Saturday, August 29, 2009


Kennedy remembered for 'the dream he kept alive'

BOSTON – Sen. Edward M. Kennedy was celebrated Saturday for "the good he did, the dream he kept alive," his funeral inside a soaring Catholic church a memorial to one man's life and a remarkable political era now ended.

Row upon row of mourners sat facing the casket bearing Kennedy's mortal remains, President Barack Obama as well as previous occupants of the White House, enough senators to make up a quorum and dozens of members of the most famous political family in the land.

One son, Patrick, wept quietly as another son, Teddy Jr., spoke from the pulpit of the day years ago, shortly after losing a leg to cancer, that he slipped walking up an icy driveway as he headed out to go sledding. "I started to cry and I said, `I'll never be able to climb up that hill,'" said Teddy Jr.

"And he lifted me up in his strong, gentle arms and said something I will never forget, he said, `I know you can do it. There is nothing that you can't do.'"

Rain beat down steadily as Kennedy's coffin was borne by a military honor guard into the Basilica of Our Lady of Perpetual Help, and again when it was brought back out to the hearse for the trip to his final resting place at Arlington National Cemetery outside Washington.

In life, the senator had visited the burial ground often to mourn his brothers, John and Robert, killed in their 40s, more than a generation ago, by assassins' bullets.

"He was given a gift of time that his brothers were not. And he used that time to touch as many lives and right as many wrongs as the years would allow," Obama said in a eulogy that also gently made mention of Kennedy's "personal failings and setbacks."

As a member of the Senate, Kennedy was a "veritable force of nature," the president said. But more than that, the "baby of the family who became its patriarch, the restless dreamer who became its rock."

Those left behind to mourn "grieve his passing with the memories he gave, the good he did, the dream he kept alive" Obama said inside the packed church.

Hundreds lined nearby sidewalks, ignoring the rain, as the funeral procession passed.

"I said to myself this morning, 'No matter what the weather, I'm going, I don't care if I have to swim," said Lillian Bennett, 59, who added she was a longtime Kennedy supporter and determined to get as close as she could to the invitation-only funeral.

"The Mass of Christian burial weaves together memory and hope," said the Rev. Mark R. Hession, parish priest at the church in a working class neighborhood of Boston.

There was plenty of both in a two-hour service filled with references to Kennedy's political accomplishments and personal recollections of his private life. Cellist Yo-Yo Ma and tenor Placido Domingo provided musical grace notes.

Kennedy's widow, Vicki, his sole surviving sibling, Jean, and Robert Kennedy's widow, Ethel, carefully arranged the cloth funeral pall atop the coffin.

Like others, Teddy Jr., touched on his father's legacy.

"He answered Uncle Joe's call to patriotism, Uncle Jack's call to public service and Bobby's determination to seek a newer world. Unlike them, he lived to be a grandfather," he said.

Joseph Kennedy Jr. died in World War II, John F. Kennedy was the nation's 35th president when he was assassinated in 1963 and Sen. Robert F. Kennedy was killed five years later as he campaigned for the presidency.

Kennedy died Tuesday at 77, more than a year after he was diagnosed with a brain tumor.

Saturday's events marked the end of four days of public and private mourning meant to emphasize Kennedy's 47 years in the Senate from Massachusetts, his standing as the foremost liberal Democrat of the late 20th century yet a legislator who courted compromise with Republicans, a family man and last heir to a dynasty that began in the years after World War II.

Thousands of mourners filed past his flag-draped coffin earlier in the week when Kennedy lay in repose at the John F. Kennedy Library in Boston. Republicans and Democrats alike recalled his political career in a bipartisan evening of laughter-filled speechmaking on Friday.

Even the church had special meaning for the family. Kennedy prayed there daily several years ago during his daughter Kara's successful battle with lung cancer.

___

David Espo reported from Washington. AP writer Karen Testa contributed from Boston.

Thank God For The Irish

Friday, August 28, 2009

"On what planet do you spend most of your time?"

user

Joe Scarborough & Peggy Noonan: Americans Secretly Yearning for Republican-Controlled Congress

By: Blue Texan Friday August 28, 2009 10:30 am

Some pretty first-rate concern trolling here on "Morning Joe."

What Nooners and Scar conveniently ignore is that Obama's numbers are dropping primarily because he's losing Democrats. While he's slipped among independents as well, the Republicans are hugely unpopular and have zero credibility on health care reform, so there's no objective evidence that voters are clamoring for a McConnell/Boehner coup.

Moreover, Nooner's notion that "Americans won't support" Democratic legislation is truly bizarre. We just had a national election less than a year ago in which Americans elected a Democratic President and gave the Democrats substantial majorities in both houses of Congress, two years after giving them total control of the legislative branch. That's a fairly strong indicator that they want Democratic legislation -- not the Republican legislation Nooners likes.

Obama's not struggling because he's insufficiently centrist. He's struggling because he's insufficiently partisan.

java muses:

I have been wondering what is behind the plain obstructionism that has infected the GOP and have come to the conclusion that it is the loss of power and the near ending of an abusive relationship that the party has had with the American people for the past 14 years. There is not one bit of interest in moving this country forward under any circumstances. President Obama has held out his hand and has been met at every turn with a clenched fist. It is a pathology of control. It is the methodology of abuse.

If I Can't Have You (Then Nobody Can)

If I can't have you then nobody can
I've waited so long to be your man
And now you're telling me that we may never be
Well I'm telling you that we'll be for eternity

I'll slit your throat, suffocate you
But know that I'm not doing this because I hate you
I'm doing this for love, you and me forever
Even after all the years have gathered we'll still be together

If I can't have you then nobody can
The most beautiful person in all of the land
And I can't stand to know that they have touched you
And that thought alone, it is enough to...

Bring a lump to my throat, a pain in my chest
The blood pouring down, your pale breasts
I’m sorry that I hurt you, but you hurt me more
And they’ll never have you, because you are worth more

If I can’t have you then nobody can
The last man to hold your hand
And walk with you know, to your place of death
Where the roses are dead here and there’s nothing left

Prince ....

http://www.poemhunter.com/

WellPoint Calls Attention To Its Own Immoral Practices In Effort To Smear Health Reform


For-profit health insurance giant WellPoint fired off an email blast to its customers (using its Anthem Blue Cross Blue Shield subsidiary) yesterday attacking the public option and Democratic plans for reforming health care, according to Politico’s Ben Smith. The email directs customers to its “grassroots Web site” for instructions on contacting legislators, a website ThinkProgress revealed to be run by the secretive corporate lobbying firm Democracy Data and Communications (DDC). DDC, which is operated by a former veteran of the astroturf organization now known as FreedomWorks, has helped various corporate and Republican interests shape legislation by helping to generate seemingly organic phone calls and letters to Congress.

In the letter to its customers, WellPoint makes a variety of false charges against health reform. Ironically, the attacks WellPoint makes against the public option are more appropriate criticisms of the way the private insurer does business:

1. THE LETTER STATES: Health reform will “increase the premiums of those with private coverage.”

– WELLPOINT POLICIES: In a recent giddy report about WellPoint’s expected profitability to investors, Barrons reported that WellPoint will be “hiking” premiums to at least “6% to 8% annually.” In 2006, WellPoint’s profits increased 34% as premiums and fees surged.

2. THE LETTER STATES: Health reform will cause “millions of Americans to lose their private coverage” and end up in the public option.

– WELLPOINT POLICIES: In March 2007, the state’s Department of Managed Health Care fined Blue Cross of California and its parent company, WellPoint, $1 million after an investigation revealed that the insurer routinely canceled individual health policies of pregnant women and chronically ill patients. Earlier this summer, despite promises by their lobbyists to the public, WellPoint refused to end the controversial practice of rescinding coverage after an applicant files a medical claim.

While WellPoint has been busy shedding customers and increasing premiums, AMNews reported that WellPoint has cut its medical loss ratio this year — meaning a greater percentage of every premium dollar is going to profits and overhead, rather than being spent on actual medical care. Not only that, while WellPoint has tried to put a “human face” on its company by encouraging their employees to show up at town halls with corporate talking points, WellPoint has cut over 1,500 jobs since the beginning of this year. As former CIGNA executive Wendell Potter has explained, private health insurance companies like WellPoint are an ATM machine for Wall Street.

In a recent interview, NPR’s Steve Inskeep forced WellPoint CEO Angela Braly to concede her company fears that “changes in the insurance market and regulations” could cut into her profits the most. That is because, as Igor Volsky has observed, WellPoint’s business model is “antithetical to regulation,” since the company aggressively pursues healthy customers who are less likely to use benefits to pay for medical care. As the company adds healthy customers, WellPoint has made a science of finding ways to deny coverage to the sick. California regulators uncovered more than 1,200 violations of the law by the company in regard to unfair rescission and claims processing practices.

Braly, who earns nearly $10 million a year, wants “sustainable reform,” yet opposes what her company calls “Obamacare,” refuses to stop rescinding coverage to the sick, and is even suspicious of an individual mandate. Although health insurance lobbyists continue to press their case that they truly want reform “this time,” WellPoint and its stealth lobbying efforts severely undermine that claim.



In the media
— June 23, 2008

Medical Care's State of Denial

Doctors are supposed to prescribe tests and treatments that are medically necessary for their patients. Health insurers are expected to cover that care, while keeping inappropriate expenses in check.

