Good Afternoon! Happy Martin Luther King Day!!
I’ve been spending the morning getting back up to speed on Health Care Economics which is something I never enjoy but never seem to be unable to avoid. The facts on the ground never change much. What we know about single payer and third party payer systems remains pretty much the same. The only thing that seems to change is the hostility in this country on the subject. I keep having to dredge up the same information over and over with the new twists.
Well, here I go again …
There are three articles that BB sent me this morning that sum up the situation nicely. I’m going to start with those and then finish up by reviewing the mini-case of the failed single payer case in the state of Vermont. I’m not doing this because I don’t think single payer health insurance is a good deal ceteris paribus. It obviously works in other countries. As the Republicans remind us daily, we are not other countries. Theoretically, it provides superior risk sharing and economies of scale on cost. So, my theoretical economist side loves it. My living in America with everything that’s already standing and Republicans who thwart everything at every turn except tax cuts for the wealthy and wars side has a different train of thought.
Yes, it’s time to heal those suffering badly from Berns. I’m going to be in good company because the public wonks are with me on both accounts. We yearn for a simpler, cheaper, more efficient way of paying and getting health care. But, we know the difference between brainstorming and an actionable policy. I’m cursed with a heart longing for idealism but a brain that reins the damn thing in. Bernie Sanders plan really isn’t a plan. It’s a lofty goal.
Here’s Ezra Klein writing for VOX stating ‘Bernie Sanders’s single-payer plan isn’t a plan at all: Sanders’s long-awaited health care plan is, by turns, vague and unrealistic.‘ You should read these links fully if you can manage the time.
Sanders calls his plan Medicare-for-All. But it actually has nothing to do with Medicare. He’s not simply expanding Medicare coverage to the broader population — he makes that clear when he says his plan means “no more copays, no more deductibles”; Medicare includes copays and deductibles. The list of what Sanders’s plan would cover far exceeds what Medicare offers, suggesting, more or less, that pretty much everything will be covered, under all circumstances.
Bernie’s plan will cover the entire continuum of health care, from inpatient to outpatient care; preventive to emergency care; primary care to specialty care, including long-term and palliative care; vision, hearing and oral health care; mental health and substance abuse services; as well as prescription medications, medical equipment, supplies, diagnostics and treatments. Patients will be able to choose a health care provider without worrying about whether that provider is in-network and will be able to get the care they need without having to read any fine print or trying to figure out how they can afford the out-of-pocket costs.
Sanders goes on to say that his plan means “no more fighting with insurance companies when they fail to pay for charges.”
To be generous, it’s possible that Sanders is just being cynical in his wording, and what he means is that, under his plan, individuals have to fight with the government rather than private insurers when their claims are denied.
But the implication to most people, I think, is that claim denials will be a thing of the past — a statement that belies the fights patients have every day with public insurers like Medicare and Medicaid, to say nothing of the fights that go on in the Canadian, German, or British health-care systems.
What makes that so irresponsible is that it stands in flagrant contradiction to the way single-payer plans actually work — and the way Sanders’s plan will have to work if its numbers are going to add up.
Behind Sanders’s calculations, both for how much his plan will cost and how much Americans will benefit, lurk extremely optimistic promises about how much money single-payer will save. And those promises can only come true if the government starts saying no quite a lot — in ways that will make people very, very angry.
“They assumed $10 trillion in health-care savings over ten years,” says Larry Levitt, vice president at the Kaiser Family Foundation. “That’s tremendously aggressive cost containment, even after you take the administrative savings into account.”
The real way single-payer systems save money isn’t through cutting administrative costs. It’s through cutting reimbursements to doctors, hospitals, drug companies, and device companies. And Sanders’s gestures towards this truth in his plan, saying that “the government will finally have the ability to stand up to drug companies and negotiate fair prices for the American people collectively.”
But to get those savings, the government needs to be willing to say no when doctors, hospitals, drug companies, and device companies refuse to meet their prices, and that means the government needs to be willing to say no to people who want those treatments. If the government can’t do that — if Sanders is going to stick to the spirit of “no more fighting with insurance companies when they fail to pay for charges” — then it won’t be able to control costs.
Put it this way: for all the talk about being honest and upfront, even Sanders ended up delivering mostly smoke and mirrors — or as Ezra Klein says, puppies and rainbows. Despite imposing large middle-class taxes, his “gesture toward a future plan”, as Ezra puts it, relies on the assumption of huge cost savings. If you like, it involves a huge magic asterisk.
Now, it’s true that single-payer systems in other advanced countries are much cheaper than our health care system. And some of that could be replicated via lower administrative costs and the generally lower prices Medicare pays. But to get costs down to, say, Canadian levels, we’d need to do what they do: say no to patients, telling them that they can’t always have the treatment they want.
Saying no has two cost-saving effects: it saves money directly, and it also greatly enhances the government’s bargaining power, because it can say, for example, to drug producers that if they charge too much they won’t be in the formulary.
But it’s not something most Americans want to hear about; foreign single-payer systems are actually more like Medicaid than they are like Medicare.
And Sanders isn’t coming clean on that — he’s promising Medicaid-like costs while also promising no rationing. The reason, of course, is that being realistic either about the costs or about what the system would really be like would make it a political loser. But that’s the point: single-payer just isn’t a political possibility starting from here. It’s just a distraction from the real issues.
The deal is this. We have entire systems, institutions, and agents that have been functioning under multiple plans for quite some time. This includes Medicaid, Medicare, SCHIP, the VA, and a myriad of private health insurance plans. You just don’t wave a magic wand and expect that all to unwind costlessly and seamlessly. You also don’t expect all those folks to be thrilled about it either or to seamlessly transfer their efforts and resources to a new system. It takes big money and time to do that. We’re not operating from scratch here.
That also doesn’t take into account politics. Yes. POLITICS. Remember when we first got the ACA and how the majority of Dems and Republicans voted for a single payer plan when the Dems controlled Congress? Remember how the ACA should work if SCOTUS hadn’t let so many states opt out of the system? Yes, Virginia, there is no Santa Claus.
Dear Bernie Sanders-supporting Friends: Sanders is nice enough. He’s got some good ideas. But, no, I do not think he’s got what it takes to be President. He operates out there in gadfly paradise. Or, as Michel Cohen writes it: ‘Bernie Sanders doesn’t get how politics works’.
Now for my deeper impression of the debate: even with his rising poll numbers in Iowa and New Hampshire, I find it increasingly difficult to take Sanders seriously as a presidential candidate.
Maybe it’s the fact that he’s 74, would be the oldest man to ever become president, and yet couldn’t be bothered to release his medical records until a Clinton surrogate attacked him for it.
Maybe it’s that Sanders finds a way to answer virtually every question by turning it back to another predictable and one-dimensional attack on Wall Street and big money.
Maybe it’s that he gets away with proposing unrealistic policy ideas that have little chance of being passed even by Democrats in Congress, let alone Republicans, and then gets praised for being authentic. Sunday night Sanders finally released his single-payer health care plan, which is all of eight pages and provides little detail on how he’ll implement a complete restructuring of the US health care system. That’s at least an improvement over his plan for breaking up the banks, which is four pages and just as short on detail.
Maybe it’s that every time he answers a question on foreign policy and national security, it’s blindingly apparent that not only does he not understand foreign policy and national security, he simply doesn’t care to know more. I mean, only Bernie Sanders could answer a question about instability Middle East by pivoting to an attack on wealthy nations like Saudi Arabia, which he repeatedly says has to play a greater role in the civil war in Syria, as if no one on his staff could bother to tell him that Saudi Arabia is already playing an important role in the civil war in Syria.
It’s all that and something else — Sanders really does have a singularly naive and simple-minded understanding of American politics. He genuinely seems to believe — and I know this because he repeatedly yelled it at me during the debate — that money is the root of all evil in politics and that if you get the big money out, great things will happen. Sanders said that “a handful of billionaires . . . control economic and political life of this country.” He argued that Republicans and Democrats don’t “hate each other.” He called that a “mythology.” Instead, he said, the “real issue is that Congress is owned by big money and refuses to do what the American people want them to do.”
I’m sorry, but that is a maddeningly simplistic — and wrong — explanation of how American politics works.
