“Scoreboard”

Let’s get this straight up front: I do not care, and never will, what professional athletes (or anyone else FTM) do with themselves during the national anthem. While it is amusing to watch earnest rednecks threaten abandon all their religious beliefs and boycott the NFL, and watch moon-eyed hippies who could not tell me where the Chargers play, try to become interested in “American football”, none of this is objectively important.  They are free to protest, and I am free to refresh the ice in the cooler while they do so, because I do not care.

So the football metaphors that follow are purely coincidental.

“Scoreboard”

This is the ideal response to someone talking trash on the field. It only works when you are winning – but it works.

This is what I am finding myself saying, increasingly out loud, to the Trumpsters who remain baffled why the rest of us have yet to embrace their Troll King. Because talking trash – which the President does have some skill in – is not the same as playing well, and flashy plays – which the Trump administration has made – mean little unless they put points on the board.

The internet is overflowing with voices pointing out what the Trump Administration has done wrong, but I think it is more instructive to point out what they have done right. Because that is a much shorter list, and that is our point.

If you are conservative, you can legitimately point to these as accomplishments::

Neil Gorsuch sits upon the Supreme court. Which, to be fair, was basically a gift from Mitch McConnell, who sacrificed any  historical legacy he might have earned to stall the 21st century one last generation.

Most of the executive actions from the last half of the Obama administration have been rescinded or undermined. Most significantly:

  • DACA – which now threatens the most sympathetic immigrants imaginable with deportation.
  • Mid-level salary rules, which holds the “management”  overtime exempt salary threshold in the mid $20k’s – barely above poverty line – a blessing for small and medium businesses who can continue to demand uncompensated labor from the employees they rely upon the most.

From the moderate side, I can add the following:

He has returned troops to Afghanistan to take a slightly more active role, a move that is actually welcomed by what passes for the Afghan government.

 

While we are all relieved that his publicity appearances in Houston and Florida did not make things worse, and that we are not in an active shooting war with North Korea (yet) these are not actually accomplishments.

He has no major legislative accomplishments. His foreign policy has been more noise than substance (which may be a blessing, but cannot be considered an accomplishment). A majority of his executive branch offices remain vacant because they haven’t appointed anyone.

Tell me something he’ done, not just undone. Tell me something people who aren’t already wearing MAGA hats might view as a positive step forward. Something. Anything.

NOT what the Democrats are failing to do – because they don’t have the ball. NOT what Hillary Clinton may or may not have done now or in the past – because she’s not on the field.

Name something Good that the Trump administration has done.

Because when I look up at Team Trump on the scoreboard all I see is a bunch of zeroes.

 

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Your Regularly Scheduled North Korean Toddler Crisis

Every President since Eisenhower has had their North Korean Toddler Crisis. And up until now, every one of them has managed to be the adult. Up until now. How you manage a toddler throwing a tantrum at the grocery store might determine the lives and fates of millions of people.

Let me explain.

The Toddler

You are a parent who has taken your child to the grocery store. Child sees candy or toy or whatever and wants it. You say no. Toddler then launches into a screaming, crying, lay on the linoleum floor and pound their fists fit. Now what do you do?

You can’t spank them. You’re in a grocery store for fuck’s sake, and we, as a civilization , no longer tolerate that in public. In any case, you have an excellent chance of making it worse. You could try reasoning with the toddler, but an inability to reason calmly under emotional duress is kinda what defines a toddler. You could yell at them, but that makes you both effectively toddlers.

Let me tell you how I used to solve this. I’m not proposing it as The Answer in  terms of textbook best-practice parenting, but this worked – at least with my kids.

You buy them the damn candy on the condition that they shut up immediately. Even wound up, the toddler will take that deal. Toddlers are immature, but they are not stupid. Later, once they are in the car seat with their precious candy, you stop the car before you are out of the parking lot, you turn around and face the child, and tell them in an adult voice, “If you ever do that to me again, it will be the last time you go to grocery store with me.”

They will do it again. And you will buy them more candy. But after that, you make a show of going to the grocery store without them a couple of times in a row.  Go out of your way to make this happen. It’s worth it.  When you magnanimously let them off the hook, you will have several trips to the grocery store without incident.

Here’s why this works: more than candy or toys or praise, the toddler wants to be included.

