The Widdershins

Posts Tagged ‘Affordable Care Act

Noted scholar and transcendentalist Ralph Waldo Emerson said, “I hate quotations. Tell me what you know.” So to begin my self-allotted 800 words, what do I do? I quote a smart man explaining his utter disdain for quotes.

True story. I love quotes. Collect them I do. I’m always looking for smart words from those who have journeyed before. Their wisdom is manifest and unmistakable. I find comfort in that.

So this week while thinking about this post, I began looking for a quote about shame. There weren’t that many shame quotes and the few I found were all wrong. They talked about shame as a regulator of behavior – as something to be “ashamed of”. There weren’t any quotes about the lack of shame.

Given the lack of quotes about shamelessness, it might indicate we are regressing along the evolutionary continuum. I imagine shamelessness requires less higher reasoning and a greater reliance on the lower brain stem – which brings me to Supreme Commander Monkey Butt (hereinafter “His Redness” or sometimes “Dolt 45” or “His High Assholiness”).

When I’ve described Dolt 45’s personality traits, I’ve been quite reticent about his mental health. With a high degree of probability I can surmise his behavior patterns, but his mental condition I will leave to others.

This brings me to his shamelessness. The only shame he fears is being labeled a fraud which is his primary and paramount behavioral avoidance priority. For all other types of normal, human shame – he has none. The shame a normal human would suffer does not faze him.

Within the last forty-eight hours, he told Tea Party groups not to worry if the Trump/RyanCare plan failed because he would make sure the ACA failed so he could blame the Democrats. Or telling the same groups he was fine with accelerating the human suffering by speeding up the Medicaid cutbacks by two years if that’s what it takes to win. Sociopathic behavior for sure, but no evidence of shame.

My point is this: While His High Assholiness’ behavior is abhorrent, it is the new Republican Trumpism. He is near the perfect Republican or so says at least 89% of self-described Republicans. Again, my feeble mind is called to a quote from H.L. Mencken:

As democracy is perfected, the office of president represents, more and more closely, the inner soul of the people. On some great and glorious day the plain folks of the land will reach their heart’s desire at last and the White House will be adorned by a downright moron.

The great and glorious day has arrived and the White House is now resplendently adorned by the consummate “downright moron” who happens to be unburdened by shame. He was the apple-eyed desire of the plain folks or at least 70,000 under-educated white men in three states. That desire still burns white-hot in nine out of ten Republican hearts.

The areas in green fare better under Trump/Ryan Care while the areas shaded in maroon fare better under the ACA.

These Trumpian sycophants know no shame. Just consider: Passing legislation affecting one-sixth of the economy without a hearing in the dead of night. Or ending life-sustaining medical care for maybe 15,000,000 people. Or ending opioid therapy or mental health treatment for millions. Or ending health clinics and outreach for the poorest and most under-served populations. Or doing all of this without an estimate of the costs.

All of this to give the wealthiest, most secure, and most powerful a massive tax cut. And on top of that giving insurance companies and medical device manufacturers a tax cut. And on top of that making sure the inadequate tax credits are as regressive as possible without regard to need or ability to pay. And on top of that, and this is where the shamelessness is extraordinary, financing the whole damn thing by draconian cuts to Medicaid – cuts to the poorest, weakest, and most vulnerable among us.

This bill isn’t a health care plan, it is a massive tax cut disguised as a political slogan to repeal the ACA. It is a WealthCare plan. It is a risible act of ignominy so outrageous it wouldn’t even make the SNL trashcan.

Not for a second do I believe this nasty pettiness wasn’t planned as a feature to make Grandpa Grumpy happy…

As discerning Widdershins, you are asking, “Why isn’t he mentioning the hypocrisy?” The answer is simple – without shame there is no hypocrisy. Talking to these people about hypocrisy is like talking to a cobra about venom or a skunk about stink. It is what makes them who they are.

The inimitable Mr. Emerson was a transcendentalist meaning he believed in the inherent goodness of individuals. I want to believe that too since there’s no shame in that – at least not yet.

I’m going to leave you with a musical interlude then I’ll list some links for interesting stories I couldn’t work into my self-indulgent rant/therapy. As always, take the safety off, comment at will, and thanks for listening.