Take single-payer health care, which Sanders claims has been difficult to enact because of a corrupt campaign finance system that allows the “pharmaceutical industry” and private insurance companies to spend millions in “campaign contributions and lobbying.”
On the one hand, Sanders is right — those are powerful interests. But so are doctors and hospitals, who’d pay a huge price if single payer became law; so are Republicans, who fought tooth and nail to defeat Obamacare and would do the same for a single-payer plan; so are Democrats, who couldn’t even support a public option for Obamacare and are unlikely to support single payer; so are Americans, who may not be inclined to support another restructuring of the health care system — a few years after the last one. It’s not just about money; it’s also about a political system constructed and reinforced to block the kind of massive reform Sanders is advocating. Money is important, but it’s not even close to the whole story.
How someone who’s been in Washington as long as Sanders can believe that all that stands between doing “what the American people want [Congress] to do” is something as simple as reforming campaign finance is stunning. Sanders, who brags the NRA gives him a D- rating, is the same politician who supported legislation giving gun manufacturers immunity from civil lawsuits and voted against the Brady Bill. Why? Perhaps it is because Sanders comes from a state that has few gun control laws and lots of gun owners. Yes red-state senators who oppose gun control receive contributions from the NRA. They also have constituents who oppose gun control measures and vote on the issue — like Bernie Sanders. It’s as if in Sanders’ mind, parochialism, ideology, or politics plays no role . . . in politics.
So, yes, we have the ACA (Obamacare) which is a “kludge” to borrow a turn of phrase from Krugman. If we could start from scratch then single payer health insurance would be infinitely cheaper and better. But, that’s not the way it is.
Krugman admits that Obamacare is far from perfect, an awkward, imperfect solution that does not work for everyone. But he thinks it would be a mistake for Democrats to expend political capital refighting the battle that gave them their biggest victory in decades. Here’s how he lays out his case:
If we could start from scratch, many, perhaps most, health economists would recommend single-payer, a Medicare-type program covering everyone. But single-payer wasn’t a politically feasible goal in America, for three big reasons that aren’t going away.
First, like it or not, incumbent players have a lot of power. Private insurers played a major part in killing health reform in the early 1990s, so this time around reformers went for a system that preserved their role and gave them plenty of new business.
Second, single-payer would require a lot of additional tax revenue — and we would be talking about taxes on the middle class, not just the wealthy. It’s true that higher taxes would be offset by a sharp reduction or even elimination of private insurance premiums, but it would be difficult to make that case to the broad public, especially given the chorus of misinformation you know would dominate the airwaves.
Finally, and I suspect most important, switching to single-payer would impose a lot of disruption on tens of millions of families who currently have good coverage through their employers. You might say that they would end up just as well off, and it might well be true for most people — although not those with especially good policies. But getting voters to believe that would be a very steep climb.
Bottom line for Krugman is that single-payer ain’t gonna happen. Like it or not, the fact that Obamacare did not disrupt the millions of Americans who get health insurance through their employers gives it a leg up. Then there is the fact that taxes would have to be raised on the middle class to pay for it, as even Sanders acknowledges. And even though the middle class would not doubt save even more on their health insurance premiums, Krugman comes down on the side that higher taxes on them would not fly politically.
I’d like to add something to all of this. It’s frequently nice to have test cases for policy change. Massachusetts was the test case for ChaffeeCare/DoleCare/RomneyCare/ObamaCare. It wasn’t perfect but it worked.
According to a new analysis, health care reform in Massachusetts, popularly known as “Romneycare,” didn’t cause hospital use or costs to increase, even as it drove down the number of people without health insurance.
Implemented by the state in 2006, and signed by then-Gov. Mitt Romney, the reform is looked at as a model for the Affordable Care Act, also known as “Obamacare,” the sweeping and controversial health care law that Republican lawmakers in the House tried to repeal for the 37th time Thursday.
Amresh Hanchate, an economist with the Veterans Affairs Boston Healthcare System and lead author of the study, which he presented Thursday at an American Heart Association conference, says that the results of the study were surprising.
When it was implemented, about 8.4 percent of Massachusetts citizens were uninsured; by 2010, just 3 percent were uninsured. Uninsured rates fell most among minorities: In 2006, 15 percent of African-Americans were uninsured, in 2010, that rate was at 3.4 percent. Uninsured rates for Hispanics in the state fell from 20 percent to 9.2 percent during the same period.
Similarly encouraging news is found on the ACA even though it was seriously hampered by the SCOTUS ruling that allowed many states to opt out of the medicaid expansion and hosting local exchanges. We have one state that tried to have single payer. It failed. The state was Vermont. Sanders was asked about it during the debate. He dodged the question by referring it to the state’s governor. Well, there’s a lot of information out there on it. I’ll start with NEJM.
On December 17, 2014, Vermont Governor Peter Shumlin publicly ended his administration’s 4-year initiative to develop, enact, and implement a single-payer health care system in his state. The effort would have established a government-financed system, called Green Mountain Care, to provide universal coverage, replacing most private health insurance in Vermont. For Americans who prefer more ambitious health care reform than that offered by the Affordable Care Act (ACA), Shumlin’s announcement was a major disappointment. Was his decision based on economic or political considerations? Will it damage the viability of a single-payer approach in other states or at the federal level?
Shumlin’s exploration of a single-payer health care system, which included three assessments by different expert groups, was among the most exhaustive ever conducted in the United States. A 2011 study led by Harvard health economist William Hsiao provided optimistic projections: immediate systemwide savings of 8 to 12% and an additional 12 to 14% over time, or more than $2 billion over 10 years, and requirements for new payroll taxes of 9.4% for employers and new income taxes of 3.1% for individuals to replace health insurance premiums (see table) Financial Estimates from Three Projections for a Vermont Single-Payer Health Plan.).
Two years later, a study by the University of Massachusetts Medical School and Wakely Consulting projected savings of just 1.5% over 3 years.2 Finally, a 2014 study by Shumlin’s staff and consultants predicted 1.6% savings over 5 years and foresaw required new taxes of 11.5% for employers and up to 9.5% for individuals. The governor cited these last projections in withdrawing his plan: “I have learned that the limitations of state-based financing, the limitations of federal law, the limitations of our tax capacity, and the sensitivity of our economy make that unwise and untenable at this time . . . . The risk of economic shock is too high,” Shumlin concluded.
Two factors explain most of the decline in the plan’s financial prospects. First, the anticipated federal revenues from Medicaid and the ACA declined dramatically. Second, Shumlin’s policy choices significantly increased the total projected cost of Green Mountain Care: raising the actuarial value of coverage — the expected portion of medical costs covered by a plan rather than by out-of-pocket spending — from 87% to 94%, providing coverage to nonresidents working in Vermont, and eliminating current state taxes on medical providers. Still, even Shumlin’s projections indicated that the plan would reduce Vermont’s overall health spending and lower costs for the 90% of Vermont families with household incomes under $150,000. Despite differing projections, all three studies showed that single payer was economically feasible.
In reality, the Vermont plan was abandoned because of legitimate political considerations. Shumlin was first elected governor in 2010 promising a single-payer system. But in the 2014 election, his Republican opponent campaigned against single payer. Shumlin won the popular vote by a single-percentage-point margin, 46% to 45%, which sent the election to the Democratic-controlled House of Representatives; though the House reelected him easily in January, a clear public mandate for his health care agenda was nowhere in evidence.
Here’s some slightly less academic explanations. This one comes from the Boston Globe.
Vermont took Obamacare a step further. In 2011, Shumlin proudly signed a bill to establish a publicly financed, single-payer system. The law required Shumlin to submit a detailed financial plan by 2013.
Shumlin missed the deadline, raising fears among supporters and critics alike that single-payer health care would cost much more than anticipated. Those fears were realized on Dec. 17, when Shumlin, two years late and just a month from narrowly winning reelection, released the financial analysis.
The numbers were stunning. To implement single-payer, the analysis showed, it would cost $4.3 billion in 2017, with Vermont taxpayers picking up $2.6 billion and the federal government covering the rest. To put the figures into perspective, Vermont’s entire fiscal 2015 budget, including both state and federal funds, is about $4.9 billion.
