Come for the politics, stay for the snark.
well here's your quote for the day http://t.co/vdCOQ7eqKC pic.twitter.com/l0CK0vkslS
— Simon Maloy (@SimonMaloy) October 7, 2014
.
Title of the Times article (in case you had any doubt): “GOP Candidates May Benefit From Supreme Court’s Gay Marriage Decision“. Heads Repubs win, tails Dems lose!
Apart from Predictable Politicos Being Predictable, what’s on the agenda for the evening?
Tuesday Evening Open Thread: Profiles in CouragePost + Comments (131)
(via Gawker)
Per the Washington Post, the Dallas County prosecutor is considering criminal charges against Thomas Duncan:
… “We are looking at whether he intentionally and knowingly exposed the public to the virus,” said Debbie Denmon, a spokesperson for the Dallas County prosecutor’s office…
Denmon said the prosecutor’s office is debating whether to file aggravated assault charges against Duncan.
The case would be similar to other cases in which defendants have knowingly infected people with the HIV virus, she said.
“If he ends up being on his deathbed, it would be inhumane to file charges,” she said. “It’s a delicate situation.”
Denmon said the county prosecutor’s office received several complaints from citizens last week about the case…
Why is it I suspect that “Dallas county prosecutor” is an elective office?
Meanwhile, Charles D. Ellison at The Root wonders “Where Ebola Meets Concerns Over Race, Class and the Uninsured“:
… Some observers and public health experts are beginning to wonder if there’s an elephant in the room that no one wants to talk about: race and the politics of health insurance. Texas Health Presbyterian Hospital Dallas, the private medical campus where Thomas Eric Duncan is currently under care and isolation, still can’t explain exactly how medical staff let the 42-year-old Liberian national go home with useless antibiotics. Hospital officials have only said that Duncan’s travel history wasn’t “communicated,” and now mainstream media reports are stuck on everything from malfunctions in Presbyterian Hospital’s electronic record system to Duncan being dishonest about the level of his Ebola exposure when he left Liberia.
But few want to touch the pointy eggshells of race and class in the frantic discussion over Ebola as it enters the United States. Did Duncan get initially turned away because he is black and, possibly, uninsured?…
Former District of Columbia Chief Medical Officer Dr. Ivan Walks, who led the response against Washington, D.C.’s first bioterrorism attack, believes it’s a question we need to start asking. “I was stunned,” Walks tells The Root. “You could put [Duncan’s] picture in the dictionary under what you look for when responding to Ebola. How do you miss that guy?”…
EMTALA—or what Walks jokes is called the “wallet biopsy”—is the 1986 federal law that requires doctors, in any location, to provide immediate care regardless of insurance status for an “emergency medical condition.”
Still, as Patel notes, the burden of proof is on the hospital. If the patient, like Duncan, isn’t exhibiting any severe, life-threatening signs, then doctors can simply circumvent EMTALA and discharge the patient…
On the reassuring side of the equation, Atul Gawande tells the New Yorker that “The Ebola Epidemic Is Stoppable“:
… It is worth repeating what experience with twenty Ebola outbreaks over the past four decades has established. The disease has many features in our favor. Unusually, it does not make people contagious until they are actually noticeably sick, which makes screening far more effective than for other diseases. It cannot spread through the air or just by being near someone. It is spread through contact with a symptomatic person’s bodily fluids—saliva, vomit, stool, urine, even sweat. It is much harder to spread than a cold. That’s why it is primarily those who take care of the sick—health-care workers and family members—who contract the disease. Even then, it is relatively difficult to pick up.
In a 1996 case in South Africa, a patient spent twelve days in a high-level hospital sick with an illness that wasn’t recognized as Ebola until after he was discharged. Some three hundred health-care workers took care of him. None contracted the disease. A 1995 study of a Congo outbreak looked at seventy-eight household members who lived with patients with Ebola who did not directly touch them or their fluids after they became sick. Again, none contracted the disease…
Perhaps Ebola Is Also A “Social” DiseasePost + Comments (165)
I’ve got nothing but inchoate rage and depression that can best be expressed as blaaaarrrgh!!!! — and who wants to talk about that? No one, especially me. So let’s look at these lemurs licking lollipops instead:
My god, are those lemurs cute! Open thread.
