I’ve said before that health care reform is of vital importance to the disability community. To further illustrate my point, I offer the case of Ian Pearl. Pearl has spinal muscular atrophy, uses a ventilator, and received private duty nursing under his father’s small group insurance plan. Guardian, the insurer, cancelled insurance policies across the entire state to stop paying for high-cost beneficiaries like Pearl. One Guardian executive revealed the company’s naked greed when he referred to these beneficiaries as “dogs” in an internal e-mail.

Pearl lives in Florida, which doesn’t provide nursing care as part of its Medicaid program. His family is wealthy enough to continue funding his care for a few years, but that money will eventually run out. Pearl may eventually be faced with the untenable choice of entering an institution or moving to another state that does provide nursing care.

The bills under consideration wouldn’t force insurers to offer nursing care as a benefit, but it could prevent this kind of large-scale rescission as a cost-cutting measure. And at some point, the feds really need to look at creating a uniform package of home care services for people with severe disabilities that is largely or completely federally funded.

I realized today that I need to make an appointment for a seating adjusted. Over the last several months, I’ve noticed that I’m slouching to one side even more than usual and that the sweet spot of total comfort has become more elusive. The last straw came today when I was compelled to stick an empty bottle behind my back cushion in order to give me a bit of extra support. I have a bad habit of ignoring minor discomforts until I finally get annoyed enough to jury-rig a half-assed solution and wait for an appointment with a professional. Fortunately, I’ll only have to wait a couple weeks this time.

My seating system is over fifteen years old and has already been through a couple revisions, which makes me wonder how much more can be done with this old thing. It’s served me well, but I no longer have the body of a man in his early twenties. Well, relatively speaking, anyway.

We may finally have a proposal on the table that could provide a resolution to the war of attrition on the public option. Under the proposal brought forth by Delaware senator Tom Carper, states would have the ability to opt out of the national public option if they did not with to participate. From a policy perspective, it’s an imperfect but workable solution. Perhaps two-thirds of states would likely enroll in the public option immediately, giving the government a substantial customer base and corresponding bargaining power with health care providers. The downside is that some people–especially those in poorer Southern states–might not have the public option available for at least the first year or two after it goes into effect in other states.

I don’t like the idea of excluding some people from a public option simply because they have the misfortune of living in a state full of Glenn Beck acolytes and conspiracy theorists, but these states might be prodded to adopt the public option once they see that it’s working in other states (without an accompanying boom in communes and without any seizures of private property). Given the toxic politics surrounding this issue, this compromise might be the best way to ensure passage of a strong public option while simultaneously giving conservative the opportunity to realize the real-life consequences of their nihilistic public policy.

Matt Yglesias is right on when he writes “[h]anding Barack Obama an oddly premature Nobel Peace Prize puts the liberal blogger in your life in a bit of an awkward position.” I’ve spent much of today sorting out my own feelings on the topic. The prize committee seemed intent on expressing their relief that Bush is no longer president, but I don’t think Obama is being rewarded just for being the un-Bush. I can’t imagine Hillary Clinton receiving this award if she occupied the Oval Office.

Obama has relatively few accomplishments as president thus far, but he still has great potential to leave the world a better place than he found it. Awarding him the Peace Prize is a somewhat clumsy attempt to both acknowledge his potential and pave the way for future successes. Having a Nobel laureate for a president won’t make it any easier to pass a health care bill, but it might grease the diplomatic wheels just enough to get us through whatever international crises lie ahead.

The Times‘ Media Decoder blog provides a brief update on the ongoing efforts to reach a settlement in the Google Books case. For those of you who haven’t been following this story, Google is attempting to scan millions of out-of-print books into a ginormous digital library. The federal government, along with publishers, authors, and others, has blocked this initiative out of legitimate concerns that Google would have a monopoly over access to these digital books. The parties are now trying to reach a settlement. Most of the post is about the judge in the case setting a deadline for a settlement agreement, but the last graf contains an interesting tidbit. Under the current draft of the settlement, Google will be required to create audio editions of every book it scans. That would be a huge boon to readers who are blind or visually impaired. What’s not clear is whether the audiobooks will be available for free. The deadline for an agreement is November 9th, so hopefully we’ll have more details soon.