Edwards Refuses to Negotiate -- With Insurance Companies

The Los Angeles Times covers a medical case they portray as extremely complex and difficult -- one where doctors and an insurance company were forced to decide whether to provide a liver transplant to a leukemia-stricken 17 year old girl. The expensive procedure had a fair chance of extending the girl's life for at least 6 months, but there were no guarantees.

Cigna ultimately reversed their initial decision and elected to cover the procedure, but by the time the approval letter reached the family, they had taken their daughter off of life support:

Doctors treating Nataline told the family and Cigna in a letter that patients in similar situations have a 65% chance of living six months if they receive a liver transplant. Doctors had qualified Nataline for a transplant Dec. 6 and a liver became available four days later, the family said. But the transplant was not performed because Cigna had refused to approve and pay for the procedure, they said.

Cigna turned down the transplant, calling the procedure experimental because it was not supported by enough medical literature as safe or effective in such cases. The family's benefit plan does not cover experimental treatments. But this week, after receiving an appeal from the family and UCLA doctors, the company reconsidered.

Arlys Stadum, a Cigna spokeswoman, said the insurer submits all transplant requests to physicians with transplant expertise for review. Every request that is refused has been seen by at least one expert physician, she said.

In explaining the reversal, she said, "It was really just looking at how complex the decision was..."

"We are making this decision on a one-time basis, based on the unusual circumstances of this matter, although the treatment, if provided, would be outside the scope of the plan's coverage and despite lack of medical evidence regarding the effectiveness of such treatment," Garnsey wrote.

Dr. John Roberts, chief of the transplant service at UC San Francisco, said Cigna faced a difficult decision in the case, based on the facts presented by the UCLA team.

Roberts said his center generally will not accept a patient without a 50% chance of living five years. According to UCLA's letter to Cigna, patients like Nataline had a 65% chance of living six months.

"The problem that they got into is, here's a situation where she didn't have very long to live," he said. "Probably in this situation, they're probably better off to say, 'The transplant center really feels like this is the right thing to do, let them go ahead.' "

The standard of care for this particular situation is "going to be pretty hard to know," Roberts added. "I think it's a very difficult decision for both the transplant center and the insurance company."

This sounds like a terrible case. As a parent, there's no doubt that I would want for my daughter any procedure that might save or extend her life. I'd protest, blog, call my Congressman, go to the news -- do whatever it took to try to get the necessary treatment for my child.

By the same token, no medical system can afford to provide every conceivable procedure to ever needy patient. At some point, caregivers need to assess the chance of success, the risks, the cost of a given procedure, and decide when a given procedure simply doesn't have enough of a chance of success to warrant providing it. This is the way it is in the real world.

But that's not the way it is in John Edwards' world. When John Edwards is President, it seems that any patient will be entitled to any procedure he or she wants. And Edwards won't 'negotiate' with the people who try to control cost and keep the system solvent. It seems he'll rule by fiat:

Nataline Sarkysian died last night at UCLA Medical Center after complications arose from a bone marrow transplant to treat her leukemia. Her insurance provider, CIGNA Healthcare, first denied the potentially lifesaving transplant, but relented after a loud public protest and outrage. By that time, though, Sarkysian passed away before the procedure could be performed.

"Are you telling me that we're gonna sit at a table and negotiate with those people?" asked a visibly angered Edwards, challenging the health care companies. "We're gonna take their power away and we're not gonna have this kind of problem again."

Edwards also told the audience of about a hundred people at the Score Pavillion in Nevada, Iowa, that it will take a fighter (i.e. him) - and not a negotiator (ii.e. Obama) - to take on large insurance companies like CIGNA.

We've all heard horror stories from Britain, Canada, Japan, or some other wealthy nation with national health care. Experience shows pretty clearly that single-payer systems have plenty of flaws -- with health care rationing high on the list. As the Cato Institute explained it:

Wherever national health insurance has been tried, rationing by waiting is pervasive, putting patients at risk and keeping them in pain. Single-payer systems tend to leave rationing choices up to local bureaucracies that, for example, fill hospital beds with chronic patients, while acute patients wait for care. Access to health care in single-payer systems is far from equitable; in fact, it often correlates with income—with rich and well-connected citizens jumping the queue for treatment. Democratic political pressures (i.e., the need for votes) dictate the redistribution of health care dollars from the few to the many. In particular, the elderly, racial minorities, and those in rural areas are discriminated against when it comes to expensive treatments. And patients in countries with national health insurance usually have less access to critical medical procedures, modern medical technology, and lifesaving drugs than patients in the United States.