[H/T: Salon for the licking lemurs]These days, even if you’re racist, most people generally know to try and keep that to yourself. Not so much with people’s ire for Muslims. On Friday’s Real Time with Bill Maher, Ben Affleck, of all people, set the record straight when he felt that Bill Maher and author Sam Harris were being “gross” and “racist” in their generalizations:
Affleck reacted furiously to claims by Maher that Islam manifested as “the only religion that acts like the mafia” and which would “fucking kill you if you say the wrong thing, draw the wrong picture or write the wrong book”.
“Hold on — are you the person who officially understands the codified doctrine of Islam? It’s gross and racist. It’s like saying, ‘Oh, you shifty Jew!’ Your argument is, ‘You know, black people, they shoot each other.’” Affleck added: “How about more than a billion people who aren’t fanatical, who don’t punch women, who just want to go to school, have some sandwiches, pray five times a day, and don’t do any of the things you’re saying of all Muslims. It’s stereotyping.”
How about them apples.
Team Blackness also discussed the white lesbian couple crying over a biracial baby, new strides in marriage equality, and Thug Kitchen.
Subscribe on iTunes | Subscribe On Stitcher | Direct Download | RSS
Sally Pipes at Forbes is spewing fear, uncertainty and doubt at Forbes magazine on Obamacare again. Her ‘argument’ this time is that Obamacare is bad for wage earners and she commits the usual sins of trusting Avik Roy and his ilk to be good faith brokers of non-bullshit, but then she tries to slide one hell of a doozy by that flies in the face of any economic modeling or theory that I can think of:
Killing jobs and reducing pay is bad enough. But another report, from the American Health Policy Institute, finds that Obamacare will also shrink the labor force by reducing incentives to work.
In other words, workers are going to get squeezed from both sides. There will be less demand for them even as Obamacare makes it less financially appealing to have a job.
This is a reprisal of the CBO report from last winter that wingnuts used to claim that Obamacare would cause 2 million job losses. In actuality, what the CBO reported was that people would voluntarily remove themselves from the labor force because they did not need to work just for healthcare, and if healthcare was disconnected from employment, they had much better things to do with their time.
These are the types of decisions the CBO project will occur for millions of Americans over the next decade. Some people will opt out of the labor force because they are not tied to their health insurance any more and they have better things to do with their time and money then work. Some people will not enter the labor force because they no longer have to work for insurance. Some people will voluntarily work part time because insurance is no longer just available to full timers. The summations of all of these projected decisions is two million or more people deciding to get ouf of the labor pool over the next decade.
More importantly, let’s go back to simple supply and demand for labor. If in the base case the labor pool is at a certain level, then the labor market (assuming non-zero-bound conditions) clears at a certain set of wages. If two million people leave the labor pool because they have better things to with their time than hang onto health insurance, what happens to the labor market, all else being equal?
The labor pool gets smaller, the competition for fewer workers gets slightly more intense and better offers have to be made to keep and get good workers. The really simple story is that total employment compensation package will rise. Most likely this means more cash in my pocket every two weeks. If we make it a more complex story and project that Obamacare does a decent job of holding down the rate of medical cost inflation, the story gets even better as the proportion of compensation that goes to health insurance stabilizes or declines which means more people start seeing cash raises. But even with the simpler story, a smaller workforce, all else being equal, is a good thing for the remaining workers.
Now, it is not as good of thing for business owners and Forbes magazine readers but fuck them, as Ms. Pipes is the asshole of the week for spreading illogical FUD.
