Come for the politics, stay for the snark.

Why is it so hard for them to condemn hate?

When your entire life is steeped in white supremacy, equality feels like discrimination.

Also, are you sure you want people to rate your comments?

But frankly mr. cole, I’ll be happier when you get back to telling us to go fuck ourselves.

You cannot shame the shameless.

If a good thing happens for a bad reason, it’s still a good thing.

Trump’s cabinet: like a magic 8 ball that only gives wrong answers.

This chaos was totally avoidable.

It’s always darkest before the other shoe drops.

People are complicated. Love is not.

Just because you believe it, that does not make it true.

Since we are repeating ourselves, let me just say fuck that.

Most of you should go to bed and try to be better Jackals in the morning.

We will not go back.

The line between political reporting and fan fiction continues to blur.

Technically true, but collectively nonsense

Peak wingnut was a lie.

Humiliatingly small and eclipsed by the derision of millions.

Jack Smith: “Why did you start campaigning in the middle of my investigation?!”

There are consequences to being an arrogant, sullen prick.

You are either for trump or for democracy. Pick one.

Wake up. Grow up. Get in the fight.

Consistently wrong since 2002

With all due respect and assumptions of good faith, please fuck off into the sun.

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Keeping it like the Kaiser

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There have been a flurry of articles in the past months about more hospitals becoming insurers and more insurers also becoming providers.  In most of the articles, there is a comment that these hospitals are trying to become fully integrated payer-providers just like Kaiser.  No they are not.  The payer provider model has been around US healthcare for a very long time, but the Kaiser twist on it is very wierd and as far as I know, no one else does it quite like Kaiser.

Kaiser is a fully integrated payer provider with exclusive usage.  What does that mouthful mean?  It means Kaiser owns its own hospitals, owns its own labs, owns it own rehab places, and 99% of the doctors that its members see will be employed and receiving a salary from Kaiser.   It also has an insurance arm.   This part is not too unusual.  Geissenger in  Pennsylvania is  like that.  Steward in Massachusetts is like that.   Medstar in Washington/Baltimore is like that.  Sutter Health in Northern California is becoming an integrated payer-provider.  This part of the model is fairly common, and it is becoming even more common as the large hospital groups which are particpating in ACO experiments realize that they need the claims and predictive modeling capacity of an insurance company, so selling insurance is a short leap.

However, the unusual part of the Kaiser model is the exclusivity.  Kaiser only allows its insured members to use its facilities and doctors for non-emergency care.  If there was a major crisis, Kaiser would open its doors to a trauma stream but on a day to day basis if you are not insured by Kaiser and you need an ACL repair, you are not allowed into the Kaiser hospital four blocks from your house.  If you have a heart attack, the ambulance will drop you off at the Kaiser facility four blocks from your house and Kaiser will stabilize you to the point where you are capable of transport and then ship you out.  This part is extremely unusual.

Medstar in Washington D.C. owns Georgetown University hospital.  GUH would go bankrupt if it only treated Medstar patients, so GUH takes Medstar insurance plus most if not all of the other major carriers who have a presence within 100 miles of Washington D.C.   Vivity in Southern California has several world class medical centers. None of those centers could survive on the projected Vivity membership census. So Vivity member hospitals will take anyone who can pay.  Geissenger hospitals will accept other major carriers  as well.  These organizations, and almost all other non-governmental payer-providers are not exclusive walled gardens that systemtically seek to minimize interaction with the entire US healthcare delivery ecosystem.

Kaiser is different.

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Tuesday Morning Open Thread: I {Heart} My Senior Senator

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We live in cynical times. At BloombergPolitics, Annie Linskey asks “What Exactly Is Elizabeth Warren Going For?“:

… She has said she’s not running for president and disavowed a super-PAC formed to push her candidacy. And yet the former Harvard Law School professor is traveling a path familiar to presidential candidates, drawing crowds that would make some potential Democratic rivals jealous. With one week’s notice, hundreds of supporters shouldered their way into her Iowa events. Once again, a first-term senator who doesn’t look like the typical U.S. president is basking in the adulation of a eager Democratic crowd. …

In just the past 72 hours, Warren has headlined rallies for Democrats in Colorado and Minnesota, in addition to Iowa. This year, she’s campaigned in 15 states, including Ohio, New Mexico, Kentucky, Oregon, West Virginia, Wisconsin, Michigan and her home state of Massachusetts. That makes her one of the most-requested campaign surrogates this year, said Justin Barasky, a spokesman for the Democratic Senatorial Campaign Committee. “She’s incredibly popular,” he said.

She’s also opening her campaign wallet, giving money from her political action committee, PAC For a Level Playing Field, to 26 of the 36 Democrats running for the Senate this year, including the maximum $10,000 donation to 19 of them. Her PAC ranks as the fifth most generous to Democratic candidates among senators, according to the Center for Responsive Politics. Her political operation churns out a steady stream of fundraising emails–one says she has raised $6 million for candidates this cycle.

Why all the work if she has no ambitions for the White House?

