There is one thing that all Republicans know: Obamacare is an unmitigated disaster that is destroying the great system that we had before — “The best healthcare in the world!” But their real problem with it is not the policy. As I’ve discussed a lot around here: Obamacare is the most conservative healthcare reform that could work. All the supposed conservative alternatives since have been brainless ideology that would have made the situation worse — things like tort “reform” (not allowing patients to sue when they’ve been harmed) and allowing insurance across state lines (destroying local control and causing a race to the bottom).
The one thing that Republicans have focused on has been the individual mandate. And that has been a winner. The truth is that no one likes it. It’s like how people like Social Security but don’t like payroll taxes. But you can’t have one without the other. The individual mandate is what allows Obamacare to work. Otherwise, people would have an incentive to put off buying insurance until they were sick. This would result in the risk pool being expensive, resulting in high insurance costs. After all this time, you probably know the drill.
But the Republican hatred of Obamacare has no bounds. And there is no rationality to it, so they hate everything in the healthcare law. Of course, if someone mentions pre-existing conditions or coverage of college students, Republicans will always claim that they too will have those things once their replacement comes out — right after America turns into a land of fairies and elves and everyone gets all the cotton candy they want. But one thing Republicans only scoff at are the measures in the law designed to lower healthcare costs. And not surprisingly, no amount of data is going to stop them from thinking that.
A recent study reported in Health Affairs highlights the way that one of those measures is working. Michael Hiltzik has the details, Here’s Another Way Obamacare Is Changing US Healthcare for the Better. One way that healthcare costs more than it should is by not properly treating a patient. If a patient comes in with chest pains, gets released with antacids, and then comes back the next day with a heart attack, it costs a lot more money than if the chest pains had been properly treated in the first place.
Obamacare deals with this issue by cutting back on Medicare reimbursements to hospitals that have too many of these kinds of re-admissions. This is an especially big deal because hospitals are probably the single most dangerous place to be in terms of getting a disease. So there really is a lot that hospitals can do to improve the situation. The authors of the study looked at these re-admission rates and found that Obamacare really was changing behavior and reducing rates. Hooray!
This didn’t stop Paul Ryan — now chairman of the House Ways and Means Committee — from saying this week, “The whole law’s a lemon.” But of course he would. For him, like all Republicans, the complete catastrophe of Obamacare is definitional. It’s interesting to contrast this with Medicare Part D. Many Democrats were against it. But after it was in effect and working as it was supposed to, the Democrats changed their position. But such open mindedness is asking far too much from Republicans.

On this day in 1777, the stars and stripes were adopted by the Second Continental Congress as the official flag of our country — or at least our little rebellion. To be honest, I’m not fond of it. It’s badly designed. There’s a blue rectangle in the upper left hand cover with a variable number of stars. Don’t get me wrong: I like one star for each state. But I don’t like them relegated to the corner in such an awkward way. And the 13 stripes representing the first colonies? I really don’t care. Maybe we should have eight red stripes to correspond to the eight slave states at that time. Not that they weren’t all culpable.
Anyway, I remember telling my first wife that I didn’t like our flag. She snapped at me, “What do you want? Three stripes like Italy?” I was too shamed to respond, but the truth is: yes, I would prefer that. But what I had in mind was the Soviet Union’s flag, which I still think is gorgeous. But there are many beautiful flags today. I like the simplicity and the symbolism with the Japanese flag. Israel’s flag is arguably better on these counts. Canada has a very fetching flag. There is much to say for Papua New Guinea’s flag with the Southern Cross and its national bird, the raggiana bird-of-paradise. I could go on. And on. And on. There are only a handful of flags that I like less.
Not that any of this matters. A nation needs a distinct flag and we have that. But it annoys me that we could never change it. If anyone tried, Americans would rise up and claim that it is a wonderful flag and we could never admit to being wrong. Just as our 225 year old Constitution is the best one imaginable (except it isn’t), our 240 year old flag couldn’t possibly be improved upon. So we are stuck with it.
There are two large difficulties with equal opportunity as a principle of justice. First, what exactly should be this hypothetical moment of perfect equality — the equal starting line, to use the metaphor of a footrace? Should it be birth? This means that the unequal distribution of luck before birth must be counterbalanced, so that those who are congenitally stronger or more clever should be disadvantaged in equal measure. If that doesn’t appeal to you, then you perhaps imagine a moment even before birth and before genetic qualities are doled out. But related to this is the problem that, as soon as we are born, we begin to do things or have things done to us that, if not offset, will lead to unequal life chances down the road. The further back we push the moment of equality, the more subsequent inequality we must accept. If opportunities are to be equal at birth, then the advantages that some get in childhood will not count against “equal opportunity.” Perhaps you would set a much later age for the “starting point” — say 18. This commits you to much greater intervention to offset all the many pluses and minuses that can accrue by that age, including many that are due to the choices that children make for themselves. At the same time, it can be seen as a bit heartless, since it doesn’t allow for second chances. If someone discovers what they truly want at the age of 25 or so, too bad: they missed the moment of equality and they will have to make do with whatever opportunities they are lucky enough to still have. This sort of criticism can be addressed by requiring a multiplicity of “somewhat equal opportunities” that can reappear as one grows older, but then the criterion loses its sharpness: how equal must these second chances be and how many must be offered?
Timothy Taylor wrote an article that answers a question that I’ve wondered about for a while,
The other part of this is that I saw my parents treat the actual employees they had fairly badly. And they were not at all exceptional — I’ve seen it countless times with employers I’ve had as well as ones I’ve observed from the outside. They live in constant fear of bankruptcy. They never feel secure, even when things are going really well. And they expect their employees to care as deeply about the business as they do. Sadly, employees often do feel deeply committed to the business. But they are rewarded with bad pay and treatment until they finally have enough.
We Democrats all admire Obama. But unlike the stereotype, we don’t worship him. We’ve had a lot of problems with many of his policies. And I do mean “we.” Obviously, as a functional Democrat — I’m a member of the party because it is the more liberal of the two major parties, not because I agree with it — I have even bigger problems with President Obama. But he has never been so clearly outside the current thinking of the Democratic Party as he is on the Trans-Pacific Partnership (TPP). So now was a really good time for the Democrats in the House of Representatives to say what needed to be said, “Suck. On. This.”
I’m not a big fan of Jean Sibelius. In fact, he is just the kind of Romantic composer that I’m thinking of when I say that I don’t like Romantic music. But that isn’t to say that he wasn’t a great composer. And he certainly didn’t commit any of the truly vile sins of the period like mindless chromaticism. And there are some times when you really want Romantic music. It is still very much alive in many film scores.
On this day in 1966, in a 5-4 decision, the Supreme Court found that the police must tell suspects of their right to remain silent in
Graham Greene’s excellent
In the past 50 years, independents have grown from one-quarter to one-third of the electorate, according to Gallup polls. In California, the number of independent voters more than doubled between 1991 and 2005. The fastest-growing political party in the United States is no party.
You may remember the 2010 documentary,