Last week I noted that all appearances were showing that the Republican Party was on the verge of losing one of its most loyal constituencies -- doctors, and more specifically the American Medical Association -- as a result of GOP efforts in the United States Senate to filibuster a measure that would avert a more than 10 percent cut in Medicare payments. Just how big of a supporter has the AMA been for Republicans in years past? Prior to this cycle, the AMA gave 67 percent, 76 percent, 60 percent, 53 percent, 70 percent, and 76 percent of their contributions to GOP candidates during the 2006, 2004, 2002, 2000, 1998 and 1996 cycles, respectively. Overall, during the period of Republican control over Congress, the AMA gave more than two-thirds of its $15 million in contributions to Republican candidates.

Yet despite the prospect that it is the GOP appears of the verge of losing the support of the doctors -- at a time, I might add, when it looks like the party will slip even further out of contention for majorities in either chamber of Congress, with losses of 20 or more seats possibly on the horizon in the House and half a dozen or more in the Senate to boot -- The Hill seems to think it's the AMA that should be worried.  Here's Jeffrey Young's article under the heading "Docs risking ire of GOP on Medicare".

Lobbying groups representing physicians have been taking a noticeably partisan tack in their fight to protect their Medicare fees, siding with Democrats and risking a backlash from Republicans in the process.

Trade groups tend to be wary of favoring one party, since politicians have long memories and today's minority could be tomorrow's majority.

But sometimes interest groups find themselves in a position where they have to risk future comeuppance for present gain.

"It's a calculated risk that's made," said a lobbyist who has worked to pass the Medicare bill. "It certainly can come full circle and bite you on the butt in the end," the lobbyist said. "We'll see what happens in future years."

Young gets a few things backwards here. First, doctors aren't beholden to the GOP. They aren't required to take it on the chin from a party they have long supported -- particularly when the hit is coming because the Republicans are putting insurance companies, another constituency that has helped fund the GOP over the years, over the doctors. The Republicans made a calculation: They thought they could completely contravene the sentiments of their backers and get away with it scot-free. Turns out they can't. Shocking, I know. But that's politics.

The other thing Young misses is that the Republicans will have a decreasing ability to get back at the AMA. Young talks about the long memory that legislators have -- but it's going to have to be awfully long to make much of a difference here. As noted above, the likelihood is that the Republicans will have significantly fewer seats in the House come January and somewhere at or just slightly above 40 seats in the Senate. With these types of numbers, there just isn't a huge amount of wrath that the party can inflict on anyone. What's more, looking ahead to the 2010 cycle -- one in which Republicans must defend more seats than the Democrats, including potentially endangered seats in Florida, Ohio, Pennsylvania, New Hampshire, Missouri, Kentucky (Jim Bunning), Kansas (Sam Brownback retiring), Louisiana (David Vitter), and even Arizona (John McCain), as well as others -- the prospects aren't great for the GOP being able to do much to get back at the doctors.

As far as I'm concerned, Republicans should continue to piss of their key constituencies. Their voting base is already unenthusiastic this year, so why not add their financial base, too?

Throughout the entirety of the current Congress, Republicans have adhered to a strict obstruction whenever possible regimen in the hopes of thwarting any and all progressive change. While by and large the media have given the GOP a pass on the subject (save for a few stories here and there from McClatchy or The Washington Post), it was bound to be the case that the GOP's tactics would come back to bite them at some point.  

According to Congressional Quarterly (subscription required), for instance, the American Medical Association, a group that has overwhelmingly backed Republicans in the past (giving at least 61 percent of their contributions to GOP candidates since 1990), is now not only withdrawing support from Republicans but is going so far as running ads against endangered GOP Senators up for reelection this fall on the topic of harsh cuts in Medicare payments to doctors supported on Capitol Hill by those members.

The Senate vote has made for an easy talking point for Democrats and doctors. In the AMA ads, a narrator charges: "A group of U.S. senators voted to protect the powerful insurance companies at the expense of Medicare patients' access to doctors."

The ads name GOP Sens. John Cornyn and Kay Bailey Hutchison of Texas; John E. Sununu of New Hampshire; John Barrasso and Michael B. Enzi of Wyoming; Bob Corker and Lamar Alexander of Tennessee; Roger Wicker and Thad Cochran of Mississippi; and Arlen Specter of Pennsylvania.

Alexander, Cornyn, Sununu, Barrasso, Enzi, Cochran and Wicker all face elections this year. Sununu and Wicker are seen by Democrats as particularly vulnerable.

An AMA spokeswoman would not say what the association is paying to run the ads, but called the buy "significant."

Per the CQ article, this fracas is making particular waves in Texas, where the local AMA actually withdrew its support for GOP incumbent John Cornyn, and Mississippi, where Democrat Ronnie Musgrove is talking about the issue at all of his events. (Note that both races are being targeted in the MyDD Road to 60 effort). For those interested, a version of the ads the AMA is running in these races is available online here.

For those not entirely familiar with the GOP obstruction on this front, here's The New York Times' Robert Pear:

Doctors face a 10 percent cut in Medicare payments next week, following the Senate's failure on Thursday to take up legislation that would have averted the cuts.

Republican senators blocked efforts by Democrats to call up the bill, which was approved Tuesday in the House by an overwhelming bipartisan vote of 355 to 59.

In the Senate, supporters fell two votes short of the 60 needed to close debate. The vote was 58 to 40.

Senator Charles E. Schumer, Democrat of New York, said, "We have to pass this bill to avoid catastrophic cuts to doctors."

Dr. Nancy H. Nielsen, president of the American Medical Association, said the cuts would force many doctors to "limit the number of new Medicare patients they treat."