Far from being accidental byproducts of government-run health care systems that could be solved with the right reforms, these are the natural and inevitable consequences of placing the market for health care under the control of politicians.

It makes intuitive sense that many decisions about care for people near death will be difficult and painful. Regardless of whether it's the insurance company or the taxpayer paying the bill, at some point a decision needs to made as to when to cease curative therapies. Leave it to an ambulance-chasing shuyster like John Edwards to claim that it will suddenly be easy.

A final comment: the LA Times article mentions that one of the reasons the case attracted so much attention is that the family turned to a DailyKos contributor to help publicize it. (I have no argument with that; as I mention, I too would do whatever it took.) Any surprise that Edwards is attentively reading DailyKos?

Silky Maybe, But Definitely Not Fluffy

Heh, heh:

Ben & Jerry's co-founder Ben Cohen is surprisingly on-message. The activist businessman, who launched a group dedicated to redirecting federal government spending away from the Pentagon and toward health care, education and other domestic priorities, is backing John Edwards' presidential campaign.

After a news conference today in which a part of that organization, Caucus for Priorities, announced its backing of Edwards, Cohen pontificated on the possibilities his association with the candidate brought up. He denied there were plans for an Edwards-inspired ice cream flavor, even though, as one reporter pointed out, erstwhile presidential hopeful Stephen Colbert enjoys a concoction bearing his name.

Pressed on what an Edwards flavor might be, Cohen stuck to message. "It's not going to be a very fluffy flavor," he predicted. "It's going to be a very solid flavor..."

That's right. When I think 'Edwards;' I think 'tough guy -- hard as nails.' After all, it takes a tough man to look this pretty:

Edwards' Sleazy and Offensive Ad

Just disgusting:



Hat Tip: Dave Weigel, who says:

"And Elizabeth and I decided in the quiet of a hospital room." Subtle. "After 12 hours of tests and after getting very bad news." Even subtler. His wife has cancer. "We're not going to quietly go away. Instead we're going to go out there and fight for what it is we believe."

You know, Mitt Romney's wife has multiple sclerosis. Obviously that's not going to shorten her life the way Elizabeth Edwards' cancer will shorten hers. But it's the kind of thing that could stir up sympathy and handkerchief-clutching out there in Iowa and New Hampshire, and the Romneys only ever talk about it when asked. There's no TV ad pimping her illness. If Romney has no emotions, than Edwards has only the basest ones. There's not enough Lysol on the eastern seaboard to scrub his slime away.

When I think of those I love, and how their lives have been touched by illness and tragedy, I wonder how I would feel if I were a candidate for office and tried to use the pain of others to win sympathy and votes. I don't think I'd sleep well at night.

Unions Will Spend More in 08 than Ever Before

Democrats frequently complain that there is too much money in politics, and that 'special interests' in Washington have undue influence. It seems that Senators Edwards and Obama in particular, have complained that Ms. Clinton is bought and paid for.

But if big money in political campaigns is bad, Democrats should be training their fire on America's labor unions, who have promised to spend more on the 2008 election than they ever have before:

The AFL-CIO, the largest labor federation in the country, last month predicted that its 55-member unions will spend over $200 million in the 2008 campaign, a sum that includes both funds for grass-roots mobilization efforts and contributions directly to candidates through PACs, according to spokesman Steve Smith. The AFL-CIO itself has pledged a budget of $53 million for spending on mobilization for the election, up from $50 million in 2004. It is the federation’s largest election budget ever...

Electoral success doesn’t come cheap, however, and the labor movement appears set to spend more than it ever has before to boost its chosen candidates. That spending is directed to three separate outlets. Under federal election law, unions are prohibited from donating directly to candidates, but can spend unlimited funds from the union treasury to communicate with their own members. These funds are generally derived from member dues. Unions thus spend heavily to mobilize their own members to support labor-friendly candidates.

That is what the AFL-CIO has in mind when it comes to the $53 million it will be spending in 2008. According to Smith, the funds will go toward “a prolonged campaign that moves from issues education to engagement to mobilization to finally get-out-the-vote efforts in late stages of the campaign.”

With more than 10 million workers in unions affiliated with the AFL-CIO, including high concentrations in battleground states such as Michigan, Pennsylvania, Ohio and Wisconsin, effective mobilization efforts could have a pivotal effect in both the Congressional and presidential races.

