McHugh Watch

“Socialized Medicine” – Mr. McHugh’s distortion of a National Health Insurance program still rings in my ears. A distortion he purposely and repeatedly used to denigrate a noble and way overdue solution to a pressing national problem. Of course he did it to appeal to his voter base’s primal instincts. To acknowledge that it was a valid solution to a problem that desperately needs solving was to oppose his President, who he has enabled for eight years. To acknowledge a real solution would only invalidate his useless grandstanding tax break bills that solved nothing and went nowhere. His opposition to National Health Insurance was a calculated stance to maintain his populist (both Republican and Democratic) base. A base that hates taxes but has no compunction about pork spending and a government subsidized economy, so long as it comes back to this district

Today he had a particularly hard choice between maintaining his conservative populist ideology that abhors government intrusion into the private sector and deserting his President or voting to “socialize” the banking sector. While the healthcare of his constituents doesn’t rise to the necessity of creating a real solution, the needs of all those poor distressed and suffering bankers, CEO’s and Wall Street wheelers and dealers prompted him to give away the shop to the tune of seven hundred billion dollars. Yes, Mr. McHugh, how does the phrase “socialized banking” strike you. How about “socialized investment” or, what the heck, a “socialist economy.” The bailout bill is an extortion of money from the American taxpayer, and John McHugh is all in favor of it. He has a lot of explaining to do to his base. I think they are catching on.

Let’s cut him some slack though. He’s desperate for the ranking position on the Armed Service committee and a sure way to forfeit that position is to buck the Republican leadership, including George Bush.

Let Wall Street drop. It will come back. Reckless banks are being taken over by stronger banks. Barclays gets Lehman Brothers. Citigroup gets Wachovia and Bank of American gets Merrill Lynch. So what. They are acquiring them in a fire sale, just as they should. That I can take this position with real credibility is because I just lost a lot of money today. Mr. McHugh has never had to save and has nothing in the market. His retirement pension is guaranteed by we taxpayers.

Yes, I will wager that the prospect of loosing a fraction of their fortunes will make the pirates of Wall Street real sick. Not to worry, they’ll still have their health insurance.

Now let’s turn and create a real solution to the credit crisis. There are two moral hazards from which to choose. John McHugh chose the moral hazard of bailing out reckless bankers and CEO’s. The majority of the House, as do the majority of the American people, reject this. The other moral hazard is correcting the root cause of the credit crunch: the individual homeowners who are in or going into foreclosure. Say what you want about those homeowners in trouble, but the mortgage brokers and bankers who obscenely profited from these loans also share in the blame. Bailout the little guy. Role back the interest rates to their initial values that were affordable and restructure the loans. As I noted a few days ago and published in the Watertown Times yesterday, rolling back the variable rates, including allowing bankruptcy judges to restructure loans allows everyone to win – including the banks and the secondary market investors. They just don’t win as big.

Guaranteed, that solution will win a convincing majority of the House.

Ted Ford, author of the Danger Democrat blog today thanked me for a news link that I sent him regarding Gov. Palin. He called me his, “Friend, fellow lefty, sole thoracic surgeon in Sackets Harbor and former congressional candidate.”

Yes, I am a good friend of Ted, Sackets Harbor’s (not to mention the entire North Country’s) sole thoracic surgeon and a twice former congressional candidate. However, I consider myself a moderate in the middle of the road rather than a “lefty”.

For example, take my concept of National Health insurance. Yes, I want to combine the best of the “left” by instituting Medicare for all, where everyone contributes and everyone is covered, with the best of the “right” by keeping the private nature of healthcare delivery where hospitals and doctors are still private entities along with each of us having the sole choice of our healthcare provider. I would call that middle of the road.

In my debates with Mr. McHugh, he continually invoked the “lefty” pinko red specter of “socialized medicine.” In fact, his almost exact phrase at a Watertown debate was that “you can put lipstick on a pig but it is still a pig.” Sound familiar. He knew full well that he was mischaracterizing the concept of Medicare for all. What he was really saying was that most of us that already have healthcare coverage (particularly those in congress), don’t give a damn and don’t want to help others who are not covered. Those without coverage are still a minority, one sixth of the population, whose votes he doesn’t need. His appeal was to the basest of our nature – I’ve got mine, I don’t care about you.

