Trumpie’s going to be very mad
by digby
Not only is President Obama the most admired man, by a long shot. Hillary Clinton is the most admired woman for the 21st time.
Look for a tweet calling Gallup a failing company that nobody listens to anymore in 5…4…3…2…
Happy Hollandaise everyone.
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And now for something completely frightening
by digby
Perhaps the most monstrous thing about the American medical system — and the bar for that title is high indeed — is predatory billing.
A great many medical providers adjust their prices based on how defenseless the patient is, and bleed the weakest ones for every last red cent, often with preposterously inflated charges for things like aspirin and bandages. A 2015 study looked at the worst price gougers in the country and found 50 hospitals that charged uninsured people roughly 10 times the actual cost of care.
Key to this practice is something called “balance billing,” and it’s why the American Medical Association is strongly supporting Donald Trump’s pick of Rep. Tom Price (R-Ga.) to lead the Department of Health and Human Services, which oversees Medicare. Balance billing is forbidden for Medicare enrollees, but Price wants to allow it — thus allowing doctors and hospitals to devour the nest eggs of thousands of American seniors.
So what is balance billing? It’s the practice of billing the patient for the difference between the sticker price and what insurance will pay. So if a hospital visit costs $1,000, but your insurance will only cover $300, some providers will “balance bill” you for $700.
For unscrupulous providers, the method of exploitation is obvious: When doing any sort of expensive procedure, take a rough estimate of the absolute maximum the patient can pay, and jack up the price so the balance hits it. Or if you’re short on time, just bill them into the stratosphere, and you’ll get whatever the patient has during the bankruptcy proceeding.
Balance billing is basically illegal for Medicare patients, and heavily restricted for Medicaid patients. It was restricted under the Affordable Care Act as well, but only partially. Out-of-network care — increasingly common as insurance networks get narrower and narrower — can still be balance billed even if it is for an emergency, both for ACA plans and employer-provided ones, and doesn’t have to be counted toward out-of-pocket limits. People being blindsided by immense out-of-network bills — going to an in-network hospital that employs an out-of-network surgeon they conveniently failed to tell you about, for example — is an increasingly common experience. That is why ObamaCare failed to stop people being bankrupted by medical debt (though it did slow medical bankruptcies substantially).
Permanently obliterating the financial security of helpless families with no or bad insurance as a loved one dies slowly and painfully of a chronic illness is a nice little profit center for providers. But it pales in comparison to the gravy train they might get if they can bring balance billing to Medicare. Seniors use far more care than the younger exchange population, and there are a lot more of them — 55.5 million, versus 12.7 million people on the exchanges. Perhaps most importantly, they’re quite a bit richer on average. Many seniors have been scrimping their whole lives to save for retirement, in keeping with decades of agitprop from conservatives and Wall Street, and the more sociopathic among the health-care population are licking their chops at the prospect of being able to devour those nest eggs.
That brings me back to Tom Price and the AMA. In 2011, Price (an orthopedic surgeon himself) introduced a Medicare “reform” bill in Congress that, among other things, would have brought balance billing to the program. This would greatly increase provider and physician revenues, and the AMA eagerly lined up behind it. Physician salaries are of course already none too shabby: An average salary for a primary care doctor in 2015 was $195,000; for specialists it was $284,000. Hey, a few thousand grandparents might lose their retirement, but that fourth BMW isn’t going to buy itself.
But balance billing would also go no small distance toward abolishing Medicare as an actual program of insurance. Because really, how can you be said to be insured if any provider can swipe your entire net worth simply by fiddling with the prices?
There’s more if you can bear it.
I’m sure that there will be a huge pushback from various quarters, including the Democrats. But with polarization I can easily see elderly Republicans getting on board with this even though it will destroy them personally.
And, by the way, it won’t just destroy the old people. It’s going to wipe out entire families. If you haven’t dealt with an elderly person lately you simply cannot imagine how much health care they need and how insanely expensive it is. The idea that we can be “wise consumers” when we’re 85 is simply ridiculous. Unless, of course, they plan to implement those death panels after all. They’re going to need them.