All in all, there is a simple narrative, one that we have heard over and over again in recent years (and indeed for the past several decades, at least since the New Deal): When push comes to shove and the Republicans have had to choose between the people and the special interests that fund GOP efforts, Republicans will almost invariably choose the latter.

By the way, nice work John McCain for not even bothering to show up for the vote -- particularly given that your support for the measure would have meant that the bill would have passed (Senate Majority Leader Harry Reid switched his vote to "no" for parliamentary reasons so that he could bring the measure up again in the future, so the bill actually had the support of 59 Senators).

I like MyDD.  This is a lively and interesting place that - at least until it finds a purpose and draws a lot of people to it - has a small population and therefore an intimate feel.  As much as my personal satisfaction may be served by having such a small community, I would think this is not the purpose of MyDD.  

In fact, if all we do is circle our own drain we can be certain that the population here will not get bigger and, in the end, will all go away.

So, I would like to suggest to the many capable diarists out there that they find something worth writing about on a progressive blog, and write about it.

This is a short diary. Obama is speaking in Raleigh, North Carolina right now, and he just said he'd be partnering with Elizabeth Edwards on his healthcare approach. That's incredibly encouraging. I can't tell you how excited I feel right now, as this is my top issue. Elizabeth could do so much to improve Obama's plan. A lot of his supporters don't seem to realize that healthcare is the number one issue for many of Hillary's supporters. Some of us dislike his plan immensely, and it's actually the reason I ruled Obama out when I was choosing a candidate in the beginning. As I've said, I'll be glad to back him, but nothing would make me happier than seeing him improve his plan and take a bigger step toward UHC.

So could it be?

So, if you're me and you care about health care, and optional medicine that your doctor says is necessary to avoid permanent mild to moderate shock -- but your health care insurance company says that you have to take the nonprescription stuff that is still sending you into shock -- you got a beef.

But what have you done to push health care? By the numbers, probably not much. In all reality, people do very little to get bills passed.  I can cite you over a hundred bills (including many on smoking and seatbelts) that no citizen ever really wanted passed. Insurance companies made the laws, and they got them passed. The nannyization of our society, as the conservatives like to so quaintly put it, comes from CORPORATIONS.

Health care is becoming a big beef, and deservedly so. But most people don't realize just yet how big of a beef it is -- and so we don't see the activism you would expect. No marching in the streets (that got covered, at least). No coverage of the poor folks holding garage sales because their "best of the bunch" insurance still wouldn't cover their bills. If the TeeVee ain't screamin' about something, most people wouldn't know shit about it. I regularly mention the food crisis -- and people, even educated professors, look at me like I should need to take a class to learn about my world.

As MyDD has spiraled exponentially into the depths of anti-Clinton and anti-Obama hatchet jobs (and more recently...whose supporters said what when that offended whom and who honestly cares...diaries), we seem to have lost touch with a number of ideals and characteristics which, for me at least, are inherent in the spirit of a tireless progressive activist.

As progressive activists, we can separate out our emotions - which run rampant toward the furtherance of progressive causes - from the strategic choices we know that we must make in order to see progressive policy implemented. We can find it in our hearts to forgive and forget when a (largely) progressive candidate panders for votes by trotting out gimmick-laden policies. And perhaps most importantly, we can temper our enthusiasm for progressive causes with the pain that millions of Americans are suffering. We can know and understand that sometimes the best policy for the country isn't the best policy for each individual voter, and that sometimes progressive unity requires understanding an issue from an alternative perspective.

Stop with the pitchforks, people! I don't like Kucinich either!

And to be honest, I don't like Obama's Health Care plan either (kindly accept my apologies for the hyperbole above. I just like alliteration).

They are both broken, both keep corporate and wall street interests involved. As far as I am concerned, they are both failed plans.

This is not to say that they would not improve matters. Far from it. But... They aren't panaceas, and they don't fix the big problems.

Nonprofit health care is what we should be shooting for, a place where everyone can be insured, and no one has to worry about anything.

Not a place where kids die from toothaches.

They both have flaws, and I'm sick to death of people saying "but he/she's is better!" Because to me that's splitting hairs. And we can do better than that.

(P.S. my last diary title was not snarky. So there!)

As an RN of 29 years and a CNA/NNOC RN who witnessed the dramatic vote for change by St. Rose Las Vegas RNs, who voted by 53% for CNA/NNOC, I am proud to post this diary today.

In the last few years, America's RNs have formed--at last--a National Nurses' Movement, with the creation of the first national union of RNs.  So far we are 80,000 RNs banding together for guaranteed healthcare, nursing practice, and a progressive labor movement, and that number grows daily.  As patient advocates we believe that this is the only path towards making sure that every one of our patients get the care they deserve.

You may know CNA/NNOC for its political profile, but it is the nurse organizing that has allowed us to make a difference for RNs across the country.  Here's a quick update on the incredible progress we're making just this week:

Intro
You must enter an Intro for your Diary Entry between 300 and 1150 characters long.
As an RN of 29 years and a CNA/NNOC RN who witnessed the dramatic vote for change by St. Rose Las Vegas RNs, who voted by 53% for CNA/NNOC, I am proud to post this diary today.

In the last few years, America's RNs have formed--at last--a National Nurses' Movement, with the creation of the first national union of RNs.  So far we are 80,000 RNs banding together for guaranteed healthcare, nursing practice, and a progressive labor movement, and that number grows daily.  As patient advocates we believe that this is the only path towards making sure that every one of our patients get the care they deserve.

You may know CNA/NNOC for its political profile, but it is the nurse organizing that has allowed us to make a difference for RNs across the country.  Here's a quick update on the incredible progress we're making just this week: