brainiac conspiracy

Also Too, Prolific Wastes of TIme

Sure glad we expended so much political capital a couple years back to pass a landmark piece of legislation that ensures universal access to affordable health care. Sure, we midwifed the Teabillies, alienated the netroots and lost the House of Representatives in the process, but hey, this was a big fuckin' deal! Eggs and omelettes, bitches.

---Vitelius

Light Blogging Morning

Off to the weekly farmer's market to grope some fruits and vegetables. Try not to enslave anyone with a broccoli mandate until I get back.

---Vitelius

Barney's Right

The PPACA was a disaster of politics and of policy, though Josh differs:

Stepping aside from the politics of the matter and the atmospherics of this story, to me it seems delusional to assume that the Democrats could have pulled back from the effort and come back later and gotten bits and pieces of reform. How much do you figure will get through Congress if the whole thing is struck down by the Supreme Court? You can’t choke at the gut check moments.

Seems here as though the real gut-check moment occurred several months earlier, at summer's end in 2009 when our still-new President still had favorable approval ratings; a health-care bill with a public-option provision that was ready in the House of Representatives; and broad public support for the bill's most contentious element. Instead of seizing the moment to re-frame the narrative after the inaugural Teabilly Summer of Love, the White House committed an unforced error---one of many during its first two years, and nearly all of them following a similar pattern---and unilaterally pulled the rug out from under itself in the name of Getting a Big Deal Done™. To me, that was the "choke" moment that stalled the initiative's momentum because it accomplished little other than alienating Congressional Democrats, angering the netroot activists, and ensuring that getting any health-care bill through Congress would be a horrendously protracted and tortuous process; and that the final product would be a needlessly complex and confusing laundry list of concessions to the balance sheets of the insurance, drug and HMO lobbies, as well as to the personal vanities of a couple dozen Senators.

Kinda like making sausage out of ammoniated meat scraps, come to think of it.

Bad policy. Bad politics. One often follows the other.

Put another way: Considering the beating Team Democrat took at the polls in 2010 after getting the ACA passed, would they really have fared that much worse if they'd just tabled the bill until after the midterm elections? Shit, they lost 63 House seats as it was, so I'm having a hard time believing the alternative would have been appreciably worse.

As to getting "bits and pieces" of reform after the midterms: Agreed, there was little chance of that happening. But this only confirms the wisdom, indirectly to me, of pushing the most ambitious, far-reaching piece of legislation out of the gate. That is, if you're pushing one of the most ambitious and far-reaching legislative agendas of the last 100 years. And I think we can agree that the White House's push on health care was certainly among those---and yes, if results are all that count in politics, they got their Big Fuckin' Deal. Unfortunately for them, public consensus has long held steady that it was also a Bad Fuckin' Deal. Granted, the public may be ill-informed about many of the ACA's provisions, but notwithstanding the Teabilly 27, whose fault is that, really? Team Democrats' messaging on this bill has always been lousy---which could be symptomatic of the fact that it's, like, a generally lousy law.

---Vitelius

Just Like Wrestling II

Still not understanding what the suspense is all about:/p>

If five justices want to strike down the individual mandate, they can. But to do so honestly, they would have to admit that they were rejecting precedent and drawing new lines around federal power.

That would assume they are honest men. They're not, and they won't admit anything. They'll simply say the health-care mandate and the rest of the PPACA are unconstitutional because Madison and Hamilton didn't write about them in the Federalist Papers. That's what they've been groomed for, and that's what they're going to deliver. As always, would loved to be proved wrong here, but I have a feeling I won't be.

---Vitelius

Also Too, Making Up Fees as They Go Along

It's been written about elsewhere, but shopping for health care is really not anything like shopping for a car or a computer:

To see what consumers were up against, The Times contacted 10 California hospitals and asked for the cost of a routine gallbladder surgery for someone with a high-deductible insurance policy.

Seven of the hospitals offered at least partial estimates, but the quoted prices ranged widely from $1,200 an hour for the operating room to a $8,687 facility fee. None included the cost of the doctors, although California Pacific Medical Center in San Francisco did say that the total cost for hospital services, including a room, drugs and other supplies, could be $37,217.

One hospital, Desert Regional Medical Center, didn't return calls. Contacted later, spokesman Richard Ramhoff apologized and said Desert Regional "strives to make sure everyone with a question about rates gets an answer." Another hospital said it would take 10 business days to get an estimate, and another required detailed insurance information before discussing prices.