But what happens when that process breaks down and sick patients are left to fight for medical care?

Each year, thousands of Californians find themselves at odds with their health insurers over whether they, as patients, should get the treatment their doctors prescribed.

Peter Isgro of Santa Cruz is among them. His insurer, Anthem Blue Cross, stopped paying for certain chemotherapy drugs after his cancer progressed, a decision that has been upheld in two appeals.

Isgro said he feels like the insurance company is second-guessing his doctor. "If your doctor wants to give you something and they can deny it, that's wrong," he said.

Anthem Blue Cross said it follows strict protocols, relying on medical evidence in determining what is necessary and appropriate to cover.

"Even in a dire situation, it is ethically appropriate to withhold treatment if it's not effective," said Dr. Michael Belman, medical director of Anthem Blue Cross, who was not speaking specifically about Isgro's case. Belman said doctors do not always recommend the best treatments, and cost is never a primary consideration.

Consumer advocates, however, see the situation differently.

Health insurers "are going back to the old strategies of the '90s, when they interrupted care on the front end by denying or delaying treatment offered by a doctor," said Jerry Flanagan, health advocate for Consumer Watchdog, a Santa Monica group. According to him, insurers hope patients will give up or settle for less, either way saving them money, a contention the companies dispute.

Patients now have a number of resources to turn to if they believe they received an unfair denial. Last year, the state's HMO Help Center received nearly 90,000 calls from consumers asking for help in resolving their health plan woes.

About 7,000 Californians have taken advantage of third-party medical reviews since 2001, when the state Department of Managed Health Care started offering them. Last year, the department resolved 1,716 independent medical review, or IMR, cases.

The Department of Insurance, which regulates a smaller number of plans, received 35,280 complaints and resolved 262 IMRs in 2007.

About 40 percent of all IMR decisions are settled in favor of the patient, according to the Department of Managed Health Care.

The majority of treatment disputes address whether the proposed therapy is "medically necessary" or if it is considered to be "experimental" or "investigational." Even treatments approved by the U.S. Food and Drug Administration can be deemed experimental if they are typically used in a different fashion or there is simply not enough evidence to support the use.

Physicians often feel caught in the middle.

"Do I stop treating them while the insurer determines they have eligibility? Even if they get authorization, they say that doesn't guarantee payment," said Dr. Michael Sherman, an oncologist who has offices in Walnut Creek and San Ramon. Sherman said he is forced to provide unreimbursed treatments to patients in those situations.

Dr. Alan Sokolow, chief medical officer for Blue Shield of California, said insurers try to strike a balance.

"We think that is our job - to help patients and providers apply the benefit package the patient has, the dollars they put for insurance coverage and health care, in the most appropriate and effective way," he said, adding that patients should appeal if they disagree.

When appeals don't work, patients can sue their health plan. But that can be a difficult proposition, given that it can be tough to get a lawyer to take such a case, and most plans require their members to agree to binding arbitration.

In the end, patients usually want to get the treatment rather than endure a lengthy legal process.

Joanna Smith, a patient advocate who runs Healthcare Liaison Inc. in Berkeley, said persistence and doing research to back up the case give patients a better chance of success.

"I always say to people appeal, appeal, appeal," she said. "And then appeal again."

Case studies: Three Northern California patients' struggles with insurance carriers.

Karen Vinci:


In December 2006, when Karen Vinci's bile-duct cancer recurred, she was told surgery wasn't an option because of the location of the tumor.

Instead, a group of doctors at UCSF recommended what they considered the Alamo woman's only option: five weeks of external-beam radiation followed by noninvasive radiosurgery that used a robotic device called CyberKnife, which attacks the tumor with high doses of targeted radiation.

Vinci's insurer, Blue Shield, approved all the treatments she needed in preparation for the therapy, including the implantation of gold seeds in the tumor. But about two weeks into the radiation treatments in March 2007, Blue Shield reneged on the rest of the radiation as well her CyberKnife procedures.

So Vinci's husband pulled out a checkbook and paid UCSF $10,000 of the $60,000 treatment to make sure his wife's care was not delayed or canceled.

"I had no choice. It was either die or give them money," said Vinci, 57.

Blue Shield had labeled the treatment, which received FDA approval in 2001 for treatment of nonoperable tumors in all parts of the body, "experimental." CyberKnife's manufacturer, Accuray Inc., said the federal government's Medicare program covers the treatment, which has been used on more than 40,000 patients.

Vinci, with the help of her husband and a patient advocate at UCSF, immediately filed a grievance to have a doctor within the insurance company review her case. After that was denied, Vinci went to the insurer's second-level appeal, a three-party panel, which sided with the company.

When Vinci requested an expedited independent medical review of her case through the Department of Managed Health Care, she got the answer she wanted. The state's reviewers overturned Blue Shield's decision, and the hospital promptly refunded the Vincis' money.

Vinci, who is now cancer-free, still does not understand the denial, especially because the treatment was expected to give her a full recovery.

"It was just devastating to know that money was an issue when it comes to your life," she said.

Richard Reynolds:

Richard Reynolds' health insurer, Blue Shield of California, paid for virtually everything - surgery, chemotherapy, radiation and medication - after the Berkeley man was diagnosed last year with a rare form of cancer.

When his tumor failed to show on a standard CT scan, his doctors recommended a more sensitive and expensive imaging technique called a PET scan. But his medical group and insurer, having denied an earlier PET scan request, again balked, labeling the tool "experimental" or "investigational" for his diagnosis.

Reynolds managed to get the scan covered when his surgeon appealed directly to high-ranking Blue Shield executives. But a follow-up scan requested several months later was still denied.

Fearing a delay in care, Reynolds shelled out $2,200 in March for the scan at a private PET imaging center. CT scans cost about half the price of PET scans.

Reynolds was mystified by Blue Shield's position. "They've paid for all kinds of specialists. They've put out hundreds and thousands of dollars. But with this one thing - the PET scan - they've drawn this bizarre line in the sand," said Reynolds, 64, communications director at Mother Jones magazine.

His doctor recently submitted a fourth request for an upcoming PET scan, which also was denied.

Reynolds, whose appeals were initially denied through Blue Shield's internal grievance process, submitted a request for an independent medical review through the state Department of Managed Health Care. But when a reporter told Blue Shield officials about the issue - even without identifying the patient or his diagnosis - they tracked down Reynolds' case and resolved the problem.

Blue Shield's medical director, Dr. Alan Sokolow, said his company should have covered the test, but found itself in the difficult terrain of trying to apply standardized protocols to a rare condition.

"We try very hard to be consistent and be fair and correct in our decision making. But this is why we have an appeal process," he said. "Sometimes, we don't always make the correct decision."

Peter Isgro:

When antiques store owner Peter Isgro was diagnosed with late-stage colon cancer, he was told he had just months to live. That was more than two years ago.

For those two additional years, the 61-year-old Santa Cruz resident credits a different oncologist who put him on an intense chemotherapy regimen - a multidrug concoction of older and cutting-edge therapies that costs about $10,000 every other week.

It was a treatment that gave Isgro the ability to continue working four days a week, allowed him to travel to Europe and kept him alive.

But after scans showed his tumors were growing, his insurer, Anthem Blue Cross, discontinued coverage of the more expensive drugs in his chemotherapy regimen. Since their use was stopped in early May, Isgro's disease, according to his oncologist, has "exploded."

"Clearly, we were keeping a lid on it. It was progressing very slowly and, when we stopped the drugs, it progressed very quickly," said Dr. James Cohen of Los Gatos, adding that all of the drugs he had been combining are approved by the U.S. Food and Drug Administration for colon cancer.

Cohen said no amount or combination of medication would cure Isgro. Rather, he hoped to give him a better quality of life as well as more time.

Two appeals to the state Department of Managed Health Care have gone in favor of the insurer. In the most recent decision, issued June 12, two of the three reviewers concluded that the requested therapy would not be more beneficial than the standard, less expensive treatment the insurance company approved.

Isgro believes his insurer simply doesn't want to spend any more money to keep him alive. And he's angry.

"If my name was Kennedy, do you think they'd try to deny me?" he said, referring to Sen. Edward Kennedy, who recently underwent surgery for brain cancer.

Isgro, who has found an attorney to represent him at no cost, is considering his options. He recently resumed the more expensive treatments with the help of his sister, who paid more than $4,000 out of pocket. He also is contacting the pharmaceutical companies that make his drugs to see if they will help pay for his therapy.

"What good does it do to have any kind of national health care plan or state health care plan if your doctor, your primary doctor, does not have the right to prescribe the medications he feels are best for you?" he said. "That's not health care."
What to do if you are denied medical care

If your health insurance carrier is refusing to approve treatment recommended by your doctor, you have a number of options. First, contact your health plan. You probably will have to go through the plan's internal grievance process first. If time is of the essence, ask for an expedited review through the state.

Tips to help you get the care you need:

-- Review your health plan policy. Many are available online.

-- Make sure your doctor is aware of your problem. Sometimes the initial denial comes from the medical group, which is charged with managing costs. In any case, your doctor's support is important.

-- Request the reason for the denial in writing. Take detailed notes of all conversations, including the date and time of the call and the name of the person you speak with. Save copies of all paperwork, and keep these records in chronological order.

