Lenny's Campaign Chronicle

Lenny Calls Brian Higgins Incompetent

Lenny's Blog — Thu, 29 Jul 2010 18:01:57 +0000

For Immediate Release

(Buffalo, NY-July 29, 2010) Roberto Says Brian Higgins’ Mistake on House Floor Proof of His Incompetence

Republican congressional candidate (NY-27) Leonard Roberto called Brian Higgins’s mistake vote on the House floor Tuesday that stripped away over $14 million of federal spending from Western New York evidence of Higgins’ incompetence.

Responding to the news that Congressman Brian Higgins voted against a bill by mistake that killed old federal spending slated for projects totaling $713 million nationwide, Roberto said that “for a local congressman who has championed federal spending for the economic redevelopment of Western New York- who has made it the centerpiece of his congressional career- to not be paying attention when a bill is passed that takes away that funding is the height of incompetence.”

The bill, which was rushed to House floor by Colorado Democrat Betsy Markey, was intended to cut unspent earmark funding by the federal government. It was passed Tuesday by a vote of 394-23. Brian Higgins publicly announced that he opposed the measure and would be a “no” vote. However, Higgins voted “yes” on the bill and subsequently inserted a statement in the Congressional Record that his vote was an error.

“Higgins has admitted he made a mistake,” Roberto said. “He has admitted he did not look at a memo prepared by his own staff that urged him to vote against the measure, and he has admitted that he did not even check what he was voting on. This is simply unacceptable leadership for Western New Yorkers and it is time that we bring Brian Higgins home.”

Roberto also said that, “what makes Brian’s voting error particularly egregious is that he has been the champion of bringing public dollars to the waterfront and this bill takes away $6.2 million of funding from the Canal Side Project. He didn’t have the impetus to fight for his pet project. How could he ignore something so personally important to him? So important for Western New York?”

Roberto said he would have voted for the measure because he is concerned about the federal debt. He also said that with his “mistaken” vote, Brian Higgins has proven to Western New Yorkers that he is an extremely liberal congressman who believes in the out-of-control federal spending that is stalling economic recovery.

“Higgins and his staff came out against this measure which cuts unspent transportation funding from the federal budget,” Roberto added. “In many cases,” he continued, “some of the funding was earmarked for projects from two decades ago. Cutting this kind of excess from the federal budget now is a no-brainer.”

“Western New Yorkers should understand that this is where Higgins stands on federal spending,” Roberto continued. “He would have been one of only 24 congressmen that would have voted against this measure if he didn’t make his voting mistake. This act has been praised by taxpayer groups and good government organizations across the board as a good start to getting the federal budget under control.”

Roberto added that Western New Yorkers have a real fiscal conservative to vote for this year.

“I believe that we need to enact a plan that emphasizes less federal spending and tax cuts in order to get the American economy moving again. Brian Higgins is a tax and spend liberal and as we are seeing now, spending our way to recovery does not work,” he said.

“In Buffalo, we have a legacy of failed big government projects that have done nothing for our local economy except send it spiraling into decline,” Roberto added. “The Democrats in Congress and the White House are now enacting policies that is spreading economic decline to the rest of the nation. I am running this year in order to change the fiscal policy of the United States. This is code red time for fiscal conservatives, and my candidacy is one of the most important in the nation. If we can beat Brian Higgins and the left-wing machine in Western New York, they can be beaten anywhere.”

Leonard Roberto is the endorsed Republican and Conservative candidate for U.S. House of Representatives NY-27. He is a local business owner and the Founder of Primary Challenge, an organization dedicated to government reform. Primary Challenge has members in 35 states.

Lenny Pledges to Repeal Obamacare/Stop Public Option Amendment

Lenny's Blog — Tue, 27 Jul 2010 21:06:49 +0000

For Immediate Release

Roberto For Congress

(954)609-2914

(716)833-3915

jason@robertoforcongress.com

(Buffalo, NY.July 27, 2010) Roberto Pledges to Repeal Obamacare and Resist New Public Option Amendment

Congressional candidate Leonard Roberto (NY-27) has pledged to repeal the Patient Protection and Affordable Care Act (Obamacare) that was signed by President Obama March 21, 2010. He said that he will be unwavering in his commitment to get the health care bill repealed and has signed a pledge promising “to vote in any floor, procedural and committee votes to repeal the bill; to help get co-sponsors for a repeal bill; to help build a veto-proof majority among my colleagues; and to help in any other way to assure this bill is repealed.”

Roberto also said that he will oppose the recent attempts by liberal Democrats in the Congress to renew the public option by amending the health care bill.

