How the Game Is Played

Something that isn’t getting big headlines, but ought to, is the fact that on December 1 the Medicare reimbursement rate for physicians will drop by a whopping 23 percent. It is anticipated that a lot of physicians will drop their Medicare patients as a result.

Last Friday the Senate passed a “doc fix” to keep the current reimbursement in place for one more month, and it is expected the House will do the same when it reconvenes after Thanksgiving. Then the lame duck Congress will try to pass something more long-term before it passes into history.

The cuts are the result of a Clinton-era attempt to control rising Medicare costs. Sometime in the 1990s Congress passed a formula for physician reimbursement called the “sustainable growth rate” (SGR) that tied physician reimbursement to the Gross National Product. This may have seemed a good idea when the economy was growing. But when the economy stopped growing, it seemed to be a very bad idea.

Instead of repealing the SGR forumula, Congress kicked the can down the road. Beginning in 2003, every year Congress passed a one-year “doc fix” to override cuts to the reimbursement rate mandated by the SGR. Every year until this year, that is.

Early versions of the Patient Protection and Affordable Care Act (PPACA), or the health care reform bill, provided for repealing the SGR. But that repeal added to the cost of the bill. So the SGR repeal was removed, along with some other things, to lower the bill’s price tag and buy the last few hesitant votes to get the thing passed.

Dems figured this was not necessarily a loss, because there was no reason the repeal couldn’t be introduced in a separate bill, and if worse came to worse they could kick the can down the road one more year, as they’d been doing for the past several years.

Republicans, however, sensed opportunity. With the help of Blue Dogs, Republicans were able to block a separate SGR repeal bill and also refused to support the annual “doc fix.” Then they went home to their constituents and blamed the looming cuts in Medicare reimbursement on “ObamaCare.”

And you can just bet that if the 23 percent cut isn’t stopped, and lots of seniors suddenly find themselves without doctors, the Right will milk that for all it’s worth and persuade the older folks that their problems were all caused by those tax-and-spend socialist Democrats. I can see all the tea party marches / power chair rallies already.

And this, my dears, is how the game is played.

As listed in the last post, there is a growing realization that Republicans deliberately are trying to wreck the economy so that Democrats can be blamed for it. Paul Krugman wrote more about this today.

The fact is that one of our two great political parties has made it clear that it has no interest in making America governable, unless it’s doing the governing. And that party now controls one house of Congress, which means that the country will not, in fact, be governable without that party’s cooperation — cooperation that won’t be forthcoming. …

… These days, national security experts are tearing their hair out over the decision of Senate Republicans to block a desperately needed new strategic arms treaty. And everyone knows that these Republicans oppose the treaty, not because of legitimate objections, but simply because it’s an Obama administration initiative; if sabotaging the president endangers the nation, so be it.

Steve M. has a good point

… as I see it, for 30 years we’ve had a country that’s nominally democratic, but in which presidents are allowed to govern only if they’re Republican or forced to defer to Republicans.

Don’t think of the Democrats and Republicans as the two major political parties in a democratic system; think of the Republican Party as the U.S. equivalent of, say, the people who really run Pakistan — the generals and members of the intelligence establishment. Pakistan has elections, but if you’re elected, you’re still not free to do what that crowd doesn’t want you to do. Cross them and you’re likely to suffer the consequences.

I’d never quite thought of it that way before, but damn, I do believe he’s on to something.

We don’t have literal coups or assassinations (so far), but that seems to be because our authoritarian permanent government doesn’t need them, and because maintaining the illusion that we’re not a country run by a strongman force strengthens the Republicans in the long run. As Krugman notes (and as Zandar notes), Republicans seem able to run the country this way without attracting any scrutiny from even the most plugged-in observers. Hard to imagine when that will change, if ever.

“Our nation is in much worse shape, much closer to a political breakdown, than most people realize,” Krugman writes.

My illustration of the Medicare cuts is just one tiny little example. At least some Republicans want to play politics with the lives and health care of seniors, just to stick another knife in Democrats. This stuff happens over and over and over, and the Dems remain helpless to stop it.

