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No Sense of Decency

[ 15 ] July 31, 2016 |

Fallows on Trump attacking Khizr and Ghazala Khan:

Dowd’s quote doesn’t render Trump’s tone, but it’s become clear since then that he was implying that, as a Muslim woman, Ms. Khan was not allowed to speak.

The truth is that she was overwhelmed by grief.

[…]

Why do I mention this? I am not imagining that even an episode as heartless as this will necessarily change any committed Trump supporters’ minds. Although the accumulation of Trump’s offenses should increasingly shame the “respectable” Republicans standing up for him. Paul Ryan and Mitch McConnell, this starts with you.

But it is important to document the starkness of the two conceptions of America that are on clear view, 100 days before this man could become president. The America of the Khan family, and that of Donald Trump.

“Until this moment, I think I never really gauged your cruelty.” Joseph Welch, 1954.

See also Pollock and Klein.

Then there’s Trump latest statement:

“While I feel deeply for the loss of his son, Mr. Khan who has never met me, has no right to stand in front of millions of people and claim I have never read the Constitution, (which is false) and say many other inaccurate things,” Trump said.

You have the love the literal answer to the rhetorical question. To be Scrupulously Fair, he has clearly read the First Amendment that was framed and ratified by Sarah Palin.

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Health care, software and gender identity

[ 11 ] July 30, 2016 |

The nondiscrimination in health programs and activities rule went into effect July 18. However (of course there’s a however), health plans have until next year to make some of the changes necessary to comply with the rule.

One area where both providers and plans will need to make changes is to their software systems. These systems will need to handle claims that would normally trigger gender-specific edits.

Here’s how one of those critters works: A doctor submits a claim for a Pap smear for a patient who is listed as male. Somewhere along the line someone’s software is going to flag that as an error and kick it back out with a little note that reads Submit with the correct code plz. That’s fine if the doctor meant to submit a code that is not gender specific or appropriate for a male patient. When the doctor needs to submit a claim for a Trans* patient who is male, the doctor will needs some sort of override. Medicare created such an override in 2009. I see other health plans have adopted it and Health & Human Services suggested the use of the override in the final rule.

However, private plans have time to make that kind of upgrade and an override on the plan’s end won’t help a provider if the practice’s system, or that of an intermediary vendor, keeps saying I’m sorry Dave, and insisting that the provider fix the non-existent problem. (Imagine an email system that won’t let you send an email unless the text of the message is formatted in a specific way. Then imagine that you need to send an email that doesn’t fit the format exactly. Then imagine your income depends on sending lots and lots of emails.)

That’s the type of scenario that a member of a list-serv I frequent was trying to avoid. List member’s practice has a trans* patient and the list member wanted some ideas for entering the patient in the practice’s system in a way that worked for the practice, the patient and his insurer.

Another member made a couple of suggestions which included asking the software vendor to add transgender to the range of gender choices, and to call the insurance company for a pre-authorization when the patient needs a procedure that doesn’t match his listed gender.

(By the way, I’m not paraphrasing to eliminate obnoxious things people said, I’m doing so to keep this thing from devolving into a giant pile of Medadmintechlish. But perhaps it is too late.)

At any rate, in my semi-informed opinion those solutions are fine, because the practice is doing whatever it needs to do to get claims processed and the patient just comes in and receives health care.

If the practice has to wrestle with its software vendor’s rep. in order to get a needed upgrade, that’s not the patient’s concern. If someone has to sit on hold for half a day to get the patient’s pelvic exam cleared, so be it. (However, I would also talk to the payer about installing the Medicare override sooner rather than later.)

My other semi-informed opinion is software upgrades could prove to be the bigger hurdle for practices. Plans have to comply with the law. Software vendors don’t.

Ichiro!

[ 14 ] July 30, 2016 |

IMG_3152One of the upsides of writing for a magazine that focuses on the Asia Pacific is that I occasionally get to write about baseball…

Ichiro Suzuki, known to baseball fans simply as “Ichiro!”, will likely exceed 3,000 Major League Baseball (MLB) hits sometime this week. Ichiro currently sits at 2996, the product of a fantastic age 42 season in which the veteran outfielder is hitting .339.

