Come for the politics, stay for the snark.

If you thought you’d already seen people saying the stupidest things possible on the internet, prepare yourselves.

Is trump is trying to break black America over his knee? signs point to ‘yes’.

America is going up in flames. The NYTimes fawns over MAGA celebrities. No longer a real newspaper.

Well, whatever it is, it’s better than being a Republican.

So many bastards, so little time.

If you still can’t see these things even now, maybe politics isn’t your forte and you should stop writing about it.

There are times when telling just part of the truth is effectively a lie.

It is possible to do the right thing without the promise of a cookie.

… pundit janitors mopping up after the gop

There are a lot more evil idiots than evil geniuses.

If you voted for Trump, you don’t get to speak about ethics, morals, or rule of law.

I would try pessimism, but it probably wouldn’t work.

the 10% who apparently lack object permanence

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

We’re watching the self-immolation of the leading world power on a level unprecedented in human history.

Historically it was a little unusual for the president to be an incoherent babbling moron.

Giving up is unforgivable.

Never give a known liar the benefit of the doubt.

When do we start airlifting the women and children out of Texas?

Republicans do not trust women.

We know you aren’t a Democrat but since you seem confused let me help you.

These are not very smart people, and things got out of hand.

A snarling mass of vitriolic jackals

I’m starting to think Jesus may have made a mistake saving people with no questions asked.

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Archives for 2014

Open Thread: Huggins, Bring The Bentley Around

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Ol’ Assrocket over at Power Line reviews Colbert’s sendoff and his effect on the zeitgeist, beginning thusly:

I have never seen Stephen Colbert’s show on Comedy Central, but I take it that it consists of an endless series of anti-Republican “jokes.”

monocle-guy

 

What really impresses me is the fact that no matter what happens, he hasn’t broken character for years, this guy.  That’s the only way this massive, decade-long joke works, and he’s nailed it since the Bush years.  His utterly oblivious cementheaded persona’s been an endless source of real humor in what’s been otherwise an ugly, partisan, political dumpster fire of a nation for quite some time now.

But enough about Hinderaker.

Open thread.

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Stopping the stupid

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I’ve said repeatedly that in the long run I am optimistic about health care reform and health care finance reform in this country for a very simple reason; we do so much stupid and counterproductive things at present that significant improvements can be achieved by not being stupid.  We don’t have to be brilliant, we don’t have to push the knowledge frontier, we just had to stop being stupid.

The Incidental Economist recently looked at a case of system stupidity on how a certain set of breast cancers are treated:

There are RCTs looking at using shorter, more intense radiation treatments for many early-stage and other types of breast cancer. It works just as well, has similar side effects, but it takes less time and it costs less. In 2011, the American Society for Radiation Oncology endorsed it. In 2013, Choosing Wisely encouraged it.

And, hooray, the use of hypofractionated WBI increased from 11% to 35% in 2013 in the “endorsed” cohort. It went from 8% to 21% in the “permitted cohort”. Hypofractionated WBI cost, on average, about $2900 less in the “endorsed” cohort and about $8600 less in the “permitted” cohort.

The preferred treatment schema costs less, and hassles the patients’ lives less while producing the same results.  Cheaper, faster and the same outcome is a massive system engineering win.

in Canada, 6% of patients who received WBI without regional lymph node irradiation got the longer therapy. In the US, 72% did. In Canada, 53% of patients under age 50 without regional lymph node involvement received hypofractionated WBI; in the US, 13.0% did….

 if you have a fee-for-service system, then it’s going to be hard to change provider behavior….

The incentives are lined up in the United States for providers to be systemically stupid by engaging in costlier and longer term treatments  because that determines their paychecks.  People seldom willfully give up several thousand dollars worth of income at once on a repeated basis.  So we as a society and an insurance finace system has to change the incentives and pay structures so this case of system stupidity can be minimized.

And UnitedHealthcare is experimenting with an incentive shifting system:

UnitedHealthcare (UNH), the biggest U.S. health insurer, is taking aim at controlling costs of treatment with a new pilot program that will provide a set sum for a patient’s coverage. The plan is being developed with the University of Texas MD Anderson Cancer Center and will enroll about 150 patients at first…what happens if the cost of treatment exceeds the bundled payment? The annual payment won’t increase if complications increase treatment costs. Eight bundles are available for patients, depending on what services they need, the insurer said.

“The bundled payments (there is a total of 8) cover all services and care provided by MD Anderson for treatment, including complications,” UnitedHealthcare said. “Each bundle has a fixed, specific price depending on the type of services and care included in a treatment regimen. For example, some patients may just need radiation and chemotherapy, while others may need those services plus surgery.”