 

Speaking of clowns, here’s one, and he’s a substitute for the Presidential Daily Briefing:

 

A wonderfully researched study of 1.25 million stories by the Columbia Journalism Review indicating Breitbart to be the right-wing media anchor hub of a distinct and insulated media system that appears to have set the agenda and overall tone for Hillary’s negative coverage.

An interactive demonstration that the “higher premium” lamentation by the shameless Republicans is, like so many things, made of whole cloth.

The lackadaisical use of military force is troubling and a bad omen of things to come. One week of bombing is equal to one year of missions under Obama.

Watch Paul Ryan’s Adam’s Apple when he’s asked about his “good, best friends” the rich.

One way the Trump Administration is a fine-tooled machine.

Good afternoon Widdershins. For those tuning in for one of Fredster’s always insightful posts, you’ll have to suffer me today. Fredster’s computer is “CPU”ny and “app”opletic today and I’m subbing for him. He’ll be back in a day or so.

Personal religious ascendancy can be triggered by many things — it might be a burning bush, an archangel, a miracle, or something as mundane as a call to your corporation’s general counsel. It’s that last thing that spawned yesterday’s case before the Supreme Court, Hobby Lobby, et al. v. Sebelius.

You see, Hobby Lobby was already providing contraceptive coverage, even emergency “Plan B” contraception, to Hobby Lobbytheir employees until that fateful day when their General Counsel’s phone rang. It was the Becket Fund for Religious Liberty, a poseur victimhood factory, calling to ask if Hobby Lobby was interested in suing the federal government over the provisions of the Affordable Care Act.

Hobby Lobby, with its 500 to 640 stores and 13,000 to 28,000 employees (differing accounts give differing estimates), was soon joined by Conestoga Wood Specialties Corp., a Mennonite owned company from Pennsylvania with 950 employees. Both agreed to serve as the plaintiffs in this first blush attempt at endowing personal religious freedom upon corporations. I’m sure after a torrid tryst punctuated with passionate disdain for the ACA, Hobby Lobby, et al. v. Sebelius was conceived in the appropriate missionary style.

At the heart of this case is the 1993 Religious Freedom Restoration Act (RFRA). RFRA itself was a congressional reaction to a prior Supreme Court case Congress wanted to rectify. That case was Employment Division v. Smith. Decided in 1990, the issue presented in Smith was whether or not Oregon could deny unemployment benefits to two Native American men who were fired for using peyote, even though peyote was part of their religious rituals.

ScaliaNone other than Justice Scalia wrote:

A person’s religious beliefs cannot prevent him or her from abiding by laws that are neutral and not aimed at restricting religious freedom.

After the Smith case, Congress wanted to ensure minority religions were protected and passed RFRA in response. The RFRA legislative history is without question — Congress wanted to protect individuals, religious institutions, and religious organizations. Nowhere within the legislative history does RFRA mention or even hint at for-profit corporations like Hobby Lobby.

In any discussion of RFRA, you might have heard the term, “shield versus a sword”. The Congressional Record is unambiguous about this point, RFRA was meant as an individual shield and not as a sword when it came to religious rights. Simply put, RFRA was meant to protect individual religious rights and not to be used as a weapon to force religious beliefs upon others.

In the words of a smart 17th century guy, “Therein lies the rub.” The question of the Hobby Lobby case is whether or not a corporation can force, through its actions and overwhelming economic power, its religious fervor upon its female employees when it comes to certain types of contraception — not all contraception mind you, just those types of contraception the billionaire Green family find objectionable.

 

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Good afternoon Widdershins — I hope you have plans to take advantage of the first vestiges of Spring lurking about.  Please enjoy!

A word of caution today — more than a word, several sentences in fact.  I’m hunting gnats with an elephant gun Read my lips, no to Obamacaretoday.  While I don’t mean to rant, I’m just exasperated.  In the following paragraphs, I hope whatever finds its way from my head to my fingers isn’t too negative or off-putting, but “I just gotta say it.”  Who knows, maybe you are feeling the same way.

Here we are — a full four freaking years after the passage of the Affordable Care Act and there is no sustainable political narrative holding with the electorate!  That is unbelievable to me.  Honestly, how can this be?

