Thursday, July 9, 2009

Al Franken Gets Serious

After months of waiting during which incumbent Norm Coleman waged a fruitless legal battle to keep him from Washington, Al Franken was sworn in this week as the 58th Democrat in the Senate, representing the State of Minnesota.

Franken was declared the winner by just 312 votes after an eight-month recount and dispute, much to the chagrin of conservatives he has bashed over the years. Two years ago, in the spring of 2007, I spoke with Franken about growing up in a political family, the importance of alternative media and what led to his decision to challenge Coleman for his Senate seat.

He’d announced his candidacy several months before I wrote this profile, which was published online by Common Sense magazine in its Spring 2007 issue:

Al Franken has been known by a lot of names in his career: comedian, actor, talk-show host, author - Now he's hoping to add a new one to the list: Senator. On Feb 14, Franken officially launched his bid to challenge Minnesota's Republican incumbent senator Norm Coleman, saying he would seek the state's Democratic-Farmer-Labor Party nomination in the 2008 election.

He made the announcement on his last day as a talk-show host on Air America - five months into the station's bankruptcy and after weeks of whispered speculation that he was planning a Senate bid. It was the second time since 2003 that his name had come up as a possible contender.

"I'm not a professional politician. I know I'm going to make some mistakes. And it's going to be the hardest thing I've ever done," he said.

If his statement seemed overly candid, it's probably because Franken has built a career out of being honest - sometimes brutally so. Consider his first book: Rush Limbaugh Is a Big Fat Idiot and Other Observations, published in 1996. Since then, he's written Why Not Me? - a parody of a fictional presidential run; Oh, the Things I Know! A Guide to Success, or Failing That, Happiness; Lies and the Lying Liars Who Tell Them: A Fair and Balanced Look at the Right; and most recently, The Truth, which explores the 2004 election.

Meanwhile, he's become increasingly involved in the political process. In 2005, he founded the Midwest Values political action committee, which raised more than $1.1 million in its first year from over six thousand donors.

"Like a lot of people, I started to get very upset and concerned with what was happening to the country the last six years between the eroding of our values, the loss of our standing in the world, the widening gap in income, the unfairness of the tax structure - just the assault on basic American values," Franken says of his decision to run.

"I just thought that we needed somebody else in the Senate other than Norm Coleman."

Franken's opponent Norm Coleman is a Bush devotee who opposes the legal recognition of same-sex marriages, has voted against stem-cell research, supports the privatization of Social Security, and has voted against an amendment to create an Office of Public Integrity to monitor compliance to lobbying and ethics rules. He was also a leading defender of Karl Rove during the Valerie Plame leak scandal. Formerly a staunch DFLer, Coleman switched to the Republican Party in 1996. Critics say the former St.
Paul mayor made the move to pursue a personal ambition: to run for statewide office. He counted Rove among his key advisors to his 2002 Senate campaign.

It was because of these stands taken by Coleman that Franken mulled over the decision to throw his hat into the political ring. Despite such a clear agenda and cutting insight into what ails America, Franken says his choice to run for office did not come lightly. Since 2003, he's been splitting his time between writing, radio and entertaining American troops overseas. Franken has been on seven USO tours, four of them to Iraq, and he says the experience has been at once disheartening and enlightening. It was during one of these trips that he made his decision to run.

"I really put a lot of long thought into this. There was a long lead-up to it - a lot of gut checking," he says. "I finally made the decision in Iraq... I looked around me and looked at the troops and what they were giving up. I really learned a lot from these guys about the sense of duty and the sense of honor and of doing something bigger than yourself."

The decision has not come without its challenges. Immediately after announcing, the Minnesota Republican Party issued a "fact sheet" about Franken, calling him an "angry, mean-spirited and divisive partisan." Most of their evidence is taken from Franken's comedy - some going back to the 1990s. Candidate Franken has since toned down his acerbic wit.

He's also been criticized by some progressives for his early support of the invasion of Iraq and "lukewarm" stance on an immediate withdrawal. Franken insists he supports withdrawing troops from Iraq, but says it needs to be approached with extreme care. To start with, he says the Administration should enact the recommendations of the Baker-Hamilton Commission and should put pressure on the Maliki government by making an American presence in Iraq conditional upon the Iraqi government's willingness and ability to meet certain benchmarks.