In any case, if this is actually proposed, we’re going to find out if our politics are now simply a team sport in which people don’t care at all about the details or if a direct assault on a prime GOP constituency will finally sober them up. I’m skeptical that anything will but you have to have some hope.
Oy. The hits just keep on coming.
Happy Hollandaise everyone. :/
The return of the Eunuch Caucus
by digby
And no I’m not talking about the Democrats. I wrote about it for Salon this morning:
Like most political observers, I made a lot of wrong assumptions during the last campaign. While I always took Trump seriously and knew he could win, I was certainly convinced by the end of the campaign that Clinton had eked out a victory. But if I made one consistent error from the very beginning it was in thinking that members of the conservative movement actually had a core ideology, and that leaders of that faction would have too much pride to capitulate to an apostate like Donald Trump. At the very least I expected that a few of them would assume that a President Trump would fail spectacularly, and would cynically see a political opportunity in being one who saw it coming and stood tall.
There was a time when that assumption made a lot of sense. During the GOP primaries, when Trump was taking a meat ax to every one of his competitors, playing as dirty as anyone has ever played, it looked like a good bet that some of those people would find it hard to forgive him. Trump didn’t just blaspheme against the Bible, he went even further and violated Ronald Reagan’s 11th commandment –” thou shalt not speak ill of any fellow Republican” — with relish.
He didn’t just speak ill of them. He went after them like a 12-year-old bully in the lunchroom. Of Carly Fiorina he said “Look at that face! Would anyone vote for that? Can you imagine that, the face of our next president?” He laughed at Chris Christie saying he “acted like a little child” when President Obama came to help with Hurricane Sandy. He called Marco Rubio “little Marco” and Jeb Bush “low-energy.” He claimed that Ben Carson had a pathological temper and compared him to child molesters. He called Rand Paul ugly and said that he didn’t get his father’s appealing genes. At one of his rallies he claimed Lindsey Graham was “one of the dumbest human beings I have ever seen” and sent a tweet demanding that Graham “respect” him. He said Rick Perry should have to take an IQ test before being allowed into the debates. He said the way John Kasich eats is “disgusting,” and wondered whether people wanted that in a president.
And then there was Ted Cruz, the man who kept Trump close to him throughout the early primaries, under the assumption that when Trump flamed out he would inherit his voters. It didn’t work out that way and when it came down to the two of them, Trump turned on him so hard it left him sputtering. He called him “Lyin’ Ted” and tweeted out an insulting image of Cruz’s wife, comparing her unfavorably to his own wife, Melania the former model. Trump even accused Cruz’s beloved father, a Cuban immigrant, of being involved in the Kennedy assassination.
These are just a few examples of the puerile, crude and vicious personal attacks deployed by Donald Trump against his Republican rivals. Indeed, he rarely engaged with them on policy at all. He dispatched his rivals with insults and taunts on a level never before seen in a presidential campaign. And with rare exceptions they rarely descended to his levels, despite surveys which indicated that attacking him on his personal character was the most effective.
Still, one would have thought that between his rude personal insults and his conservative apostasy on issues like Social Security and foreign policy, it would have been difficult for these GOP officials to forgive and forget, much less jump on board the Trump train. After all, for years they have made a fetish out of being men and women of “principle” who simply could not compromise their deeply held beliefs even if it brought the country to its knees. But lo and behold, they have suddenly found their inner pragmatists.
Marco Rubio, safely ensconced back in his Senate seat, has made his peace with his former tormentor. So has Jeb Bush, who recently penned an op-ed backing Trump’s controversial choice for the EPA. Poor Chris Christie prostrated himself before Trump for months only to be ignominiously fired from his job as head of the transition. Nonetheless, he is reportedly waiting by the phone just in case Trump’s inner circle fails him.
