Come for the politics, stay for the snark.

If you’re gonna whine, it’s time to resign!

A thin legal pretext to veneer over their personal religious and political desires.

“They all knew.”

Nancy smash is sick of your bullshit.

It may be funny to you motherfucker, but it’s not funny to me.

Today in our ongoing national embarrassment…

Sadly, media malpractice has become standard practice.

My years-long effort to drive family and friends away has really paid off this year.

Republicans in disarray!

You know he’s going to shit a cat.

I’d like to think you all would remain faithful to me if i ever tried to have some of you killed.

Republican also-rans: four mules fighting over a turnip.

This blog will pay for itself.

Stay strong, because they are weak.

There is no right way to do the wrong thing.

And now I have baud making fun of me. this day can’t get worse.

To the privileged, equality seems like oppression.

“Facilitate” is an active verb, not a weasel word.

Jack be nimble, jack be quick, hurry up and indict this prick.

“When somebody takes the time to draw up a playbook, they’re gonna use it.”

Hell hath no fury like a farmer bankrupted.

The revolution will be supervised.

Republicans seem to think life begins at the candlelight dinner the night before.

The press swings at every pitch, we don’t have to.

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Archives for November 2015

Busy Day

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Several things:

1.) Spent pretty much the entire day dealing with eye exams and pricing new glasses. I am finally breaking down and buying bifocals, and in addition I am getting computer glasses and prescription sunglasses for driving. I went to several places after my eye exam, and had several estimates and finally got one that I thought was reasonable for all three. I suppose 500 bucks is not a bad deal, especially since I got all the bells and whistles (anti-glare, polarized for the sunglasses, etc.). I got three reasonably decent frames by some company named fatheadz, so I think I did alright.

2.) Don’t forget, if you are using amazon for the cyber Monday bullshit or just general purpose christmas shopping- click the amazon link to the right.

3.) Heard from Alain and he is still working on tweaking things, so expect some changes here and there.

4.) Made a new recurring donation to Planned Parenthood for 10 bucks a month. Who wants to match me?

5.) You’ve all been reasonably well behaved, so here is a video of Thurston and Rosie wrestling. If I do not pay enough attention to them, they will do this until they fall over or I yell at them and pay attention to them and take them out.

If you look closely, you can check out Thurston’s mad ninja skills when he jumps up onto the couch and then back down for an aerial attack.

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Open Thread: “Whisper Campaigns and Zipper Problems”

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Interesting story from McKay Coppins, at Buzzfeed, on Jeb Bush’s (so far futile) attempts to crush Marco Rubio in advance of the 2016 campaign.

TL; DR (IMO) — First, if thoroughly middle-of-the-road journos like Coppins are willing to attach names to narratives like this, then JEB! is TOAST! (at least in 2016).

And second, the “well known” rumors that Rubio’s financial problems relate to funding his “second secret family” are no more than that. If Marco did have one or more off-registry kids to support, some enterprising fellow Repub would’ve gotten the data out by now. He’s just no good at managing his money, like so many of the rest of us.

… [B]eneath the glossy exterior of his public profile — that of the compassionate conservative, the happy warrior, the good-natured reformer — Jeb possessed a hard-edged, often ruthless political style that ran through his entire rise and reign in the Sunshine State. “He’s been the big, bad kid,” Chris Smith, a leading Democrat in the Florida House, complained to a reporter toward the end of Jeb’s term. “And he’s wielded that power mercilessly.”

It wasn’t until Rubio dazzled a roomful of donors at the Koch brothers summit in Rancho Mirage that Jeb and his tight-knit 2016 team decided the young senator needed to be neutralized. For their new mission, they adopted a code name: “Homeland Security.” Few of Jeb’s lieutenants believed they would need to subject Rubio to too much browbeating in order to sideline him, and their commander agreed. All he needed was a gentle reminder of his place in the pecking order. And so the word went out to Jeb’s army of foot soldiers: Carry the message…

Meanwhile, Jeb’s ever-expanding political operation made a big show of its fundraising supremacy, particularly in Florida. At an event hosted by his political action committee in Tallahassee, his team branded the donors like cattle, with large red stickers exclaiming “Jeb!” — and then they invited reporters into the formerly private meeting so they could ooh and ahh and tweet about the impressive herd of millionaires…

…[T]he Bush brigade had Florida on full, threat-level-red lockdown, and with the exception of a few loyal backers, Rubio wasn’t getting anywhere in his home state. Meanwhile, as they tried fundraising outside of Florida, they began to notice a curious pattern among the Republican donors who were turning them down. Many of them seemed to like Rubio’s ideas and message, but when they explained their doubts about his 2016 prospects, they often used the same vague, coded language: concerns about the wealth of “oppo” that could drag him down, or the “talk coming out of Tallahassee,” or the importance of nominating a “fully vetted” candidate. This, of course, was nothing new for Rubio. But it seemed oddly top of mind all of a sudden in certain quarters of the GOP money world.