-- Act soon. If you wait longer than six months, you could lose the right to file a complaint, ask for an independent medical review (also called an IMR), or take other action against your health plan such as arbitration or a lawsuit. An IMR decision is binding on the health plan, but not the patient.

Members of the public pay their final respects at the John F Kennedy library

Thousands of people have gathered for a second day in Boston to bid farewell to Edward Kennedy as his body lies in the John F Kennedy Presidential Library.

Many people lined up before the doors opened to view the flag-draped coffin of the long-serving US senator, who died on Tuesday of brain cancer.

President Barack Obama is to deliver a eulogy at his funeral Mass on Saturday.

He will be buried on Saturday at the Arlington National Cemetery near his brothers ex-president John and Robert.

Three days of ceremonies to commemorate Mr Kennedy began on Thursday with a private family Mass at the family property in Hyannis Port, Massachusetts.

Edward Kennedy - file photo

His body was then driven in a long procession to Boston along roads lined with thousands of mourners - some waving American flags, others holding up signs that read "Thank you Teddy".

The library was kept open until 0200 (0600 GMT) to allow more than 20,000 people to file past the coffin, placed before a large window overlooking Boston harbour.

Senator Kennedy's widow Vicki and other members of the family shook hands with the mourners.

"We just wanted to pay our respects and say thanks for all he has done," Trisha McLaughlin said.

'Extraordinary good'

After the public have paid their respects in Boston, there will be an invitation-only memorial service at the JFK library on Friday evening.

Bobby Kennedy Jnr: Edward Kennedy believed that "every individual counted"

President Barack Obama is expected to address a funeral Mass for Mr Kennedy at Our Lady of Perpetual Help Basilica in Boston on Saturday, before his burial that evening.

Mr Kennedy's death on Tuesday prompted a flood of tributes from across the US and around the world.

In the US, Mr Kennedy's death has been seen as the end of an era.

The charismatic senator had long been the leader of one of America's great political dynasties, following the assassinations of his brothers in 1963 and 1968.

In a televised tribute on Wednesday, Mr Obama said Mr Kennedy had achieved "extraordinary good" and was "one of the most accomplished Americans ever to serve our democracy".

But others have noted that his legacy of public service was counter-balanced by heavy drinking in his early years - and the death of a female companion, Mary Jo Kopechne, in 1969 when he drove off a bridge at Chappaquiddick in Massachusetts and fled the scene.

Wonkette: GEORGE BUSH SR. SIMPLY WILL NOT ATTEND THIS FUNERAL: George H.W. Bush, an evil oil baron and son to a Nazi financier, will not make it to Ted Kennedy’s funeral in Boston Saturday, even though every other living president will be there. A spokesperson says that the old coot “feels his son’s presence would ‘amply and well represent’ the family Saturday.” COLD. [AP/Raw Story]

wow, you'd think that in 47 years of service it never occurred to senator kennedy to discuss the most important issue of his life with these partisans


ABC quoted Hatch saying Kennedy "wouldn't want [health care bill] passed if it wasn't good" -- but Kennedy did think it was good


On ABC's World News, senior congressional correspondent Jonathan Karl stated that "Republicans, even those close to Senator [Ted] Kennedy, are not buying" the argument that health care reform should be passed to honor Kennedy's memory, then aired a clip of Sen. Orrin Hatch (R-UT) claiming Kennedy "wouldn't want it passed if it wasn't good." But ABC did not note that Kennedy voted by proxy to pass the Senate HELP committee's health care legislation -- a bill Hatch criticized -- and advocated for progressive policies included in the bill, such as universal health care coverage and a public plan.

From the August 27 broadcast of ABC's World News with Charles Gibson:

KARL: The most senior senator, Robert Byrd, said yesterday, "My heart and soul weeps" at the loss of Senator Kennedy and called for naming the health care bill after him, a view widely held among Democrats.

REP. EDWARD MARKEY (D-MA): Senator Kennedy's spirit will infuse the Congress towards the goal of providing coverage for all those people who he cared for.

KARL: The tactic has worked before. After the assassination of John Kennedy, President Johnson invoked his memory to revive the long-stalled civil rights bill.

TAD DEVINE (Democratic strategist): What President Johnson did then, by telling the Congress and the people of America that it was time to finish an unfinished agenda, was exactly the right thing to do. And I think it's the right thing to do again.

KARL: But Republicans, even those close to Senator Kennedy, are not buying it.

SEN. ORRIN HATCH (R-UT): Frankly, I'm getting a little bit upset at some of these people trying to take advantage of this and saying we now have to pass health care reform because of Ted. Well, Ted wouldn't want it passed if it wasn't good.

Kennedy voted for HELP bill, saying he "could not be prouder of our Committee"

Kennedy: "We have done the hard work that the American people sent us here to do." A Senate HELP committee press release announcing its July 15 passage of The Affordable Health Choices Act stated:

"I could not be prouder of our Committee. We have done the hard work that the American people sent us here to do. We have considered hundreds of proposals. Where we have been able to reach principled compromise, we have done so. Where we have not been able to resolve our differences, we have treated those with whom we disagree with respect and patience," Chairman Kennedy said. "As we move from our committee room to the Senate floor, we must continue the search for solutions that unite us, so that the great promise of quality affordable health care for all can be fulfilled."

HELP bill includes public option, requirement that all Americans have health insurance. The bill includes a public option and a mandate that each American is covered by a health insurance plan. According to the press release's summary of the bill:

Shared responsibility requires that everyone -- government, insurance companies, medical providers, individuals and employers -- has a part in solving America's health care crisis. The Affordable Health Choices Act requires those businesses which do not provide coverage for their workers to contribute to the cost of providing publicly sponsored coverage for those workers. It includes an exception for small businesses.

The bill also includes a strong public option that responds to the wishes of the American people to have a clear alternative to for-profit insurance companies. Like private insurance plans The Community Health Insurance Option will be available through the American Health Benefit Gateway, a new way for individuals and small employers to find and purchase quality and affordable health insurance in every state.

Kennedy advocated for passage of HELP bill, called health care for all Americans "the cause of my life"

Kennedy called for passage of the bill, citing "urgency" in the need for reform. In a July 18 Newsweek op-ed, Kennedy wrote that ensuring Americans have access to quality health care is the "cause of my life" and advocated for policies in the HELP bill. From the op-ed:

But quality care shouldn't depend on your financial resources, or the type of job you have, or the medical condition you face. Every American should be able to get the same treatment that U.S. senators are entitled to.

This is the cause of my life. It is a key reason that I defied my illness last summer to speak at the Democratic convention in Denver -- to support Barack Obama, but also to make sure, as I said, "that we will break the old gridlock and guarantee that every American...will have decent, quality health care as a fundamental right and not just a privilege." For four decades I have carried this cause -- from the floor of the United States Senate to every part of this country. It has never been merely a question of policy; it goes to the heart of my belief in a just society. Now the issue has more meaning for me -- and more urgency -- than ever before. But it's always been deeply personal, because the importance of health care has been a recurrent lesson throughout most of my 77 years.

[...]

All Americans should be required to have insurance. For those who can't afford the premiums, we can provide subsidies. We'll make it illegal to deny coverage due to preexisting conditions. We'll also prohibit the practice of charging women higher premiums than men, and the elderly far higher premiums than anyone else. The bill drafted by the Senate health committee will let children be covered by their parents' policy until the age of 26, since first jobs after high school or college often don't offer health benefits.

To accomplish all of this, we have to cut the costs of health care. For families who've seen health-insurance premiums more than double -- from an average of less than $6,000 a year to nearly $13,000 since 1999 -- one of the most controversial features of reform is one of the most vital. It's been called the "public plan." Despite what its detractors allege, it's not "socialism." It could take a number of different forms. Our bill favors a "community health-insurance option." In short, this means that the federal government would negotiate rates -- in keeping with local economic conditions -- for a plan that would be offered alongside private insurance options. This will foster competition in pricing and services. It will be a safety net, giving Americans a place to go when they can't find or afford private insurance, and it's critical to holding costs down for everyone.

[...]

I believe the bill will pass, and we will end the disgrace of America as the only major industrialized nation in the world that doesn't guarantee health care for all of its people.

Hatch criticized its passage. Calling the bill "partisan," Hatch asserted in a July 15 statement that "we have another trillion dollar Democratic bill that will impose a job-killing employer tax, create another government-run health care program and give Washington bureaucrats more power than ever before to dictate health care for families in Utah and across the nation."

Karl also used video of town hall from before Kennedy's death to question whether his death inspired "newfound unity"

Karl said town hall occurred "last night," but it actually occurred on the afternoon of August 25, before Kennedy's death. In addition to uncritically airing Hatch's quote, Karl claimed that if "last night's town hall meeting in Phoenix is any indication" of whether Kennedy's death will "inspire newfound unity on health care reform," "the answer seems to be no." But the video Karl aired to support his claim was from an August 25 event that occurred before Kennedy's death, not from "last night."

Thursday, August 27, 2009

Raw Story : GOP senators: No personal responsibility to pass health care in Kennedy's honor

Raw Story » GOP senators: No ‘personal responsibility’ to pass health care in Kennedy’s honor

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He who loses his reputation, loses his shame.
An té a chaillfeas a chlú, caillfidh sé a náire.