"This really highlights how impossible it is for consumers right now with high-deductible plans to effectively shop for care," said Ateev Mehrotra, a policy analyst for Santa Monica-based Rand Corp. and an assistant professor at the University of Pittsburgh School of Medicine.

Mehrotra's Rand study in 2009 produced similar results in California. Only 28% of the state's hospitals responded to a request for an estimate from a fictional uninsured patient and less than 3% offered detailed price quotes including hospital and physician fees.

Let's see here. Medicare For All would be universal, would cost less, and would eliminate the guesswork. So why didn't our leaders even bother discussing it?

And to those who think that the Supreme Court invalidating the Affordable Care Act will "pave the way" for single-payer, what the hell are you smoking? We can't even get a decent transportation bill out of Congress these days, let alone a Favorite Toy like universal health care. Too bad nobody at the White House was lobbying for this when they had the votes to get it done. Who knows, they might even have succeeded.

---Vitelius

Story of My Life

Too young to die, too old to start over:

It's not just about the illness. It's also the fear that your entire life will be in shambles and you'll have to start all over again if you are lucky enough to recover. The years between 50 and 65 are quite terrifying in that respect. Not much time left to rebuild.

Tell me about it. I've had a lot of the same concerns since I got laid off my job last September---and wouldn't you know it coincided with several thousand dollars' worth of dental work I needed to have done, some of which I've postponed indefinitely until I'm working again. And even though I'm in (generally) good health at 55, the financial stress that our medical-industrial complex exerts on people with limited incomes (i.e., unemployment insurance) is borderline immoral; in my case, outside of rent (which is fairly modest for the neighborhood), my biggest single monthly expense is the fucking COBRA payment. Granted, it's better than nothing, and I'm darn glad to have it, but boy, if I was still on the hook for a mortgage payment, or was in the process of putting a couple of kids through USC or Juilliard, I don't know how the hell I would handle it. I guess, like a few million other people, I'd simply go uninsured.

---Vitelius

Market-Based Solutions

They're the cure for what ails us:

Many of the drugs in short supply, particularly older generic ones, are “sterile injectable” medications that are more complicated to produce and more prone to manufacturing problems.

Sometimes these older drugs are discontinued in favor of newer, more profitable drugs, officials said.

That leaves only a handful of sources for the drugs. More than 50 percent of the drugs on the FDA’s shortage list are supplied by three or fewer manufacturers, industry and government officials said. If one facility has production problems, cannot obtain ingredients or fails an inspection, other companies cannot ramp up production quickly.

Quality problems, including fungal contamination and findings of glass shards and metal filings in drugs, were the leading cause of drug shortages, according to an FDA report in October.

The shutdown of four factories by an Ohio lab because of serious quality problems contributed to the cancer-drug shortages. Although those have eased somewhat because of new suppliers, the idled factories are a big reason for the scarcity of other drugs, said Valerie Jensen, associate director of the FDA’s drug-shortage program.

Also too, price fixing.

But at least we know we're free.

---Vitelius

Why Have Elections, Anyway

When you let the losers dictate policy?

In the midst of the bitter 2009 battle to pass a law to provide health care to tens of millions of uninsured Americans, the United States Preventive Services Task Force announced in November that most women should not get routine mammograms until age 50 because the risks of the X-ray screens and surgical biopsies that often follow outweighed the benefits in younger women.

Although the task force did not consider cost in its analysis, Republicans charged that its recommendation was the start of health care rationing, an accusation given prominent play on Fox News.

“That scared the bejesus out of everybody,” a top F.D.A. official said.

The Obama administration became extremely risk averse, fearing further controversies might jeopardize the passage of health care reform, agency and administration officials said. It refused many interview requests for agency officials and scientists until the health law passed.

“To the career people, that was disappointing,” a top F.D.A. official said. “Employees here waited eight long years for deliverance that didn’t come.”

A provision of the new law required chain restaurants and “similar retail food establishments” to post calorie counts on menus, a provision championed by consumer advocates and the restaurant industry, which favored standardized rules over a hodgepodge of state and local ones.

