Thursday Morning Open Thread: YES!

Speaking on the penultimate night of the convention, Obama made a forceful case for his former rival. He’s not likely to have an audience like this again as president, and Obama soaked in the cheers and chants of “Yes we did!” from a party that, despite its divisions, remains enthralled by his charisma and vision.

Before the speech, Obama’s aides had said that it would be more of a positive testimonial for Hillary Clinton than anything else. But Obama also delivered a passionate indictment of Donald Trump, casting him as a menace whose positions aren’t just on the other side of the political spectrum, but on a different spectrum all together.

This election, Obama said, is “not just a choice between parties or policies; the usual debates between left and right. This is a more fundamental choice – about who we are as a people, and whether we stay true to this great American experiment in self-government.”

“You know, there’s been a lot of talk in this campaign about what America’s lost – people who tell us that our way of life is being undermined by pernicious changes and dark forces beyond our control,” Obama said.

Of the current Democratic nominee, Obama said, “there has never been a man or a woman, not me, not Bill, nobody more qualified than Hillary Clinton to serve as president of the United States of America.”

He added, as Bill Clinton leapt to his feet and roared a cheer, “I hope you don’t mind, Bill, but I was just telling the truth, man.”…

Late Night Open Thread: Early Reviews of the Evening

Interesting side note:

Read more

Best President Ever


Sorry for stepping on AL, but I had a good cry during that speech and my nose is all stuffed up.

I just love that man. He’s just such a fundamentally decent guy. I don’t want to have a beer with him, I want to be like him. He makes me want to be a better person, and makes me ashamed at how cynical and crude I am sometimes.

I’m happy, but I am also sad, because I just don’t think I’m ever going to see a political leader like him again in my lifetime. I’m so lucky to have lived during his time as President.

DNC Afterglow Open Thread


I think this was a very effective evening for us Democrats. Anyone here chose to disagree?

Open Thread: Livestreaming President Obama

Got the feeling this may reach TBogg (500+ comments) all by its lonesome.

This has been a gooood night to be a Democrat!

DNC Convention Livestream

Courtesy of the Guardian, which is livestreaming here.

Another livestream here, via, but I can’t find a way to embed that one.

DNC Night Three Open Thread

Everybody got their pompoms and toasting mugs ready?

Open Thread: Good Job Breaking It, Repubs!

Shit Stirring

Buzzfeed still trying to stir up the Clinton/DNC collusion stuff:

Hillary Clinton and Democratic National Committee staffers began the gradual process of merging operations and consolidating key campaign functions weeks before the primary ended, emails in last week’s WikiLeaks release show.

Starting in May, the staffs at the DNC and Hillary For America integrated their distribution of press and television clips and what’s known as “media monitoring,” a standard but robust and time-consuming research operation aimed at tracking a candidate’s friends and foes around the clock on cable, local, and national news.

Once a candidate has become the presumptive nominee, it’s typical for their campaign and the party to join forces, building out a coordinated effort for the general election and consolidating day-to-day functions between the two offices.

But messages show this process began while Bernie Sanders remained a viable candidate, sooner than previously reported or publicly disclosed.

DNC research director Lauren Dillon informed a group of colleagues about the shift in an email dated May 20, more than two weeks before Clinton became the presumptive nominee and three weeks before the last contest of the Democratic Party.

Bernie was done after Pennsylvania. Only Buzzfeed, the Sanders campaign, and the Bernie dead-enders who last night compared walking out of the convention with tape covering their mouths to the March on Washington and who today are planning a fart-in, apparently unaware that television have no smell capacity, still refuse to recognize this.

Dare Call It Treason (Update)

As Adam noted yesterday, the DNC hack isn’t just standard intel gathering that virtually all governments do. The decision to use WikiLeaks as an outlet to publicly release the information to interfere with an election “meets the definition of an act of cyberwar,” according to Dave Aitel, whose Ars Technica editorial was quoted in Adam’s post.