Stuff to Read

This is important, and it relates to the recent post “Failure Is the GOP’s Only Option.” Please read:

Steve Benen, “None Dare Call It Sabotage.”

Kevn Drum, “The Liberal Noise Machine.”

Brad DeLong, “Paul Krugman on the Axis of Depression.”

BooMan, “Cynical or Crazy?

Among other things, BooMan, says,

So, Benen is correct. If you wanted to design a party to destroy America’s economy, you couldn’t do much better than the current GOP. But, are they going to do it for purely cynical reasons or because they’re crazy? The answer is: a little of each. The top echelon…the movers and shakers…have never been social conservatives and the only ideology they’re wedded to is keeping as much cash for themselves as possible. They probably don’t want the U.S. economy to suck for the next two years, although most of them are smart enough to win at the casino either way. But the lower level Republicans, including a good percentage of their caucuses? They’re going to fuck everything up because they’re crazy.

Yeah, pretty much.

If Airport Strip Searches Save Lives …

There’s a lot of uproar at the moment about body scans and “patdowns” at airports recently. Some of the stories do seem outrageous, such as the woman who had to remove her prosthetic breast to show she wasn’t hiding explosives in it.

Other people seem to be over-reacting. Best comment so far: “If you think a TSA pat down is sexual assault then you don’t ever want to go on the New York subway at rush-hour.” Yes. I call them “sardine cars,” because people are packed in them like sardines. Do you shove yourself into the car and experience full-body contact with a bunch of strangers, or do you wait for the next train, in the chance that it will be less crowded? If you’ve lived in New York for a while, you learn to not be too squeamish if you want to get to work on time.

But it strikes me that (if Memeorandum is any indicator) there is more uproar about the TSA coming from the Right, not the Left. Some of it is the usual posturing (it’s “Obama’s” TSA, after all). And, let’s face it, righties are whiners. But it strikes me that these are the same people who justified waterboarding because it might “save lives.”

If you could get information that would save lives, or save a school full of children, or prevent another 9/11, wouldn’t it be wrong to not waterboard somebody? We were asked. The fact that such information is rarely reliable was never part of the scenario.

To me, it was like asking If you could stop a terrorist by leaping off an office tower and landing on him, killing both of you, wouldn’t it be wrong to not leap off the office tower? Never mind the sacrifice involved; it’s unlikely I would be able to direct my falling body with enough precision to do much good. So the answer is, um, no. Let’s go with what works, which is not waterboarding.

And let’s not even start on the wisdom of invading random foreign countries on the chance they might have weapons of mass destruction-related program activities.

The thing is, if bodily violations actually provide greater security and reduced the possibility that the plane would be hijacked or blown up by terrorists, I might go along with them. I can imagine being on a plane that is being hijacked and thinking, damn, why weren’t we all body scanned?

It’s not clear that body scans and patdowns actually make us safer, since apparently the TSA hasn’t caught any prohibited items that they probably would not have found through more conventional screening means. On the other hand, it’s possible the security theater discourages would-be terrorists from attempting anything.

What say you?

MSNBC: Grow Up

This is absurd. I’m no fan of Joe Scarborough, but I don’t see any big bleeping deal if he gives standard campaign donations to candidates he likes.

It’s hardly a scandal that Joe Scarborough, or Keith Olbermann, or any other cable show host has partisan preferences. Of course they do. That should be obvious to anyone who watches those programs. What purpose is served by pretending otherwise?

If there’s an issue, it’s that the cable news programs blur the line between journalism and opinion/commentary, so that the networks themselves aren’t sure which is which any more.

Failure Is the GOP’s Only Option

There’s movement among House and Senate Dems to force a vote on extending the Bush middle-class tax cuts, defying Republicans to vote against them. And they didn’t do this sooner, why?

If the message the Dems got from the mid-terms is that they have to fight back, then maybe the loss was a good thing. We’ll see. Glenn Thrush at Politico is skeptical that the Senate will actually pass anything, but to get Republicans to vote against a tax cut is an accomplishment in itself.