I knew that it was a good solution, because no one liked it. The young didn’t want to pay because they’re immortal and don’t get sick. The old didn’t want to pay because they’ve already paid through their Medicare withholding. The rich didn’t want to pay because they would pay more and the poor didn’t want to pay because they don’t have any money. The employed didn’t want to pay because some else was paying for them. So while everyone wants coverage, no one wants to pay. It’s a great plan. No special interests get special treatment. It sounds equal and very middle of the road to me.

Healthcare reform is coming, and my only regret is that I will not be at the table. It will be written by lawyers who are more interested in process rather than by surgeons whose success is measured by results. Hillary Clinton’s 1990’s debacle brought us managed care – the worst of processes. No surprise, written by someone trained in the law and not in medicine.

No one would argue today that Medicare is “socialized medicine.” Mischaracterizing a position, just like exaggerating, shading, stretching or embellishing, is not telling the truth. When you don’t tell the truth, you’re lying. Lipstick on a pig.

This week we will look at where our healthcare dollar is being spent and where our money goes. Be forewarned: this is tough stuff and can’t be presented in a sound bite. You are going to have to wade through the numbers and follow the money. Doing so, you will begin to understand how wasteful our healthcare financing is and will begin to formulate a broad outline of how the system can be redesigned to be effective and equitable. The bottom line: we can save between $350 - $450 billion by redesigning the system. That’s a lot of money – as much as the yearly military budget.

We’ve already established that we spend more, in both absolute and proportional dollars to our Gross Domestic Product (GDP), than any other country in the world. For that expenditure, we have some of the worst healthcare measures in all the industrialized world¹.

So where does our money go? It is instructive to look at the Security and Exchange Commission (SEC) filling of UnitedHealth Group² (open in a separate page so you can follow along). Through the purchase of Oxford Health Plans and Mid-Atlantic Medical Services, United HealthGroup is now the dominant health care insurance provider in New York. Note that the filings are expressed in millions of dollars, so that any of the four or greater digit numbers represent Billions.

United HealthGroup’s revenues come from direct premiums ($65,666 billion) and administrative health care services ($4,268 billion) that it sells in the open marketplace. These services are mostly to large corporations or government entities – including New York State. From these revenues it expends $53,308 Billion in health care coverage. Do the math and United HealthGroup retains nearly 25% of the health care dollar that it collects directly as a premium or an administrative service that it sells because the coverage plans are so complicated.

There are literally hundreds of plans that can be selected. All this proliferation of choice is of course a smokescreen for reducing coverage all the while appealing to our fantasy that we are being given the “freedom” to choose and determine our own destiny. United HealthGroup is so good at charging more and providing less that its corporate profits (net earnings) have increased a billion dollars each year, from $2.4 billion in 2004 to $3.1 billion in 2005 to $4.1 billion in 2006.

Net Earnings (profits) are reported after all expenses are paid, including the salaries and benefits to the corporate officers, most notably, the $1.6 Billion in stock options to the company’s CEO, William McGuire. To put this into perspective, the US spends $1.5 trillion on healthcare and therefore United HealthGroup’s CEO got more than 1/1000 of the entire US expenditure on health care (10¹² – 10⁹ = 10³ = 1000) – but he thinks it’s enough! I’m ashamed to say that he’s a doctor.

Realizing the enormous profit involved, is it any wonder Empire Blue Cross/Blue Shield wanted to convert from a non-profit to for-profit organization. In 2002, New York under Gov. Pataki took the mantra of market efficiency and allowed the conversion. The price was a one time payment to the state. The deal is most succinctly related by Health Affairs³

“On 7 November 2002 Empire Blue Cross Blue Shield (BCBS) culminated a seven-year effort to convert from nonprofit to for-profit ownership, selling 20 percent of its stock and obtaining $417 million in one of the most successful initial public offerings (IPOs) in the history of the health insurance industry. The IPO proceeds and other corporate assets were not used to endow a charitable health care foundation, as is done in most other states, but were transferred to the New York State budget largely to finance wage increases for unionized hospital and nursing home workers. The quid pro quo was the endorsement of a conservative governor by a liberal labor union, contributing to a Republican electoral landslide in a Democratic state and to the governor’s commitment to sustain health care programs in what otherwise was a disastrous budgetary context. The big losers were the community organizations that would have received the largess of a charitable foundation and who instead were left to gnash their teeth, denounce the predatory state, and invoke constitutional objections to one of the most brilliant and sordid chapters in the annals of health policy.”

