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“What are Republicans afraid of?” Everything.

Dead end MAGA boomers crying about Talyor Swift being a Dem is my kind of music. Turn it up.

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

SCOTUS: It’s not “bribery” unless it comes from the Bribery region of France. Otherwise, it’s merely “sparkling malfeasance”.

One lie, alone, tears the fabric of reality.

The cruelty is the point; the law be damned.

I desperately hope that, yet again, i am wrong.

When I decide to be condescending, you won’t have to dream up a fantasy about it.

Their freedom requires your slavery.

FFS people, this was a good thing. take the win.

“Jesus paying for the sins of everyone is an insult to those who paid for their own sins.”

A sufficient plurality of insane, greedy people can tank any democratic system ever devised, apparently.

JFC, are there no editors left at that goddamn rag?

You come for women, you’re gonna get your ass kicked.

Putin must be throwing ketchup at the walls.

It’s always darkest before the other shoe drops.

Never entrust democracy to any process that requires republicans to act in good faith.

The worst democrat is better than the best republican.

Relentless negativity is not a sign that you are more realistic.

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

Conservatism: there are people the law protects but does not bind and others who the law binds but does not protect.

Beware of advice from anyone for whom Democrats are “they” and not “we.”

Elections aren’t won by handwringing, cowering, and/or bashing your own candidates.

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Archives for March 2016

Wednesday Evening Open Thread: Lest We Forget

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The Repubs have been just this bad for a loooong time. But in Dubya’s day, they could get away with being less public about their non-stop venality.

Apart from adjusting the signal-to-noise ratio, what’s on the agenda for the evening?

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Trump Continues Female Voter Outreach — Updated

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Via Bloomberg, Trump, who once described himself as “very pro-choice” but now claims to be “very pro-life,” said women who have illegal abortions should be punished in a manner to be determined later:

At a taping of an MSNBC town hall to be aired later, host Chris Matthews pressed Trump on his anti-abortion position, repeatedly asking him whether abortion should be punished if it is outlawed. “This is not something you can dodge.”

“Look, people in certain parts of the Republican Party, conservative Republicans, would say, ‘Yes, it should,’” Trump answered. “How about you?” Matthews asked.

“I would say it’s a very serious problem and it’s a problem we have to decide on. Are you going to send them to jail?” Trump said. “I’m asking you,” Matthews said.

“I am pro-life,” Trump said. Asked how a ban would actually work, Trump said, “Well, you go back to a position like they had where they would perhaps go to illegal places but we have to ban it,” Trump said.

Matthews then pressed Trump on whether he believes there should be punishment for abortion if it were illegal.

“There has to be some form of punishment,” Trump said. “For the woman?” Matthews asked. “Yeah,” Trump said, nodding. Trump said the punishment would “have to be determined.”

As discussed this morning, there’s no logic or coherence to this or any other position Trump espouses because it’s not grounded in anything other than his ardent desire to make Lady Liberty his next trophy wife.

Will the Republican primary voters figure this shit out before Trump secures the nomination and choose a real forced birther over the fake one? Does it even matter?

EDITED TO ADD:

Per a tweet from The Guardian’s Ben Jacobs, the Trump campaign issued a statement walking back the earlier call for punishing abortion sluts:

Also, to clarify: Some of y’all made a good point (as Cole did on Twitter) when you noted that it’s morally consistent for people who run around shrieking that abortion is murder to want to hold the woman who is complicit in infanticide (as the forced birthers see it) accountable. But it’s politically stupid to say that out loud, which is why most candidates aren’t dumb enough to go there. And it’s inconsistent with Trump’s other positions on abortion, i.e., exceptions for rape, incest, etc.

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Texas, Jake

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ETA: Annnnnndddd….always read the fine print.  I was taken in by a fake news story at a parody site.  Mea culpa.

I’ll leave this up as (a) a warning to self not to be an idiot, and (b) as a reminder of how hard it is (at least for me), in this election year of our discontent, to tell the difference between what should be obvious parody, and what is.

***************

I’ll start by saying that no state could withstand a characterization drawn only from its most batsh*t crazy denizens.  So I apologize in advance for painting the great, diverse and fascinating state of Texas with a broad brush.

I’ll also note that it does matter a bit that so many of the most batsh*t insane Texans seem to end up in state government.  What this says about the too many of their fellow citizens* who put them there I’ll leave as an exercise for the reader.