Elsewhere in Put Up or Shut Up News, Ezra Klein writes that senators Ron Wyden (D-Oregon) and Scott Brown (R-Massachusetts) have introduced a bill called the “Empowering States to Innovate Act.”

The legislation would allow states to develop their own health-care reform proposals that would preempt the federal government’s effort. If a state can think of a plan that covers as many people, with as comprehensive insurance, at as low a cost, without adding to the deficit, the state can get the money the federal government would’ve given it for health-care reform but be freed from the individual mandate, the exchanges, the insurance requirements, the subsidy scheme and pretty much everything else in the bill.

A variation of this idea was inserted into the Patient Protection and Affordable Care Act by Wyden and Senator Bernie Sanders (S-Vermont), but it won’t go into effect until 2017, three years after everything else kicks in. The Wyden-Brown bill allows states to have their alternative programs in place by 2014, when everything else kicks in.

The Republican fantasy, of course, is that they can find a “free market” solution to health care reform. What this bill says is “go ahead — try it. Good luck making it work.” It also would allow progressive states like Vermont to enact a statewide single payer system, which Senator Sanders advocates.

This law also would kick the legs out from under right-wing efforts to repeal the mandate and other parts of the PPAC Act. The Republicans are flapping around saying they want to repeal the law and enact “real” reform. So, let them try, I say. Make them take their stupid theories off the shelf and actually try to make them work in the real world. I predict at least some Republicans will resist this idea, because they know in their hearts their theories were never meant to be tried out in the real-world light of day. They’re all just empty talking points, meant to keep the lemmings moving.

It’s that real-world thing that always trips up right-wing ideology. A couple of days ago David Leonhardt of the New York Times published a post that argued the Bush tax cuts were a colossal failure, so why are we talking about extending them? He followed up with another post responding to reader criticism of his data.

Bottom line, any way one measures it, there is no data showing that the Bush tax cuts spurred economic growth, created jobs, or encouraged entrepreneurship. All they did was drain the treasury of revenue. Not that you’ll get a True Believer to admit any of that.

Paul Krugman today writes about Repuplican efforts to stop the Federal Reserve from creating jobs. The only rational answer for what Republicans are doing is politics — it benefits Reublicans if the economy remains stagnant, so the government must be stopped from doing anything that might make it better. It’s all they can do; they can’t succeed, so in order to sell themselves to voters they have to make Democrats fail, too.

The Ahmed Ghailani Verdict

As is often the case, reactions to the Ahmed Ghailani verdict from Left and Right are poles apart. The Right is furious that Ghailani was acquitted of terrorist acts to which he had confessed under torture. In their twisted little minds, this proves civilian trials for terrorist suspects are a failure, because they cannot be counted on to produce the desired outcome.

Liberals, of course, see the verdict as proof that a Muslim accused of terrorist acts can get a fair trial in America. My Buddy the Talking Dog writes,

I for one welcome our new ant overlords am proud of my fellow New Yorkers who served on the jury, for doing the highest service our justice system can do: be fair to the most hated man around, in this case, an accused mass murderer, by carefully assessing the case before them, rather than, as virtually all our politicians seem to do, relying on prejudices or propaganda or expedience. Obviously, this is what our politicians are most afraid of, and why the Ghailani trial will probably be the last of its kind.

Alas, conventional wisdom says the Dog is probably right — this will be the last civilian trial for terrorism suspects. The rest of the terrorism suspects at Gitmo very likely will be tried out of sight, and without the unpredictable factor of an impartial jury, so that the “correct” verdicts can be produced. Or, at least, that’s the theory. Glenn Greenwald says that the current rules governing military tribunals require exclusion of the same torture-obtained testimony that the civilian trial excluded

Ghailani was found guilty of one count of conspiracy to blow up a government building, for which he will serve 20 years to life, so it’s not as if he’s going to be set free with a gift basket and note of apology.

