Month: June 2011

Howard Gleckman trashes the GOP’s Medicare plan. Medicare vouchers would only save money if seniors use less healthcare or if insurance companies ration care:

What if  insurance companies ration care? The theory sounds great: Insurers that provide the most cost-effective care can lower premiums and attract more buyers. But as we learned in the disastrous HMO experiment of the 1990s, there is a fine line between managing care (a very good thing) and cost-cutting. Properly coordinating care for seniors with multiple chronic diseases may both save money and improve health outcomes.  However, the perception that insurance companies were merely slashing benefits to boost profits inspired a consumer revolt two decades ago. The result:  HMOs largely disappeared and little has been done to control the long-term growth of medical expenses.

You either ration by price or by regulation. Usually, I’d back the former.

But the private sector market in US healthcare has revealed far, far higher costs and cost increases than equivalent systems in the rest of the developed world. Which brings us back to rationing. I fear there is no way out of this. Yes, we can do all we can to shift incentives to better and more efficient care – and the ACA has a lot of mechanisms to try and do that. But I don’t believe it will be anywhere near enough to avoid a fiscal disaster, given the increasing numbers of seniors and increasing life-spans and accelerating medical technologies. The free ride is over.

So I’ve shifted my own position to what might be called the left, but which, from a fiscal perspective, is actually on the right. Medicare needs more means-testing and more heavy-handed rationing. Private insurance companies will equally have to ration to remain affordable – until, one suspects, the logic of the crisis forces the US to move to single-payer. Even then, my Tory pessimism suggests we will need some major tax hikes, and defense cuts to boot. It’s all gruel and no gravy. Is America capable of understanding that, let alone embracing it?

Or is decline going to accelerate?

Walter Shapiro is troubled by Obama’s near-silence on the debt-ceiling:

Of course, the president is not going to convince the Glenn Beck brigades and Rush Limbaugh legions to support extending the government’s borrowing authority. But the bully pulpit does count for something with the independents who misguidedly believe that raising the debt ceiling is somehow more dangerous than the government refusing to pay its obligations. Two months is long enough for Obama to explain to the voters in the middle what the stakes are in what could prove to be the biggest political showdown between now and the 2012 election.

Give him a month or so. The man never pounces too soon, and too much is still up in the air. And in fairness to the GOP, until Obama actually presents an alternative to the Ryan plan for Medicare that is even faintly plausible as a real cost-cutter, or offers defense cuts to balance the fiscal equation, or proposes more serious tax hikes than his current position (the Clinton levels), he is empowering the GOP's fiscal vandalism. Chait hopes Obama will demagogue the issue after the fact, if it comes to that. Andrew Pavelyev, meanwhile, is unimpressed by the Republican debt "strategy":

House Republicans failed to prioritize the long-term over the short-term and wasted a lot of legislative time funding the government in two- and three-week increments.  They only achieved very modest budget cuts and didn’t address any long-term structural problems. Unfortunately, that was actually the most productive use of time in the House. The rest was totally, completely wasted on symbolic actions designed to please some (not even all) segments of the Republican base while driving away independents and setting a confrontational tone in Washington (thus making it harder to accomplish anything, given that the Democrats still control the Senate and the White House).

Maybe Obama's strategy is to allow the GOP to become so identified with not raising the debt ceiling that if we default, the GOP will be far more clearly on the hook for the consequences than even Gingrich was more than a decade ago. To my mind, that's too scary to contemplate. The consequences of an actual default are infinitely more damaging than a mere government shut-down – and simply not worth the partisan benefits of a GOP-led global depression. Which means I hope Obama and the Dems resist their partisan edge right now and endorse a Bowles-Simpson-style grand bargain before the worst happens.

What I worry about is that the GOP is, in fact, increasingly the reverse of a conservative party. They don't much care if extraordinary damage – even a global depression – occurs in their mission to take us back to before the Great Society. And a default and recession is something they hope to pin on Obama.

I don't think that would work. But I'm not sure they realize that. Gulp.

(Photo: Two cocks fight for a ball during a chicken football match show in Shenyang, northeast China's Liaoning province on July 8, 2010. AFP/AFP/Getty Images)

The early  jobs numbers are worrying. Ryan Avent analyzes:

There are one-off factors contributing to the slowdown, the Japanese earthquake and subsequent economic slowdown chief among them, but it's hard to avoid the conclusion that America is joining in the broad global economic deceleration which appears to be underway.