And others who either distanced themselves from the Donald’s crudest behaviors during the campaign or even outright condemned him are now groveling before him. Paul Ryan slickly tried to have it both ways and now the two are BFFs, appearing together before audiences where Trump makes it clear that he expects Ryan to toe the line and Ryan, the leader of one house of Congress in an equal branch of government, gamely grins and goes along. Poor old Mitt Romney tried to patch things up by agreeing to a humiliating public ritual in which Trump pretended to consider him for secretary of state, only to reject him after he’d issued a laudatory statement.
Former House speaker Newt Gingrich has been insinuating himself into the inner circle for some time and is usually quite careful about flattering the boss. But he made a mistake the other day by saying that Trump told him “drain the swamp” was just a “cute” campaign slogan and was forced to publicly admit that he “made a big boo-boo.”
I goofed. Draining the swamp is in, @realDonaldTrump is going to do it, and the alligators should be worried. #DTS https://t.co/nCHs61gpvepic.twitter.com/OCO7eaSKvk
— Newt Gingrich (@newtgingrich) December 22, 2016
But the saddest of all the Republican supplicants is Cruz, the man who actually took a brave stand before the whole country when he appeared at the Republican National Convention and refused to endorse the nominee. That took guts and many of us thought it showed that Cruz either had more integrity than we thought or that he had wisely surmised that Trump was going to destroy the party and he would be there to revive it as the one true conservative.
But Cruz bailed along with the rest of them. He eventually endorsed Trump and is back to trolling as only he can. The man who nearly single-handedly shut down the government is warning that Democrats will become “obstructionists at a level we’ve never seen” because they’ve been “radicalized.” He is positioning himself as Trump’s Senate defender, the man who will fight the crazy lefties on his behalf. If he plays his cards right, the talk is that he might even get the nod for a Supreme Court appointment, which would be a smart move. He’d be a shoo-in since all his Senate colleagues would do anything to get rid of him.
Whatever happens, all of these once promising GOP luminaries and elder statesmen have made it clear. Trump can say and do anything and they’ll tug their forelocks and say, “Thank you, sir. May I have another?” It’s his Republican Party now and they just live in it.
Happy Hollandaise everyone.
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What’s a few mangled pedestrians?
by Tom Sullivan
Photo by Dllu, CC BY-SA 4.0 via Wikimedia Commons..
David Dayen reminded us yesterday that while predicting how autonomous machines will act is still a crapshoot, predicting how another human invention, corporations, will behave is not. Over the holidays, Uber was playing in traffic with its autonomous test vehicles (with human co-pilots). Dayen writes, “The cars were almost immediately caught running red lights and stop signs and barely missing pedestrians…” After the California DMV and state Attorney General Kamala Harris demanded the tests stop, Uber refused, citing “an important issue of principle”.
The Guardian reported two weeks ago:
Uber’s open defiance of California regulators marks the latest case of a “sharing economy” corporation ignoring government under the guise of “disruption” and “innovation”. Uber has long claimed that it is a technology “platform” and not a transportation company and thus does not have to classify its drivers as employees or follow traditional taxicab regulations.
That strategy has resulted in more than 70 lawsuits in federal courts and hefty settlements, along with claims from opponents that the company is abusing workers’ rights and failing to ensure the safety of riders.
As a cyclist before the Tour de France reached into American living rooms, I got used to having drivers in passing cars scream, throw objects, and run me off the road for impeding their God-given right to proceed with all the fleetness their steel steeds could muster. Uber’s not being so rude. Uber believes it has a right to be an asshole because profit.
Dayen continues:
Days later, Uber acknowledged that the vehicles have a problem with unsafe turns across bike lanes, something they knew in pre-launch tests before placing the cars on roadways with lots of bikes, like in San Francisco. It must have been an important principle or something. Eventually, Uber bugged out of San Francisco after the DMV revoked registration on all its vehicles. But don’t weep for Uber: Arizona Gov. Doug Ducey welcomed them into the state for a pilot project in Phoenix.
