh, and, and, and make it be really popular, because if it’s really popular it doesn’t generally fix anything.

Question [second questioner]:  The handouts that were left, uh, on the chairs regarding the, the ten myths, I think, that’s so, uh, something that will be distributed at [inaudible] the other meetings today and tomorrow as well? [crosstalk]

Senator McCaskill: We’ve been distributing ’em for a while. We think that may be the easiest way to begin to get people focused that, realize some of the things they’ve heard aren’t true.

Aide: Sorry, we’re on a tight schedule. [crosstalk]

Questioner: Thank you, that’s all I need.

Senator McCaskill: Hey Michael, how are you? Nice to see you.

[….]

Question [first questioner]: ….instead of extending the Bush tax cuts for everyone we let them expire and then give everyone a credit to purchase it or has insurance because you want to incent them to do that. So the net effect is zero on the recipients, those who have insurance. The only people who are not incented are those who don’t have insurance, but they’re not penalized, they just don’t get a tax break.

Senator McCaskill: Well, [crosstalk] the problem is…

Question [first questioner]: And you could do the math really.

Senator McCaskill: …the vast majority of the people who don’t have insurance are not people who enjoyed any benefit under the Bush tax [crosstalk] cuts.

Question [first questioner]: But they don’t pay, yes they did,  as EITC recipients. And so what you do in essence, is say your EITC is gonna shrink unless you use some of that money to buy insurance, in which case your EITC goes back up, you’re made whole and by the way, you now have health insurance.  And it’s a backdoor way of paying for it. [crosstalk]

Senator McCaskill: Well, you know, I’m gonna get you the numbers on it [crosstalk] because they ran ’em.

Question [first questioner]: The math [crosstalk].

Senator McCaskill: They ran ’em [crosstalk].

Question [first questioner]: Well [crosstalk], but you.

Senator McCaskill: And I want you to see the numbers. But, you need to run, clearly, you’re itchin’.

Question [first questioner]: [inaudible]

The “Ten Myths” handout [pdf][Note: This is the online version. The printed version which we received at the town hall had additional information and citations] provided to each person in the audience by Senator McCaskill’s staff:

HEALTHCARE REFORM

TOP 10 MYTHS AND FACTS

Myth 1: The value of your health insurance will be added to your W-2 income and you’ll be taxed on it.

Reality: Most people do not know how much their insurance costs since employers often pay a large share of the premium. The new law requires employers to report the value of insurance on employees’ W-2s, but it is solely informational and is on a separate line that is not included in the taxable income.

Myth 2: When you sell your house you will be required to pay a 3.8% tax on the sales price.

Reality: The new law includes a 3.8% tax on unearned income for individuals who make over $200,000 or couples who make over $250,000. Unearned income includes making a profit on the sale of a home, but a couple can exempt the first $500,000 in profit from such a sale. That means that a couple would have to make over $250,000 per year AND make a PROFIT of over $500,000 on their home to be taxed. The median home sales price in MO is $149,900.

Myth 3: Congress is exempted from the healthcare law.

Reality: Like everyone else, members of congress and their personal staffs are required to maintain minimal essential coverage. Congress and their staff are the only people required by law to buy their insurance on the exchanges.

Myth 4: The exchanges are “Government-run” insurance.

Reality: The exchanges are shopping sites comparable to Expedia™ where private insurance companies like BlueCross sell their insurance. None of the choices will be government-run and individuals are not required to buy their insurance there, but rather can get their insurance through their employer or private broker. The exchanges make sure that state-specific laws are met, and by setting minimum standards they ensure that consumers won’t end up being sold bogus insurance.

Myth 5: Healthcare reform will cut benefits for military families.

Reality: Nothing in this law reduces any benefits to active military members or veterans. The president of the Military Officers Association of America, VADM Norb Ryan Jr. (Ret.), had this to say about the new healthcare law: “But if you were worried that national health reform legislation is somehow aimed at whacking military beneficiaries’ health coverage, that’s just not so.”

Myth 6: This law creates death panels that will order euthanasia for sick patients.

Reality: There are no panels to determine end of life care. The decisions about patient care rest in the hands of the patient and their family as was always the case. This false claim was a scare tactic fabricated by opponents and cannot be found anywhere in this law.

Myth 7: The healthcare reform law cuts Medicare benefits.

Reality: No guaranteed Medicare benefits are cut by this law. An experiment started in 1997 created Medicare Advantage, a privatized form of Medicare, with the hope of saving money. It turns out that the federal government pays 14% more for this private form of Medicare than for government provided Medicare so this new law cuts these subsidies. Seniors will still be able to choose between getting their benefits from traditional Medicare or a Medicare Advantage plan, but the government will stop wasting billions of dollars by overpaying Medicare Advantage plans.