Unions also can form political action committees and raise funds from their members via voluntary donations. Those PACs can then donate to candidates of their choice...

In the House races, 40 candidates have already received more than $100,000 in union contributions, the vast majority of whom are members facing challenges in what CQ has deemed “races to watch.” Members of the Democratic leadership, notably Speaker Nancy Pelosi and Majority Leader Steny H. Hoyer also received sizable contributions.

On the Senate side, two candidates have received more than $100,000 in labor donations — Democrats Sen. Tim Johnson of South Dakota and Mark Udall , who is running for the open seat in Colorado.

Among presidential contenders, Clinton leads the way with more than $48,000 in labor PAC contributions, followed by New Mexico Governor Bill Richardson, D, with $38,000. Two other Democrats who are union favorites — Edwards and Illinois Sen. Barack Obama — do not accept money from PACs.

The sum of contributions made from union PACs has grown steadily in the last ten years, despite the fact that the number of PACs themselves has declined. In the 1996 election cycle, such PACs made $57.6 million in donations to federal candidates. In 2004, that number reached $68 million. PACs affiliated with organized labor donated more than any other single industry sector in the last presidential election cycle.

John Edwards has spoken at length about the corrupting influence of money in politics, and how there are Two Americas because some can buy access and some cannot. He seems to be rather close to labor unions -- who obviously fall into that first category. Since Senators Obama and Edwards have renounced contributions from labor PACs, perhaps they'd be willing to go the whole nine yards and refuse all contributions from labor unions and leaders. Who knows -- maybe they'd start a trend.

Hillary Clinton: Wimp, Victim

Mickey Kaus has more on Senator Clinton's attempt to play the victim card:

It's never attractive for a frontrunner, male or female, to complain about "rough treatment," especially if it comes in the form of mere questioning--and Russert's illegal-license question was standard fare. Adding an implicit gender charge to the Hillary response didn't make it any better. (By attempting to get away with something--complaining--that male pols can't get away with, she arguably made it worse: a claim of special privilege.) ... In other words, Hillary's damned if she does complain. But she's not damned if she doesn't complain. Indeed, not complaining seems like an easy way to project toughness without being seen as "harsh and shrill."

Barack Obama has criticized Hillary effectively on this point:

In an interview with NBC, Obama scoffed at the New York Democrat's complaint that she was being forced to "compete in the all-boys club" of presidential politics, saying he would never use his race -- Obama is black -- to shield him from political attacks.

Obama's comments marked the first time that the undercurrent of identity politics has become an issue of open contention between the two trailblazing candidates.

"I am assuming and I hope that Sen. Clinton wants to be treated like everybody else," Obama said on the "Today" show.

Referring to debates where he has come under attack, Obama said, "I didn't come out and say, 'Look, I'm being hit on because I look different from the rest of the folks on the stage.' "

He could have been more pointed, but it's something.

Edwards' campaign has prepared a very effective ad:



As has the RNC:



And what is the immediate result of all this? Hillary has gained 5 points. I think that's likely to change, but we'll have to watch and see.

John Edwards: Draft Hypocrisy?

Why not? He's already a hypocrite on global warming.

Boosting Your Self-Esteem

Even if you haven't got all that much going for you, you're probably brighter than John Edwards.

Still not convinced?

Edwards' Foreign Policy: Hope for the Best

Read it over at the Standard.

John Kerry: Permanent Adolescent

There's an amusing vignette in Bob Shrum's recent book, which demonstrates how challenging it was to try to win the White House with a self-important stiff for a candidate. Read it over here (subscription required):

THE SCRAPBOOK has taken a few swipes over the years at Robert "0-for-8" Shrum, the singularly unsuccessful Democratic campaign strategist, who worked for such legendary losers as McGovern '72, Kennedy '80, and Kerry '04. To be fair, it's hard to see anyone winning with some of the candidates he's been saddled with. Consider this anecdote from Shrum's dishy new book, No Excuses:

At an evening house party [in Iowa, January 2004], [Peter Yarrow] was performing "Puff the Magic Dragon" when Kerry, standing in the back of the room, mimed puffing on a joint. Most of the people there didn't see it--and neither did I; I'd retreated back to the bus to make some calls. When [press aide David] Wade stepped onto the bus and sat down next to me, he was beside himself as he recounted what had just happened. As we drove away, Kerry denied it. Wade said it was on tape. Kerry responded that, well, it was just a joke. Wade went to the back of the bus. We were lucky, he reported when he returned. It was late Saturday night, the camera crews didn't all have it, and most of the network imbeds didn't think it was a big deal. We were told later that a CBS crew got the tape to Washington in time for Face the Nation, but that Bob Schieffer's reaction was, Not on my program.