Shumlin’s office estimated the state would need to impose new personal income taxes of up to 9.5 percent, on top of current rates that range from 3.55 to 8.95 percent. Businesses would be hit with an 11.5 percent payroll tax, on top of 7.65 percent payroll taxes employer pay for Social Security and Medicare.
And even those tax increases might not have been enough. The governor’s office estimated the Green Mountain Care program would run deficits of $82 million by 2020 and $146 million in 2021. Shumlin said he feared the tax increases would harm businesses and the economy.
Okay, this is VERMONT, folks. Now, try doing that in Louisiana and Kansas or try getting their elected officials in the District to buy off on it.
So, a lot of children just really like believing in Santa Claus and it doesn’t take much to get them to continue their buy-in. Then there was Doctor Daughter who figured out it was her Dad and me at an extremely tender age after careful empirical study then asked me if that was the case. Of course, I said yes rather than try to lead her on like my parents did me for the sake of my sister. I just told her to go along if other kids believed and their parents hadn’t told them the truth yet. She did so like a little Nixonian co-conspirator.
I will not lie to you. Ceteris paribus. I prefer Single Payer Health Insurance. Ceteris paribus. Bernie Sanders has some really nice ideas.
I have never been one of those theoretical researchers. All of my stuff is empirical. I live in the land of empirical evidence. Yes, folks socialized medicine works just fine in the UK and is fairly cheap and folks get turned away for stuff that would probably piss the average American off. Yes, single payer health or a government option works great in Switzerland and other places. But, this is a country where it appears that our options will be Hillary Clinton or Donald Trump.
Spare me the Santa Claus mythos or the Senator Gadfly mythos.
Sorry this is so long, but as you can see, I had a lot to say and prove. I vote we try to improve on the ACA and for Hillary. Just sayin’.
Mea culpas go to any one whose work I over quoted. I love fair use but I also loved what you wrote. I quoted and cited you. Just sayin’.
What’s on your reading and blogging list today?
Tonight’s debate is likely to feature some fireworks and a good exchange of ideas between Hillary Clinton and Bernie Sanders–as long as the moderators can keep Martin O’Malley from constantly breaking in with his patented line “I’ve actually already done that in Maryland.”
Mediaite has the basics on how to watch the debate. It will be available on line at the NBC News website and YouTube. It begins at nine and goes for two hours.
The back and forth between Hillary and Bernie this week has been interesting, to say the least. Hillary seems to have gotten under Bernie’s skin too, because he has now partially flip flopped on his vote to immunize gun dealers from liability, his campaign has promised to release specifics on his health car plan and how he hopes to pay for it “very soon,” and they’ve also said they’ll release a “doctor’s note” on Sanders’ health.
Just a couple of days ago the Sanders campaign announced they wouldn’t release the health care tax figures and they previously pooh poohed the need to release medical records.
I’ve thought for awhile now that Sanders has begun to believe his own reviews in the media. After reading what he said on Face The Nation this morning, I’m convinced he has allowed the failure of the media to vet him and the adulation of his supporters to go to his head.
“I think we have a good chance to win both those states,” he said of Iowa and New Hampshire, the first two states to hold nominating contests. “I think we have a good chance to win this election.”
If he does win, Sanders predicted his campaign would come to be known as “one of the great political upsets in modern history.”
He is feeling so good, in fact, that the Vermont senator told “Face the Nation” host John Dickerson that while he was watching President Obama’s final State of the Union address last week, “the thought did cross my mind” that he could be delivering that address in the near future.
Then he caught himself.
“It’s a very humbling feeling,” he said, but added a moment later, “It’s a long way to go before we talk about inaugural speech, before we toss State of the Union speeches in.”
Hmmm…. he doesn’t sound so humble.
I have a few other good links for you on Bernie.
First a diary from DailyKos (!) on the health care law that Sanders has proposed multiple times in Congress: Sanders’ Health Care Plan. The diarist simply reports the contents of Senate Bill 1782, introduced in December 2013. Please go read it.
The law would end Medicare, Medicaid, SCHIP, the Federal Employees’ Health Benefits Program, and TRICARE. The money that was going into those programs, and use it to fund a “single payer” plan to be run and partially paid for by the states.
We already know that Supreme Court is not going to force states to accept something they don’t want from the Feds. That was their decision on the ACA Medicaid expansion. Even if Sanders could somehow get this through the Republican Congress, it would never get past SCOTUS.
I can’t even imagine what would be involved in implementing this. Right now, Medicare has low overhead costs because it turns over administration of supplemental plans to insurance companies–which would be outlawed in Sanders’ alternative universe.
I’m on Medicare and I get help paying my premiums from the government. Those premiums are more than $100 per month. Basic Medicare only pays for hospital bills, so I also have a government funded supplemental plan with very high co-pays that I get “free.” At least I can go to a doctor if it’s absolutely necessary. What would happen to people like me when all that infrastructure is demolished?
Here’s another must-read that Babama posted in a comment yesterday.
Recently, Chelsea Clinton got panned for saying that Bernie Sanders’ health care plan – commonly heralded as ‘Medicare for All’ by the revolution-peddlers – would give Republican governors the opportunity to dismantle publicly funded health insurance for the poor and middle class, that is, Medicaid and the health insurance exchanges. Seems absurd to accuse a self-proclaimed socialist with a proclaimed demand for single-payer universal health insurance of trying to take away health care. Politifact rated Chelsea Clinton’s claims ‘mostly false.’
Politifact got it wrong. Bernie Sanders’ plan does, in fact, allow for states to take away health care from the poor and middle-income, if not most everyone in a state. Although, that shouldn’t be a surprise, given that Sanders’ plan itself targets the economically disadvantaged for punishment. As Politifact notes, Sanders hasn’t proposed a full health care plan for his presidential campaign, instead choosing to use a bill Sanders introduced in the Senate in 2013 without a single cosponsor, titled ‘American Health Security Act of 2013’ as the template.
Poltiifact notes it is in fact true that Sanders’ plan repeals all health insurance funding from Medicare, Medicaid, and the Affordable Care Act Health Insurance exchanges. But he would channel the revenue instead to fund the single-payer system! [….]
The problem is, what Sander’s bill “seeks to” do and what it actually does are quite different. Since Politifact helpfully pointed us to Sanders’ 2013 bill, I decided to read it. In short, it ends all funding to Medicaid, Medicare, SCHIP an the ACA insurance provisions, directs it to this single-payer insurance program, raises additional revenue on the back of those who can least afford it, and charges states with the job of actually running it.
Each state, in theory, would have its own program that follows basic guidelines and the vast majority of the funding (80-90%) is provided by the federal government. Nonetheless, for states that refuse to run their own program, federal authorities – specifically, a Board – can do so instead. Sanders’ bill would also ban the sale of private health insurance.
Until I read that last night, I really didn’t understand how clueless Sanders really is. Please read the whole thing if you haven’t already, because Robert Reich is running around saying the plan makes sense.
One more Bernie link from Dean Barker at “Birch Paper.” This one has been getting retweeted a lot today. The piece takes us back to the early days of Sanders’ political career when he ran again and again for office, and always lost. Then he got smart and used guns to get into Congress.
Sanders repeatedly talks about how he lost an election because he supported a ban on assault weapons. What really happened is that Sanders did so well in a third-party run that he got Republican Peter Smith elected. After he got to Washington, Smith’s conscience bothered him and he ended up supporting a bill to ban assault weapons.
In 1990, Sanders ran for the House seat again, and defeated Smith with the help and monetary support of the NRA. So when Bernie went to Washington, he voted against the Brady bill–repeatedly.
You have to read that article! There are tons of good links in there too.
Hillary was on the morning shows today too, and she learned from George Stephanopoulos that Karl Rove’s super pac is running an ad in Iowa that supports Sanders attacks on her.
The web spot, titled “Hillary’s Bull Market,” was launched by American Crossroads, which is run by the Republican strategist and former President George W. Bush adviser. After watching the ad for the first time during her interview on “This Week,” Clinton just smiled.
“I think it shows how desperate the Republicans are to prevent me from becoming the nominee,” Clinton said about the ad, which goes after her ties to Wall Street. “I find that, in a perverse way, an incredibly flattering comment on their anxiety, because they know that not only will I stand up for what the country needs, I will take it to the Republicans.”
