Health insurance monopolies vs. the public option, at TPM (now hiring!).

The report, released by Health Care for America Now (HCAN), uses data compiled by the American Medical Association to show that 94 percent of the country's insurance markets are defined as "highly concentrated," according to Justice Department guidelines. Predictably, that's led to skyrocketing costs for patients, and monster profits for the big health insurers. Premiums have gone up over the past six years by more than 87 percent, on average, while profits at ten of the largest publicly traded health insurance companies rose 428 percent from 2000 to 2007.

Far from healthy market competition, HCAN describes the situation as "a market failure where a small number of large companies use their concentrated power to control premium levels, benefit packages, and provider payments in the markets they dominate."

So extreme is the level of consolidation, in fact, that one former top Federal Trade Commission official working with HCAN has sent a letter to the Justice Department's Antitrust Division, asking for an investigation into the health insurance marketplace.

The problem is most acute in small rural states, according to the report. In Shelby's own state of Alabama, the biggest insurer, Blue Cross Blue Shield, controls 83 percent of the statewide market. There, and in nine other states -- Hawaii, Rhode Island, Alaska, Vermont, Maine, Montana, Wyoming, Arkansas and Iowa -- the two largest health insurers control at least 80 percent of the market. So much for Shelby's "marketplace for health care."

Josh Marshall tells the story of how TPM became TPM.

Obligatory McCain/Palin posting: Team Maverick™ has lost even the AP, whose Washington Bureau is famously staffed by a man MoveOn has been trying to get fired for bias and conflict of interest. It's the lying, stupid:

The "Straight Talk Express" has detoured into doublespeak.

Republican presidential nominee John McCain, a self-proclaimed tell-it-like-it-is maverick, keeps saying his running mate, Sarah Palin, killed the federally funded Bridge to Nowhere when, in fact, she pulled her support only after the project became a political embarrassment. He accuses Democrat Barack Obama of calling Palin a pig, which did not happen. He says Obama would raise nearly everyone's taxes, when independent groups say 80 percent of families would get tax cuts instead.

Even in a political culture accustomed to truth-stretching, McCain's skirting of facts has stood out this week. It has infuriated and flustered Obama's campaign, and campaign pros are watching to see how much voters disregard news reports noting factual holes in the claims.

Krugman, too, is outraged, and Josh Marshall (to his credit) has basically been having a week-long freakout. Here's Krugman:

But I can’t think of any precedent, at least in America, for the blizzard of lies since the Republican convention. The Bush campaign’s lies in 2000 were artful — you needed some grasp of arithmetic to realize that you were being conned. This year, however, the McCain campaign keeps making assertions that anyone with an Internet connection can disprove in a minute, and repeating these assertions over and over again.

They're not the only ones. ThinkProgress has a growing list of McCain's ever-shifting positions. (Steve Benen has another one.) Basically every post on the respected and independent factcheck.org from the last week has about McCain's lies. And on The View, just today, he falsely claimed that Sarah Palin had never requested an earmark as governor—a flagrant, wild lie.

It's a farcical situation that turns tragic with the media's refusal to properly report any of it. The cost for lying must be public approbation—otherwise politicians will lie constantly. The failure of the news media since the Republican convention to substantively report on basic, easily provable distortions is as great a betrayal of the public trust as any other over the last ten years. And as we all know well, all too well, that is saying a lot.

Obama, too, hasn't yet done enough. But that may soon change: a spokesperson today claimed that McCain "would rather lose his integrity than lose an election," presumably the first salvo in their new aggressive approach. I've got a lot of faith in Obama and his team; as I've mentioned before, whenever I've disagreed with their decisions they've turned out to be (more or less) right. Obama is cautious, perhaps too cautious, when it comes to hitting back—but it's gotten him this far.

I agree, that is to say, with Noam Scheiber: I really think Obama's been playing rope-a-dope, letting McCain embarrass himself with nonsense 50-days-and-change out from November 4—and now that McCain has completely overreached, Obama's free to hit back as hard as he wants. Let's hope the gloves really are coming off, finally and at last.