Now, several times is the longest you can hope for a toddler to maintain their own policy. Eventually, they will revert to their toddler instincts, and you will have another tantrum, and the process will repeat. The key to success here, is that you still have to be the adult, because there is no realistic hope that the toddler will magically mature lying there in the store aisle. You buy the candy to deescalate the situation, and you lay out the consequences later, when everyone is calm, and you can get at their true priorities, as opposed to why they were crying right then.

You do this because you are the adult.

 

North Korea

North Korea can never grow up; not while they remain an impoverished military dictatorship – which they seem very determined to remain.  Martial law, which has become the norm for that country, requires some sort of crisis to justify itself, and continuous martial law then requires continuous crisis. This cannot be sustained if the country were run like adults were in charge. A  moment where cooler heads prevail might expand to a moment of clarity, and upend the whole tin pot.

North Korea does not simply want to throw a tantrum in the grocery store – they need to throw a tantrum in the grocery store.

In the past, US Presidents have bought them their damn candy – specifically food aid, which is typically what they really want. They can’t just ask for it like adults, obviously. They must throw a tantrum and then accept the candy as tribute.

The US, in contrast, gets to frame itself as the adult, save thousand of North Koreans from starvation, and possibly avert a war which would kill possibly millions of Koreans on both side of the line.

Then, when everyone has calmed down, you lay down the law at whatever hand-wavy multi-party talks the North Koreans finally sulked into, and they will storm out, but you will have a while now before the next crisis.

The Trump administration has chosen a different approach, because The Donald is smarter than all other presidents combined. He has chosen to get in a screaming match with the toddler in the grocery aisle. Which would be hysterical if a second Korean War (or, technically, the resumption of the existing one – there has only ever been a cease fire) were not guaranteed to kill a million Koreans.

Maybe … just maybe … this is some good/cop/bad cop regime coordinated with the Chinese. We might hope so, but who would really bet on that? Happily, there is a more certain dynamic you can bet upon, and sleep better at night.

When Stalin set off his first nuclear bomb, we had the same discussion, and in the end, we decided to hope that Stalin saw the actual end game the same as us: that he could not win a war with the US, he could only deter it.

That is all North Korea can ever hope to do with their damn bomb: deter a war. They can carry on indefinitely because no one cares enough about their horrible government to uproot it at the cost of half the population oppressed by it. The only thing guaranteed to change that calculus is firing a missile at someone – particularly at the United States.

Hell, China takes them out at that point – they can’t afford a war with the US the way they could in the 1950’s, and this would give them some say in the final outcome.

There is an adult in whatever sad concrete bunker North Korea uses as a situation room that knows all this, and so far, he has won the shouting matches. He also reminds them that eventually the United States will act like the adult and save them all from their toddler selves.

We used to believe in that fable too.

When the Trolls marched through Phoenix

AS the smoke cleared from Trump’s campaign rally in Phoenix (yes – his 2020 campaign fund paid for the event) it became clear that trolls had been trolling without competence or consequence.

First, the trolls we did not expect:

Reliable sources have informed me that the Phoenix Police fired teargas first, and issued the order to disperse afterwards. This is not the result of any particular investigation on my part. I simply stumbled into these accounts, from people who otherwise do not know each other.

The Phoenix Police say they responded to thrown bottles and rocks, but no one other than the cops claim this happened. Everyone agrees that the teargas was already billowing when the helicopter commanded the crowd to disperse.

Am I outraged? Not all that much. This was the tail end of a protest that was never going to accomplish anything anyway. Most of the adults had gone home, and mostly kids in hoodies were left in the streets. And I can totally believe that some of them might have thrown something. And teargas would be their just reward if that happened. And it may well be that they would have escalated until they got their teargas.

BUT unless they are throwing grenades, the otherwise well regarded Phoenix PD could have managed a verbal warning first.  And if they just screwed that up – they could have owned up to that without much damage to their reputation.

Hell, if they had said that they fired teargas because they were otherwise going to go into another hour of overtime, the fine folk of Phoenix would have forgiven them.

BUT – they would still have to admit they fired the gas first, and gave the order afterwards. We’ve come to expect our police force to actually tell us the truth.