CNN’s report on the morning shows: Hillary Clinton zeroes in on Bernie Sanders.
Hillary Clinton on Sunday sharpened her attacks on Bernie Sanders over the Vermont senator’s record on gun control, just hours ahead of their fourth debate as both vie for the Democratic presidential nomination.
“I am very pleased that he flip-flopped on the immunity legislation,” Clinton told CNN’s Jake Tapper on “State of the Union,” a day after Sanders, who had been hammered by her campaign for his past position, announced he would change course and back legislation to reverse a 2005 law granting firearm manufacturers legal immunity.
She then called on her rival to do the same with the so-called “Charleston loophole,” which allows licensed dealers, once they have initiated a federal background check, to complete the gun sale in question if they haven’t hears back from authorities after three days.
Good news for Hillary:
Hillary Clinton is leading Bernie Sanders in a new national poll ahead of Sunday’s final Democratic debate before the Iowa caucuses.
The former Secretary of State is beating Sanders by 25 points nationally, according to according to the latest NBC News/Wall Street Journal poll of likely Democratic primary voters. Clinton is the top pick among 59% of Democratic primary voters, while Sanders has the support of 34%, the survey shows. Third-place candidate Martin O’Malley got the support of just 2% of likely voters.
Read the rest at CNN.
And From US News: Yes, Hillary’s Still the Inevitable Democratic Nominee She can recover even if she loses the first two nominating states to Bernie Sanders. Here’s why. Read about it at the link. It’s not easy find a brief excerpt to summarize the findings.
I’m putting this up a little early so we’ll have time to discuss these articles–or anything else you want to talk about–before the debate begins at 9PM. I look forward to reading your reactions to what happens tonight. This is the most important debate yet!
Actually, the fight has been ongoing, this past year there have been vicious attacks among the powerful females within the group, causing injuries…pretty bad ones at that. They have even had to close the exhibit and re-arrange the back enclosure to include additional, “escape routes.”
See this article from Toronto about the ongoing war:
Medical records show numerous injuries among five of the six female olive baboons, from deep lacerations near their eyes to hair ripped out and tail injuries. At least two required surgeries to close deep gashes.
The exhibit was closed for several days because “there were some injuries that we thought best to keep them at the back because our visiting public don’t know baboon behaviour,” said Maria Franke, the curator of mammals at the zoo.
The baboon house — the area not open to the public where the animals eat and sleep — also had to be modified to allow for more space and additional escape routes, Franke said.
Chris Dutton, the zoo’s senior veterinarian, said the animals are fine and are “incredibly tough and they heal incredibly well.”
Now, Dutton said, two females sit on the throne in an uncomfortable truce, with the rightful heir biding her time until the older one dies.
Baboons, both in the wild and at zoos, have societies that are run by females — and that dominance runs through family lines. So the oldest daughter of the matriarch is the rightful heir to become queen.
That’s what happened to Betty, the longtime queen of the 12-member troop who took the reins when her mother, Boss Lady, died.
But troubles began a year ago when keepers noticed differences in Betty’s behaviour, Franke and Dutton said.
“She was changing her naturally dominant behaviour and she was hanging out with the subordinates and starting to slow down a little,” Dutton said.
The medical records, obtained via freedom-to-information legislation, note Betty was “reported to be lethargic, losing weight and not eating well.”
By early December, Betty stopped eating.
So Dutton and his staff anesthetized her to figure out what was going on. An exploratory surgery revealed a tumour in her uterus that had spread to the abdominal wall. It was terminal, Dutton said, so they euthanized her on the operating room table on Dec. 5, 2014. She was 16 years old.
That’s when the brawling began.
So, in Canada…they need the freedom of information act to get records on…Baboons.
But I got distracted.
Let’s get on with the fighting, back to when the shit hit the fan:
Molly is Betty’s oldest daughter and baboon society dictates the throne was hers. But she was young at six years old, and not fully mature.
So Putsie, who at 18 years old is the enclosure’s oldest female, saw an opportunity.
“She’s fighting to be dominant because of age, I guess,” Franke said.
It’s unclear exactly who inflicted which wounds on whom, as the attacks happened mostly at night and away from the keepers. But over the course of the following year, Putsie had only one minor injury, while the remaining five animals fared worse.
Molly and her sister, Susan, appeared to suffer the most attacks early on, according to the medical records.
Molly was attacked at least eight times over the course of three months. At one point, her left eye was swollen shut and she had deep lacerations above both eyes and a gash to the bone on her nose, the records show. Molly was anesthetized and one wound was stitched up.
By mid-month, Susan was attacked and suffered “severe lacerations” of the right side of her face that left the orbital bone exposed. The injury required surgery similar to Molly’s.
The eye itself wasn’t affected, the records say, “but the eye remains semi closed before and after suturing and cannot rule out muscle or nerve damage to peri-orbital structures.”
Three subordinate females, Kristina, Kate and Kalamata — all Putsie’s daughters — were also attacked. Kristina’s left eye was swollen shut after a fight, according to the medical records.
Kate had cuts on her face and several bites to her tail.
“Now all the aggression is occurring to the other animals, the least dominant, which is Kalamata,” Franke said.
Damn, the shit is getting real!!! Poor Kalamata is the one who is weakest, and of course, the one they are ganging up on.
“Most of the hair on top of her head has been ripped out,” the medical notes read. “This individual has been attacked multiple times within the last two months.”
She was attacked again this past October, Dutton said, when one baboon bit her tail.
Dutton and Franke only intervened when a baboon needed medical treatment. They were loathe to interrupt the baboon’s own game of thrones.
“You have to let their natural behaviour happen,” Franke said. “They have to sort it out. In the wild, a lot of times it’s to the death.”
She added a baboon has never been killed by another baboon at the Toronto Zoo.
Well, thank the gawds for that!
A veterinary note that was attached to several baboons’ medical files suggests various interventions, including modifying the enclosure to add outdoor heaters and shelters so that the animals can have outdoor access at night without freezing.
The note also suggests looking into medical options for regulating aggressive behaviour.
Hmm, I bet you are wondering about pills right? Dope them up, eh?
As for medical intervention, Dutton said: “We don’t particularly want our animals on some form of mood-altering drugs of any kind because we don’t think that’s appropriate.”
I guess the Scientologist are pleased with that diagnosis.
Now, the name of the male in this next and last nugget of the piece made me laugh like hell….
The only drama came when one male made a sexual play for a female.
Bwana Joe, the oldest and largest male, took offence and chased several baboons up the rock wall — but eventually succeeded in wooing one of the females himself.
I think we have a new nickname for Joe Biden…don’t you?
Today’s post is full of links, to a variety of stories. I am purposely not touching on the Planned Parenthood shooting, and the disgusting remarks from the fuckers on the GOP side. I can’t deal with it now, it will get me too upset.
My mind is in another place. Last night I read this headline, Unemployed Florida man tries shocking father to death – NY Daily News. You want to know what my first thought was? The guy coming out behind a bush or something and yelling boo! Seriously. I thought of that werewolf scene from High Anxiety:
It never occurred to me that “shocked” meant…shocked, as in electrocuted.
After finding out he would get his father’s entire inheritance, an unemployed Florida man tried electrocuting his dad.
John Knudsen, 44, had a shocking ploy to take his 81-year-old father’s money — by killing him and reaping the inheritance. The Ormond Beach son learned that he would be the sole beneficiary of his father’s will, and pulled his charged stunt on Thanksgiving morning, according to reports.
Black lives matter is in the news again. I was trying to explain to my parents the point behind #BlackLivesMatter on why they are not bringing up the black on black crime**…especially the most recent violence that we have seen in the news in New Orleans and the assassination of the 9 year old boy in Chicago (a supposed gang leader’s son). The point being that BLM is for the cause of certain specific things, i.e…..this:
Chicago’s police chief was ousted on Tuesday after days of protest over a white officer’s shooting of a black teenager 16 times and the department’s refusal to release a video of the killing for more than a year.
Mayor Rahm Emanuel announced during a news conference that he had asked Garry McCarthy, police superintendent since May 2011, to resign. Emanuel also said he was creating a new police accountability task force.
