Tag Archives: kentucky

Medicare Advantage Might Not Be a Boondoggle Anymore

by Robbie Sutter Posted on August 18, 2014

Mother Jones

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I’ve written periodically in this space about the problems with Medicare Advantage. In a nutshell, it costs a lot more but provides very little in the way of additional services. It’s really not much of a poster child for the benefits of program choice.

But wait! Apparently a big part of the problem with MA was the fact that people were allowed to switch in and out of their plans on a monthly basis. If they got sick, they could quickly switch into MA if that was a better deal for them. This obviously raised the cost of MA as sick people switched in to avoid the copays and other limitations of traditional Medicare.

However, that changed in the mid-2000s, when beneficiaries were required to choose a plan and stick with it for a full year. Austin Frakt provides the details of a new study:

By 2006-2007, health differences between beneficiaries in Medicare Advantage and those in traditional Medicare had narrowed….Also, in contrast to studies in the 1990s, more recent work finds that Medicare Advantage is superior to traditional Medicare on a variety of quality measures. For example, according to a paper in Health Affairs by John Ayanian and colleagues, women enrolled in a Medicare Advantage H.M.O. are more likely to receive mammography screenings; those with diabetes are more likely to receive blood sugar testing and retinal exams; and those with diabetes or cardiovascular disease are more likely to receive cholesterol testing.

That Health Affairs paper also found that H.M.O. enrollees are more likely to receive flu and pneumonia vaccinations and about as likely to rate their personal doctor and specialists highly.

So now things are a little murkier. MA still costs more than traditional Medicare, but only by 5-6 percent. And recent evidence suggests that MA beneficiaries might be getting enough additional benefit to justify that much extra money. It’s still not clear that MA is worthwhile, but it appears now to be at least worth further study.

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Medicare Advantage Might Not Be a Boondoggle Anymore

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White House Tightens Up Arms Shipments to Israel

by BonitaIliffe Posted on August 14, 2014

Mother Jones

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The Obama administration has tightened up the process for providing arms to Israel:

White House and State Department officials who were leading U.S. efforts to rein in Israel’s military campaign in the Gaza Strip were caught off guard last month when they learned that the Israeli military had been quietly securing supplies of ammunition from the Pentagon without their approval.

Since then the Obama administration has tightened its control on arms transfers to Israel. But Israeli and U.S. officials say that the adroit bureaucratic maneuvering made it plain how little influence the White House and State Department have with the government of Israeli Prime Minister Benjamin Netanyahu —and that both sides know it.

….U.S. officials said Mr. Obama had a particularly combative phone call on Wednesday with Mr. Netanyahu, who they say has pushed the administration aside but wants it to provide Israel with security assurances in exchange for signing onto a long-term deal.

….While Israeli officials have privately told their U.S. counterparts the poor state of relations isn’t in Israel’s interest long term, they also said they believed Mr. Netanyahu wasn’t too worried about the tensions. The reason is that he can rely on the firmness of Israeli support in Congress, even if he doesn’t have the White House’s full approval for his policies. The prime minister thinks he can simply wait out the current administration, they say.

Well, I’d say the prime minister is probably right. It’s not as if Obama has actually done much of substance to put pressure on Israel despite endless provocations from Netanyahu, but it’s a very good bet that the next president will do even less. On the Democratic side, Hillary Clinton is the heavy favorite, and she’s made it crystal clear that her support for Netanyahu is complete and total. On the Republican side, it doesn’t really matter who the nominee is. As long as it’s not Rand Paul, Netanyahu can expect unquestioning fealty.

And in the meantime, he can count on the US Congress not really caring that he publicly treats the US president like an errant child. I keep wondering if one day he’ll go too far even for Congress, but I’ve mostly given up. As near as I can tell, there’s almost literally nothing he could do that would cause so much as a grumble.

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White House Tightens Up Arms Shipments to Israel

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This Judge Just Destroyed the Stupidest Argument Against Gay Marriage Ever

by VirgilioWjd Posted on July 1, 2014

Mother Jones

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On Tuesday, a federal judge ruled Kentucky’s ban on same-sex marriages unconstitutional and issued a withering take-down of marriage equality opponents.

Kentucky had argued that legalizing gay marriage would harm the state’s birth rate. “These arguments are not those of serious people,” wrote US district judge John Heyburn. “Though it seems almost unnecessary to explain, here are the reasons why.

“Even assuming the state has a legitimate interest in promoting procreation, the Court fails to see, and Defendant never explains, how the exclusion of same-sex couples from marriage has any effect whatsoever on procreation among heterosexual spouses. Excluding same-sex couples from marriage does not change the number of heterosexual couples who choose to get married, the number who choose to have children, or the number of children they have.