The F.D.A.’s first draft of the guidelines---approved by the Department of Health and Human Services and the White House---stated that movie theaters, lunch wagons, trains and airlines would be included. A report about the proposal in The Wall Street Journal on Aug. 31, 2010, nevertheless caught the White House by surprise.

“This was the era of Glenn Beck, and the White House was terrified that Beck would get up and say this is all part of the nanny state,” a senior F.D.A. official said.

In politics, I think that's called pissing away your mandate. And boy, did this administration find every possible way to do it during their first two years in office.

I really, truly hope that the President's newfound progressive-populist voter pitch is sincere, that he's finally seen the folly of trying to placate these people and is willing to govern going forward without their participation, and that he's not simply mouthing a cynical appeal to his liberal base to stay the course until election day. I'll vote for him, obviously, since there's no palatable alternative out there, but on the larger question of motive, I think the jury is still out.

---Vitelius

Term Limits

In general, I think they're another failed conservative policy proposal that's left us with weaker, less-effective and actually less-accountable government (exactly as intended), though I can see their appeal as they pertain to unelected officials such as Supreme Court justices. A better idea, seems to me, would simply be a mandatory retirement age. Considering that most justices these days get confirmed to the court around age 50, I'd propose a retirement age of 70---early enough to minimize the prospect of judges issuing opinions in the throes of senile dementia, but a sufficiently long period to provide the justice with enough time to learn the ropes, and to ensure his/her legacy on the bench. I don't think for a minute this will ever happen---it would take a Constitutional amendment, wouldn't it?---but it's certainly worth discussing, and a preferable option to term limits, which have a proven track record of failure.

---Vitelius

Kinda Like Talking to The Cat

This really get to the heart of what's ailing our politics:

According to a 2009 poll by Public Policy Polling, “52% majority of GOP voters nationally think that ACORN stole the Presidential election for Barack Obama last year, with only 27% granting that he won it legitimately.” Conservative commenters are pointing to the indictment as further proof of rampant voter fraud and more evidence of the need for voter ID laws nationwide.

This also explains why it was a completely inexcusable and pointless waste of time for the President to attempt any good-faith negotiations with the opposition party at any time, for any reason, for as long as he was in office. Because a majority of people in the opposition party no longer believes in the legitimacy of our two-party political system. This is kind of, you know, like a big fucking deal.

This should come as no shock to anyone who's been paying attention to the devolution of Republican Party politics in the Limbaugh Era, or to anyone who figured out what was underpinning all of the myriad Clinton pseudo-scandals the Mighty Wurlitzer farted up throughout the 1990s. It's a natural byproduct of an authoritarian mindset, and it has been many decades in the making. I guess for the long term, the question I have is: How much further to the right do the Democrats continue to shift to placate a gang of crazies who view them as traitors before they marginalize themselves into irrelevance? Or will a future Democratic regime (in the House, Senate or elsewhere) halt the slide and finally jerk the party---and our discourse---sharply back to the left where it belongs? I would have expected this to have happened already, starting in 2009, and I don't think this was an unreasonable expectation, then or now, contrary to what some of the President's backers claim. Frankly, I'll go to my grave believing that Americans didn't elect a liberal black man named Hussein in a landslide so they could watch him dithering away half of his term of office negotiating over tax cuts that voters don't care about, and running interference for financial industries that consumers despise---and that's why there's a Tea Party militia in Washington now. Not because Hussein Obama was guilt of liberal overreach, contra the conventional wisdom, but because he ran away from liberalism at too many opportunities, and hence made himself irrelevant to voters who want their elected officials to stand for something they can identify with, whether or not they agree with him on all the particulars.

Where do we go from here? Given the centrality of High Broderism in official Washington, the only reasonable forecast anyone can make---if nothing substantively changes---is that we wake up 20 or 30 years from now to find we're living under a government that very much resembles, say, the government of Mexico, where they have a Constitution and elections, and term-limited Presidents, and competing political parties, and all the appearances of a democracy, but where the country is basically run by a single dominant political party and the 5,000 families who bankroll them and control virtually every facet of the private-sector economy. Sometimes I think we're more than halfway there already.

Yes, I know the coming change in America's racial and cultural demographics don't seem to favor the crackpots. But the demographics in Mexico never seemed to favor the PRI, either, but they've managed to maintain a near-monopolistic grip on power anyway. But one thing that those of us on the left side of the aisle can do is be willing to work for Democratic candidates---like this guy---who understand what we're up against, and withhold our support from Democrats who don't. We may or may not be able to prevent America from turning into Mexico-with-better-wireless-access, but if we can't, at least we can refuse to become accessories to our political marginalization.

