Quick Thoughts after Reading the GOP “Health Care” Bill

I can’t believe more people aren’t talking about the last page of the Senate bill:


Late Night Open Thread

Here’s a picture of Steve sitting in the dark at the top of the stairs bitching for food. He perches there so if I make any movement towards the stairs, he can race downstairs and be prepared for to inhale whatever I give him.

He’s not getting anything until tomorrow morning.

Only a fool would think someone could save you

I think that repealing Obamacare would be a disaster for Republicans. You could argue that the takeaway from GA-6 and the other specials is that, while things aren’t great for Republicans in 2018, they have a good chance to hold the House unless some crazy shit happens. Repealing Obamacare qualifies as crazy shit and then some.

So I can see reasons why McConnell, who’s a shifty one, might be happy if repeal fails. That said, all the Senators expressing “concerns” about the bill looks and smells like kabuki to me. Jim Newell is probably right:

If he’s sticking to the script, McConnell has a list of giveaways that he saved to offer members later so that they can argue they only voted for the bill after extracting concessions:

This bill could fail, but that would be an abrupt last-minute rewrite of a script from which none of the players, so far, have deviated. Conservatives are organized, coordinated, and eager to share with the press their early objections. They will move the bill further to the right. Moderates are disorganized and press-shy, keeping their objections within the family. They will get offered a few more bucks or state-specific carve-outs and then draw straws to determine who has to vote for it. The Senate sequel to the House bill process is playing out like the most disciplined scene-by-scene retread since Home Alone 2. Don’t expect a surprise ending.

The so-called moderates always cave. I’m not a fan of calling people cucks but if anyone deserves it, it’s so-called moderate Republicans in Congress.

The GOP Is Becoming A Domestic Terrorist Organization

They’re tryng to be responsible for the suffering and death of thousands of Americans, and they’re proud of their efforts. Not so proud they aren’t lying as fast as they can talk, of course…

Healthcare, Birthday, and other Bullshit

It’s truly impressive that the Republicans managed to make the House health bill care worse. But they got rid of the individual mandate and rich and healthy people benefit and will get tax cuts, so WINNING! I have nothing going on the next few days so may actually try to find protests and go march in front of Capito’s local offices. I am not a protest person, but this shit requires drastic measures. Of course, the bill is not evil enough for the Zodiac killer and his cadre.

Speaking of healthcare, I turned 47 today. I’m not a person prone to celebration- I think this irritates ABC a touch because I’m not one to get really excited about things. I’m really not a hot or cold person (despite my irate ramblings), I just cruise along comfortably at the speed of grumpy. I mean, I am not miserable. I’m generally a happy person (ask people who know me IRL). I feel like I am defending myself too vigorously.

At any rate, mom and dad wanted to go out to dinner tonight, and I was not feeling it. I initially agreed, but then thought about it and cancelled. I decided I would rather stay and home and putz around the house, cook a nice dinner with a ribeye, and so I pushed back the plans until tomorrow night. I bought a steak and planned a nice dinner, and then had leftover fajitas that Christion and I made yesterday. Because who says I am not spontaneous?

Back to health and healthcare. Every summer as I head toward a new birthday I schedule a lot of health related events. I’ve had sleep apnea since 2005 (if you snore, get yourself checked- it will change and maybe save your life), and have not had a test since, so I scheduled a new sleep study. I had a friend die of pancreatic and colon cancer this past year, so I scheduled my first colonoscopy. I had another friend die of a heart attack, so I am headed to get a stress chest and a cardiac check up just because I don’t want to die before my parents so they don’t accidentally see the contents of my hard drives. I had my b-annual physical and labs. I went for my six month checkup at the dentist, had a crown replaced, a cleaning, and bought a night guard because I grind my teeth. I had my eyes checked and got new glasses two months ago. All in all, it cost about $2500 out of pocket (eyes and dental were the worst), which is a lot, but I’ll have it all paid off by the time I have to go in next year.

None of that would be possible without health insurance. None of it. And again, I am one of the upper tiers as far as lucky goes when it comes to health insurance. I’m having this shit done. A shit ton of Americans can’t, and that’s before the Republicans have their way and dismantle the ACA. What they want to do is cruel, inhuman, and flat out evil. The slashing of funds to deal with the opiod epidemic and things like that will stand out, but all of it is uniformly vile and awful. They are just horrible people beyond redemption. They sicken me emotionally, and they intend to sicken the nation physically, all just to throw a couple more bucks to the already rich. I don’t know how these reptilian motherfuckers sleep at night.