Yeah, teargas is miserable, and people’s nights (and rights)  were ruined without reasonable warning. And every ground level lobby downtown now smells like pepper spray.  BUT all of the actual required medical attention was heat related. On a relative scale (we’re eyeing you, Charlottesville) that’s a public service victory all around.

BUT next time, bullhorn first, then teargas, OK? And if you screw that up, don’t lie about it. That only makes it worse.  Cops gotta follow the rule because they are cops.

 

Speaking of unforced errors…

 

Of course President Trump pardoned his birther buddy Joe Arpaio. Trolls look after other trolls – it’s the closest they come to an admirable trait. What saddens me, as a moderate wonk, is the incompetent way he went about it.

He could have pardoned him at the Phoenix rally, making real news and maximizing his troll cred.  1426 trolls would have cheered madly while he nodded pompously on television. Or he could have tried to come across as an adult troll and wait until Arpaio was actually sentenced, thereby rescuing an 84 year old man from real consequences of letting politics get before actual law enforcement.

But he pardoned him before sentencing at the tail end of a news cycle, as if the act embarrassed him. So not only is this a slap in the face of rule of law, and a self-sabotage of any sustained attempt to appear less racist, it wasn’t even well done politically.

He tossed his most racist base a bone they didn’t need. They can’t abandon him – they have nowhere else to go. Particularly not after Charlottesville when the rest of the GOP was forced to publicly rebuke them. Only Trump continues to whistle in way that only they would respond to.

Only Trump. Which would be hysterical, if the rest of us didn’t have to live here with them.

 

The Inevitable Justice Gorsuch

The question is not whether Judge Neil Gorsuch is going to become a Justice of the Supreme Court. The question is how much it will cost politically. The variable there is the political acumen of the senate democrats. Place your bets accordingly.

 

This is an opinion piece so it will not have the voluminous research links at the bottom. Adjust your expectations accordingly.

 

Neil Gorsuch is going to be confirmed to the Supreme Court of the United States. Sorry, liberals. It is inevitable. We know – they stole the vacancy from President Obama, who was prepared to nominate the least liberal judge a Democrat could possible put up without whispers of bribery. The confirmation of Merrick Garland would have been, from a Moderate’s perspective, a boon to the overall direction of our republic.

But the Republicans were able to drag their feet until Obama termed out, and now consider Trump’s nominee. And they’re going to get away with it. Here’s why:

  • The Republicans felt no repercussions at the polls for brazenly refusing to give Garland a hearing. In fact, many saw benefits on election day.
  • The Democrats, despite all their current proclamations, are likely to fold and do the adult thing in the end – as they typically do.
  • In replacing the deceased Justice Scalia with an equally arch-conservative justice, the republic essentially breaks even.

From the Moderate perspective, we would prefer a Supreme Court with a pair of moon-eyed liberals and a pair of scorched earth conservatives, and five justices floating around somewhere in the middle. You want some extremists because they catch things the moderates never considered – you just don’t want them in charge. Garland would have gotten us pretty close to that point. But now we are back to 3-3-3.

MOON-EYED LIBERALS: Ginsberg, Kagan, Sotomayor

SCORCHED EARTH CONSERVATIVES: Alito, Thomas, (Garland)

RELATIVELY MODERATE: Breyer (middle left), Kennedy (center right), Roberts (middle right).

So the fate of our republic remains effectively in Justice Kennedy’s hands. We have broken even.

Senate Minority leader Chuck Schumer’s job, now, is to find a way to get something for doing the adult thing in the end, other than the thankless beating at the polls the Democrats have been rewarded in the past for raising the debt ceiling and the like. We know he has not solicited our advice, but we’re going to give it, because we have a blog.

Get an independent counsel to investigate Russia. In return, you’ll magically arrange for the filibuster to fall apart after a reasonable tantrum moment. (He owes his base at least a tantrum).

This way the Republicans don’t have to blow up the filibuster in advance of possibly losing their majority in 2018. Also, an independent counsel spares them from having to spend time listening to Trump administration officials dissemble in their committees, or worse, having to defend that nonsense in front of their own microphones.

And it provides a level of kharmic balance after stealing the seat, which they totally did.