Of special note here is Kerry's adolescent denial until the aide says his pantomime was caught on tape. Plus we like CBS's news judgment; probably helps explain why Face the Nation blows away its rivals in the ratings each Sunday.

It's stunning that some saw Kerry as the more mature and cerebral candidate. While George Bush was lampooned as only one step removed from the frat, it seems that Kerry never left.

And with regard to Shrum, you get a sense as to just how badly he must want to win a campaign. In 2004 the ticket was headed up by a candidate with... significant shortcomings, and the veep candidate (by his characterization) was a lightweight who callously exploited the tragic death of his child.

You've got to be pretty hard up to stick with that team.

Update: Welcome HotAir readers. While you're here, check out the video of Cindy Sheehan's announcement that she's running for Congress.

Elizabeth Edwards Front and Center

There is something deeply disturbing about seeing the apparently terminal illness of the wife of a Presidential candidate so prominently featured. It used to be that such an affliction was considered to be a deeply private and personal matter. I cannot help but feel that we've lost something when it becomes a focal point of a political campaign -- as this piece in the Wall Street Journal matter-of-factly reports it to be:

Mr. Edwards's strategists planned to make her a central feature of the campaign, believing both Democrats and Republicans could identify with her experiences, including a dead child, breast cancer, infertility, weight-loss struggles, aging parents, mother to both adult and young children, childhood of moving constantly as a Navy brat. "Elizabeth would be the A-number-one top surrogate for John," says Jonathan Prince, deputy campaign manager.

Then in March, she broke a rib while playing with her young son and getting a hug from her husband. She visited a doctor and discovered something that could be cancer on her X-rays. The next day, Mr. Edwards went with his wife for complete body scans. The cancer had metastasized. The couple faced the media on March 22 and explained that they would continue.

Behind the scenes, campaign staffers were thrilled at the surge in interest and Mrs. Edwards's "high likeability," but worried that "too much exposure could cause a backlash," according to one adviser. Mrs. Edwards wanted to be open about the cancer recurrence but didn't want to give specific details on her treatment or prognosis. "'Let's follow Elizabeth as she goes through her cancer' would be almost exploitive," she told them.

'Almost' exploitive? 'Following Elizabeth Edwards through her cancer' would be clearly and obviously exploitive. After all, why else would you call it 'following her around,' instead of something non-exploitive like 'answering questions and downplaying.' The only question is whether -- her denials notwithstanding -- that's what we've got. It sure looks a lot like it.

This article examines Elizabeth Edwards medical treatments, prognosis, hopes for the future, and her plans for her loved ones after her death. Beyond the macabre nature of inviting the national media to dissect it with you, this will clearly have the effect of making some people far more sympathetic to her husband's campaign. The only question is whether any of those folks turned off by it -- like myself -- would ever have backed Edwards in the first place.

A sample of what the Edwards family shared with the Journal:

Between campaign stops and monitoring political blogs, she is working on a "dying letter" to her three children -- a "guide to life" she started before her diagnosis but which takes on more poignancy now. Her advice runs from balancing work and family to telling her children they should always wear solids instead of stripes or plaid -- otherwise, she warns, you'll look back at old photos and cringe at what you're wearing. She is sorting out her and her children's possessions -- clothes, papers, photographs -- and boxing them to save after her death...

In boxes spread over a basketball court in the gym on their Chapel Hill estate, Mrs. Edwards is dividing clothes from each of her children into what should be kept and what can be given away. Otherwise, "John would just throw all this out," Mrs. Edwards says. She especially wants the family to keep the Halloween costumes she made for each of her four children.

When she finds Wade's baseball cards, she presents them to Jack. A few minutes later, she hears Jack and Emma Claire fighting over them. "I want something of Wade's too," her nine-year-old daughter cries. "You're right," Mrs. Edwards tells her, dividing the cards.

Mrs. Edwards is clearly brave, and one can only admire her work ethic. I think it's also important that as we face life and death, each of us must follow his or her own heart in deciding how to face mortality. That obviously extends to Mrs. Edwards. I join many in praying for a long and happy life for her.

