The Myth of the Free Market in Health Care

Dear Group,

Nationally we stagger, punch-drunk from issue to issue, taxes, DACA, tariffs, MeToo. The list goes on. We need to come back to this: Cathy McMorris Rodgers and “movement conservative” ideology is plain wrong and out of touch on many things, but nowhere are they more wrong than in the application of their ideology to health care in this country. On February 21 I sent out the email I’ve copied below.  I present it again today to remind us how unpopular McMorris Rodgers’ efforts to repeal the Affordable Care Act were and still should be. This issue should be front and center on our way to November.

CMR’s Ideology and the Myth of Free Market Health Care

Here in these United States we spend more than $10,000 per year on health care on average for every man, woman and child. Canada and the United Kingdom each spend per capita less than half that per person. In spite of spending less than half as much per person than we do, health outcomes in Canada and the United Kingdom are better than ours. Yes, in Canada you might have to wait, but in Canada people with diabetes have access to treatment. They don’t have to make a choice between getting treatment and feeding their families. They don’t have to neglect their disease for fear of bankruptcy, go blind, and wind up on the Canadian equivalent of Social Security Disability.

While Cathy McMorris Rodgers remains in office this WILL NOT CHANGE. Why is that? It is because McMorris Rodgers has drunk the Republican/Libertarian Kool-Aid. Contained in that Kool-Aid is the absolute conviction that the free market solves all problems and that all government social programs are inefficient and foster dependence.

Facts that don’t fit her mind frame of Libertarian ideology bounce off–if they reach her at all. At a “Coffee With Cathy” in April of 2017 I brought up the Canadian experience. Her response was pure Republican/Libertarian framing: She asserted that Canadians come down to the United States in droves to get procedures done in the United States on account of endless waits and rationing.

Spokane is a major medical center close to the Canadian border. I told Ms. McMorris Rodgers I practiced for 28 years doing ocular surgery, quite a lot of it urgent and emergent. I told her that in those 28 years I operated on just one Canadian patient. I told her that I have many Canadian friends, and that all of them speak well of the Canadian health system. There was a brief blank stare in response, a tiny gap before she pivoted to another angle. Was that the moment my reality bounced off her frame? I’ll never know. 

Did McMorris Rodgers carry this inconvenient fact with her as a result of our meeting? No. On May 4, 2017, she enthusiastically voted for and cheerled the American Health Care Act, the AHCA, aka Trumpcare. There was nothing in that bill that was aimed at reducing the per capita cost of health care or even a glimmer of recognition that other countries have great health care systems that cost half of what we spend. Instead, the AHCA would have moved us further away from national systems.

The Republican House AHCA…proposed major reforms relative to current law (ACA) that would substantially reduce the number of persons covered, moderately lower the budget deficit over a decade, reverse the tax increases on the top 5% (mainly the top 1%), dramatically cut Medicaid payments (25-35%) that benefit lower-income persons, and expand choice by allowing lower quality insurance to be purchased at lower prices for the young and middle-aged.  Wikipedia

Notice the earmarks of Libertarian ideology. McMorris Rodger’s AHCA cut taxes on the rich (a basic tenet of her faith), lowered total government expenditures over a decade (which she later enthusiastically gave to corporations and the already wealthy by voting for and cheerleading the Tax Scam Law), and cut money out of a social program, Medicaid (another of her fundamental tenets of faith). Would it lower the per capita cost of health care? NO! It pretended to lower cost by expanding “choice” (a fundamental talking point), in this case, the “choice” was to buy inadequate insurance and expose oneself to medical bankruptcy. 

Oh, yes, there is one McMorris Rodgers talking point about lowering the actual cost of care. What is it? “Encouraging competition by increasing transparency.” Really? The patient is going to lower the per capita cost of health care in the system by shopping around for the cheapest lab test or MRI? That isn’t just unrealistic, it is absurd. A very few patients equipped to critically evaluate quality and willing to spend the time might bargain for the best deal in this market, but that is a tiny minority. You won’t find Trump or Charles Koch bargaining for a cut rate MRI. They’ll hire the best physician they can find to get the best MRI…and damn the cost. The folks with the least time (working two minimum wage jobs) and in the most dire circumstances (presenting with a neglected and now acute problem) certainly are NOT going to “shop around”. What make-believe planet do these free market true believers live on?