“There Are Too Many Liberals Nowadays. Please Eliminate All of Them. I Am Not A Crackpot.”

[ 354 ] July 30, 2016 |

jillstein

It’s not exactly news that Jill Stein, The Only True Leftist In America (TM), is an ill-informed crackpot. But this is…special:

The answer to neofascism is stopping neoliberalism. Putting another Clinton in the White House will fan the flames of this right-wing extremism. We have known that for a long time ever since Nazi Germany. We are going to stand up to Donald Trump and to stand up to Hillary Clinton!

“The only way to stop the neofascist Donald Trump is to electe Donald Trump.” Hard to dispute that logic! As Chait says, her argument that the lesson of Nazi Germany is that liberals are the #1 enemy of the Real Left and it’s better to have fascists in power if forced to choose is, ah, idiosyncratic.

In a recent Salon interview, the takes are almost as hot:

Ok, but my question is, do you think there’s a meaningful difference between Trump and Clinton? Is one not objectively scarier than the other?

I’m terrified of Donald Trump. I’m terrified of Hillary Clinton. And I’m most terrified of a political system and people who apologize for it. I’m terrified of people who tell us that we have two deadly choices and we must pick our weapon of self-destruction. We should not resign ourselves to a trajectory that is making a beeline for oblivion. The day of reckoning on climate is coming closer and closer, and I don’t regard Hillary Clinton as one iota safer than Donald Trump on the climate. She’s been promoting fracking around the world. Maybe she’s the most effective evil. She gets a lot of people to do what she wants. She’s got a whole Democratic Party system behind her, which has proven itself extremely effective and extremely dangerous.

The idea that there is no difference between Hillary Clinton and Donald Trump on climate issues is, to put it mildly, insane.

She then goes on to argue that a Republican in the White House is no big deal because the fact that the Burger Court produced Roe v Wade and Richard Nixon signed some of the liberal legislation a Democratic Congress put on his desk a unified Republican government in 2017 and a Supreme Court where the median vote is to the right of Antonin Scalia is no big deal. No, really.

Admittedly, while her answers are loonier than most, when someone asks a vanity party candidate or supporter exactly how voting for a third party in a first-past-the-post system will actually accomplish anything that could be worth the huge downside risk, the answer will inevitably be a bunch of non-sequiturs and meaningless gibberish because there is not, in fact, a rational answer to that question. Dr. Stein is truly a crank for all seasons, however, as you can see from this anti-vaxxer-curious woo-woo:

“I think there’s no question that vaccines have been absolutely critical in ridding us of the scourge of many diseases — smallpox, polio, etc. So vaccines are an invaluable medication,” Stein said. “Like any medication, they also should be — what shall we say? — approved by a regulatory board that people can trust. And I think right now, that is the problem. That people do not trust a Food and Drug Administration, or even the CDC for that matter, where corporate influence and the pharmaceutical industry has a lot of influence.”

Stein’s warning about corporate influence in the vaccine approval process is often voiced by “anti-vaxxers.” In reality, most members of the Vaccines and Related Biological Products Advisory Committee work at academic or medical institutions, not drug companies. But for Stein, the fact that people saw corporate and lobbying influence running rampant meant that some skepticism was warranted.

[…]

“As a medical doctor, there was a time where I looked very closely at those issues, and not all those issues were completely resolved,” Stein said. “There were concerns among physicians about what the vaccination schedule meant, the toxic substances like mercury which used to be rampant in vaccines. There were real questions that needed to be addressed. I think some of them at least have been addressed. I don’t know if all of them have been addressed.”

Christ.

As I’ve said before, if your personal brand won’t let you vote for the Democratic Party, you can find a better vanity candidate to write in than Jill Stein — Donald Duck, I.P. Freely, Amanda Hugandkiss, anybody really.