The most recent NBC/WSJ poll shows the electorate evenly split between total repeal versus keeping and fixing the Affordable Care Act.  A 50/50 split after four years and Democrats, with vulnerable Senate seats this cycle, are tepid about even talking about health care for fear of igniting a firestorm.  Well, here’s a news flash:  Republicans and the paid mouths of the Koch “billopede” are going to be talking about it, or rather lying, with all the eloquence billionaires can buy.

Here’s the deal — Alex Sink should have won the Florida 13th District Special Election over David Jolly, a dyed-in-the-wool Potomac huckster/lobbyist.  Alex Sink was the better candidate, she essentially spent as much or more than Jolly, and the Republican powers had given up on Jolly.  So what happened?

At first glance, the pundits will say, “Obamacare sunk Sink.”  The Koch affiliated billopede ran millions of dollars of the lying ads about the “$716 Billion Medicare” cut in senior citizen heavy Florida, but that is not the reason.  The reason Alex Sink lost was turnout.  Sink needed 200,000 voters to turn out in the election, but only 180,000 voted.  So it wasn’t Obamacare that sunk Sink, it was a lack of voter enthusiasm.  The question then becomes: How can a Democratic base be excited and motivated if there is no clarity about the main issue — access to health care.

Hiding from a skunk doesn’t make it smell sweeter.  Instead of hiding, what if the message was:  Seniors, do you want the donut hole for prescription drugs reopened?  Republicans do.  Do you want to go back to double-digit increases in health care premiums?  Republicans do.  Do you want Medicare to be weakened by giveaways to the insurance companies?  Republicans do.  Do you want to be bankrupt because of a pre-existing illness?  Republicans are okay with that.  Do you want your insurance cancelled because of lifetime caps?  Republicans are okay with that too.  Do you want to do absolutely nothing about getting control of health care costs because Republicans don’t?

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Good afternoon Widdershin friends.  I hope this is a not just a good Friday, but a great Friday for you.

I dunno, DIY rhinoplasty seemed like a good idea...

I dunno, DIY rhinoplasty seemed like a good idea…

Sometimes the most difficult part of writing one of these posts is how to start it.  This is one of those posts.  It’s difficult because today’s subject combines  purposeful misrepresentation with political motive, but they are so entwined as to ultimately do harm to those actually promoting the misrepresentation.  In other words, it is something like describing the therapeutic benefits of Pinocchio performing do-it-yourself rhinoplasty.  Go figure — the subject does lend itself to a certain irony worthy of a post.

As most of you probably have read, the Congressional Budget Office has released an updated set of estimates for the economy.  On page 39 of the CBO report there was an update on the effects of the Affordable Care Act on the labor force.  Granted, the report talks in the elementary concepts of supply and demand within the labor force, but anyone who has successfully applied Oxy-10 for zits should be able to understand the concepts.

The report estimates Obamacare will reduce the supply of labor by about 2.3 million workers, an increase from the CBO’s prior estimate of 800,000 workers.  This reduction in the supply of labor will be from people voluntarily, I emphasize voluntarily, leaving jobs since they are no longer tethered to their jobs for the purposes of insurance — meaning people finally have a choice.

This report doesn’t say employers are reducing their demand for labor.  Just the converse is true — with these 2.3 million workers leaving their jobs, there will be an increase in the demand for replacement workers.  That is good news.

Not good news to the Republicans who ran over each other to get to microphones or Twitter accounts.  Just like Punxsutawney Phil — Mitch McTurtle emerged from his shell to proclaim, “Obamacare means the loss of 2.0 Million jobs.”  John Boehner and Eric Cantor joined the chorus along with the Heritage Foundation, Limbaugh, Hannity, the Faux News crew, and just about any Tea Party House member evolved to the point of enjoying both opposable thumbs and a Twitter account.

The headline writers of newspapers and online services took the bait, but of course they took the bait in order to promote a fake controversy.  These headline writers ignored other noteworthy facts such as the premiums under Obamacare are a full 15% lower than initially estimated.  There’s also an informed belief the “risk corridors” created under the ACA to protect against adverse actuarial impact will actually result not in increased spending, but with the insurance companies actually paying the federal government around $8.0 Billion.  You didn’t see those headlines because those headlines weren’t written.

