June 23rd, 2017

The debate about the Senate version of the health care insurance reform bill…

…rages on.

I believe the bill will be modified, and has not reached its final form. But in the meantime, I was thinking about the following question to ask the critics who say it’s just Obamacare light: what else would you expect? After all:

(1) The president is not a conservative and would be unlikely to favor, and has not pushed for, a more conservative solution.

(2) Same for Congress, which does have some conservatives in the GOP, but they are not in the majority and not likely to be so any time soon.

(3) American citizens have become accustomed to subsidized medical insurance as a right, just as Obamacare proponents expected them to and planned that they would.

(4) Democrats are more than prepared to portray Republicans as heartless meanies who want to kill people. In fact, they’re portraying them that way right now—but a more Draconian, market-based bill would cause the cries to crescendo even further.

(5) As a thought experiment, consider what the GOP did when they last controlled the House and Senate as well as the presidency. They passed Part D of Medicare. They wanted to get out ahead of the Democrats on this; not that they ever got much credit for it. But I wonder what the GOP might have passed to deal with health care insurance reform prior to Obama’s election (and prior to Obamacare, of course), had they been focusing on the problem. Would it in fact have been something that looked something like Obamacare-lite, even without Obamacare having been previously enacted? I’m using Part D as an indicator.

And now—ta-da!—we have the article I was waiting for: Avik Roy’s analysis of the Senate bill. He is enthusiastic. Here’s an excerpt:

The reason that Medicaid’s health outcomes are so poor is because the outdated 1965 Medicaid law places a laundry list of constraints on states’ ability to manage their Medicaid programs. As a result, the main tool states have to keep Medicaid costs under control is to pay doctors and hospitals less and less each year for the same care. Hence, many doctors don’t take Medicaid, and Medicaid enrollees struggle to gain access to care.

The Better Care Reconciliation Act of 2017 addresses these problems in several ways.

First, the bill repeals Obamacare’s Medicaid expansion, and replaces it with tax credits so that low-income Americans can buy the coverage of their choice at an affordable price.

Second, the bill gives states a new set of tools to make their Medicaid programs…

A third area where the Senate bill does extremely well is in giving states the latitude to come up with new ways to serve their needy populations with better results and lower costs.

We’ve talked already about the new flexibility that states will have with their Medicaid programs. They’ll have even more flexibility to open up their private insurance markets to innovation and competition, through a new set of “Section 1332” waivers in which the validity of the waiver applications will be assumed by the federal government so long as the plan doesn’t increase federal spending…

…[A]ny Republican conservative in the Senate who is thinking of voting “no” on this bill: how many times in your life will you have the opportunity to vote for a bill that fundamentally transforms two entitlement programs? How often will you get to vote for a bill that cuts spending by hundreds of billions of dollars? How often will you get a chance to make a difference for millions of your constituents who are struggling under the weight of rising premiums and exploding deductibles?

Please read the whole thing. One of the main points I take away from it is that the bill would restore a measure of federalism to the entire operation.

Why do I put so much weight on what Avik Roy says? Simply because, in the past, I’ve found him to be the most knowledge and fair writer on health care insurance reform issues, as well as practical and realistic.

I find what he writes about the current bill to be very encouraging—that is, if his voice isn’t drowned out by all the others.

June 23rd, 2017

The opioid epidemic

For anyone interested learning more about the opioid addiction epidemic, I strongly recommend this very comprehensive article. It’s long, but it covers a great deal of territory rather succinctly, and illuminates some of what was previously unclear.

Rather than post excerpts, I’ll just link to it and suggest you read it. It’s the best thing I’ve read so far on the subject.

June 22nd, 2017

Tale of the non-tapes: Trump says…

nope, no tapes:

With all of the recently reported electronic surveillance, intercepts, unmasking and illegal leaking of information, I have no idea whether there are ‘tapes’ or recordings of my conversations with James Comey, but I did not make, and do not have, any such recordings,” Trump tweeted.