Jeff Clemans is posting a very interesting set of posts on the argument that Medicaid expansion lowers the premiums for the Exchange population. The mechanism is simple; Medicaid acts as a quasi-high risk pool and vaccuums up a disproportionate number of high cost individuals. That creates a high cost Medicaid pool, and a healthy, low cost Exchange pool. However there is one line that I think needs further explanation.
Under national health reform, community rating regulations apply to purchases made on state exchanges by both individual consumers and small employers. In 2011, the health care costs of individuals getting insurance in these ways averaged $4,300 (with lower costs for the healthiest among them). By contrast, health care costs for nonelderly adults on Medicaid averaged $8,300 (even though Medicaid pays low rates to hospitals and physicians).
Non-elderly adults who are on Medicaid in 2011 fall into a couple of general populations for most states. The first population is expectant mothers, the second is chronic disease sufferers and the last group may be people who are just extremely poor (where extreme poverty is heavily correlated with poor health as there are no good choices available). Babies are absolutely adorable, but they like to put merconium meconium on the financial statements of states and insurers. An uncomplicated pregancy with a simple vaginal delivery will cost Medicaid $8,000 to $12,000; a high risk pregnancy could run ~$100,000 to $300,000 for a prolonged NICU stay. Chronic conditions mean frequent contact with providers and heavy prescription usage.
The key here is to understand case mix comparisons. A risk pool of 500 pregnant women, 100 diabetics, 75 hypertsensive, 25 traumatic brain injuries and 200 people in reaosnably decent health but are dirt poor and 100 random chronic conditions is far more medically needy than a random sample of 1,000 people who have employer sponsored group health insurance.
Just on the basis that Medicaid pays much lower reimbursement to provders for physical health services than commercial insurers, an equalized case mix comparison of Medicaid and commercial populations would show that Medicaid is much cheaper. I know that Jeff knows that, but this is a distinction we need to make in analyzing claims.
.
At a time where everything seems to have fallen into the hands of idiots, crooks, and crooked idiots, I give thanks for Mr. Charles P. Pierce and his pigbladdering of the latest Politico “competence” blather:
… Given the choice between “competence” and a guy who promises to protect them from the scary monsters of his own shrewd creation, “the American people” will choose the latter every time. (And, if the rhetoric surrounding recent events here and abroad is any indication, 2016 is going to be a fertile year for the mongering of unmoored terror.) However, Tiger Beat on the Potomac declines to address this salient concern, the better to send that Competence Gap notion aloft on great gusts of unmitigated hot air. Moreover — and, geez, it gets boring typing this over and over again — the problem with Washington is not “dysfunction.” It is vandalism. It is not incompetence. It is the deliberate sabotage of the institutions of government by one half of the American political system….
Do I care what Mark McKinnon thinks about “competence” in the presidency, McKinnon having helped foist C-Plus Augustus on us, a man who has to dial 1 and an area code to reach “ignorant”?
Nope. I don’t…
Republican operatives and fundraisers believe the new environment would help former Florida Gov. Jeb Bush and governors like Scott Walker of Wisconsin, John Kasich of Ohio, or Mike Pence of Indiana if they get into the race – and even Chris Christie of New Jersey or Rick Perry of Texas, despite their recent troubles.
So, to get us across Competence Gap, and because I am not wise in the ways of swallows, not being a king or anything, we have the Terri Schiavo Meddler With The Cursed Surname, The Endlessly Investigated Goggle-Eyed Homunculus Who Promised 250,000 New Jobs And Fell Miserably Short, The Formerly Youthful Phenom Who Got His Ass Kicked Around The Block In Ohio, A Human Fencepost, Another Endlessly Investigated Guy Who Took Firemen’s Pensions And Handed Them Over To Pirates, and An Actually Indicted Guy. If it’s all the same, I’ll stay off the bridge and take the long way around, thanks…
***********
Apart from taking one’s pleasures where one finds them, what’s on the agenda for the day?
Tuesday Morning Open Thread: The RebrandingPost + Comments (93)