– some real insight into the sordid side of New York politics.

The same analysis can be applied to Empire Blue Cross/Blue Shield. The parent company is WellChoice, incorporated in Delaware. The SEC fillings of WellChoice shows that is not much better than United Healthcare and retains 23% of our healthcare premium.

Do this for any of the insurance companies in the healthcare arena (should I now call it a racket) and the long and the short of it is that 1/4 of our healthcare dollar does not go for healthcare but rather to insurance companies coffers.

A word about the concept of market efficiency. There is no doubt that successful companies in the private sector are very efficient. That means that they will turn the greatest profit for the least expense. Of course they will – they are there to make a profit. The question is: do we have the financial luxury to allow the insurance companies to make a profit off our healthcare?

No one wants to turn our healthcare mess into a government service mess – see the last post for the ills of making hospitals and healthcare providers into civil servants as is done in Great Britain⁴. Is there, however, another alternative to a private system of health insurance and the true socialized medicine of Great Britain?

The answer can be found in Medicare.

Medicare is essentially public insurance coverage for those over 65 and for the disabled. Its overhead – the cost of running the program – is 3.4%. Of the revenues that Medicare collects, as opposed to the 25% that the private insurance companies keep, Medicare only retains 3.4%. So when “efficiency” is applied to the peoples’ healthcare coverage and the amount of money available to pay for it, Medicare wins hands down.

Realizing the tremendous profits that are involved, is there any wonder why the insurance companies viciously oppose a national health insurance system and why they spend millions (which is really a drop in the bucket compared to their profits) in campaign contributions and on advertising campaigns – remember Harry and Louise of the 1990’s. (Let’s be very clear. Hillary Clinton’s healthcare plan utilizing “managed care” in the 1990’s was a disaster, and we are now left with its private form. So now instead of the government limiting your choice of medical treatment, it’s the insurance companies – they aren’t stupid and are very efficient at extracting profits for minimal performance).

Combine this with the added administrative costs of hospitals and providers, nearly one third, 31% of our healthcare dollar is eaten up – wasted – on administrative costs⁵.

That brings us to our congressman. Why would he oppose an efficient public national health insurance program calling it “socialized medicine”. Follow the money. Over the years he, along with most of our lawmakers, including Hillary, have been generously funded by the HMOs and insurance companies. This funding ensures that the insurance companies get their way. Some of Mr. McHugh’s contributors are:

HealthNet, Inc. $14,000

Humana $7,000

America’s Health Insurance Plans the trade organization for the insurance companies. $2,000
The contributors to this PAC are all the insurance companies, including guess who: United HealthGroup.

What is also notable is the interlocking relationships between PACs. For instance, the Texas Freedom Fund is funded by insurance companies and pharmaceuticals among others, that gives to the CME Fund the gives our congressman $2,000. Follow the money.

I think you can see how corrupting it is, and why our representative, and for the matter, most of our politicians will not do what is best, least expensive and most effective for all of us. The only way to solve this problem is public campaign financing.

Next post: The pharmaceutical industry’s cut of our healthcare dollar.

1. Theophilus, Post 12/06/2007
2. Filing 10-K United HealthGroup, Annual Report 2006
3. Health Affairs 22(4):100-118, 2003
4. Theophilus, loc. cit.
5. Woodhandler, S., Campbell, T., Himmelstein, D., “Costs of Health Care Administration in the United States and Canada,” New England Journal of Medicine, 349:768-75, 2003.

When I first entered politics in 2004 one of the biggest hurdles in explaining my roadmap to healthcare reform was to convince people that the system was broken. I tried to accomplish that by telling them of the 47,000,000 Americans – one sixth of our population – were uninsured. Being uninsured meant that those 47 million would therefore seek the most expensive health care in emergency rooms far into the course of their underlying disease. Early treatment before the ravages of the disease progressed, would not only have been better for those people, but would have been far less expensive. Far less expensive does not mean a few dollars, but rather one or two orders of magnitude less expensive, from the tens or hundreds of thousands of dollars to just thousands of dollars. Disappointingly, most voters didn’t really care about those 47 million, not to mention their 108,000 neighbors who reside in our own congressional district without health insurance.