The bundles are not covering breast cancer in this pilot trial but the logic is expandable in forcing the providers to choose the most efficient treatments in order to make significant money instead of ordering more treatments to make more money.  Bundled payments are one of the big health financing reforms that does not require policy brilliance; it requires patience, dogged determination to work with the data as it is, and an ability to retweak as needed.

 

 

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Friday Morning Open Thread

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Now our President is just funning with his critics. Per NBC News:

When outgoing Gov. Deval Patrick of Massachusetts began the final WGBH-FM radio call-in show of his tenure, he probably didn’t expect to hear a tongue-in-cheek complaint from a former resident – who now happens to be the leader of the free world.

Patrick, who has routinely done the “Ask the Governor” show during his eight years at the state’s helm, was surprised to discover that a caller “formerly of Somerville” was actually President Barack Obama, who called in to congratulate his pal, with a little ribbing first…

(Well, it’s better publicity than the other seasonal Commonwealth story making the national news… )
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Apart from that, what’s on the agenda as we wrap up another week?

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So Long, Colbert

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I am sadder than I should be by the end of the Colbert Report, but the new show is going to be excellent, I’m guessing. Larry Wilmore always cracks me up.

Long day today- still sort of feeling the effects of the weekend cold I had, and I had to run around and do a bunch of errands. Picked up a new set of box springs for the bed, because they had been damaged during the move four or five years ago. Since then, it has slowly been deteriorating, and I noticed that my bed was listing like a sinking ship. It was made worse because I would slide to the left a little while sleeping, the dogs would move to get close to me, I’d slide more left, rinse and repeat until my left arm and left leg were dangling off the bed.

Come to think of it, sleeping on a sinking ship is a pretty solid metaphor for my entire existence.

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Open Thread: GOP Star of the Evening

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Blake farenholdtvia BurntOrangeReport

Per the prescient Mr. Charles P. Pierce:

Regular visitors to this shebeen will recall that, once Michele Bachmann announced that she would be fluttering out of Congress one step ahead of the ethics committee, we ran a little contest to find out who would replace her as Royal Regent Of The Crazy People. (Louie Gohmert, of course, is Padishah Emperor of the Crazy People for life.) Our winner was Blake Farenthold of the 27th Congressional District of where-the-fk-else? Texas. Recently, with the election of a Congress that, by all indications, will be an even chewier cluster of fk than the 113th was, we wondered how Farenthold would manage to hold onto his throne against a new crop of pretenders.

Worry no longer. He’s got an unbreakable grip on the crown — and, apparently, on other things, too…

At NYMag, “Congressman Who Owns ‘Blow-me.org’ Sued for Sexual Harassment“:

… In court documents filed Monday, Lauren Greene, Farenthold’s former communications director, claims that he regularly made comments meant to “gauge whether Plaintiff was interested in a sexual relationship.” She says she was cut out of important meetings after she complained, and was then fired in July 2014.

Greene claims that when she mentioned to the congressman’s executive assistant, Emily Wilkes, that he seemed to be avoiding her, she said he’d “admitted to being attracted to Plaintiff and to having ‘sexual fantasies’ and ‘wet dreams’ about Plaintiff.” She describes Farenthold pointing out that she had a stain on her skirt, saying “a reasonable person would infer that Farenthold was joking that she had semen on her skirt.”…

Greene also offers this tidbit: “Farenthold regularly drank to excess, and because of his tendency to flirt, the staffers who accompanied him to Capitol Hill functions would joke that they had to be on ‘red head patrol’ to keep him out of trouble.”…

The Washington Post‘s gossip column, Reliable Source, discusses Farenthold’s… qualifications:

… CV: He was an attorney and owned a computer consulting and web design firm before being elected in 2010. Now he’s in Congress, where he chairs the subcommittee that oversees the Postal Service. He won re-election for a second time this year, defeating Democratic challenger Wesley Reed — a feat made easier by GOP redistricting that made his seat safer for Republicans — though he was a finalist in comedian Bill Maher’s “Flip a District” campaign.

Legislative accomplishments: Farenthold sponsored six bills in 2013, according to his last report card from Govtrack, which tallies congressional stats. He attracted only four co-sponsors for them, putting him in last place (out of 435) in that category. But! he did have perfect attendance…

Bonus drama: Politico reports that Farenthold hired veteran GOP mouthpiece Kurt Bardella to handle the fallout from the lawsuit. Hey, we’ve heard that name before! Bardella is the House staffer fired for leaking emails to NYT’s Mark Leibovitch, as he was writing “This Town,” his send-up of official Washington.

It’s a small (but certainly not tidy) little village, there inside the Beltway. As Anthony Trollope might’ve said, one cannot in honesty attest that stranger things happen in fiction.

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Confirmation, In Case You Needed It

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Chuck Lane is very het up about the Cuba policy shift. Oddly enough, I don’t remember him or the WaPo editorial board calling for torture prosecutions in the US.

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