I would have loved to have listened to a tape of the Trump/Comey dialogues, but I never thought such tapes existed. I thought Trump was just teasing us (and Comey) with the notion.

Not exactly “presidential,” but very Trumpian.

June 22nd, 2017

Covering the Senate health insurance bill

First of all, let’s call it the right thing: it’s not a health care bill, it’s a health insurance bill.

Semantics aside, what’s in it? And does it matter? I doubt this will be the final version, but it’s a good indication of where the thing may be headed.

Trouble is, it’s a hard subject to talk about for the simple reason that we can’t trust the media to summarize it or report on it fairly, and that distrust been present for a long time. Here’s the memeorandum coverage for today, for what it’s worth; you can see for yourself how much is propaganda.

I’m not about to read the bill myself (I’m very busy today), although I may have to resort to that. It’s not a question of left or right, either, because the left tends to distort in one way (“this is going to kill us all!”) and the right in another (“It’s fabulous!” or “It’s another cruel lie of the GOP establishment cucks!”, depending on which part of the right is speaking).

I will wait for the analysis by someone in whom I feel a relative amount of trust, like Avik Roy. But I noticed that Roy has tweeted a preliminary reaction: “Finished reading the Senate HC bill. Put simply: If it passes, it’ll be the greatest policy achievement by a GOP Congress in my lifetime.” The responses on that page are as you might expect.

Roy also added, “The centerpiece of the @FREOPP plan (http://bit.ly/2sFwCDk )—means-tested, age-adjusted tax credits—is in the Senate bill. This is huge.”

I am tentative, but I have to say that I’ve found Roy to be the fairest and most intelligent analyst of health care insurance bills in the past, and I find his reaction very encouraging indeed.

June 22nd, 2017

Longest sniper kill confirmed

It occurred in Iraq, killed an ISIS fighter, was by a Canadian sniper, and was fired from two miles away (11,319 feet.).

That’s pretty extraordinary.

The sniper and the exact location have not been identified, but we do know this:

The bullet was fired from a McMillan TAC-50 rifle set on a high-rise tower and took 10 seconds to travel the 2.14 miles towards the fighter, who was attacking Iraqi soldiers…

A military source told The Globe and Mail the kill was verified by video, adding: ‘This is an incredible feat. It is a world record that might never be equalled.’

Canadian snipers are regarded as among the best, if not the best, in the world.

When I saw the news I wondered whether snipers who fire at these distances have to take into effect the curvature of the earth. Seems to me they would, although I know next to nothing about it. The fact that the rifle was set on a high-rise tower certainly indicates it, but perhaps a reader can enlighten me as to whether I’m off-base with that supposition.

I also picture the movie scene: something a little like when, in a Western, a shot comes seemingly out of the blue, and then later you see where the shot came from—which, of course, is never two miles away. In the Iraqi case, no one ever actually saw its origins; it just appeared out of the blue. But I’m sure the onlookers got the drift of what must have happened.

There’s also this scene from “High Noon,” which I realize has little to do with it, but which came to mind. This scene always moves me, because the Grace Kelly character is a Quaker, and yet she feel she must respond this way:

June 21st, 2017

Another daycare child abuse conviction overturned

The 80s and 90s featured a great deal of hysteria about child abuse in daycare, and there were a number of high-profile miscarriages of justice, most notably the McMartin case and Fells Acres in Massachusetts. In large part, the convictions were a result of the fact that investigative techniques were primitive and prejudicial to the accused, with a great deal of cross-contamination and leading of the tiny child witnesses.

There were a few “real” cases—child abuse exists everywhere. But they were far more rare than believed at the time. Unfortunately, though, once a conviction has occurred, it’s extremely hard to reverse it.

Here’s news of a Texas case (one with which I was previously unfamiliar) in which a convicted couple has been exonerated—after 25 years, most of them spent incarcerated:

The exoneration is the first for the nascent conviction integrity unit of the Travis County District Attorney’s Office under the new DA, Margaret Moore. Court documents filed Tuesday announced that there is “no credible evidence” against the Kellers. Moore said she personally reviewed the case and believes exoneration “to be a just outcome.”