“The state’s attempts to connect the exclusion of same-sex couples from marriage to its interest in economic stability and in ‘ensuring humanity’s continued existence’ are at best illogical and even bewildering…The Court can think of no other conceivable legitimate reason for Kentucky’s laws excluding same-sex couples from marriage.”

Heyburn stayed his ruling while Kentucky appeals, meaning no same-sex marriages are taking place just yet.

Read the full ruling:

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A Federal Judge Just Struck Down Kentucky’s Gay Marriage Ban (PDF)

A Federal Judge Just Struck Down Kentucky’s Gay Marriage Ban (Text)

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This Judge Just Destroyed the Stupidest Argument Against Gay Marriage Ever

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Carbon Plan Puts Democrats in Coal States on the Defensive

by Myrna Posted on June 2, 2014

The president’s proposal to cut emissions from power plants could become a key issue in hard-fought midterm races across the country. Read this article:   Carbon Plan Puts Democrats in Coal States on the Defensive ; ;Related ArticlesDot Earth Blog: White House Stresses Widespread Energy Progress Ahead of New Climate RuleObama to Take Action to Slash Coal PollutionNews Analysis: Trying to Reclaim Leadership on Climate Change ;

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Carbon Plan Puts Democrats in Coal States on the Defensive

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John Oliver Explains Why He Attacked Mitch McConnell With an Old, Wrinkly Penis

by ConnieMobley Posted on May 13, 2014

Mother Jones

On Sunday’s episode of HBO’s Last Week Tonight, host John Oliver and his crew got… graphic.

During one of the segments, Oliver discussed the state of the American political attack ad, and argued that as more money floods into the system, the quality of the ads declines. He said that the only way attack ads could get any worse would be if they were shown on cable TV, which doesn’t have to abide by network content standards. To demonstrate the point, the LWT crew made a pair of fake attack ads for the Kentucky Senate race between Alison Lundergan Grimes and Senate Minority Leader Mitch McConnell.

“For too long, politics in Washington have been dominated by old, white, wrinkled dicks,” the narrator says in the fake anti-McConnell ad. “And no dick is older, whiter, or wrinklier than Mitch McConnell’s.”

And then viewers are treated to a shot of an old, wrinkled penis that is supposed to represent Mitch McConnell.

Watch:

Try unseeing that. You can’t.

Anyway, I talked to Oliver on Tuesday to get the inside scoop on the humor and the horror that is his show’s old, wrinkly attack ad. Here’s an excerpt of our conversation:

MJ: Whose idea was it, if you recall, and whose penis did you use?

JO: Okay, those are two excellent questions. The first one, I’m not sure, and it might help to just go with collective responsibility. I don’t want to go with a sort of “I am Spartacus” moment but I think plausible deniability might be useful at that point. The second is the much more interesting question. And that is that, of course, you do need to cast a penis. And to do that you have to be presented with a selection of penii—I don’t know if that’s the collective term. And so then what you’re looking for—it’s amazing—when you look at then you start judging them for the purpose, because you want something that is funny but not sad. Because, you know, a sad penis does not help the comedy. No, it makes you think about the person the penis is attached to. So really, you just want a representative old man penis. And I’m not sure that sentence…has ever been said out loud before…We got to one that we liked, and the owner of that penis was generous enough to model it for us.

MJ: How did you get to one you liked? Like, what is the process of “getting” penii?

JO: We went through photos. It was basically the penis version of a headshot.

MJ: So this was like models?

JO: Models, basically. And you go through and say, “This one’s good, this one’s good, let’s get down to a short-list. Okay, it’s between these three. Um. I like this one.” And then what you do is you make a decision, you walk out of a room, and you stare out a window and question what the fuck you’re doing with your life…That’s basically how it goes.

MJ: I’m assuming you weren’t in the room when they shot it?

JO: I actually wasn’t because we were having to write…But apparently the man was very happy…I just came back and our editor, she had to live with that footage for a few days, but she did a fantastic job.

MJ: Has she recovered, psychologically?

JO: Yeah, she was very good. She’s called Cori McKenna, and she actually edited both the commercials…The other commercial was basically a chainsaw massacre in a mine involving a kitten, and I think she found that slightly less alarming to cut together than a sequence of beautiful tracking shots of an old man’s junk.

So there you have it.

My full interview with Oliver with be featured on Friday’s episode of the Inquiring Minds podcast, so stay tuned.