But I don't want this glimpse inside her illness. And I can't see a good reason for the Edwardses to cooperate in a piece like this one at this time. Since they've decided not to exploit the illness, should they not have been pleased that coverage of her cancer had largely disappeared from the front pages -- allowing them to deal with it privately and within the family?

John Edwards $400 (Discount) Hair Cuts

Rob has the story, and video:

Beverly Hills hairstylist Joseph Torrenueva is the man behind the scissors, and $400 isn’t the most he’s charged Edwards for a cut. During the 2004 campaign, Edwards once paid $1,250 for a haircut and on two other occasions spent $500. He also paid for Torrenueva’s travel expenses because he needed to fly to Atlanta, Washington and Cincinnati to service his client.

I can't believe Edwards can get his hair in order in just 2 minutes. I usually block out at least a half hour.

John Edwards & the Rise in C-Sections

Was talking to a friend the other day who was curious about the rise in C-sections in Northern Virginia. I told him he just ought to thank John Edwards. This issue got a fair amount of attention a few years ago, and this isn't a bad time to bring it up:

Medical malpractice was his specialty, and he reportedly tried more than 60 such cases, winning more than $1 million in over half of those. Most involved Ob/gyns. Indeed, he was so feared, according to the Center for Public Integrity, "that doctors would settle cases for millions of dollars rather than face him at trial."

Edwards' specialty was cerebral palsy, a set of permanent conditions affecting control of movement and posture that usually appear at toddler stage. There is no cure, although stem cell studies in both humans (umbilical cord cells) and rats (neural cells) have produced promising results. More than 10,000 U.S. children are diagnosed with it yearly. Edwards claimed the disease developed because negligent doctors ignored fetal heart monitors indicating the child might not be getting enough air during birth and thus failed to deliver it immediately through cesarean surgery.

The rise in C-sections isn't limited to my region (around Washington D.C.) ABC news recently reported that it's up 40 percent nationwide:

The World Health Organization has said the ideal rate for c-sections would be about 15 percent of all births. But in this country, final figures for 2004 — the last year for which data is available — show the national rate is nearly 30 percent of all births.

American women have more c-sections than women in the United Kingdom, Canada and many European countries.

So what gives? Why are so many women having c-sections instead of delivering their babies the old fashioned way? It turns out the answer is very complicated. There is no one single reason behind the rising numbers.

No one single reason, but litigation is right up there:

And, for doctors, the threat of lawsuits also comes into play. Obstetricians are among the most vulnerable to litigation if something goes wrong in the delivery room. Choosing to perform a c-section, in some cases, can help reduce the possibility of being sued.

"They're never faulted for doing a c-section," said Faith Frieden, chief of obstetrics and gynecology at Englewood Hospital and Medical Center in New Jersey. "It's never the wrong decision to do a c-section. No one's ever going to say to them, 'why were you so quick to do the cesarean section?'

"Usually what happens is, if anything goes wrong, then they're questioned later on, 'wouldn't it have been better if you did the cesarean section a little sooner?' 'Why didn't you do the c-section?' 'Wouldn't that have been the easiest way to deliver this baby — the less traumatic way to deliver this baby?'" Frieden explained.

Well, so long as the procedure is elected to reduce the risks to mother and child, right? Wrong:

...And while the number of women and infants who die during childbirth is very small, studies have found that mothers and babies are more likely to die during or after a cesarean delivery. That may be, in part, due to the condition in which the mother enters the operating room, but it is a sobering statistic, nonetheless.

"I think we're engaged in a great big uncontrolled experiment as to what happens when cesarean section rates rise," said Plante.

As a public health issue, many doctors worry that it is costing the health care system — and, therefore, all of us — more money to have so many women delivering by c-section and staying in the hospital for longer recoveries. Some say it is an unnecessary drain on resources.

The article excerpted above -- by Michael Fumento -- goes further than ABC is willing to:

Now here's the horrible kicker: A Swedish report released in December found that emergency cesarean delivery increased the odds of cerebral palsy by a statistically significant 80 percent. It's bad for the mother, too. Another 2006 study, in the journal Obstetrics & Gynecology, found that moms with cesareans had more than three-and-a-half times the chance of dying shortly after childbirth than those who had vaginal delivery.

