Open thread Feb. 4, 2020 Dan Crawford | February 4, 2020 5:39 am Tags: open thread Comments (12) | Digg Facebook Twitter |
Way past time.
“Hanging over all of this is the absurdity of the Iowa caucuses in general. That’s a preexisting condition. The caucus system is undemocratic and bizarre, demanding too much time of too few participants.
Why, in supposedly the world’s most advanced democracy in the Year of Our Lord 2020, are we watching people scream at each other to come stand on the other side of a gymnasium in order to help determine who should be the next president? Iowa itself is also a poor choice for a first-in-the-nation contest. It is not representative of the country’s demographics, and even less so of the Democratic Party’s broader makeup.
There really is no reason for the Iowa caucuses, and if one good thing comes of all this, it will be the end. One of the great benefits of living in a secular democracy—and that is what we are, a least for now—is that tradition alone is no reason to keep doing something destructive. At this point, the Iowa caucuses are destructive. Get rid of them and start anew. Unfortunately, the damage to the 2020 contest is already done. The fault lines within the Democratic electorate will sprawl and deepen from this moment, regardless of the final result. Trump and his allies will feast on the discord. So, perhaps, will those friends across the pond.”
Don’t we have enough issues besides not being able to get a primary/caucus properly done?
No kidding. One silver lining, there should be no way Iowa retains its outsized position in the primaries. One screwup after another, hopefully they get pushed back to last.
We’ll forget about the obviously racist attack by this moron Shapiro for the moment, cause I doubt he knows what he really said:
“BEN SHAPIRO (HOST): The basic idea that you should be able to have basic lit — you know, basic, not, as you say, fake poll test, literacy test designed to exclude black people or something — the idea that you would have to have, like, a basic knowledge of America’s Constitution, for example, to vote, I don’t see that as a horrible idea. I really don’t.”
More than 50 Rep senators just showed total ignorance of the Constitution.
I am interested in your take on this program. Beyond my pay scale.
“Trump’s Plan Will Expand—Not Gut—Medicaid
February 4, 2020 Health Care
The expansion of Medicaid to low-income, able-bodied adults was the largest element of the 2010 Affordable Care Act, both in terms of cost and enrollment. But the structure of this expansion – whereby the federal government, without limit, gives $9 to states for every $1 they spend on enrollees – provides little incentive to control costs.
On January 30, 2020, the Trump administration unveiled its Healthy Adult Opportunity initiative, which would give states the option of receiving funds to cover Medicaid expansion enrollees as a pre-calculated grant. The hope is that this would give states more freedom and responsibility to make good use of federal funds, encouraging them to allocate resources in more nuanced, equitable, and better-targeted ways. That may be possible to some extent, but it is unlikely to reduce costs overall.”
1. Today, states receive states federal funding to cover 50 percent to 75% percent of the cost for the traditional Medicaid populations pre-ACA (like kids, the elderly, the disabled, and pregnant woman). For those people who were newly covered under the ACA Medicaid expansion (working-age adults), the federal government contributes 90 percent of the total cost.
2. Trump is giving out block grants to states to cover Medicaid if they want it. The “Block Grants” will “Cap” Medicaid spending. States will decide what how they use the money no matter what it is the need (conceivably tax breaks if decided). Consider for a moment, medical CPI has been going up at twice (or more) the rate of normal CPI. 5% is the number for pharma increases this year. Hospital inpatient and outpatient care have been the leading cause for healthcare insurance premium increases. Yearly, Block Grant increases will hardly match normal inflation much less medical inflation.
3. The Oregon study selected 90,000 candidates for Medicaid to be monitored over a 2 year period. The findings stated they used medical care more than others who are normally insured with less positive results. My point is, if you had little healthcare in the past and suddenly had it; you would probably be catching up. One issue was the use of the ER. With in Medicaid they also have emergency dental treatment leaving the new recipients to believe they have dental insurance. When told they did not, they started to go to the ER. Without regular doctors, the same is true. Capping costs will force less use.
4. There is an argument for the overuse of healthcare. It is more a meme than it is a documented fact. Here is Kip Sullivan (Champion of Single Payer) on the topic.
5. In the end, the federal share would be indexed to inflation, usually at a rate that would grow slower than medical costs. Over time, the federal share of Medicaid funding would start to decrease, a cut in spending relative to current law. States could make up those shortfalls by administering the program more efficiently (as conservatives claim they can do) or by reducing benefits and enrollment (as advocates fear they will).
