News Dump Comes Early Today

This is going to be a quick post. Between noticing earlier that some of my cactuses are in bloom

and heading up to Los Alamos tonight to meet Ray Monk, who has written a biography of J. Robert Oppenheimer, I want to post some early questions about the revelation that the FBI had a possibly fraudulent document, possibly Russian, that caused James Comey to make his July announcement last year. I have the feeling that I am missing some things and have many questions. Some are unlikely to be answered any time soon, but others may be due to my confusion and hurry. Read more



CBO on the AHCA

This will be a running and updated post on the cost estimates of the AHCA by the Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT)

17:20 TLDR It is about the same bill that got scored in March with marginal changes. CBO does not think MacArthur/Upton will have large net effects

16:22 The JCT estimates the bill that passed the House has a $662 billion dollar tax cut over the scoring window.

16:30 The March 23, 2017 CBO score is here. This was the managers amendment leading into the week of the first vote window which got pulled. It does not include everything that was in the bill before it got pulled.

The baseline is -24 million incrementally not insured for a total 52 million people without insurance and $150 billion in total deficit reduction.

16:33 Here it is

16:34$120 billion in deficit reduction, donut plans will be purchased, slightly more people covered

In addition, the agencies expect that some people would use the tax credits authorized by the
act to purchase policies that would not cover major medical risks and that are not counted
as insurance in this cost estimate.

1635 Read more








Incentives from caps in Medicaid

I was on a webinar this afternoon listening to analysis and “analysis” of the Medicaid proposals in the AHCA. One of the things that I wish they brought up was the incentives that a cap structure gives state Medicaid directors to severely limit care that patients with outlying care requirements can receive. Let’s assume that the incentives for state Medicaid directors is to do as much good for as many people as they can given the state budget constraint with a weaker objective of minimizing how many times and how loudly they get yelled at.

Let’s take the $12,000,000 member in Iowa and assume s/he is on Medicaid instead of an Exchange plan.

Currently, if s/he receives an additional dollar of Medicaid spending to finance care, the state pays $0.42 and the Federal government pays $0.58 if s/he is Legacy qualified or the state pays a nickel and the feds pay $0.95. There is a very loose constraint on spending based on Iowa’s state budget but the spending is leveraged through the federal match rate.

Under a cap system, an extreme outlier does not bring in any additional federal funding. Any incremental dollars spent on an individual with extremely costly needs will be originating from only state level funds. Outlier funding is tough as it would be explicitly moving money from dozens or hundreds or thousands of people to spend it on one or two extremely expensive to care for people.

The state director’s incentive is to severely limit outlier spending. That could be done by eliminating coverage of certain classes of care. It could be done by instituting annual or life time caps. In both cases the societal response is to either let people bankrupt themselves and die or shift the cost of care to the hospital and doctors in the form of noncollectable debt instead of spreading the costs to society in the form of taxes.

In each major eligibility category, there is a spread of spending. Some people in the Aged&Disabled category are far more expensive to cover than others even if the absolute average spending is high. Some kids are more expensive than others to cover. The incentive under a capped system of funding where all outlier costs are borne by the state government is to aggressively reduce outlier costs even if those costs are efficient, effective and medically necessary.








Fox News Trifecta? (Open Thread)

As you’ve probably heard, Trump toady Sean Hannity has been shamelessly exploiting the tragic death of DNC staffer Seth Rich to distract folks from the RussiaGate scandal that is engulfing Trump’s administration. Fox News went along for a while. But as it became increasingly clear that the story is an absurd conspiracy theory propagated by disreputable louts, even Fox News retracted it:

On May 16, a story was posted on the Fox News website on the investigation into the 2016 murder of DNC Staffer Seth Rich. The article was not initially subjected to the high degree of editorial scrutiny we require for all our reporting. Upon appropriate review, the article was found not to meet those standards and has since been removed.

We will continue to investigate this story and will provide updates as warranted.