Sure, humans kill 35,000 people a year with their cars, but if we want a reliable autonomous system, the argument goes, only real-world testing will suffice. What’s a few mangled pedestrians in pursuit of an all-American dollar? That, plus a multi-trillion-dollar public investment in “the largest infrastructure project in the history of mankind” to upgrade the Eisenhower interstate highway system to make it robot-ready. That might require dedicated lanes or else upgrades to the roadways with enough buried cabling to reach the moon and back.
Dayen asks whether simply investing in “stronger mapping or sensory technology” might be a wiser investment. He concludes:
I think normal people would call what we have here a grift. The car companies want to commandeer public infrastructure as a massive subsidy for their business model. And in the zero-sum world of government spending, such a scheme necessarily crowds out transportation that everyone can afford to use. We’re already seeing cities cut mass transit spending in favor of giving people coupons for Uber or Lyft. Considering that these companies aren’t making money and will eventually have to cash in on their oligopoly with higher rates, this kind of trade-off will eventually price poorer Americans out of getting where they need to go.
That’s a small price for the public to pay, right? Technological advancements are deemed inevitable, and something everyone in business gets all moist over. Only a Luddite would oppose progress. But for the people running corporations that profit from them and find ways to make the public pay for it, there’s one decrepit legal technology that, strangely, they have no interest in upgrading: the corporation itself. Like any other technology, it behaves just as it’s designed to. That’s just the way they like it.
It’s Holiday Fundraiser time. If you’d like to contribute, you can do so below or use the snail mail address at the top of the left column. Thank you!
Happy Hollandaise everyone.
cheers — digby
Godspeed, princess
By Dennis Hartley
Can we just say that 2017 officially begins today? Seriously, I’ve had it with you, 2016. You have more than worn out your welcome. Over.
I’ve always felt Carrie Fisher missed her calling. Of course, she will be forever cemented in our collective unconscious as Princess Leia; the smart, fearless, beautiful, and wisecracking heroine of the original Star Wars saga. But Carrie Fisher herself happened to be smart, fearless, beautiful, wisecracking ; a gifted comedic writer and raconteur. As we say in the business of show: she had “funny bones”.
Even if Star Wars had never been part of the equation, she would have taken her place alongside Fran Lebowitz or Spalding Gray. If you’ve seen her autobiographical one-woman show, Wishful Drinking, you know what I’m talking about. If not, when you’re done with your Star Wars marathon, do yourself a favor and catch it (I believe it’s still available in HBO’s On Demand). You’ll see a Carrie Fisher who is brutally honest, self-effacing…and an absolute riot.
I bet she already has Ziggy Stardust and John Glenn in stitches. R.I.P.
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QOTD: Lin-Manuel Miranda
by digby
When asked how he felt about the election:
I woke up with a very pronounced case of moral clarity. In addition to the disappointment, it was like, oh, this does not change the things that I believe in. The things that I believe in that this candidate doesn’t means we’re going to have to fight for them. You don’t want to go backwards when it comes to our LGBT brothers and sisters; you don’t want to go backwards when it comes to the disenfranchisement of voters of color. We have to keep fighting for the things we believe in, and it just made that very clear: I know who I am, and I know what I’m going to fight for in the years to come. That felt like the tonic of it.
Really, what choice do we have?
Happy Hollandaise everyone.
Putting “Jeanie” back in the bottle
by digby
This probably will not be of much interest to most people but this piece by Michelle Goldberg at Slate about how feminism has been set back is quite insightful. Like her, I was cautiously hopeful that this election would be a ratification, at least in some ways, of the idea that social justice and women’s equality in particular were national voting issues of importance. I thought the contrast with the sexist pig Donald Trump especially might lead a majority of Americans to reject what he stands for once and for all.