Today’s Texan OMG S/HE SAID WUT???!!!! comes from TX state rep. Debbie Riddle (R-Planet Ten), who’s got a problem with the idea of one particular subset of her fellow double-X Americans doing their ladybusiness in public:

Rep. Debbie Riddle requested that the bill be modified to contain some conditions that not all mothers are going to like. Namely, the modified bill states, among other things, that “only women who possess the breast size C-cup or smaller shall be allowed to breastfeed in public areas.” Asked to comment on the discriminatory clause in the bill, Riddle simply stated, “Nature knows what it’s doing.”

I have to say that I really hope that this is somehow a hoax, that Riddle really didn’t say what she’s reported to said.  Because here’s where she is described as going next:

She also added, “It’s for the greater good. We already have more than enough distractions when walking the streets, and we don’t need this one as well.”

Lucas_Cranach_d.Ä._-_Madonna_mit_Kind_(Budapest)

You know that old line, “when you hit bottom, stop digging?”  Riddle apparently does not:

“…everybody knows what happens when a woman with a D-cup size breasts starts breastfeeding her child in the park or on the street. Everybody immediately stops and starts staring.

Riddle also added that“studies have shown that women with bigger breasts are not commonly associated with modest behavior.”

 

Alright.  If the Texan legislator really did say all that (and more! — check out the link!) I got nuthin.  Or perhaps, as our legal beagle friends might say, res ipsa loquitur.

Ladles and Jellyspoons, have at it.  For me, I despair of the Republic.  Or at least that part of it that gave us the Honorable Riddle.

*Somewhere Rousseau — and Jefferson — are weeping.

Image:  Lucas Cranach the Elder, The Virgin Giving Suck c. 1515

 

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Doesn’t matter who staffs the bureaucracy: Safe access to abortion edition

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The FDA released a new approved utilization regime for Mifepristone, a medication used to induce first trimester abortions:

Mifeprex is approved, in a regimen with misoprostol, to end a pregnancy through 70 days gestation (70 days or less since the first day of a woman’s last menstrual period).  The approved Mifeprex dosing regimen is:

  • On Day One: 200 mg of Mifeprex taken by mouth

  • 24 to 48 hours after taking Mifeprex: 800 mcg of misoprostol taken buccally (in the cheek pouch), at a location appropriate for the patient

  • About seven to fourteen days after taking Mifeprex: follow-up with the healthcare provider

 

From Medscape, a description of the previous FDA regime:

Numerous protocols have been studied and are in use, but only 1 has been approved by the FDA.( Table 3 and Table 4 ). The FDA-approved regimen can be initiated up to 49 days after the first day of the LMP and consists of mifepristone 600 mg orally on day 1, misoprostol 400 mcg orally provided at the doctor’s office on day 3, and a follow-up appointment on days 12-20. This protocol is 92% effective in inducing a complete abortion.[12,13] It is hoped that studies using different variations of the FDA-approved regimen will lead to expanded options that are safe and reduced costs.

There are a couple of major changes here.  The first is the dose for Mifeprex went down and the second round medication dosagage went up.  That may or may not be clinically important.  From a policy perspective there are three major changes.

The first is that the FDA allowed window to have a medical abortion goes from 7 weeks after the last day of the woman’s menstrual cycle to 10 weeks.  This gives women a lot more flexibility and decision time from the point where she knows she is pregnant to the point where the least invasive option can is no longer FDA approved.

Secondly, the window for the follow-up dosage expands; again this is flexibility which means compliance and follow-up is easier.

More importantly, the change in location for where that second dose is administered is critical.  Previously, that second dose was to be down at the doctor’s office.  Now it is as a location appropriate for the patient.  That is massively more flexible as it means an individual could take the second pill home with her.

Why is this important?  It is a counter-move to the proliferation of TRAP anti-abortion access laws as Think Progress explains:

anti-abortion lawmakers — who have mounted an incremental strategy based on chipping away at abortion from all angles — were quick to exploit the discrepancybetween the official FDA label and the real-world medical practice. States started passing laws requiring doctors to stick to the outdated FDA method of prescribing the abortion pill. It was easy for politicians to misleadingly argue that they were simply interested in keeping women safe and ensuring that abortion patients aren’t taking dangerous, unregulated drugs.

This reduces practical restrictions on pharmaceutical abortion access by reducing the number of trips needed while also expanding the time option space.  As a side note, it allows clinics a little more flexibility to cope with other TRAP laws as some of the current surgical abortions in restrictionist states can be transferred to pharmaceutical abortions which will free up staff and appointment slots to handle more misogynistic bullshit.

So staffing the federal bureaucracy matters.

Let’s keep that in mind for November!