Myth 8: Extends government benefits to illegal aliens

Reality: Not only are government-sponsored benefits like Medicaid not extended to illegal aliens, but they are not even allowed to buy insurance even if they pay for it with their own money. Illegal immigrants cannot receive any benefits under the new law.

Myth 9: There are accounting gimmicks used to give the appearance that the law is paid for.

Reality: The Congressional Budget Office (CBO) is the official “scorekeeper” of Congress and they have determined that this bill is not only paid for, but reduces deficits over the next two decades by a trillion dollars. While CBO adjusted their estimates upward after the bill became law, even with that adjustment the bill is still paid for whether the bill is analyzed over 3, 5, 10 or 20 years, and reduces the long-term deficit. Benefits start immediately including $5 billion for high-risk pools, help for early retirees, and tax credits to small businesses that pay for health insurance.

Myth 10: The government will decide what care you can receive and will ration your care.

Reality: The law funds research to figure out which treatments are the best for curing diseases and makes that information available to your family doctor, but regardless of this research the law specifically states: “Nothing in section 1181 (the section funding research) shall be construed as authorizing the Secretary to deny coverage of items or services under such title solely on the basis of comparative clinical effectiveness research.”. In other words, this law makes sure that doctors and patients have
access to the best information in the world about healthcare options, but leaves those decisions between the doctor and patient.

Transcripts of the audience question and answer portion of the town hall will follow in subsequent posts.

Before the August 3rd primary we received a photocopied flyer on our doorstep in the name of a right wingnut astroturf organization in support of proposition C and in opposition to federal health care reform legislation. Of course, it’s much ado about nothing because of the supremacy clause in the U.S. Constitution, but it does serve republican posturing.

Let’s take a look at the money.

They received some interesting contributions in the days leading up to the election – as reported to the Missouri Ethics Commission:

CONTRIBUTION OF MORE THAN $5,000.00 RECEIVED BY ANY COMMITTEE FROM ANY SINGLE DONOR – TO BE FILED WITHIN 48 HOURS OF RECEIVING THE CONTRIBUTION

C101350 MISSOURIANS FOR HEALTH CARE FREEDOM [pdf] 7/30/2010

Ethelmae Humphreys

Joplin, MO Retired 7/29/2010

$25,000.00

[emphasis added]

CONTRIBUTION OF MORE THAN $5,000.00 RECEIVED BY ANY COMMITTEE FROM ANY SINGLE DONOR – TO BE FILED WITHIN 48 HOURS OF RECEIVING THE CONTRIBUTION

C101350 MISSOURIANS FOR HEALTH CARE FREEDOM [pdf] 7/22/2010

Menlo Smith

St. Louis, MO Sunmark Capitol 7/22/2010

$5,000.00

[emphasis added]

CONTRIBUTION OF MORE THAN $5,000.00 RECEIVED BY ANY COMMITTEE FROM ANY SINGLE DONOR – TO BE FILED WITHIN 48 HOURS OF RECEIVING THE CONTRIBUTION

C101350 MISSOURIANS FOR HEALTH CARE FREEDOM [pdf] 7/21/2010

Mark Andrews

Sanibel, FL Retired 7/21/2010

$10,000.00 [emphasis added]

[emphasis added]

CONTRIBUTION OF MORE THAN $5,000.00 RECEIVED BY ANY COMMITTEE FROM ANY SINGLE DONOR – TO BE FILED WITHIN 48 HOURS OF RECEIVING THE CONTRIBUTION

C101350 MISSOURIANS FOR HEALTH CARE FREEDOM [pdf] 7/19/2010

Fred Sauer

St. Louis, MO Orion Investment Co. 7/19/2010

$5,000.00

[emphasis added]

CONTRIBUTION OF MORE THAN $5,000.00 RECEIVED BY ANY COMMITTEE FROM ANY SINGLE DONOR – TO BE FILED WITHIN 48 HOURS OF RECEIVING THE CONTRIBUTION

C101350 MISSOURIANS FOR HEALTH CARE FREEDOM [pdf]7/19/2010

William Canfield

Kirkwood, MO Retired 7/17/2010

$5,000.00

[emphasis added]

CONTRIBUTION OF MORE THAN $5,000.00 RECEIVED BY ANY COMMITTEE FROM ANY SINGLE DONOR – TO BE FILED WITHIN 48 HOURS OF RECEIVING THE CONTRIBUTION

C101350 MISSOURIANS FOR HEALTH CARE FREEDOM [pdf]6/28/2010

Ray Vincent

Chesterfield, MO US Auto Protection 6/28/2010

$5,000.00

Missourians for Goodman

Mount Vernon, MO 6/28/2010

$5,000.00

Citizens for Brad Lager

Savannah, MO 6/25/2010

$5,000.00

[emphasis added]

Ah, some of the usual suspects.

