It’s All Over But the Crying

I honestly don’t give a shit if Bernie debates Donald Trump- it’s his god damned reputation he’s ruining. This is over, and this Molly Ball piece nails it:

But in the world Sanders’s supporters inhabit, this is all so much media manipulation. “Do you trust the media?” asked one of his introducers, the television host Cenk Uygur. “No!” yelled the crowd. “Do you believe they’ve treated Bernie Sanders fairly?” “Fuck the media!” yelled someone standing near the press riser. (Sanders was also introduced by two actors, Dick Van Dyke and Rosario Dawson.)

Sanders and his people have their own sets of rules. All you have to do is unskew the delegate counts, they explain, take out the superdelegates, imagine they all vote for Sanders, imagine certain primaries had been conducted according to different rules. Angry memes about missing votes and stolen precincts ricochet around social media. Did you see what happened in Nevada, when the party, Sanders’s supporters claim, changed the rules to keep them from getting more delegates at the state convention? The game is rigged!

The Sanders movement has become impervious to reality. Some have even called into question the nature of reality itself: “Bernie Sanders’ ‘political revolution’ is political only inasmuch as thought is political,” a self-described “metamodernist creative writer” named Seth Abramson wrote in the Huffington Post a few days ago. “By the very nature of things—we might call it perceptual entropy—the impossible, once perceived, enters a chain of causation whose natural conclusion is realization.” By this logic, Abramson reasons, Sanders is actually winning. It’s, like, the Matrix, man, or something.

The Abramson piece is priceless and a must read for Sokol fans. This was my reaction the other day when I read it:

Ball continues:

The question is what it will take for Sanders to be satisfied with some sort of moral victory short of the nomination. This week, he was given five slots on the Democratic platform committee, which will allow him to influence what the party stands for—presumably an important goal. Sanders is also thought to be interested in reforms to the nominating process that he has derided as “rigged.”

But while his aides have occasionally alluded to these sorts of goals, Sanders continues to behave like a candidate who still believes he can win. On Monday, he criticized Clinton for turning down one last debate; on Tuesday, he sought to wring an additional delegate out of Kentucky by challenging the vote count in one district. His speeches give about as much critical time to both Clinton and Trump, and his crowds boo both with equal vehemence.

Is Sanders—the onetime liberal gadfly whose views few of his colleagues heeded—simply enjoying the spotlight’s validating glow for as long as it lasts? Or is he as delusional as some of his dead-ender fans? It’s impossible to tell.

Alternate working theory- he’s just a cranky old asshole and we’re finally seeing the Bernie Sanders that his colleagues have been putting up with for decades. That’s why all the Super Delegates went with Hitlery.

I Think I Can Barely See the Light

So I’ve been kicking around this idea for some years now, and it’s been greatly on my mind for the past few weeks. As time goes on, things appear to be getting clearer, and I’m getting a stronger hold on my thesis. This is the beginning of what I hope to be a much longer treatise or series on this theme, and your comments and feedback are very welcome either in public or private to help challenge, develop and hone it. I’ll be around to discuss and explore with commenters, but please, no tech issues or questions today. That’s soon, not today.

Succinctly, I think we are already deep into the effects of Climate Change without realizing it. To be clear, I’m not talking about the alarming carbon dioxide levels or growing average high temperatures, recurring new monthly record high temperature, fires in Alberta, abnormal highs in Alaska, drought in the Southwest, diminished Arctic ice, or decreased reflectivity of glaciers and snow deposits world-wide due to pollution and soot. This is not about any physical aspect of Climate Change and the Anthropocene era. I’m concerned with the internal psychological, value, and cultural effects, those subsequent effects on populations, and what I see as larger trends worldwide.

I’m not usually a doom-and-gloomer, but there are a lot of powerful and scary currents across a wide swathe of humanity right now that seem, at their root, to share some intangible motivation. I think it’s fear – not of the other, not of progress or modernism or capitalism or Judgement Day or gay rights or transsexuals or Donald Trump or women’s rights or blasphemy or sacrilege or hippies or ethnic minorities or anything else rooted in our normal experience.

I think we, as a species, are already waist-deep into Climate Change and we’re acting like many other species do when put under serious, unseen-from-their-perspective environmental stress: we’re freaking out, and as tension rises, striking out against others and tearing down social and cultural edifices and the order that has served us well for the past few hundred years.