Easy A

[ 111 ] July 30, 2016 |

A few people seem to think that Andrew Sullivan deserves some sort of credit for endorsing and voting for Hillary Clinton in the coming presidential election (only 325 bamillion days to go).

This – and I say this as someone who thinks the man is a complete  ass – is incredibly unfair to Andrew Sullivan.

This is the equivalent of saying Sullivan did a great job looking both ways before he crossed a busy street. Or: Let’s give Sullivan a pat on the back because he decided to shave with a razor instead of a Ginsu knife. Or even: I was impressed by Sullivan’s decision to climb a tree when a pack of ravenous hyenas was chasing him. What the hell else would he do?

Nov. 8 will be the first time Sullivan votes in the U.S. and one may almost imagine that the universe conspired to make sure the process of selecting a candidate was as easy as possible. Does anyone think there was any sort of prolonged decision-making process? Let’s review his – and the rest of America’s – choices:

H.R. Clinton/Kaine

Tantrumville Stein or Contradiction Heights Johnson (or is that the other way around?)

TrumPence

Does this look like a head-scratcher? I don’t think he’s anywhere near as clever as he believes himself to be, but even I don’t think he’s as dim as all that.

Even under normal circumstances, I’ve never seen the point of praising or (odder still) thanking people (usually white and male) who decide to vote D instead of R. Thanks for not voting for oppression in all it’s forms! Whatever next? You didn’t kick that puppy into a storm drain, bravo!

No, that would be ridiculous in a normal year and  this year isn’t normal. Inevitable, certainly. For as long as I can remember the only question has been how long the GOP could keep the plates spinning before something Trump-like stomped out of the wings and got a standing ovation for telling jokes about the coloreds.

This year, anyone who says that after intense internal debate, they decided they would vote for Clinton (or against Trump) is either too stupid for a mother’s tears and should be left alone; winding you up and should be ignored; or some species of selfish jackass who may be ignored or told to go nap on I-95, depending on personal preference.

Praised? No. Thanked? Ha ha ha. No.

Mr. Sullivan wants a candidate as warm & poetical as M. Thatcher

[ 220 ] July 29, 2016 |

The unofficial motto for 2016 has been What fresh hell can this be? And that was before Andrew Sullivan stepped back into blogging. I had managed to forget about that particular pet hair on the foundation brush until I saw on the Twitter feed of Mr. Elon Green, the following:

It didn’t connect with me. It was a theme-free pudding delivered by someone you can respect but not exactly warm to. She’s not really at ease speaking in public, and it shows. I get that this is actually her appeal to some: that she’s a detail-oriented pol who works best off the public stage. But a president does need to connect, to inspire and to rally. She may well grow more into this role, or we’ll simply have to deal with prose rather than poetry from here on out. But it didn’t do it for me. And I’m not gonna lie.

Oh for the love of fuck … Where to start when it’s too early to start drinking? Basically, his criticism comes down to Clinton – a person everyone has known for more than two decades, a person who has recently been in the public eye as only a woman running for president for the second time can be – didn’t deliver whatever he was expecting even though he had no right or reason to expect whatever he was expecting.

In short, it is a very male criticism. You didn’t read my mind and do what I wanted you to do! he shouts, or snarls, or snivels at the non-male who displeases him. And this criticism can be delivered at any time, even when delivering it gives the impression that he hasn’t been paying any attention to current events: That was far from the first speech Clinton has given, and apparently her style inspired and rallied enough people that she was the one who accepted the nomination last night.

To view this as a valid criticism, I’d have to believe that he thought she was holding back the good stuff until her acceptance speech last night and still failed to deliver. However, I’m inclined to think the criticism was preordained. But don’t worry, Sullivan takes a lurching step and:

I should address the gender thing.

[Brief break to allow people to knock back a big glass of Lethe water, run away or click to the next post]

Readers lambasted me for every criticism of her speaking style on feminist grounds. And I understand how Clinton carries an enormous weight as the first woman presidential candidate that makes the usual criticisms of her – that she’s pedestrian, uninspiring, and hectoring at times – sound sexist.

