Health Care

Daily Meme: Embrace the Discomfort

Try to relax; today's meme is all about discomfort. And there's no one feeling more of it than Republicans, who were hit yesterday with the rhetorical stylings of their erstwhile hero Cliven Bundy—Nevada rancher, defier of laws, and racial philosopher. The Republican Party's chief spokesperson, for instance, can't figure out why anyone would associate Bundy with the GOP . "The issue with Cliven Bundy has absolutely nothing to do with his party, zero," he said. After all, it's not like the GOP's chief organ in the media had been giving the guy blanket coverage all the while Republican politicians were praising his crusade. I mean, c'mon. Republicans are also being made uncomfortable by their own candidates, who haven't all gotten the message on the "outreach" the party is supposed to be doing. Here's one who has proposed an effort to round up and deport every undocumented immigrant in the country , which he calls, no kidding, "Operation Wetback." Here's one who said it was an "...

Daily Meme: The Fall of Cliven Bundy

It's media discovery day here at the Daily Meme. What's being discovered? The story of the day is of course Nevada rancher and public property thief Cliven Bundy, who, to the surprise of pretty much nobody, turns out to be a stone-cold racist. When a guy holding a press conference starts a sentence with, "I want to tell you one more thing I know about the Negro," the clever reporter starts writing. And so does a right-wing hero fall from his perch. Bundy will now disappear from Fox News, where he was getting round-the-clock coverage. Bundy's greatest media advocate has been Sean Hannity, who has gotten into an ugly/funny back-and-forth with Jon Stewart over the issue . We assume that with this latest development, Hannity will apologize for ever promoting Bundy, and apologize sincerely to Stewart. And that Stewart will not gloat about it at all. As Jamelle Bouie notes, Bundy's ideas aren't really all that unfamiliar : "In short, the only difference between Bundy and a whole host of...

We Hate Obamacare (But Like What It Does)

The word on Americans—one bit of conventional wisdom that is nonetheless true—is that they are ideologically conservative and operationally liberal. They are opposed to big government but support actual universal government programs like Social Security and Medicare. Confronted with Obamacare, conservative Americans have taken this paradox to new heights. They intensely dislike the program, but they like what it actually does. The New York Times has a poll of four Southern states (Arkansas, Kentucky, Louisiana, North Carolina) out today, undertaken in conjunction with the Kaiser Family Foundation. It shows that most of those states’ residents “still loathe the law,” but that majorities in three of those states and a plurality in the fourth don’t want Congress to repeal and replace it. They just want Congress to improve it. In Kentucky, which established its own exchange under Obamacare’s stipulations, a majority believed that the exchange was working well. In Arkansas, which has...

The Religion of Unreason

Flickr/Dustin Grayson
I think it's safe to say that this period in history is one in which liberals have felt unusually exasperated with conservatives, perhaps more than ever before. I can say this with some confidence as a liberal who runs in liberal circles; it may well be that conservatives are also more exasperated with liberals than they have ever been. Our ability to feed that exasperation is driven by the fact that, for all the polarization of information sources, we're actually more aware of what people on the other side say than we ever have been before. Fifteen years ago, I would have had no idea if Rush Limbaugh said something offensive, but today (once it rises to a certain level of horror), Media Matters will record it and put it on their web site, the Huffington Post will put it on their web site, and half a dozen people in my Twitter feed will let me know it happened. So there are all kinds of new ways to become appalled with your opponents. And there's nothing we liberals find more...

Republicans on the ACA: Wrong, but Rational

Courtesy of earloftaint.com
I find it strange," said Barack Obama on Thursday as he announced that the total of Americans getting private insurance through the exchanges has now exceeded 8 million, "that the Republican position on this law is still stuck in the same place that it has always been. They still can't bring themselves to admit that the Affordable Care Act is working." But it really isn't so strange. The Republicans' continued refusal to grant that anything good could possibly come from a law they've fought so bitterly for five years, even as encouraging news continues to roll in, is quite understandable. What's more, it's perfectly rational, even when all the predictions they made about its inevitable self-destruction fail to come true. Therein lies one of the paradoxes of our politics: At times, the most rational politician is the one who appears to be acting like a fool. Let's say that you're a Republican running for Senate. Perhaps you're whichever congressman will out-crazy his primary opponents...

Would You Let a Robot Give You a Sponge Bath?

