Come for the politics, stay for the snark.

One of our two political parties is a cult whose leader admires Vladimir Putin.

Donald Trump, welcome to your everything, everywhere, all at once.

Too often we confuse noise with substance. too often we confuse setbacks with defeat.

This isn’t Democrats spending madly. This is government catching up.

It’s not hopeless, and we’re not helpless.

“And when the Committee says to “report your income,” that could mean anything!

Polls are now a reliable indicator of what corporate Republicans want us to think.

People are complicated. Love is not.

You are so fucked. Still, I wish you the best of luck.

Happy indictment week to all who celebrate!

Come on, media. you have one job. start doing it.

American History and Black History can not be separated.

Republican speaker of the house Mike Johnson is the bland and smiling face of evil.

If marriage is the equivalent of selling yourself into slavery, women with self respect should reject the offer.

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

Trump makes a mockery of the legal system and cowardly judges just sit back and let him.

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

Republicans are radicals, not conservatives.

The arc of history bends toward the same old fuckery.

Cole is on a roll !

President Biden is doing good where he can, and getting it done.

“The difference between stupidity and genius is that genius has its limits.”

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

This really is a full service blog.

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Archives for November 2017

Kim Jung-Orange

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I can scarcely recall what I imagined the internet would bring when it bloomed a generation ago. But my speculation about an interconnected future did not include reading the real-time rage-tweets of a malevolent clown while he pinches off a loaf in the White House throne room, having been placed there by traitors, racists, misogynists and assorted goddamned nitwits.

Nope. I did not see that coming.

I often wonder what good it does to repackage the more outrageous tweet-turds for your consideration, look at what the media says about them or discuss them with family and friends. Some days I just don’t bother. Some days, I wonder if it’s harmful to give the shitgibbon’s childish rants any energy and attention at all. And some days, I feel compelled to bear witness, even in a small and insignificant way.

This morning’s rage-tweets fall into the latter category, so even though several hours have passed since they dropped into the Twitter toilet bowl, here’s a representative (stool) sample:

There are several more in the same vein, which include allusions to “Crazy Bernie” and “Pocahantas” and additional ranting about “Crooked Hillary.” But this line is the most alarming: “Lets [sic] go FBI & Justice Dept.”

These are the ravings of a tinpot authoritarian. These are the rantings of an unhinged, predatory demagogue who is salivating at the prospect of using the apparatus of the United States government to conduct show trials and persecute political opponents. Trump expanded on the same idea in a radio interview [via CNN]:

“The saddest thing is that because I’m the President of the United States, I am not supposed to be involved with the Justice Department, I am not supposed to be involved with the FBI. I look at what’s happening with the Justice Department. Well, why aren’t they going after Hillary Clinton with her emails and with her, the dossier? I’m very unhappy with it that the Justice Department isn’t going. I am not supposed to be doing the kind of things that I would love to be doing. And I am very frustrated by it.”

Should we be grateful that Trump seems to grasp that he’s “not supposed to” leverage the justice system to punish political enemies, however unfair he rates that restraint? Maybe. But given the fact that those agencies are headed up by his flunkies, the fact that he’s applying even more pressure on them to do his bidding is worrisome.

I think Cheryl’s post downstairs asks the following question in a different way: Will our institutions be sufficient to withstand the onslaught of this lunatic? I vacillate between optimism and pessimism, but this latest push has me worried.

As the Civil War began, Ulysses S. Grant said, “There are but two parties now: traitors and patriots.” There’s a good argument that the party that countenances rule by a manifestly unfit crackpot who was sleazed into office in part via the machinations of a hostile foreign power has already become a party of traitors. There can be no doubt about it if Trump succeeds in turning the DOJ and FBI into his own personal score-settling force and distraction circus.

Anyhoo, it seemed important, if futile, to note for the record that the president of the United States escalated his calls to turn this nation into a nuclear-armed banana republic today. The wonder — and perhaps the danger — is that it attracted comparatively little attention. We’re used to this shit now, and that’s not healthy.