“The repeal of Obamacare has been the most important focus of my campaign since we began in April. And now, since Harry Reid has announced that Democrats will continue their fight for a public option in the U.S. Congress, and a new bill-H.R. 5808- has been introduced in the House, it is more important than ever for voters to know where the candidates stand on Obamacare and health care reform,” Roberto said.

“Not only have I always held the belief that much of the health care bill is unconstitutional, it is very clear to me that the financial burdens it puts on small businesses and the taxpayers is unconscionable,” Roberto said. “Congressman Brian Higgins supported Obamacare and continues to support a public option. Voters should know exactly where the candidates stand on this issue, so I want them to know I have vowed to repeal the health care bill and will stand against any attempt at a public option amendment.”

Roberto said that his campaign volunteers will be passing out his pledge as they talk to voters in Western New York about his congressional race. The pledge asks voters to vote and volunteer only for those candidates that have promised to fight for repeal of Obamacare. Roberto added that he represents a real choice in the race this year and that he plans to remind voters that Brian Higgins not only supported Obamacare, but he is also an advocate of government-run health care for the United States.

“We know that many Democrats are ideologically committed to developing a national health care system in the United States, and a public option amendment added to the recently passed health care bill would be a big step in that direction,” Roberto said. “However, they like to obfuscate on the issue. Brian Higgins is a great example of a liberal Democrat trying to run away from his vote on Obamacare and his desire for a public option and advocacy for government-run health care.”

Roberto said that Higgins is making his campaign about local issues and the work he has done for Buffalo’s waterfront. Roberto also said that Higgins does not want Western New York voters to be reminded about his vote on Obamacare and his other votes supporting the radical Democrat agenda that so many Americans now oppose.

“Not too long ago, Brian Higgins said he was the most independent and conservative Democrat in New York State. In Congress he has proven that he is neither, and is one of most consistent proponents of Barack Obama’s and Nancy Pelosi’s radical agenda. If Western New Yorkers want to stop that agenda and want prevent bills like H.R. 5808 from becoming law, they will have a choice this year. Through my pledge, I will keep reminding people about what Brian Higgins really believes and let them know that they can send a real conservative reformer to the U.S. Congress this year.”

Leonard Roberto is the endorsed candidate for the 27th-NY congressional district of the Republican and Conservative parties. He is a local business owner and the Founder of Primary Challenge, an organization devoted to the reform of government and corruption in the political process. Primary Challenge has members in 35 states

Lenny Gets Tea Party Endorsement

Lenny's Blog — Mon, 26 Jul 2010 14:07:15 +0000

For Immediate Release

Roberto For Congress

716-833-3915

954-609-2914

jason@robertoforcongress.com

Leonard Roberto Endorsed By Tea Party

July 26, 2010. Buffalo, NY.- The local Tea Party movement has endorsed Leonard Roberto for U.S. Congress in the 27^th District-NY. The group Tea New York, which is comprised of a coalition of Western New York tea party organizations, is opposed to higher taxes and seeks to achieve government reform through political and citizen action and policy development. Tea New York called the endorsement of Roberto a “no-brainer” in an e-mail released to its members on July 24.

Roberto was given the group’s endorsement after he won a vote of over 200 members of Tea New York at a meeting held by the group on June 12, 2010. Roberto was also a featured speaker at that meeting where he said that he would repeal the Patient Protection and Affordable Care Act (Obamacare) and he would focus his efforts on restoring fiscal responsibility to the U.S. Congress in the form of lower taxes, less spending and opposition to further bailouts and stimulus programs.

Leonard Roberto is a local small business owner and is the founder of Primary Challenge, a group dedicated to reform in the election process. Roberto is also the endorsed candidate of the Republican and Conservative parties to run against Brian Higgins in the 27^th Congressional District this year.

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Lenny Responds to Brian Higgins’ Bass Pro Ultimatum

Lenny's Blog — Thu, 22 Jul 2010 01:13:40 +0000

For Immediate Release

(Buffalo, NY-July 21, 2010) Leonard Roberto Says Brian Higgins’ Bass Pro Deadline is “Disingenuous” and Calls for an End to Corporate Welfare at Canal Side

Congressional candidate Leonard Roberto believes that Brian Higgins is merely trying to score political points with his letter sent to Bass Pro executives yesterday.

Roberto said that “Higgins surely knows that the $35 million in public subsidies offered to Bass Pro to anchor the Canal Side project has been recently ruled unconstitutional by the New York Appellate Courts, and that the ruling may end the ability of the Erie Canal Harbor Development Corporation to legally subsidize Bass Pro at all.”

Referring to the recent decision by the New York State Appellate Court in the Bordeleau case, which was championed by local tea party activists, Roberto believes that Higgins knows the days of corporate welfare and public subsidies to private business may become a more difficult proposition in New York State.