There were a few interesting contributions in the committee’s “eight day” report filed with the Missouri Ethics Commission on July 24th:

Detailed Summary of Contributions And Loans Received

Committee: MISSOURIANS FOR HEALTH CARE FREEDOM

Report Date: 7/24/2010

Midwest ENT Center PC Saint Peters, MO 7/19/2010 $1,000.00

August Busch III Saint Peters, MO Retired 7/22/2010 $1,000.00

Billy Long For Congress Seminole Springfield, MO 7/22/2010 $100.00

[emphasis added]

Yep, that Billy Long.

The expenditures:

Detailed Summary of Expenditures And Contributions Made

Committe: MISSOURIANS FOR HEALTH CARE FREEDOM

ReportDate: 7/24/2010

Media Placements Kansas City, MO 7/20/2010 yard signs 6300 $3,000.00

Market and Communications Research Kansas City, MO 7/6/2010 campaign management 14192.37 $5,000.00

John Hancock and Assoc Chesterfield, MO 7/9/2010 fundraising 499.55 $499.55

Phelan Design Group Wildwood, MO 7/9/2010 graphic design 1462.5 $1,462.50

Media Placements Kansas City, MO 7/9/2010 yard signs 6300 $3,300.00

Market and Communications Research Kansas City, MO 7/9/2010 online/social media 14192.37 $2,000.00

Market and Communications Research Kansas City, MO 7/16/2010 campaign management 14192.37 $5,000.00

Market and Communications Research Kansas City, MO 7/20/2010 travel reimbursements 14192.37 $2,192.37

CAMPAIGN Date Established:5/21/2010

COMMITTEE: MECID:C101350

MISSOURIANS FOR HEALTH CARE FREEDOM

KANSAS CITY MO 64171

TREASURER: PATRICK TUOHEY

[emphasis added]

Market and Communications Research, Inc.? Any connection [pdf]?

We also received three mail pieces from the Missouri Hospital Association in opposition to proposition C (and yes, they did spend a lot of money, too):

The MHA asks the question that the teabgger opponents to health care reform legislation never seem to want to answer: “Should Missourians who already pay for health insurance also have to pay for those who choose not to pay?”

The best quote about the outcome of the Proposition C vote, given the usual republican turnout in these August primaries: “It’s like expecting Red Sox fans to vote for the Yankees.”

An editorial in today’s St. Louis Post-Dispatch quite sensibly observed that Proposition C was a very poor tool for amplifying the anti-Obamacare message nationally:

The megaphone is muffled when the message is “One in every six registered Missouri voters (71 percent of the 23 percent who turned out) sent a message to Washington.”

On the other side of the state, the Kansas City Star struck the same deflationary note:

…a light turnout made clear what the vote wasn’t: a sweeping referendum on health reform. An electorate seriously riled up about an issue sends more than roughly a fourth of registered voters to the polls.

The silliness of all the conservative celebratory braying is recognized even outside the state. Ezra Klein of the Washington Post put the matter very succinctly:

I’m really not sure why conservatives are so excited that an electorate primarily made of Republican primary voters passed  an anti-individual mandate ballot initiative in Missouri. I don’t even understand why conservatives would be excited if it passed during a normal election. For one thing, states can’t invalidate federal laws. … . Moreover the focus on the individual mandate speaks to how weak the conservative case against the bill is. The individual mandate can be replaced. That wouldn’t be a good thing, but you could substitute automatic enrollment, or some form of lock-out..

All very rational – however, if we were living in a rational political world, there would never have been a proposition C. If you want to gauge the effect of Proposition C in our current political Bizarro World, look no further than the first page of today’s Post Dispatch.

Despite the excellent editorial,  the cover story on Proposition C gave State Senator and Proposition C cheerleader, Jane Cunningham (R-Dist.7), full bragging rights. The reporter evidently felt that bringing up real, verifiable facts like the small turnout was not necessary when he could manufacture a story about how Missouri voters “overwhelmingly rejected a federal mandate to purchase health insurance.” I am afraid that this reporting path will prove to be that most traveled before this is all over.

Nor do we have to wait too long to see just how an orgy of Proposition C triumphalism is going to encourage the crazies to go even further. FiredUp! reported yesterday that State Senator Jim Lembke (R-Dist. 1) is so emboldened by the Prop C victory that he proclaimed his support for having Missouri defy the federal mandate that requires emergency rooms to treat the uninsured – which does, at least, have the virtue that it tells anyone who is interested just how mean-minded Proposition C-loving GOP fringers really are.