Getting ready for their shift on the pediatric ward. (Kai Schreiber/Wikimedia Commons)
Imagine it's 50 years from now, and you've checked into the hospital for a minor surgery that will require you to spend a couple of nights there. There's a nurses' station down the hall, but you know that the nurses are also caring for lots of other patients and may not be able to come quickly when you have a need, particularly if it isn't an emergency, like getting a hand walking to the bathroom, or having someone pick up the TV remote you dropped, or maybe getting a foot rub just because that would be nice. Upon checking in, the clerk says to you, "I see that your insurance provides for a robotic aide while you're here. Is that something you'd like?" What are you going to say? According to a survey the Pew Research Center did on people's feelings about future technologies, most people would say "No thanks"—or at least they think so now. The survey is fascinating in part because many of the results seem (to me anyway) to be ridiculous. For instance, 39 percent of respondents think...

The Abortion Restriction That’s Too Extreme for Most Pro-Lifers

AP Images/The Columbus Dispatch/Brooke LaValley
E arlier this month, lawmakers in Kansas ended this session’s debate over abortion on a surprisingly low-key note. The Republican leadership shepherded two minor tweaks to existing abortion policies through the legislature, while staving off a far more contentious measure: a bill that would criminalize abortion after a fetal heartbeat can be detected, as early as six weeks into a pregnancy. The bill’s advocates say they are confident it would have passed, had it reached the floor; Kansas has strong anti-abortion majorities in both houses of the legislature and pro-life crusader Sam Brownback in the governor’s mansion. But the Republican leadership, prompted by the state’s most powerful pro-life group, Kansans for Life, used a legislative loophole to keep their more radical colleagues from attaching the fetal heartbeat proposal. Why, in a state where nearly every strain of anti-abortion restriction has taken root with ease, are advocates of the fetal heartbeat ban facing such stiff...

The Most Expensive Health Care In the World

The high-grade stuff.
As a reader of this web site, you are informed and aware, so you no doubt saw the stories that came out yesterday about the data trove the government just released on what individual doctors bill Medicare. The shocking news was that some have managed to charge the government millions of dollars, including one ophthalmologist, Salomon Melgen, who billed Medicare an incredible $21 million in 2012 alone, and who just happens to be caught up in an investigation of influence peddling with a Democratic senator. But before this story disappears with some head-shaking about scandal and fraud, we should take note of what it teaches us about why we have the most expensive health care system in the world. A lot of people had the same reaction to that detail about the Florida ophthalmologist: How on Earth is it possible for one doctor to bill $21 million to Medicare in one year? The good doctor's answer is that he has a large practice, but the biggest reason comes down to one word: Lucentis. It's...

Fetal Abnormalities: The Next Minefield in the Abortion Wars?

AP Images/Steve Helber
I n January, two legislators in Virginia’s House of Delegates introduced a bill that should have been uncontroversial. The bulk of HB 612 created new rules for genetic counselors practicing in the state, who had been unregulated and unlicensed. The roughly 95 genetic counselors already working in the state, screening pregnant women and adults for serious inheritable conditions, favored the law, which they saw as an extra layer of patient protection. The bill was so innocuous that by the time it passed in the House in late February, no one seemed to have noticed that it contained a conscience clause so sweeping that could allow counselors to refuse to provide fetal test results for conditions like Down Syndrome or Tay-Sachs Disease—the information patients came to them for in the first place—if they believed it could cause a woman to terminate her pregnancy. Originally, the bill had only created a loophole for genetic counselors who want to refrain from offering information about...

How Barack Obama Trapped the GOP On Health Care

It was all downhill from here.
Barack Obama has done many dastardly things to Republicans. He regularly ridicules their arguments. He insists on being treated as though he were legitimately the president of the United States. And most cruelly of all, he beat their standard-bearers in two national elections. Is it any wonder they loathe him so? But one thing Obama has done to the GOP has gone unnoticed: he made it impossible for them to be serious about health care policy. By now you're well familiar with how the core of the Affordable Care Act—a ban on insurance companies denying coverage for pre-existing conditions (also known as "guaranteed issue"), accompanied by an individual mandate and subsidies for people of moderate incomes to purchase private insurance—was originally a conservative proposal. The idea was that unlike in most other western countries where a large government program like Medicare covers all citizens, you could achieve something close to universal coverage and health security through the use...