“Yet,” Roberto commented, “Brian Higgins wants to appear as if he was the one who single-handedly ended Buffalo’s unpleasant saga with Bass Pro.”

“While I hope that Brian’s ultimatum to Bass Pro executives will end the Canal Side project’s association with the sporting goods store for good, it is important to remember that it was local tea party activists and people from the grassroots tax revolt who brought the case that successfully challenged the ability of the state to channel public funds to private entities for purposes of economic development.”

“In fact,” Roberto continued, “it was the cozy relationship between ECHDC and Bass Pro Shops that inspired the successful lawsuit in the first place. Both ECHDC and Bass Pro are named as defendants in the Bordeleau case which means that they are directly affected by the Court’s decision. This could mean that depending on how the court rules on the appeal and/or subsequent litigation, any public funds awarded to Bass Pro by ECHDC would be a violation of the law and may be subject to challenge on constitutional grounds.”

In light of this, Roberto said that it is important to remember that Brian Higgins has promoted Canal Side and the public funding of much of the project, and up until recently, has been a cheerleader for Bass Pro’s claims that it is a viable anchor for economic development and a tourist draw.

“Throughout his years in office Brian Higgins has been an advocate of Bass Pro and its model of development for Buffalo and Western New York. Only now has he taken a stand, when it is has become clear that the New York law may prevent the deal from ever occurring,” Roberto said.

“Besides, this model of development gouges the taxpayer and transfers public money to private entities that in the long run do not create a sustainable business climate; at least for Buffalo. Brian Higgins, and many other politicians in Buffalo, are true believers in corporate welfare because they continue to believe that there is a magic bullet to the economic revitalization of Buffalo, he said.”

Citing projects like the rapid transit, the baseball stadium, and subsidized hotels and office buildings, Roberto maintained that projects driven by political elites instead of the free market have not worked in Buffalo as the City has continued to decline despite the completion of big projects by the government.

“Large projects funded by the taxpayer which grant subsidies to private businesses have not worked in Buffalo for the last 50 years,” Roberto said.

” Look at some of the failed projects which have done nothing but make Buffalo the second poorest city in the United States,” he continued. “They have been merely a catalyst for higher taxes, more regulations and the failed idea that more public subsidies of private business is the answer. “

“If the definition of insanity is to do the same thing over and over again while expecting different results, the Bass Pro model of development is insane, Roberto said. “In fact, I believe that corporate welfare has been one of the primary causes for the economic decline and stagnation of our region.”

Roberto then briefly touched on his alternative vision for Canal Side development.

“I believe that Western New York would be better served by free market models of development, and that would mean having the government sell a good portion of the land it owns at Canal Side to small, private businesses. In that way, people will be able to spend their own money where they choose and will not be burdened with taxes if the government fails to accurately decide who wins and who loses again,” he said.

“Our region already has large sporting goods stores like Gander Mountain. They have been in business in our community for years, selling a very similar product line as Bass Pro. It is not fair for government to subsidize one and ignore the other. I believe that this has always been fundamentally a violation of equal protection guaranteed by the U.S. Constitution, ” he said.

“When in Congress I will do everything I can to end corporate welfare and promote free market ideas of economic development. Western New York cannot continue to place its hopes in the corporate welfare model that is promoted by politicians like Brian Higgins. The failures of our past have shown it does not work. It is time we tried another way.”

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Lenny’s Statement on the Firing of General McChrystal

Lenny's Blog — Wed, 14 Jul 2010 19:55:42 +0000

Statement Released to the Press June 24, 2010

Congressional Candidate (NY-27) Leonard Roberto’s Statement on the Firing of General Stanley McChrystal

The disparaging comments made by General Stanley McChrystal and his staff to a Rolling Stone reporter about President Obama, Vice-President Joseph Biden, and other administration officials were unfortunate and ill-considered. As a veteran of the United States Navy I understand the necessity for military discipline and respect for the chain of command. I also believe that it is clear that the U.S. Constitution gives elected civilian representatives the ultimate authority on military action, and challenges to that authority by military officials should be taken seriously.

However, I do not believe that General MChrystal’s remarks were insubordinate and I do not believe that he should have been relieved of his command of all American and NATO forces in Afghanistan. Rather, while it should be acknowledged that Gen. McChrystal’s comments were inappropriate, for McChrystal to have been relieved of his command at this serious point in the war in Afghanistan is a blow to the military’s effort in Afghanistan and to the morale of the troops.

Further, I believe that McChrystal’s comments may have underscored a growing frustration that military commanders have with the Obama Administration’s prosecution of the counterinsurgency in Afghanistan. McChrystal has been the commander of American and NATO forces in Afghanistan for almost a year. In that time he has been confronted with a number of decisions by the administration that has added to the problems prosecuting the war in Afghanistan.