Emerging markets have been tightening rapidly to tame inflation, and the effects are now apparent. Chinese industrial figures are showing an easing in activity, and India's economic growth slowed sharply in the first quarter. All signs in Europe point to deceleration, threatening to exacerbate the euro zone's crisis. Things should—should—turnaround as the year progresses. Moderating commodity prices will be good for growth, the Japanese economy should rebound, and America's housing market looks poised for a second-half recovery. But fiscal and monetary tightening, or new shocks, could prevent this.

A reader writes:

My teen kids went to a party Saturday and among the gossip they brought home was the tale of a very popular girl who approached a boy who it is common knowledge is crushing on her and encouraged him to think she was going to make his dream come true. Then, in full view of onlookers, she pivoted away with a cruel “JK” (just kidding) and laughed at his gullibility to the amusement of her exclusive clique.

I wondered to myself what kind of person does that?  Then I saw the coverage of the press following Palin down the rabbit hole.  Some mean girls just grow up to punk bigger prey, I guess.

Another reader elaborated on the "mean girl" comparison a while back. Another writes:

Palin stopped in Philadelphia yesterday for a quick jaunt to the Liberty Bell (because nothing honors the founding of American democracy like a quick photo op). Her family's personal, PAC-sponsored, no attention-seeking RV was parked near my husband's office. It was being guarded by Philadelphia police officers. And the street on which it was parked was closed off to all local traffic. If you've ever been to Old City, you might understand just how inconvenient such a closure, however brief, can be. Surely it was a minor concern when ensuring the intensely private family has some quality time soakin' up the history. All in all, I'd say it was an excellent use of already strained municipal resources.

Politico reported that Palin was "mobbed" by crowds of supporters and media. It should be noted that the Liberty Bell is located in a complex directly across from Independence Hall in the heart of Old City. This time of year, large groups of tourists, school field trips, etc. swell the already crowded area. Just as half a million bikers did not turn out on Sunday to support Sarah Palin (nice try though on her part), crowd estimates at any of the sites she visits don't reflect her popularity.

Varysburg, New York, 3 pm

Timothy Brown discovered he had HIV in 1995. In 2007, he got a couple stem-cell transplants from a donor with a genetic mutation called delta-32, and he now has no trace of HIV. Tina Rosenberg reports:

More than four years after he stopped taking anti-retroviral therapy, there is also no sign of HIV in his body. Brown is now surely one of the most biopsied humans on Earth. Samples from his blood, his brain, his liver, his rectum, have been tested over and over. People in whom the disease is controlled with anti-retroviral therapy will still have hidden HIV—perhaps a million copies. But with Brown, even the most sensitive tests detect no virus at all. Even if trace amounts remain (it is impossible to test every cell), it no longer matters. Absent the CCR5 receptors, any HIV still present cannot take root. He is cured.

A stem-cell transplant from an unrelated donor can cost $250,000 and is a reasonable risk only in the face of imminent death. What cured Timothy Brown is obviously not a cure for the rest of the world. But it is proof of concept, and it has jolted AIDS-cure research back to life. Sometimes science follows sentiment; the abandonment of cure research after the disillusion of the nineties is now playing out in reverse.

For Brown’s cure to be relevant on a wide scale, it would have to be possible to create the delta 32 mutation without a donor and without a transplant—preferably in the form of a single injection. As it happens, progress toward that goal has already begun, in the laboratory of Paula Cannon at the University of Southern California. Instead of a donor, Cannon is using a new form of gene editing known as zinc finger nucleases, developed by the California company Sangamo BioSciences. Zinc finger nucleases are synthetic proteins that act as genetic scissors. They can target and snip a specific part of the genetic blueprint: They can, for instance, cut out the code that produces the CCR5 receptor, yielding a cell with HIV resistance.

The re-booting of the immune system with HIV-free stem cells was much discussed in the early 1990s – only to be abandoned. I fervently believe that anti-retroviral treatment and sero-sorting are still easily the most cost-effective ways of curbing the epidemic. But getting HIV out of those pesky reservoirs where it can lurk forever, adding stem cells with an immunity to HIV so they replicate and reboot the entire body over time: this is exciting stuff.

