Vouchers For Medicare

The most helpful piece I've read on Paul Ryan's proposal suggests that a voucher system for Medicare may be popular – but it likely won't cut costs, as the history of Medicare Advantage shows. Money quote from Austin Frakt:

The politics of Medicare are such that Ryan’s idea, paying for care entirely through private plans, costs more. That's not due to a market failure, but a political one. Congress likes to spend money; insurers, providers and beneficiaries like to receive it. Congress spends even more when it can satisfy those interests under the guise of a seemingly pro-market, pro-competitive program. When it comes to cost control and considering the political calculus of Congress, vouchers and Medicare don't add up.

The argument seems to be that private insurance companies have so much political clout that they would be a more formidable impediment to cost-control than traditional, single payer Medicare. That seems defeatist to me. And, as Krugman points out, there is a very strong and simple mechanism for cost control in the Ryan-Rivlin proposal:

I’m sure that the Republicans will claim savings — but those savings will come entirely from limiting the vouchers to below the rate of rise in health care costs; in effect, they will come from denying medical care to those who can’t afford to top up their premiums.

Yep: seniors will have to accept limits to the care they receive. And instead of the government rationing, they will just have vouchers that do not keep up with the price of cutting edge medicine. That should not mean abandoning the cost controls in health insurance reform, and constant exerimentation to make the health sector more efficient. And such an austere remedy requires, to my mind, sacrifice from those who earn over $250,000 a year.

Obama’s Latest Volte Face, Ctd

Jane Mayer criticizes the decision to not give KSM a trial:

Experts say that the military tribunals’ standards are far higher than they were during the early Bush days, and that K.S.M. is likely to get a fair trial in Guantánamo, too. But regardless of the reality, the forum will always seem tainted by politics, allowing the most heinous terrorist in the world to claim that he is America’s victim, rather than the other way around.

Discovering Sissy Bounce

A reader writes:

For some reason, I can't stop watching this MHB. I've now seen it five times in full screen HD, and it just gets better every time. It's Busta Rhymes mashed up with Antoine Dodson flamboyance, the booty-fixation of Sir Mix-A-Lot, the vapid lyrics, professional production and bad white person dancing that is Rebecca Black, and whatever learning disability that causes my students to think that the solution to a shitty project is adding more and more special effects. It's an awesome high point in a new art movement that I can only describe as craptacularism.

Exposure to such delicious randomness is a small but vital part of why your blog is one of my daily reads. Thanks for sharing.

From an interview with social theorist Alix Chapman:

Sissy Bounce is really not all that different [from the more widely known genre of "bounce."]. It incorporates call and response, the triggerman and brown beat, and a lot of the same dancing and sexually provocative lyrics associated with the rest of Bounce. There's a lot of social critique and explanation throughout Bounce music, just like any other form of hip-hop.

The only difference is these "sissies" are commenting and explaining a way of life that is not usually heard. I'm sure if you gave anybody marginalized by their sexuality or gender the chance to speak from their lived experience you're gonna hear something different. 

OMG Blog recommends:

[C]heck out the excellent website "Where They At", an oral history of bounce music curated by photographer Aubrey Edwards and writer Alison Fensterstock for the Ogden Museum of Southern Art in New Orleans. The site features music and audio interviews with veteran bounce acts such as Mia X, Cheeky Blakk and DJ Jubilee, and sissy bounce performers Katey Red, Vockah Redu and of course, Big Freedia.

A reader passes along a great short doc on NOLA's bounce movement. The above video is Katey Red performing at SXSW last year. Stereogum features a very NSFW performance by Big Freedia:

Here’s a video where the artists’ statement makes all the difference. On the surface it’s a strip club video. But underneath:

… Freedia encourages the dancers at Sassy’s to shake not for the customers specifically, but rather for their own pleasure and expression. The result is evident in the cheering and support of the crowd. In these three songs money rains on the stage (a necessary part of the work these girls do) despite the fact that the girls themselves rarely acknowledge the crowd. No longer performing “for” the men and women who are visiting the club, the energy of the room transcends the practical nature of “stripping as a profession” and illustrates that what works the best when trading sexuality for sustenance is a genuine expression of sexual joy.

The Bugs Or Mickey Debate, Ctd

Some remaining observations on this popular thread. A reader writes:

Bugs is ethnic humor – Jewish vaudeville schtick. Mickey is WASP, whitebread humor. It's the difference between Groucho Marx and Bob Hope.

Another:

This seems similar to the Letterman vs. Leno debate – do you prefer the sly, offbeat and sometimes ridiculous (Bugs, Letterman) or the predictable and safe (Mickey, Leno)?

Another:

When we talk about Bugs, the question needs to be raised "Which Bugs"? The character had different personality traits depending on who directed the cartoon. In Tex Avery's version, he was violent and somewhat sadistic, whereas in Chuck Jones' cartoons, he was invariably minding his own business when some bully started messing with him. The violence in the Jones' cartoons was always retaliatory ("Of course you know, this means war," being the popular refrain.)

Mickey evolved over time, moving from a Chaplinesque arse-kicking scamp to the friendly everyman corporate icon of today. He had to. If you look at the early, great black-and-white shorts, he was no sort of mascot any multi-national would want to represent them.

Another corrects:

Your reader who references Bugs Bunny asking Elmer Fudd how many lumps he wants with his tea has got his cartoon characters mixed up.  Bugs actually asked the question of Pete the Puma, another of his nemeses.  Here’s a short clip.