McMorris Rodgers’ slavish devotion to free market ideology blinds her to reality. The unfettered, unregulated free market is the bedrock tenet of the “Republican cause,” the cause for which she hones the sales pitch. Health care in this country is ridiculously expensive because it is not and never will be a “free” market. No amount of pontification by Paul Ryan, McMorris Rodgers and the Freedom Caucus will make it so. Pretending that free market principles will lower cost in a for-profit environment is a delusion from which McMorris Rodgers is incapable of recovering. 

Our country’s problem with health care cost will not be solved while McMorris Rodgers is in office. Her ideological frame prevents her from understanding. Send her home.

Keep to the high ground,


The ADA, What HR620 says of our Rep and the Republican Party

Dear Group,

The Americans with Disabilities Act was passed and signed into law by a Republican, George H.W. Bush, in 1990. It passed the Senate 76-8. It passed the House on a voice vote, a voice vote in a chamber with 250 Democrats and a 183 Republicans. It wasn’t even controversial enough to have a roll call vote! 

Last Thursday the House passed HR 620, the ADA Education and Reform Act of 2017, and sent it to the Senate. It passed 225 to 192. It is a short bill. You can read its text here. It is superficially innocuous, a mere technical fix, but that is deceiving. Even McMorris Rodgers recognized this. She actually voted “Nay” on final passage of H.R. 620, one of the few times she has voted against the “conservative cause.” 

She even issued a statement: “The ADA was enacted more than 25 years ago to protect the disability community, and as part of that community, I could not in good conscience vote for this bill,” she said in a statement.

McMorris Rodgers voting against a Republican bill was so notable it got a quarter page article in the Northwest Section of the Spokesman on Friday! In the paper version it was titled “McMorris Rodgers breaks with GOP on disability vote.” McMorris Rodgers is quoted, “While I can appreciate and understand the intent to provide fairness to businesses, any changes should preserve the spirit of the ADA and reduce the burden on individuals with disabilities to bring legitimate compliance claims,”

I am pleased with McMorris Rodgers’ statements and vote. Her family is, indeed, part of “the disability community.” Her “Nay” vote on H.R. 620 was politically painless. The bill, part of the “conservative cause” she ordinarily supports, passed easily. I don’t wish to sound snarky, but I might like her voting record better if she had family members who were a part of other at-risk groups. The following three paragraphs are from

In the re-authorization of the Violence Against Women Act, Congresswoman Cathy McMorris Rodgers [R-Wash] supported the version of this bill that excludes Lesbians, Native Americans, and immigrant women from protection.  Cathy McMorris Rodgers stated that those women are “a side issue”.   Spokane County’s own sheriff, Ozzie Knezovich, a Republican, has stated “My concern is that the safety nets are rapidly being stripped away with funding.  As safety nets slip away, it will increase the number of calls, and number of violent calls we respond to.”

Second, Cathy McMorris Rodgers voted against the Lilly Ledbetter act, which is aimed at protecting women from pay inequalities in the workplace.

Third, through the sequestration process McMorris-Rodgers voted with her party leadership to cut funding for birth control for low income women.  This is likely to result in thousands of unwanted pregnancies.

I want a Representative who recognizes and supports all solid social programs no matter the composition of her family.

Keep to the high ground,


P.S. Extraneous detail on H.R. 620 voting:

McMorris Rodgers was joined in her “Nay” vote by Dave Reichert, “The Sheriff,” the Republican Rep from WA CD-8 who is stepping down this year (Dino Rossi is running to replace him). I applaud Reichert’s vote. Not running again apparently frees him from Republican orthodoxy.

Rep. Jaime Herrera Beutler, [R-WA-CD3], a protege of McMorris Rodgers, not only voted “Yea” on H.R. 620 but co-sponsored it. Dan Newhouse [R-WA-CD4] joined Buetler with a “Yea” vote. All other WA Reps are Democrats and voted “Nay”. 

