Sunday, September 29, 2013

'I Refuse To Join Any Party That Would Have Me As A Member'---Part II

'I wonder if people think I am obnoxious, irritating,
irreverent and incoherent? Na'ah, they love what
I have to say to them'
We have used the great Groucho Marx line before as he related it to joining social and country clubs. It is so great we thought we would use it again.

Have you ever wondered if you are making a solid impression on other people and changing their minds to see anything 'your way'?

We have a friend in higher academe who ends her orientation each year with this admonition:

'If you don't know who the a**hole is in your class, chances are it is you!' (Honest, this is a direct quote. Blame higher education. Not us)

The recent furor over Tea Party Republicans demanding that the federal government be shut down unless Obamacare is completely defunded reminded us of this quote.

Apparently, there are people in society who think that if they call people 'stupid', 'ignorant' and 'unpatriotic', the people they attack will somehow come to their senses and say: 'Hey! You know what Mr. and Mrs. Tea Party People? I am stupid, ignorant and unpatriotic to disagree with everything you say. So I am going to change my mind and come over to your side right now. How about that? Are you happy now?'

That never happens, does it?

Here's what we don't get:

  1. Why do people think RINO (Republican In Name Only) is such a bad name? Are we in kindergarten or something?
  2. Are we even teaching the Constitution in any of our public or private schools anymore?
    It simply stuns us how many people seem to believe that just because one House of Congress wants something done (Republicans in the House don't want Obamacare to start October 1) that the other House of Congress, the US Senate now controlled by the Democrats, has to pass it. They don't. And in this case, they won't.
  3. When did the word 'compromise' start being written with only 4 letters? (We are pretty sure it started with Newt Gingrich in 1978 when he started a rear guard action against moderate Republicans in the House minority led by Bob Michel of Illinois)
  4. If we are not going to fund the CR (continuing resolution) because some part of the Republican Party hates it so much, why don't we just start holding the CR hostage for every other issue some part of Congress 'hates'?
    Hold the CR hostage if you don't like our foreign policy towards Syria or Iraq; or if you don't like our agriculture programs; welfare programs; education policies or any other discretionary program. Democrats should do the same if they think defense programs are too wasteful and expensive. Why not? It is the same principle as defunding Obamacare, right?
  5. Ronald Reagan once said the 11th Commandment was 'Thou shalt not speak ill of a fellow Republican'.  When did that Commandment start being violated?
    Reagan also said anyone who agreed with you 75-80% of the time is your friend and ally. Who has forgotten that Commandment? (Let's call it the Twelfth Commandment for Small Government Patriots)
We have heard some interesting things lately from people who are in the political game. Here's a few of the them:
  1. In North Carolina today, roughly 41% of the registered voters are Democrat; 28% Republican and 27% Independent.
  2. In 2016, those percentages are expected to be 41% Independent; 32% Democrat and 24% Republican. Who will be the 'majority party' then?
  3. 35% of the Republican Party now identifies themselves as being part of the Tea Party. 65% find themselves in agreement with the Tea Party general principles of smaller government and less taxes, but they are just not as strident, energized or ardent as many of the Tea Party members.
  4. 'What Tea Party people don't realize is just how few people in the country agree with them' one expert told us. Uh-oh. That doesn't bode well for building a huge groundswell of support for upcoming elections, does it?
  5. Every time the Tea Party claims another 2-3% of the GOP, 1-2% of the GOP falls off into the self-identified Independent category. Moderate to liberal Republicans, or Libertarian Republicans who don't care too much about social issues are typically signing up or voting as Independents and Unaffiliateds. 'Lost Republicans' as some pollsters designate them.
  6. The same thing is happening on the Democrat side of the aisle. There used to be 91 Blue Dog, moderate to conservative fiscally responsible Democrats, mostly from the South, in the US House of Representatives in 1980. Today, there are only 5. They have been all wiped out in the primaries by more liberal, African-American or Latino Democrat challengers or they have been replaced by conservative Republicans in redrawn general election districts.
  7. 80% or so of the American voting population really do not care very much about politics and only really pay close attention for the last month or so of any election, presidential years usually. They have better things to do such as providing for their families; coaching their Little League son's team or attending church services.
What we are seeing is the classic ripping apart of a political party today with the internecine warfare between the fiery Tea Party members and the more traditional Republican base. We have seen it happen before in American politics where new factions erupt out of what used to be 'whole' parties; there have been Federalists and Anti-Federalists (before and during 2 unanimous elections of George Washington as President); Democratic Republicans and Federalists (after Jefferson split away from the unanimity); Democrats and National Republicans (when the Federalists died); Whigs and Democrats (over the split in the National Republican Party over slavery) and then for the most part of the last 163 years, Democrats and Republicans.