Hannity kept beating the drum on his show, despite the Rich family’s direct appeal to his producer to stop exploiting their dead son. Last night, Hannity was supposed to reveal “game-changing” information from known fraudster Kim Dotcom. He even teased it by retweeting this deeply idiotic cartoon tweeted by the fraudster himself:

But according to the WaPo story linked above, Kim Dotcom tried to access the late Mr. Rich’s Gmail account to plant fake evidence this week but was rebuffed. So, no big reveal on the Hannity show. Instead, Hannity pretended to grow a conscience and drop the matter “out of respect for the family’s wishes.” But to satisfy his mouth-breather audience, he hinted on Twitter that he’s still pursuing the story:

My guess is that, in addition to the Dotcom bust, the network’s lawyers told him to STFU. Right now, #FireHannity is trending on Twitter, and Hannity is bellowing like a ruptured bull about his persecution by Soros-Hillary-Satan:

MediaMatters has a handy list of Hannity’s advertisers here. I don’t know if Hannity is in any real danger. He’s probably screaming at the top of his lungs about being silenced to save face after being taken in by a known bullshit artist. But it would be cool if he got shit-canned right after O’Reilly was kicked to the curb and Ailes croaked.

Anyhoo. Open thread!



Open Thread for All Purpose Assholery

Stay out of the fucking thread below.








Help Me With My Music Library

I spent the last month importing every single CD I own. I imported it all to a LaCie external drive.

I opened Itunes today, and it “organized” my external hd and 90% of my music is gone. Here is what I need besides a hockey puck sized sedative and a box of kleenex.

All I fucking want is to import all of my music in .aiff to my LaCie external hd. Then, once it is all there, I want to be able to make sure it can not be deleted, and I can create playlists for my iphone.

That is it. That is all I want. I am reformatting my LaCie, I am deleting everything with my MusicMonkey Pro and doing a fresh install, and I am doing the same with itunes. I am on a Windows PC running Win10 64 bit, and I have a macbook pro as well.

I want point by point instructions. If I need another application, let me know. I will give you my god damned phone number so you can walk me through this. I am ready to fucking break shit.

*** Update ***

Also, I am in a pretty fucking volatile mood right about now so if you have nothing to offer other than “that sucks” or “buy a radio” this is not the goddamned cocksucking thread for you or your shitfuckery.








Advice From A Former President

This is excellent.

Open thread!








Open Thread

Looks like time for a new thread.

Have at it!

ETA: I wish I was still living in Colorado. I’d have taken off today and gone to setup a campsite for a few days and then head back home for the night with fresh trout for dinner.  We would drive the hour after work, and this would have been our Friday evening view (minus the pop-up, I use tent and cots for back reasons). And crawdads so tasty, those mountain lakes deliver!








Wednesday Morning Open Thread: Another Battle Begins

(Jeff Danziger’s website)
.

As if Lord Smallgloves could tell you what was in “his” budget… Greg Sargent, in the Washington Post, “Even some Republicans balk at Trump’s plan for steep budget cuts”:

While some fiscally conservative lawmakers, particularly in the House, found a lot to praise in Trump’s plan to balance the budget within 10 years, most Republicans flatly rejected the White House proposal. The divide sets up a clash between House conservatives and a growing number of Senate Republicans who would rather work with Democrats on a spending deal than entertain Trump’s deep cuts.

“This is kind of the game,” said Senate Majority Whip John Cornyn (R-Tex.). “We know that the president’s budget won’t pass as proposed.”

Instead, Cornyn said he believes conversations are already underway about how Republicans can negotiate with Democrats to avoid across-the-board spending cuts that are scheduled to go into effect in October. Those talks could include broad spending increases for domestic and military programs that break from Trump’s plan for deep cuts in education, housing, research and health care…

Budget experts questioned many of the economic assumptions that the White House put into its plan, saying it was preposterous to claim that massive tax cuts and spending reductions will lead to a surge in economic growth…

“Even some Republicans” plan on a political career that lasts beyond the next election — maybe even one that doesn’t involve people spitting on them in the street. This ain’t a budget proposal, it’s a new chapter in a cultists’ holy book. Or a performance-art script for grifters hoping to massage the plutocrats’ greed glands…



California single payer

California is studying a single payer system. It is doing the homework to make explicit the assumptions that are needed to make the system work. Modern Healthcare has some details:

SB562 would guarantee health coverage with no out-of-pocket costs for all California residents, including people living in the country illegally. The state would contract with hospitals, doctors and other healthcare providers and pay the bills for all residents similar to the way the federal government covers seniors through Medicare.