The first of these was the fact that it took the administration the better part of 2009 to decide on an overall strategy for Afghanistan. While American and NATO forces were facing some of the worst fighting of the war since 2001 over the summer of 2009, it took Obama until November to decide whether to deploy more troops. And, notably, it took Obama 3 months to make a final decision on the strategy after McChrystal submitted his proposal for a new surge in August.

Also, and far more importantly, the Obama Administration decided to impose a July 2011 deadline for withdrawal from Afghanistan. Many believe that this strategy has limited the ability of the military to succeed. It is believed that the military operates better on condition-based withdrawal and not publicized timelines for withdrawal.

General McChrystal has also faced significant push back on his counterinsurgency strategy from Ambassador Karl Eikenberry, appointed by Obama. During his tenure as Ambassador to Afghanistan, Eikenberry very publicly opposed McChrystal’s surge strategy and has made it widely known that he and McChrystal do not see eye-eye on many matters in Afghanistan.

I believe that the administration’s inability to finalize a strategy for most of 2009, the ill-conceived timeline for withdrawal, and the push-back from Eikenberry have frustrated the military and its commanders in executing counterinsurgency in Afghanistan. I believe that McChrytsal’s comments, though inappropriate, outline a dangerous rupture in communication between the administration and military commanders over their strategy in Afghanistan.

Further, General McChrystal was preparing to implement a new phase of his surge strategy in Kandahar amidst the fact that the last six weeks have seen some of the most violent fighting of the War in Afghanistan. To have replaced him now, disrupting the continuity of leadership, jeopardizes the new southern offensive. Despite being put in the hands of General David Petraeus, Americans cannot be confident that the Obama Administration felt it necessary to replace a very competent commander at this critical juncture of the war in Afghanistan over comments that were unfortunate but not insubordinate.

Leonard Roberto’s Public Policy Statement on McDonald v. Chicago Decision

Lenny's Blog — Tue, 13 Jul 2010 17:53:29 +0000

Released to the Press July 1, 2010

The decision by the U.S. Supreme Court in McDonald v. Chicago should be a welcome one for gun owners and advocates of the Second Amendment and the right to self- defense. The McDonald decision is historic because it reaffirms that the ownership of a handgun in a person’s home is a fundamental right protected by the U.S. Constitution (first decided in Heller-2008). It also assures that the rights guaranteed by the Second Amendment are applicable in all the states.

However, it is important for gun rights advocates to understand that while the decision by the Supreme Court asserts that the “right to keep and bear arms” is a fundamental individual right, the decision may still make it possible for state and local governments to impose very broad gun control regulations within their jurisdictions. In the majority opinion written by Justice Samuel Alito, the Court reasons that their decision does not eliminate all restrictions on gun possession.

The Court says:

It is important to keep in mind that Heller, while striking down a law that prohibited the possession of handguns in the home, recognized that the right to keep and bear arms is not “a right to keep and carry any weapon whatsoever in any manner whatsoever and for whatever purpose.” We made it clear in Heller that our holding did not cast doubt on such longstanding regulatory measures as “prohibitions on the possession of firearms by felons and the mentally ill,” “laws forbidding the carrying of firearms in sensitive places such as schools and government buildings, or laws imposing conditions and qualifications on the commercial sale of arms.” We repeat those assurances here. Despite municipal respondents’ doomsday proclamations, incorporation does not imperil every law regulating firearms.

Thus, it is important for gun rights advocates to recognize that while McDonald represents a victory, it is quite possible that activist judges and liberal state and local legislators will seek to impose broad gun control regulations and argue these are allowable by the Court’s Heller and McDonald decisions.

44 states have constitutional provisions that recognize the “right to keep and bear arms” as an individual right. However, despite this being written into their Constitutions, most gun regulations have been upheld by the Courts when challenged.

The State of Illinois has such a provision in their constitution but the de facto ban on gun possession and ownership imposed by the City of Chicago remained legal and was considered constitutional until the Supreme Court decided otherwise in McDonald.

Whether the Supreme Court’s decisions in Heller and McDonald will spark a flurry of legislation that will expand the right to gun ownership in the states with heavy regulation on gun possession and ownership is yet to be seen. Gun rights advocates must understand that the expansion of Second Amendment rights is not inevitable after McDonald, and they must continue to educate and petition on behalf of the right to “keep and bear arms.”

Roberto Urges Leaders to Reject Obama’s $50 Billion Stimulus

Lenny's Blog — Tue, 15 Jun 2010 01:21:16 +0000

For Immediate Release:

Congressional Candidate Leonard Roberto Urges Leaders to Reject Obama’s New $50 Billion Stimulus

Buffalo, NY June 14, 2010

Republican candidate for U.S. House District 27-NY, Leonard Roberto, is urging that Congressman Brian Higgins and other federal representatives from New York reject passing the proposed $50 billion stimulus package proposed by President Barack Obama.