Key Dem: "Brain dead" Blue Dogs just out for insurance money

Raw Story » Key Dem: ‘Brain dead’ Blue Dogs just out for insurance money

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A debt is still unpaid, even if forgotten.
Ní dhíolann dearmad fiacha.

t r u t h o u t | Bernanke, Feats and Flaws

t r u t h o u t | Bernanke, Feats and Flaws

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It is the quiet pigs that eat the meal.
Is iad na muca ciúine a itheann an mhin.





"The Cause of My Life"

by: Edward M. Kennedy | Visit article original @ Newsweek

photo
U.S. Senator Ted Kennedy (D-MA) writes that the cost of inaction on reforming the health care system will cost far more over the next decade then current legislation. (Photo: Reuters)

Inside the fight for universal health care. From the magazine issue dated Jul 27, 2009.

In 1964, I was flying with several companions to the Massachusetts Democratic Convention when our small plane crashed and burned short of the runway. My friend and colleague in the Senate, Birch Bayh, risked his life to pull me from the wreckage. Our pilot, Edwin Zimny, and my administrative assistant, Ed Moss, didn't survive. With crushed vertebrae, broken ribs, and a collapsed lung, I spent months in New England Baptist Hospital in Boston. To prevent paralysis, I was strapped into a special bed that immobilizes a patient between two canvas slings. Nurses would regularly turn me over so my lungs didn't fill with fluid. I knew the care was expensive, but I didn't have to worry about that. I needed the care and I got it.

Now I face another medical challenge. Last year, I was diagnosed with a malignant brain tumor. Surgeons at Duke University Medical Center removed part of the tumor, and I had proton-beam radiation at Massachusetts General Hospital. I've undergone many rounds of chemotherapy and continue to receive treatment. Again, I have enjoyed the best medical care money (and a good insurance policy) can buy.

But quality care shouldn't depend on your financial resources, or the type of job you have, or the medical condition you face. Every American should be able to get the same treatment that U.S. senators are entitled to.

This is the cause of my life. It is a key reason that I defied my illness last summer to speak at the Democratic convention in Denver—to support Barack Obama, but also to make sure, as I said, "that we will break the old gridlock and guarantee that every American…will have decent, quality health care as a fundamental right and not just a privilege." For four decades I have carried this cause—from the floor of the United States Senate to every part of this country. It has never been merely a question of policy; it goes to the heart of my belief in a just society. Now the issue has more meaning for me—and more urgency—than ever before. But it's always been deeply personal, because the importance of health care has been a recurrent lesson throughout most of my 77 years.

Nothing I'm enduring now can compare to hearing that my children were seriously ill. In 1973, when I was first fighting in the Senate for universal coverage, we learned that my 12-year-old son Teddy had bone cancer. He had to have his right leg amputated above the knee. Even then, the pathology report showed that some of the cancer cells were very aggressive. There were only a few long-shot options to stop it from spreading further. I decided his best chance for survival was a clinical trial involving massive doses of chemotherapy. Every three weeks, at Children's Hospital Boston, he had to lie still for six hours while the fluid dripped into his arm. I remember watching and praying for him, all the while knowing how sick he would be for days afterward.

During those many hours at the hospital, I came to know other parents whose children had been stricken with the same deadly disease. We all hoped that our child's life would be saved by this experimental treatment. Because we were part of a clinical trial, none of us paid for it. Then the trial was declared a success and terminated before some patients had completed their treatments. That meant families had to have insurance to cover the rest or pay for them out of pocket. Our family had the necessary resources as well as excellent insurance coverage. But other heartbroken parents pleaded with the doctors: What chance does my child have if I can only afford half of the prescribed treatments? Or two thirds? I've sold everything. I've mortgaged as much as possible. No parent should suffer that torment. Not in this country. Not in the richest country in the world.

That experience with Teddy made it clear to me, as never before, that health care must be affordable and available for every mother or father who hears a sick child cry in the night and worries about the deductibles and copays if they go to the doctor. But that was just one medical crisis. My family, like every other, has faced many—at every stage of life. I think of my parents and the medical care they needed after their strokes. I think of my son Patrick, who suffered serious asthma as a child and sometimes had to be rushed to the hospital for treatment. (For this reason, we had no dogs in the house when Patrick was young.) I think of my daughter, Kara, diagnosed with lung cancer in 2002. Few doctors were willing to try an operation. One did—and after that surgery and arduous rounds of chemotherapy and radiation, she's alive and healthy today. My family has had the care it needed. Other families have not, simply because they could not afford it.

I have seen letters and e-mails from many of these less fortunate Americans. In their pleas, there's always dignity, but too often desperation. "Our school is closing in June of 2010, which means that I will be losing my job and my health insurance," writes Mary Dunn, a 58-year-old schoolteacher in Eden, S.D. "I am a Type I diabetic, and I had heart bypass surgery in 2005. My husband is also a teacher [here], so we will both be losing insurance. I am exploring options and have been told that I cannot stay on our group policy or transfer to another policy after our jobs cease because of my medical condition. What am I to do after 39 years of teaching to acquire adequate health coverage?" Dunn also serves as mayor of Eden, for which she is paid $45 a month with no health benefits.

How will we, as a nation, answer her? I've heard countless such stories, including one from the family of Cassandra Wilson, a 14-year-old who once was a competitive ice skater. She's uninsured because she has petit mal seizures, often 200 times a day. Her parents have run up $30,000 on their credit cards. They've sold her skating equipment on eBay to pay for her care.

These two cases represent only those patients who lack coverage. We also need to find answers for the increasing number of Americans whose insurance costs too much, covers too little, and can be too easily revoked when they face the most serious illnesses.

Our response to these challenges will define our character as a country. But the challenges themselves—and the demands for reform—are not new. In 1912, when Theodore Roosevelt ran for a third term as president, the platform of his newly created Progressive Party called for national health insurance. Harry Truman proposed it again more than 30 years after Roosevelt was defeated. The plan was attacked, not for the last time, as "socialized medicine," and members of Truman's White House staff were branded "followers of the Moscow party line."

For the next generation, no one ventured to tread where T.R. and Truman fell short. But in the early 1960s, a new young president was determined to take a first step—to free the elderly from the threat of medical poverty. John Kennedy called Medicare "one of the most important measures I have advocated." He understood the pain of injury and illness: as a senator, he had almost died after surgery to repair a back injury sustained during World War II, an injury that would plague him all of his life. I was in college as he recuperated and learned to walk without crutches at my parents' winter home in Florida. I visited often, and we spent afternoons painting landscapes and seascapes. (It was a competition: at dinner after we finished, we would ask family members to decide whose painting was better.) I saw how the pain would periodically hit him as we were painting; he'd have to put down his brush for a while. And I saw, too, how hard he fought as president to pass Medicare. It was a battle he didn't have the opportunity to finish. But I was in the Senate to vote for the Medicare bill before Lyndon Johnson signed it into law—with Harry Truman at his side. In the Senate, I viewed Medicare as a great achievement, but only a beginning. In 1966, I visited the Columbia Point Neighborhood Health Center in Boston; it was a pilot project providing health services to low-income families in the two-floor office of an apartment building. I saw mothers in rocking chairs, tending their children in a warm and welcoming setting. They told me this was the first time they could get basic care without spending hours on public transportation and in hospital waiting rooms. I authored legislation, which passed a few months later, establishing the network of community health centers that are all around America today.

Some years later, I decided the time was right to renew the quest for universal and affordable coverage. When I first introduced the bill in 1970, I didn't expect an easy victory (although I never suspected that it would take this long). I eventually came to believe that we'd have to give up on the ideal of a government-run, single-payer system if we wanted to get universal care. Some of my allies called me a sellout because I was willing to compromise. Even so, we almost had a plan that President Richard Nixon was willing to sign in 1974—but that chance was lost as the Watergate storm swept Washington and the country, and swept Nixon out of the White House. I tried to negotiate an agreement with President Carter but became frustrated when he decided that he'd rather take a piecemeal approach. I ran against Carter, a sitting president from my own party, in large part because of this disagreement. Health reform became central to my 1980 presidential campaign: I argued then that the issue wasn't just coverage but also out-of-control costs that would ultimately break both family and federal budgets, and increasingly burden the national economy. I even predicted, optimistically, that the business community, largely opposed to reform, would come around to supporting it.

That didn't happen as soon as I thought it would. When Bill Clinton returned to the issue in the first years of his presidency, I fought the battle in Congress. We lost to a virtually united front of corporations, insurance companies, and other interest groups. The Clinton proposal never even came to a vote. But we didn't just walk away and do nothing—even though Republicans were again in control of Congress. We returned to a step-by-step approach. With Sen. Nancy Landon Kassebaum of Kansas, the daughter of the 1936 Republican presidential nominee, I crafted a law to make health insurance more portable for those who change or lose jobs. It didn't do enough to fully guarantee that, but we made progress. I worked with my friend Sen. Orrin Hatch of Utah, the Republican chair of our committee, to enact CHIP, the Children's Health Insurance Program; today it covers more than 7 million children from low-income families, although too many of them could soon lose coverage as impoverished state governments cut their contributions.

Incremental measures won't suffice anymore. We need to succeed where Teddy Roosevelt and all others since have failed. The conditions now are better than ever. In Barack Obama, we have a president who's announced that he's determined to sign a bill into law this fall. And much of the business community, which has suffered the economic cost of inaction, is helping to shape change, not lobbying against it. I know this because I've spent the past year, along with my staff, negotiating with business leaders, hospital administrators, and doctors. As soon as I left the hospital last summer, I was on the phone, and I've kept at it. Since the inauguration, the administration has been deeply involved in the process. So have my Senate colleagues—in particular Max Baucus, the chair of the Finance Committee, and my friend and partner in this mission, Chris Dodd. Even those most ardently opposed to reform in the past have been willing to make constructive gestures now.