But there were many, many women in this convention who spoke far more memorably than she did, who held the crowd in more rapt attention, who were able to modulate their speeches in ways that helped people understand their message better. This is not, in other words, a woman problem; it’s a Hillary Clinton problem. She simply doesn’t have certain gifts of oratory and connection with people that other more natural politicians do. It’s a weakness in a presidential candidate.

Two things.

1. I do not think it is at all inappropriate to suspect the man who was obsessed with proving Bristol Palin was Trig Palin’s mother and who has defended Gaters is being a sexist.

2. He addresses the gender thing in response to people who did not care for such comments as this:

10:41 p.m. And we head into a thicket of prose … and she keeps looking as if she’s sternly correcting a school-room.

and

10:48 p.m. A smile! Almost a human one!

Ah right. He invokes the image of the mean school marm when talking about a woman and criticizes here smile. People reply with a raised eyebrow and a Really? He starts yakin’ and quackin’ about how some other women did it better. (But not Chelsea, booooring!)

There will be a gender gap in this election of possibly huge proportions. I suspect Trump will turn off more women than Clinton turns off men. But it will be close.

This is one of those statements I would expect from someone who really hates men with the heat of a thousand Hothead Paisans. Or someone who is attempting to justify bad behavior by men.

Because women are turned off by Trump for a number of reasons, some of which are gender neutral (he’s a sack of orange assholes) and some of which are not (he’s a sexist sack of orange assholes). According to Sullivan, however many women are turned off by Trump (and I have to assume he means women who have or intend to vote Republican to make any sense of this),  a “close” number of men who have or intend to vote Democrat, are such fussbudgets that they’ll be turned off because Clinton is too much of a wonk or is otherwise insufficiently entertaining.

Maybe this is all leading up to the publishing of a pre-written article: Why I stayed home on Election Day.

[Update – Thanks (?) to Junker for bringing this to my attention. Fortunately it is now late enough to drink!]

The Garland Silence

[ 144 ] July 29, 2016 |

20160319_usp503

To expand on Paul’s post below, there is obviously no chance that Merrick Garland is going to get a hearing — let alone be confirmed — before the election. And even if Clinton wins with a Democratic Senate, it is still highly, highly unlikely that he would get confirmed by a lame duck Senate. To give you the tl; dr version, the argument that he will be confirmed is superficially plausible — Garland is the best Republicans could get, so why not confirm him? But the problem is that it’s flatly inconsistent with how the Republican Senate conference has consistently acted in the McConnell era. Again and again and again, they’ve passed up the chance to make marginal policy gains in favor of total obstruction. Any Republican who voted to confirm Garland would be subject to attacks within the party and be vulnerable to a primary challenge. There’s no reason to believe that the typical Republican senator would be willing to take that risk to get a justice who votes with Ruth Bader Ginsburg 87% of the time rather than 95% of the time. And remember also that in the very tight time frame of the lame duck session there would have to be a near-consensus among the Republican Party to allow the nomination to proceed. There is no reason whatsoever to believe that such a consensus exists, and it would be remarkable for the the Senate GOP to break with their long-standing practices for a relatively minor substantive benefit.

I do, however, think that the radio silence at the DNC about Garland is interesting in itself. It’s striking that the Democrats didn’t even try to make an issue out of the unprecedented obstruction of Obama’s Supreme Court nominee. But I don’t think this has anything to do with signaling Congress or anything. Rather, what it tells you is that Merrick Garland has no particular constituency within the party. I can’t prove the counterfactual, but I find it hard to believe that if Paul Watford or Tino Cuellar had been the nominee nobody would have tried to make an issue of it. The Republicans obstructing Watford or Cuellar would have allowed the Democrats to combine several themes — the diversity of their coalition, the intolerance of the Republicans, the importance of the Supreme Court — to create a narrative that might have been useful to the candidates in marginal Senate races. With Garland, however, the only story you can tell is a procedural one about obstruction — and nobody actually cares about that. Since there was never any chance that Obama could get a replacement for Scalia confirmed, the only thing that mattered was the politics. And the politics didn’t make sense at the time and they still don’t.