I fear that the future truly is undiscovered country as human history, norms, rules, etc. did not develop under this type of environmental stress – we’ve flourished coincident with a mild climate, and moved on when local climate changed too much or too quickly. Too many ascendant disharmonic forces across the globe strongly question, challenge, threaten, or violate their previous norms of behavior, treatment, principles, values, and history for me to not feel there is a trend, and it’s related. And no, it’s not the plants working together to drive us insane and reclaim the Earth for Mother Nature. And yes, for you wiseacres and cynics, in a way, the ascendency of women’s, gay, and transsexual rights is a positive effect of this break with who we thought we were.

It’s Happening Everywhere
I spend a lot of time reading about, thinking about, reading and listening to the Far Right so-called fever swamp. And to my ears, things have changed, and it truly scares me. Trump is like a stumbling, wind-up toy with lit sparklers sticking out of its head in a dry and dusty storeroom filled with rich fuel. But he’s no more than a match, which is horrible enough and will likely be tragic. He’s just one example, too close, gaudy and loud to ignore, and even if we Americans dodge the bully bullet, the rest of the world is also being challenged, and the good guys won’t win everywhere, certainly not every time.

Trumps scares me and it’s taken a lot of introspection to figure out why – it’s what he’s building off of that really scares me. He’s tapped into something for, although I don’t think he’s very smart in a traditional sense, he is a genius (not used lightly) at reading people and getting under their skin, intuiting what will anger them or put them off-balance so he has an advantage. The thing is, the people he’s appealing to are not just in the South or rural areas, or even just the US, or even the Western or developed world. There are far-right/quasi-fascist movements rising across Western and Eastern Europe, even Western Asia that share an anger, rooted in fear. And they are sharing, working together, learning and cross-training. These are movements that promise a return to greatness, incorporating a fundamental theme of palingenesis. They are organizing, recruiting, training, influencing, even winning (or almost winning, thank you Austria!) elections. Far-right leaders across Europe have reached out to or attended meetings or rallies with Trump!

It’s familiar to those of us who have studied the Right or Fascism – a focus on purity, on land, on blood, on heroes of old, on a strong leader who has the will to set things right. On rebirth, trying to recapture some idealized past when things were better and those “others” knew their place and it was at our feet or cowering in fear. When the future was exciting and not full of dread.

The thing is, it’s not just in Russia, the ‘stans, Europe, or the US. It’s ISIS. It’s the LRA. It’s Boko Haram. It’s Somalia/Kenya. It’s Y’all Queda and other resurgent secession and Confederate movements. It’s the Zetas and other drug gangs that are just as horrible as ISIS. (yes, they’re a drug gang but they are also powerful rebellions and mini chiefdoms that control large parts of Mexico’s territory) It’s a dozen more groups spread across the world. It’s happening almost everywhere, and where there’s not such a growing movement, there are established powers that are dropping their masks and embracing division and cultivating fear, selfishness, scarcity, and envy. And not being called on it like they would have been in the past. It’s like norms and expectations no longer are considered important. And it’s happening everywhere. It’s never been this way before, never so pandemic.

The Era of Migrants
Into this maelstrom of psyche and influence, a new problem has emerged. It’s here, and it won’t stop for hundreds of years – the era of mass human migration. Many point to the unprecedented drought in Syria as leading to the mass migration of the rural population to the cities, the subsequent overcrowding, scarcity of jobs, food and relief, the subsequent rebellion and fracturing of the formerly-strong Syrian state, and it did. You move lots of people and things change.

This instability, coupled with the US-caused fractures and instability in Iraq, and touched off by a millennial cult wishing for an end-times-inducing battle between the powers of the West and their holy warriors bathed in blood, has resulted in ISIS and it has spread. And so we now see millions of refugees, internal and external, and this Era is just beginning.

Germany has been at the lead in accepting their brothers and sisters in humanity, but I fear that a few more exploitations by ascendant movements in Europe coupled with inevitable ISIS attacks will result in walls and dogs and machine guns and barbed wire being first tolerated, then accepted, then embraced as these pressures transform us into something different: more reptilian, less Enlightened.

The thing is, climate migrants are not just far away. Certainly, a not-insignificant portion of Central American emigrants are seeking escape from social fractures heralding collapse of their fragile governments and systems. Just a few weeks ago, an entire city of 125,000 people evacuated due to Climate Change-caused fires in Alberta. Luckily, this was a temporary evacuation, but next time, it may be permanent.

In case you missed it, our first domestic climate migrants are escaping the rising water and sinking land. From Southern Louisiana, very poor rural refugees are being helped by a new model program that will become commonplace the rest of our lives – helping Americans, our brothers and sisters, to relocate and not be thrust into abject poverty and hopelessness.