The good news of employees no longer having to stay in jobs for insurance coverage has huge policy implications.  It will not only open employment opportunities for replacement workers, it opens new horizons for those who previously couldn’t cut insurance umbilical cords.  It will free workers to pursue other interests — start a new career, start a new business, or even spend more time with their families — all good and admirable societal goals.  Goals heretofore espoused by the very same people who are now critical.

Hate my job...A good news fact you don’t readily hear discussed is that when people are in jobs they love and utilizing their talents, they are more productive and most importantly, happier.  A societal goal so cheeky as to have been embodied in the Constitution by the words, “Pursuit of happiness.”

While I won’t cast aspersions on the strategic thinking of those crafting the Republican message on this issue, I’ll only say their family reunions are undoubtedly held in the lush jungle canopies of Borneo.  Given the real significance of the CBO report and its subsequent misrepresentation, the Republican Party is really peddling this slogan:

Work years longer in a job you hate

for an hourly wage we have no intention of raising.

Now that’s a slogan.

This is an open thread.

Good afternoon Widdershin friends.  Here’s hoping your work week is a light one in preparation for a Thanksgiving holiday heavy in family and friends.  Given that this a holiday week, I’m just going to throw out a couple of subjects for your consideration — please talk about anything and everything circulating on the interwebz.

Somewhere back in time I read Colin Powell kept a Thucydides quote on his  desks throughout his career.  That quote:  Of all the manifestations of power, restraint impresses men most.

This past weekend we saw the embodiment of that Thucydides quote with the announcement of the interim agreement with Iran.  All the secret meetings, all the intrigue, all the high drama to announce a six months speed date to see if we can trust one another long enough to come to the simple understanding that throwing kerosene on the fires of the Middle East wouldn’t be a good thing.

Sounds infinitely reasonable to almost everyone except the neo-cons who have never seen a war they didn’t love.

Walrus envy or whisk broom experimentation gone horribly wrong...

Walrus envy or whisk broom experimentation gone horribly wrong…

Chief among them is that human with a whisk broom implanted on his upper lip — John Bolton.  Bolton is not alone, but he is the go-to guy anytime the neo-con chicken hawks feel they have been cheated out of a war.

Among other things, the interim agreement provides for daily monitoring of the Iranian enrichment facilities, a 5% cap on any enrichment activities, a commitment to dilute any uranium above that 5% cap, and in turn, we will just so slightly loosen economic sanctions on Iran to the tune of $6.0 to $7.0 Billion out of the $100 Billion we are holding over the next six months.

Benjamin Netanyahu’s position of total elimination of nuclear development for peaceful uses by Iran is unworkable, inadvisable, and ultimately dangerous for the world.  There are those of both political stripes in Congress who Netanyahu controls so there are sure to be obstacles to this agreement.

Any additional sanctions during these six-months completely voids the agreement.  Anyone, of whatever political flavor, voting to abandon this process before it begins should be shown the door at the next election.

No matter what the ill-informed reporters and pundits offer, there are only three options logically available if a negotiated settlement isn’t reached:  1.  Retain or enact tougher sanctions; 2. Actively work to change the Iranian regime; or 3. Military action.

We’ve tried military action next door in Iraq with abysmal results and during eight years of the Bush Administration where the official policy was regime change, Iran went from zero enrichment centrifuges to over 8,000.  At some point politicians need to pay attention to those stubborn things called facts.

Since the Saturday night announcement, I’ve been amazed at the number of critics who see absolutely no alterative other than a military strike.  The dirty little secret is this:  A military strike only temporarily eliminates brick and mortar, we do not, as yet, have a bomb that can suck out the brains of Iranian scientists.

Hassan RouhaniA military strike just prolongs the inevitable and with it, hardens the resolve of the Iranian regime against constructive engagement with the West.  The new Iranian President Hassan Rouhani has shown great courage to take such a positive step after thirty-four years of our countries ignoring one another.  We should reward such courage.

No matter what the protestations of Bolton and his ilk are, we need to show, as Thucydides advised, we are powerful enough to exercise restraint.

The next story I want to share is one I’m sure you will think I’ve dug out of The Onion.  It is not.  This is real.  This is scary and most disheartening.

More time hobbyin' less time hobnobbin'...