Another passes along the classic "Hillbilly Hare" cartoon and writes:

My late uncle Bill, an artist who escaped to New York from the depressed hinterlands of Maryland and West Virgnia, loved the WB cartoons and cited them often. Same for all his artist pals of his generation who I've gotten to know. Like the oddballs and rejects of Mad Magazine, the WB 'toons were heroes to their young anti-establishment minds: they were triumphant individualists in ink, characters who punched the bullies in the nose and got away with it every time. The guys behind Mad are now celebrated as countercultural icons. The WB artists deserve the same.

Watching For Dark Horses

Nate Silver takes a close looks at primary polling. Contrary to the conventional wisdom, he finds that "national polls of primary voters — even this far out from the Iowa caucuses and New Hampshire primary — do have a reasonable amount of predictive power in informing us as to the identity of the eventual nominee." In his second post on the subject, he outlines some basic principles:

First, the absence of a true frontrunner makes it easier for a dark-horse candidate to emerge — and that means not just a lesser-known name like Mitch Daniels, but also somebody whose chances are not being taken seriously at all so far. Second, though, the Republicans are not necessarily doomed in the general election just because their field looks weak right now: Mr. Carter did, after all, win the general election.

Then again, Mr. Carter won by only 2 points against Gerald Ford, an unelected vice president whose approval ratings spent most of their time in the low to mid-40s (and who barely survived a primary challenge).

We Made A Profit On TARP! Ctd

David Frum explains "why TARP’s $24 billion profit is so important":

The profit confirms that what happened in October 2008 was truly a panic, truly a situation where a buyer of last resort could restore values by decisive action. Which is what happened. Had such a thing happened in 1931, the whole history of the world would have been different.

The Uncorrected Mistakes Of Rush Limbaugh

Dish alum Conor Friedersdorf, blogging at his new home, exposes Limbaugh's inconsistency by documenting his comments on Libya:

Dissent in wartime can be vital to the health of a democratic polity. On Libya, I am a dissenter myself, and inclined to believe that President Obama's actions make him as unfit for high office as his predecessor, who at least got Congressional authorization for his ill-conceived, poorly executed military adventure. Senator Rand Paul has called on his colleagues in Congress to reassert their power to declare or not declare war. Good on him. And some earnest critics of President Obama have echoed some of the arguments made by Limbaugh. As shown above, however, the talk radio host isn't guided in his commentary by any consistent principle, nor does he acknowledge obvious errors in analysis. Instead he blithely misinforms his audience about reality daily.

Yemen’s Descent

Mackey finds an "extremely graphic clip posted on the Taiz Facebook page show[ing] more clashes and the body of a badly wounded man, described as a "martyr" by the Yemeni activists." AJE's context:

Yemeni security forces have shot dead at least 16 anti-government demonstrators and wounded 30 in the city of Taiz, south of the capital Sanaa, medics said. The violence began when thousands of protesters marched through Taiz toward Freedom Square, where demonstrators have been camped out. As the march passed the governor's headquarters, troops stationed there blocked the procession, and clashes broke out, with some protesters throwing stones, witnesses said. Troops on nearby rooftops opened fire with live ammunition on the crowd and the marchers then turned to besiege the governor's headquarters….

Mackey has more footage from the day, as does Enduring America. Jane Novak gives a snap analysis of the "Hell breaking out all over" Yemen:

Some are suggesting Saleh gave the green light after the NYT article on US shift in position to seeking Saleh’s departure from office. The determination was made that Saleh is unlikely to enact reforms, which is accurate. At every crisis juncture over the last years, with every new declaration of sincerity, Saleh never enacted reforms, only smoke, mirrors and propaganda. 

From that article:

The United States, which long supported Yemen’s president, even in the face of recent widespread protests, has now quietly shifted positions and has concluded that he is unlikely to bring about the required reforms and must be eased out of office, according to American and Yemeni officials…. That position began to shift in the past week, administration officials said.

Goldblog absorbs the news of Obama's slow walk away from Saleh.

Now We’re Talking, Ctd

Ezra Klein dismisses Paul Ryan's plan:

To my knowledge, Ryan’s budget doesn’t attempt to reform the medical-care sector. It just has cuts. The hope is that those cuts will force consumers to be smarter shoppers and doctors to be more economical and states to be more innovative. But all that’s been tried, and it hasn’t been enough. That’s why the Affordable Care Act had to go so much further, digging deep into the delivery system ..

Jonathan Cohn, unsurprisingly, agrees:

[S]imply switching from public to private insurance doesn't actually make Medicare more efficient. If anything, the very opposite is true. Medicare has lower administrative overhead and so, benefit for benefit and person for person, it's actually cheaper than private insurance–which means that privatizing Medicare should increase costs, all else being equal.

Michael Cannon of Cato differs

Because vouchers enable seniors to keep the savings, they will do what ObamaCare won't: reduce the wasteful spending that permeates Medicare. Seniors will choose more economical health plans and put downward pressure on prices across the board. Indeed, vouchers are the only way to contain Medicare spending while protecting seniors from government rationing.

Ryan Avent is more evenhanded:

Mr Ryan deserves credit for not dodging the long-term entitlement question. But this dramatic a shift could only pass with strong bipartisan support. Given that Mr Ryan has included much that will offend the Democrats and plenty that will cost him Republican support, it's hard to have much confidence in the ability of the GOP budget proposal to advance the conversation.

Tyler Cowen provides tips for evaluating Medicare reforms.