The measure envisions using all public money spent on healthcare — from Medicare, Medicaid, federal public health funds and “Obamacare” subsidies. That’s enough to cover about half of the $400 billion cost, according to the legislative analysis.

The rest would come from higher taxes on businesses, residents or both. It would take a 15% payroll tax to raise enough money, the analysis said.

Matt Bruenig makes one very good point before I want to look at some details:

After the implementation of single payer, the report says, health expenditures in the state of California would total $400 billion per year, or 15 percent of the state’s GDP. This is 3 percentage points lower than the share of GDP the US overall spends on health care.

I have a couple of questions about the finances.

Does the analysis assume or not assume the AHCA will be passed? If it does not assume the AHCA, there is a potential $10 billion Medicaid annual gap in the financing. More importantly it is assuming some incredibly complex and currently not authorized in law much less by rule making waivers.

What happens when there is a recession? California has a balance budget constraint. Wage and capital gains income taxes tend to be pro-cyclical. They go up in good times and crash in bad times. How is this program financed in bad years?

Finally, we need to look at the distributional fight inherent within universal access programs. Single payer is exceptional for the fifty two year old making $11 an hour with either no benefits or Bronze level benefits. It is not as good of a deal for a twenty nine year old independent contractor making $39,000 a year who has a cheap policy in the individual market. It is a really bad deal for the mid-40s couple making $200,000 with exceptional coverage through work.

The American political system is most responsive to people who have a lot to lose, people who have power and people who can mobilize significant resources. In this case, that is an apt set of descriptors for the mid-40s couple making very good money.

Single payer is hard. California is trying to make explicit the trade-offs needed to get a single payer system off the ground. There are choices to be made with winners and losers from each choice made. And each set of people whose current situation is changed for the worse will scream.

Update 1 And oh yeah, how does this play nicely with ERISA, the controlling law on most employer sponsored benefits including health insurance?



On The Road

Good Morning All,

This weekday feature is for Balloon Juicers who are on the road, travelling, etc. and wish to share notes, links, pictures, stories, etc. from their escapades. As the US mainland begins the end of the Earth day as we measure it, many of us rise to read about our friends and their transient locales.

So, please, speak up and share some of your adventures, observations, and sights as you explore, no matter where you are. By concentrating travel updates here, it’s easier for all to keep up-to-date on the adventures of our fellow Commentariat. And it makes finding some travel tips or ideas from 6 months ago so much easier to find…

Have at ’em, and have a safe day of travels!

Should you have any pictures (tasteful, relevant, etc….) you can email them to picstopost@balloon-juice.com or just use this nifty link to start an email: Start an Email to send a Picture to Post on Balloon Juice

Just a few for hump-day. I’ve been working so much on site and related stuff, I didn’t have the time I had hoped for tonight. Forgive me, will make it up tomorrow! But I trust that these pictures will suffice – the wow factor is high.

Read more



Babylon throne gone down gone down

Via the comments, there was a big upset in the New York State assembly race in Long Island tonight:

Democrat Christine Pellegrino has defeated Republican Thomas Gargiulo in the District 9 State Assembly special election.

With all election districts reporting, unofficial results have Pellegrino ahead of Gargiulo by margins of 3,338-2,282 in Suffolk County and 2,252-1,767.

Trump won 60 percent of the vote in this district in 2016, and it’s a longtime Republican stronghold:

Typically, Democrats would hardly compete in the 9th, a horseshoe-shaped district on the Nassau-Suffolk county line that includes Massapequa, West Babylon, Babylon Village, West Islip and West Bay Shore.