Roberto said that adding $80 billion more dollars to the federal debt in order to save the jobs of government workers is not the path to recovery and will not create sorely needed private sector jobs, especially in Western New York.

In a letter sent to Congress on Saturday June 12, President Obama urged lawmakers to pass an emergency stimulus plan that would mostly include additional aid to state and local governments.

Obama wants additional funding added to the “Tax Extenders” bill being debated in the U.S. Senate this week that would provide more federal funds for Medicaid and, especially, add federal dollars to the coffers of the President’s proposed Teacher Firing Prevention Fund.

The non-partisan Congressional Budget Office (CBO) has concluded that Obama’s newest emergency proposals would eventually add $80 billion to the federal budget deficit over the next decade.

Leonard Roberto, the endorsed Republican and Conservative Party congressional candidate in New York’s 27th district , said that this approach to economic recovery is wrong for the country and will not help Western New York.

“The 2009 Stimulus Act has been a proven failure,” Roberto said. “The Stimulus failed to create private sector employment, and it has actually done little for areas even with high government employment rates like Western New York.”

“Why are we now going to add more of a burden to taxpayers in order to pay for a proven policy failure?” Roberto added.

“I find it disheartening that in the midst of one of the worst recessions in our history that the President is proposing more spending in order to bailout bloated state governments and is not doing the things necessary to stimulate growth in the nation’s private sector.” Roberto said.

“The original Stimulus was also touted as a necessary government-to-government transfer in order to save the jobs of teachers and first responders. However, in many places, these jobs were never in jeopardy. “

“Even in New York, despite this year’s budget crisis and the cuts to education spending, most school districts were able to use their own reserves and some targeted spending cuts of their own to preserve the jobs of teachers. That’s how fiscal emergencies should be handled.”

Roberto also said that many states, like New York, must start making painful decisions about the size and sustainability of their own governments and not pass along the costs of their poor decisions to other states that have made better ones.

“Obama’s Stimulus has been costly to taxpayers and it has added over one hundred billion dollars to the size of the federal deficit, Roberto said. “ At the same time, it did very little to fix the structural cost issues that afflicted state governments last year. As we are witnessing now in New York, the same fiscal problems exist today in state government, one year later and they will continue. For states with bloated budgets to ask for a federal bailout that burdens people from states with more sustainable fiscal policies is simply unfair.”

“That is why the President’s new Stimulus proposal is the wrong approach to economic recovery,” Roberto warned.

“ Wise investment for a long-term sustainable economic recovery should not include more transfer payments to governments but spending cuts and tax relief,” Roberto continued. “Obama’s new stimulus proposal does little to stimulate economic growth or create jobs and instead merely throws money down a fiscal rathole.”

“The last stimulus did not bring jobs to our area. Instead the money was used to retro-fit local municipal garages with wind energy units, to install booster pumps at the VA Hospital, and to change a lot of light bulbs at city halls,” Roberto asserted. ” While this may make us feel good, this is not the solution to bringing back the manufacturing base and the well-paying jobs that Western New York needs,” Roberto added.

“Additionally, the bad news is that we know that we will be paying for these projects far into the future because, according to some estimates, the total cost of the first Stimulus could run as high as $3.27 trillion.”

“We need to drastically change what we think government can and should do for us in Western New York,” Roberto concluded. “Government stands in the way of economic growth in our state and in our region and it is now seeking to do the same nationally. Leaders in Washington must be more dedicated to reducing the long-term deficit created by Obama and they must start by opposing his out-of-control spending policies; like the new Stimulus. ”

Critical Health Care Study Being Questioned

Lenny's Blog — Fri, 04 Jun 2010 17:23:24 +0000

(from The New York Times)

In selling the health care overhaul to Congress, the Obama administration cited a once obscure research group at Dartmouth College to claim that it could not only cut billions in wasteful health care spending but make people healthier by doing so.

Wasteful spending — perhaps $700 billion a year — “does nothing to improve patient health but subjects you and me to tests and procedures that aren’t necessary and are potentially harmful,” the president’s budget director, Peter Orszag, wrote in a blog post characteristic of the administration’s argument.

Mr. Orszag even displayed maps produced by Dartmouth researchers that appeared to show where the waste in the system could be found. Beige meant hospitals and regions that offered good, efficient care; chocolate meant bad and inefficient.

The maps made reform seem relatively easy to many in Congress, some of whom demanded the administration simply trim the money Medicare pays to hospitals and doctors in the brown zones. The administration promised to seriously consider doing just that.