In that short time, even those who were content with the status quo are coming to realize intuitively that our healthcare system is broken. Their employers are no longer providing unlimited access to healthcare and many are not even providing it at all. Under the euphemism of “choice” each year they are having to pay more for less. It turns out that only the very few can avail themselves to all the treatments that the best medicine in the world has to offer. Of course, that doesn’t include the members of congress – they have the best coverage.

Back then, I tried to use statistical measures of health in comparison to other counties to show we did not have a healthcare system, but rather a “sickcare” system. I would present data as if I were presenting a paper to my colleagues. It turns out the voters just weren’t interested. They were not impressed that of the 30 most industrialized countries in the world, we were number 24 in life expectancy1. Neither were they impressed that our premature deaths were the second and fourth worse for females and males² . They weren’t impressed we were number five in our deaths from heart disease³. They didn’t seem to care that we were number twenty seven in infant mortality with only Mexico, Turkey and the Slovak Republic worse than us⁴.

For all that, we spend over twice for each person than almost all the other countries⁵. In fact, you could even say that the Slovak Republic was getting a good deal. They spend six times less than we do and have an infant mortality just slightly higher than ours. Yes, we spent $1.5 TRILLION dollars last year for the best medicine but nearly the worst health care in the world.

So long as someone else paid, i.e. their employers, most voters didn’t care. These were just statistics and if their neighbors ran into trouble, it was just an aberration of the “best medicine in the world,” and it wasn’t going to happen to them. I’ve often wondered what these voters think of the fund raisers to raise money for those non or under insured who need a transplant or treatment for cancer. You see these fund raisers all the time. Is there something not repugnant that the sick have prostrate themselves and go begging for help?

The voters, however, were very impressed with the draconian phrase “socialized medicine.” John McHugh couldn’t say it enough times. A phrase that was used over and over by the American Medical Association to fight prenatal care in the 1920’s and 1930’s, Harry Truman’s healthcare insurance in the 1940’s and Medicare in the 1960’s^6,7.

In parroting that, McHugh was selling a fantasy, just at Giuliani, Romney, Thompson, McCain and Ron Paul – yes, Dr. Ron Paul – and every other Republican presidential candidate is selling now. The fantasy is that you have unlimited, unfettered access to American medicine. Those fund raisers that we just talked about – they must be scams – because we all know that everyone has access to all the wonders of modern medicine. What these public “servants” are really saying is that they can avail themselves to all of American medicine – the best medicine in the world – and they want to keep it just that way. So long as you are convinced that you have the choice, freedom and ability to tap all the resources of the best medicine in the world, that is just fine with them. Just keep paying your taxes, provide them with cushy benefits, while they sell you a scam – along with Iraq’s weapons of mass destruction, Iran’s nuclear weapon program, Karl Rove and Scooter Libby having nothing to do with outing a CIA agent, water boarding isn’t torture and …” Walt Disney couldn’t do it any better.

I unsuccessfully tried to persuade the voters to change the way we finance health care, not the way we provide it. John McHugh knew that then, as do the Republican Presidential candidates know that now when they stoop into the linguistic gutter and dredge up “socialize medicine.” If there is any country in the world where “socialized medicine” is an accurate description of a health care system, it is Great Britain. That truly is socialized medicine, where the hospitals are owned by the state, all the health care providers are paid by the state and where you have to register at the local GP’s office for your health care. You don’t have a choice of doctors and there is no incentive for hospitals or doctors to provide care. They are paid a straight salary, regardless of how many patients the see. Hence the long waiting lists. Except for Dennis Kucinich (HR 1200)8, that is not what the other Democratic Presidential candidates are proposing.

The financing of health care to provide everyone with coverage is a far cry from the government owning hospitals, doctors, and telling you where you can go for your health care.

I don’t think the American public needs anymore explanations of how broken our health care system is. They now viscerally know it. They’ve been hit in the gut; their wallets feel it and their loved ones can only look in the window and marvel at the wonders of American medicine.

Next post: Now the we’ve got the hysteria of “socialized medicine” out of the way, we’ll find out where our money goes.