"The debate shouldn't be whether we withdraw, it should be how," he says. "I'm not talking about getting out in a week or an hour. We have to put more thought into how we get out than we did on how we got in. That's not a high bar, but I think we have to really put a lot of thought into that. It's a long answer, but it starts by admitting that we can't do anything militarily, that we're not accomplishing anything militarily."
Then there are the two attorneys - Bob Olson and Mike Ciresi - who recently joined the race, also vying for the DFL nomination. Still, by the looks of it, Franken's off to a running start. Within months he's built a war chest approaching $1.5 million and has gained the support of celebrities like Tom Hanks and Meryl Streep as well as a growing base of Minnesota voters.

Most recently, on June 8 (2007) he picked up the endorsement of Minnesota's state auditor and 19 other state legislators. In May he was endorsed by the United Steelworkers District 11, which called Franken the "only candidate running an aggressive, statewide grassroots campaign that has the capability of mobilizing working families." What's more, his effective use of the Internet coupled with his celebrity status has helped spread his message well beyond the confines of his home state.

Born in New York, Franken, 56, moved to Minnesota with his family when he was just four years old. He says his first notion of a political agenda came from his parents. In a nation then caught up in the Civil Rights movement, Franken says he learned early on the importance of fighting for what's right.

"My dad was both a Republican and a card carrying member of the NAACP, and he would point to scenes from the South... and he would just go 'that's wrong' - In 1964 when Goldwater got the nomination and ran opposing the Civil Rights Bill my dad became a Democrat - that was a big turning point for him."

A Harvard graduate with a degree in government, Franken found his calling in the entertainment industry and developed a remarkable talent for parody and satire. He was doing political humor long before joining Saturday Night Live in 1975, but he says it wasn't really until after he left the show that he began to define himself by his politics.

"I guess my career sort of had this shift when I left SNL," he says. "At SNL we did a lot of political material but we were careful not to have a political ax to grind. We didn't feel it was appropriate so the ethic was to do satire that's neither left nor right. When I left the show I felt like it was time to let my own political feelings out."

An admirer and friend of the late Minnesota senator Paul Wellstone - who was killed along with his wife and daughter in a tragic 2002 plane crash - Franken's progressive sentiments parallel those of his political mentor, who was known for his work for peace, the environment, labor, and healthcare.

Franken has made universal healthcare a linchpin of his campaign agenda and it is something he says he plans to tackle early if elected. "The cost of healthcare and the fact that there are so many people uninsured and the uncertainty it creates - that's a huge issue that needs to be addressed," he says. "I'd like to get that done as quickly as possible. At least we could insure every kid, that seems like something you could get done fast."

Yet on other issues, he evokes a more centrist view. He's said he would have voted for NAFTA, for example, though he admits the free trade pact needs work. On the recent debate over immigration, Franken supports a comprehensive s olution that includes a guest worker program, but believes the flow of immigration needs to be strictly controlled.

"I don't think you send 12 million people back where they came from. Putting them on a track for citizenship makes sense, but I think it also makes sense not to award them for coming in illegally," he says. "We need to come up with some tamper-proof documentation, so you can really start enforcing this at the workplace. Immigrants need to learn English and not have committed any crime and have paid their taxes. And we need to make sure the temporary work force that comes in doesn't drive down wages for Americans."

In the months leading up to the March 2008 Minnesota primaries, we can expect to see much more of Franken as he continues to define himself as a viable challenger to Coleman.

As a champion of alternative media, he is particularly visible on the Internet, and his website has become a model for the way campaigns will be run in the future. Having witnessed the failure of Air America, Franken says he worries that the progressive movement lacks the support it needs to effectively challenge the conservative dominance of traditional media.

"I think we need a little more help from our billionaires. [On Air America] we were undercapitalized, and if you look at Fox News Channel, they had hundreds and hundreds of billions of dollars. We could never lose as much money as Fox News. And yet I would still get a million and a half distinct listeners a week.

We never really had the money to do it right. I really think that more than ever our billionaires have to step up."

Monday, July 6, 2009

A Primary Concern

On July 1 President Obama hosted a much-hyped town hall meeting on healthcare reform during which he responded to questions delivered via YouTube, Facebook and Twitter.

The next day the administration took some heat for what journalists complain was the “restrictive” way in which the forum was handled; some implied the forum was padded with questions from political allies.