The white officer, Jason Van Dyke, was charged a week ago with first-degree murder in the 2014 killing of Laquan McDonald. The video, from a patrol car’s dashboard camera, was released on the same day.
High-profile killings of black men at the hands of mainly white law enforcement officers in U.S. cities have fueled demonstrations for some two years, stoking a national debate on race relations and police tactics.
The Illinois attorney general called for a federal civil rights investigation into the Chicago Police Department on Tuesday, hours after Mayor Rahm Emanuel fired the superintendent for his handling of an officer’s killing of a black teenager.
Attorney General Lisa Madigan sent what she characterized as an urgent request to U.S. Attorney General Loretta Lynch, asking that the Department of Justice Civil Rights Division investigate Chicago police use of deadly force and the department’s internal review process, and determine whether there is a “pattern of discriminatory policing.”
“Trust in the Chicago Police Department is broken, especially in communities of color in the City of Chicago,” Madigan wrote.
“An investigation into whether there are patterns and practices of civil rights violations by CPD is vital to bringing about the systemic change that is necessary here,” Madigan continued. “Chicago cannot move ahead without an outside, independent investigation into its police department that moves toward improved policing practices and increasing trust between the police and the community.”
Nearly an hour and a half of surveillance footage from the night of Laquan McDonald’s death is missing from the security system at a Chicago Burger King near the scene of the black teen’s alleged murder, and new evidence obtained by NBC Chicago suggests police may have been the last ones to view it.
Jay Darshane, district manager for the Burger King at Pulaski Road and 41st Street, told NBC Chicago in May that his cameras were fully operational when police came in on Oct. 20, 2014, the night of the shooting. While he wasn’t at the restaurant at the time, he said he authorized the manager on duty to give the officers access to the footage. He suggested that the video wouldn’t show the fatal 16 shots, but it might contain details about what happened directly before and after officer Jason Van Dyke killed McDonald.
The next day, however, Darshane discovered an 86-minute gap in the footage, from 9:13 p.m. to 10:39 p.m. Prosecutors say Van Dyke fired the first of 16 rounds at 9:57. Darshane — who testified about the missing video before a federal grand jury earlier this year, according to the Chicago Tribune — said he believes police deleted the key footage. But local law enforcement officials say they haven’t found evidence that the security system was tampered with.
Now NBC Chicago has revealed the two screen grabs below, which appear to show at least one officer reviewing security recordings at Burger King on the night of McDonald’s death.
Be sure to go to the links to those articles to read the rest of the stories. Especially the last one on the missing 86 minutes of tap, and the footage of officers reviewing the film at the Burger King. I think that could be huge…in a holy shit sort of way.
In an interview with NPR last week, Chicago attorney Craig Futterman said he’d seen footage similar to the screen grabs obtained by NBC. He accused the police of erasing the key minutes.
“The officer went into the Burger King, and he erased all seven of those files,” said Futterman, who aggressively lobbied for the release of a related video taken by the police dashcam. “The irony is, though, that the Burger King surveillance video was running while the officer erased them. And so there’s a videotape of the officer erasing the video.”
The grainy images don’t show exactly what officers are doing or for how long, but Darshane recently told the Tribune that police had come with their own information technology specialist and hung around the restaurant until about midnight. He also claimed that officers were having a difficult time operating the security system.
At a press conference last week, Cook County State’s Attorney Anita Alvarez described the matter of the mysterious gap as closed. She said “forensic testing” had revealed no tampering, but refused to answer any further questions.
Also at the press conference, Garry McCarthy, then superintendent of Chicago’s police force, called allegations that his officers had altered the footage “absolutely untrue.” The missing video was the result of “technical difficulties,” he said.
(I myself don’t understand the reason behind the BLM protesters attacking Hillary, when they should go after the assholes who don’t give a damn…like the GOP dickheads. But maybe someone can explain it to me?)
Then you have some in the black community who do speak out on such matters as black violence, like Spike Lee did a few weeks back: Spike Lee’s Comments on Black Lives Matter Might Piss You Off | News | BET
He says we “can’t ignore that we are killing ourselves, too.”
Spike Lee isn’t afraid to make people angry with his opinionated points of view, and he doesn’t disappoint when it comes to sharing his views on Black Lives Matter. The director, whose controversial film Chi-Raqhits theaters on December 4, tells CNN’s Anderson Cooper that he supports the movement, but that attention should also be paid to Black-on-Black crime.
“We cannot be out there” protesting police violence “and then when it comes to young brothers killing themselves, then mum’s the word. No one’s saying nothing? It’s got to be both ends,” Lee said, adding that he’s “all for Black Lives Matter,” but “we as a people can’t be blind” to Black-on-Black crime.
Lee said Black Lives Matter should focus on police brutality, “but you can’t ignore that we are killing ourselves, too. We can’t ignore that.”
Unsurprisingly, conservative blogs are picking up on Lee’s comments and using them to tout their own agendas, which will anger many who support the #BLM movement, but seeing that Spike has been immersed in the world of Chicago gun violence for at least the past year, his views are not that surprising.
Oh, and those asses at the GOP really do use these words to their own advantage…just two words for you on that. Richard Sherman.
**As to the phrase, black on black crime: Myth of Black-on-Black Crime
Anyway, your thoughts on the subject?
More Americans had their backgrounds checked purchasing guns on Black Friday than any day in the on record, according to data released by the FBI this week.
The National Instant Criminal Background Check System processed 185,345 requests on Nov. 27, one of the largest retail sales days in the country.
“This was an approximate 5% increase over the 175,754 received on Black Friday 2014,” wrote Stephen Fischer, the FBI’s chief of multimedia productions. “The previous high for receipts were the 177,170 received on 12/21/2012.”
Previous spikes for background checks, conducted before a gun buyer can obtain a firearm, occurred after prominent mass shootings, like in December 2012 in the wake of the Sandy Hook Elementary School shooting.
Other Black Friday shopping days in 2014, 2013 and 2012 occupied the FBI’s “top 10” list of the most background checks processed in a 24-hour period.
Since 1998, FBI data shows that the bureau has processed requests for more than 220 million firearm purchases.
I still think they need to regulate bullets. Like they do cough syrup…and Sudafed.
If there is a system in place to give over your license and sign in for OTC medicines like Sudafed, then by all means, make people accountable for the bullets they are buying. Fucking hell!
Did y’all see the latest shitfest from the GOP? This time a candidate from Iowa: Iowa State Sen. Mark Chelgren Suggests Death Penalty for Some Immigrant Felons – NBC News The dude wants to illegally kill immigrants that come back into the states:
An Iowa state senator running for U.S. Congress is getting blasted by both his Republican Party and Democrats after saying that immigrant felons who try to re-enter America illegally should be executed.
State Sen. Mark Chelgren’s controversial comments were published Monday by the Journal Express of Knoxville and Marion County, which presented his views on border security and immigration. The newspaper said the two-term state legislator believes in a fence to help protect the nation’s borders, and that if an undocumented person who committed a felony is deported and then tries to return to the U.S., he or she should be subject to capital punishment.
Damn, and it somewhat non-related news:
Adolf Hitler’s Mein Kampf, with critical notes by scholars, is to be published in Germany next month – for the first time since the end of WW2.
The Institute of Contemporary History (IfZ) in Munich says it will print up to 4,000 copies with some 3,500 notes.
IfZ director Andreas Wirsching says the text with expert comments will “shatter the myth” surrounding the manifesto.
But the move has been criticised by Jewish groups, who argue that Nazi works should never be republished.
I am concerned and don’t know how to feel about this. I think they should not publish it, but then free speech and all…I don’t know. With all this refugee stuff going on, and the anti-immigrant/migrant stance in Europe and here too…it could be dangerous.
Speaking of which: Few Syrians would choose to leave homeland for North America: poll | Reuters
Senate GOP plans to beef up ObamaCare repeal package | TheHill – Jeezus, will they ever stop!!!
Just a few more links and we are through…
The next series of links are from the Independent. I thought it would be interesting to see what is up across the pond, and this is the news on one of Britain’s front pages:
- Tory defence chair Julian Lewis speaks against strikes, saying ‘instead of dodgy dossiers, we now have bogus battalions’
Dammit…that is some hot shit going on there.