Between Kaine’s inept flailing on the Hyde Amendment and the absence of Garland from the DNC, I wouldn’t say this has been a great week for theories about the political benefits that allegedly accrue from picking bland white guys.

Was Merrick Garland’s name ever mentioned during the DNC?

[ 63 ] July 29, 2016 |

garland

This guy says it wasn’t, and he has a theory as to why:

[R]ight now the conventional wisdom is that Republicans are blocking Garland’s nomination on the outside chance they can win the presidency and fill Scalia’s seat themselves; and if Clinton wins, they’ll just confirm Garland after the election, during the lame duck session. This plan will work, even if the Republicans lose the Senate, because they’ll still hold the majority until their replacements take office in January. The only way this doesn’t work is if Garland’s nomination is withdrawn. So what if the Garland nomination is withdrawn?

Look, I believe Obama nominated Garland because Garland is who he actually wants on the Court. But the Republican pitch on filling Scalia’s seat is “the voters should decide.” I’ve already explained why that doesn’t make any sense—the voters decided who should fill Supreme Court vacancies when they elected Obama. But a pitch that’s good for the goose is good for the gander. The GOP has handed Obama an excuse to withdraw Garland’s nomination the morning after the election. (Obama: “Guys, guys, you wanted to let the voters decide, and the voters have decided they want Hillary Clinton to fill this seat.”)

Do I think Obama would actually withdraw Garland’s nomination? I didn’t a week ago. But that was before we witnessed an entire week of the DNC, packed with speeches about Democratic goals and priorities—with plenty of talk about Supreme Court decisions that need overturning and plenty of promises to nominate justices who will overturn them—but not a single mention of confirming Merrick Garland.

My theory: If we get deep into August and the polls are showing not only a strong lead for Clinton but also promising leads in enough of those senate races, it will take only credible whispers of withdrawing Garland’s nomination to make the Republicans nervous enough to go ahead and confirm him before the election. And how do you create a credible threat of withdrawal? By taking the stage before millions of viewers for a week to talk about goals and priorities, and the importance of the Supreme Court, without mentioning Garland. There was an effort to rally Democratic voters behind the importance of appointing the right people to the Supreme Court—but no effort to rally Democratic voters behind Garland. Why? Because absenting Garland from the DNC was a signal. The Party didn’t commit itself to Garland. Clinton didn’t commit herself to Garland. Even Obama didn’t push for Garland. The signal: after this week, the possibility of withdrawing Garland on November 9 is real.

This is superficially plausible — and it’s certainly noteworthy that Garland wasn’t mentioned, assuming he wasn’t — but I can’t see the GOP folding on Garland right before the election even if the polls look dismal for them. That sort of show of weakness would just enrage the base further, assuming that particular dial won’t already be cranked up to 11 by then.

For It After He Was Against It After He Was For It

[ 138 ] July 29, 2016 |

Tom-Perez-AP-IAMGASJH

As a follow-up to my piece yesterday, Tim Kaine has decided to change his changed position on the Hyde Amendment:

You can see the interview from this morning here. The quote in Quigley’s tweet isn’t unfairly taken out of context; it’s not preceded or succeeded by him saying that “of course I will support the party’s platform irrespective of my personal views” or something like that.