 

OUR ONE SOURCE:

 

http://abcnews.go.com/Politics/meet-sitting-supreme-court-justices/story?id=37229761

 

Democracy v Capitalism v Health Care

Now that the Republican alternative to the Affordable Care Act has gone down whimpering, we can gaze ahead in sober daylight and think about how a capitalist republic might deal with health care.  US health care costs rise well above inflation, and we pay more than anyone in the civilized world, and yet our overall outcomes are below average. How do we fix this?

The more you look at the actual numbers, the more you realize that Obamacare, or some revision of it, might be as good as it gets.

 

How We Got Here

 

If (when) you become sick or injured, health care is not a purchase you can realistically delay or avoid. In the United States, you have no enumerated right to receive it. This puts providers in a position of being able to say, effectively, “your money, or your life.”

Costs and profits in the healthcare field have soared accordingly. Medical costs for similar procedures have risen well above inflation and well above average wages for decades. The majority of personal bankruptcies in the United States have their root cause in healthcare bills. While insurance companies complain about the low margins on the individual exchanges under the ACA, they somehow seem to report record earnings to their investors. Not hard to figure out where the money went.

The reason the Republicans could not come up with a plausible alternative to Obamacare (other than they, collectively, have little experience in actually governing) is that the Affordable Care Act is essentially a Republican plan. It’s core outlines can be found Newt Gingrich’s short lived alternative proposal to Clinton Care back in the 1990’s, and the revised and updated version that Mitt Romney managed to install in Massachusetts (Romney had help for the Mass dems in that regard).

The Obama administration ditched single-payer (which they could have passed on party line) for the orphaned GOP plan because they were (one) futilely hoping for some Republican buy in (they got zero) but (two) more importantly, they did not want to go to war with the insurance industry, which is how Clinton Care went down in flames even with a Democratic majority.

The Affordable Care Act  is Newt Gingrich’s plan as revised by the insurance industry. Now, because they were Democrats, they added some needless bureaucracy, and some taxes to pay for it. It passed by a single vote on reconciliation.  And then they bungled the roll out. And then the Democrats were rewarded for their efforts by being booted decisively out of office by GOP foes fueled by insurance company contributions.

So this band-aid, compromise, duct-tape and bailing wire solution does not lower costs. But it has, overall, lowered the rate at which those costs rise, and it has, overall, marginally improved outcomes, and it has actually decreased the number of uninsured, though most of that was achieved by pumping more money into existing Medicaid programs.  (Sigh.)

The true slogan of the Obama administration : It Could Have Been Worse.

Since we have just seen that there is no viable Conservative alternative, let’s look to the other side.

 

Medicare for Everybody

 

Medicare for Everybody is touted on the left as The Answer. It leaves delivery of healthcare largely in private hands (thereby saving us from something like the VA). It provides universal coverage – or at least the option of coverage – to anyone on the tax rolls at greatly reduced costs to those typically faced now. It would be effectively group health insurance coverage for US citizens.

NOTE FOR DEMS: You want to start calling it “group coverage for US citizens”. You want to outlaw the phrase “single payer”.

Conservatives respond to this by imagining all manner of administrative obstacles and pitfalls, and those are plausible with any large bureaucracy. Then they will cry about the unfairness of redistributing wealth. These arguments waste everybody’s time. Private insurance companies are notorious for deciding it is cheaper to pay court-ordered settlements for wrongful death than actually deliver the services they were contracted to deliver.  The summary term for that is “evil”.

Plus, your scheme to exempt the rich from contributing to the health care of others just went down to defeat at the hands of your most conservative partisans. So quiet now. Grown-ups are talking.

Here are the real problems with Medicare for Everybody:

The US government would have a financial interest in promoting, and perhaps requiring safe and healthy behavior for its citizens – because they pay the hospital bills. There would be a real impetus to outlaw foolish behavior, and mandate safe and sound, from everything from food to paragliding.  By gaining an effective right to healthcare, we might give up our freedom to be foolish.

You might wonder who would miss half-toxic food and paragliding, but these rules will creep towards eliminating all voluntary risk. The ability to take risks is a key component in innovation, which is a required component of capitalism. Plus – paragliding is fun (I would assume).

In a working republic, diligent citizenry can mitigate the excesses of the Safety State, but this would remain a constant struggle. It is however, the lesser of the obstacles.

Medicare for everyone presents an existential threat to private health insurance. For all conservatives rouse their rabble about the sweet purity of the market, and the inherent incompetence of any government program, no private insurance wants to compete against Medicare.