Note the last link in the series. Yeah. Right.
But across the globe, a new government is preparing to take power: In step towards power, Myanmar’s Suu Kyi meets president, top general | Reuters
And in regards to the question I submitted to you all up top, as to why BLM activist protest at Hillary events…. Will Hillary Clinton Do More For Black America Than Did Obama? Is That A Low Enough Bar? | Black Agenda Report
We are in the final dash now folks:
No need to say it again, Ted Cruz is a fucking asshole, and idiot…but he can’t be this much of an idiot, I think he is just a prick who doesn’t give a damn.
Another day, another boneheaded not terribly nuanced comment from a politician about women’s reproductive health, this one courtesy of Republican presidential candidate Ted Cruz. He believes Democrats are lying about GOP efforts to limit women’s access to birth control.
“Last I checked, we don’t have a rubber shortage in America,” Cruz said in a campaign stop in Iowa. “Look, when I was in college, we had a machine in the bathroom, you put 50 cents in and voila. So yes, anyone who wants contraceptives can access them, but it’s an utterly made-up nonsense issue.”
Sadly for Cruz — and more pressingly, for women throughout the United States — that assessment is nothing short of absurd. The Supreme Court has ruled that some owners of private companies can deny birth control coverage because of religious beliefs. House Republicans have targeted family planning providers who provide health services to women, including pregnancy prevention. And Republicans have threatened to defund Planned Parenthood, which provides millions of women with contraception.
Because it unfortunately still needs to be said, for the 190,567th time, birth control is anessential part of women’s health care, and it is critical that women have access to a range of options. Sorry, Cruz, but the condoms you seem to think are readily available for 50 cents in every bathroom just won’t cut it. Here are just six reasons why:
We all know the reasons, so I won’t go there.
Last link, hurrah!
That article is something you will have to just go to the link and read yourself!!!!!!!
What is on your mind today…
I’ve got all kinds of personal reasons to hope that when the Supreme Court decides King v. Burwell next month that one just one Republican-appointed justice will consider the complaint trivial and it will be dismissed. That’s because I will be among the millions of people that will lose their health care. Jonathan Chait-writing for New York Magazine--wonders if that’s really what Republicans want in the year running up to a Presidential election.
Next month, the Supreme Court will rule on King v. Burwell. If all five Republican appointees support the plaintiffs (there’s no chance any of the Democrat-appointed justices will take the lawsuit seriously), some 7 million Americans will quickly lose their insurance. The prospect that this will occur has induced a wave of panic — not among the customers at risk of losing their insurance, who seem largely unaware, nor even among Obamacare’s Democratic supporters, but among Republicans. The chaos their lawsuit would unleash might blow back in a way few Republicans had considered until recently, and now, on the eve of a possible triumph, they find themselves scrambling to contain the damage. It is dawning on the Grand Old Party that snatching health insurance away from millions of helpless victims is not quite as rewarding as expected.
Unlike the Obamacare lawsuit that failed three years ago, the latest case is not based on a radical legal theory. Instead it is based on a novel reading of legislative history. The law allows states to set up their own exchanges to sell insurance to those who don’t have it through employer coverage, Medicare, or Medicaid. If states don’t establish an exchange, the federal government sets one up for them and, as it does with the state exchanges, offers customers tax credits. The trouble is that the law authorizing tax credits defines the exchange as “established by the state.” This ambiguity — does “by the state” not also mean the federal government? — was a technical omission. Many other parts of the law indicate its intent to make tax credits available to customers on the federal and the state exchanges alike.
The plaintiffs are led by a Vietnam veteran in Virginia named David King who makes $39,000 a year and objects to having to purchase insurance on a federal exchange. He would be exempt from this requirement were he not eligible for the tax credit — his $275 monthly payment would rise to a disqualifyingly unaffordable $648 — and this exemption, his lawyers argue, was exactly Congress’s intent. Without tax credits, the insurance would be unaffordable to most customers, triggering an actuarial death spiral that would destroy the individual insurance market in any state that attempted it. The plaintiffs insist Congress created the threat of self-destructing federal exchanges to coerce states into creating their own. (Disregard the copious evidence that the law’s drafters, and officials at the state level in both parties, believed federal exchanges would include tax credits.)
The lawsuit works more on the level of an elaborate prank than as a serious reading of the law. And yet it stands at least some chance of success — it only needs to persuade Republican-appointed judges. That prospect has grown suddenly unnerving because, unlike previous Republican efforts to strangle the law, the current one comes as Obamacare is functioning extremely well. Premiums on the exchanges have come in well under projected costs, customers report higher satisfaction with their coverage than those who have employer-sponsored insurance, and overall medical costs have grown far below the projected rate. It is one thing to take away a scheduled future subsidy, of which most intended beneficiaries are unaware. It is quite another to take away a benefit they’re already using.
Can you imagine the optics of people being taken off chemotherapy, dialysis, or insulin shots? So, Republicans are gearing up a way to blame it on Obama or trying to find a way to get the extreme right to compromise and provide a short term extensions of the credits should SCOTUS agree with the plaintiffs.
Senator Ben Sasse of Nebraska has likewise warned that a successful lawsuit would create problems. “Chemotherapy turned off for perhaps 12,000 people, dialysis going dark for 10,000. The horror stories will be real,” he wrote in a Wall Street Journal op-ed. For decades, medical deprivation of this sort used to be a uniquely American fact of life, at least among industrialized countries. Obamacare has turned it into something different: an actual political problem for opponents of universal health insurance.
Neither Johnson nor Sasse has a real plan designed to stop those horrors from taking place. Instead, their aim is to give Republicans a way to divert the blame onto Obama. The party is circulating contingency plans to temporarily restore the tax credits in exchange for crippling the law in other ways. Phil Gramm, the former Republican senator turned conservative-think-tank “visiting scholar” and financial-industry lobbyist, has proposed that Republicans pass a bill to temporarily extend the credits in return for eliminating the law’s regulations prohibiting insurance companies from rejecting old or sick customers. Competing proposals by Johnson and Sasse would likewise weaken Obamacare’s insurance regulations, ultimately destroying the law’s functionality. Gramm evenacknowledges that his plan “would put Obamacare on the path to extinction.” Obviously, Obama is not going to sign a bill that puts Obamacare on the path to extinction. The purpose is simply to give Republicans a talking point — they can say they passed a bill and blame Obama for vetoing it. But odds are that Republicans will fail to unify around a bill that can pass both houses of Congress with only Republican votes, because some will deem even a bill that causes Obamacare’s eventual demise unacceptably conciliatory.
At that point, it will fall to the states to either establish their own exchanges or watch their individual-insurance markets collapse. Neither option is terribly attractive for Republicans. The former means surrender. Doing nothing means sowing chaos, deprivation, and death. Will Republicans let this happen?
Legal Analyst and Lawyer Jeffrey Toobin has a lengthy article in The New Yorker examining the issues.
So that’s the theory: millions will suddenly be uninsured, and will blame Republicans. As Harry Reid, the Democratic leader in the Senate, put it recently, “I don’t think they will [win the case]. If they do, that’s a problem that the Republicans have.”
No, it’s not. If the Obama Administration loses in the Supreme Court, the political pain will fall almost exclusively on the President and his Party. To paraphrase Colin Powell and the Pottery Barn rule, President Obama will have broken health care, so he owns it. To the vast mass of Americans who follow politics casually or not at all, Obamacare and the American system of health care have become virtually synonymous. This may not be exactly right or fair, but it’s a reasonable perception on the part of most people. The scope of the Affordable Care Act is so vast, and its effects so pervasive, that there is scarcely a corner of health care, especially with regard to insurance, that is unaffected by it. So if millions lose insurance, they will hold it against Obamacare, and against Obama. Blaming the President in these circumstances may be unfair, but it’s the way American politics works.