Okay, it's 3:30 on the west coast . . . Is it too early to start drinking yet?

---Vitelius

Sorry, Not a Problem

Regardless what this post says, inflation really is not much of a problem in this country. Yes, fuel and (some) food prices are up, and while those increases may be greater than current declines in housing, our current 2.5 % inflation rate is modest by historical standards. (Back in the '70s, when I was entering the job market, that number would have been viewed as a godsend.) The real reason why inflation seems to be hitting people hard is because (1) the inflated sectors are ones that hit people's pocketbooks every day, and (2) people are making a lot less money and have a lot less worth than they did a few years ago. This really isn't tricky to figure out.

---Vitelius

Also Too, Unicorns

Sure, it's reassuring to think that the pending demise of the ACA will somehow pave the road for single-payer health care in the future. But as single-payer is an example of liberal social legislation, you need legislators who will actually, you know, propose liberal social legislation, then vote for it. We really haven't experienced this phenomenon at the national level since the 1970s, and there's a reason for it: Because we no longer have a liberal political party to propose and vote in favor of liberal laws. When we get one, things will change again, but thinking that this change will somehow occur organically on its own without institutional regime change within the Democratic Party strikes me as an exercise in self-delusion. Again, as always, would love to be proved wrong here, but the last 20 years of Third Way centrism suggests an opposite outcome.

---Vitelius

No Good Deed

Sure glad these people got a seat at the table when the Affordable Care Act was being written. You can never have enough good-faith negotiators in the room.

Can't say I'll be shedding too many tears when the Supreme Court throws out the law.

---Vitelius

Pretty Easy Math

Ayn Rand + Baby Jesus = Teabilly Frankenstein:

Gauchat further validates the argument of The Republican War on Science by showing that the decline in trust in science was not linear. It occurred in association with two key “cultural break” points that, I argue in the book, heightened right wing science politicization: The election of Ronald Reagan, and then the election of George W. Bush.

Which just happened to be the points in GOP history when the religious nuts were (a) first welcomed into the party policy machinery, then (b) handed the keys to the store and given free rein over the bureaucracy. Of course, the materialistic atheism of Ayn Rand---the plinth of old-school industrial-age free-market Republicanism---and the repressive moralism of ascendant Christian fundamentalism are philosophically incompatible with each other, and that's frankly why so much of what passes for conservative discourse these days sounds like incoherent babbling. Because basically, it is. But either way, this is another good reason why we really, desperately need to get this Religion Crap out of our politics. We can't really legislate it, but we can withhold our support from legislators who pimp and pander to it.

---Vitelius

Nothing Will Change

The "legitimacy" of the Court after they trash the Affordable Care Act. Three reasons:

1. Most people don't follow this stuff all that closely, so when the Court rules against ACA, the public at large will simply internalize the decision to harmonize with the conventional external narrative that their preferred media outlets have barraged them with, i.e., that "Obamacare" was an example of "executive overreach";

2. The religious crusaders on the Court don't give a shit about "legimitacy" because that's not something that can be bestowed by the rabble:

Every one of these men was a member of the Federalist Society. Every single one of them was groomed for exactly what they are doing right now. This is their time to shine, to do what they have been groomed to do. When you train soldiers to fight, and drill their mission into them every day, and drill the rightness and correctness of their mission into them every day, and assure them they are fighting for truth, justice, and the American way, only a fool would be surprised that they are eager to go into combat.

3. In the most painfully obvious way, the Court stopped being a "legitimate" arbiter of Constitutional disputes on December 12, 2000. What, this is news to anyone?

---Vitelius

Heartbreaking

Read this now. Because it makes you realize why all of these legalistic arguments we've been hearing over the Affordable Care Act are so hollow, and really, so offensive, whether for or against it. Because people are dying every day in America because we won't confront the simple reality that the demands of capitalism and the needs of sick people simply cannot be resolved to the mutual benefit of both parties. And because we have opted to favor the former at the expense of the latter. (Via DeLong.)

---Vitelius

Lesser Blog Morning

Out for more periodontal hijinks today. Hilarity ensues.

---Vitelius