"Some of the increased risks for the mother include possible infection of the uterus and nearby pelvic organs; increased bleeding; blood clots in the legs, pelvic organs and sometimes the lungs, says the March of Dimes. Further, cesarean birth "is more painful, is more expensive, and takes longer to recover from than a vaginal birth," says the group.

It's reprehensible that John Edwards made a fortune encouraging a procedure that seems to be overused, and likely to increase risks. He could at least show some shame.

Roll Call Considers Hillary's Reverse Coattails

Roll Call ($) considers the impact that the leading Democratic presidential contenders might have on down-ballot races. This is an important question, because the Democrats are now very heavily exposed in GOP-leaning Congressional districts. Democrats currently represent 61 House seats that Bush won in 2004; 47 are in seats that Bush won twice. By contrast, Republicans represent only 8 seats won by Kerry.

So it's important that Democrats nominate a candidate who won't drive up the turnout in GOP-leaning seats. That's a problem when your choices are Hillary, Edwards and Obama:

“Having her at the top of the ticket is just as polarizing as [President] Bush at the top of the ticket, even though the electorate right now is looking for a less polarizing figure,” Florida-based Democratic consultant Dave Beattie said.

Beattie said he believes Clinton can be elected president but if she competes in and wins largely the same states that Sen. John Kerry (D-Mass.) did in 2004, she could have an adverse impact downballot on Democratic Members and candidates in states that aren’t competitive on the presidential level.

“I think that the problem with Hillary is there is a caricature of Hillary Clinton among conservative voters. Her campaign is about countering that caricature,” Beattie said. “But where the caricature is strongest, where it’s going to hurt the most, they’re going to be doing the least to counter it...”

Rep. Earl Pomeroy (D-N.D.), who has won re-election since 1992 in a state that overwhelmingly favors the GOP in presidential elections, spoke very favorably of Clinton and noted that Republicans were attacking her awfully hard for someone they say they would prefer to run against.

“It’s way too early to conclude that Hillary would be a disaster downballot for the party,” said Pomeroy, who is still mulling a 2008 endorsement...

“It’s a huge motivator for our base,” said one GOP operative. “Keep in mind where we need to win. We need to regain Republican territory and in those particular districts our base is larger than theirs is.”

Not surprisingly, backers of Obama and Edwards seem to agree.

Rep. Artur Davis (D-Ala.), an early supporter of Obama and also the recruitment chairman at the DCCC, said vulnerable Members in Southern states have expressed private concerns about the top of the ticket.

“They think Barack Obama would be stronger in their district than Hillary Clinton would be,” Davis said, asserting that the Illinois Senator has the broadest appeal, while Clinton’s strength is with rank-and-file Democrats.

Edwards, meanwhile, is campaigning on electability and vowing to expand the 2008 battleground into Southern territory...

Still, while the one-term Senator from North Carolina might appear on paper to have the best-selling assets in conservative states, his campaign has focused on liberal and populist themes that put him to the left of his two major rivals. He has renounced his vote in favor of authorizing the Iraq War and said he doesn’t believe there is a global war on terror — not a message that resonates well with the conservative Southern electorate.

“Edwards has the best demographic profile in the general election, but he will end up having the least sellable ideological profile in the general election,” noted one GOP consultant...

Rep. Lincoln Davis (D-Tenn.), who has not endorsed any of the candidates, put it this way: “I’d a whole lot rather have to defend Hillary Clinton than George Bush in my district.”

Still, he’s holding out hope that former Vice President Al Gore, a Tennessee native, eventually will enter the race.

Congressman Davis is laboring under a misimpression. Republican candidates won't be defending him. They will be drawing distinctions.

There are no apt analogies in recent memory to this election year -- no year when the incumbent president's party nominated someone with no link to the sitting president. But think about 1992 and 2000, when the two parties nominated vice presidents. Even in those years, the election was primarily about the nominee -- not the incumbent. In 1976, Gerald Ford almost won -- even though he was Nixon's Vice President, and was tarred with Watergate and Vietnam. No -- the GOP won't be 'defending Bush' -- at least not in the way Davis means.

Apart from that, Hillary and Edwards -- who is the furthest left of the top tier Democratic candidates -- will be a GOP dream for driving up turnout. In the charged atmosphere of a presidential election year, either will drive up GOP turnout.

And while Obama is extremely liberal himself, his manner -- and the fact that he is African American -- make it harder for me to guess whether he'll be different in that respect.