Republicans, of course, will encourage this sentiment. The precise legal claim in King v. Burwell is an esoteric one. It is not based on a claim that Obamacare is unconstitutional. (The Supreme Court upheld the constitutionality of the law three years ago.) Rather, the central assertion by the plaintiffs is that the Obama Administration violated the law itself. In any event, the subtlety of the issue at the heart of the case will surely be lost in its aftermath. The headlines will read, correctly, “Court rules against Obamacare,” and this will be all that matters. The Republicans will argue that the Supreme Court showed that the law was flawed from the start, that the Obama Administration is lawless, that a full repeal of the law is the only appropriate response to the Court’s decision—and that the millions who lose their subsides should blame the sponsor of the law. Watch for references to a “failed Presidency.” There’ll be plenty of them.
Understandably, perhaps, the Administration has courted this kind of reaction. Better than anyone, Administration officials know the scale of the problems that would be created by a loss in the Supreme Court. Advertising this possibility makes sense as a litigation strategy; Obama officials don’t want to make it easy for the Supreme Court to rule against them. In testimony before Congress and elsewhere, Sylvia Burwell, the Secretary of Health and Human Services (and the defendant in the case), said that the Administration has no contingency plan for an adverse ruling in the Supreme Court. But playing chicken with the Justices only works if it works. If the Supreme Court strikes down the subsidies, the Administration will also have to answer for why it didn’t prepare for this possibility.
A few weeks ago, the Heritage Foundation’s Edmund Haislmaier published an “Issue Brief” entitled “King v. Burwell: A Loss of Subsidy Does Not Mean a Loss of Coverage.” That’s a provocative title, considering 87 percent of the 8.8 million enrollees from federal exchanges receive those tax credit subsidies, meaning they have low or moderate incomes.
Haislmaier recently was seen saying it’s “premature” to conclude the huge drop in the uninsured rate since Obamacare passed is the result of Obamacare passing. In this brief, he correctly points out the Affordable Care Act and previous federal and state laws would enable current Obamacare enrollees to switch to some other form of health insurance if the lawsuit he supports succeeds in making their current plans unaffordable. (The brief also chides low-income people for using their subsidies to buy “king-crab-legs-and-steak” insurance rather than take the cheapest possible “powdered-milk-and-frozen-peas” plans.)
“In sum, should the Supreme Court’s eventual ruling in King v. Burwell result in people losing insurance subsidies, the affected individuals will have options for maintaining their coverage or choosing replacement coverage,” Haislmaier wrote. There’s even a chart.
Is that good news for people at risk of losing their health insurance subsidies? Maybe not. “Of course, some might still not be able to afford the unsubsidized premium even if they switched to a less expensive plan,” Haislmaier adds as a disclaimer. Of course.
That seems like it could be a problem, since 83 percent of Obamacare enrollees on the federal exchanges have annual incomes of 250 percent of the federal poverty level or less, which works out to no more than $23,450 for a single person, according to Avalere Health, a consulting firm. In other words, these aren’t Americans with a lot of extra money. And the average value of the tax credits they stand to lose is $263 a month, a substantial amount for people at this income level.
There’s a lot of variation in the price of health insurance, but a look at national average premiums and cost-sharing requirements illustrates what the “Let them eat Bronze plans” line of thinking ignores.
A 40-year-old at the poverty line, which is $11,770 for a single person, would pay $20 a month for a mid-tier Silver plan with tax credits. That amounts to about 2 percent of her annual income. Take away the subsidies, and her premiums jump almost 14-fold to $276 — or about 28 percent of her income.
What about dropping down to a lesser Bronze policy with higher out-of-pocket costs like deductibles?
That would cost almost 11 times as much as the subsidized Silver plan, at $213 a month, or about 22 percent of her income. Another person making twice as much money as her would see his premiums for the same Silver policy rise by 80 percent, which would eat up 14 percent of his income. His premiums would rise by 39 percent if he switched to a Bronze plan, which would cost him 11 percent of his yearly earnings.
Even opting for a slimmer policy might not make sense for lower-income people, considering how much more Bronze policyholders have to spend before their coverage kicks in. For example, the average deductible for an individual Bronze plan is $5,181, compared to $2,927 for a Silver plan, according to Health Pocket.
And this doesn’t even factor in the effects of a second type of subsidy only available to people earning up to 250 percent of poverty, which reduces their out-of-pocket health care expenses, and which also would go away in the high court rules for the plaintiffs.
But what may eventually prove to be the key line of questioning may have been kicked off by Justice Sonia Sotomayor, who expressed concern about the consequences of a ruling for the challengers. If a state’s residents don’t receive subsidies, she told Carvin, it will lead to a “death spiral”: because a large group of people in those states will no longer be required to buy health insurance, but insurers will still be required to offer insurance to everyone, only sick people will buy health insurance. And that will cause everyone’s insurance costs to rise, leading more people to drop out of the insurance market. States will then feel like they have no choice other than to establish their own exchanges to ward off the “death spiral” – a scenario that is so coercive that it violates the Constitution.
Perhaps critically for the government, Justice Anthony Kennedy – who is often regarded as a strong supporter of states’ rights – also expressed concern about the possibly coercive effect of a ruling for Carvin’s clients. There is, he told Carvin, “something very powerful to the point” that if the challengers prevail, the states have to choose between the death spiral and creating an exchange. “There’s a serious constitutional problem,” he concluded. (Carvin tried to downplay this concern by telling Kennedy that the government had not raised this issue, but Kennedy quickly retorted that “we sometimes think of things the government doesn’t argue.”)
Like Carvin, Solicitor General Don Verrilli – the government’s top lawyer at the Supreme Court – also faced questions about the challengers’ right to sue. But between his acknowledgement that, as Carvin had asserted, a veteran who had only served a short time would not be eligible for free health care and the lack of certainty about the plaintiffs’ 2014 annual incomes (which would determine whether they would be required to buy health insurance at all), the issue didn’t seem to have much traction with the Justices.
On the merits of the challenge to the subsidies, Verrilli faced repeated questions from Justices Scalia and Alito, who were both obviously skeptical of the government’s arguments. Scalia pushed back against Verrilli’s argument that the challengers’ reading simply doesn’t work, while – by contrast – the government’s interpretation accounts for the ACA’s structure and design. The question, Scalia admonished Verrilli, is not what Congress intended; the question is what it actually wrote in the statute. But in any event, Scalia queried a few minutes later, if the Court were to rule for the challengers, did Verrilli and the government actually expect Congress to “really just sit there while disaster ensues?” (Based on Verrilli’s response – a dubious “This Congress?” – the answer appeared to be yes.)
Justices Alito and Scalia also contested Verrilli’s assertion that, had Congress actually intended to force states to choose between setting up their own exchanges and depriving their residents of subsidies, it would have done so more clearly. Scalia asked rhetorically why, because the ACA is “not the most elegantly drafted statute,” would it “be so surprising” if Congress didn’t make the states’ obligations obvious? Alito added that, if Congress didn’t want to limit the subsidies to the residents of states that had set up their own exchanges, it could have used more precise language to do so – as it did, for example, in making clear that the District of Columbia (which is not a state) nonetheless qualifies as a “state” for purposes of the ACA.
So, we’re down to brass tacks again. Will the ACA go down on a technicality which, essentially, is what the law is all about?
What’s on your reading and blogging list today?
I could not bear to write a post today. So just take this one for what it is, my overzealous attempt to find a few Medieval images for the thread that reminded me of the GOP idiots who are running or announcing that they are running for Prez…in 2016. I was looking and next thing I know it is four am…go figure.
So, I decided to post the illuminations, manuscripts, marginalia, bestiary, cheeky monkeys and the like with my own various commentary. Most of which will call back to the clowns that Boston Boomer and Dakinikat have been talking about lately. The images below are found here:
and here: Pinterest: Getting Medieval On Your Ass
So the captions within the slide show are just my observations. Click on the links above for the information on the links.
Just a few that are beyond the scope of the political references that are the theme of the post today.
This reminds me of the Seinfeld episode with the marbled rye…“Seinfeld” The Rye (TV Episode 1996) – IMDb it airs tomorrow by the way on TBS.
The next image is also from a Seinfeld episode.
Little Jerry was born to cock fight! “Seinfeld” The Little Jerry (TV Episode 1997) – IMDb
Okay, now for the slide show…click on the first picture below, it should open up to the larger gallery slide show….if you cannot read the full caption under the image, use the down arrow on your keyboard, it should work to move the text so you can read the entire entry.