There was some party crossover. Twelve Democrats voted for the bill, nineteen Republicans voted against it. Eight Democrats and five Republicans did not cast votes. 

CMR–Who is she really?

Dear Group,

So who is Cathy McMorris Rodgers really? What is her background? Well, here it is. It speaks volumes. 

Most of what follows is based on her Wikipedia article and an article on her life that appeared in the Spokesman in 2004. Cathy McMorris was born May 22, 1969 in Salem, Oregon. In 1974 when Cathy was five her parents and young brother moved to an off-grid farm in Hazleton (pop. 305), British Columbia, not far from Alaska. She was taught in a two-room schoolhouse. Just seven years later when Cathy was twelve they moved again, this time to Quesnel, B.C. (pop. 10,000) 350 miles SE, so her father could take a job as the principal of a private Christian school. That lasted three years. 

Cathy was a fifteen year old high school junior in 1984 when they moved to an orchard near Kettle Falls where she worked at the family’s fruit stand. Cathy and her brother attended the Columbia River Christian Academy, a school established in 1973 by people looking for a way to school their children in their brand of Christian worldview. Her father taught the younger grades at the same school. He served as chairman of the Stevens County Republican Party. They attended a “non-denominational evangelical Christian church”. 

Ms McMorris went off to the “Pensacola Christian College” in Florida. The wikipedia article notes that at the time she attended the College it was not accredited. It is identified as an “Independent Baptist liberal arts college.” The Independent Baptist churches are also referred to as Independent Fundamental Baptist or IFB. A Pew Research Center 2014 survey found that members of Independent Baptist churches comprised a mere 2.5% of the adult U.S. population. The Pensacola Christian College was finally accredited in 2013 by the Transnational Association of Christian Colleges and Schools. Ms. McMorris graduated in 1990 with a degree identified as Pre-law.

I invite you to the Wikipedia article on the Pensacola Christian College to comprehend the narrowness of the experience. This is NOT a place where a student is exposed to wide ranging ideas. 

In 1990 Ms McMorris went straight from college to managing the campaign of Bob Morton in his run for the Washington House of Representatives from the 7th Legislative District. When he was elected and then took office in 1991 she became his legislative assistant. When Morton was appointed to the LD7 Senate seat, Ms. McMorris was appointed to fill the LD7 Rep seat that Morton had held. Ms. McMorris was all of twenty five years old at the time. 

During her time in Olympia she pursued an “Executive MBA” from the University of WA starting in 1993 and graduating in 2002. According to Wikipedia: “Executive MBA (EMBA) programs developed to meet the educational needs of managers and executives, allowing students to earn an MBA (or another business-related graduate degree) in two years or less while working full-time.” 

Serving for LD7 she never faced serious opposition for her State Rep seat. George Nethercutt gave McMorris the nod in 2004 when he vacated the U.S. House CD5 seat to run for Senate, a race he lost. She bested Don Barbieri that year for the seat, winning with nearly 60% of the vote. Peter Goldmark in 2006 whittled her down to 56.5%, the lowest percentage with which she has won in a general election. 

I will save her U.S. Congressional career for another column. 

If, as George Layoff points out in “Don’t Think of an Elephant”, people develop frames around issues that cause facts to bounce off, Cathy McMorris Rodgers’ frame, based on her education and upbringing, must be particularly impervious. She has been steeped in Independent Fundamental Baptist Christianity. From a fundamentalist childhood and education she shot directly into politics. There was no pause to examine her place in the world. Her frame provides rigid certainty with no need to consider other points of view. Empathy, the ability to imagine oneself in another’s shoes, is not likely to be her long suit.

It is not my intent to paint Ms. McMorris Rodgers as evil. She does not go to the mirror every morning and ask herself, “What nasty, awful thing should I work on today.” She does, however, go to that mirror with the mind frame of absolute certainty conditioned by the narrowest of narrow religious upbringings, carefully shielded even from broader Christian thought. She goes to that mirror having spent her entire adult life in politics in Olympia or D.C. and with almost no broader life experience. 

We need a Representative with a broader understanding of the world and how it works.

Keep to the high ground,


Nigel Farage in Spokane?