Laying It All Out On Medicare

Flickr/Donkey Hotey
The release of a new Paul Ryan budget plan is always the occasion for a lot of ridicule from liberals, for a whole bunch of reasons, and this year's will be no different. Ryan's budgets always manage to combine a remarkable cruelty toward poor people with a sunny optimism that draconian cuts to social services will result in a veritable explosion of economic growth, allowing us to balance the budget without taking anything away from the truly important priorities (like military spending) or, heaven forbid, forcing wealthy people to pay more in taxes. I'm sure there are other people preparing detailed critiques of the Ryan budget, but I want to focus on one thing this brings up: the question of how we talk about Medicare. As he has before in his budgets, Ryan proposes to repeal the benefits of the Affordable Care Act, like subsidies for middle-class people to buy insurance and the expansion of Medicaid, but he'd keep the tax increases and Medicare cuts that the bill included in order...

Sunday Show Becomes 10 Percent Less Awful

Look! People who know what they're talking about!
A week and a half ago, I wrote a post over at the Plum Line with a couple of suggestions for how the Sunday shows could become less terrible. Some commenters pointed out that the real audience for these programs isn't actual people, but those within the Washington bubble for whom status and influence are everything. So my suggestion that the shows should never again interview a White House communication director or a "party strategist" of any kind—in other words, people who are there solely for the purpose of spinning—was unlikely to get much of a hearing. And my suggestion to drastically scale back on interviews with elected officials, who are also exceedingly unlikely to say anything interesting, would likewise fall on deaf ears. Which is perfectly true, and it hasn't stopped me from complaining about this topic before. But lo and behold, on yesterday's Meet the Press, something remarkable happened: They booked Jonathan Cohn of The New Republic and Avik Roy of Forbes to talk about...

Is the "Mend It" Period of the Affordable Care Act's Evolution Beginning?

All of a sudden, people in Washington seem to want to fix the Affordable Care Act. And regardless of their motivations, that should be—well, maybe "celebrated" is too strong a word, but we can see it as a necessary and positive development. Is it possible that the arguments about whether the ACA was a good idea or should have been passed in the first place are actually going to fade away, and we can get down to the businesses of strengthening the parts of it that are working and fixing the parts that aren't? It might be so. Sure, cretinous congressional candidates will continue to display their seriousness by pumping paper copies of the law with bullets , probably for years to come. But with this year's open enrollment period coming to an end in a few days, a particular reality is starting to set in, namely that, however you feel about the law, millions of Americans have now gotten health insurance because of it. Repealing it would mean taking that insurance away. So let's look at...

Hobby Lobby and the Return of the "Negro Travelers' Green Book"

Jalopnik
V ictor Green loved to travel. Being a mail carrier in the mid-20th century was a good, solid job, and the heyday of the American automobile was just beginning. Americans felt more mobile than ever before, especially once Eisenhower's interstate highway system expanded like a web through the country. The freedom of the open road beckoned. But Victor did not feel particularly free. As an African American, much of the nation was closed off to him and his family. Hotels rented rooms only to whites; restaurants wouldn't take his money; shops and markets kept their doors shut. Jim Crow was everywhere. So he wrote the first travel guide for African Americans, listing restaurants, hotels, gas stations, and even private homes that would aid the “Negro Traveler.” Known as The Green Book, it was an essential part of African American life for more than 20 years. By 1952, it had expanded its listings to include barbershops, bars, and nightclubs. Such a guide was essential, since each particular...

The Strange Bedfellows of the Anti-Contraception Alliance

AP Images/Patrick Semansky
AP Images/Patrick Semansky O n March 25, lawyers representing the owners of a large purveyor of craft supplies and a much smaller cabinetry business will appear before the Supreme Court in what has become the cornerstone case for opponents of the Affordable Care Act’s “contraception mandate.” Under the mandate, all employers—with the exception of religious organizations like churches—must include free birth control under their insurance plans. Catholic schools, hospitals, and social service agencies immediately raised a ruckus. Dozens of Catholic nonprofits filed lawsuits against the government, arguing that because their tradition forbids them from using birth control, paying for it—even indirectly through insurance—would violate their religious liberty. The cases that will appear before the highest court deal with a different question: whether the owners of corporations can claim religious liberty exemptions. But there’s a stranger and less remarked-upon twist. The owners of both...

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