To help finance a bill, the pharmaceutical industry has agreed to lower prices for seniors, not only saving them money for prescriptions but also saving the government tens of billions in Medicare payments over the next decade. Senator Baucus has agreed with hospitals on more than $100 billion in savings. We're working with Republicans to make this a bipartisan effort. Everyone won't be satisfied—and no one will get everything they want. But we need to come together, just as we've done in other great struggles—in World War II and the Cold War, in passing the great civil-rights laws of the 1960s, and in daring to send a man to the moon. If we don't get every provision right, we can adjust and improve the program next year or in the years to come. What we can't afford is to wait another generation.

I long ago learned that you have to be a realist as you pursue your ideals. But whatever the compromises, there are several elements that are essential to any health-reform plan worthy of the name.

First, we have to cover the uninsured. When President Clinton proposed his plan, 33 million Americans had no health insurance. Today the official number has reached 47 million, but the economic crisis will certainly push the total higher. Unless we act now, within a few years, 55 million Americans could be left without coverage even as the economy recovers.

All Americans should be required to have insurance. For those who can't afford the premiums, we can provide subsidies. We'll make it illegal to deny coverage due to preexisting conditions. We'll also prohibit the practice of charging women higher premiums than men, and the elderly far higher premiums than anyone else. The bill drafted by the Senate health committee will let children be covered by their parents' policy until the age of 26, since first jobs after high school or college often don't offer health benefits.

To accomplish all of this, we have to cut the costs of health care. For families who've seen health-insurance premiums more than double—from an average of less than $6,000 a year to nearly $13,000 since 1999—one of the most controversial features of reform is one of the most vital. It's been called the "public plan." Despite what its detractors allege, it's not "socialism." It could take a number of different forms. Our bill favors a "community health-insurance option." In short, this means that the federal government would negotiate rates—in keeping with local economic conditions—for a plan that would be offered alongside private insurance options. This will foster competition in pricing and services. It will be a safety net, giving Americans a place to go when they can't find or afford private insurance, and it's critical to holding costs down for everyone.

We also need to move from a system that rewards doctors for the sheer volume of tests and treatments they prescribe to one that rewards quality and positive outcomes. For example, in Medicare today, 18 percent of patients discharged from a hospital are readmitted within 30 days—at a cost of more than $15 billion in 2005. Most of these readmissions are unnecessary, but we don't reward hospitals and doctors for preventing them. By changing that, we'll save billions of dollars while improving the quality of care for patients.

Social justice is often the best economics. We can help disabled Americans who want to live in their homes instead of a nursing home. Simple things can make all the difference, like having the money to install handrails or have someone stop by and help every day. It's more humane and less costly—for the government and for families—than paying for institutionalized care. That's why we should give all Americans a tax deduction to set aside a small portion of their earnings each month to provide for long-term care.

Another cardinal principle of reform: we have to make certain that people can keep the coverage they already have. Millions of employers already provide health insurance for their employees. We shouldn't do anything to disturb this. On the contrary, we need to mandate employer responsibility: except for small businesses with fewer than 25 employees, every company should have to cover its workers or pay into a system that will.

We need to prevent disease and not just cure it. (Today 80 percent of health spending pays for care for the 20 percent of Americans with chronic illnesses like diabetes, cancer, or heart disease.) Too many people get to the doctor too seldom or too late—or know too little about how to stay healthy. No one knows better than I do that when it comes to advanced, highly specialized treatments, America can boast the best health care in the world—at least for those who can afford it. But we still have to modernize a system that doesn't always provide the basics.

I've heard the critics complain about the costs of change. I'm confident that at the end of the process, the change will be paid for—fairly, responsibly, and without adding to the federal deficit. It doesn't make sense to negotiate in the pages of NEWSWEEK, but I will say that I'm open to many options, including a surtax on the wealthy, as long as it meets the principle laid down by President Obama: that there will be no tax increases on anyone making less than $250,000 a year. What I haven't heard the critics discuss is the cost of inaction. If we don't reform the system, if we leave things as they are, health-care inflation will cost far more over the next decade than health-care reform. We will pay far more for far less—with millions more Americans uninsured or underinsured.

This would threaten not just the health of Americans but also the strength of the American economy. Health-care spending already accounts for 17 percent of our entire domestic product. In other advanced nations, where the figure is around 10 percent, everyone has insurance and health outcomes that are equal or better than ours. This disparity undermines our ability to compete and succeed in the global economy. General Motors spends more per vehicle on health care than on steel.

We will bring health-care reform to the Senate and House floors soon, and there will be a vote. A century-long struggle will reach its climax. We're almost there. In the meantime, I will continue what I've been doing—making calls, urging progress. I've had dinner twice recently at my home in Hyannis Port with Senator Dodd, and when President Obama called me during his Rome trip after meeting with the Pope, much of our discussion was about health care. I believe the bill will pass, and we will end the disgrace of America as the only major industrialized nation in the world that doesn't guarantee health care for all of its people.

At another Democratic convention, in arguing for this cause, I spoke of the insurance coverage senators and members of Congress provide for themselves. That was 1980. In the last year, I've often relied on that Congressional insurance. My wife, Vicki, and I have worried about many things, but not whether we could afford my care and treatment. Each time I've made a phone call or held a meeting about the health bill—or even when I've had the opportunity to get out for a sail along the Massachusetts coast—I've thought in an even more powerful way than before about what this will mean to others. And I am resolved to see to it this year that we create a system to ensure that someday, when there is a cure for the disease I now have, no American who needs it will be denied it.

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This story was written with Robert Shrum, Senator Kennedy’s friend and longtime speechwriter.

Wednesday, August 26, 2009

God's Speed. We Who Take Up The Torch Will Miss You



Kennedy brothers in Hyannis Port 1960


090826-edward-kennedyIn the aftermath of the 2004 presidential election, the Democrats were roundly accused of losing the “moral values voters” in America, and of being the party of “secularists” who were hostile to faith and religion. The very first Democrat to call me and ask to talk about that accusation and how to change the moral debate in America was Ted Kennedy. He invited me to his home, where he and his wife, Vicki, engaged me in a long and very thoughtful conversation into the night about the relationship between faith, morality, and politics. Their own deep Catholic faith was evident and their articulation of it very impressive. Our discussion was not partisan at all — it was not about how to win religion back for the Democrats. Rather, we focused on the great moral issues facing the nation, and how we as people of faith needed to respond to them.

On the occasion of his death, I pray that God may now move us as a nation to address the greatest commitment of Sen. Kennedy’s life — the need for a comprehensive reform of the health-care system in America — as a deeply moral issue and one that calls forth the very best that is within us. May we honor the life and death of Sen. Edward Kennedy by laying aside the rancor, lies, fear, and even hate that has come to dominate the health-care debate in America this summer, and regain our moral compass by recovering the moral core of this debate: that too many Americans are hurting and suffering in a broken and highly inequitable health-care system, and that it is our moral obligation to repair and reform it — now.

Edward Kennedy, Senate Stalwart, Dies

Senator Edward M. Kennedy of Massachusetts, a son of one of the most storied families in American politics, a man who knew triumph and tragedy in near-equal measure and who will be remembered as one of the most effective lawmakers in the history of the Senate, died late Tuesday night. He was 77.

The death of Mr. Kennedy, who had been battling brain cancer, was announced Wednesday morning in a statement by the Kennedy family, which was already mourning the death of the senator’s sister Eunice Kennedy Shriver two weeks earlier.

“Edward M. Kennedy — the husband, father, grandfather, brother and uncle we loved so deeply – died late Tuesday night at home in Hyannis Port,” the statement said. “We’ve lost the irreplaceable center of our family and joyous light in our lives, but the inspiration of his faith, optimism, and perseverance will live on in our hearts forever.”

President Obama issued a statement acknowledging Mr. Kennedy’s accomplishments. “An important chapter in our history has come to an end,” the statement said. “Our country has lost a great leader, who picked up the torch of his fallen brothers and became the greatest United States senator of our time.”

Mr. Kennedy had been in precarious health since he suffered a seizure in May 2008. His doctors determined the cause was a malignant glioma, a brain tumor that often carries a grim prognosis.

As he underwent cancer treatment, Mr. Kennedy was little seen in Washington, appearing most recently at the White House in April as Mr. Obama signed a national service bill that bears the Kennedy name. Last week Mr. Kennedy urged Massachusetts lawmakers to change state law and let Gov. Deval Patrick appoint a temporary replacement upon his death, to assure that the state’s representation in Congress would not be interrupted by a special election.

While Mr. Kennedy was physically absent from the capital in recent months, his presence was deeply felt as Congress weighed the most sweeping revisions to America’s health care system in decades, an effort Mr. Kennedy called “the cause of my life.”

On July 15, the Senate Health, Education, Labor and Pensions committee, which Mr. Kennedy headed, passed health care legislation, and the battle over the proposed overhaul is now consuming Capitol Hill.