Dear Group, 

During the Affordable Care Act/American Health Care Act debate I wrote of being invited to attend a forum hosted by “Cathy McMorris Rodgers’ staff”. While it was true that Traci Couture, CMR’s District Director, was there, the featured “physician”/speaker was Dr. Roger Stark, a member of the Washington Policy Center. We were all admonished repeatedly to speak into the microphones so Chris Cargill, the Eastern Washington Office Director of WPC, could record our opinions, presumably for later analysis. When Dr. Stark asked for a show of hands of the attendees who were in favor of a single payer system, all attendees raised a hand. I realized this was not really a forum, but a “constituent biopsy”, an effort to gauge the arguments of the opposition. 

That experience made it clear to me that the Washington Policy Center functions as Cathy McMorris Rodgers’ brain. As such, it bears watching, which, thanks to the internet, is not all that difficult. You can go right to their website or you can explore WPC’s links to the Koch brother’s donor group, their links to the American Legislative Exchange Council, and their misinformation on climate and the environment, for example, here

Legislators like Cathy McMorris Rodgers have neither the time nor the money to read widely and form their own opinions, especially if they are not exactly intellectual giants to begin with. Most legislators simply must depend on the framing and “facts” fed them from well-funded institutions like the WPC. 

It is worth your while fix the term Washington Policy Center in your memory. Learn the names of some of the talking heads on their staff. Once you do you will notice how often they get quoted and the influence they wield. 

It is with that background that I noted the ad I posted above. Just think, prominent donors and Republican supporters in little ‘ol Spokane can attend this Gala Dinner at the Davenport for a mere $150 or sponsor 20 people with a contribution of $15,000. For your donation you’d get a chance to listen to a speech by Nigel Farage, “Briton of the Year”, former leader of the far right UK Independence Party, prominent anti-immigrant spokesperson, engineer of Brexit and friend of Steve Bannon. (There was a rumor that Betsy DeVos was coming to Spokane. I cannot confirm that, but she IS noted somewhere on the WPC website.) 

Put September 27th on our calendar. It would be a good evening to take a walk…with a sign. More later.

Keep to the high ground,



Constituent Biopsy by the Washington Policy Center fbo CMR

Dear Group,

“Constituent Briefing” Turned Gauging Meeting, Constituent Biopsy

Yesterday I attended a “constituent briefing” to which I was invited by an email from Cathy McMorris Rodgers’ office.  It was limited to thirty participants.  About fifteen appeared.  Traci Couture, CMR’s head of staff, officiated, but it was really a meeting held by the Washington Policy Center, the Koch donor network funded non-profit “think tank”.  They were represented by Dr. Roger Stark, who did much of the talking, and Chris Cargill, who said not a word but sat dourly in a corner behind his Washington Policy Center stickered computer, probably recording the event.  The second spokesperson was Megan Perez, CMR’s Legislative Director and Healthcare Policy Advisor who has worked “on the hill” for seven years for a variety of Congresspeople.  I heard no mention of Alison White with Better Health Together, although she was advertised in the invitation.

A handout was provided with all the usual Republican talking points about freedom, choice, and the “failed” Affordable Care Act. Dr. Stark and Ms. Perez each made very brief presentations and then the floor was opened to questions and comments. They got the earful I’m sure they were counting on. When Dr. Stark asked for a show of hands of those who were in favor of a single payer system, every hand shot up. We had been carefully chosen…

I left feeling used. I and others suspect this meeting will be used to craft the Republican defense of their abominable AHCA. This was what some describe as a “gauging meeting”. The image I have is of Frank Luntz, the genius of Republican framing and messaging, carefully choosing the right buzzwords to prescribe for the Republican propaganda machine.  

How much Cathy McMorris Rodgers functions as a mouthpiece for the policies of the Koch-funded Washington Policy Center and the mega-wealthy Libertarian Koch donors seemed glaringly obvious. 

Cathy McMorris Rodgers, of course, was nowhere in evidence. We were told she was “meeting with constituents mostly in the southern part of the district”. Clearly, she isn’t holding town halls. Traci gamely encouraged everyone to sign up for a “Coffee with Cathy”. 

Keep to the high ground,