More time hobbyin’ less time hobnobbin’…

The Supreme Court, just a few minutes ago, decided to take a case out of the 10th Circuit Court of Appeals (sits in Denver and covers Colorado, Kansas, New Mexico, Oklahoma, Utah, and Wyoming).  The case:  Whether or not for-profit corporations have guaranteed religious freedoms.

You read that correctly, the case is whether or not Hobby Lobby, a secular, for-profit corporation has guaranteed religious freedoms based upon the religious beliefs of its primary shareholders and executives.

Supreme Court watchers had their eyes on this case since it is such a departure from anything we have seen before.  If corporations are people with free political speech rights, who’s to say they don’t have religious rights.

This is yet another challenge to the Affordable Care Act by Paul Clement who was the Capt. Stubing of the unsuccessful 2012 challenge.  This case centers around whether or not Hobby Lobby can deny its employees coverage for birth control, sterilization, and certain other services based upon its owners religious beliefs.

The 10th Circuit, in overturning the lower court decision, used Citizen’s United to essentially say if a corporation has free speech rights then the Supreme Court must have also meant for a corporation to have other First Amendment rights.

“This is a perfect storm,” said Richard Garnett, a law professor at Notre Dame.  “Debates about campaign finance in Citizen United and abortion and Obamacare could distort the court’s analysis of religious freedom.”

Bad law begets a progeny of bad law and this is another potential ugly stepchild of Citizen’s United.  It has implications for privacy rights, contraceptive rights, women’s freedom of choice, and most importantly, the applicable constitutional test for religious freedom.  Beware — the improvident legal stepchild which may spring from this mess might well be named Damien.  Watch this space.

This is an open thread.

Good afternoon Widdershin friends.  I’m cheating today.  I had started a post about this very subject and then I ran across this better written synopsis.  I’m a firm believer in only serving the best.

This comes from the Washington Post Wonkblog and it was published yesterday.  (I wouldn’t want anyone to mistake me for a varmit-headed plagiarizing Rand Paul.)

The preferred que for the Insurance Industry's status quo...

The preferred que for the Insurance Industry’s status quo…

As often happens, the prospect of reform has led to a sudden eruption of affection for the health-care status quo. The airwaves are alive with impassioned protests against the idea that anyone might change a market that relies on discriminating against the old, the sick, the female, and people who don’t read the fine print of insurance policies. This is the best health care in the world, you know.

The Commonwealth Fund’s latest survey of international health systems stands as a refreshing reality check. Their data compares the U.S. to Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, and the United Kingdom on a host of health-system measures, both objective (like diabetes amputations) and subjective (like satisfaction). The results are a reminder of why reform is so badly needed.

Start with cost. Americans spend 17.7 percent of GDP on health care. No one else spends even 12 percent. Let’s make that more concrete: If Americans only spent 12 percent of GDP on health care we would have saved $893 billion in 2012.

The reason isn’t that Americans get more health care than anyone else. We have more uninsured than anyone else. We have fewer physicians per capita than anyone but the Japanese. We go to the doctor less often than anyone but the Swiss. We don’t have more hospital beds than other developed countries, and when we do go to the hospital, we don’t stay longer.

But we do pay more for the privilege. The average hospital stay costs more than $21,000 in the U.S. It costs only $8,363 in France. (See “Why an MRI costs $1,080 in America and $280 in France“.)

Nor do we receive better, swifter, or more flexible service. For all the talk of waiting lines in foreign countries, America is second only to Canada in the number of adults reporting difficulty getting a next-day appointment when they’re sick. Americans also find it unusually difficult to get after-hours care, and by a wide margin, Americans are more likely than residents of any other developed country to report that cost is a barrier to getting health care. Oh, and Americans are more likely to report being the victim of a medical error.

There are some bright spots for the American medical system. Residents of the U.S. find it easy to get quick appointments with specialists, and only citizens of France, Germany, the Netherlands, and Switzerland report that they can get schedule elective surgeries as rapidly.

The data on quality, however, is more mixed. Americans lead the world in five-year survival for breast cancer. But we lag competitor nations on diabetes amputations. And we’re only middle-of-the-pack on surviving myocardial infractions (a common kind of heart attack).

This is, to say the least, a pretty poor performance for a health-care system that costs so much more than any other. And it shows up in public surveys. Only 29 percent of Americans say the health-care system works well and only minor changes are necessary. That’s lower than anywhere save Australia. Meanwhile, 29 percent say the system needs to be completely rebuilt. That’s higher than anywhere else in the survey, period.