Fran and Dan Keller were each sentenced to 48 years in prison for the alleged sexual assault of a 3-year-old girl who was an occasional drop-in at their home daycare center on the rural outskirts of Austin. The child initially accused Dan of spanking her “like daddy” used to, but under intense and repeated questioning by her mother and a therapist, the story morphed to include claims of rape and orgies involving children. From there, the number of children alleging abuse increased and the accusations grew even more lurid and confounding: The Kellers had sacrificed babies; they held ceremonies in a local graveyard; they put blood in the children’s Kool-Aid; Fran cut off the arm of a gorilla in a local park; they flew the children to Mexico to be sexually assaulted by military officials.

At the time of their conviction, there was a prevailing belief that children never lie in such cases. That was always a preposterous supposition, and it is no longer the going theory. Fortunately.

June 21st, 2017

I have grown to dread computer updates

An update is supposed to make things better, right? But it seems to me that a great many of them (you can’t predict which ones—or at least I can’t) will throw a monkey wrench into the works instead.

After several near-disastrous experiences, I never update iTunes if I can help it. My cellphone recently updated Google Maps (which I use for navigation), and although I consider some of the new bells and whistles to be improvements, others make me gnash my teeth with frustration.

And don’t get me started on Yahoo Mail (fortunately, I’ve written about it before). Suffice to say that with Yahoo’s various revamps, nearly everything that was done was a negative and nothing a positive. The only reason I still use it is a combination of the inertia of force of habit, dislike of other email services too (for other reasons), and not wanting the bother of informing everyone of a new email address.

And one of the reasons I haven’t gotten a new computer is lack of desire to learn Windows 10. I’ve used it on other people’s computers and I hate it (I have an archaic 7). I know, I know; I should bite the bullet and make the adjustment. I’ve never done well with change in any computer system, though. It’s not just the initial transitions that I find hard, although there’s that. I continue to be annoyed at losing the things I liked and gaining things I don’t like, although I’m happy for the improvements. It just seems that, a lot of the time, the so-called improvements turn out on balance to be not-so-much, or even steps backward.

However, all I have to do is look back on my early days with computers and remember when pre-Google search engines would throw the kitchen sink at you in what seemed like random order, and you could make lunch while waiting for each site to load, and I see that progress is not an illusion after all. And remember the sound of the dial-up? Even the memory fills me with dread.

June 21st, 2017

Karen Handel wins Georgia seat

Georgia’s 6th Congressional District has been Republican for quite some time, sometimes solidly Republican, and it turns out that yesterday was no exception: Republican Karen Handel won by about four points despite the Democrats’ throwing a ton of money into defeating her, and despite their hopes that Trump had alienated enough usually-Republican voters that they’d take it out on Handel by rejecting her.

Didn’t happen. The money was wasted, and either voters are not all that disaffected with Trump or they managed to realize that Handel and Trump are two different people (they don’t even look alike!), or both.

Dan McLaughlin has this to say in National Review:

Patrick Ruffini estimated on Twitter this morning that the two parties combined to spend more money in this House race ($50 million) than Ronald Reagan spent on his 1984 presidential re-election (even adjusting Reagan’s $28 million campaign for inflation). At this writing, given the projected outcome, the net result looks very much like Verdun: a costly and depressing victory for the Republicans, bled white defending their own turf, and a debacle for Democrats, who came home empty-handed and must be able to win districts like GA-06 if they are to take control of the House in 2018 and carry out their chief policy goal of impeaching President Trump…

The reason why both sides poured so many resources into this race was the simple calculation by both sides that upscale suburban Romney-not-Trump voters are precisely the kind of swing votes that the Democrats need in 2018 to reclaim the House. And yet, Karen Handel persisted, and prevailed. If the Democrats are going to crack that code in 2018, they haven’t yet. Ossoff’s message was a mixed bag of occasional Trump-bashing, conservative-sounding promises to tackle wasteful DC spending, and a very belated rush to hit Republicans on health care after soft-pedaling the issue until the campaign’s final days, when candidates traditionally give up on persuasion and focus on firing up their base.

