March 25, 2015 archive

The Two Headed Coin


Congress’ Medicare ‘Fix’ Could Leave Seniors Paying More

By David Dayen, The Fiscal Times

March 20, 2015

Washington perpetually laments the loss of bipartisanship in this polarized political environment. But ordinary Americans might want to fear one example of bipartisanship’s return, and what it could mean for their pocketbooks.

John Boehner and Nancy Pelosi have been locked in negotiations to clear two of the biggest hurdles facing Congress this year: the so-called “doc fix” for Medicare reimbursement rates, and an extension of the Children’s Health Insurance Program (CHIP). We don’t have all the details, because the negotiations have taken place far from the public eye, with the release of the House and Senate budgets this week affording them cover.

The “doc fix” refers to the rate the government pays doctors who see Medicare patients. A 1997 law created something called the “sustainable growth rate” or SGR that governs the level of payments. Since Medicare spending consistently outstrips economic growth, this translates into large reimbursement cuts under the SGR formula. If nothing is done by April 1, the reimbursement rate will fall by 21 percent. More important, doctors claim they would react to pay cuts by prioritizing other patients, making it harder for Medicare beneficiaries to get treatment.

This 21 percent cut should always be accompanied by the phrase “in theory,” because every potentially large rate cut since 2002 has been patched; hence the phrase “doc fix.” On 17 different occasions, Congress has made sure Medicare doctors get their expected paycheck, sometimes even adding a small raise, and often finding money somewhere else in the budget to offset it.

Congress appears to want to stop having conversations with angry doctors every year, and have cast about for a permanent “doc fix” that would repeal and replace the old Medicare payment system. Doing this would cost $177 billion over the next decade, but the Boehner-Pelosi negotiations are looking at covering less than half this, around $70 billion in back-ended cuts, and letting the rest add to the budget deficits. To sweeten the pot for liberals, the emerging package would include a two-year, $30 billion extension of CHIP for 8 million children, at the boosted benefit levels under the Affordable Care Act. The tentative plan is for the House to vote next week, and throw it into the Senate’s lap just before the April 1 doc fix deadline.

It’s the other half of the cuts that get problematic. There would reportedly be more means-testing for Medicare beneficiaries, increasing premiums for seniors showing income over $133,000 and couples over $266,000. These seniors would have to pay 65 percent of their total costs under the new plan. This would go up at higher incomes. Means-testing historically dips lower and lower as budgeters try to get more out of beneficiaries, so this continues that ratcheting process for Medicare.

But this would raise out-of-pocket expenses on all 9 million seniors with a Medigap plan, including the 86 percent of these beneficiaries who have incomes under $40,000, and almost half with incomes below $20,000. So this cut hits those who can’t really afford it. (This idea, along with the means-testing, was in President Obama’s budget, incidentally.)

The proper term for this is cost-shifting, pushing funding for a public program onto those who get the benefits. Medigap was created to deal with cost-shifting in Medicare, and now Congress may look to shift costs within it as well. And like means-testing, cost-shifting is prime terrain for double-dipping over time.

All of this is being done to protect doctor salaries, which are among the highest in the industrialized world. Maybe Medicare doctors shouldn’t endure a 20 percent pay cut, but the idea that they wouldn’t see patients if the cut were 5 or 7 percent doesn’t pencil out. Plus, doctor payment rates are tied to Medicare premiums, as the Congressional Budget Office has explained: “Beneficiaries enrolled in Part B of Medicare pay premiums that offset about 25 percent of the costs of those benefits.” This means that any permanent change to a new doctor payment formula will likely result in a hike to Part B premiums.

Clearly everyone in Congress hates the messy process of annual “doc fix” patches, and the uproar from the hospital lobby that accompanies it. But nobody in Washington has raised the point that higher costs for ordinary patients might not be a great solution to the supposed problem of lower cash flow for doctors.

And Effect-

U.S. Voter Turnout is Low Because There’s Little to Vote For

by Glen Ford, Black Agenda Report

Wed, 03/25/2015

President Obama wants you to believe that the political map of the United States would be transformed – “completely changed,” he says – if citizens were required by law to vote. Obama told a town hall meeting in Cleveland that mandatory voting would “counteract” the influence of money in the U.S. electoral process. That’s a hell of a statement from the guy who wrecked the public campaign finance system by opting out of it in 2008, and outspent his Republican opponents in both of his runs for the presidency. Obama ought to have his picture on a million dollar bill.

But, why does the United States have the lowest voter turnout in the industrialized world, including Russia? It’s not because Americans are happier with the way they’re living than the rest of humanity. The U.S. ranks 17th on the global Happiness index and 23rd on the Satisfaction with Life scale. And, although racial exclusion in voting is very important when comparing Black voter turnout with whites, white Americans also vote in numbers far below almost all of the rest of the developed world.

Americans don’t vote because both major political parties are answerable to the same people: the moneyed classes, the power structures that determine the issues that will be on the political agenda long before the party primaries begin. This is called the hegemony of the bourgeoisie, the rule of the rich.