Electing an Outsider in 2008

The confidence rating for Congress is about as low as it's ever been. Americans view Congress as out of touch, resistant to change, and unwilling to tackle important issues. There's no confidence that Iraq will end well, and little chance that:

• Congress will take action on immigration, energy, entitlement reform, and ethics; AND,
• The American people will view those challenges as 'solved' in a meaningful way.
  

Unless things change dramatically in 16 months, the American electorate will be awfully restive come election day. They are likely to want significant change in Washington.

Now consider the candidates. Who's best situated to take advantage of that?

OUTSIDERS:

Michael Bloomberg: Bloomberg fits the bill. While a lifelong liberal, he hasn't been a (registered) Democrat in a while. He governed a Democratic city as a nominal Republican. He is seen as having solved big problems and gotten Republicans and Democrats to work together. He'll run as an Independent. Credentials on 'independence' and 'change?' Best in the field.

Barack Obama: As an African-American, he clearly is somewhat different. Plus, his style and manner seem a 'breath of fresh air.' He'd be more credible than some in talking about 'changing the tone' in Washington. Still, his record on the issues is that of an old-line Kennedy liberal. The GOP nominee would have fun contrasting the rhetoric and the substance.

Rudy Giuliani: Not shockingly, his profile is similar to Bloomberg's. His record is that of a problem solver (crime, budget, welfare, and the economy in NYC) who can bring Republicans and Democrats together. His high-profile unwillingness to shift on abortion enhances his credibility. The only knock on his outsider status is that he actually has been a defender of the Bush administration.

Fred Thompson: Outsider credentials? He's an actor; he served just one full Senate term and then showed no desire to return to elective office; and he sounds like the no-nonsense, maverick outsider (a persona that's heavily reinforced in his acting roles). Weaknesses? He will be painted as a DC lawyer/lobbyist, and there's more than some truth to the characterization. Can he promise to get Republicans and Democrats to work together? Perhaps not -- but he will probably strive to be the fed-up outsider who promises to shake things up -- and he might be the strongest in the field in that respect.

MIXED RECORD:

John Edwards: He hasn't served in office for several years, and his 'two Americas' message has a strong and inherent outsider flavor. His criticisms of Democrats in DC help him as well. Undercutting the outsider image is that he's been running for President since 2003 or so.

John McCain: Has spent a lifetime in Washington, fighting the establishment. Outsider credentials? Mixed. Bipartisan credentials are excellent, due to McCain-Feingold and McCain-Kennedy. Those bipartisan credits also seem likely to prove fatal to his candidacy.

Mitt Romney: Pretty good outsider/change credentials. He is not of Washington; he solved problems in Massachusetts (health care), and he certainly worked with Democrats -- plus he's the closest thing to an 'Iraq critic' now in the GOP field. His achilles heel is the perception that he has dramatically changed position to get in line with GOP orthodoxy.

THE INSTITUTION:

Hillary Clinton: Outsider credentials? She's a woman. That counts for something, but apart from that she's the closest thing to a Washington institution in this race. Can she promise to 'change the tone,' or 'get Republicans and Democrats to work together?' Not a chance in hell. Plus, after 20 straight years of Bushes and Clintons, she's the only one in the field that offers more of the same. If she wins the nomination and the electorate wants change, she could get trounced in the general election -- particularly if Bloomberg runs.

Am I missing anything? It seems to me that if voters want change in DC -- and they will -- then the candidates best positioned to take advantage are Bloomberg, Obama, Giuliani and Thompson. This doesn't mean of course, that these are the best candidates overall -- they all have plenty of other strengths and weaknesses. But in a general election, 'outsider/change' credentials are likely to be a big boost.

Kerry's Doubts About Edwards

This was previewed some days ago:

Kerry talked with several potential picks, including Gephardt and Edwards. He was comfortable after his conversations with Gephardt, but even queasier about Edwards after they met. Edwards had told Kerry he was going to share a story with him that he'd never told anyone else—that after his son Wade had been killed, he climbed onto the slab at the funeral home, laid there and hugged his body, and promised that he'd do all he could to make life better for people, to live up to Wade's ideals of service. Kerry was stunned, not moved, because, as he told me later, Edwards had recounted the same exact story to him, almost in the exact same words, a year or two before—and with the same preface, that he'd never shared the memory with anyone else. Kerry said he found it chilling, and he decided he couldn't pick Edwards unless he met with him again.