Well, we know how that went. Anyway, here’s Goldberg:
Instead of the year that the highest glass ceiling shattered, 2016 might go down as the year the feminist bubble burst. In America, men have always ruled, and right now I wonder if they always will…
I never wore one of those T-shirts proclaiming “The Future is Female,” but I came close to believing it. Certainly, I’ve always known that many women don’t identify as feminists, and don’t see their interests as being bound up with those of womankind. But in 2016, the polls foretold a history-making gender gap. Donald Trump’s bombastic campaign seemed like the terminal stage of aggrieved American machismo rather than simply the terminal stage of America.
In the days before election, I kept returning to a 4,000-word essay by Christopher Caldwell that the Weekly Standard ran 20 years ago. Titled “The Feminization of America,” it was meant to be apocalyptic, but it gave me a giddy hope. “Women are now thought to have more in common with other women than they do with men of similar ethnicity, religion, or income level, their interests coinciding more with those of other women than with those of their own fathers and brothers and husbands and sons,” Caldwell wrote with palpable alarm. “Women now constitute a class — a dominant class.” It wasn’t true in 1996, but in 2016 the world that Caldwell warned of was just visible on the horizon. It seemed significant that his piece both began and ended by griping about Hillary Clinton.
For 25 years, after all, Clinton was reviled as a synecdoche for unseemly female ambition. That’s part of what made her candidacy so fraught. If she’d become president, it would have been in the teeth of widespread male opposition; even the models that showed her winning had her losing the majority of men. She proposed policies that would have increased women’s power and autonomy at every level of society: equal pay, paid family leave, subsidized child care, abortion rights. For all her manifold faults, her election would have both signified progress toward gender equality and made more such progress possible. Before Nov. 8, it looked as if the arc of history was bending toward women.
Trump’s victory has obliterated this narrative. In many ways it was a fluke; had a few thousand votes in a few Rust Belt states gone another way, we’d be talking about Clinton’s popular vote landslide and the decisive defeat of Trumpian reaction. However freakishly contingent his triumph, it forecloses the future feminists imagined at least for a long while. We’re going be blown backward so far that this irredeemably shitty year may someday look like a lost feminist golden age. The very idea that women are equal citizens, that barriers to their full human flourishing should be identified and removed, is now up for grabs. A pastor warming up the crowd at a post-election Trump rally in Louisiana promised that with Trump in office, the White House would be a place “where men know who men are, women know who women are.” The massive power of the American state is about to be marshaled to put women in their place.
We might well lose Roe v. Wade in the next four years. Trump has said the issue would then go back to the states, but there’s no reason to think that Republicans would settle for anything less than a national ban. There is a particular insult at the thought of a sybarite like Trump, who still won’t say whether he’s ever paid for an abortion himself, imposing a regime of forced birth on American women. When and if Trump strips us of bodily autonomy, there won’t be any illusions that he’s doing it to protect life or the family or sexual morality. It will be because he has power, and women’s hopes and plans for their own lives don’t matter to him at all.
Controlling the course of our own lives is going to get harder in many different ways. We can say goodbye to Department of Education pressure on colleges to address campus rape. We can expect the end of federal aid for Planned Parenthood and of federal government action to promote equal pay and fight sexual harassment and pregnancy discrimination. The Women’s Bureau, the one department in the federal government tasked with responding to the needs of women in the workforce, will now fall under the aegis of former Carl’s Jr. honcho Andrew Puzder, whose company is known for commercials featuring near-naked women in orgasmic communion with sandwiches. “I like beautiful women eating burgers in bikinis,” he said. “I think it’s very American.” Like top Trump adviser Steve Bannon, Puzder has also been accused of assaulting his now-ex wife.
In Achieving Our Country, a 1998 book much discussed since Trump’s election, Richard Rorty discussed how culture would change after the ascension of an American strongman. “Jocular contempt for women will come back into fashion,” he wrote, adding, “All the sadism which the academic Left has tried to make unacceptable to its students will come flooding back.” This will likely prove prescient. Under an administration hostile to women’s equality and contemptuous of modern political norms, the way we live will slowly start to change.