Funny thing; I don’t see many Republicans today who find this victory the least bit depressing. I suppose Handel’s victory should have been larger, but it was a substantial win and wins are usually not a cause for sorrow.

My takeaways from this election?

(1) Once again, the Democrats ran a bad candidate. Bad fit for the county, extraordinarily young, inexperienced, and to the left. Why did they make such an obvious error? I’ve researched it a bit, and I haven’t found the answer, except that the other candidates must have been pretty awful. That’s a problem that’s getting very serious for the Democrats in general, and was responsible (IMHO) for their 2016 loss of the presidency, when the very poor candidate Hilary Clinton emerged as the most viable candidate, with the geriatric (sorry, Bernie!) Sanders close behind. Osoff was new blood, but not all new blood is good blood.

(2) Money can’t buy you love. Ooops, I mean elections. But it can help.

(3) Polls continue to be not so hot, although not so very bad either.

June 20th, 2017

News about cancer research that could be very, very important

As I get older, I have lost more and more people I love and care about to cancer—one of them very very recently. Others I’m very close to have had the disease and are (knock wood) okay so far.

Anyone who’s as old as I am knows what I’m talking about. Cancer is a vile and terrible disease that can cause great suffering, and the treatment is often extremely difficult as well.

Therefore I am encouraged by this news:

Jayatilaka and a team at Johns Hopkins discovered the biochemical mechanism that tells cancer cells to break off from the primary tumor and spread throughout the body, a process called metastasis. Some 90 percent of cancer deaths are caused when cancer metastasizes. The team also found that two existing, FDA-approved drugs can slow metastasis significantly…

Typically, cancer research and treatment has focused on shrinking the primary tumor through chemotherapy or other methods. But, the team said, by attacking the deadly process of metastasis, more patients could survive.

“It’s not this primary tumor that’s going to kill you typically,” said Denis Wirtz, Johns Hopkins’ vice provost for research and director of its Physical Sciences-Oncology Center, who was a senior author on the paper…

Many researchers believe metastasis happens after the primary tumor reaches a certain size, but Jayatilaka found it was the tumor’s density that determined when it would metastasize…

Once the cancer cells start to sense the presence of too many other cancer cells around them, they start secreting the Interleukin proteins, Wirtz said. If those proteins are added to a tumor that hasn’t yet metastasized, that process would begin, he said…

The drugs the team used were Tocilizumab, a rheumatoid arthritis treatment, and Reparixin, which is being evaluated for cancer treatment.

The drugs bind to the Interleukin receptors and block their signals, slowing metastasis.

These two drugs have fewer side effects than typical chemo drugs, which is another plus. Of course, this has only been tested in animal models and the effect may not transfer to humans; that’s always a caveat with such research. But the knowledge about how a tumor metastasizes should be invaluable for the future.

The article says that about 90% of cancer deaths are caused by metastasizing tumors. It doesn’t explain the other 10%, but I’m pretty sure that a portion of them are from the category of cancers known as blood cancers—that is, leukemia, lymphoma, and myeloma—which don’t involved solid tumors. They involve types of tissue that already spread throughout the body, and so my guess is that this research would not apply to them. [NOTE: We have a resident oncologist among our regular reader here, and I would welcome him weighing in on the subject.]

June 20th, 2017

The Georgia special election is today—and I’m making only one prediction

I have no idea who will win. Neither does anyone else.

But it’s being hyped to the skies as very very important, as well as indicative of trends and signs and portents for the future not limited to this one Georgia district. That’s why, when I saw the headline to this article by pollster Nate Silver—“Why The Georgia Special Election Matters”—I thought “oh-oh, here’s another stupid piece on how the Georgia election is a predictor of a whole bunch of other things, including what will happen in the 2018 midterms.”

I don’t agree that it’s that big a deal; I actually think this particular battle is an idiosyncratic and atypical election that doesn’t tell us much about anything except whether Karen Handel or Jon Osoff will be going to Congress to represent Georgia’s 6th Congressional District.

But it turns out I was wrong about the Silver article. For the most part, it agrees with much of what I was thinking:

In either case, the narrative that emerges from the Georgia 6 runoff will lack nuance and will oversimplify complex evidence. While special elections overall are a reasonably useful indicator in forecasting upcoming midterms, their power comes in numbers. A half-dozen special elections taken together are a useful sign; any one of them is less so.

Silver adds this:

But we’re at a moment when Republicans have a lot of decisions to make now, and the story they tell themselves about the political environment matters as much as the reality of it. The narrative will probably be dumb, but it might matter all the same.

I would add that the story the MSM and the Democrats will tell is likely to be every bit as dumb or perhaps even dumber.

Silver points out that Georgia’s 6th Congressional District has a varied electoral history, particularly if you look at presidential elections:

Georgia 6 is a tough district to diagnose because its politics in presidential elections shifted a lot from 2012 to 2016. In 2012, the district went for Mitt Romney by 23 percentage points in an election that then-President Barack Obama won by 4 points nationally. That made it 27 points more Republican than the country as a whole. In 2016, by contrast, it chose Trump over Hillary Clinton by only 1.5 points in an election where Clinton won the popular vote by about 2 points nationally. Therefore, it was only 3 to 4 points more Republican than the national average.

That’s strange, but there is a certain consistency there in that the Republican candidate won each time, although the margins of victory were wildly different in 2012 and 2016. Of course, Trump was hardly a generic Republican candidate, so his low margin of victory could be explained by Trump-aversion rather than aversion to Republican candidates in general. Silver goes into a lengthy analysis of the Congressional vote in the district in 2016—too lengthy and complicated to easily summarize—but probably worth reading. Silver did very very well in predicting the 2012 election. He did far less well in 2016.

So, what’s my one prediction? Whatever the outcome, it will be used for propaganda purposes to indicate far more than it really indicates. Of course, if the victory margin is yuge (as someone we know would say), that actually might be indicative of some sort of trend (however, Romney’s huge 2012 margin there was indicative of absolutely nothing). I also want to remind everyone that it’s about a year and a half till the 2018 midterms. That’s an aeon in political life.

June 20th, 2017

Otto Warmbier…

has died.

Very sad indeed. RIP.

The tour company that sponsored Warmbier’s trip has now decided it will no longer offer this service:

For years, Young Pioneer Tours has happily boasted: “We provide budget travel to destinations your mother would rather you stayed away from.” On Monday, after Warmbier’s family announced he’d died that afternoon at a Cincinnati hospital, the message that the China-based tour company sent via e-mail to USA TODAY wore a darker and more anguished tone.

“Our deepest sympathies are with Otto Warmbier and those who loved him,” the e-mail read. “We had held onto hope that he might recover, and have the life that he should have had, but now those hopes are gone, and we too are reeling with the shock of a young man’s life taken well before his time.”

Considering these facts and this tragic outcome we will no longer be organizing tours for U.S. citizens to North Korea.”

I think it’s a wise decision. If people are determined to go there, I suppose they will, however.

June 19th, 2017

What is it with the Japanese?

I mean really, what is it?:

[A] hotel in Japan…allows couples getting married to hire an alpaca to act as the witness.

Allows it? I’d say encourages it:

The hotel in question, the Epinard Nasu in Tochigi, even allows the animals to appear in the wedding photographs, before returning to the local zoo, which just happens to be next door.

When you see the photos, you may want an alpaca at your wedding, too:

That is one cute critter.

I have friends who raise alpacas, so I’m very familiar with them and the fact that they are indeed cute. But that one is cuteness squared. I think it’s the grooming—which makes it look like a large and loopy Bichon Frise—as well as the bow tie, that combine to put it over the top of almost unbearable cuteness.

About Me

Previously a lifelong Democrat, born in New York and living in New England, surrounded by liberals on all sides, I've found myself slowly but surely leaving the fold and becoming that dread thing: a neocon.

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