This is an open thread.
Just can’t seem to bring myself round to reading any news lately. I have spent most of my time immersed in episodes of Foyle’s War. What an incredible series, if anyone has Netflix….
Anyway, so for today’s news reads, it will be a lazy link dump. The latest on the Amtrak accident will be at the bottom of the post.
Just to highlight something before we get to the hard core stuff:
Remember that black man found dead, who supposedly “hung” himself from a swingset in South Carolina?
A black man who’d recently been questioned in connection with the death of a white woman was found dead hanging from a tree Monday morning in rural Greensboro, Georgia, police said. Local and state investigators said there was nothing to immediately suggest foul play.
Greensboro Police Chief Ossie Mapp told NBC News that a neighbor called 911 about 9 a.m. ET to report finding a body behind a house on Martin Luther King Jr. Drive. Police discovered the body of Roosevelt Champion III, 43, who Champion didn’t live at the address in Greensboro, in east-central Georgia between Athens and Augusta, Mapp said.
Champion’s body was suspended by tie-down strap similar to those used to secure cargo on the roofs of vehicles, Mapp said.
There were no visible wounds on Champion’s body, his feet were scraping the ground and his knees were slightly buckled, suggesting that he hadn’t been lifted into the tree, said Georgia Bureau of Investigation Special Agent Joe Wooten, who is in charge of the investigation. Wooten and Mapp said it’s too early to determine the formal cause of death, which is pending an autopsy.
But Wooten said Champion was questioned at least twice last week in a homicide case involving the death of a white woman. In the end, no charges were filed, he said. Details of that investigation weren’t immediately available.
“I understand that there is a lot of concern” in the community because the victim was a black man who was hanged in the Deep South, Wooten said. “Because of that, we’re going to be as transparent as we can be.”
Champion’s family does not believe it was suicide: Death of G.A. Man Found Hanging Ruled a Suicide — NYMag
Many suspected foul play when a black man recently questioned in the murder of a white woman was found hanging from a tree in Georgia on Monday, but his death has been ruled a suicide. The Georgia Bureau of Investigation said an autopsy found no evidence of trauma to the body of Roosevelt Champion III, and his hands and feet were not bound. However, his family refused to accept that explanation. “I’m angry, I’m angry because I don’t have answers,” Miranda Wright, one of Champion’s sisters, told NBC News. “He’d do a lot of things but he wouldn’t have harmed himself, I doubt it.”
Nine sheriff’s deputies in Georgia were fired on Friday over the New Year’s Day death of a black inmate who had been placed in restraints, officials said.
The dismissals come amid a series of killings by police in cities including of Baltimore, New York, and Ferguson, Missouri over the past year that have raised questions about officers’ use of lethal force, especially against black men and other minority groups.
The Chatham County Sheriff’s Office said its decision was based on an internal review and a separate probe by the Georgia Bureau of Investigation into the Jan. 1 death of 22-year-old Matthew Ajibade.
Officials said he injured three deputies while being booked into jail on charges of domestic violence, battery and resisting arrest. Ajibade, a college student, was then placed in an isolation cell and later found unresponsive, officials said.
The local Savannah Morning News reported that area clergy members said in a letter to the sheriff’s office this week that Ajibade suffered from bipolar disorder. They also said he was handcuffed to a restraining chair when officials used a taser on him, according to the News.
The Sheriff’s office said it had turned over its findings to the county prosecutor to weigh possible criminal charges. The office said it would not make its report available unless a local court rules the findings are subject to release or the prosecutor finishes investigating.
The office did note in Friday’s statement however that among the changes instituted following Ajibade’s death and the subsequent investigations was a “clear written policy of when tasers may not be used.”
And while you are thinking about all this goings on in Georgia….‘The Nightly Show’ skewers Georgia educators | www.ajc.com
Monday night’s episode of “The Nightly Show with Larry Wilmore” focused on three stories of racism and bigotry that have been trending in the news. Two of those stories involved Georgia educators.
“The Nightly Show with Larry Wilmore” has been making waves since its premiere in January. The new show, a spinoff of “The Daily Show,” focuses less on the media’s coverage of political news (that’s Jon Stewart’s job) and more on trending news topics.
Last night’s show began with host Larry Wilmore discussing the remarks made by Principal Nancy Gordeuk at the graduation ceremony of Stone Mountain’s TNT Academy. The video — of Gordeuk calling the crowd “goobers,” “cowards” and (after accidentally dismissing the crowd before the Valedictorian’s speech) yelling,“Look who’s leaving? All the black people.” — was played.
Wilmore then played the video clip of Gordeuk claiming the devil was responsible for her comments.
The show then switched focus to Nancy Perry, the Dublin, Georgia, teacher that was removed from the classroom after telling students President Barack Obama was not Christian, if their parents voted for Obama they were not Christian, and the President is an “evil Muslim.”
Here are the best quotes from Wilmore’s monologue:
“The devil? First of all, everyone knows the devil hasn’t been back in Georgia since he lost that fiddling competition.”
“A Georgia teacher tells her students Obama is an evil Muslim. In a related story, she’s now the front-runner for the Republican primary!”
“Hey Georgia educators, can I talk to you for a sec? If people wanted their kids to learn coded racism, false truths about the president and be talked down to, they would homeschool them. And leave them watching Fox News all day.”
“They (parents) have their kids in a Georgia public school to learn actual facts. You know, like the Civil War should actually be called the ‘War of Northern Aggression.’ So teach them what’s right and leave your half-baked, unsubstantiated opinions where they belong: Thanksgiving dinner.”
The best quotes from the roundtable:
“It’s weird, it’s almost like black people can’t do anything right now. Everything we do is stereotypical. We like chicken, that’s bad. We like watermelon, ‘Ehh, they like that watermelon’. They leave when you dismiss them? ‘Look at these Negros, just doing what we tell them to do.’” – Mike Yard
“If you look, it was the black people leaving … But here’s the thing: If you were a student or parent and had to be subjected to this crazy racist principal all year and finally you graduate? You would get the hell out of there too!” – Will Packard
“People always blame the devil too. I thinks it’s okay, like if you murder your kids, blame the devil, but not for casual, everyday racism.” – Rachel Feinstein
Put this is perspective…or context with the rest of the shit going on in the US of late.
Which brings me to this: Shakesville: And Again
In March, 19-year-old Tony Robinson, a black man, was killed by Madison, Wisconsin, Police Officer Matthew Kenny following an altercation, according to police. Today, the prosecutor announced that Kenny will not face charges.
“I conclude that this tragic and unfortunate death was the result of a lawful use of deadly police force and that no charges should be brought against Officer Kenny in the death of Tony Robinson Jr.,” Ismael Ozanne, the Dane County district attorney, announced Tuesday afternoon at a news conference.
…Robinson’s death on March 6 prompted days of sustained, peaceful demonstrations in Wisconsin’s second-largest city. Police say they were responding to multiple calls about a disturbance involving Robinson, including calls that said he had assaulted other people and ran into traffic.
In a brief statement after the shooting, police said that when they found Robinson, “a struggle ensued” and he was shot and killed. Kenny was placed on paid administrative leave, and the police chief apologized for the shooting and asked for patience during the investigation.
…Ozanne, who was appointed in 2010, is a lifelong Madison resident and the first black district attorney in Wisconsin history, according to his office. He said that he viewed his responsibilities through this lens as “a man who understands the pain of unjustified profiling” and described discussions he has had recently with community members who are distrustful of the criminal justice system.
“My decision will not bring Tony Robinson Jr. back,” Ozanne said Tuesday. “My decision will not end the racial disparities that exist in the justice system, in our justice system.”
Robinson, of course, being dead, was unavailable to tell his version of events. But, according to Kenny, he chased Robinson into a building, where Robinson hit him in the head and so he “opened fire after he feared that he would be hit again and his gun taken and used to shoot him or others. Kenny fired seven shots in three seconds, and all of the shots hit Robinson on the front of his body.”
Toxicology shows Robinson was high, but what the fuck? Shoot him over repeatedly killing him? Dead? I don’t get it.
The rest in of it in dump format:
And the latest on the Amtrak Derailment:
This is an open thread…