In house related news, my water filter needed to be replaced on my fridge. So I went and bought a new one. I installed it. The warning light was still on. I read the manual from cover to cover. I googled. Couldn’t find help anywhere. So I called GE and I spent an hour on the phone to have a person tell me to turn my unplug/plug my fridge back in to get rid of the warning light. He called it a “factory reset” to justify his existence and for me to not feel like a stupid asshole who is confused by household appliances.

I also found another board on the back deck (right next to the one I fell through) that needs to be replaced, so now I am wondering if I should have another expert come in and check the entire damned thing. I think it is too big to begin with, but I am not financially prepared to rip it out and replace it, so mending will have to be all I do.

The garden is weeded and up looking good. I did not put in raised beds yet because $$$, and I had a large portion of the yard where the ground was really uneven and nothing but shitty weeds were growing, a remnant of the yard being in disrepair so long. Remember, the weeds were chest high when I bought the place. So what I did this year was just plow up a big section of it and plant a garden right in the damned middle where I know I will have to level next year, and I am using that. It is unsightly, but it works. Next year I will get a dumptruck of topsoil and fill that in and seed it.

Also next summer I have decided I am going to ring the outside of the fence with native flowers and the like. The front yard has shrubbery and all that, and i will plant some bulbs and some other stuff there, but around the sides the length of the house I am going to plant day lilies, snap dragons, sage, milkweed, black eyed susan’s, milkweed, and use that and have a more free look than the paean to Prussian order that is my front yard. I figure I will have those around the whole yard and then I can plant a solid butterfly/bee garden in the back yard with a little butterfly pond. Under the pines I am going to put in blueberry and blackberry bushes.

The front yard is looking ok, but I apparently have swarms of ground bees (they are yellowjackets), so I bought some thing I have to pour into the nests to kill them. I don’t like pouring chemicals into the ground for obvious reasons, but I also don’t want swarms of bees attacking ABC’s kids when they come down.

Today while getting the water filter at Lowe’s, I picked up a flag mount for the front porch and a nice nylon flag. Is there a specific etiquette to where you hang it- if you are facing the house, to the right or to the left? I know neither adheres to official flag regulations, but I was wondering if there was an informal rule.

Finally, I got a fern. For some reason, I love ferns, but everyone says “don’t get a fern they are a pain in the ass.” They are probably right, but I have Thurston, so my definition of pain in the ass might be a little bit different than other people. At any rate, I am hanging it from the ceiling on the landing of the stair case in between the first and second floor by the window. I just think it will look good there, especially with pictures lining the staircase walls. Now I am looking for a neat pot hanger to go with it. I like this, but it seems kind of expensive:

Any thoughts? I thought it would go well with the colors of the house.

That’s about it for me. Guess I will sit down and start searching netflix and amazon prime for something to binge.

“Fundamental Meanness”

President Obama posted a heartfelt plea on Facebook asking legislators to rethink their support of the heinous Trumpcare bill and encouraging citizens to speak out. An excerpt:

I recognize that repealing and replacing the Affordable Care Act has become a core tenet of the Republican Party. Still, I hope that our Senators, many of whom I know well, step back and measure what’s really at stake, and consider that the rationale for action, on health care or any other issue, must be something more than simply undoing something that Democrats did…

I was careful to say again and again that while the Affordable Care Act represented a significant step forward for America, it was not perfect, nor could it be the end of our efforts – and that if Republicans could put together a plan that is demonstrably better than the improvements we made to our health care system, that covers as many people at less cost, I would gladly and publicly support it.

That remains true. So I still hope that there are enough Republicans in Congress who remember that public service is not about sport or notching a political win, that there’s a reason we all chose to serve in the first place, and that hopefully, it’s to make people’s lives better, not worse.

But right now, after eight years, the legislation rushed through the House and the Senate without public hearings or debate would do the opposite. It would raise costs, reduce coverage, roll back protections, and ruin Medicaid as we know it. That’s not my opinion, but rather the conclusion of all objective analyses, from the nonpartisan Congressional Budget Office, which found that 23 million Americans would lose insurance, to America’s doctors, nurses, and hospitals on the front lines of our health care system.

The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else. Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions.

Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely.
Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.

He’s right. Toward the end of the essay, President Obama says, “this debate has always been about something bigger than politics. It’s about the character of our country – who we are, and who we aspire to be.”

That’s what worries me — that the “fundamental meanness” at the core of the GOP bill reflects the selfishness of Americans all too well.

I’ll make my daily calls, show up at meetings and continue to support candidates and programs that make people’s lives better — even stupid people who think the way to give “elites” the finger is to vote for a buffoon in a golden tower who craps in a golden toilet.