There’s more and I agree with it as depressing as it is. Some genies you can’t put back in the bottle but it’s amazing how “Jeanie” can slide right back in. It won’t happen all at once. But think about how independent and liberated all those women in WWII were and how quickly they all retired to to the kitchen to start making sandwiches and babies. That won’t happen now, of course. Women are too intrinsic to the workforce. But feminism as an explicit cause has taken a serious hit.
Sure, there will be token women advanced to high profile positions on both sides of the political aisle. It’s useful PR. But the eagerness (desperation actually) with which we’ve seen the entire political world dismiss the idea that misogyny played a role in the campaign or the lack of interest in the tens of millions of women who enthusiastically voted for the first female nominee tells a story just as much as the race to seek out the deepest feelings of the white non-college educated men (and the women who love them) who voted for Trump.The relief at going back to that familiar ground is palpable.
Anyway, I know many will respond with the old “just not this woman” line and I’m sure they believe it’s true. All the bosses I had for many years certainly believed that.
I’d love to hire a woman for the job, you know I would. It’s just that the women who come in aren’t qualified and all the women who already work here are too valuable where they are. And I just had a bad feeling about that last one. But it’ll happen when the right one comes along, I promise you that. I’m committed to equality.
FYI: Here’s where we are today, it just a few random sectors.
Happy Hollandaise everyone.
Dick Morris comes through
by digby
As you know, he’s the National Enquirer’s new political editor:
Trump has brought peace with Russia, in case you were wondering. The Cold War is finally over.
I saw this the other day in the grocery store line and two women were in front of me leafing through it. The first one says, “Trump’s family sure is attractive.” The other won replied, “Oh is that his family? I thought it was one of those space alien stories.” The whole line erupted in laughter.
But then I live in the elitist west coast enclave of Santa Monica where people only care about things like money and looks … oh wait. I’m confused again.
Happy Hollandaise everyone. cheers, digby
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They want us to die part XXIII
by digby
Well look at this. It turns out that Obamacare needed a little time to work out the kinks:
Obamacare is not in a death spiral. In fact, insurers’ prospects in the individual market are looking brighter, according to a new S &P Global Ratings analysis.
Insurers have started closing the kind of eye-popping losses that prompted them to hike premiums for the Obamacare benchmark plans an average of 25% for 2017. S & P expects rate requests for 2018 will be “well below” that level.
“We view 2017 as a one-time pricing correction,” the report found.
S & P did not take into account the impact of President-elect Donald Trump’s vow to repeal Obamacare next month. What happens in 2018 and beyond will depend on how and when Trump and congressional Republicans replace the health reform law, S&P said.
The individual market — both on and off the Obamacare exchanges — has proved challenging for the insurance industry. Many insurers initially underestimated how sick enrollees would be, leading them to price their plans too low. The industry suffered $3 billion in losses in this market in 2014 and another $4.5 billion last year, promoting some insurers to scale back or exit the sector.
Related: Obamacare 2017 enrollment hits record
To address this, insurers raised their rates for 2016, limited their networks of doctors and hospitals to lower-cost providers and boosted the use of HMOs, which employ primary care providers to manage patients’ medical needs more closely. Also, the Obama administration tightened the rules for signing up for policies outside of open enrollment after insurers complained that lax enforcement allowed people to join only when they became sick.
Nonetheless, the Republicans intend to repeal, if not replace, immediately. If you want to get depressed, read this from a former Republican staffer which indicates that any stopping of it — and it will require three Republican Senators to do it — has to be done quickly. This week, in fact.
Jonathan Cohn explains why they are in such a hurry.
If you have a GOP Senator take the time to place a call this week to their home office. It can make a difference.
Happy Hollandaise everyone — cheers, digby
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Oh damn
by digby
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| You’re right, you’re right, I know you’re right |
Carrie Fisher died today. She was a very special, smart woman and a very funny writer. Too soon.
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