Drink CoffieeChange is painful. But the status quo is a disaster.

The point of my post is quite simply, “Vision without a plan of execution is a hallucination.”  The Affordable Care Act is proof positive of this aphorism.  There is a reason leaders are often called “Chief Executives” — not the least of which is their overriding need to be able to execute.

The inability of the administration to execute on the ACA has automatically conjured up longing for the status quo which isn’t bad if you are one blessed with status.  For the rest of us, the status quo is the enemy of progressive change.

Yes change is painful, but not near the price of over 40,000 deaths a year from inadequate health care.

This is an open thread.

Good day Widdershin friends. “May you live in interesting times,” is an ancient Chinese curse that seems to have particular resonance today. I’m writing this post on Monday afternoon, so let’s hope things have become a little less interesting overnight.

“The dog ate my homework.” “Officer, I came to a rolling stop.” “Lipstick? Oh that, there was an office Avon demonstration and it went horribly wrong.”

All plausible denials as if they hadn’t been heard before. All worthless diversions. All are excuses of the unimaginative. And most importantly, each affords a pretty good clue if anyone was wondering about truthfulness.

Likewise it appears the truthfulness of the “kamikaze caucus” of the House of Representatives is no longer in question. What we have witnessed over the last few days is not only a patent disregard for responsible governing, but also a front row demonstration of the fact “when a political party commits suicide it is indeed a messy event.”

Just add Republican caucus...

Just add Republican caucus…

If this spectacle was a Paula Deen cooking segment, the recipe would go something like this:

Large pot (really, really large pot)
Fill with cooking oil
Bring to a full, rolling, boil
Jump in

Receptionist of the House John Boehner has completely lost control of his caucus. He seems to be doing nothing more than taking messages from Ted Cruz, Jim DeMint, and the Heritage Action PAC. Their messages have translated into something pretty simple, “Keep Obamacare alive until 2014 as a campaign issue otherwise we will ‘primary’ you.” Jim DeMint is causing more trouble as a million-dollar-a-year enforcer for the Brothers Koch than he ever did in the Senate.

This whole mess is about the kamikaze caucus (about 40 Tea Partiers from gerrymandered districts) being able to run once more against the Affordable Care Act. Along the way, perhaps the Senate can be won as well. The hope? Essentially blocking any potential legislation for the remaining two years of the Obama Administration.

It seems as though Ted Cruz, the current flavor of the week in conservative circles, has heeded the message of the infotainment overlord, Jabba the Limbaugh. That message: No compromise because the conservative message represents the majority of Americans. Of course there is formidable evidence refuting such a claim, but as many headstones proclaim — formidable evidence is the last refuge of people who lack the ability to ignore facts.

The Limbaugh/Cruz/Koch/kamikaze caucus view is a simple one: People love, love, love the conservative view of the world, we just need to say it louder and with more conviction. A position not unlike a drowning man believing he will more easily float if only he had more water.

Obamacare remains the issue of choice for the Republicans in 2014. It worked for them in 2010 so in their dutiful aversion to thinking about anything new, ergo, it will work in 2014. As Chat often reminds us, “What could go wrong?”

What could go wrong is pretty simple and it begins today with the debut of Obamacare. If there are no locusts, if cows don’t run dry, if the Earth continues to spin on its axis, if the Kardashians still need to shave — the fear fulminated and forecasted for the past three years will carry the same weight as “the dog ate my homework.”

Monsters under the bed...Inevitably there will be glitches and problems with building out what is essentially an online insurance system, but if the world doesn’t come to an end and grandma doesn’t have a date with a death panel, the fear-mongering will have been for naught.

When you are told there are monsters lurking in the darkness everywhere, it takes very little light to dispel the fear. The fringe right’s smug, dazzling, self-proclaimed brilliance failed to recall that kamikazes didn’t fly in darkness — they only flew in the light of the day. Thirteen months of light around Obamacare should disperse the fear mongering quite nicely.

This is an open thread.


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Our 2016 Ticket!

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Busted: Glass ceiling

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Kellyanne Conway’s new job

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Take the kids to work? NO!

3 turds control fate of healthcare for millions

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