The explanation, according to people who have followed her closely, is that she’s not building a presidential campaign. She’s following Obama’s lead, with a slight twist, by trying to build a movement that could redefine the party and later lead to a future White House candidacy…

Warren’s broader message for overhauling the way Washington works hasn’t changed much since her 2012 campaign to unseat Republican Senator Scott Brown. “This is not only an election,” she told a group of supporters back then. “We’ve got to make the wind blow in the right direction.” There’s some evidence the movement-building is working—even in “deep maroon” South Dakota, where Democratic candidate Rick Weiland has campaigned on Warren’s efforts to reduce interest rates on student loans…

When Warren finished in Iowa City, she and Braley rushed to their next event, another rally 120 miles west to Des Moines. They drove two hours through golden brown cornfields and arrived in another ballroom jammed with pro-Warren activists. “I am so glad to be here today,” she began. What came next—about her parents, her brothers—was not going to make news to the reporters following her for the past couple of years. But it just might make a movement.

A movement which does not necessarily end with the words … now elect me your God-King President. It’s not required that every politician looking to support their agenda must make a move on the Oval Office — it might very well be a distraction from Warren’s focus on leveling the financial playing field. Right now, she’s giving the best kind of support to other Democrats who need it badly, and that’s more than good enough.
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Apart from Our Failed Media Experiment, what’s on the agenda for the day?

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By Request

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I chatted with the MARC folks, and boy have they been busy. I’ll post a big update tomorrow.

You all were asking for Tunch pics, so I found one of my favorites: tunch

I loved him so much and still do. Makes me laugh every time I think about him.

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Ebola, Labwork, and Microbiology

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Regular commentor LAMH36 has volunteered to help us out:

So, with all this talk of Ebola and health care workers, of which I have been one for the past 10+ years, I would be willing to answer serious questions from commenters in the comments section to the best of my knowledge as an active Microbiology Medical Laboratory Scientist.

So, what many already know, I’m originally from New Orleans, so I began my career working in the state run public health laboratory. My primary work at the public health lab was in Bacteriology, including work involving many of the Bioterrorism organism most people know and some they don’t, but also regular old outbreak-y bugs like Salmomella, E.coli, Pertussis, etc.

Thanks to Katrina I evacuated to DFW and I ended up living and working there for 7 years. I worked for 6 years at a large public teaching hospital in Microbiology and 2 years (one of which concurrently) at a small private hospital that I believe I’ve mentioned is a sister hospital to Presby Dallas.

After close to 8 years I finally made it home back to NOLA, or rather to Baton Rouge, where I worked at a large private Catholic hospital, until this past February when I was finally able to make my way back to New Orleans where I now work at another large public teaching hospital which is soon to be to part of an even larger for property entity, yet still “public” here in NOLA.

All of my experience is in Microbiology with a little bit of Biological research thrown in and some other colorful careers from my college years.

I figured when you have experienced knowledge about some subject, it always better to help spread factual information rather than allow misinformation to become embedded in the psyche.

Any questions I cannot answer or that is outside my purview of knowledge, I can ask some of my other friends who are currently working in the hospital laboratory, CDC and beyond.

Any questions?

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Monday Evening Open Thread: Thought for the Evening

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And if anyone’s prepared to give us some nice, well-polished superficial…

Apart from profundicity, what’s on the agenda for the evening?

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Ray Rice Is Not the Issue

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The issue is the culture of covering up partner abuse in the NFL:

Smith-Williams says she has talked about this phenomenon with dozens of football wives and girlfriends over the years, all of whom echo her feeling of powerlessness when law-enforcement, NFL, and NFLPA officials all failed to intervene against signs of domestic-abuse. The women, she says, eventually come to believe there’s nothing they can do fix the problem, so they focus on living with it. “I had friends who had black eyes. They said they ran into cupboards. There were women who said their husbands ran them over like they were on a football field,” Smith-Williams recalls. “There are many other families’ experiences that have already been minimized, ignored, or overlooked by the law and by the NFL because of the protection of the NFL brand.”

Among them was the then-wife of another New Orleans Saints player — the one who asked not to be named because her now ex-husband is still associated with the league. She recalls that one night, when several players were at a bar celebrating their first win of the season during the 1990s, her husband became enraged at her request to go home early. He grabbed her arm roughly and dragged her to their SUV while a teammate convinced two police officers who’d been patrolling nearby not to intervene.

The abuse intensified once they got home, where her husband dragged her into their apartment by her hair and then beat her, she says.

He pushed me to the top of the stairs and shoved me over to the bed. When I stood up, he punched me, and the next thing I remember is coming to on the floor. I remember pulling my legs up to the fetal position to protect myself from his kick after kick. I was vomiting and gasping for air and remember screaming, ‘You are going to kill me!’

Her black eyes lasted for four weeks, she says.

Neighbors who saw the altercation begin outside their home had called the police. But when they arrived, instead of arresting her husband, the officers chatted and laughed with him about his successful game, she says. One requested an autograph for his kid. When her husband cleaned the blood from her face and ushered her downstairs to assure the police officers all was well in the home, they overlooked any evidence of abuse, she says, and as far as she knows they never filed a police report.

Read the whole thing. It’s awful. If the NFL and the Players’ Association cared about the wives and girlfriends of players, they’d be working to have advocates for wives and girlfriends’ who are victims of partner violence, to have safe places for those women and their children, and to structure contracts so that penalties for partner abuse don’t destroy the future of the player’s family along with the player’s career, to name three obvious things. I’m sure there are many others. Instead, Roger Fucking Goodell is still head of the NFL and Ray Rice is going to be reinstated.

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