Rather than take on Pharma, Hospitals, Healthcare Supply industry, and Healthcare Insurance companies; Conservatives/Republicans would rather put the squeeze on the poor and minorities who lack the political power. It is far easier than taking on industry and remember minorities already outnumber non-Hispanic children in Grade Schools. Politicians are not going to help them and the soon to be minority whites think they are lazy.
States can expand within the limits of their block grants. Right now the Federal Gov pays 90% of all costs in the ACA expansion.
Ask if you need more.
Some Examples of Block Grants ?
Perhaps the most well-known block grant (and the one Paul Ryan wanted to use as a model for other programs) is TANF. The law converted a cash assistance program known as Aid to Families with Dependent Children (AFDC) into a block grant now known as Temporary Assistance for Needy Families (TANF). Since the funding is set at a fixed dollar amount, it has helped fewer and fewer families over the years—down from supporting two-thirds of eligible families in 1996 to just one-quarter of eligible families today. (For more on how and why that happened, TANF.) https://talkpoverty.org/2016/08/22/rep-doggett-time-fix-broken-welfare-system/
Other significant block grants include the Social Services Block Grant (SSBG), the Community Services Block Grant (CSBG) and the Community Development Block Grant (CDBG). Ironically, these programs have long been targets for elimination by conservatives, who claim they’re not accountable enough. Donald Trump’s most recent budget, for example, calls for full elimination of CDBG—which helps fund things like affordable housing, Meals on Wheels, and natural disaster recovery. https://www.cbpp.org/the-problems-with-block-granting-entitlement-programs
Re above discussion on Block Grants – they are made with the AIM of saving money, but not of being effective (at anything). i.e. They may actually encourage waste and grifting because there is no incentive to provide service at all.
I guess we could apply the same logic for work requirements to receive Medicaid? It too is meant to save money or expenditures on the poor and minorities. The headliner for Republicans is war on the poor and the minorities as they do not do their part in the economy. The idea is to create a lower class to which the next level can look down upon and be satisfied,
Atrios pointed to this which is good:
I suspected it was bs as it was on MArgianl Revolution, but I lacked your knowledge.
The bothsiderism of the mainstream media is helping to usher in an authoritarian state.
“That includes the elite political media, of course. Some under that label have engaged in investigative reporting to expose the president’s relentless corruption. Some have outlined his assault on democratic institutions, and the checks and balances that undergird our constitutional republic. Some have steadfastly documented his lies and called them what they are. But far too many seem to accept the premise that American self-government is a system to be gamed, that Trump’s reality-TV theatrics are an exciting new strategy rather than a scam on our constitutional birthright. CNN described his fourth State of the Union address on Tuesday night thusly:
‘ “If elections are won by defiant showmanship alone, Donald Trump, the grand political illusionist, will waltz to a second term in November.”‘
This was the same speech in which the same CNN’s Daniel Dale identified that the president lied or misrepresented the facts about judicial appointments, illegal border crossings, drug prices, The Wall, insurance for pre-existing conditions, trade-deal jobs, U.S. oil and gas production. He continually suggested the economy was in freefall before he took office and magically revived it, when in fact the strong economy he touts—and it is strong—is an extension of the Obama-era recovery. He demonized immigrants as rapists and criminals, just like always.
And yet some within Dale’s network seem to have watched all this and processed it as a show. Just another piece of theater from the man who last week added Nigeria—Africa’s largest economy, where one in five Africans live—to his travel-ban list. Surely it’s a coincidence that, in an Oval Office meeting, he reportedly dismissed Nigerians on the basis that they’ll never “go back to their huts” in Africa if allowed in. Nigerian-Americans are statistically the most highly educated subgroup in this country…..
And I fear the end result, as we know for a fact that the 2020 election will not, in any way, shape or form be an honest election. And a trump win will mean the end of the Republic.
“But it seems a whole lot easier to simply not invite the president to address Congress when he has essentially rejected the legitimacy of the Congress as an institution and a co-equal branch of government. He has repeatedly signaled that Congress has no power before him. He has declared its oversight powers null. He has engaged in open defiance of their lawful subpoenas. When they refused to exercise their power of the purse to fund his Big, Beautiful Wall, he tried to simply seize the money by declaring a phony national emergency. If the president can take money for whatever he wants, whenever he wants, he can do anything. His lawyers argue from the Senate floor that he can do anything he wants to secure re-election, including undermine the integrity of that election, so long as he decides it’s in the national interest that he is re-elected. His Senate allies will vote to acquit him Wednesday on charges of which some even admit he’s guilty, and God knows he’ll take that to heart. We are sliding towards the abyss now, and far too few of us are feeling any friction at all.”