1. Tabulation: Organization for Economic Co-Operation and Development, Life Expectancy at Birth, 2007.
Graph: Organization for Economic Co-Operation and Development, Life Expectancy and Per Capita Spending 2007.
2. Organization For Economic Co-Operation And Development, Premature Mortality, 2007.
3. Organization For Economic Co-Operation and Development, Ischemic Heart Diseae Mortality, 2007.
4. Organization For Economic Co-Operation and Development, Infant Mortality, 2007.
5. Organization For Economic Co-Operation and Development, Health Expenditure Per Capita 2007.
6. David Greenberg, “Who’s Afraid of Socialized Medicine”, Slate Magazine, Oct 8, 2007.
7. NPR Morning Edition 12/06/07 read NPR listen:
8. HR 1200 text HR 1200 Summary

The House passed yesterday, 247 to 176 with 37 moderate Republicans in favor, HR 5 the Stem Cell Research Enhancement Act. Predictably, Mr. McHugh, along with Mssrs. Walsh and Kuhl were opposed, again waving their true arch conservative colors and un-yielding support for George Bush. We must add these three to those who offer us only “Blood, Oil, Fears and Debt.” This vote reconciled the Senate and House versions. It next goes to George Bush for his probable veto – Only 591 days to a Democratic President.

Here is an non exhustive list of potential diseases for which stem cells have potential use:

Diabetes
Parkinsonism
Alzheimer’s
spinal cord injuries
Lou Gehrig’s (ALS) Continue Reading »

Today our congressman voted against taking care of our wounded soldiers, against providing healthcare for children, against funding education, and against deficit reduction and tax relief for the middle class – clean sweep.

Also today, DangerDemocrat found a story from UPI quoting our congressman’s concern about the military healthcare system for our soldiers:

“There is no doubt that these are most difficult times for the military health system. One of the most severe challenges rests in the fact that, for the second year in a row, the budget for the Defense Health Program has been significantly reduced with the hope of congressional support for changes to the benefit in the form of increased fees for TRICARE,” Rep John M. McHugh,R-N.Y., the ranking Republican on the Military Personnel Subcommittee of the U.S. House of Representatives said in a statement at the subcommittee’s hearing on the state of the U.S. military health care system.

“The budget assumes reductions to funding for military treatment facilities for the third year in a row with the expectation that these facilities must become more efficient. The fiscal year 2008 budget reduction is $2.1 billion,” McHugh said..

“It is undeniable that the care provided to our troops, their families and to our retired beneficiaries is vital to the success of our military now and in the future,” he said.

He was commenting upon the President’s budget sent to Capital Hill a few weeks ago. His words sound pretty good. He’s sounds somewhat “concerned” – a favorite word of his.

What happened today? The House passed the 2008 Budget Resolution.

After receiving the President’s budget, both the Senate and the House (usually by early April) draw up a spending plan for the year: the Congressional Budget Resolution. It provides a fiscal roadmap for the various congressional committees for later appropriations – in a future post I’ll explain the appropriations process. The Resolution balances the budget by 2012 with a surplus projected for that year.

Here are the major highlights:

• Most importantly it increases and assures funding for wounded veterans. The resolution provides $43.1 billion for veterans in 2008, representing a 98% of the level requested in The Independent Budget, a plan developed by four leading veterans groups. It is $3.5 Billion more than Bush requested. It also rejects Bush’s proposal to raise TRICARE co-payments and removing more than 100,000 veterans form the VA healthcare system. From the Resolution itself:

  SEC. 501. SENSE OF THE HOUSE ON SERVICEMEMBERS’ AND VETERANS’ HEALTH CARE AND OTHER PRIORITIES.It is the sense of the House that–
  (1) the House supports excellent health care for current and former members of the United States Armed Services, who have served well and honorably and have made significant sacrifices for this Nation;
  (2) this resolution provides $43,055,000,000 in discretionary budget authority for 2008 for Function 700 (Veterans Benefits and Services), including veterans’ health care, which is $6,598,000,000 more than the 2007 level, $5,404,000,000 more than the Congressional Budget Office’s baseline level for 2008, and $3,506,000,000 more than the President’s budget for 2008;
  (3) this resolution provides funding to implement, in part, recommendations of the bi-partisan `Walter Reed Commission’ (the President’s Commission on Care for America’s Returning Wounded Warriors) and other United States Government investigations into military and veterans health care facilities and services;
  (4) this resolution assumes the rejection of the enrollment fees and co-payment increases in the President’s budget;
  (5) this resolution provides additional funding above the President’s inadequate budget levels for the Department of Veterans Affairs to research and treat veterans’ mental health, post-traumatic stress disorder, and traumatic brain and spinal cord injuries; and
  (6) this resolution provides additional funding above the President’s inadequate budget levels for the Department of Veterans Affairs to improve the speed and accuracy of its processing of disability compensation claims, including funding to hire additional personnel above the President’s requested level.

