Vouchercare

My name, it is Mulvaney, and I’m known quite famously

by DougJ| April 12, 20173:15 pm| 154 Comments

This post is in: Vouchercare, I wish a motherfucker would!

There’s now way this would pass the Senate, so, yeah, I wish a motherfucker would vote for VoucherCare in the House:

Office of Management and Budget Director Mick Mulvaney—previously a House GOPer known for being a budget hawk—kept the door open for President Donald Trump approving of some kind of overhaul of Medicare or Social Security.
Referencing the proposal oft-floated by House Speaker Paul Ryan (R-WI) to privatize Medicare by transforming it into what’s known as “premium support,” Mulvaney told CNBC’s John Harwood that his “guess is the House will do either that or something similar to that.”
Harwood brought up Trump’s campaign pledge not to touch Medicare and asked whether he would veto it.
“That’s not a really conducive way to sort of maintain a relationship between the executive and the administrative branch,” Mulvaney said. “Let them pass that and let’s talk about it.”

I realize they’ve passed stuff like through the House before without getting hammered, but if they think they can do it now, with a Republican president who might sign the thing, they’re in for a big fucking surprise.

My name, it is Mulvaney, and I’m known quite famouslyPost + Comments (154)

What does Chuck Schumer look like?

by DougJ| November 25, 20163:10 pm| 178 Comments

This post is in: Vouchercare

Say Medicare privatization again, I dare you, I double dare you motherfucker:

“The Republicans’ ideological and visceral hatred of government could deny millions of senior citizens across the country the care they need and deserve,” Schumer said in the statement. “To our Republican colleagues considering this path, Democrats say: make our day. Your effort will fail, and this attack on our seniors will not stand.”

I don’t care how many fucking Russian twitter bots they send out there to talk up the glories of vouchercare, this aggression will not stand.

What does Chuck Schumer look like?Post + Comments (178)

Round one

by DougJ| November 16, 201612:51 pm| 254 Comments

This post is in: Vouchercare, Our Failed Political Establishment

The first big battle of the Trump administration is going to be over Ryan’s plan to replace Medicare with vouchers. We’ve got to win this battle. Remember, Bush losing the battle to privatize Social Security was the beginning of the end for him. I’m calling my Congress people about this later today. Josh Marshall says Dems don’t have a plan yet:

Over recent days, as I’ve spoken to people in the world who might lead the fight against Paul Ryan’s plan to phaseout Medicare and replace it with private insurance vouchers and one message is quite clear: No one is paying attention. No one is ready. No one has a plan. Half the people are still too shell-shocked to think about anything. The other half are telling themselves something so crazy can’t happen. But wait, at least one person on TV is starting to talk about this.

Round onePost + Comments (254)

More on Kentucky

by David Anderson| November 4, 20157:01 am| 38 Comments

This post is in: Anderson On Health Insurance, Vouchercare

Via Tbogg:

Basically Bevin wants the other states to take care of his poor people. Must be a states rights thing: pic.twitter.com/j6IAAV3EsY
— TBogg (@tbogg) November 4, 2015

The 1115 waiver is how Montana, Alaska, Iowa, Arkansas and half a dozen other states have expanded Medicaid. If straight up Medicaid expansion is replaced with a 1115 waiver Medicaid expansion in Kentucky, then most of the 420,000 people who are on expanded Medicaid in Kentucky will still have coverage although it has been worse coverage.

The 1115 waivers that have been approved have set some strict limits:

No more than 2% of income can be spent on premiums and only if people make more than 100% of the Federal Poverty Line
Cost sharing can be maxed out at 5% of income
Redetermination of eligibility can happen annually instead of every six months
Health Savings Accounts are approved with state seed money
Medicaid is not tied to job or educational efforts.

I don’t think Kentucky would go Arkansas model of paying for private insurance. Arkansas is seeing that this route is extremely expensive. So far it has not mattered for Arkansas as the Federal government has been paying 100% of the cost to expand Medicaid without calling it Medicaid Expansion or Obamacare. That changes on 1/1/17 as the states will have to start kicking money in. The Arkansas model will cost the state an incremental $15 to $20 million dollars per year over straight up Medicaid expansion.

If we assume the Center for Medicare and Medicaid Services follows their precedent, a probable Kentucky 1115 waiver will impose some premiums or mandatory HSA contributions, some non-ambulatory transportation services will be cut and cost sharing for emergency room visits will increase. The premiums will push some people out of the program. Everyone else will have another hoop to jump through but they’ll still have coverage.

I thought this was a 10% probability last night, but with new information I’m bumping this up to a 60% probable outcome.

Enough to Choke an Everglades Python…

by Betty Cracker| May 8, 20159:12 pm| 60 Comments

This post is in: Austerity Bombing, Fuck The Poor, Vouchercare, Assholes, Teabagger Stupidity

I suspect our healthcare reform correspondent, Richard Mayhew, will cover this in more detail at some point, so I’ll keep it short:

Florida’s sleazy, serpent-like governor, Rick Scott, slithered up to DC this week to try to locate a fat wad of cash he could ingest to reimburse Florida hospitals for providing indigent care.

He had to do it while still eschewing Medicaid expansion (Obamacare!), thus enabling Scott to get money from the Feds while saving face with the teaturds back home.

Mind you, Scott’s strategy is not the fiscally responsible move — the Obama admin peeps rightly pointed out that it’s more cost efficient (not to mention more HUMANE) to give people coverage and nip developing health problems in the bud rather than pay for a medical crisis in the ER.

But bootstraps, welfare queens in Cadillacs and strapping young bucks buying t-bones, etc. So no.

Anyway, HHS Secretary Sylvia Burwell told Scott to fuck off. Basically, she said, “Swallow Obamacare, or depart, foul serpent! “

Well done, Madam Secretary!

Did I say I’d “keep it short?” Ha! Another lie! But that’s a perfect illustration of why morons and liars win healthcare reform debates. It takes too many words to explain. I’m out of them. Words, that is. The end.

Enough to Choke an Everglades Python…Post + Comments (60)

Problems with high deductible health plans

by David Anderson| January 30, 20148:41 am| 25 Comments

This post is in: Anderson On Health Insurance, Vouchercare

From a loyal reader, I was pointed to this story down in Georgia concerning state employees getting a slightly better health insurance plan mid-year. I want to highlight the problem with the original health plan.

This year has brought on an onslaught of changes, which included one form of insurance from Blue Cross Blue Shield of Georgia – a high-deductible HRA (Health Reimbursement Arrangement) – and no additional selections to choose from. It is no secret that an HRA is not a one-size-fits-all medical plan for every family, particularly individuals with long-term illnesses….In late December, our family was notified that our daughter’s occupational therapy would increase from a $25 co-pay to $127 per one hour session. We are facing $1,000 per month in medical bills between insurance premiums and four hours of therapy….

Health reimbursement arrangements/health savings accounts/high deductible health plans are designed to do one basic thing. That thing is to shift costs onto the individual for anything that could vaguely look like a “day-to-day” expense. The theory of change is that the individual will be much more price sensitive and thus a much better price shopper as well as being much more not consume any medical service in a marginal situation. From here, costs will stabilize and eventually decline. That is the theory of change.

It is a theory of change that is built on the Rand Insurance Experiment. The Rand Insurance Experiment showed that making people pay out of pocket reduced health care consumption and expenditure. However the Rand Insurance Experiment also showed that people are not perfectly rational, infinitely discounting, amazingly discerning health care shoppers; people are human with the limitations of bounded rationality that is shaped by information processing costs and competing priorities. People being people instead of perfectly rationalizing agents means high deductible cost sharing plan designs don’t guarantee that people get the care that they actually need which leads to worse health outcomes including death in some cases.

High deductible plans are appropriate choices for some people. They are not appropriate for everyone if we value appropriate as a means of providing effective, efficient care that meets the medical needs of an individual without bankrupting them or their family.

If I was the health insurance dictator in this country, I would allow high deductible plans to be sold. They would only be sold to individuals and families who are reasonably young (age is a pre-exisiting condition) without any signifcant claims history. The policies would not be automatically renewed until the most recent claims and medical history was reviewed. Furthermore, the potential buyer pool would be limited to people who have the ability to absorb a one-time shock of several thousand dollars without it being a crisis. This sub-population is fairly small, and can absorb the risk shifting that is inherent in a high deductible plan design. Anyone with chronic conditions or recurring health maitenance problems should not be a plan designed like this if the goal is to effectively manage health.

Problems with high deductible health plansPost + Comments (25)

Same old Song and Dance

by David Anderson| September 19, 20138:40 am| 42 Comments

This post is in: Anderson On Health Insurance, Free Markets Solve Everything, Fuck The Middle-Class, Fuck The Poor, Vouchercare, All we want is life beyond the thunderdome, Assholes

The House Republican Study Committee is offering a “repeal and replace” plan for Obamacare. If we assume that this is purely a marketing document aimed to fulfill the check box that there is a “plan” to “replace” Obamacare that can get 218 votes in the House, then this document aces that evaluation. However, my therapist asked me to try not to be a cynical bastard before my first cup of coffee every morning, so lets evaluate this plan on the following criteria:

Provides coverage for people with pre-exisiting conditions
Provides coverage for people who aren’t part of the Republican donor class
Attempts to bend the cost curve down
Covers neccessary medical processes

Before we evaluate, let’s go over the major policy planks.

Repeal all of Obamacare including Medicaid expansion and the three legged stool of subsidies, community rating/guaranteed issue, and mandate.
Give people a tax deduction of $7,500 for an individual and $20,000 for families
Significant expansion of HSA tax advantages.
$25 billion for state run high risk pools with premium support for any premiums that are over twice the state average for insurance.
Coverage guarantee for pre-exisiting conditions only applies to people who maintain continuous coverage
Allow insurance companies to sell a single product through a single state regulatory filing
Allow small groups to pool together for better risk pool pricing.
Improve pricing transparency
Stop comparative effectiveness research
Tort reform to cap damage limits
Random anti-abortion plank

The short version is MASSIVE FAIL

The long version is below the fold:

show full post on front page

The big “idea” behind the “policy” document is that tax breaks solve all problems. The tax break is aimed at decoupling insurance from employment. However, as we all know, deductions give more money back to people who have higher incomes. Someone in the 25% bracket will see a $1,875 refund on the $7,500 deduction while someone earning $16,000 (or just slightly above 138% of poverty line for an individual) will see either $750 back (10% bracket) or less if there were any other deductions they were taking. So the tax break idea gives more help to those who don’t need it.

Right now for Obamacare, there is a significant debate on whether or not an individual with an income of $16,000 is able or willing to pay $600 a year for health insurance after they receive a $4,000 or $5,000 subsidy. The House GOP inverts the dynamic and gives a $750 subsidy for a several thousand dollar a year policy (if it covers anything at all).

Moving down the income ladder and working up in family size, a $20,000 deduction to buy health insurance does not help a family that has less than $20,000 income, and it is a cruel joke to a family of four with an income of $40,000. And as a kicker, if this policy did go into play, we can expect to hear about the 57% and all of those lucky duckies who weren’t part of the 47% for years to come. Now if a family is making $250,000 a year, this ain’t a bad policy set. But that is to be expected.

HSAs are going to be a part of the health care and health payment environment for a while. If we had a functional political system that has working factional blocks interested in give and take, HSA treatment could be a point of reasonable negoatiation. We don’t have that, we have a quasi veto controlling faction that likes to eat anthrax laced tired rims.

As a policy note, HSA tax treatment against massively favors the well-off on both the tax advantages and the fact that they have the money to put into these accounts to begin with while the middle class and poor can’t come up with $5,000 or more in cash in a single year to cover a catastrophic event, much less an annual several thousand dollar lump to cover expensive chronic care (unless you’re in Colorado). Furthermore, there has been significant research that has shown tax incentived savings don’t materially impact the total value of savings, it just redistributes savings to the favored uses. As it is, we as a society have too much of our personal savings tied up in illiquid assets such as houses and 401(k)s, so having another dedicated use savings vehicle is probably a bad idea.

High risk pools have been a conservative hobby horse. The idea to to pay for the care of people who no insurance company wants to touch. The problem is that insurance companies won’t insure these people because they are guaranteed money losers because they have known and expensive care requirements. Obamacare gets these people into the risk pool by the community rating requirement and distributes the risk via the mandate. This policy proposal shunts them to the side. The policy failure is that these people will cost way more than $25 billion dollars over 10 years to serve. And since the high risk pool often contains individuals who are more likely to either not be able to work, or can only work at low wage jobs, they don’t have the resources to pay double state average premiums before they can get any federal assistance. Again, this is a good deal for someone with means.

Continuous coverage in the private market only matters when there is no three legged stool with guaranteed issue. This allows people with pre-exisiting conditions to get insurance coverage if they have always had private market insurance coverage. If someone is employed at a place without health benefits, they are SOL as the individual market won’t insure them under this proposal. Again, if someone is pulling in 150K a year no big deal because the odds that they work at a job without health benefits is minimal, but someone make 20K a year is SOL.

Selling insurance across state lines already happens. Cigna, Aetna, Wellspan and several other major players have operations in at least half the states in the country. Right now they have to demonstrate to the satisfaction of the individual state that they are selling in that they have a sufficient network and product offering. The House Republican plan introduces the credit card and corporate law model of “regulation.” A plan approved in one state can be sold in all fifty. Some small state that is easily bought out like South Dakota or Delaware will under this scenario pass a set of insurance regulations that makes it extraordinarily easy for insurance companies to collect premiums without having to pay claims.

Furthermore several states have passed laws that allow for state residents to buy out of state approved insurance. The program evalution on these policies have shown massive fail:

The two states that have implemented across state lines laws, Georgia and Wyoming, reported similar challenges. No out-of-state insurers have entered either of these markets or indicated their intent to do so as a result of the states’ across state lines legislation. Maine officials reported that no out-of-state insurers have yet indicated their intent to enter…

As a side note, I don’t have a problem with a state deciding to either form interstate compacts with other states with similar regulatory priorities or opening up their entire insurance market to national race to the bottom regulation. States are allowed and should experiment, I oppose national race to the bottom standards. Massachusetts does not want to be Mississippi’s bitch.

Allowing small groups to pool together is already happening. That is called the “SHOP” experience on the Exchange. This is not a bad idea, it is just reinventing the fucking wheel when the pre-exisiting wheel is almost ready to roll.

Improving price transparency again is something that in a rational political environment should be a fairly easy policy to hammer out as theoretically all veto players should be interested in roughly the same agreement region.

Stopping comparative effectiveness research is a great way to waste money. We should only pay for treatments and interventions that work. CER is an attempt to figure out what actually works. This is a throw-away policy to assuage the Rascal Riders that there are no death panels and it is amazingly stupid.

Tort avoidance and damage limitation policies are designed to fuck over a Democratic donor group and reward Republican donor groups. It is a rent distribution system to favor certain groups. Furthermore, Texas has enacted tort “reform” and it has had no impact on the rate of cost growth or doctor retention in Texas.

The researchers said their study suggests that Medicare payments to doctors in Texas rose 1 to 2 percent faster than the rest of the country, Black said.
Since tort reform, some Texas residents have complained that they cannot find a lawyer to pursue a malpractice case because of the $750,000 cap on payouts for pain, suffering, disfigurement and mental anguish. The limit often makes litigation cost prohibitive…
Texas saw the number of direct patient care doctors grow more slowly after tort reform than it did before, the study says. Afterward, Texas did slightly worse than other states in attracting doctors, the study says….