This is good – while our issues are still small and before they grow, we’re trying to figure out how to best handle this type of situation domestically. But as evidenced by a not-insignificant portion of our governing class (ahem, Republicans) not seeing the importance of fully funding our efforts against Zika before it becomes a much bigger problem (and it will), I fear that we will not continue to develop the capacity and mechanisms to move and incorporate internal climate migrants. So when we need to relocate millions of Americans permanently, we will not be able to do it well, and we will have discord and likely pockets of rebellion and retributive violence against falsely-accused “others”. This is what animals do when under extreme environmental pressure.

When an environment changes and the stresses on a population increase, we humans move on or we fade away. That’s been our history as a species, and one of the chief reasons that we’ve been so successful on this planet the past 500,000 years or so. But in this case, we’re all on the Titanic and we’re all just re-arranging the deck chairs since there are no lifeboats. I think that at a very low, primeval level, we, as a species, know that. And so we are already well into freaking out. We just haven’t realized it yet and we don’t have the leadership and level of trust in our cultures to identify, manage, and overcome our animal nature at the worldwide scale.

So while I look around and marvel at the wonders of everything from our technology, art, science, the beauty and glory of this planet, and the wonderful, kind, silly, beautiful things billions of people do for each other every day, I am filled with optimism and joy. But no matter how much I smile and greet the day, I fear that things will quickly devolve.

The only reason we as a planet survived the Cold War was through wisdom, procedure, communication, fear, and the knowledge that one small mistake could blow everything up. I fear that because this is not as much of a conflict and certainly lacks a clear enemy and intuitive visual of the results of failure – a barren, lifeless radioactive planet -we are not going to be able to adapt well to this ever-growing pressure. Although it seems logical that if there’s a major climate-related issue before the election, the Democrat would be elected, I fear that we’re gibbering apes, and the cocky bully baboon will step into power.

Trump-Sanders Debate, Dog Help Us (Updated)

So last night on Jimmy Kimmel, Donald Trump kinda agreed to debate Bernie Sanders “for charity,” and Sanders tweeted, “Game On. I look forward to debating Donald Trump in California before the June 7th primary.” Two questions — the first rhetorical, the second sincere:

1) Is Sanders out of his fucking mind?
2) Any chance this debate actually happens?

Fox News is the network that was going to sponsor the California Clinton-Sanders debate before Clinton declined to participate, which is what frontrunners do when they develop an insurmountable lead. I’m sure Fox News would field impeccably impartial moderators with 100% fair questions that advanced no partisan agenda whatsoever. Not.

Trump left himself plenty of wiggle room in his comment to Kimmel, but if I were him, I’d damn sure try to make this thing happen – what a golden opportunity to ingratiate himself to Sanders dead-enders while bashing Clinton nonstop. It’s all upside for Trump.

Oh, and let’s pause for a moment and imagine the ear-splitting hissy fit the Sanders people would pitch if Hillary Clinton agreed to debate Trump before the primary ends. This kind of shit right here is what made me evolve from “I’m glad Sanders is in the race — he’s pulling Clinton to the left” to “STFU and go away, Bernie.”

UPDATE: From CBS: “Multiple sources told CBS News Thursday morning, however, that the presumptive nominee [Trump] was just kidding about debating Sanders — it will never happen, they said.” H/T: Commenter Mike J.

Zika Cost update

Thanks to Liz Szabo for willing to chase down a number that we needed in yesterday’s Zika post:

From the CDC on 3/10/2016:

we know the cost of caring for one infant with a birth defect can be up to $10 million or more.  Funding is crucially important and urgently needed.  The rains are coming and with the rains will come mosquito season and with mosquito season will be the risk of explosive spread of Zika as well as dengue and other Chikungunya.

That works out to be $120,000 in incremental costs assuming an 85 year lifespan. If we assume a 50 year life span, we’re looking at $200,000 per year in incremental costs.

Depending on the life span assumptions, a Zika birth defect case ranges from the equivilent of an additional Hep-C treatment year to a Cystic Fibrosis treatment year. If there are widespread but low level infections and a low probability of significant birth defects from Zika, then state budgets can handle a few more catastrophic on-going claims. If there are concentrated areas of infection with significant birth defects then state budgets will blow up.

Exchange Strategery thoughts

Exchange strategy is dynamic and I think the new round of pricing plus additional insurance company learning by doing will see some significant changes this during this Fall’s open enrollment period.