More evidence that Dems need to compete EVERYWHERE over the next few years.








Late Night Open Thread: Vindication…

… and Lord Smallgloves is too “exhausted” even to tweet angrily about it.

Can’t wait to hear how his audience with the Pope goes. Personal bet: ‘Rumor’ that Francis has to tell him, no, he can’t demand God grant his wishes — and if he could, “smite all Trump’s enemies, bigly” would not be on the list.

Side bet: The Swiss Guard will have to contact Trump’s entourage, post-audience, to get some number of shiny pocketable trinkets returned. No questions asked, Mr. Bannon.



When their eloquence escapes you

For some reason, friends of mine have been talking about Sting online recently, and when I talk about his album The Tepid Heart, they can’t tell that I’m kidding! I guess that’s because if someone told you there was a Sting album called The Tepid Heart and you didn’t google it, you’d just assume it was real. Anyway, that’s caused Sting to be on my mind, and now whenever I read a column by Sting’s fellow baby boomer soft-rocker David Brooks, I can hear Fields of Gold playing in the background.

But I’m not sure “tepid” even does this one justice:

As the impeachment investigation proceeds, it’ll be important for us Trump critics to not set our hair on fire every day, to evaluate the evidence as if it were against a president we ourselves voted for. Would we really throw our own candidate out of office for this?

Jesus, this one is easy: “YES”. Let’s suppose that Lanny Davis continued to take money from the Ivory Coast and Equatorial Guinea without telling anyone while working on Hillary’s campaign. Let’s suppose the Ivory Coast hacked Republicans’ email during the campaign. And then let’s say that Hillary made Lanny Davis her National Security advisor, and that Lanny Davis then had inappropriate phone calls with the Ivory Coast and made a strange foreign policy decision favored by the dictator of Equatorial Guinea. And then let’s suppose that when the FBI investigation of Davis was heating up, Hillary asked Comey to end the investigation, then fired him when he wouldn’t.

Would anyone (other than possibly Peter Daou) be saying Hillary shouldn’t be impeached and removed? I don’t think so.

In fact, I can’t possibly think of a worst example of trying to see things from the “other side’s” point of view. In fact, I think the main difference here is that many liberals, myself included, are ambivalent about impeaching Trump right now (for political reasons), whereas we would not be ambivalent at all about impeaching Hillary under the hypothetical scenario I described above.








Pet Bleg III: The Buddy Update

Look at that face! You know you want to help that face!!!!

BL has sent along an update about Buddy. First the good stuff:

Buddy now likes to play ball. At first he was horrible at catching balls, but is getting better. His walking is also improving daily. At first he could hardly walk; now he is trotting short distances. He loves scratches and sleeps next to me as I work. He’s a really happy dog and should make someone very happy.
And now we tug your heart strings and ask you to reach deep, deep, deep!
Thanks for your help so far.  I have sent emails and phone calls to about 10 rescue groups so far, and heard back from one. That one (a lab rescue) is processing the information to see if they will accept Buddy. I think we will have better luck if I get him all his tests and vaccinations.
Buddy will spend the next few days at my daughter.
I am scheduling Buddy for vaccinations, tests and to be fixed later this week.
I estimate the initial costs for Buddy, not counting the $300-$500 that Rescue Groups ask for in donation to be $1710.
Buddy
Doctor visit $52
Anasthesia Check/Fix (checked w/vet) $520
Fecal check $51
Bordatella $37
Influenza $43
Lepto $37
Lyme $43
Heartworm screen $57
Cardiologist $700
Heartworm Prev – 6 mon $60
Lyme screen $50
Tick-Flea Prev – 3 mon $60
$1,710
I already paid for a rabies shot so it is not in the above costs. The estimate for the cardiologist to check his potential arrhythmia came from my daughter that has a dog with arrhythmia and recently saw a cardiologist.
I started a youcaring fundraiser, since they seem to charge the least in fees.
Here is the link.
Any assistance for BL efforts to get Buddy situated would be greatly appreciated! All lines are open. Operators are standing by.