Mr. Kennedy was the last surviving brother of a generation of Kennedys that dominated American politics in the 1960s and that came to embody glamour, political idealism and untimely death. The Kennedy mystique — some call it the Kennedy myth — has held the imagination of the world for decades, and it came to rest on the sometimes too-narrow shoulders of the brother known as Teddy.

Mr. Kennedy, who served 46 years as the most well-known Democrat in the Senate, longer than all but two other senators, was the only one of those brothers to reach old age. President John F. Kennedy and Senator Robert F. Kennedy were felled by assassins’ bullets in their 40s. The eldest brother, Joseph P. Kennedy Jr., died in 1944 at the age of 29 while on a risky World War II bombing mission.

Mr. Kennedy spent much of last year in treatment and recuperation, broken by occasional public appearances and a dramatic return to the Capitol last summer to cast a decisive vote on a Medicare bill.

He electrified the opening night of the Democratic National Convention in Denver in August with an unscheduled appearance and a speech that had delegates on their feet. Many were in tears.

His gait was halting, but his voice was strong. “My fellow Democrats, my fellow Americans, it is so wonderful to be here, and nothing is going to keep me away from this special gathering tonight,” Mr. Kennedy said. “I have come here tonight to stand with you to change America, to restore its future, to rise to our best ideals and to elect Barack Obama president of the United States.”

Senator Kennedy was at or near the center of much of American history in the latter part of the 20th century and the early years of the 21st. For much of his adult life, he veered from victory to catastrophe, winning every Senate election he entered but failing in his only try for the presidency; living through the sudden deaths of his brothers and three of his nephews; being responsible for the drowning death on Chappaquiddick Island of a young woman, Mary Jo Kopechne, a former aide to his brother Robert. One of the nephews, John F. Kennedy Jr., who the family hoped would one day seek political office and keep the Kennedy tradition alive, died in a plane crash in 1999 at age 38.

Mr. Kennedy himself was almost killed in 1964, in a plane crash that left him with permanent back and neck problems.

He was a Rabelaisian figure in the Senate and in life, instantly recognizable by his shock of white hair, his florid, oversize face, his booming Boston brogue, his powerful but pained stride. He was a celebrity, sometimes a self-parody, a hearty friend, an implacable foe, a man of large faith and large flaws, a melancholy character who persevered, drank deeply and sang loudly. He was a Kennedy.

Senator Robert C. Byrd, Democrat of West Virginia, one of the institution’s most devoted students, said of his longtime colleague, “Ted Kennedy would have been a leader, an outstanding senator, at any period in the nation’s history.”

Mr. Byrd is one of only two senators to have served longer in the chamber than Mr. Kennedy; the other was Strom Thurmond of South Carolina. In May 2008, on learning of Mr. Kennedy’s diagnosis of a lethal brain tumor, Mr. Byrd wept openly on the floor of the Senate.

Born to one of the wealthiest American families, Mr. Kennedy spoke for the downtrodden in his public life while living the heedless private life of a playboy and a rake for many of his years. Dismissed early in his career as a lightweight and an unworthy successor to his revered brothers, he grew in stature over time by sheer longevity and by hewing to liberal principles while often crossing the partisan aisle to enact legislation. A man of unbridled appetites at times, he nevertheless brought a discipline to his public work that resulted in an impressive catalog of legislative achievement across a broad landscape of social policy.

Mr. Kennedy left his mark on legislation concerning civil rights, health care, education, voting rights and labor. He was chairman of the Senate Committee on Health, Education, Labor and Pensions at his death. But he was more than a legislator. He was a living legend whose presence ensured a crowd and whose hovering figure haunted many a president.

Although he was a leading spokesman for liberal issues and a favorite target of conservative fund-raising appeals, the hallmark of his legislative success was his ability to find Republican allies to get bills passed. Perhaps the last notable example was his work with President George W. Bush to pass No Child Left Behind, the education law pushed by Mr. Bush in 2001. He also co-sponsored immigration legislation with Senator John McCain, the 2008 Republican presidential nominee. One of his greatest friends and collaborators in the Senate was Orrin Hatch, the Utah Republican.

Mr. Kennedy had less impact on foreign policy than on domestic concerns, but when he spoke his voice was influential. He led the Congressional effort to impose sanctions on South Africa over apartheid, pushed for peace in Northern Ireland, won a ban on arms sales to the dictatorship in Chile and denounced the Vietnam War. In 2002, he voted against authorizing the Iraq war; later, he called that opposition “the best vote I’ve made in my 44 years in the United States Senate.”

At a pivotal moment in the 2008 Democratic presidential primaries, Mr. Kennedy endorsed Senator Obama for president, saying Mr. Obama offered America a chance for racial reconciliation and an opportunity to turn the page on the polarizing politics of the past several decades.

“He will be a president who refuses to be trapped in the patterns of the past,” Mr. Kennedy told an Obama rally in Washington on Jan. 28, 2008. “He is a leader who sees the world clearly, without being cynical. He is a fighter who cares passionately about the causes he believes in without demonizing those who hold a different view.”

Mr. Kennedy struggled for much of his life with his weight, with alcohol and with persistent tales of womanizing. In an Easter break episode in 1991 in Palm Beach, Fla., he went out drinking with his son Patrick and a nephew, William Kennedy Smith, on the night that Mr. Smith was accused of raping a woman. Mr. Smith was prosecuted in a lurid trial that fall but was acquitted.

Mr. Kennedy’s personal life stabilized in 1992 with his marriage to Victoria Anne Reggie, a Washington lawyer. His first marriage, to Joan Bennett Kennedy, ended in divorce in 1982 after 24 years.

Senator Kennedy served as a surrogate father to his brothers’ children and worked to keep the Kennedy flame alive through the Kennedy Library in Boston, the Kennedy Center in Washington and the Kennedy School of Government at Harvard University, where he helped establish the Institute of Politics.

In December, Harvard granted Mr. Kennedy a special honorary degree. He referred to Mr. Obama’s election as “not just a culmination, but a new beginning.”

He then spoke of his own life, and perhaps his legacy.

“We know the future will outlast all of us, but I believe that all of us will live on in the future we make,” he said. “I have lived a blessed time.”

Kennedy family courtiers and many other Democrats believed he would eventually win the White House and redeem the promise of his older brothers. In 1980, he took on the president of his own party, Jimmy Carter, but fell short because of Chappaquiddick, a divided party and his own weaknesses as a candidate, including an inability to articulate why he sought the office.

But as that race ended in August at the Democratic National Convention in New York, Mr. Kennedy delivered his most memorable words, wrapping his dedication to party principles in the gauzy cloak of Camelot.

“For me, a few hours ago, this campaign came to an end,” Mr. Kennedy said in the coda to a speech before a rapt audience at Madison Square Garden and on television. “For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives, and the dream shall never die.”

A Family Steeped in Politics

Born Feb. 22, 1932, in Brookline, Mass., just outside Boston, Edward Moore Kennedy grew up in a family of shrewd politicians. Both his father, Joseph P. Kennedy, and his mother, the former Rose Fitzgerald, came from prominent Irish-Catholic families with long involvement in the hurly-burly of Democratic politics in Boston and Massachusetts. His father, who made a fortune in real estate, movies and banking, served in President Franklin D. Roosevelt’s administration, as the first chairman of the Securities and Exchange Commission and then as ambassador to Britain.

There were nine Kennedy children, four boys and five girls, with Edward the youngest. They grew up talking politics, power and influence because those were the things that preoccupied the mind of Joseph Kennedy. As Rose Kennedy, who took responsibility for the children’s Roman Catholic upbringing, once put it, “My babies were rocked to political lullabies.”

When Edward was born, President Herbert Hoover sent Rose a bouquet of flowers and a note of congratulations. The note came with 5 cents postage due; the framed envelope is a family heirloom.

It was understood among the children that Joseph P. Kennedy Jr., the oldest boy, would someday run for Congress and, his father hoped, the White House. When Joseph Jr. was killed in World War II, it fell to the next oldest son, John, to run. As John said at one point in 1959 while serving in the Senate: “Just as I went into politics because Joe died, if anything happened to me tomorrow, Bobby would run for my seat in the Senate. And if Bobby died, our young brother, Ted, would take over for him.”

Although surrounded by the trappings of wealth — stately houses, servants and expensive cars — young Teddy did not enjoy a settled childhood. He bounced among the family homes in Boston, New York, London and Palm Beach, and by the time he was ready to enter college, he had attended 10 preparatory schools in the United States and England, finally finishing at Milton Academy, near Boston. He said that the constant moving had forced him to become more genial with strangers; indeed, he grew to be more of a natural politician than either John or Robert.

After graduating from Milton in 1950, where he showed a penchant for debating and sports but was otherwise an undistinguished student, Mr. Kennedy enrolled in Harvard, as had his father and brothers. It was at Harvard, in his freshman year, that he ran into the first of several personal troubles that were to dog him for the rest of his life: He persuaded another student to take his Spanish examination, got caught and was forced to leave the university.

Suddenly draft-eligible during the Korean War, Mr. Kennedy enlisted in the Army and served two years, securing, with his father’s help, a cushy post at NATO headquarters in Paris. In 1953, he was discharged with the rank of private first class.

Re-enrolling in Harvard, he became a more serious student, majoring in government, excelling in public speaking and playing first-string end on the football team. He graduated in 1956 with a Bachelor of Arts degree, then enrolled in the University of Virginia School of Law, where Robert had studied. There, he won the moot court competition and took a degree in 1959. Later that year, he was admitted to the Massachusetts bar.