Eventually, word got back to the senator’s camp that Jeb’s close allies in Florida were working to revive the “zipper problem” meme in a last-ditch effort to freeze Rubio out of the race; they were circulating the rumors anew among donors and politicos and cautioning them to exercise due diligence before signing on with his campaign…

Still, most in the Rubio camp had trouble believing that Jeb would personally green-light such a brazen campaign of character assassination against someone who he had, just four years earlier, joyously introduced to the world while choking back tears (or at least pretending to). But one of the privileges of being Prince Jeb was his ability to give an order and then step back in blissful ignorance as a team of duty-bound lieutenants plotted, and strategized, and worked out all the gritty details that entailed “carrying the message.”…

Nice folks, those Bushes. Nature’s aristocrats!

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Analysis and advocacy

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There are many things in the New York Times article on the transformation of Illinois under Rauner and the new Gilded Age finance barons that piss me off.  But one of them really stands out as it offends me as a wonk:

His goal, Mr. Arnold wrote, was “to counterbalance these entrenched forces, on the right and the left, by providing policy solutions rooted in objectivity and solid analysis.”

There is no such thing as an objective solution.

There can be objective analysis in which an analyst discloses their model for review, adjusts the model to account for previous failures, makes explicit all of the assumptions embedded within a model, performs rigorous sensitivity testing of the parameters of the model, and then disclose results no matter what.  That type of analysis can be as close to objective as possible.  It is also likely to be wrong in the details of the outcome but it can be objective or at least as close to objective as we faulty humans can be.

This type of modeling and analysis allows a meteorologist to say it is highly likely to rain tomorrow.

However once an objective or more accurately, a fair attempt to be an objective, analysis leads to recommendations the recommendations are not objective.  If the objective forecast is that it will rain tomorrow, the recommendation that everyone bring an umbrella to the bus stop has massive value assumptions built into it.

It values dryness, it values professional presentation, it values appearances, it values personal comfort over the comfort of others on the bus who now may seek to avoid a wet folded umbrella siting on the seat next to the guy who could have stayed just as dried if he waited three minutes to leave the house and run to the bus stop half a block away.

Any recommendation, even one supported by reams of objective research, is a moral question of what “ought” to be instead of what is or what is likely to be.  “Oughts” are fundamentally political questions.

Should the US government increase the tax on alcohol by 10%?  Objective policy analysis could fairly predict that a higher tax on alcohol will lead to fewer car crashes, fewer arrests for domestic violence and other bodily injury crimes, fewer teen drinkers, lower short term health expenditures and potentially higher long term health care costs and a thousand other benefits.  It will also find that jobs at major breweries will decline as sales will decline and jobs at bars and restaurants will also decline.  Now the policy recommendation to support a 10% increase tax on alcohol is a value argument that the benefits massively outweigh the costs while opposition could be grounded in either an argument that the concentrated costs of job loss are too real and too much for the dispersed benefits OR in a value of keeping taxes as low as possible OR in a value system that prioritizes a government incapable of interfering in private choices OR half a dozen other plausible value propositions.

Just keep that in mind whenever you see someone make a claim that their policy recommendation is an objective recommendation.  They are bullshitting you, and most likely bullshitting themselves.

 

 

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Monday Evening Open Thread: Thank the Gods for Mockery

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It’s not a cure, but at least it’s a palliative. Mr. Charles P. Pierce:

… Fabulism has become something of a conspicuous feature in this campaign. From Donald Trump’s dancing Muslims on a rooftop in Jersey City to Ben Carson’s buckle-foiled attempt to cut a motherfcker in his wayward youth, we seem to have crossed over an invisible border from the ordinary narrative bullshit that is customary to presidential campaigns into a strange shadowland in which bizarre (and easily—and, occasionally, previously—debunked) tales have come to define candidates, and to define them, if not positively, then not entirely in a negative way, either. To stick with your story about Muslims on the rooftops in the face of all the available evidence is a way to demonstrate that you “won’t back down” or that you’re not “politically correct.” The logic seems to be that, if you stand firmly behind your hogwash, and the wilder the hogwash the better, then you will face down Vladimir Putin before breakfast and frighten Daesh to death just after lunch. Apparently, if you’re bold enough to tell obvious lies in public, and then stick to those lies when you get called on them, you are brave enough to be president.

As with so many things, this all began with Ronald Reagan. Those people who claim that Donald Trump is sui generis in this regard are very much the same as those people who find him a unique political phenomenon, instead of the logical end product of almost 40 years of conservative politics. Reagan was as full of crap as the Christmas goose, and in the same way that Trump and Carson are. Trump has dancing Muslims. Reagan had the fictitious welfare queen in Chicago. Carson had his attempt to stab a classmate. Reagan had his march into Auschwitz to liberate the death camp there. The difference is that Reagan slung his hooey with a smile and a wink. Trump has weaponized Reagan’s fabulism and that seems to make a difference to some people. But nothing that has happened in this campaign, up to and including the latest spasm of outright bigotry and fear-mongering, is new in the recent history of Republican politics. It always is the person who tells the best ghost stories who wins…

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Apart from Lying Liars Who Lie: Apocalypse Now Edition, what’s on the agenda for the evening?