Article III. of the Constitution of the United States, Section 110:

“Treason against the United States shall consist only in levying war against them, or in adhering to their enemies, giving them aid and comfort. No person shall be convicted of treason unless on the testimony of two witnesses to the same overt act, or on confession in open Court. The Congress shall have power to declare the punishment of treason.”

Republican nominee Donald J. Trump, July 27, 2016:

“Russia, if you’re listening, I hope you’re able to find the 30,000 emails that are missing,” Mr. Trump said, staring directly into the cameras during a news conference. “I think you will probably be rewarded mightily by our press.”

So to recap, GOP presidential nominee Donald Trump openly “adhered” to a hostile foreign government and encouraged it to commit an act of war on the United States.


UPDATE: I was kinda kidding about the treason thing and definitely dishing out sauce for the tangerine-hued hell-gander with the “Lock Him Up” bit above. (I’m not a lawyer, but I am a firm believer in due process.) However, a bipartisan sampling of former officials are seriously calling Combover Caligula out, including William Inboden, who served in GWB’s NSC; he said Trump’s comments were “tantamount to treason” [Politico link]. Hmm.

Trump Press Conference

I don’t know what the fuck I just watched. I honestly don’t. There was so much bullshit and so many lies I don’t even know where to start.

I remember when I was in high school and went to Kennywood and I drank a couple bottles of grape Mad Dog 20/20, and thought it was a good idea to get on the spinner or whatever the fucking ride was, and puked all over everyone in a 360 degree radius, including myself, while Joe Walsh’s “Life’s Been Good” was cranking at ear bleeding volumes. That’s the closest experience I have ever had to that press conference.

Story of Russian Meddling in U.S. Election Has Legs


Following up on Adam’s excellent post yesterday about the DNC server hack, it looks like the story is indeed gaining legs, with an assist from the president.


President Barack Obama won’t rule out the possibility that Russian President Vladimir Putin could be attempting to tip the US presidential election toward Donald Trump.

His comments came after US officials said this week that there is strong evidence that the Democratic National Committee data breach was carried out by hackers working on behalf of Russian intelligence.

“Anything’s possible,” Obama responded when asked during an interview whether Russians could be working to influence the contest between Republican nominee Trump and Democratic rival Hillary Clinton.

“Donald Trump has repeatedly expressed admiration for Vladimir Putin,” Obama said during the sit-down with NBC News that aired Tuesday. “And I think that Trump’s gotten pretty favorable coverage back in Russia.”


President Obama on Tuesday waded into the controversy over the leak of Democratic National Committee emails, saying the hack of party records was characteristic of Russian government behavior and suggesting a potential motive for that country to meddle in the U.S. presidential election.

“What we do know is that the Russians hack our systems, not just government systems but private systems,” Obama told NBC. “What the motives were in terms of the leaks, all that — I can’t say directly. What I do know is that Donald Trump has repeatedly expressed admiration for Vladi­mir Putin.”

Obama’s comments align with those made Sunday by Democratic nominee Hillary Clinton’s campaign manager, Robby Mook, who said the Russian government was behind last week’s release of DNC documents on the website WikiLeaks as a way to help Trump.

The New York Times:

American intelligence agencies have told the White House they now have “high confidence” that the Russian government was behind the theft of emails and documents from the Democratic National Committee, according to federal officials who have been briefed on the evidence.

But intelligence officials have cautioned that they are uncertain whether the electronic break­in at the committee’s computer systems was intended as fairly routine cyberespionage — of the kind the United States also conducts around the world — or as part of an effort to manipulate the 2016 presidential election.

The emails were released by WikiLeaks, whose founder, Julian Assange, has made it clear that he hoped to harm Hillary Clinton’s chances of winning the presidency. It is unclear how the documents made their way to the group. But a large sampling was published before the WikiLeaks release by several news organizations and someone who called himself “Guccifer 2.0,” who investigators now believe was an agent of the G.R.U., Russia’s military intelligence service.