Medicare has a 3-7% operating cost (depending on whose figures you go by), no real marketing or sales costs, and no investors to satisfy.  They have provided insurance coverage to the least profitable cohort imaginable (seniors) at substantially reduced cost to both the institution and the enrollees compared to private alternatives. Medicare works.

Not only that, but an expanded Medicare’s ability to set prices cuts into the margins of every entity currently providing service for something other than charity. Consequently, the insurance companies, and big pharma/big medicine are going to go all out to kill Bernie Care or anything remotely like it.

They will see this struggle as life or death.

You’d need to be polling in the 70% range to overcome that. Bernie Sanders couldn’t beat Hillary Clinton among Democrats with this idea. How are you going to convince half of Republicans?

Well, redirecting hundreds of billions of dollars out of insurance coffers and into the rest of the economy would have a positive effect, both for individuals, who could make bigger purchases instead of declaring bankruptcy over their strokes, and small and medium businesses who would no longer have to pay to provide and manage insurance for their employees.

Name one Democrat who is talking about it like this. No,  they are talking about “single payer” and “healthcare as a right”  and basically making themselves conservative archery targets. And the poll numbers demonstrate this.

Even so, the overall economic benefits of M4E are theoretical, while the massive adverse impact to the medical/industrial complex are a certainty.

So we are left with what is possible: Obamacare, for the foreseeable future. Perhaps, when the smoke clears and the blood dries, our leaders will pause for a moment from biting each other to slap a fresh layer of duct tape on the thing, see if that will hold a little better.

That doesn’t seem likely, but it at least seems possible.

 

SOURCES

http://www.medicareforall.org/pages/Home

Universal health care, Medicare for All, will establish cost efficiency that eliminates major health care bills and medical related bankruptcies. It will simplify our way of paying for health care and lower the total cost for the United States. It will be good for the physical and financial health of Americans and America.

http://www.medicareforall.org/pages/Know

[This is a zealous advocacy group for this program.]

http://healthaffairs.org/blog/2013/05/14/why-medicare-for-all-is-not-the-answer/

The classic problem of monopsony buying power, however, is underprovision of services.  The medical market is no exception. This problem manifested in Medicaid years ago — as states started to clamp down on payments, providers exited the market, leaving us with the patchwork system we have today.  Could the same happen to Medicare?  We are already hearing reports of doctors who do not take Medicare patients. In a 2010 survey of 9,000 physicians, the American Medical Association reported that 17 percent of doctors restricted the number of Medicare patients; among primary care physicians, a whopping 31 percent did.   With universal Medicare, is the population really going to accept, and would Congress really allow, the continued reductions in prices?

[Um… Yes.]

[Least whiny of the con arguments I came across.]

https://www.nap.edu/catalog/13497/us-health-in-international-perspective-shorter-lives-poorer-health

The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, “peer” countries.

https://www.fool.com/investing/general/2013/07/21/how-much-could-medicare-for-all-save-you.aspx

A new survey released by the number-crunching technocrats at NerdWallet last month clearly illustrates how extending Medicare coverage to all Americans might cut costs for everyone. According to NerdWallet, Medicare generally pays out no more than $0.27 for every dollar that hospitals bill it for medical services — a savings of 73%. Put another way, an uninsured patient receiving the same care as is provided to a patient covered by Medicare can expect to pay nearly four times as much.

[…]

If an individual consumers think they’re better off with a private health insurance plan from WellPoint — or from UnitedHealth Group, Aetna, or Cigna — then fine. They could still sign up for one of those, either as a supplement to Medicare-for-all or, if they prefer, as an exclusive plan, and choose not to participate in Medicare at all. For that matter, there should be no need to require anyone to buy any insurance whatsoever.

[The last is Motley Fool imagining a plan. It is unclear whether the plan proposed by Senator Sanders – almost certainly the Democrats’ first offering – would require compulsory enrollment or not.)

[Speaking of which:]

https://berniesanders.com/issues/medicare-for-all/

[This is essentially a campaign document.]

http://www.pbs.org/newshour/rundown/what-you-should-know-about-berniecare-sanders-proposed-health-overhaul/

https://www.consumeraffairs.com/news/health-insurance-industry-rakes-in-billions-while-blaming-obamacare-for-losses-110116.html