The Washington Post noted that of the seven questions asked, four were hand picked by the White House. The remaining three questions all came from progressive groups that have supported Obama: Healthcare for America Now, Organizing for America, and Service Employees International Union (SEIU).

To be sure, the president faces a powerful coalition of opponents to public healthcare -- made up of the vested interests currently profiting from America’s broken system – and so he can’t afford to pull punches. With the U.S. standing alone as the only industrialized nation that does not provide universal health care to its citizens, the time for debate is over and the time for decisive action is upon us. One can only hope that the Democrats have the political will to see it through.

The president, who supports a “public option” to provide an alternative to private insurance and offer coverage to the nation’s 47 million uninsured, says he is committed to a system based on preventative care that places quality of care over quantity of services.

But to see that through will require much more than simply providing coverage to those who presently don’t have it. Doctors tell me that our for-profit system of healthcare has created a dangerously lopsided medical service structure that lacks the foundation necessary for the care the Obama administration envisions.

While the president was holding his “National Discussion on Healthcare” I spoke with Dr. Ted Epperly, president of the American Academy of Family Physicians (AAFP), who applauds the notion of a holistic preventative approach to healthcare provision, yet warns that the U.S. healthcare system as it exists is plagued by systemic defects that need to be addressed if such a proposal is to succeed.

Epperly says the U.S. is suffering from a severe shortage of primary care physicians – the very doctors that will be most essential to the type of system that the president envisions.

“Unfortunately the American healthcare system does not value what primary care does to keep people healthy,” Epperly told me. “It doesn’t value wellness and prevention and it doesn’t value the relationship that a physician has with a patient that engenders trust, which is where healing happens.”

This deficit of good-ole fashioned family docs is a result of a system that applies a capitalist model to the healing professions, favoring expensive, short-term, ‘turn ‘em and burn ‘em’ procedural care over long-term ‘total body’ health maintenance.

“We’ve got a back-end system that’s treating all the disease that if we put the money on the front end of the system in terms of wellness and health promotion we could have prevented it in the first place,” Epperly says. “That is the summation of the American healthcare system.

“As a quick example, you can do an amputation of a leg for $40,000 but the system will only pay you pennies on the dollar to keep someone from needing an amputation in the first place. So, what do we get? We get a lot of guys that do amputations on legs…”

Epperly says this paradigm is most evident in the yawning pay differential that exists between family care doctors and specialists. According to the 2008 Physician Compensation Survey conducted by the American Medical Group Association (AMGA), the median annual salary for a family practitioner is $190,182, while a geriatrics doctor earns just under $180,000. By contrast, the median annual salary for a dermatologist is $344,847; an ophthalmologist, $305,301; and a diagnostic radiologist, $420,858.

With the average med student leaving school with upwards of $140,000 of debt, it’s not hard to understand why they might shy away from primary care.

“Basically, we’re saying to the nation’s medical students that primary care is complex work and we’re going to pay you less at a time when many are struggling financial themselves,” Epperly says.

How much a doctor makes is determined largely by a 26-member group called the Relative Value Scale Update Committee, or RUC. The RUC was developed in 1991 to determine the fee schedule for Medicare reimbursements and includes one member from each medical specialty. Although primary care services account for half of all Medicare volume, Epperly says that only four of the 26 members of RUC – or roughly 16 percent -- represent primary care fields.

On June 24, and then the next day, Epperly testified before the House Ways and Means Committee and a subcommittee of the House Energy and Commerce Committee -- two of the panels responsible for drafting healthcare reform legislation – to try to get this point across.

He supports the healthcare reform bill released by the House on June 19 that includes a five percent bonus for primary care services and as much as a 10 percent bonus for primary care services provided in a health professional shortage area. To qualify for the bonuses at least 50 percent of a physician’s services must be primary care.

The House plan, which includes a government-run insurance program that would compete against private insurers, would cover at least 95 percent of Americans, Rep. Henry Waxman (D, Calif.), chairman of the House Energy and Commerce Committee, said at a press conference introducing the legislation.

But the proposal has come under fire from critics, including Republicans, who say it will cost upwards of $1 trillion to implement. The bill’s drafters say they are still working out the details of how they will pay for the plan.

More from my conversation with AAFP’s Dr. Ted Epperly will appear in the upcoming July 12 edition of The Philadelphia Tribune.