Mr. Kennedy’s first foray into politics came in 1958, while still a law student, when he managed John’s Senate re-election campaign. There was never any real doubt that Massachusetts voters would return John Kennedy to Washington, but it was a useful internship for his youngest brother.

That same year, Mr. Kennedy married Virginia Joan Bennett, a debutante from Bronxville, a New York suburb where the Kennedys had once lived. In 1960, when John Kennedy ran for president, Edward was assigned a relatively minor role, rustling up votes in Western states that usually voted Republican. He was so enthusiastic about his task that he rode a bronco at a Montana rodeo and daringly took a ski jump at a winter sports tournament in Wisconsin to impress a crowd. The episodes were evidence of a reckless streak that repeatedly threatened his life and career.

John Kennedy’s election to the White House left vacant a Senate seat that the family considered its property. Robert Kennedy was next in line, but chose the post of attorney general instead (an act of nepotism that has since been outlawed). Edward was only 28, two years shy of the minimum age for Senate service.

So the Kennedys installed Benjamin A. Smith II, a family friend, as a seat-warmer until 1962, when a special election would be held and Edward would have turned 30. Edward used the time to travel the world and work as an assistant district attorney in Boston, waiving the $5,000 salary and serving instead for $1 a year.

As James Sterling Young, the director of a Kennedy Oral History Project at the University of Virginia, put it: “Most people grow up and go into politics. The Kennedys go into politics and then they grow up.”

Less than a month after turning 30 in 1962, Mr. Kennedy declared his candidacy for the remaining two years of his brother’s Senate term. He entered the race with a tailwind of family money and political prominence. Nevertheless, Edward J. McCormack Jr., the state’s attorney general and a nephew of John W. McCormack, then speaker of the United States House of Representatives, also decided to go after the seat.

It was a bitter fight, with a public rehash of the Harvard cheating episode and with Mr. McCormack charging in a televised “Teddy-Eddie” debate that Mr. Kennedy lacked maturity of judgment because he had “never worked for a living” and had never held elective office. “If your name was simply Edward Moore instead of Edward Moore Kennedy,” Mr. McCormack added, “your candidacy would be a joke.”

But the Kennedys had ushered in an era of celebrity politics, which trumped qualifications in this case. Mr. Kennedy won the primary by a two-to-one ratio, then went on to easy victory in November against the Republican candidate, George Cabot Lodge, a member of an old-line Boston family that had clashed politically with the Kennedys through the years.

When Mr. Kennedy entered the Senate in 1962, he was aware that he might be seen as an upstart, with one brother in the White House and another in the cabinet. He sought guidance on the very first day from one of the Senate’s most respected elders, Richard Russell of Georgia. “You go further if you go slow,” Senator Russell advised.

Mr. Kennedy took things slowly, especially that first year. He did his homework, was seen more than he was heard and was deferential to veteran legislators.

On Friday, Nov. 22, 1963, he was presiding over the Senate when a wire service ticker in the lobby brought the news of John Kennedy’s shooting in Dallas. Violence had claimed the second of Joseph Kennedy’s sons.

Edward was sent to Hyannis Port to break the news to his father, who had been disabled by a stroke. He returned to Washington for the televised funeral and burial, the first many Americans had seen of him. He and Robert had planned to read excerpts from John’s speeches at the Arlington burial service. At the last moment they chose not to.

A friend described him as “shattered — calm but shattered.”

A Deadly Plane Crash

Robert moved into the breach and was immediately discussed as a presidential prospect. Edward became a more prominent family spokesman.

The next year, he was up for re-election. A heavy favorite from the start, he was on his way to the state convention that was to renominate him when his light plane crashed in a storm near Westfield, Mass. The pilot and a Kennedy aide were killed, and Mr. Kennedy’s back and several ribs were broken. Senator Birch Bayh of Indiana pulled Mr. Kennedy from the plane.

The senator was hospitalized for the next six months, suspended immobile in a frame that resembled a waffle iron. His wife, Joan, carried on his campaign, mainly by advising voters that he was steadily recovering. He won easily over a little-known Republican, Howard Whitmore Jr.

During his convalescence, Mr. Kennedy devoted himself to his legislative work. He was briefed by a parade of Harvard professors and began to develop his positions on immigration, health care and civil rights.

“I never thought the time was lost,” he said later. “I had a lot of hours to think about what was important and what was not and about what I wanted to do with my life.”

He returned to the Senate in 1965, joining his brother Robert, who had won a seat from New York. Edward promptly entered a major fight, his first. President Lyndon B. Johnson’s Voting Rights Act was up for consideration, and Mr. Kennedy tried to strengthen it with an amendment that would have outlawed poll taxes. He lost by only four votes, serving lasting notice on his colleagues that he was a rapidly maturing legislator who could prepare a good case and argue it effectively.

Mr. Kennedy was slow to oppose the war in Vietnam, but in 1968, shortly after Robert decided to seek the presidency on an antiwar platform, Edward called the war a “monstrous outrage.”

Robert Kennedy was shot on June 5, 1968, as he celebrated his victory in the California primary, becoming the third of Joseph Kennedy’s sons to die a violent death. Edward was in San Francisco at a victory celebration. He commandeered an Air Force plane and flew to Los Angeles.

Frank Mankiewicz, Robert’s press secretary, saw Edward “leaning over the sink with the most awful expression on his face.”

“Much more than agony, more than anguish — I don’t know if there’s a word for it,” Mr. Mankiewicz said, recalling the encounter in “Edward M. Kennedy: A Biography,” by Adam Clymer (William Morrow, 1999).

Robert’s death draped Edward in the Kennedy mantle long before he was ready for it and forced him to confront his own mortality. But he summoned himself to deliver an eloquent eulogy at St. Patrick’s Cathedral in New York.

“My brother need not be idealized, or enlarged in death beyond what he was in life, to be remembered simply as a good and decent man, who saw wrong and tried to right it, saw suffering and tried to heal it, saw war and tried to stop it,” Mr. Kennedy said, his voice faltering. “Those of us who loved him and who take him to his rest today pray that what he was to us and what he wished for others will someday come to pass for all the world.”

A New Role as Patriarch

After the funeral, Edward Kennedy withdrew from public life and spent several months brooding, much of it while sailing off the New England coast.

Near the end of the summer of 1968, he emerged from seclusion, the sole survivor of Joseph Kennedy’s boys, ready to take over as family patriarch and substitute father to John’s and Robert’s 13 children, seemingly eager to get on with what he called his “public responsibilities.”

“There is no safety in hiding,” he declared in a speech at Holy Cross College in Worcester, Mass., in August. “Like my brothers before me, I pick up a fallen standard. Sustained by the memory of our priceless years together, I shall try to carry forward that special commitment to justice, excellence and courage that distinguished their lives.”

There was some talk of his running for president at that point. But he ultimately endorsed Hubert H. Humphrey in his losing campaign to Richard M. Nixon.

Mr. Kennedy focused more on bringing the war in Vietnam to an end and on building his Senate career. Although only 36, he challenged Senator Russell B. Long of Louisiana, one of the shrewdest, most powerful legislators on Capitol Hill, for the post of deputy majority leader. Fellow liberals sided with him, and he edged Mr. Long by five votes to become the youngest assistant majority leader, or whip, in Senate history.

He plunged into the new job with Kennedy enthusiasm. But fate, and the Kennedy recklessness, intervened on July 18, 1969. Mr. Kennedy was at a party with several women who had been aides to Robert. The party, a liquor-soaked barbecue, was held at a rented cottage on Chappaquiddick Island, off Martha’s Vineyard. He left around midnight with Mary Jo Kopechne, 28, took a turn away from the ferry landing and drove the car off a narrow bridge on an isolated beach road. The car sank in eight feet of water, but he managed to escape. Miss Kopechne, a former campaign worker for Robert, drowned.

Mr. Kennedy did not report the accident to the authorities for almost 10 hours, explaining later that he had been so banged about by the crash that he had suffered a concussion, and that he had become so exhausted while trying to rescue Miss Kopechne that he had gone immediately to bed. A week later, he pleaded guilty to a charge of leaving the scene of an accident and was given a two-month suspended sentence.

But that was far from the end of the episode. Questions lingered in the minds of the Massachusetts authorities and of the general public. Why was the car on an isolated road? Had he been drinking? (Mr. Kennedy testified at an inquest that he had had two drinks.) What sort of relationship did Mr. Kennedy and Miss Kopechne have? Could she have been saved if he had sought help immediately? Why did the senator tell his political advisers about the accident before reporting it to the police?

The controversy became so intense that Mr. Kennedy went on television to ask Massachusetts voters whether he should resign from office. He conceded that his actions after the crash had been “indefensible.” But he steadfastly denied any intentional wrongdoing.

His constituents sent word that he should remain in the Senate. And little more than a year later, he easily won re-election to a second full term, again defeating a little-known Republican, Josiah A. Spaulding, by a three-to-two ratio. But his heart did not seem to be in his work any longer. He was sometimes absent from Senate sessions and neglected his whip duties. Senator Byrd, of West Virginia, took the job away from him by putting together a coalition of Southern and border-state Democrats to vote him out.