A few implications of this:

  • Substantively, as vice president it doesn’t matter at all. He’s not going to have any effect on Hillary Clinton’s abortion policy and he’s not going to have any effect on how the public views abortion policy. In terms of the direction of the party, Clinton’s stated views are obviously vastly more important than Kaine’s.
  • If he becomes president because Hillary Clinton has to leave office and the Republicans retain at least one house of Congress, it doesn’t matter at all. Because it’s not a stand-alone provision it’s nearly impossible to veto, so all a president can do to affect abortion policy is nominate Supreme Court justices. And when picking nominees, Kaine’s views on the Hyde Amendment will matter about as much as Obama’s nominal opposition to same-sex marriage mattered.
  • It matters if he becomes president and the Democrats somehow assemble a governing majority before 2024. Very unlikely, given the Republican structural advantage in the House, but not impossible. Given what some of the marginal members of the House would look like if the Democrats were to take it back I suspect the president’s views would be the least of the problems with putting together a majority to get rid of the Hyde Amendment, but it certainly doesn’t help.
  • It’s a reason to oppose him for the Democratic nomination even if he runs for president in 2024. Even if he adopts the position on the party’s platform now, he won’t be trusted and shouldn’t be. (Obama took too long to come out for same-sex marriage, but he didn’t flip back after 2 days.)
  • This is really bad form from Kaine. If he wanted to just say something like “whatever my personal views, our nominee for president and the party platform support repealing the Hyde Amendment,” and stick with it, OK. His comments on the 27th, although not the 29th, are acceptablish. But this immediate flip-flop and miscommunication with Clinton’s staff, while not the biggest deal in the world, is a thumb in the eye to an important part of the Democratic coalition. When the rationale for picking someone is that he’s a boring but experienced politician, he’s not supposed to make mistakes like this.
  • The case for Perez over Kaine was obvious — he’s more progressive than Kaine, he represents a crucial and growing Democratic constituency, and he doesn’t but a crucial Senate seat at risk. Against Perez was the idea that because of the magic of his having held statewide elected office Kaine would be much less likely to make political mistakes. Hmmmm. I don’t really see the basis for this — experienced pols commit blunders all the time. (Cf. Joe Biden, who worked out fine anyway.) I still think the idea that Perez wouldn’t the minimum standards of a vice presidential nominee is baseless and insulting.

Dr. Jill Stein Has a New Biggest Fan!

[ 38 ] July 29, 2016 |

Insty!

Screenshot 2016-07-29 11.59.53

“Have You Even Read the United States Constitution?”

[ 287 ] July 29, 2016 |

I thought Clinton was as good as she needed to be, maybe a little better — started a little slowly, but got a lot stronger as it proceeded. But my opinion doesn’t matter — we’ll see how the polls shake out.

But we shouldn’t forget what’s at stake here.

The children of the revolution. Now with Won’t get fooled again update.

[ 103 ] July 28, 2016 |

The DNC Attention Seeking Committee – entrants in the Most Ridiculous Use of the Black Power Fist contest – have a new and even more cunning plan to save America and the world from treasonous traitor Hillary Clinton. One more cunning than farting their way to freedom: A citizen’s arrest.

Citizen’s arrest worked so well for the right wing shoutbots that kept threatening to come here and arrest treasonous traitor Obama and the rest of the administration, so I can definitely see why DNCAC wants to give it a try. But to show they have a 12 rubber cement jar a day habit how very peaceful and lawful they are, the DNCAC asked les flics and the Secret Service to help them out.

Like, could we borrow some handcuffs?

Like, could we borrow some handcuffs?

It’s a new way to stick it to The Man. Get The Man to help you do the sticking. Or maybe it’s the sort of plan one concocts when one has a cup of cold watery grits where normal people keep their brains.

And on the topic of people who need to contract a chronic case of the shut ups, here’s Dr. Stein.

“Putting another Clinton in the White House will fan the flames of this right-wing extremism,” she said. “We have known that for a long time, ever since Nazi Germany.”

Only 352 gajillion days until the election!

Update – Never mind. Apparently Ida Know, who was probably acting on orders from  Der Hillderbiest, gained access to DNCAC’s Facebook account and posted the citizen’s arrest thing. Now the DNCAC is the real victim for the 1,500th time this week because the press believed something that sat on the group’s Facebook page for several hours.

No word yet on whether they’ll protest this fresh outrage by tying themselves to Wolf Blitzer.

The DNCAC's current position. Until the next one.

The DNCAC’s current position. Until the next one.

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