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John Oliver Explains Why He Attacked Mitch McConnell With an Old, Wrinkly Penis

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Sanctions Against Putin Won’t Do Much For Crimea, But We Should Impose Them Anyway

by IonaMartinelli Posted on March 7, 2014

Mother Jones

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Dan Drezner, after waiting an unconscionably long four or five days, has weighed in on the efficacy of economic sanctions against Russia:

Sorry, but the fact remains that sanctions will not force Russia out of the Crimea. This doesn’t mean that they shouldn’t be imposed. Indeed, there are two excellent reasons why the United States should orchestrate and then implement as tough as set of sanctions on Russia as it can muster.

First, this problem is going to crop up again. Vladimir Putin has now invaded two neighbors in six years to destabilize regimes perceived to be hostile to him. Post-Crimea, any new Ukraine government will continue to be hostile to the Russian Federation. There are other irredentist areas in the former Soviet Union — *cough* Transnistria *cough* — where Putin will be tempted to intervene over the next decade. At a minimum, he should be forced to factor in the cost of sanctions when calculating whether to meddle in his near abroad again. President Obama was correct to point out the “costs” to Putin for his behavior — now he has to follow through on that pledge.

Second, while sanctions cannot solve this problem on their own, they can be part of the solution. Over the long term, Russia does need to export energy to finance its government and fuel economic growth. Even if planned sanctions won’t bite in the present, the anticipation of tougher economic coercion to come is a powerful lever in international bargaining. The closer the European Union moves towards joining the U.S. sanctioning effort, the more that Russia has to start thinking about the long-term implications of its actions. Any political settlement over the future of Ukraine will require compromise by the new Ukrainian government and its supporters in the West. Imposing sanctions now creates a bargaining chip that can be conceded in the future.

This mirrors my own judgment. Putin has very plainly decided that invading Crimea is worth the price, and it’s improbable that economic sanctions—especially the scattershot variety that we’re likely to put together in this case—will change that. Nevertheless, it needs to be clear that there really is a price. It also needs to be clear that face-saving compromises are still available to Putin that might lower that price.

For my money, the biggest price Putin is paying comes not from any possible sanctions, but from the very clear message he’s now sent to bordering countries who have long been suspicious of him anyway. Yes, Putin has shown that he’s not to be trifled with. At the same time, he’s also shown every one of his neighbors that he can’t be trusted. Two mini-invasions in less than a decade is plenty to ramp up their anti-Russian sentiment to a fever pitch.

Putin’s invasion has already cost him a lot in flexibility and maneuvering room, and it’s very unlikely that tighter control over Crimea really makes up for that. At this point, it’s hardly a question of whether Putin has won or lost. It’s only a question of just how big his losses will be.

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Sanctions Against Putin Won’t Do Much For Crimea, But We Should Impose Them Anyway

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CIA Lashes Out at Senate Staffers it Says Mishandled Classified Info

by HollieHazon Posted on March 6, 2014

Mother Jones

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McClatchy has an update to yesterday’s story about the CIA monitoring Senate staffers who were investigating the CIA’s detention and torture practices. Apparently, long after their report was complete and the CIA had already responded, the Senate staffers were trawling through a CIA database and ran across an internal review ordered by former CIA Director Leon Panetta of previously released materials. The staffers concluded that the Panetta review confirmed their findings, even though the official CIA response had strongly disputed them:

The aides printed the material, walked out of CIA headquarters with it and took it to Capitol Hill, said the knowledgeable person.

….The CIA discovered the security breach and brought it to the committee’s attention in January, leading to a determination that the agency recorded the staffers’ use of the computers in the high-security research room, and then confirmed the breach by reviewing the usage data, said the knowledgeable person.

Sen. Mark Udall, D-Colo., a member of the Intelligence Committee who has led calls for the release of the report, disclosed at a hearing in December the existence of the Panetta review without saying how the committee had learned of it. He contended that the review broadly corroborated the committee’s findings and questioned why it was dramatically different from the CIA’s official response.

Roughly speaking, Senate staffers say their actions were justified because they had evidence the CIA was lying to them. The CIA says its actions were justified because Senate staffers were removing top secret materials that weren’t supposed to leave the secure room they were working in.

In the meantime, the 6,300-page report itself is still in limbo, with the CIA fighting tooth and nail to prevent it from being released. But maybe it’s time for the report and the internal review and the CIA response and everything else to be published so the American public can decide for itself what it thinks of all this? We’re the ones paying the bills, after all.