• Increases children’s access to health care by increased funding of the State Children’s Health Insurance project (SCHIP program).
• Invests in Education by restoring Pell grants, increased funding of the No Child Left Behind Act along with increased funding of the Individuals with Disabilities Education Act (IDEA).
• Protects middle-class taxpayers by providing Alternative Minimum Tax (AMT) relief for 2007 and 2008 – one year more than the President – preventing millions of middle-class taxpayers from being subjected to the AMT. It includes no tax increase. Under PAYGO (pay as you go) it allows for new tax relief and the extension of expiring tax provisions, IF the cost of these measures is offset. By requiring offsets, the resolution protects the American taxpayer from having to pay the higher interest costs on the debt that would accumulate when tax cuts are not paid for. The resolution also calls for strong new measures to close the tax gap, shut down tax scams, and address offshore tax havens. And it sets the stage for tax simplification and reform.

Guess who voted against it. You’re right, our very “concerned” congressman. Later today, NCPR is going to showcase his concern. Any bets on them asking him about his vote today. Highly doubtful. He mouths concern and then turns his back on our soldiers.

Says all the right things: does nothing. When are we going to wake up?

During his last campaign for Congress, Dr. Bob Johnson repeatedly faulted John McHugh for neglecting his responsibility to provide effective congressional oversight. Now that McHugh stands accused of bearing direct responsibility for permitting a military health care scandal that has been in the making ever since the invasion of Iraq, we know how right he was.

At the end of last week the Bush administration was forced to take pre-emptive action by a series of Washington Post exposes of the deplorable out-patient care of our wounded soldiers at the Walter Reed Army Medical Center, Bob Woodruff’s first-hand reporting on the Pentagon’s and VA’s failure to address the widespread incidence of brain injuries and post-traumatic stress disorder, and imminent long overdue congressional oversight, now that the voters have returned Congress to Democratic control.

To his credit, Robert Gates, the new Secretary of Defense, fired the Secretary of the Army and promised to hold other ranking Pentagon officials accountable for conditions that President Bush belatedly called “unacceptable.” In addition to the Pentagon’s own internal inquiry, Bush announced the creation of a bi-partisan commission to investigate inadequacies in the health care system for active duty military personnel, reservists, and veterans.

Such a presidential commission is a waste of taxpayer’s money designed to deflect attention from the administration’s primary culpability, as happened with the 9/11 Commission report. Our constitutional system of checks and balances empowers Congress to pass laws that protect the health, morale and welfare of the nation’s military personnel and its veterans and to exercise investigative oversight to insure that the executive branch administers these laws responsibly and effectively.

The House and Senate share congressional oversight responsibility for military health care. In the House it is vested in the Armed Services Committee, specifically in its sub-committee with jurisdiction over military personnel matters. From 1999 to the end of 2006 Representative John McHugh chaired this sub-committee, known in succession as Special Oversight Panel on Morale, Welfare and Recreation, Military Personnel, Total Force, and again Military Personnel.

Responding to complaints that the military medical facilities were not up to the task of giving adequate care to the wounded soldiers from Iraq and Afghanistan, especially the growing number of wounded reservists returning home for demobilization, McHugh’s Total Force sub-committee held a brief hearing one day after President Bush assured the troops in his January 2004 State of the Union address that the government “will give you the resources you need to fight and win the war on terror.” Accepting the assurances of military officials that the problems that had contributed to a suicide at Walter Reed were being addressed and that the medical health care system had the necessary resources, McHugh’s panel did not even issue a report. It allowed the situation to get worse as casualties mounted over the next three years.

McHugh still supports the President’s futile quest for “victory” in a war that should never have been started. His failure to exercise leadership in congressional oversight may be due to his unwillingness to expose facts that would embarrass the administration. After each one of his six short trips to Iraq he assured his constituents that steady progress was being made in an admittedly difficult war. He has attended funerals of fallen soldiers and visited the wounded in Walter Reed. But shows of compassion are a poor substitute for lack of action that could have helped the soldiers and their families who have sacrificed so much in a disastrous war.

McHugh has failed his constituents, the soldiers from Fort Drum, and the nation. He bears personal responsibility for the military health care scandal. It is high time for the voters to retire the affable ineffectual dandy to Pierrepont Manor.

Publius