This is in reference to New York state pricing. The cost of the second lowest Silver in some regions is projected to go down dramatically from 2016 and 2017 even as the median insurer in the state is asking for an increase. This means there looks to be two clusters on the Silver Exchange market. The first cluster is Medicaid like pricing near the subsidy attachment point of the second least expensive Silver. The other cluster are plans that pay near standard commercial rates to providers and they are much more expensive. The first cluster will get most of the membership and even more of the healthy membership.

Insurance administration needs scale. As I have said before, my job when I was a plumber, was effectively membership scale invariant. A product with 300 people took me as much time to plumb as a product with 30,000 people but my costs were spread out over a much larger population. High cost insurers will be facing administrative scaling problems in markets where there is a Medicaid like provider that gets most of the healthy membership.

Risk adjustment based strategies are a plausible path forward. High cost insurers could offer disease specific plans and make their money by offering good chronic disease control while getting risk adjustment inflows from the low cost plans. The problem with this strategy is the risk adjustment inflow is calculated based on average premiums in the region. The low cost plans bring down regional average premium which means the risk adjustment transfer payment does not fully compensate the high cost plan’s provider reimbursement.

Over the long run (2018/2019), high cost insurers are likely to get off Exchange in regions where there are low cost Medicaid like insurers that get most of the membership.

The other major modification to my thought process on Exchange strategy is on the issue of spamming the exchanges with isomorphs in order to capture the #1 and #2 Silver. This is not a bad strategy but it is a suboptimal strategy.

Let’s use the Chicago zip code 60290 on Health Sherpa as an example for a 40 year old non-smoker.  Ambetter Chicago The chart to the right is the 2016 Silver prices.  As you can see, Ambetter effectively   spammed the Exchanges.  They had the low cost Silver and then another six plans before the first plan offered by another (high provider reimbursement) insurer.  This plan offering configuration means the subsidized individual who chooses the lowest cost Silver pays $3 less per month in out of pocket premiums then they would have if they chose the 2nd Silver.

Right now there is a $54 gap between the first Ambetter product and the first product offered by a competitor.  However there is only a $3 gap between the first Silver and the second Silver.

This is a business opportunity.

Ambetter can make themselves significantly better off (with the side effect of making most subsidized buyers better off) by rejiggering their product offering profile.  Offering fewer silver plans would lead to higher enrollment of healthy people who are heavily subsidized.

They continue to offer the low cost Silver plan at $195 per month and then either discontinue their other low cost Silver plans so that the second Silver  is the Blue Cross Silver plan or offer a medium cost Silver as the new second Silver priced below the Blue Cross offering.  This would increase the Silver subsidy gap bonus.  This would improve their retention of heavily subsidized, healthy members.

Right now, an individual who makes $18,000 a year pays $63 per month for the Second Silver, and they would pay $60 per month for the low cost Silver.  Under this gap maximization plan the Blue Cross Silver would be $63 per month for this individual but the low cost Silver plan would be $9 per month.  Healthy individuals with low incomes are the most likely people to drop coverage because they can’t afford it.  A premium of under $10 per month is far easier for a poor 23 year old Young Invincible to handle than a $60 per month premium.

This is an extreme example as it excludes the relative price dynamics of making the Blue Cross plan much cheaper, so the Blue Cross risk pool will get comparatively healthier as some of the sicker people who are currently in the Ambetter pool buy Blue Cross broader network coverage plans so Ambetter would have even larger risk adjustment outflows.

The highly probably strategy for companies that are very confident that they will offer the # 1 Silver with a large gap between their low price offerings and the next insurer’s lowest priced Silver is a modified plan spam approach with the aim of maximizing the gap without losing too much profitable membership. In this example, that would mean Ambetter would offer the #1 Silver at $195 per month and then the current #5  as their second, benchmark setting Silver plans at $213 per month.  This would make the gap $18 .  For an individual making $18,000 per year, the low cost Silver now costs them $45 per month while there is still a plan choice owned by Ambetter between the subsidy point and the first offering by a competitor.  This will lead to higher initial uptake of healthy, subsidized members during open enrollment as well as less attrition due to failure to pay.

Thursday Morning Open Thread: Working Hard

dave c josephine

Per commentor Dave C:

I work from home. Josephine helps!