And the random anti-abortion plank is in the policy proposal because the policy proposal was released on a day that ended with “Y”.

Same old Song and DancePost + Comments (42)

Expand and loot

by David Anderson| September 13, 20138:37 am| 47 Comments

This post is in: Anderson On Health Insurance, Election 2010, Fuck The Poor, Glibertarianism, The Party of Fiscal Responsibility, Vouchercare, Our Failed Political Establishment

Good news (via Politico) for Pennsylvania:

Republican Pennsylvania Gov. Tom Corbett is planning a Monday press conference to throw his support behind a version of Obamacare’s Medicaid expansion, industry and legislative sources tell POLITICO.
Corbett’s eyeing versions of expansion that rely on private-sector health plans rather than adding to the public Medicaid rolls, similar to approaches being considered in Iowa and Arkansas, according to the sources. The approach would bring in billions of Obamacare dollars marked for states that back expansion and use them to buy private insurance for the state’s poorest residents.

Medicaid expansion is a good thing for the working poor in Pennsylvania. The Oregon study strongly indicated that Medicaid significantly improves health and quality of life for its recipients. Pennsylvania is one of the last Obama voting states that had been holding out and it is a large hold-out.

The bad news on this probable announcment is that the expansion is being done in a cockamanie manner designed to prove that government can’t work. Simply expanding state Medicaid elibigibility rules would be faster and cheaper (as Medicaid pays a low reimbursement rate) than sending people to exchanges for products that have yet to be designed. Two steps forwards, one step back and then a piroutte towards social justice…..

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I’m not seeing them as underdogs, but it’s entirely possible I lost my place in the test booklet

by Kay| April 17, 20131:04 pm| 23 Comments

This post is in: David Brooks Giving A Seminar At The Aspen Institute, Show Us on the Doll Where the Invisible Hand Touched You, Vouchercare, Bring on the Brawndo!, Clap Louder!, Democratic Cowardice, Democratic Stupidity

I’m temperamentally inclined to resist sales pitches that are based on fear. Every time I hear one I think of those home alarm commercials where the frantic women sees the masked intruder crashing through the sliding door. They’re not selling the alarm system. They’re selling fear. They lose me when they choose that approach. The longer I read on the school reform industry-marketing end the more I believe they’re not selling “reform” substantively, to the public, anyway. They’re selling fear that they hope will drive their version of “reform.” Because I have been alive and had a pulse the last 20 years I’m particularly wary of fear-based political appeals that spring from a “bipartisan consensus” because all that really means is a bipartisan group of politicians, think tank, elite non-profits and opinion media people have reached consensus, and what that means to me is there are very few dissenters in the top ranks.

Whether it’s system-wide in Atlanta or DC or Chicago or all the way down to the individual level, where certain anxious fourth graders are taking a high stakes test where they didn’t review the material and they aren’t given enough time to complete the test, fear seems to permeate the whole reform approach. Here’s some political schemers of various stripes and motives who are hoping for low scores on a test that is essentially rigged to produce low scores so they can sell reform in the suburbs. Do they sound like people who are confident in the value of the product? Why would they need to create failed and failing public schools full of failures to sell market-based reform to people in the suburbs? Why not just sell their “sector agnostic” approach to public education– where a public school is the same as a publicly funded for-profit or private school-directly?

While kids are taking their standardized tests some very well compensated reformers are back out on the road, selling reform, or something. This is the message of a reformer who is a particular favorite of Arne Duncan:

Educators make excuses for failing schools, Rhee said. But, she added, “The bottom line is: The system did not become the way that it is by accident. It operates exactly the way it was designed to operate, which is in a wholly unaccountable, dysfunctional manner.
“So when you seek to change that dynamic” – including going after “low-performing” teachers – “you’re gonna have a whole lot of unhappy people on your hands. When you stop that gravy train, somebody is going to be unhappy.”