That loss shook Mr. Kennedy out of his lethargy. He rededicated himself to his role as a legislator. “It hurts like hell to lose,” he said, “but now I can get around the country more. And it frees me to spend more time on issues I’m interested in.” Many years later, he became friends with Mr. Byrd and told him the defeat had been the best thing that could have happened in his Senate career.

Turmoil at Home

In the next decade, Mr. Kennedy expanded on his national reputation, first pushing to end the war in Vietnam, then concentrating on his favorite legislative issues, especially civil rights, health, taxes, criminal laws and deregulation of the airline and trucking industries. He traveled the country, making speeches that kept him in the public eye.

But when he was mentioned as a possible candidate for president in 1972, he demurred; and when the Democratic nominee, George S. McGovern, offered him the vice-presidential nomination, Mr. Kennedy again said no, not wanting to face the inevitable Chappaquiddick questions.

In 1973, his son Edward M. Kennedy Jr., then 12, developed a bone cancer that cost him a leg. The next year, Mr. Kennedy took himself out of the 1976 presidential race. Instead, he easily won a third full term in the Senate, and Jimmy Carter, a former one-term governor of Georgia, moved into the White House.

In early 1978, Mr. Kennedy’s wife, Joan, moved out of their sprawling contemporary house overlooking the Potomac River near McLean, Va., a Washington suburb. She took up residence in an apartment of her own in Boston, saying she wanted to “explore options other than being a housewife and mother.” But she also acknowledged a problem with alcohol, and conceded that she was increasingly uncomfortable with the pressure-cooker life that went with membership in the Kennedy clan. She began studying music and enrolled in a program for alcoholics.

The separation posed not only personal but also political problems for the senator. After Mrs. Kennedy left for Boston, there were rumors that linked the senator with other women. He maintained that he still loved his wife and indicated that the main reason for the separation was Mrs. Kennedy’s desire to work out her alcohol problem. She subsequently campaigned for him in the 1980 race, but there was never any real reconciliation, and they eventually entered divorce proceedings.

Although Mr. Kennedy supported Mr. Carter in 1976, by late 1978 he was disenchanted. Polls indicated that the senator was becoming popular while the president was losing support. In December, at a midterm Democratic convention in Memphis, Mr. Kennedy could hold back no longer. He gave a thundering speech that, in retrospect, was the opening shot in the 1980 campaign.

“Sometimes a party must sail against the wind,” he declared, referring to Mr. Carter’s economic belt-tightening and political caution. “We cannot heed the call of those who say it is time to furl the sail. The party that tore itself apart over Vietnam in the 1960s cannot afford to tear itself apart today over budget cuts in basic social programs.”

Mr. Kennedy did not then declare his candidacy. But draft-Kennedy groups began to form in early 1979, and some Democrats up for re-election in 1980 began to cast about for coattails that were longer than Mr. Carter’s.

After consulting advisers and family members over the summer of 1979, Mr. Kennedy began speaking openly of challenging the president, and on Nov. 7, 1979, he announced officially that he would run. “Our leaders have resigned themselves to defeat,” he said.

The campaign was a disaster, badly organized and appearing to lack a political or policy premise. His speeches were clumsy, and his delivery was frequently stumbling and bombastic. And in the background, Chappaquiddick always loomed. He won the New York and California primaries, but the victories were too little and came too late to unseat Mr. Carter. At the party’s nominating convention in New York, however, he stole the show with his “dream shall never die” speech.

With the approach of the 1984 election, there was the inevitable speculation that Mr. Kennedy, who had easily won re-election to the Senate in 1982, would again seek the presidency. He prepared and planned a campaign. But in the end he chose not to run, saying he wanted to spare his family a repeat of the ordeal they went through in 1980. Skeptics said he also knew he could not fight the undertow of Chappaquiddick.

A Full-On Senate Focus

Freed at last of the expectation that he should and would seek the White House, Mr. Kennedy devoted himself fully to his day job in the Senate. He led the fight for the 18-year-old vote, the abolition of the draft, deregulation of the airline and trucking industries, and the post-Watergate campaign finance legislation. He was deeply involved in renewals of the Voting Rights Act and the Fair Housing law of 1968. He helped establish the Occupational Safety and Health Administration. He built federal support for community health care centers, increased cancer research financing and helped create the Meals on Wheels program. He was a major proponent of a health and nutrition program for pregnant women and infants.

When Republicans took over the Senate in 1981, Mr. Kennedy requested the ranking minority position on the Labor and Public Welfare Committee, asserting that the issues before the labor and welfare panel would be more important during the Reagan years.

In the years after his failed White House bid, Mr. Kennedy also established himself as someone who made “lawmaker” mean more than a word used in headlines to describe any member of Congress. Though his personal life was a mess until his remarriage in the early 1990s, he never failed to show up prepared for a committee hearing or a floor debate.

His most notable focus was civil rights, “still the unfinished business of America,” he often said. In 1982, he led a successful fight to defeat the Reagan administration’s effort to weaken the Voting Rights Act.

In one of those bipartisan alliances that were hallmarks of his legislative successes, Mr. Kennedy worked with Senator Bob Dole, Republican of Kansas, to secure passage of the voting rights measure, and Mr. Dole got most of the credit.

Perhaps his greatest success on civil rights came in 1990 with passage of the Americans with Disabilities Act, which required employers and public facilities to make “reasonable accommodation” for the disabled. When the law was finally passed, Mr. Kennedy and others told how their views on the bill had been shaped by having relatives with disabilities. Mr. Kennedy cited his mentally disabled sister, Rosemary, and his son who had lost a leg to cancer.

Mr. Kennedy was one of Bill and Hillary Clinton’s strongest allies in their failed 1994 effort to enact national health insurance, a measure the senator had been pushing, in one form or another, since 1969.

But he kept pushing incremental reforms, and in 1997, teaming with Senator Hatch, Mr. Kennedy helped enact a landmark health care program for children in low-income families, a program now known as the State Children’s Health Insurance Program, or S-Chip.

He led efforts to increase aid for higher education and win passage of Mr. Bush’s No Child Left Behind Act. He pushed for increases in the federal minimum wage. He helped win enactment of the Medicare prescription drug benefit, one of the largest expansions of government health aid ever.

He was a forceful and successful opponent of the confirmation of Robert H. Bork to the Supreme Court. In a speech delivered within minutes of President Reagan’s nomination of Mr. Bork in 1987, Mr. Kennedy made an attack that even friendly commentators called demagogic. Mr. Bork’s “extremist view of the Constitution,” he said, meant that “Robert Bork’s America is a land in which women would be forced into back-alley abortions, blacks would sit at segregated lunch counters, rogue police could break down citizens’ doors in midnight raids, and schoolchildren could not be taught about evolution, writers and artists could be censored at the whim of government, and the doors of the federal courts would be shut on the fingers of millions of Americans.”

Some of Mr. Kennedy’s success as a legislator can be traced to the quality and loyalty of his staff, considered by his colleagues and outsiders alike to be the best on Capitol Hill.

“He has one of the most distinguished alumni associations of any U.S. senator,” said Ross K. Baker, a political scientist at Rutgers University who has worked in Congress. “To have served in even a minor capacity in the Kennedy office or on one of his committees is a major entry in anyone’s résumé.”

Those who have worked for Mr. Kennedy include Stephen G. Breyer, appointed to the Supreme Court by President Clinton; Gregory B. Craig, now the White House counsel; and Kenneth R. Feinberg, the Obama administration’s top official for compensation.

Mr. Kennedy “deserves recognition not just as the leading senator of his time, but as one of the greats in its history, wise in the workings of this singular institution, especially its demand to be more than partisan to accomplish much,” Mr. Clymer wrote in his biography.

“The deaths and tragedies around him would have led others to withdraw. He never quits, but sails against the wind.”

Mr. Kennedy is survived by his wife, known as Vicki; two sons, Edward M. Kennedy Jr. of Branford, Conn., and United States Representative Patrick J. Kennedy of Rhode Island; a daughter, Kara Kennedy Allen, of Bethesda, Md.; two stepchildren, Curran Raclin and Caroline Raclin; and four grandchildren. His former wife, Joan Kennedy, lives in Boston.

Mr. Kennedy is also survived by a sister, Jean Kennedy Smith, of New York. On Aug. 11, his sister Eunice Kennedy Shriver of Potomac, Md., died at age 88. Another sister, Patricia Lawford Kennedy, died in 2006. His sister Rosemary died in 2005, and his sister Kathleen died in a plane crash in 1948.

Their little brother Teddy was the youngest, the little bear whom everyone cuddled, whom no one took seriously and from whom little was expected. He reluctantly and at times awkwardly carried the Kennedy standard, with all it implied and all it required. And yet, some scholars contend, he may have proved himself the most worthy.

“He was a quintessential Kennedy, in the sense that he had all the warts as well as all the charisma and a lot of the strengths,” said Norman J. Ornstein, a political scientist at the American Enterprise Institute. “If his father, Joe, had surveyed, from an early age up to the time of his death, all of his children, his sons in particular, and asked to rank them on talents, effectiveness, likelihood to have an impact on the world, Ted would have been a very poor fourth. Joe, John, Bobby ... Ted.

“He was the survivor,” Mr. Ornstein continued. “He was not a shining star that burned brightly and faded away. He had a long, steady glow. When you survey the impact of the Kennedys on American life and politics and policy, he will end up by far being the most significant.”