Because I can: In the NYTImes, Elizabeth Word Gutting, “What My Mother Sees in Hillary”:

IN 1973, my mother’s first husband was killed in a car crash in downtown St. Louis. My brother, Jason, was nine months old. In swift succession, my mother lost the following things: the father of her first child; access to a credit card; her car insurance; and the ability to take out a loan. The first was terrible luck. The other things were taken from her because she was a single woman — with a son, to boot — it was the 1970s, and, as she put it, “you were not considered legitimate at that time unless you had a man in your life.”

Four decades later, my mom is looking forward to having the chance to vote, she hopes, for this country’s first female president. She and Hillary Clinton are a year apart in age. Though my mom’s experiences are so different from my own, they serve as a constant reminder to me of the work it’s taken for Mrs. Clinton to get where she is today, and the force of society’s attitudes about women, and their value, that she has been pushing against…

At a town hall a few months ago, a young man asked Mrs. Clinton why young people lacked enthusiasm for her.

She sounded a bit wounded, but she tried to explain what she’d been up against for so many years. Despite all the criticisms, she said, over the course of several decades in the public eye, all she could do was continue to stand her ground…

In the years when my mom was a single mother, people commented on her lifestyle with alarming frequency. Why wasn’t she living with her parents, they wanted to know. Wasn’t she worried that if she didn’t marry again soon, her son would grow up to be gay? Her landlord came over after her husband died, hemming and hawing, saying how sorry she was, but also that she was hoping my mom might move out to be closer to family, which would probably be better for everyone.

Well. My mother persevered. She smiled politely and bit her tongue and did what she had to do to survive those rough years…

Late Night B-Movie Open Thread: Giant Albino Amphibian vs. Zombie-Eyed Grannie Starver

Jim Newell, at Slate, on “the perfect running mate for Donald Trump”:

… Gingrich, in his trademark way of exuding unsubtlety in the execution of what he believes to be a stealth operation, is angling for the vice presidency even more aggressively than Trump is angling for the presidency. When Gingrich responded to a question about the inexperience of Trump’s foreign policy advisers by instructing Slate’s Isaac Chotiner to read both The Art of the Deal and The Art of the Comeback, such a shameless non sequitur could only be read as that day’s canned talking point in his campaign for the vice presidency. Gingrich was among the earliest bold-name political figures to liaise between Trump and official Republican Washington. Like Chris Christie, Gingrich may have realized that taking the plunge early with the party’s incoming standard-bearer was the best way to position himself for a sweet gig down the road—and perhaps persuade Trump to help retire lingering campaign debt.

Trump basks in what normals might consider uncomfortable levels of flattery, and so, by several accounts—including Trump’s own mouth—Gingrich has successfully implanted himself on his new master’s veep shortlist. Though Gingrich has said Trump would need “psychiatric help” if the presumptive nominee were to select him as his running mate, he definitely will not rule himself out. The former speaker of the House is now a ubiquitous force in the Trump effort, selling him in the media and advising him on policy and politics…

For all of his put-on suck-uppery, Gingrich is one of the few people on Earth who can understand what it’s like to be in Trump’s shoes. Gingrich, over a more gradual period of time and climaxing in the 1994 elections, blew up an existing political era—that of the Democrats’ supposedly permanent House majority. He knows what it is to have the world looking in horror at you for shattering their reality, much as they’re looking at Trump now. He can brief Trump about how to weather this and, should Gingrich cave to the sort of introspection that neither he nor his tutee are known for but which may exist somewhere deep inside, teach him from his own mistakes….

I’m old enough to remember The Rain Reign of Speaker Newt, and this is good news for Democrats. The Newt’s thin skin and enormous ego are indeed very reminiscent of a certain short-fingered vulgarian, and Gingrich’s inability to keep his eye on the prize (or his pecker in his pants) were largely responsible for the implosion of the GOP’s ‘new permanent majority’ twenty years ago. Putting him under the lights with Deadbeat Donald over the next five months would mean taking bets on which of the two would throw a total pants-soiling hissy-fit first… and whether it would be directed at the other half of the ticket. Read more

Open Thread: Staffing Up the DNC Party Platform

We are serious people here, or at least serious political junkies, so it’s probably worth discussing the latest news about picking the Democratic party platform committee. (The rights to which are either “fools gold” if you believe Ed Kilgore, or “how Hillary and Bernie will make peace” if you listen to Jim Newell.) Here’s Politico‘s report:

While DNC rules allow the chair to pick all 15 members of the national convention drafting committee, the organization struck a deal with the two campaigns so that Hillary Clinton will pick six members, Sanders will pick five, and DNC Chairwoman Debbie Wasserman Schultz will appoint four, party officials confirmed…

Consultations between the DNC and the two campaigns were finalized last week and Wasserman Schultz began calling appointees over the weekend, a Democratic party official with knowledge of the process told POLITICO. The appointments to the drafting committee are being made from lists of about a dozen suggested by each campaign.