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CIA Lashes Out at Senate Staffers it Says Mishandled Classified Info

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Coal Firm to Pay Record Penalty and Spend Millions on Water Cleanup in 5 States

by Myrna Posted on March 5, 2014

Alpha Natural Resources and 66 of its subsidiaries agreed to reduce pollution from coal mines in Kentucky, Pennsylvania, Tennessee, Virginia and West Virginia. Link to article –  Coal Firm to Pay Record Penalty and Spend Millions on Water Cleanup in 5 States ; ;Related ArticlesUtility Cited for Violating Pollution Law in North CarolinaNational Briefing | Midwest: Great Lakes ReboundDot Earth Blog: Timber Thieves Threaten California’s Redwood Giants ;

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Coal Firm to Pay Record Penalty and Spend Millions on Water Cleanup in 5 States

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Please Don’t Confuse Me With Facts, Vaccine Edition

by SamanthaTerry Posted on March 4, 2014

Mother Jones

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A couple of days ago I watched Othello for the first time.1 By chance, I had never seen or read it before. But that Shakespeare. He sure had us humans figured out, didn’t he? Here is Emilia, responding to Desdemona’s plea that she had never given Othello cause to doubt her fidelity:

But jealous souls will not be answer’d so;
They are not ever jealous for the cause,
But jealous for they are jealous: ’tis a monster
Begot upon itself, born on itself.

Why do I mention this? Because of Aaron Carroll’s tidy little summary of some Brendan Nyhan research on how to persuade people that the MMR vaccine is safe:

When they gave evidence that vaccines aren’t linked to autism, that actually made parents who were already skittish about vaccines less likely to get their child one in the future. When they showed images of sick children to parents it increased their belief that vaccines caused autism. When they told a dramatic story about an infant in danger because he wasn’t immunized, it increased parents’ beliefs that vaccines had serious side effects.

Basically, it was all depressing. Nothing was effective.

So that’s that. They believe not for cause, but believe just to believe. ‘Tis a monster begot on itself, born on itself. Of course, it’s possible that Nyhan simply didn’t find the right intervention. Or that an intervention from a researcher has no effect, but the same intervention from a family doctor might. Still, Carroll is right: it’s all kind of discouraging. It’s nothing new, but still discouraging.

1It was the 1965 movie version with Laurence Olivier in blackface. Kind of disconcerting. But Frank Finlay was great as Iago.

UPDATE: More here from Dan Kahan, including a reminder that (a) vaccination rates in the US actually haven’t declined over the past decade and (b) freaking out about a nonexistent problem is genuinely unhelpful. Also this:

The NR et al. study is superbly well done and very important. But the lesson it teaches is not that it is “futile” to try to communicate with concerned parents. It’s that it is a bad idea to flood public discourse in a blunderbuss fashion with communications that state or imply that there is a “growing crisis of confidence” in vaccines that is “eroding” immunization rates.

It’s a good idea instead to use valid empirical means to formulate targeted and effective vaccine-safety communication strategies.

Much more at the link.

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Please Don’t Confuse Me With Facts, Vaccine Edition

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The Best Oscar of Last Night Was the Screenplay Award for "Her"

by EllaBlocker Posted on March 3, 2014

Mother Jones

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Today presents a blogging problem: The news cycle is devoted almost entirely to events in Ukraine—as it should be—and I’ve already probably said more about this than I should. I don’t have any special expertise in the area, and I really hate the phenomenon of instant expertise that takes hold of pundits everywhere whenever something like this happens. I’m keenly aware of all the big underlying issues—Russia’s long cultural ties to Ukraine; the eastward spread of NATO and the EU; anti-Russian sentiment in Kiev; the weakness of Russia’s military; Putin’s one-note thuggishness; Ukraine’s endemic corruption and its internal fights over who gets to profit from the Russian gas trade; etc. etc.—and also keenly aware that a bare knowledge of all this stuff doesn’t really make me worth reading on the subject. For what it’s worth, I’ve already made a prediction that Putin will stop at Crimea because (a) the Russian army doesn’t have the strength to do much more, and (b) Putin isn’t willing to pay the price both in military and diplomatic terms for a broader intervention in eastern Ukraine. But I could be wildly wrong. Who knows?

So then, what should I write about today? I’m not sure, though I imagine that I’ll end up writing more about Ukraine despite everything I just said.

In the meantime, how about a nice Oscars thread? No? Oh come on. I’ll toss out a provocation to get everyone started: the best award of the night was the Best Original Screenplay win for Her. Not because it was my favorite movie of the year or anything, but because it was the first screenplay in ages that genuinely surprised me. Not in the sense of a last-minute twist that comes out of nowhere—that’s common enough—but in the sense of a narrative that shifted directions smoothly and naturally into something much more interesting than I thought it would be. The art of Hollywood screenwriting has deteriorated so badly that this doesn’t happen very often anymore. I won’t say more in case you haven’t seen the movie and still plan to, but feel free to discuss in comments.

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The Best Oscar of Last Night Was the Screenplay Award for "Her"

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