Certainly Edwards would dispute this, and even according to this excerpt from Shrum's book, Kerry and Edwards no longer speak. In case of 'he said/she said' such as this, who knows the truth?

The piece also leaves us with a weird 'he said/she said' on the question of whether John McCain wanted to serve as Kerry's running mate:

One option, the one that would have sealed the election, was off the table. John McCain's political strategist John Weaver had talked earlier with Cahill and said he needed to see Kerry about McCain. According to Kerry, when he met with Weaver and Cahill, Weaver said McCain was serious about the possibility of teaming up with him. Kerry had then sounded out McCain, who rejected the idea.

This is consistent with the account that Kerry offered two months ago: that he was approached by Weaver. Was Weaver acting on McCain's behalf? Was he acting as a free agent, and McCain reined him in? All we know is that this version is very different from the account around the time that Edwards was selected -- which had Kerry repeatedly asking McCain to take the spot.

If nothing else, McCain seems to have moved past the controversy.

Will Edwards Answer the Tough Questions?

The Politico notes that some of his supporters really need him to address... his hair:

Edwards Second Life Vandals Identified

Surprise, they're not Republicans. They're liberals. (Content warning at that site, relevant text below):

The attackers have been identified — and they’re alive and gloating.

“Guess what: we’re not Republicans. In fact, I’m one of the most hard-core liberals I know.”

A post on the John Edwards blog claimed credit for an attack on his campaign HQ in Second Life — saying that “We simply did it for the lulz… The fact you were so bent out of shape to make a blog post on the OFFICIAL JOHN EDWARDS BLOG about how some people placed a bunch of ******************* on your lawn is mighty telling.”

The post was deleted from Edwards blog. (Its last line was “Enjoy your AIDS!”) But the poster used the name Mudkips Acronym, which also turns up in a January entry on Encyclopedia Dramatica, identifying him as a member of a longstanding Second Life “invasion group.” Its name is given as “Patriotic Ni****: e-terrorists at large,” and Saturday the entry was updated to claim credit for the Edwards attack.

This would make the Edwards attack just the latest installment in a longer history of random assaults. The page describes the group’s first attacks as griefing pranks on Second Life’s “Gay Yiffy” virtual nightclub — blocking the exit doors on a disco’s private rooms, and filling its dance floor with an annoyingly large box. They returned to build a wall with a swastika of American flags, and eventually acquired a “Doomsday” weapon that creates endlessly replicating cubes.

This blog post does link to YouTube videos of some of the previous 'attacks' by this groups. If they post a video of the attack on Edwards' campaign HQ, I'll try to link it.

Stop Picking on My Little Pony!

Wow - Second Life is getting some tremendous free advertising. Last week we learned it was the place to go if you wanted to experience a virtual terrorist attack with nuclear weapons. Now we see it's the place to go to see John Edwards' campaign headquarters vandalized by anarchists or conservatives - depending on your conspiracy theory.

From the Edwards campaign blog:

Shortly before midnight (CST) on Monday, February 26, a group of republican Second Life users, some sporting "Bush '08" tags, vandalized the John Edwards Second Life HQ. They plastered the area with Marxist/Lenninist posters and slogans, a feces spewing obsenity, and a photoshopped picture of John in blackface, all the while harrassing visitors with right-wing nonsense and obsenity-laden abuse of Democrats in general and John in particular.

I witnessed this event, taking names and photos, including the owners of the pictures. I also kept and saved a copy of the chat log. I have filed an abuse report with Linden Labs, and am awaiting their investigation.

Yeah - I'm with you. I wish Marcotte was still the blogger, too. It would have had a lot more flair.

John Brownlee at Wired offers this comment:

This is the modern-day equivalent of hippies freaking out the squares. You see countless news stories about this, over and over again: the gray humorless drones of political parties or corporations rushing to establish a presence in Second Life because it's the thing to do, only to find themselves staring directly into the collective Goatse.cx of the Internet's soul.

The alternate reality that is Second Life offers a great haven for Democrats by the way. Given their discomfort with the world as it is - with George Bush as President, and troops in Iraq, and all the rest - maybe they can make a home in Second Life. Over there, John Kerry can be President and John Edwards can succeed him. I bet Dennis Kucinich is already President in part of Second Life.

Heck, maybe they can even make Al Gore President over there as well; I bet his virtual home over there in Flatland wouldn't use near as much energy as the one in our plane of existence.

They just need to be willing to swallow the Red Pill...

Hat Tip: Glenn