But at some point, the people who keep enabling this shit have to suffer the consequences. I’m not talking about morons like Trump, ghouls like Ryan or money-grubbing pricks like McConnell; I’m talking about the voters who put them office.

Maybe when they hit the lifetime cap on their crappy insurance plan, sell everything they own, alienate family members and friends with constant begging and their cancer-stricken child still dies because they can’t afford treatment, they’ll get it. Maybe when their dementia-riddled, incontinent grandmother is ejected from the assisted living facility for non-payment and dumped on their doorstep, they’ll understand.

Or maybe they’ll never get it. Maybe this really is who we are, and who we aspire to be — or enough of us to make those of us who hope for something better irrelevant. If we let these bastards get away with robbing millions of people of healthcare access, if they don’t pay with their jobs, I really don’t know how we can argue otherwise.

Mitch McConnell Will Not Hesitate to Abuse People with Disabilities

Literally. As long as he doesn’t have to show his face on camera, of course.

I doubt McConnell does think he’s a good guy, actually; he figures he’s defending his cushy “leadership” job, and whatever it takes to accomplish that is just fine by him.

Take me to the airport

A lot of Senators are flying home tonight out of Washington National Airport. This is a pretty sweet way to let them know what we think of their shitty health care bill.

See Ya In Court, Jackass

Or probably not, as this will quickly get thrown out:

A Republican coal baron is suing John Oliver, HBO, Time Warner, and the writers for Oliver’s show over the most recent episode of Last Week Tonight.

The suit, filed on June 21 in the circuit court of Marshall County, West Virginia, holds that Oliver and his team “executed a meticulously planned attempt to assassinate the character of and reputation of Mr. Robert E. Murray and his companies” by airing an episode that ripped into him. Murray runs the country’s largest privately owned coal company, Murray Energy Corporation.

“They did this to a man who needs a lung transplant, a man who does not expect to live to see the end of this case,” reads the complaint, which also lists Murray’s companies as plaintiffs.

The lawsuit isn’t a surprise to Oliver. In fact, the British comic said on the episode of his show that aired on June 18 that he expected it, noting that Murray has sued several other media outlets in the past (including, in May, the New York Times). In the episode, Oliver criticized Murray’s business practices, saying he doesn’t do enough to protect his miners’ safety. Oliver also noted that his team contacted Murray’s company before the episode aired, and that the company sent a cease-and-desist letter––the first time that had ever happened to his show.

In the interest of full disclosure so Mr. Murray will not sue me and because I am a big fan of the Streisand effect, here is the entire Last Week Tonight piece:

Screw Murray.

Good manners and bad breath will get you nowhere

You all know by now that SC-5 ended up being closer than GA-6. You probably also know that SC-5 is full of hopeless rural idiots whereas GA-6 is full of well-educated suburbanites who just need a little non-ideological persuasion to start voting Democrat. David Atkins nails it:

The lesson of the special elections around the country is clear: Democratic House candidates can dramatically outperform Clinton in deep red rural areas by running ideological, populist campaigns rooted in progressive areas. Poorer working class voters who pulled the lever for Trump can be swayed back to the left in surprisingly large numbers—perhaps not enough to win in places like Kansas, Montana and South Carolina, but certainly in other more welcoming climes. Nor is there a need to subvert Democratic principles of social justice in order to accomplish this: none of the Democrats who overperformed Clinton’s numbers in these districts curried favor with bigots in order to accomplish it.

But candidates like Clinton and Ossoff who try to run inoffensive and anti-ideological campaigns in an attempt to win over supposedly sensible, wealthier, bourgeois suburban David-Brooks-reading Republican Romney voters will find that they lose by surprisingly wide margins. There is no Democrat so seemingly non-partisan that Romney Republicans will be tempted to cross the aisle in enough numbers to make a difference.

The way forward for Democrats lies to the left, and with the working classes. It lies with a firm ideological commitment to progressive values, and in winning back the Obama voters Democrats lost to Trump in 2016 without giving ground on commitments to social justice. It does not lie in the wealthy suburbs that voted for Romney over Obama in 2012, or in ideological self-effacement on core economic concerns.

I think it’s quite possible to run different kinds of campaigns in different areas, and I’m not faulting Ossoff for running the campaign he did. But I do think there’s something fucked up about the Democratic party’s idea that it should run civil, non-ideological campaigns. We’re not running to be the president of Fred Hiatt.

No amount of civilitude and centrist common sense is going to get suburban upper-middle class white voters who have spent their entire lives voting Republican to reconsider their obsession with tax cuts and become Democrats en masse (yes, you can pick off a few I’m sure).