But while the research compiled in the Dartmouth Atlas of Health Care has been widely interpreted as showing the country’s best and worst care, the Dartmouth researchers themselves acknowledged in interviews that in fact it mainly shows the varying costs of care in the government’s Medicare program. Measures of the quality of care are not part of the formula.

For all anyone knows, patients could be dying in far greater numbers in hospitals in the beige regions than hospitals in the brown ones, and Dartmouth’s maps would not pick up that difference. As any shopper knows, cheaper does not always mean better.

Even Dartmouth’s claims about which hospitals and regions are cheapest may be suspect. The principal argument behind Dartmouth’s research is that doctors in the Upper Midwest offer consistently better and cheaper care than their counterparts in the South and in big cities, and if Southern and urban doctors would be less greedy and act more like ones in Minnesota, the country would be both healthier and wealthier.

But the real difference in costs between, say, Houston and Bismarck, N.D., may result less from how doctors work than from how patients live. Houstonians may simply be sicker and poorer than their Bismarck counterparts. Also, nurses in Houston tend to be paid more than those in North Dakota because the cost of living is higher in Houston. Neither patients’ health nor differences in prices are fully considered by the Dartmouth Atlas.

The mistaken belief that the Dartmouth research proves that cheaper care is better care is widespread — and has been fed in part by Dartmouth researchers themselves.

The debate about the Dartmouth work is important because a growing number of health policy researchers are finding that overhauling the nation’s health care system will be far harder and more painful than the Dartmouth work has long suggested. Cuts, if not made carefully, could cost lives.

Looking in detail at Dartmouth’s evidence helps show why.

Criticisms on Spending

A main focus of the Dartmouth Atlas is comparing spending among the nation’s hospitals. To do that, Dartmouth researchers use data on how much hospitals have billed Medicare for patients with a chronic illness who were in their last six months or two years of life.

“We show where the waste is in medicine,” said Dr. Elliott Fisher, a physician who is one of the principal authors of the Dartmouth work and was a frequent visitor to Washington during the long legislative debate. “If everyone could operate like Oregon, Seattle or the Upper Midwest, there’s huge savings.”

But the atlas’s hospital rankings do not take into account care that prolongs or improves lives. If one hospital spends a lot on five patients and manages to keep four of them alive, while another spends less on each but all five die, the hospital that saved patients could rank lower because Dartmouth compares only costs before death.

“It may be that some places that are spending more are actually getting better results,” said Dr. Harlan M. Krumholz, a professor of medicine and health policy expert at Yale.

Failing to receive credit for better care enrages some hospital administrators. But for the Dartmouth researchers, making these administrators uncomfortable is the point of the rankings.

“When you name names, people start paying more attention,” Dr. Fisher said. “We never asserted and never claimed that we judged the quality of care at a hospital — only the cost.”

In interviews, administration officials acknowledged that the Dartmouth Atlas was far from perfect. Mr. Orszag says he does not rely on the atlas alone to prove that huge savings are possible.

“What I have repeatedly said is that a wide variety of evidence suggests there is substantial opportunity for savings, and the challenge is in capturing that opportunity,” he said.

Still, the Dartmouth work remains influential in Washington.

Dr. Donald Berwick, nominated by President Obama to run Medicare, called it the most important research of its kind in the last quarter-century. In March, in response to the Congressional Democrats who would have otherwise withheld their support for the health legislation, the administration made a promise. It said it would ask the Institute of Medicine, a nongovernment advisory group, to consider ways of putting the Dartmouth findings into action by setting payment rates that would punish inefficient hospitals and reward efficient ones.

But if that system penalizes big city hospitals like those at the Ronald Reagan UCLA Medical Center and NYU Langone Medical Center — which look profligate by Dartmouth’s measure but may rank much higher by other quality indicators — a battle over the validity of the Dartmouth work is almost certain in Congress.

Peter Orszag, the budget director, said a wide array of evidence backed claims for savings in health care.

In fact, among health policy analysts, that battle has already begun. Critiques have been published in prominent medical journals, and more are on the way.

Differences in Patient Care

In interviews and extensive written comments, Dr. Fisher and Jonathan Skinner, a health economist at Dartmouth who works with him, vigorously defended their work. They berated what they described as “a cottage industry in new studies trying to debunk our findings.”

They say their critics fail to understand the issues and often make significant statistical errors. And they say even if they adjusted more fully to reflect differences in regional costs and patients’ health, the overall effect on the atlas’s findings would be relatively small.

The researchers also say they have made some of those adjustments in some of their other published work. Many other health researchers say Dartmouth should be praised for highlighting the tremendous differences in how patients are treated and for emphasizing that patients often fail to benefit from additional care.