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Bergdahl Sentenced

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Dishonorable discharge, no jail time:

Bowe Bergdahl received a dishonorable discharge from the US Army but will avoid prison time for desertion and misbehavior before the enemy after abandoning his outpost in Afghanistan in 2009, a military judge ruled Friday.
The judge also ruled that Bergdahl’s rank be reduced from sergeant to private. Additionally, he will be required to pay a $1,000 fine from his salary for the next 10 months.

“Sgt. Bergdahl has looked forward to today for a long time,” Eugene Fidell, Bergdahl’s civilian attorney, said at a news conference after the sentence was announced.

“As everyone knows he was a captive of the Taliban for nearly five years, and three more years have elapsed while the legal process unfolded. He has lost nearly a decade of his life.”
The sentence is effective immediately, except for the dishonorable discharge, which Bergdahl is appealing, according to Fidell.

And, of course, Twitler played a role in the sentencing:

One of the mitigating factors in his sentencing were disparaging comments by President Trump as a candidate and while in office. Nance ruled Monday that while Bergdahl can get a fair trial despite the remarks, he would consider them in his sentencing.

As a candidate, Trump denounced Bergdahl and the Obama administration’s agreement to get him back from the Taliban. On Oct. 16, 2015, for example, Trump called him “a rotten traitor” and suggested he should be shot or dropped from an airplane.

“In the old days he’d get shot for treason,” the president told a crowd of supporters. “If I win, I might just have him floating right in the middle of that place and drop him, boom. Let ’em have him. … I mean, that’s cheaper than a bullet.”

More recently, Trump declined to comment on Bergdahl’s case, telling reporters, “I think people have heard my comments in the past.”

Even those comments were seen by Nance as “unlawful command influence,” writing in his ruling, “The plain meaning of the president’s words to any reasonable hearer could be that in spite of knowing that he should not comment on the pending sentencing in this case, he wanted to make sure that everyone remembered what he really thinks should happen to the accused.”

The most pressing issue for me regarding this is who in command is going to pay the price for allowing a guy who washed out of the Coast Guard into an Airborne unit with a waiver to enter the Army and then deployed him despite knowing that he should not be deployed. Because that’s a big damned problem, and also exposes a key flaw in the all volunteer Army- when you need to ramp up the number of soldiers quickly, quality control gets thrown out the damned window.

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After the gold rush

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I’ve mostly lost interest in David Brooks. He’s bad, but day in day out, he can’t quite match the awfulness of Frank Bruni or David Von Drehle. He’s self-involved, but not as self-involved as Bruni. He’s dumb, but not as dumb as Von Drehle. I just don’t think he matches up well against either of them.

What makes Brooks special when he’s at his best/worst, is his ability to get fixated on a random word. It could be a word he heard at a TED talk, it could be something he saw on a menu at a deli. Or it could be something he made up. Today he decides to describe guys who are just trying to get laid as “prospectors”. I think this is a real gem because it combines glib both sides stupidity with an awkward phrase that no one in history has ever uttered before:

In the political world, for example, partisans of left and right rationalize their support for Bill Clinton or Donald Trump because they could tell themselves in effect, “Oh, he’s just a horny prospector.”

Who do you think is the worst columnist working at a major outlet right now? Tom L think it’s still Bobo, but I think Bruni has far surpassed him, this shining example notwithstanding.

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What Comes Next?

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With Monday’s revelations, we know more about Donald Trump’s Russian connections, but there is obviously more to come. As I urged in August, we need to think about options for the country’s response as this plays out.

David Roberts (@drvox) posted a tweetstream Sunday night on whether the country can come together, given the division sown by the Republicans and their implications of “Second Amendment solutions” and, potentially, civil war. Daniel Nexon (@dhnexon), a professor of political science, posted a similar, but shorter tweetstream. Roberts has now written a post that is still longer and goes in a different direction than I take here. I’ll work from the tweetstreams.