Here’s an interesting reaction from the rightie blogger Blackfive:

Terrorists 279 America 1

This was the test case the Obama team wanted to use to prove that they could pull off civilian trials. They accepted that much of the information they had tying this clown to the bombings wouldn’t be used, like his confession for one. They assumed that their smarty-pants lawyers could play a RICO conspiracy tale and they would convince a jury to ignore the gaping holes in their case because we knew this guy is a terrorist. This mentality was readily apparent when they started discussing the KSM case and trying him in NYC. Holder, Obama and Gibbs all basically said it would be a show trial and conviction was already in the bag.

Let’s see if we can deconstruct this. There were “gaping holes in the case,” the guy says, but we “know” he’s a terrorist, and the trial was supposed to find him guilty in spite of those gaping holes. The blogger is derisive of the Obama Administration for failing to deliver an allegedly promised “show trial.”

In other words, we are to stage some Justice Theater to keep up appearances, but no honest verdict or lawful procedures can be allowed.

A commenter at Blackfive’s site writes,

The minimum sentence that he can receive is 20 years. This is a lot more than MANY of the sentences that have been obtained at Gitmo.The average sentence has been much shorter for convictions that happened at Gitmo. Remember Khadr? Hicks? Hamadan We had 850 detainees there most have been let go by the military. We just read that the last ones that were released back to the UK will now be all receiving fat payoffs from the UKs new conservative government.Pesky things like the Geneva Conventions and the US Constitution seem to be troublesome sometimes.

Indeed. It may be that the only substantive difference between accused terrorists tried and acquitted by a military tribunal and an accused terroroist tried and mostly acquitted by a civilian court is that the military tribunals don’t get the press coverage that a public trial in New York City gets. And also it’s harder to bash the Obama Administration for what a military tribunal does.

BTW, a news story says that 534 prisoners have been “moved out” of Guantanamo Bay, but I can’t find how many of those were released and how many were transferred to facilities in their home countries. If anyone else can find that figure, I’d like to see it.

The same news story also says that some of the released Gitmo prisoners have “returned” to terrorist activities, but there’s no way to know if the former prisoners were really “returning” or if they were originally innocent but became radicalized at Gitmo.

Anyway — the real failure, as far as justice is concerned, is that because prisoners were tortured they cannot be tried properly, which puts the United States in a very ugly position. Essentially, we have little choice but to either let them go or keep them locked up indefinitely without trial. And lots of people tried to explain that to the Bushies, but the Bushies wouldn’t listen.

Sighted: Dems With Spines

If only they could be cloned. Four House Dems — Joseph Crowley of New York, Linda T. Sanchez of California, Donna Edwards of Maryland and Tim Ryan of Ohio — sent an open letter to Republicans in Congress asking which of them would forgo their congressional health benefits:

“If your conference wants to deny millions of Americans affordable health care, your members should walk that walk,” four Democrats write in the letter, which is addressed to Senate Republican leader Mitch McConnell and House Republican leader John Boehner. “You cannot enroll in the very kind of coverage that you want for yourselves, and then turn around and deny it to Americans who don’t happen to be Members of Congress.” …

…In their letter, the Democrats write they were “surprised” to see [flaming hypocrite Andy] Harris complain that “there is a delay before benefits take effect. Ironically, this is the same predicament millions of Americans currently find themselves in.”

“We also find it interesting that members of the Republican conference would have no problem taking away health coverage from hard-working Americans, but expect expanded coverage for themselves and their families,” they add, writing that the health care reform bill gives Americans the option of selecting a plan in a manner similar to members of Congress.

A little more of that, please.

While I Was Out

So I step out for a bit, and I see Nancy Pelosi will be minority leader in the next House and Lisa Murkowski is relected to the Senate from Sarah Palin’s Alaska®. Congressional Republicans refuse to meet with President Obama because they are still pissed at him for accepting their invitation to their retreat last January. And Sen. Jon Kyl (R-AZ) has flushed national security and weakened America’s position vis à vis Iran, Afghanistan, and most of the rest of the world, down the toilet, for no apparent reason. Anything else?