The whole non-ideological civilitude thing smacks of class bullshit. We don’t need to fight, we’re all reasonable here, not like the poors! That’s what it sounds like to me, at least. Republicans have gotten lower-income white Americans to vote Republican by feeding them xenophobia and resentment. Xenophobia doesn’t pay your medical bills. Obamacare does. We just can’t cede rural America to Republicans, not when Republicans are offering so little to rural America policy-wise.

The summary of the Senate AHCA

Here is the TLDR of the Senate AHCA draft.

There are a lot of details that matter (I even like Sec. 102-b-1-B-II) but that is the fundamental difference.

CPI-U comes into play for Medicaid funding in FY 2025.
Per Capita Caps are in play for Medicaid
Enrollment caps for block grants for Medicaid are in play.

Old people in Alaska will be paying 16% of their income in premiums before receiving subsidy assistance.

Taxes are being cut massively with no incentive effect intentions.

There are massive work disincentives embedded in multiple spots throughout the bill

Deductibles are going up

Silver and Gold plans will be hideously priced and hyper narrow networks to dodge sick people

Section 1332 waiver protections are gutted

Any federal dollar can not be in the same zip code as a dollar that is used for abortion

New York is getting hit hard on both the Buffalo Kickback and the Basic Health Plan as immigration status is tightly defined.

The Tree of Liberty…

…is a f**king vampire:

Nearly 1300 children die and 5790 are treated for gunshot wounds each year. Boys, older children, and minorities are disproportionately affected. Although unintentional firearm deaths among children declined from 2002 to 2014 and firearm homicides declined from 2007 to 2014, firearm suicides decreased between 2002 and 2007 and then showed a significant upward trend from 2007 to 2014. Rates of firearm homicide among children are higher in many Southern states and parts of the Midwest relative to other parts of the country. Firearm suicides are more dispersed across the United States with some of the highest rates occurring in Western states. Firearm homicides of younger children often occurred in multivictim events and involved intimate partner or family conflict; older children more often died in the context of crime and violence. Firearm suicides were often precipitated by situational and relationship problems. The shooter playing with a gun was the most common circumstance surrounding unintentional firearm deaths of both younger and older children.

Guns kill kids. That baseline number, almost 1300 kids every twelve months, is more than a 9/11 every three years.

Guns don’t just kill kids; they are a leading cause of death for children and teenagers.  The data in the chart below don’t perfectly line up, as it doesn’t break out gun homicides and suicides from the overall rates by all methods, but still here are ball park figures.

(To weight those numbers, the FBI reports that as of 2014, roughly two thirds of all murders were committed with a gun, and the CDC reports that guns are involved in about half of all suicides.  Childhood figures may weight more towards firearms for a couple of reasons, but I haven’t dived into the data and I’m not a domain expert, so value that opinion as you will.)

In any event, it doesn’t take much to see this as a peculiarly American evil.  In the discussion section of the paper quoted above:

International studies indicate that 91% of firearm deaths of children aged 0 to 14 years among all high-income countries worldwide occur in the United States, making firearm injuries a serious pediatric and public health problem in the United States.14

The net:

Approximately 19 children a day die or are medically treated in an ED for a gunshot wound in the United States. The majority of these children are boys 13 to 17 years old, African American in the case of firearm homicide, and white and American Indian in the case of firearm suicide.

Nineteen kids a day, killed and wounded, and the Republican Party is completely on board with that.

We all knew that of course; now we’ve got numbers.  What will this nation do with this newly quantified knowledge?

Nothing: the slaughter of American children will continue until the tree of liberty swallows us whole.

ETA: On a moment’s reflection, that’s too damn depressing even for me.  Eventually this country will get sick of self-murder. I hope that day comes sooner than I’m thinking now.

Image: Nicholas Poussin, The Massacre of the Innocents, (drawing for this painting) c. 1628-9

Paul Ryan Has A Challenger: Randy “Ironstache” Bryce

DougJ shared Bryce’s now-famous campaign ad earlier this week, though not in a prime time slot. There’s been a rash of news reports since then, but the best I’ve seen is from Mike Elk’s Payday Report:

RACINE, WISCONSIN – Despite his 6’2 frame, the half-Mexican, half-Polish Army veteran known as the “@IronStache” on Twitter is the epitome of a gentle giant. Holding a beef brisket sandwich in his hand, he hugs, back slaps, and laughs his way through the crowd at the Juneteenth parade on the lakefront of Racine.