What is that? What are these awesome, mighty forces that are opposing her? It seems to me she has nearly every powerful political actor and billionaire behind her, including the person who did or did not invent Facebook. How much cheering affirmation does she need? Isn’t South Carolina a Right To Work For Less state, anyway? South Carolina isn’t known for worker protections, reformers. Maybe she didn’t know where she had landed that day, because there’s also this:

Former Washington, D.C., schools chancellor Michelle Rhee had trouble recalling the names of South Carolina’s “key players” after a quick visit to the State House on Wednesday. But state lawmakers may want to take note of hers.
Rhee’s education advocacy group, StudentsFirst, is lobbying in 18 states, including South Carolina.

Eighteen states! No wonder she can’t keep the “key players” straight. That’s all right. She’ll get it when she writes them a campaign check. The Committee To Elect Reform Rubberstamper probably won’t cut it. Why would the US Department of Education back this stuff, to the extent where Duncan personally intervened to try to save this particular reformer’s job in DC?

I’m the parent of a public school student and I don’t believe our local public school employees are “riding a gravy train.” I know what public school teachers are doing here right now, in fact. They’re prepping for Duncan’s standardized tests. I thought 2011 was the year for the ritual denunciation of public employees, and now we’re back to thanking teachers and firefighters “for their service” after Newtown and then Boston, whatever that means. I hope it doesn’t mean they have to be unpaid volunteers or they’re self-interested and not credible. Why doesn’t that rule apply to lobbyists? I’m not a teacher, but it seems to me they’ve set this up so there’s no way for those teachers who don’t agree with them to question what reformers are doing in our schools without their being labeled wholly self-interested slackers. I’m not a teacher so it also won’t bother me or shut me up (obviously) but why all the threats and grim fear-mongering? There’s nothing new or “transformational” about that. It’s an old, old idea.

I’m not seeing them as underdogs, but it’s entirely possible I lost my place in the test bookletPost + Comments (23)

Mid-Afternoon Open Thread

by Soonergrunt| October 31, 20124:32 pm| 186 Comments

This post is in: Election 2012, Open Threads, Vote Like Your Country Depends On It, Vouchercare

The polling in the last couple of days has all gone the President’s direction. Of course, 538 and the Princeton Election Consortium have it decisively in the President’s favor the last several days. Princeton reported this morning (before the site went offline) that the re-election likelihood was 93% for the random distribution, and 98% for the weighted calculation.

I’m trying not to get too excited. I’m trying to keep perspective, but it looks, from reports out of Michigan and Ohio, that the whole “lying about car production” and the fake relief rally have both hurt Romney in the region.

Now it’s time for the final argument. If there’s anyone out there that any of you know that is still undecided, or uncommitted at this point, please, please refrain from choking the ever-living shit out of this person, and make this final argument:

It is time to take responsibility. Our vote is our voice in how we want the country to be run, and what we stand for. It is, in the purest sense, our will writ upon the world stage. We have to take responsibility for the leaders of our country, and we have to vote accordingly. If you are OK with a man who lies and dissembles every time he gets in front of a microphone, you should vote for Rmoney. If you are OK with the idea that a small group should control everything in the country from positions of immunity and leisure while the rest of the country toils from birth to death for what scraps they’ll drop, then you should vote for Rmoney. If you think that the citizens of the greatest and most powerful country in the world should risk being poverty-stricken due to illness, you should vote for Rmoney. If you think that going to war against Iran in order to protect a third country is the proper use of American military personnel–if you think that protecting Israel and Saudi Arabia are worth your children being killed and maimed, then you should vote for Rmoney. And you should do these things with pride. If you think however, that America deserves better in every one of the above cases, then you should vote to re-elect the President.

Some of the aforementioned polling:

NYT/CBS: Obama up 5 points in Ohio, 2 points in Virginia, and 1 point in Florida.

Franklin & Marshall College: Obama up 4 points in Pennsylvania.

PPP: Obama up by 5 in Wisconsin and in Iowa.