Rep. Elijah Cummings will serve as chairman of the committee and Andrew Grossman, former director of the Democratic Senatorial Campaign Committee, will serve as platform executive director, the convention committee said Monday.

Sanders’ picks for the committee were: Arab-American Institute President James Zogby; Cornel West; Minnesota Rep. Keith Ellison; Deborah Parker, an activist on Native American rights; and Bill McKibben, an activist on environmental issues…

Clinton named Center for American Progress president Neera Tanden, former State Department official Wendy Sherman, Rep. Luis Gutierrez, former White House Energy and Climate Change Policy director Carol Browner, Ohio state Rep. Alicia Reece, and the American Federation of State, County, and Municipal Employees union’s Paul Booth.

The committee also includes two non-voting members, one from each campaign. The Sanders team picked policy adviser Warren Gunnels alongside Maya Harris, who serves as senior policy adviser for Clinton.

Most of the discussion I’ve seen on my center-leftish rounds has concerned Cornel West, who is not one of President Obama’s biggest fans. (I think Rep. Cummings has more than enough experience with angry agitators to handle Dr. West.) It’s certainly an interesting and diverse bunch — a good showcase for both small- and big-D Democratic values.

Your thoughts?

Liking Their Way to Victory

I thought this was a parody at first, but now I think it’s actually real. (This election season has Poe’d even seasoned cynics):

like for victory

Found it by following a link from a post at Booman’s joint about the upcoming March on the DNC, which is totally gonna happen, y’all.

Any thoughts on how much that kind of crap might help the Orcs capture the White House? My guess is that it will be a fart in a whirlwind like the PUMA phenomenon. Just wait until President Obama weighs in…

Open thread!

Wednesday Evening Open Thread: Hostile (to Reality) Takeover

It’d be funnier if Deadbeat Donald didn’t have a minimum 40% (very) base vote for the taking…

Psychological research suggests that people, in general, suffer from what has become known as the Dunning-Kruger Effect. They have little insight about the cracks and holes in their expertise. In studies in my research lab, people with severe gaps in knowledge and expertise typically fail to recognize how little they know and how badly they perform. To sum it up, the knowledge and intelligence that are required to be good at a task are often the same qualities needed to recognize that one is not good at that task—and if one lacks such knowledge and intelligence, one remains ignorant that one is not good at that task. This includes political judgment…

This syndrome may well be the key to the Trump voter—and perhaps even to the man himself. Trump has served up numerous illustrative examples of the effect as he continues his confident audition to be leader of the free world even as he seems to lack crucial information about the job. In a December debate he appeared ignorant of what the nuclear triad is. Elsewhere, he has mused that Japan and South Korea should develop their own nuclear weapons—casually reversing decades of U.S. foreign policy.

Many commentators have pointed to these confident missteps as products of Trump’s alleged narcissism and egotism. My take would be that it’s the other way around. Not seeing the mistakes for what they are allows any potential narcissism and egotism to expand unchecked…

Apart from acknowledging that too many of our fellow citizens think Idiocracy was a documentary (or an instruction manual), what’s on the agenda for the evening?

The Ad That Will Win the Election

I can see it now:  Testimony of parents who have contracted Zika virus and given birth to babies with microcephaly, overlaid with comments by Republican Members of Congress, explaining why they delayed the vote on Zika funding by 3 months, and underfunded it by 1/3.

Isn’t this the Daisy ad of this election, or am I missing something?

Some Mostly Stolen Thoughts On That Old Politics Vs. Revolution Thang

So this morning I’m reading a diary on the Great Orange Satan about political doings over in Bagdad By The Bay.  Though I grew up in the San Francisco area, I’m not really current on what’s happening, aside from the fact that I couldn’t afford a shack in SF itself anymore — notamidst all those Twitter-, Apple-, and Google-erati.  So I gobble down the story, assume/accept the big-city, big-money corruption narrative, and move on.


I do have friends and relatives back by the Bay, as it turns out, and one of them has worked in city government for a long time.


He’s got first hand knowledge of San Francisco’s allegedly lost progressive mindset as it works within local government, and he weighed in.