“Dartmouth opened our eyes to something that I believe is real and important,” said Dr. Robert M. Wachter, a professor in hospital medicine at the University of California, San Francisco.

But even those who defend Dartmouth say that failing to make basic data adjustments undermines the geographic variations the atlas purports to show. David Cutler, a professor of economics at Harvard, likens it to failing to account for inflation when looking at gross domestic product. “Nobody in their right mind would talk about G.D.P. growth without adjusting for prices,” he said.

In addition to their hospital rankings, the Dartmouth researchers have also done separate studies of how Medicare spending affects patient care regionally. A 2003 study found that patients who lived in places most expensive for the Medicare program received no better care than those who lived in cheaper areas.

Because some regions spent nearly a third more than other regions without any apparent benefit, the Dartmouth team concluded that at least one dollar in three was wasted by Medicare. When applied generally to the nation’s health care system, that meant about $700 billion could be saved.

But as it began publicly discussing its research, the Dartmouth team often extrapolated beyond this basic finding. Not only do high-spending regions fail to provide better care, the Dartmouth team began to argue, but those regions actually offer worse care.

In just one example of this extrapolation, Dr. Fisher, in testimony before Congress last year, summarized his and others’ work by asking, “Why are access and quality worse in high-spending regions?”

And on Dartmouth’s Web site, a question-and-answer section suggests that this interpretation is appropriate:

“The evidence is that higher utilization does not extend life expectancy, and might be correlated with shorter life expectancy, compared with lower utilization. Therefore, sending people with chronic diseases to higher-efficiency, lower-utilization hospitals for their care could result in both lower spending and increased quality and length of life.”

While a few studies by other researchers have shown that more spending leads to worse health, some others have suggested the opposite — that more expensive hospitals might offer better care. But many have shown no link, either way, between spending and quality.

In other words, there is little evidence to support the widely held view, shaped by the Dartmouth researchers, that the nation’s best hospitals tend to be among the least expensive.

In interviews, Dr. Fisher and Mr. Skinner acknowledged that there was no proven link between greater spending and worse health outcomes. And Dr. Fisher acknowledged the apparent inconsistency between his statements in interviews with The New York Times and those made elsewhere, saying that he was sometimes less careful in discussing his team’s research than he should be.

In any case, the more-is-worse message has resonated with insurers, whose foundations now help to finance the Dartmouth Atlas. Dartmouth researchers also created a company, Health Dialog, to consult for insurers and others on Dartmouth’s findings. Valued at nearly $800 million, the company was sold to a British insurer in 2007 and still helps to finance the Dartmouth work.

of 3)Last June, as Mr. Obama campaigned for his health care overhaul, he visited Green Bay, Wis., praising the city for getting “more quality out of fewer health care dollars than many other communities.”

Two of Green Bay’s hospitals, Bellin and St. Mary’s Hospital Medical Center, rank fourth and 11th within Wisconsin on the Dartmouth list.

But again, Dartmouth ranks hospitals only by costs and number of treatments and procedures. A different picture emerges from work done by the Wisconsin Collaborative for Healthcare Quality, a voluntary group of health care organizations that uses both price and quality of care measures. In an analysis of heart attack care, for example, it ranks Bellin second, and St. Mary’s 15th, among the 22 hospitals in the state.

And a Medicare ranking based on its own data that shows how many people die after treatment for certain conditions — statistics that exclude costs entirely — puts Bellin fifth, but drops St. Mary’s to second-to-last: 67th of the 68 hospitals statewide that were measured by both Dartmouth and Medicare.

Do the Green Bay hospitals favored by Dartmouth really offer better care? Maybe not.

Similar problems arise with Dartmouth’s regional data. In Dartmouth’s rankings, for instance, New Jersey comes in dead last because its costs per Medicare beneficiary are the nation’s highest. And yet, for the quality of care offered in New Jersey, independent of cost, federal health officials rank New Jersey second only to Vermont.

Researchers who have examined the Dartmouth Atlas numbers have found other flaws that can distort hospital rankings. Doctors at Cedars-Sinai in Los Angeles, for instance, found that Dartmouth had failed to distinguish two different types of intensive care units the hospital runs. Dartmouth also might have overcounted the number of specialists examining each patient.

The errors, Cedars-Sinai said, meant the hospital probably fared worse in the Dartmouth rankings than it should have. Cedars-Sinai’s chief medical officer, Dr. Michael Langberg, said he had tried to discuss these problems with Dartmouth researchers but had thought they were unresponsive.

Dr. Fisher said he had tried to address Cedars-Sinai’s concerns. But he also argued that while the Dartmouth Atlas was not perfect, it provided useful insights into differences in the way various hospitals treat patients.