The corporations and bankers choose the menu; the only option citizens have is whether to select from the pre-packaged list of candidates, or stay home. Almost two out of three chose not to vote in 2014. They were not behaving irrationally. Since both major parties are controlled by the rich, only the most minor tinkering with the way the country is actually run, is tolerated. No matter how many people vote, very little changes, because the U.S. offers the narrowest spectrum of electoral choices in the industrial world – which is why it has the lowest voter turnout.

The Democrats want to keep their lock on the Black vote, but they have no interest in Black people voting their own political agenda, for the simple reason that Blacks are the most left-wing constituency in the country and must, therefore, be kept in check by the Democratic Party machinery. It is the Democrats who have for decades sought to break up concentrations of Black voters, spreading them out across a number of districts. This gives the Democratic Party a better chance to win seats in more districts, but it means that only those Black candidates that can appeal to a substantial segment of white voters can win election. The Black political conversation is left in a state of arrested development. Ultimately, even the Black political landscape turns into a desert, and rational Black people choose not to vote.

What’s so hard to understand about why Congressional approval, indeed our satisfaction with all elected officials from President to Dog Catcher, is in the toilet?

It’s because they toady to the wealthy and not to the voters.

The Intellectual Bankruptcy of the Center-Left

The First Domino

Kenneth Storey

Feb 2, 2015

The Rise of Podemos




What is Behind the Collapse of the Centre Left Parties in Europe?

The NeoLib Experiment has failed.  They’re not even good at lying anymore.

The Breakfast Club (Chain Of Fools)

Welcome to The Breakfast Club! We’re a disorganized group of rebel lefties who hang out and chat if and when we’re not too hungover  we’ve been bailed out we’re not too exhausted from last night’s (CENSORED) the caffeine kicks in. Join us every weekday morning at 9am (ET) and weekend morning at 10:30am (ET) to talk about current news and our boring lives and to make fun of LaEscapee! If we are ever running late, it’s PhilJD’s fault.

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This Day in History

Rev. Martin Luther King Jr. led 25,000 marchers to the state capitol in Montgomery, Ala. 146 people were killed when fire broke out at the Triangle Shirtwaist Co. in New York. Aretha Franklin, Elton John born

Breakfast Tunes

Something to Think about over Coffee Prozac

Music has healing power. It has the ability to take people out of themselves for a few hours.

Elton John

On This Day In History March 25

This is your morning Open Thread. Pour your favorite beverage and review the past and comment on the future.

Find the past “On This Day in History” here.

March 25 is the 84th day of the year (85th in leap years) in the Gregorian calendar. There are 281 days remaining until the end of the year.

On this day in history, two tragic fires occurred in New York City. In 1911, the Triangle Shirtwaist Factory fire claimed 146 lives and 79 years later, in 1990, the Happy Land fire killed 87 people, the most deadly fire in the city since 1911.

The Triangle Shirtwaist Factory fire in New York City on March 25, 1911, was the deadliest industrial disaster in the history of the city of New York and resulted in the fourth highest loss of life from an industrial accident in U.S. history. The fire caused the deaths of 146 garment workers, who either died from the fire or jumped to their deaths. Most of the victims were recent immigrant Jewish women aged sixteen to twenty-three. Many of the workers could not escape the burning building because the managers had locked the doors to the stairwells and exits. People jumped from the eighth, ninth, and tenth floors. The fire led to legislation requiring improved factory safety standards and helped spur the growth of the International Ladies’ Garment Workers’ Union, which fought for better working conditions for sweatshop workers.

The factory was located in the Asch Building, at 29 Washington Place, now known as the Brown Building, which has been designated a National Historic Landmark and a New York City landmark.


The Triangle Waist Company factory occupied the eighth, ninth, and tenth floors of the Asch Building on the northwest corner of Greene Street and Washington Place, just to the east of Washington Square Park, in the Greenwich Village area of New York City. Under the ownership of Max Blanck and Isaac Harris, the factory produced women’s blouses, known as “shirtwaists.” The factory normally employed about 500 workers, mostly young immigrant women, who worked nine hours a day on weekdays plus seven hours on Saturdays.

As the workday was ending on the afternoon of Saturday, March 25, 1911, a fire flared up at approximately 4:45 PM in a scrap bin under one of the cutter’s tables at the northeast corner of the eighth floor. Both owners of the factory were in attendance and had invited their children to the factory on that afternoon. The Fire Marshal concluded that the likely cause of the fire was the disposal of an unextinguished match or cigarette butt in the scrap bin, which held two months’ worth of accumulated cuttings by the time of the fire. Although smoking was banned in the factory, cutters were known to sneak cigarettes, exhaling the smoke through their lapels to avoid detection. A New York Times article suggested that the fire may have been started by the engines running the sewing machines, while The Insurance Monitor, a leading industry journal, suggested that the epidemic of fires among shirtwaist manufacturers was “fairly saturated with moral hazard.” No one suggested arson.