I’ll excerpt his comment below, but first I just want to say this was an object lesson for me, a reminder of how easy it is trip up in the way that I’ve criticized some of the most extreme of the Bernie camp for doing.

That is: there’s a ton wrong with our politics, our society, and our engagement with each other.  It’s so tempting to leap from a clear problem — the impact on middle and low income residents of the gentrification of San Francisco (and elsewhere!) driven by extreme income inequality — and assume that political actors are obviously complicit.

The reality?  Sometimes they are, sometimes they aren’t, and it takes some effort to figure out the five Ws and the H in each case.  Worse yet — if the problem is truly complex, then political action is at best an incomplete tool to deal with the issue.

Which is why, in the end, I think Obama is a truly great president: he gets all of that.  The need for policy and politics; the insufficiency of politics on its own; the agonizing difficulty of addressing any truly major problem — which translates into rage-inducing slowness to see the change take shape; and the need to keep plugging away.

I feel that rage often enough, and I know that I don’t have the qualities of character our president does, the off-the-charts focus and persistence required to make sh*t happen, and to wait — years if necessary, decades — to see the results.

I have high hopes for Hillary on this score.  Not that I’ll agree with her on everything — I don’t and won’t, just as I haven’t always with Barack Hussein Obama.  But I trust her (yes, that word) to pay attention, to know her stuff, to hire good, smart folks, and to soldier on and on and on — as the job and the world requires.

Here the sermon endeth…and an excerpt from my old Bay Area companion’s comment takes over:

I’ve worked on the financial administration side for the City of San Francisco for many years, and the truth is that under successive mayors and Boards, San Francisco has put more money behind progressive goals than almost any other city in the country.

The City spends billions of dollars a year on its amazing public health programs, including a universal health access program for City residents that predates and goes well beyond Obamacare, and many hundreds of millions of dollars on programs to help the poor and homeless, including thousands of units of housing for the poorest of the poor and people with severe mental illness and other health problems.  The City spends hundreds of millions a year subsidizing its transit system and setting aside funds for children.  The City spends hundreds of millions a year subsidizing its transit system and setting aside funds for children. 

Mayor Lee …supported not just measures to attract and keep higher-paying tech jobs but also continued one of the largest and best City subsidized jobs programs in the country…

These are great progressive achievements….

You can read more at the link. The writer goes on to acknowledge that despite all this, the reality is that San Francisco’s housing costs put enormous stress on too many, and argues that the drivers of that are at best barely subject to direct political control — and that policy responses offer very tricky alternatives.  The challenge for progressives, among whom he numbers himself is thus to..

examine what housing policies we should we be pushing for that can help the most people of different income levels that need housing (not just the poorest of the poor).

TL:DR:  electioneering — and definitely punditizing —  is easy.  Governating is damn hard, which is something to be mindful of at this and every season.

Over to y’all.

Image:  J. W. M. Turner, Dido Building Carthage, 1815.

“Small, Insecure Money-Grubber”

Senator Elizabeth Warren takes a break from skewering Donald Trump on Twitter to eviscerate him in long form via a speech yesterday:

Words like “small” and “insecure” get under Trump’s skin because they contradict the grandiose image of himself Trump markets so industriously. But I like what Warren has done with “money-grubber” angle here to frame Trump’s conduct as a vulture real estate developer eager to pick clean the bones of regular folks who lost their homes.

Trump has carefully crafted a brand as a fabulously wealthy, self-made winner, and Warren paints him as a rich man’s heir who grew up to be a twisted greedhead like Mr. Potter from “It’s a Wonderful Life.” It’s a brilliant way to turn an opponent’s strength into a weakness, and I hope Senator Warren keeps it up from now to November.

[H/T: TPM]

Peter Thiel Makes The Case For Confiscatory Taxation On Billionaires

This broke over at Forbes and is bouncing around the ‘nets today:

Peter Thiel, a PayPal cofounder and one of the earliest backers of Facebook FB +0.49%, has been secretly covering the expenses for Hulk Hogan’s lawsuits against online news organization Gawker Media. According to people familiar with the situation who agreed to speak on condition of anonymity, Thiel, a cofounder and partner at Founders Fund, has played a lead role in bankrolling the cases Terry Bollea, a.k.a. Hogan, brought against New York-based Gawker. Hogan is being represented by Charles Harder, a prominent Los Angeles-based lawyer.

Whatever you think of Gawker, Hulk Hogan, or Thiel himself, this is yet one more way in which extreme income inequality destroys civic life. It’s actually worse than many, given the clandestine way it deepens the corruption of the system that could (in theory) provide a check on the damage that purchased legislative and executive branches can do.