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Day By Day

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I wanted to let you know I read each and every comment you wrote to me about my beloved Bailey and found great comfort in every one. And thank you for the emails, too.  Probably will not be a surprise to anyone who hangs here a lot, Raven brought great comfort with this (I soooo needed this):
Raven says:
November 2, 2017 at 11:53 am(Edit)

We who choose to surround ourselves
with lives even more temporary than our
own, live within a fragile circle;
easily and often breached.
Unable to accept its awful gaps,
we would still live no other way.
We cherish memory as the only
certain immortality, never fully
understanding the necessary plan.
— Irving Townsend

And while I’m grateful for all the thoughts, and I am still so broken about this sudden, unexpected loss, I know each and everyone of us has something going on that makes some days harder than others. And this place is where we can come for support, comfort and even some testy exchanges that keep us going.  I will be always be in wonder and awe of everyone here and thankful John created such a place as Balloon-Juice.

Again, thank you for taking the time to leave me a note, it means more than you could ever know. I’ll give Bixby an extra hug from all of you, he’s having a difficult time, but he’ll bounce  back.  – TaMara

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Deductibles and distribution

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Within the ACA, plans are grouped into metal bands.  Those bands have a target actuarial value with a band of allowed variance around that target.  After a plan shows that it meets the allowed actuarial value without going the maximum out of pocket limit nor violating the non-cost sharing preventative services restriction, insurers are allowed to design their plans however they want.

There is wide variation in plan design.  There are three cost sharing components.  Deductibles are what the patient pays before the insurer will do more.  Deductibles may apply to all services or only some services.  Co-pays are fixed amounts that the patient pays for a given service.  Co-insurance is a percentage that the patient pays.  Once the total out of pocket spend meets the plan’s maximum out of pocket, the insurance company is on the hook for all claims above that limit.

Insurers can choose their plan designs and those choices have significant distributional impacts:

Deductible plans favor the sickest people as the low utilizers pay for almost all of their care via deductible cash. That means the proportion of the pool’s individual responsibility amount is borne by healthy people.

Co-pay only plans favor people who use highly concentrated cost services. A co-pay does not differentiate between a specialist visit with a contract expense of $200 and a specialist visit with a contract expense of $600. It is the same fee. So people who use very costly services but only rarely are best off. People who use a lot of fairly low costs services on a regular basis pay more proportionally.

Co-insurance only plans favor low cost utilizers. They are not paying full price via their deductible, and unlike co-pays, the individual cost per unit matters.

I was talking with a colleague about insurance in North Carolina earlier this week. There are 33 plans being sold on the Exchange. Twenty-seven of the plans have a maximum out of pocket expense (Max OOP) of $7,350.  I expected to see that type of Max OOP for Catastrophic and Bronze plans. I would not have been surprised to see that Max OOP for Silver plans but I was surprised to see a $7,350 Max OOP for a Gold Plan.  The lowest Max OOP was $6,650 for a Bronze plan where the entire cost sharing was the deductible.

We looked into the plans and saw that the deductible got lower as the AV increased as well as co-pays and co-insurance.  The max-OOP translated to different levels of spending.  The Bronze Plan Max-OOP was $6,650 before the insurer paid everything the Gold plan only paid some of the claims to just over $40,000 before the insurer had to pay everything.  It is mainly a risk distribution bet on actuarial value as people who have a $10,000 claim are much better off in Gold than Bronze.

But as part of that discussion, I got curious about how much weight the deductible bears in cost sharing across the country.  I used the Landscape PUF to calculate a rough metric: Individual Medical Deductible/Individual Medical Maximum Out of Pocket.  If the quotient is 1, the deductible does all of the cost sharing.  If the quotient is 0 there is no deductible.  The Gold plan I mentioned above has a quotient of .17.

I’m seeing a few things. There is wild variance in plan design. Silver is all over the place. Zero dollar deductible plans are possible with Silver, Gold and Platinum.  Low deductible plans are fairly common for those metal plans.  They make up their cost sharing by co-pays and co-insurance.  I need to go back over time and calculate this quotient in previous years before I can make strong statements.  Right now it looks like plans of Silver/Gold/Platinum are being designed more often than not to look or actually be more attractive to healthier individuals.

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