Mid-Afternoon Open ThreadPost + Comments (186)

Discretion is the better part of valor

by DougJ| September 10, 201210:04 am| 152 Comments

This post is in: Vouchercare

A great piece by Tom Edsall on the Ryan plan. Executive summary: it cuts “Mandatory and Defense and Nondefense Discretionary Spending” down to 3.75% of GDP (by 2050) from its current level of 12.5% of GDP. Since defense itself is 4% of GDP and Ryan has pledged not to cut that, that means there is no non-defense discretionary spending at all. In particular:

By 2050, that would leave zilch under the Ryan plan for such separately funded programs as Veterans Benefits (Function 700); the administration of justice, including the F.B.I. (Function 750); Education, Train and Social Services (Function 500), and pretty much anything else.

Here’s why it’s a shell game: he never says specifically what he will cut (he probably says something about bear DNA and volcano monitoring on the stump, but you know what I mean). So if he gets quizzed by anyone who is afraid a program they like will be cut, he can just say “I am committed to saving your program”.

A neat trick.

Discretion is the better part of valorPost + Comments (152)

He hit me and it felt like a kiss

by DougJ| August 13, 20128:12 pm| 60 Comments

This post is in: Vouchercare, Our Awesome Meritocracy, Our Failed Media Experiment, Sociopaths

Atrios thinks Romney-Ryan will get points from establishment media for saying they’ll screw the middle-class:

My prediction is that the election narrative from our Villagers will coalesce around the question that voters care about most of all: which candidate (and party) will make the electorate suffer the most?
America 2012. It’s just one big laboratory for the S&M fantasies of the Villagers.

I hope he’s right. Because screwing the middle-class may send a tingle up Chris Matthews’ leg but it’s a losing proposition politically. If Cokie and David Gregory and Jon Mecham and the rest giddily agree that Romney-Ryan will put the middle-class back it its proper subservient place, that’s a win for Obama. If it’s a few Villagers grimly nodding along about hard sacrifices in the background, that helps Romney, but if it’s Sunday morning public S&M, it hurts.

But I don’t think that’s what will happen. Let’s check in with the man who is always wrong, Mark Halperin:

Mitt Romney just held a short press availability in Florida and completely dodged the question of which parts of the Ryan budget he disagrees with.
[…]
The White House and much of the media are going to stay on this issue for a good long time. Instead of playing rope-a-dope, Romney should stand and answer.

Romney should not stand and answer, he should bob and weave. Neither wingers nor pundits care about details. Unless the Obama campaign hits him hard on vouchercare — which I think they will — Romney can use sadomasochism and WOLVERINES! to give the right and the Village four hour erections without telling the public that he plans to make them eat cat food in their old age.

There’s no way that Romney can win the battle of vouchercare. But maybe he can get points for “tough decisions” from sociopaths without alienating that many normal people. Maybe. But I doubt it.

He hit me and it felt like a kissPost + Comments (60)

It starts with a face and ends up a fixation

by DougJ| August 13, 201212:34 pm| 36 Comments

This post is in: Vouchercare, Green Balloons

We’ve talked a lot about how every Republican candidate becomes a love object for both the far right and establishment media — starbursts, shoulders you could land a 747 on, tanned (in a prairie, sun-chapped sort of way), can you smell the English leather on this guy. We’ve already heard quite a bit about Paul Ryan’s piercing blue eyes and hot P90X toned physique.

So I think the PaulRyanGosling twitter feed is one to follow.

It starts with a face and ends up a fixationPost + Comments (36)

Romney is Lying About President Obama Stealing Money from Medicare

by Imani Gandy (ABL)| August 12, 20128:06 pm| 99 Comments

This post is in: Ryan Lyin' Weasel, Vouchercare, Zombie-Eyed Granny Starver, Romney of the Uncanny Valley

Robot/Zombie 2012

Mitt Romney is still lying about Medicare — no surprise there. Also it is no surprise that Romney is now dog whistlin’ while he does it. It’s the southern strategy updated for the twenty-first century:

“There’s only one president that I know of in history that robbed Medicare, $716 billion to pay for a new risky program of his own that we call Obamacare,” Romney said.