It’s almost 11:30 and after looking at today’s election results, it’s clear that what we all knew would happen has happened and Propostion C is winning in the range of 70% to 30%. I promise, I’ll try not to fall into a mad rage every time I hear some wannabe media wise man solemnly talking out of his nether anatomy about what this means for Democratic electoral hopes. I’ve actually got no problem with Tea Party gloating – these fools know as well as I do that they won this one because they’re the biggest part of the tiny fraction that turned out to vote – and they have every right to stick it to us, since we gave it away. Anyway, there’s no way they can be more outrageous and dishonest than they already are.

Of course, there’s always a silver lining – and today it’s the fact that Cynthia Davis went down in her primary, losing to Scott Rupp 45% to his 55%. I’m sure that Rupp is a total ass, but I can’t possibly believe that he could be as offensive as Davis. The only problem with Davis’ defeat is that it means that we lose the most perversely amusing member of the Missouri version of the Insane Clown Posse, also known as our Republican-led state legislature. I’m sure, though, that somehow, someway, she’ll keep right on performing her own special brand of horrorcore in order to change our evil ways –  but not, thank God, in Jefferson City.

Given the lopsided turnout of hysterically aroused Republicans expected tomorrow, Proposition C is generally expected to enjoy a rousing success. Just for laughs, I thought it might be fun to take one last look at the narrative that drives its supporters. To find an example of pro-Proposition C rhetoric I had to go no further than an opinion piece penned by local Tea Party luminary, Carl Beardon, for the St. Louis Beacon. If you are interested in what is probably an exercise in futility, follow me over the fold:

Beardon wastes no time, but jumps in and goes after the entire Patient Protection and Affordable Care Act (PPACA) with his metaphorical guns blazing:

“A “yes” vote on Proposition C — the Health Care Freedom Act — will tell the nation that Missourians have looked at this expensive, ill-conceived and unhealthy measure and rejected it.

“Unhealthy” – get the joke? A real pistol that Beardon. True, it is likely that a majority of the small fraction of eligible voters who are expected to hit the polls tomorrow may think the characterization sums the PPACA up. But given the reams of disinformation still churning out, one wonders how many have an accurate idea about what it does or doesn’t do? Or, to ask a more basic question, how many are capable of clearing their ideological closets sufficiently to find room for fact-based analysis? Certainly, Beardon completely undermines the implication that he has committed any acts of close analysis when he declares that he opposes the PPACA because:

… the government, rather than patients and their doctors would determine the level of care to be provided.

With this statement Beardon’s right up there in the realm of the mythical death panels, sprinkling pure Tea Party fairy dust. If you really want some fun, ask a Tea Partier to tell you how this terrifying government control works – based on the legislation itself, and not on the usual Rube Goldberg chain of hearsay hypotheticals and illogical inferences that they seem so ready to believe.

But enough of what supporters of Proposition C don’t know. What they really, really, think they know is that:

… there is more at stake than health care. The ballot initiative also represents a referendum on state sovereignty. … . It’s a mandate on individuals and states that goes beyond proscribed [sic] federal powers.

You’d think the fact that nobody actually takes Proposotion C seriously in this respect ought to deflate just a little of the oh-so-righteous self-importance that is so palpable in such declarations. Unless of course, the St. Louis Beacon is right, and these folks don’t understand that “a Missouri referendum cannot repeal the federal health care law.”

It gets even worse, though, when Beardon tries to get all fiscally responsible about mandates:

… employer-paid programs would be mandated, which will lead to job losses, wage cuts, loss of employer plans and accompanying choice of doctors or higher prices. All of which threaten the still struggling economy.

Of course, he offers no support for this assertion and, in fact, ignores the countless arguments, based on actual analysis by real economists who think that the PPACA has a fair chance of doing just the opposite.

At the end of his little op-ed, Beardon gets to what I suspect really drives the Tea Party love affair with Proposition C – pure spleen, the desire to put on a great big temper tantrum after last summer’s hissy fits failed to put finis to health care reform.  “Admittedly,” Beardon writes,  “part of Prop C is symbolic,” and one might add, clearly intended to put the fear of the Tea Party into legislators.  But most of all, it will be a kick in the pants aimed at Chris Koster, who wouldn’t let Missourians play with all the other kids who are filing lawsuits against the the PPACA:

Perhaps most important, Prop C would send a strong message to Missouri Attorney General Chris Koster, whose record so far on the federal health-care package has been disappointing.