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Why We Can’t Have Nice Things

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We had a lively discussion here last week about the Democrats’ inability to mobilize the very people who benefit most from policies Democrats support. It centered around a NYT article on states like Kentucky that benefit from policies like Obamacare but then turn around and vote in politicians who promise to slash the safety net.

The takeaway from that article, IMO, is that it’s not that the people who are using Obamacare hate it and want to see it stamped out (which is counter-intuitive no matter what very real sociological ills are attributed to the population) but rather that the people who are using it don’t vote.

Ezra Klein at Vox has a piece up today that looks at the findings of another NYT article about the possible Obamacare rollback in Kentucky that reaches a similar conclusion:

Carolyn Bouchard, a diabetic with a slowly healing shoulder fracture, hurried to see her doctor after Matt Bevin was elected governor here this month.

Ms. Bouchard, 60, said she was sick of politics and had not bothered voting. But she knew enough about Mr. Bevin, a conservative Republican who rails against the Affordable Care Act, to be nervous about the Medicaid coverage she gained under the law last year.

“I thought, ‘Before my insurance changes, I’d better go in,’ ” she said as she waited at Family Health Centers, a community clinic here.

There is something perfect about this anecdote: Bouchard clearly benefits from Obamacare, or at least believes she does, but less than a decade after the federal government passed the program into law, she’s decided she’s sick of politics and didn’t bother to vote. The result is that she may well lose her insurance — which will, presumably, leave her yet more disgusted by American politics, and make her that much less likely to vote.

Klein published a couple of charts that illustrate this vexing conundrum, including this one:

Vox2.1

Klein says, “The greatest trick the devil ever pulled was making the natural response to disappointment with American politics apathy rather than participation.”

I think he’s right, but I don’t know how we solve it. In the Balloon Juice post linked in the first line, we talked about highlighting great things our local reps have done, and that’s a good idea. It might make us feel less hopeless. But it won’t reach the disengaged. Anyone got any ideas on that score?

ETA: In the above-referenced thread, valued commenter Heliopause said the following:

An example of where to start — this is an example, not a comprehensive program — would be a series of TV ads, run nationally to the largest possible audience, which basically say, “we are the Democrats and we stand for X, Y, and Z.” Make sure the ad is affirmative without being treacly, and keep the faces of Hillary or whomever out of it, this is about the party and not a personality. Keep hammering this message and stick with it, it’s going to take years before it starts doing any good.

That’s the only chance, and I’d love to be wrong, but I don’t think it can happen. Balloon Juicers are somewhat obsessed with personality politics; the MSM is completely obsessed with it. If you’re not into the Khardashians you don’t watch them. Same with our politics.

That rings true to me.

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Avoiding pointlessness

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An interesting story in the Kansas City Star on a success of evidence based medicine:

A study published this month in the Journal of the American Medical Association finds that the number of elective angioplasties has fallen by a third in just five years. That mean tens of thousands of people are avoiding a procedure that may have done them little or no good but that costs on average $27,000 and may require years of drug therapy to avoid complications.

Meanwhile, a second new study in the New England Journal of Medicine finds that even after 15 years, patients who chose medication and lifestyle changes over angioplasty were no more likely to die than those who chose the procedure.

There are a couple of interesting angles here.  The first is evidence based medicine saves money, and puts people at no greater risk than folk medicine.  Secondly, these changes are sticking even as providers are still overwhelmingly paid on a fee for service basis so there is hope for change when the incentives are aligned against positive change.  As the US medical payment system moves away from widget fee for service payments to global budgets that allow providers to make more money by keeping people healthier and using only effective services, this change should continue to accelerate.
Finally, from an insurance perspective, cases like this make a strong argument for value based insurance design where highest insurance payments are made for treatments that are shown to be most likely to work for a given set of indicators.  The evidence supports angioplasty in emergency circumstances but not as an easy choice for elective procedures.
Redesigning benefit structures to tier payments to effectiveness in a fee for service payment model is a difficult lift.  However, it would remove some of the incentives to overtreat with expensive and minimally effective procedures without harming patients.  Elective angioplasty, like back surgery for unspecified back pain, could fall into the bucket of services where it is an option.  However it would not be a preferred option.  It would only be paid at a high level  after other, more cost effective options are tried first.  It should be a second or third resort, not a first resort when it is not an emergency.
This logic mainly applies to fee for service payment structures as providers should be motivated to do self-tiering in global budget and capitation models.

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Monday Morning Open Thread

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miri kit tupperbox 29 nov

From cat-rescuer and kitten-wrangler Marc:

Used all my mismatched Tupperware to send leftovers along with my guests. Went out and bought this box for the kitties, and it happened to have a brand new set inside.

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Apart from life’s simple pleasures, what’s on the agenda for the start of another week?

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