“What Paul Ryan and I have talked about is saving Medicare, is providing people greater choice in Medicare, making sure it’s there for current seniors. No changes, by the way, for current seniors, or those nearing retirement. But looking for young people down the road and saying, “We’re going to give you a bigger choice.” In America, the nature of this country has been giving people more freedom, more choices. That’s how we make Medicare work down the road.”

Get it? He is “robbing” Medicare. The black guy is stealing money from seniors! He is coming for your wallet!

Loath as I am to cite Politifact, they clearly explain why the current talking point about Obama cutting $500 billion from Medicare is a steaming pile of horseshit:

There’s a small bit of truth here. The Affordable Care Act does reduce Medicare spending by $500 billion over the next 10 years. But here’s the catch: Those dollars aren’t taken out of the current budget, they are not actual cuts, and nowhere does the bill actually eliminate any current benefits.
The $500 billion is all in future spending reductions and come through the law’s attempts to slow projected growth, not cut spending.
PolitiFact National has highlighted the biggest bits of savings: About $220 billion comes from reducing annual increases in Medicare payments to health care providers. Another $36 billion comes from increasing premiums for higher-income beneficiaries. Administrative changes land another $12 billion in savings. A new national board is set to come up with $15.5 billion in savings — but can’t get those savings from a reduction in benefits. The last big chunk of $136 billion comes in changes to the Medicare Advantage program, which has become more expensive than initially anticipated.

If all those numbers make your eyes glaze over like they do mine, the bottom line is this:

show full post on front page

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It’s a tough racket

by DougJ| August 12, 201212:27 pm| 84 Comments

This post is in: Vouchercare, The Decadent Left In Its Enclaves On The Coasts

I just spoke with a sharp Democratic Congressional staffer I know who tells me that he thinks Ryan was a smart choice for Romney. He says that there was no way Romney would be able to hide from the Ryan budget plan — because Obama would pound him on it and the wingerati would insist that Romney stick by it — and that Ryan is the best salesman for the plan. Bear in mind, it’s not Ryan’s plan per se, it’s something people drew up in a right-wing think tank. Ryan’s just a frontman for the operation. He’s done a fantastic job (via) of getting Beltway idiots to pretend that a predictably radical right-wing plan is some wonderful piece of wonky courage.

I think my friend is probably right that Romney was stuck with the Ryan budget plan anyway. The hard-core anti-New Deal right activist crowd has taken over the Republican party.

You go to war with the unpopular extremist policies you have, not the popular moderate policies you wish you had.

Telling people that you want to turn Medicare into a voucher program is probably political suicide. Real Murkins don’t like vouchers; at best, vouchers are something the airlines make it difficult for you to use, at worst, they’re a way to keep the strapping young bucks from blowing all their welfare money on steak and cigarettes.

If this election is a referendum on vouchercare, Democrats obviously win. But Josh Marshall’s stunt stand-in is completely wrong here:

Having Ryan on the ticket will make it difficult for the losers of the election to claim that the winners doesn’t have some claim to pursue their fiscal vision. A decisive electoral resolution to this high stakes political fight is actually kind of scary no matter where you come down on issues like Medicare, Medicaid and tax policy. But it’ll also be good for the country if it means the government will have new running room to pay at least passing attention to things like mass unemployment and eroding infrastructure that the next president will have to deal with, whether he’s a Republican or Democrat.

That’s bullshit. If Romney wins, it will mean Republicans have a mandate to turn the country into the Randian paradise the Founding Fathers envisioned. If Obama wins, it will mean that the Kenyan soshulist had the sense to tack to the center…and he better stay there.

As Atrios famously said about some other election (I can’t find a link on teh google), whatever happens on election night will prove once and for all time that we are a right-center nation.

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