Some people never grow up – too bad the rest of us so often have to bear the consequences of their foolish behavior.

Conventional wisdom has it that, given the unbalanced turnout that is expected next Tuesday, the Missouri effort to weaken health care reform, Proposition C, will prevail. A comment on my earlier post about the Missouri Hospital Association’s anti-Proposition C campaign noted that when it passes it “will not be pretty …, especially on Fox and hate radio.” Well, I’m here to tell you that the triumphalism has already gotten bizarre.

The St. Louis Beacon reports that State Senator Jane Cunningham believes that Proposition C is divinely ordained since its assured passage just goes to show that God “interferes in the affairs of men.” According to Cunningham, God doesn’t want all Missourians to have equal access to health care.

What I want Cunningham to ask God next time she and he get together for coffee is why he’s so worried about requiring individuals to take responsibility for their health care? She and the people she represents affirmed, after all, that they want a private rather than a public health care delivery system; did they do so only because they thought that they could push the cost of their emergency room visits onto the rest of us, helping to push health costs ever upward, and sending deficits spiraling?

Cunningham seems to imply that God opposes the individual mandate because it limits “personal freedom,” and requires people to spend money. But God doesn’t seem to be at all worried about mandates for the purchase of auto insurance. Nor does he seem to be worried about requirements for building standards, food safety measures, disabled access and a whole slew of “mandates” that have associated costs, but which make our country a decent place to live.

Cunningham and her pals also seem to think that God is all lathered up about “state’s rights” – which leads me to ask why he didn’t intervene more forcefully when that issue was settled at the conclusion of the American Civil War. Somehow, I find it hard to believe that a supposedly all-powerful God really gets too worked up about weak constitutional arguments.

All this leaves me with just one question.  If it isn’t God who’s working to deliver a victory for the Proposition C forces, who could it be?  Could it have anything to do with that force darker forces that manifest as apathy, stupidity and cupidity?  I don’t know about you, but that’s not exactly what I describe as divine intervention.

Last Friday Tony Messenger of the St. Louis Post-Dispatch observed that one of the reasons that Proposition C, the Missouri tenthers’ effort to sabotage the health care reform bill, is likely to pass is that there is no organized opposition. But on the other side Proposition C proponents are getting their act together. Organizations like Missourians for Health Care Freedom are mobilizing for the final push. A grim situation all around.

So you can imagine my surprise today when I received a big, glossy mailer from the Missouri Hospital Association (MHA) asking folks who might be inclined to vote for Prop C to get their facts straight. The particular fact that the MHA chose to emphasize in the mailer ought to have some resonance with those greedy and fearful little hobgoblins on the right who are so afraid that a poor person (or, horror of horrors, a poor black person) might get some of their hard-earned dollars:

But by law, Missouri’s hospitals must provide medical care in their emergency departments to anyone who is uninsured – even if they can afford health insurance. Hospitals must cover the cost of that care by charging more to patients who do have insurance.

So the question is: Should Missourians who already pay for health insurance also have to pay for those who choose not to pay?

If you think it’s acceptable that some who can afford insurance get a free ride, vote yes on Proposition C. If you think that’s unfair, you should vote no

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There’s more on the MHA Website, a factsheet and a statement from the MHA President and CEO, Herb B. Kuhn, explaining why the MHA has decided to join the fight against Proposition C in such a prominent way:

The MHA Board of Trustees endorsed a voter education campaign on Proposition C because, regardless of the feelings about federal reform, Proposition C could have very real – and negative – implications for  hospitals

Negative implications like upsetting the balance of Medicare and Medicaid payments – according to Kuhn, Missouri hospitals would stand to lose somewhere in the vicinity of 500 million dollars over ten years if the individual mandate were to be revoked.  He adds:

Much will be said during the next few weeks about the individual mandate and the notion of “individual freedom.” That is a powerful and persuasive argument. There is, however, another side of the story, and that’s the notion of “fairness.” Fairness to make sure Missouri’s hard-earned Medicare and Medicaid dollars stay in the state and fairness in sharing in the cost of health coverage for all.

Many argue that since Proposition C is patently unconstitutional – it clearly conflicts with the Supremacy Clause – it can be safely ignored. Don’t think, though, that a constitutional showdown will be quick, inexpensive or pretty. If the proposition were ever allowed to go into effect, Mr. Kuhn’s statement is potent testimony to some of the potentially disastrous financial impacts. At the very least, a Proposition C victory will be used as a rallying cry to revitalize the war on the President and his health care agenda.  In this environment, the MHA’s willingness to stand on the frontline and oppose this piece of pernicious political theater with a dose of reality is more than welcome and they deserve our appreciation.