“I’m running for Congress against Paul Ryan,” ironworker Randy Bryce struggles to tell an African American woman over the noise of a gospel choir singing on the stage behind them.

Ryan, the Speaker of the House and a former vice presidential candidate, has more than $8 million in the bank for his re-election bid. By contrast, Bryce is a rank and file ironworker activist who has built some of Southeast Wisconsin’s best-known landmarks, including Milwaukee’s Miller Park and the landmark Northwestern Mutual Building.

However, it’s not an entirely uphill battle. Ryan’s district includes the pro-union bastions of Racine and Kenosha, as well as the suburban Milwaukee Republican stronghold of Waukesha. According to the Cook Political Report, the district is only 5 points more Republican than Democratic. If 2018 turns out to be a wave election year, some think Ryan could be defeated by a candidate like Bryce in such a marginal swing district…

“People know that the system is rigged and something has to be done, and Donald Trump took advantage of that,” says SEIU Healthcare Wisconsin’s Bruce Coburn, who serves as the union’s Vice President for Politics and Growth. “Randy, though, is someone who really believes in people and has shown it in all the years he has been in the labor movement.”

I first got to know Randy through the #wiunion hashtag during the Occupation of Wisconsin Capitol in 2011, and since then we have become personal friends. Bryce was part of the tens of thousands who occupied the Capitol in order to stop Scott Walker’s anti-union agenda.

Bryce sips Limeaid in the living room of his small two bedroom apartment outside of Racine as he recalls that battle.

“Walker’s strategy was to divide and conquer,” Bryce says. “His strategy was pointing out people and saying they are being the reason that the others didn’t have it as good as they possibly could. Now that’s being taken to the national level with Donald Trump.”…

If elected to Congress, he sees his role there as being more of a shop steward than a politician, and that he aims to run a campaign that amplifies the voices of others. “For an African American woman, there is no possible way that I can put myself into that woman’s frame of mind, the struggles she faces on a daily basis,” Bryce says. “I could do something to pretend, but I can’t experience it myself, so I need to rely on other people.”…

Process Matters

No, this is not about health care.

This is about the recent dudebro outbreak of PELOSI GOTTA GO that has been driving me crazy since Ossoff didn’t pull off a miracle in Georgia. I don’t think there is ANYONE out there who disagrees with the fact that our leadership needs new blood. Our bench is weak and it needs to be reinvigorated. I’d like to see younger leadership.

But what also matter is how we gain that new leadership. We don’t do it by shitting all over people like Pelosi, who has been an extraordinary leader in troubling times and I shudder to think how bad things would have been were she not in charge keeping the House Dems together. She’s spent her lifetime doing what is best for the country and the party, and when the time is right she will do the right thing.

I can not say the same thing about certain independents and their crank followers who become Democrats only when it is convenient and then jump ship the moment they don’t get their fucking way. BTW- that health care bill we are rushing to save? It wouldn’t be there if it were not for Pelosi, and the assholes slagging her didn’t like the damned bill in the first place because it didn’t make us Sweden overnight.

How to read the Senate Bill

The Senate healthcare and tax cut bill is expected to drop in a few cups of coffee. There are a ton of rumors floating around. Here is a cheat sheet on how to read it.

1) Reconciliation places severe constraints on the bill

a) The Parliamentarian is most likely going to be stripping out significant non-germane to the budget items
b) $1 billion in savings must come from each of two committees (HELP and Finance)
c) Anything the Senate passes must meet or beat the $119 billion in budget window deficit reduction that the House AHCA was scored at.

2) Three major pots of money

a) Tax cuts
b) Individual market changes
c) Medicaid cuts to pay for tax cuts

3) Follow the money
Any extra dollar used to pay for a slower Medicaid termination has to come from either Medicaid on the back-end, fewer tax cuts or lower individual market changes. Anything used to up subsidies on the individual market has to come from itself, faster/steeper Medicaid cuts or fewer tax cuts. Anything that ups the tax cuts must come from the individual market or Medicaid…etc.

4) Index rates matter
Slower terminations but lower index rates on per capita caps is a budget gimmick. It gives a little bit of money in the 10 year budget window but leads to massive cuts in the out years against the current counterfactual.

5) Market design and incentives matter

a) Look at where the work disincentives apply

a1) Medicaid expansion where the FMAP disappears once a person churns out once
a2) Medicaid expansion to individual market transition without CSR as people move from high AV low premium insurance to low AV high premium insurance if they earn a dollar too much
a3) 350% FPL instead of 400% FPL

b) How does the individual market function without a mandate and without the patient and state stability funds?

6) More coffee is better