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Good Boy! (Open Thread)

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Nothing like this would ever happen to me in a million years:

pot dawg

My dogs have dropped a number of things at my feet over the years, including a large, very deceased-looking possum that was not at all dead, as it turned out. But never a pound of pot. (The possum played dead so convincingly that I sincerely believed it, but as soon as my husband took the dog inside and went to fetch a bag with which to dispose of the body, the “carcass” leapt up and ran off hissing, much to my surprise!)

What is the worst thing a pet has ever offered as a gift to you? Open thread!

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Making the Red Queen work

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The Red Queen Race is a race where to stay even, the participants have to run faster every moment. If one person maintains constant effort, that person falls behind compared to the other contestants.

the-redqueen
This plays out in the health policy world with revenue neutral risk adjustment.

significant resources are devoted to increase the appearance of illness in the claims history without actually doing a damn thing to make a patient better off… The problem is insurance companies that elect not to chase their providers for higher diagnosis coding intensity will see their risk scores look comparatively lower compared to high intensity coding companies, and thus they’ll lose money. So everyone has to do it, or no one has to do it. Right now we are in a stable, socially negative equilibrium of high intensity claim coding for risk score optimization.

This is socially wasteful use of a Red Queen race.

However this model in and of itself is not inherently problematic. If it can be directed towards achievement of socially positive goods, a red queen race where revenue neutral transfer payments are shifted from underperformers to overperformers creates strong financial incentives for the underperformers to accelerate their efforts and the over-performers to not get lazy. If there was a set of revenue neutral transfer payments based on single period achievements of common preventive measures such as vaccinations, screenings and tests that are shown to improve individual health and lower net medical spending, rates of adherence would increase significantly.

Right now flu shot uptake is fairly low.  Roughly 60% of kids get a flu shot, and 44% of adults get one as well.  There are strong clinical reasons for not everyone to get a flu shot, but that clinical exclusion does not cover 40% or more of the population.  If insurers with risk and SES adjusted underperformance have to pay insurers with risk and SES adjusted high vaccination rates, vaccination rates will increase.  I know my CFO would concuss herself and break the ceiling on the 11th floor when she is told that we need to write a $3.5 million dollar check that will be effectively made out to the Blue Cross affiliate down the street because they did a better job of vaccinating their members than we did.  That is the incentive we would want to create socially, where payments are dynamically linked to what everyone else is doing and no one entity (unless there is mass collusion) has any incentive to not vaccinate the next kid.

 

PS:  I am trying to sketch out a system of transfer payments so some of my posts in the near future may be even more wonky/esoteric than normal.

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Pre-Masticated GOP Town Hall Musings

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When I was in eighth grade, a school administrator punished me for some transgression by handing me a putty knife and ordering me to scrape gum off the undersides of the lunchroom tables after school. That probably wouldn’t happen today for fear of injury, disease transmission or lawsuits.

There were many tables in the lunchroom, so I asked my tormenter if she expected me to scrape the gum off every one of them or a set number. She considered that for a moment and then asked me to bring 30 separate blobs of gum to her in a bag, at which point she’d consider my sentence completed.

I approached last night’s Republican town hall in the same spirit in which I tackled the gum-scraping job so many years ago. And just as the dean of girls counted each blob of gum before setting me free, I’ve considered each nugget that fell from the lips of the three candidates last night before identifying the choicest for your consideration. Don’t thank me; it’s just something I do.

Anyhoo, the thing that seems to be getting the most play in the post-town hall media analysis is that all three candidates walked back their earlier pledges to support the eventual nominee. I found that neither surprising nor remarkable. But Trump’s flailing on a simple question from an audience member was revealing:

If you can’t watch the video, there’s a transcript of this particular exchange at the wingnut Free Bacon rag. To summarize, Trump is asked to name the top three functions of the US government, and he says “security, security, security” and then adds healthcare, education and housing to round it out, which of course flies in the face of wingnut orthodoxy about the proper role of government.

Anderson Cooper does feebly attempt to pin Trump down on how the federal government comes into play on these issues, but Trump just sprays pre-chewed talking points (“Obamacare is a disaster,” etc.) and mostly gets away with that. He bullshits his way through his ill-considered initial response mostly successfully, I guess, because his heresy hasn’t made many headlines.

Well, not so far, anyway: Maybe Trump’s opponents will yet make an issue of this if they recognize Trump’s ramblings as a metaphorical putty knife they can use to scrape a particularly stubborn and obnoxious orange gum blob off the Table of Conservatism.

But what in the actual fuck was Trump trying to say? I don’t think even he knows. He has no clue how the federal government operates, but he wants the personal validation of being elected as its head. And if Trump has set his sights on Lady Liberty as his next trophy wife,* who are you losers to deny him his prize? It’s really that simple.

*Metaphor borrowed from Colbert, I think.

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