Some part of me wants to die HIV-negative and American. I am now almost halfway there.

Palin and Herman ascend in Iowa in the wake of Huckabee's departure:

Cain is at 15% now despite not even having been included on our last poll. Palin's gained 7 points in the six weeks since our last poll compared to 5 point gains for Romney, Pawlenty, and Bachmann, a 3 point gain for Gingrich, and a 2 point bump for Paul.

Poor Huntsman, easily the most promising of the candidates, gets 0 percent.

I couldn't help but notice this from yesterday's bad pizza summit with Donald Trump:

Outside Trump Tower, Palin sounded a lot like a candidate, saying both she and Trump have “a desire to see our economy get put back on the right track, making sure that we have a balanced trade arrangement with other countries across this world so that Americans can have our jobs, our industries, our manufacturing again. That’s what built this country. It was manufacturing and exploiting responsibly our natural resources. We can do that again if we make sensible decisions.”

That sounds a mite protectionist, does it not? Add that little data point to the firing of her neocon kill-the-Arabs foreign policy team, and the hiring of Peter Schweizer, a more paleocon figure, as Ben Smith reported a month ago:

[C]ondemning U.S. involvement in Libya and laying out a more cautious philosophy of the use of force. Schweizer has articulated a more skeptical view of the use of American force and promotion of democracy abroad. "Egypt does a lot of things wrong, but they have also been pro-American on a lot of levels," he wrote of Obama's support for protesters in Egypt — which was being roundly criticized by neoconservatives for being insufficiently vigorous. "When protests broke out in Iran earlier during his tenure in the White House, Obama was not willing to openly back them, at least until he came under considerable fire. But now he is supporting them in Egypt?"

Schweizer has also been skeptical of American involvement in Libya, which he compared to Vietnam, speculated that France is "on the brink of a violent civil war" between radical Muslims and its resurgent right. He's a partner of former Cheney aide Marc Thiessen in a speechwriting business, and is the author of several books, including a sympathetic and well-reviewed history of the Bush family.

Palin may be moving toward the core populist position: seeing the benefits of tariffs, viewing the developing world as incapable of democracy and a hotbed of Jihadist violence, enthusiastically backing the torture of terror suspects, demonizing elites of all kinds, and viewing Muslim-Americans as a potential fifth column. It's a more natural position for her than the neocon indoctrination she was subjected to as the price of running with McCain. The difference between her and, say, Father Coughlin: a replacement of his rancid anti-Semitism with a Christianist philo-Semitism that sees Israel as the vanguard of a civilizational war that may presage the Apocalypse.

Yep: it will get worse before it gets better.

Herman Cain’s hathos-filled new video:

Pareene ponders the Cain boomlet:

Cain is a surprisingly powerful candidate, despite the fact that he’s a silly former pizza chain owner, because he makes white conservatives feel very good about themselves, as Adam Serwer (and others) have pointed out.

White conservatives have developed the belief that being called a racist is a slur on par with actual, proper racial slurs. They also tend to think that amorphous anti-white prejudice is a big problem; it is, in their thinking, perhaps a bigger problem than anti-black prejudice. Many of them also have a very simple, binary understanding of the concept of “racism.” You’re either a racist — an epithet-shouting Klan member — or you’re not. This is why, say, Andrew Breitbart says that unless there is video evidence of Tea Partyers explicitly saying “nigger,” there is no “proof” that racial resentments have anything to do with right-wing white populism. So Cain is a shield against that charge. How can we be racists when we support a black man for president?

Allahpundit is taking Cain seriously. I think he’s right to. To have a black man backing the Fundamental Restoration project is serious credentializing for the right. There’s even an insinuation that he is more authentically African-American than Obama, because his ancestors were slaves. And then there’s the Perot-style notion that anyone who can add 2 + 2 = 4 is ipso facto qualified to be president. And he has the businessman’s cred as well – more than Romney, who fired far more people in his business career than he hired. Given the fluidity of this race, I wouldn’t rule anyone out.

Finally, the emails … Alas, "2,415 pages were deemed privileged, personal, or otherwise exempt".