“For the past 20 years, my colleagues and I and now many others have been working hard to clarify the causes and consequences of regional variations in practice and spending,” Dr. Fisher said. “The work is challenging and more work needs to be done, but we have learned enough to help guide health reform.”

Unifying Western New York’s Conservatives

Lenny's Blog — Mon, 31 May 2010 01:42:37 +0000

Lenny’s Congressional Campaign had very good news this week. He received the endorsements of both the Republican Party and the Conservative Party and is now seeking the endorsement of the Independence Party. Lenny also plans to run on the T.E.A. ballot, a statewide line that will allow Tea Party patriots to vote for candidates with true conservative values.

If Lenny manages to run on four ballot lines in November, this will be big news not just for Lenny, but for all conservatives in Western New York. One of the goals of Lenny’s congressional campaign has been to unite all WNY conservatives including Republicans, Democrats, Conservatives, Tea Party groups and other patriotic grassroots organizations, in order to take a strong stand against the liberalism that has left our area one of the poorest in the nation.

This unity will be important, because more than anyone, Western New York patriots and conservatives understand how the liberal policies of high taxation and big government have decimated our economy and what happens when government becomes a region’s largest employer.

Brian Higgins once said that he was the “most independent and conservative Democrat in New York State.” He said that, perhaps, because he saw that the people of WNY were beginning to understand that liberalism was the problem and that the size of New York State government was largely responsible for the slow pace of economic growth upstate.

Higgins tried to legislate as a moderate his first few years in Congress, however, he has proven that he has become a reliable vote for Nancy Pelosi and her leftist agenda. No conservative would have voted for Obamacare and the out of control spending endemic to the last two Congresses. And no conservative, especially one from WNY, would make the argument that highly subsidized and sparse “green jobs” are the best way to bring back WNY’s manufacturing base.

Most conservatives understand that “green jobs” are not the future of economic vitality nor is green energy the solution to the growing cost of energy. Liberals in the U.S. Congress (Higgins included) have prevented new energy exploration and have voted to shackle economic development through cap-and-trade legislation. And they do this not because the science on global warming is necessarily sound, but because it fits their political ideology which sees heavy industry as a blight on human history.

Since the election of President Obama, we have seen how those who share his ideology like to govern. They clearly believe that government regulation and higher taxes are the answer to, well, just about everything. Brian Higgins has been a partner in the unprecedented and, unconstitutional, growth of the Federal Government in the past two years because he shares his ideology with the far left.

It is important that the policies of the Pelosi Congress be turned back. Patriots, conservatives, and all concerned citizens who thought they were voting for lower taxes, less spending, and essentially conservative reform in 2006 and 2008 have been deceived by the likes of Brian Higgins. He is no conservative and only believes in economic growth if it emanates from the government and is paid for by the taxpayer.

Do Western New Yorkers really want a future dominated by big government?

Been there, done that. (It can’t be said enough.)

This year, Western New York has a real conservative choice in Lenny Roberto. All of us who believe in the principles of liberty must work to get out the vote for a proven, principled conservative reformer.

In unity, we will find our strength.

And, we will win!

Great Night at 9/12 Project-Buffalo Candidates Night

Lenny's Blog — Wed, 12 May 2010 17:22:39 +0000

I was invited to the 9/12 Project’s Meet the Candidates Night yesterday (5/11/10). It was an interesting and lively night and I was there to speak with two other candidates running for office.

People were concerned with the Greek Bailouts and of course, out-of-control federal spending.

I told the 9/12 Project that all candidates running for federal office this year must make a commitment to stop the spending and not raise taxes. I made it clear that we are on a fiscal path that is not sustainable and the creation of the Fiscal Responsibility Commission by Obama, is really a cover for Washington politicians to be able to raise taxes after the 2010 elections and deflect some of the blame away from themselves.

Why vote for a politician like Congressman Brian Higgins, who once declared himself a conservative, and touts the pork money he brought to Buffalo amongst his most important accomplishments?

Our nation can’t afford the typical status quo of Brian Higgins’ liberalism. The pork money Higgins lauds, came from the failed Stimulus which has put our country in so much debt that Moody’s Rating Service has predicted a scenario where service on our national debt could reach 22% of GDP by 2013!

The next Congress must put a halt to spending and must look for ways out of our fiscal mess that does not include tax increases.

We all must face this reality and even though people have been telling me that Brian Higgins can’t be beat, I can’t stand on the sidelines and allow the Democrats to tell the entire country that what they are doing is all fine and dandy.

It is downright dangerous, and we must elect people who will try to find ways to keep our economic system viable, not those who secretly dislike the free market system and, apparently, could care less if it is overburdened by government intervention.

-Lenny