Here’s a take on the poison here revealed from Caterina Fake:

Champerty, as third-party litigation funding used to be called (and should probably be called again!) was formerly a crime, but the commercial litigation finance industry has been growing in recent years.

Fake notes that much of such litigation is actually a form of speculation, in which rich folks gamble on the possibility of significant payout.  One can imagine the “free market” argument that such funding levels the playing field, allows those who’ve suffered real harm to recoup, and thus makes the legal system a more efficient and effective dispute-settling and behavior-changing engine. But Thiel’s pursuit of Gawker illuminates what this leads to in the real world:

Generally, people avoid frivolous lawsuits because it often exposes them to as much scrutiny as those they sue, so what is significant about this case is that by funding Hogan behind the scenes, Thiel could get his revenge, escape exposure, and influence the outcome of the case.

For the very rich, this is a win however it goes, and damn the collateral damage.

Hogan’s lawyers made decisions against Hogan’s best interests, withdrawing a claim that would have required Gawker’s insurance company to pay damages rather than the company itself–a move that made Nick Denton, Gawker Media’s founder and CEO, suspect that a Silicon Valley millionaire was behind the suit.

I leave it to the actual lawyers to weigh in on the ethics (and consequences, if any) for such a litigation approach. For myself, I’ll note that what you have here is an insanely rich guy gaming the legal system to destroy a media outfit that pissed him off.

And with that, one more thought:  Franklin Roosevelt created the social welfare state in the US as an alternative to revolution.  Today’s plutocrats might want to think about that.  In plainer terms: to remain democracies, modern democractic states need to tax polity-buying wealth out of individual hands; income taxes and a levy on inheritances.  A 90% rate that kicks in well below an estate value of a billion bucks seems a good place to start.

A blogger can dream…

Image: Cornelius Bos, Lazarus in Heaven and the Rich Man in Hell, 1547.

Zika and Medicaid

I want to focus on the probable consequences of a potential Zika outbreak on Medicaid as a continuation of the discussion that Anne started last night.

Zika could be a significant push to rejigger parts of the Legacy medicaid system away from state based funding to a national reinsurance model because of who has high cost persistent conditions, where Zika infections are more likely to be concentrated and who pays for a significant number of births.

Medicaid is a significant payer for maternity, labor and delivery care in the United States.  In 2010, Medicaid paid for 44% of the births in the country.  These births are paid for via Legacy Medicaid where the states are paying between 30% and 50% of the total cost of the service.  The Southern and Southwestern states are more likely to have higher than national average percentage of births paid for by Medicaid than cooler climate states.  This means that all else being equal, the impact of Zika will be borne by more Southern and Southwestern states than states that fought for the Union or in the Mountain West.

Southern states tend to have far skimpier Medicaid plans and more importantly, they are generally poorer with less public health capacity and less economic ability to absorb significant economic and medical shocks.

The most notable impact of Zika is microcephaly.  Children born with too small heads are extreme medical risks.  These children will have lifelong medical costs for additional surgeries, drugs, treatments and rehabilitation therarpy compared to kids.  Having a child with life long medical needs is a significant constraint on earnings for parents and caregivers.  I would project that Medicaid and CHIP will cover a disproportionate share of children who have Zika related birth defects.

So we would have very expensive cases concentrated on publicly provided insurance rolls in states that stingily fund their safety net.  A state that has several hundred covered lives with Zika related birth defects on their Legacy Medicaid plans will be in significant financial trouble.  They either can’t or won’t raise taxes enough to cover the cost of catastrophic illnesses that are outside the normal variance.

There is a viable policy tweak.  It would require Congressional action.  Zika related birth defects would be carved out as  as a separate eligibility category with a distinct federal funding stream.  We already do this with end state renal disease (dialysis) and three years of immunosuppressent payments for transplants.  People who have those diseases and conditions are enrolled into  Medicare and Medicare pays for them as either the primary public insurer or as a secondary insurer for people with private insurance.  Carving out Zika would be fairly straightforward and it distributes the risk nationally.  Alaska and Montana would pay their share for public health.

The other alternative would be to have Medicaid pay kick payments to the states on a capitation basis for individuals with Zika related birth defects.  The kick payment would act to bring the total cost of treatment onto the Federal books instead of the state’s books.  This would be a narrower intervention  as it would only nationalize Zika treatment costs for individuals on Medicaid.