Even the Trumpenführer felt moved to address it today, though of course he filtered it through his narcissistic prism and missed the point entirely:

For the record, Putin never called Trump a “genius” — that description is rarely bestowed on the critter at the business end of the leash. Now release your tax returns like a good boy, Deadbeat Don.

PS: This episode removes all doubt (as if there were any) that Julian Assange is an unmitigated douchebag.

Operation and payment reform updates

Just a few updates before I get coffee.

First an interesting paper looking at surgical performance as a function of concentration on certain procedures instead of sheer volume of procedures**:

For all four cardiovascular procedures and two out of four cancer resections, a surgeon’s degree of specialization was a significant predictor of operative mortality independent of the number of times he or she performed that procedure: carotid endarterectomy (relative risk reduction between bottom and top quarter of surgeons 28%, 95% confidence interval 0% to 48%); coronary artery bypass grafting (15%, 4% to 25%); valve replacement (46%, 37% to 53%); abdominal aortic aneurysm repair (42%, 29% to 53%); lung resection (28%, 5% to 46%); and cystectomy (41%, 8% to 63%). In five procedures (carotid endarterectomy, valve replacement, lung resection, cystectomy, and esophagectomy), the relative risk reduction from surgeon specialization was greater than that from surgeon volume for that specific procedure. Furthermore, surgeon specialization accounted for 9% (coronary artery bypass grafting) to 100% (cystectomy) of the relative risk reduction otherwise attributable to volume in that specific procedure.

The argument this paper makes is that surgeons who are mainly doing one thing are better at that one thing than if they are doing lots of different things even if the total volume count on a given surgery is the same.

Intuitively, this makes sense. A surgeon who is only doing one thing can recognize at an intuitive level when something is odd and adjust or correct before there is a crisis.

Now the other payment reform piece is the Medicare bundles for cardiac care and extending hip fracture bundles:

During a conference call with members of the media, Patrick Conway, MD, Acting Principal Deputy Administrator and Chief Medical Officer at the Centers for Medicare and Medicaid Services (CMS), described three policies included in the proposal:

  • New bundled payment models for cardiac care and the extension of the joint model to include treatment for hip and femur fractures
  • A new model to increase cardiac rehabilitation
  • A proposed pathway for clinicians and physicians in bundled payment models to qualify for payment incentives under the Medicare Access and CHIP Reauthorization Act
  • Under the proposed cardiac-care bundled payments, hospitals would receive quality-adjusted pricing for heart attack and bypass episodes of care, including 90 days after a hospital inpatient stay, according to a CMS factsheet.

    What this is telling me is that the combination of bundled payments and quality accrual due to specialization is that the general surgeon and the general specialist will be declining in importance. Instead, hospitals will have emergency departments that can handle stabilization of patients and then they’ll ship the patients out to county or regional centers of excellence. If someone has a broken hip, there will be two or three hospitals in a metro area with a dozen surgeons who just do hips and nothing else. If there is a need to do a bypass, a hospital will have two bypass surgeons who do 90% of those procedures between the two of them.

    If thees results hold and if these policy changes continue to accumulate where payments are based on quality of the entire episode of care, I don’t know what the general community hospital looks like in fifteen years. It won’t be a one stop shop for 90% of a town’s needs. The quality and two sided risk arrangements won’t allow that financially.

    ** BMJ 2016;354:i3571 accessed 7/27/2016

    Wednesday Morning Open Thread: History Made

    This woman is my spiritual sister. Not my actual baby sister, who has kept herself in much better shape, but I could easily pass for this lady’s cousin. (And I too still have my ERA YES pin!)

    Apart from looking forward to this evening’s speakers, what’s on the agenda for the day?

    Later Night Calming Open Thread

    Commentor Linnaeus linked this clip on Adam’s late-night bearcam post last night. Since I live in scenic New England, I could almost see a thought balloon over that bear’s head: “Dammit, there’s always a line during tourist season… “

    And then I had to go look for this: