Archive for November 2012
David Firestone writes in the NY Times:
Republicans reportedly laughed when they saw the Obama administration’s initial offer in the fiscal negotiations yesterday. The idea that President Obama might actually want to enact his campaign promises – tax hikes on the rich, modest Medicare cuts, investments in infrastructure – is apparently considered a joke to the party that has shown virtually no flexibility in the last four years.
But some of that laughter may contain nervousness, because there is more going on here than just a pathway to splitting the difference. The White House made clear yesterday that it is approaching these talks from a position of responsibility, and that it actually takes seriously the notion of old-fashioned bargaining. That’s something Republicans have refused to do — and now they realize they’ve been called out.
It was never responsible for Republicans to spend years adamantly declaring total opposition to higher taxes as a back-door way of starving government. That’s precisely the intransigence that created the fiscal cliff in the first place. Now a few Republicans are saying they’ll agree to higher revenues, as if that obvious need is an enormous concession, but they’re still refusing to support increased tax rates.
It was never responsible to spend years on talk shows demanding “cuts in entitlements,” while running a presidential campaign that attacked Mr. Obama for cutting Medicare. The president has put $400 billion in cuts to Medicare and other social insurance programs on the table. The Republicans, out of political fear, have proposed exactly nothing.
It was, above all, profoundly irresponsible for Republicans to govern by threatening to send the Treasury into default if they did not get their way on spending, a wholly new and ugly phenomenon in American politics. Treasury Secretary Timothy Geithner spoke for the financial markets and anyone who cares about good government when he proposed yesterday a way to permanently defuse that threat by requiring a two-thirds vote of Congress to block an increase in the debt ceiling.
That was considered particularly uproarious in the offices of House and Senate Republican leaders. But once the laughter dies down, they will have to come to the table with a responsible offer of their own, rather than simply declaring a stalemate, as Speaker John Boehner did today, because he didn’t like the president’s opening bid. If they continue to refuse to do so, the public won’t find it very funny.
The GOP has become completely irresponsible. They are simply a destructive, irrational force now.
The Wife and I just watched Tabloid, a documentary by Errol Morris—his second appearance in one of my blog posts today. (See earlier post on Jeffrey MacDonald.) Tabloid is a move that may not have everything, but it does have plenty: Mormons, sex, bondage, tabloids, and more—many unexpected twists. And it does show the complete lack of empathy of the UK tabloid press: one can readily understand why tabloid executives will doubtless be going to jail, and well-deserved it is. One wants a free press, but not a duplicitous, licentious press. The UK tabloids seem to lack any sense of responsibility at all.
Because profit-oriented hospitals must constantly increase profits, cutting costs and services, increasing fees, and pushing doctors to bill more. Judy Creswell and Reed Abelson report in the NY Times:
or decades, doctors in picturesque Boise, Idaho, were part of a tight-knit community, freely referring patients to the specialists or hospitals of their choice and exchanging information about the latest medical treatments.
But that began to change a few years ago, when the city’s largest hospital, St. Luke’s Health System, began rapidly buying physician practices all over town, from general practitioners to cardiologists to orthopedic surgeons.
Today, Boise is a medical battleground.
A little over half of the 1,400 doctors in southwestern Idaho are employed by St. Luke’s or its smaller competitor, St. Alphonsus Regional Medical Center.
Many of the independent doctors complain that both hospitals, but especially St. Luke’s, have too much power over every aspect of the medical pipeline, dictating which tests and procedures to perform, how much to charge and which patients to admit.
In interviews, they said their referrals from doctors now employed by St. Luke’s had dropped sharply, while patients, in many cases, were paying more there for the same level of treatment.
Boise’s experience reflects a growing national trend toward consolidation. Across the country, doctors who sold their practices and signed on as employees have similar criticisms. In lawsuits and interviews, they describe growing pressure to meet the financial goals of their new employers — often by performing unnecessary tests and procedures or by admitting patients who do not need a hospital stay.
In Boise, just a few weeks ago, even the hospitals were at war. St. Alphonsus went to court seeking an injunction to stop St. Luke’s from buying another physician practice group, arguing that the hospital’s dominance in the market was enabling it to drive up prices and to demand exclusive or preferential agreements with insurers. The price of a colonoscopy has quadrupled in some instances, and in other cases St. Luke’s charges nearly three times as much for laboratory work as nearby facilities, according to the St. Alphonsus complaint.
Federal and state officials have also joined the fray. In one of a handful of similar cases, the Federal Trade Commission and the Idaho attorney general are investigating whether St. Luke’s has become too powerful in Boise, using its newfound leverage to stifle competition.
Dr. David C. Pate, chief executive of St. Luke’s, denied the assertions by St. Alphonsus that the hospital’s acquisitions had limited patient choice or always resulted in higher prices. In some cases, Dr. Pate said, services that had been underpriced were raised to reflect market value. St. Luke’s, he argued, is simply embracing the new model of health care, which he predicted would lead over the long term to lower overall costs as fewer unnecessary tests and procedures were performed.
Regulators expressed some skepticism about the results, for patients, of rapid consolidation, although the trend is still too new to know for sure. “We’re seeing a lot more consolidation than we did 10 years ago,” said Jeffrey Perry, an assistant director in the F.T.C.’s Bureau of Competition. “Historically, what we’ve seen with the consolidation in the health care industry is that prices go up, but quality does not improve.” . . .
Continue reading. A capitalistic, free-market, profit-making approach does not always produce the best result, as you see.
The Eldest just called to say that this recipe was terrific. Ingredients:
1 pound (2 to 2 1/4 cups) dry white beans such as Navy beans or Great Northern beans (can also use kidney beans)
1/3 cup molasses
1/3 cup brown sugar
3-4 Tbsp Dijon mustard
1/8 teaspoon ground cloves
3 cups hot water
1/2 pound salt pork (can substitute bacon), cut into 1/2-inch to 1-inch pieces
1 medium onion, (1 1/2 cups) chopped
She went with the bacon, since some said (in comments) that the salt pork was too salty. We had a good laugh at the idea of using a medium onion.
She soaked beans overnight, and then they had to soak through the day while she was at work, so they were well-soaked. She put it together in the slow-cooker overnight and said she awoke the next morning drooling at the fragrances wafting through the house.
I’ll make it soon, but I just got a smoked ham shank that I’m going to cook overnight in a 200F oven, with just a little water (or not: still deciding), and then tomorrow add onion, carrots, celery, two cans of beans, drained and rinsed (one can pinto, one can black), and shredded cabbage, water, and perhaps Penzeys Ham Soup Base to make a rainy-day soup. Maybe some rice?
Very interesting article by Rob Kampia, executive director of the Marijuana Policy Project:
In the wake of our victory in Colorado — where 54.8 percent of the voters passed Amendment 64, a constitutional amendment to regulate marijuana like alcohol — good people are understandably clamoring to pass similar measures in their states.
Here is a listing of the ingredients of the recipe that led to the historic victory in Colorado on November 6.
1. Presidential Election: Given that no one had ever previously legalized marijuana in the history of the world, we assumed that the election in Colorado would be close — win or lose. So we intentionally chose to place our initiative on the ballot during a presidential election, which always attracts a larger proportion of young voters, who are more supportive.
2. Inclusive Drafting Process: The team that drafted the initiative went out of its way to solicit feedback from key lawyers, medical-marijuana industry players, other organizational leaders, and unaffiliated activists. As a result, there was almost no infighting, which allowed us to build a strong coalition of support across the state.
3. Years of Groundwork: Officially, the Colorado campaign was two years long; unofficially, it was eight years long. In 2004, MPP’s grants program helped launch two non-profit advocacy organizations in Colorado, SAFER and Sensible Colorado. The executive directors of these two organizations eventually became the co-proponents of Amendment 64. SAFER focused on educating the public about the fact that marijuana is less harmful than alcohol; it did so through citywide, marijuana-related ballot initiatives in Denver in 2005 and 2007, which each garnered support from a majority of Denver voters. In 2006, SAFER coordinated a statewide ballot initiative to legalize marijuana and generated substantial debate in Colorado (while garnering 41 percent of the vote). Meanwhile, Sensible Colorado helped expand access to medical marijuana for patients. Most significantly, in 2008, Sensible Colorado spearheaded a court challenge to expand the state’s medical marijuana “caregiver” provision to allow for retail sales. All of this took planning and money.
4. . . .
Very interesting article by Ron Fournier in the National Journal:
Our noses were practically touching the wall. Tall, white, and seamless, it was the only thing standing between us and the president of the United States. “Stay right there,” a White House aide told me, my wife, and three children. “The president will be with you in a minute.” Suddenly, the wall opened; it was a hidden door to the Oval Office. “Come on in, Fournier!” shouted George W. Bush. “Who ya’ dragging in?”
It was my last day covering the White House for the Associated Press, and this 2003 visit was a courtesy that presidents traditionally afford departing correspondents. I introduced my wife, Lori, and two daughters, Holly and Abby, before turning to their 5-year-old brother. “Where’s Barney?” Tyler asked.
“He’s coming!” Bush replied as his Scottish terrier scampered into the room. “Let’s do a photo!”
As the most powerful man on Earth prepared to pose for a picture, my son launched into a one-sided conversation, firing off one choppy phrase after another with machine-gun delivery. “Scottish terriers are called Scotties, they originated from Scotland, they can be traced back to a single female named Splinter II, President Roosevelt had one, he called it Fala, Dad says he kept him in the office down there when he was swimming, there’s one in Monopoly, my favorite is the car …”
I cringed. Tyler is loving, charming, and brilliant—he has a photographic memory—but he lacks basic social skills. He doesn’t know when he’s being too loud or when he’s talking too much. He can’t read facial expressions to tell when somebody is sad, curious, or bored. He has a difficult time seeing how others view him. Tyler is what polite company calls awkward. I’ve watched adults respond to him with annoyed looks or pity. Bullies call him goofy, or worse.
But the president was enchanted. Waiting for Tyler to take a breath, he quickly changed the subject with a joke. “Look at your shoes,” Bush told Tyler while putting a hand on his shoulder and steering him toward the photographer. “They’re ugly. Just like your dad’s.” Tyler laughed.
Ten minutes later, we were walking out of the Oval Office when Bush grabbed me by the elbow. “Love that boy,” he said, holding my eye.
Fathers and sons don’t always know how to talk to each other, which is why we have sports. . .