A bookkeeper on the eighth floor was able to warn employees on the tenth floor via telephone, but there was no audible alarm and no way to contact staff on the ninth floor. According to survivor Yetta Lubitz, the first warning of the fire on the ninth floor arrived at the same time as the fire itself. Although the floor had a number of exits – two freight elevators, a fire escape, and stairways down to Greene Street and Washington Place – flames prevented workers from descending the Greene Street stairway, and the door to the Washington Place stairway was locked to prevent theft. The foreman who held the stairway door key had already escaped by another route. Dozens of employees escaped the fire by going up the Greene Street stairway to the roof. Other survivors were able to jam themselves into the elevators while they continued to operate.

Within three minutes, the Greene Street stairway became unusable in both directions. Terrified employees crowded onto the single exterior fire escape, a flimsy and poorly-anchored iron structure which may have been broken before the fire. It soon twisted and collapsed from the heat and overload, spilling victims nearly 100 feet (30 m) to their deaths on the concrete pavement below. Elevator operators Joseph Zito and Gaspar Mortillalo saved many lives by traveling three times up to the ninth floor for passengers, but Mortillalo was eventually forced to give up when the rails of his elevator buckled under the heat. Some victims pried the elevator doors open and jumped down the empty shaft. The weight of these bodies made it impossible for Zito to make another attempt.

The remainder waited until smoke and fire overcame them. The fire department arrived quickly but was unable to stop the flames, as there were no ladders available that could reach beyond the sixth floor. The fallen bodies and falling victims also made it difficult for the fire department to approach the building.

The Happy Land fire was an arson fire which killed 87 people trapped in an unlicensed social club called “Happy Land” (at 1959 Southern Boulevard) in the West Farms section of The Bronx, New York, on March 25, 1990. Most of the victims were ethnic Hondurans celebrating Carnival. Unemployed Cuban refugee Julio Gonzalez, whose former girlfriend was employed at the club, was arrested shortly after and ultimately convicted of arson and murder.

The Incident

Before the blaze, Happy Land was ordered closed for building code violations in November 1988. Violations included no fire exits, alarms or sprinkler system. No follow-up by the fire department was documented.

The evening of the fire, Gonzalez had argued with his former girlfriend, Lydia Feliciano, a coat check girl at the club, urging her to quit. She claimed that she had had enough of him and wanted nothing to do with him anymore. Gonzalez tried to fight back into the club but was ejected by the bouncer. He was heard to scream drunken threats in the process. Gonzalez was enraged, not just because of losing Lydia, but also because he had recently lost his job at a lamp factory, was impoverished, and had virtually no companions. Gonzalez returned to the establishment with a plastic container of gasoline which he found on the ground and had filled at a gas station. He spread the fuel on the only staircase into the club. Two matches were then used to ignite the gasoline.

The fire exits had been blocked to prevent people from entering without paying the cover charge. In the panic that ensued, a few people escaped by breaking a metal gate over one door.

Gonzalez then returned home, took off his gasoline-soaked clothes and fell asleep. He was arrested the following afternoon after authorities interviewed Lydia Feliciano and learned of the previous night’s argument. Once advised of his rights, he admitted to starting the blaze. A psychological examination found him to be not responsible due to mental illness or defect; but the jury, after deliberation, found him to be criminally responsible.

Found guilty on August 19, 1991, of 87 counts of arson and 87 counts of murder, Gonzalez was charged with 174 counts of murder- two for each victim he was sentence maximum of 25 years. It was the most substantial prison term ever imposed in the state of New York. He will be eligible for parole in March 2015.

The building that housed Happy Land club was managed in part by Jay Weiss, at the time the husband of actress Kathleen Turner. The New Yorker quoted Turner saying that “the fire was unfortunate but could have happened at a McDonald’s.” The building’s owner, Alex DiLorenzo, and leaseholders Weiss and Morris Jaffe, were found not criminally responsible, since they had tried to close the club and evict the tenant.


Ear Bugs (You Know The Words)

Why does everybody hate on Nickleback?

The Daily/Nightly Show (Cruz Control)

Ricky Valez and Mike Yard- Awkward

I haven’t screened this clip myself.  I understand it’s about two men’s search for an extinct flightless bird in Greenland.

Tonight the Twitter comes through (h/t TMC).  Our topic is Ted Cruz’s prospects for election (hint: think snowball in a volcano).  Our panelists are Lewis Black (always a pleasure), Amy Holmes (ick), Kristen Anderson (the voice of Kanga), and Kal Pen (Harold and Kumar, the White House Office of Public Engagement).

It’s all part of Larry’s Blacklash 2016 election coverage.


He prefers just ‘The Doctor’

This Week’s Guests-

Jon Ronson is perhaps best known for his book (and subsequent film) The Men Who Stare at Goats.  Less well known (at least here in the States) is his work on BBC Radio 4 and Channel 4 Television.  He’s also managed and played with some Bands.  He’ll be on tonight to talk about his new book So You’ve Been Publicly Shamed.

Ayaan Hirsi Ali’s 2 part web exclusive extended interview and the real news below.