The main question that has to be asked today is this: 'Do you want to be part of an official political party with others who seem to hate you more than they want to defeat the other side?' That is the question facing traditional Republicans today in the face of the take-no-prisoners approach on the part of many of today's Tea Party.

And the question for the Tea Party is exactly the same as the one posed by Groucho Marx long ago: 'Do you really want to be part of a party that would have you as a member, ill-temper and all?'

You may win this battle for the Republican Party but you will not stop Obamacare from being implemented through the CR process. 

You will have run off everyone who doesn't agree with you 100%. Then you will have control of a party that represents less than 25% of the American voting public.

And then what? What will you control then? It is darned hard to win any election with only 25% of the vote no matter what universe you are from.

Thursday, September 19, 2013

Defunding Obamacare in the CR (Continuing Resolution) Bill; Raising the Debt Ceiling and Kamikaze Pilots

House Republican Caucus, 2013: 'Banzai!'
We are on the side of small government and have been so for the past 33 years.

We think that any sentient American can look at the US federal budget and every state government budget in the United States and see hundreds of billions of dollars in programs that can and should be reduced, reformed or simply repealed because they: 1) don't work to accomplish broad public policy objectives or 2) favor too small of a vested interest instead of the broader national interest.

The Tea Party has aimed its sights on Defunding the Entirety of Obamacare in the Continuing Resolution (CR) now under consideration in the US Congress. They feel that it is the last chance to stop the implementation of Obamacare.

The 'last chance' to defund Obamacare was in the 2012 elections. The Republicans would have had to have picked up at least 4 seats to gain majority control of the Senate but really, gotten to 60 seats to be able to even be able to consider a measure to defund Obamacare due to the Senate rules.

And, of course, they would have had to defeat President Obama in the key battleground states of Ohio, Florida, Virginia and  4 others so that we would now have a President Mitt Romney instead of President Obama.

How many millions of Ron Paul supporters sat the election out in 2012 because Mr. Paul did not win the Republican nomination? Millions if you listen to them on the news or read their missives on-line against anyone but Mr. Paul.

What would have happened had they gathered their enthusiasm and energy behind Mitt Romney and pulled out all the stops to make sure President Obama became ex-President Barack Obama, the 44th President of the United States of America, past tense?

For one thing, the people who want to defund Obamacare or make major major changes to it today rather than fret about throwing the Hail Mary to defund Obamacare this week would have had at least a chance to defund or defang Obamacare to some extent.

The time to kill Obamacare for sure would have been 2008, to be honest about it, had everyone been working their fannies off to elect John McCain as President. But when Obama won a second term and the Republicans failed to win the Senate (by 60 votes by the way), that all but sealed the doom of Obamacare being implemented in October, 2013 no matter what anyone thinks can be done about it.

The process is basically this: The House can pass a 'Defund Obamacare' bill in or in conjunction with the continuing resolution (CR) which funds government at LAST year's levels, not the new fiscal year coming up October 1.

Let's say the Senate does not pass a CR with Defund Obamacare in it. Then what? There will be no conference bill that includes Defund Obamacare in it since the Democrats control the Senate. Therefore no bill will go to the President with Defund Obamacare in it. Not ever as long as the Democrats control the Senate and Obama is in the White House.

So what is left? Congress can choose to not pass a CR at all...and then all funding for government shuts down. All of it. SS checks for granny. Medicare checks to pay for grandpa's hip replacement. Money for military soldier's salaries and GI benefits and so on.

Plus, if the debt ceiling is not raised pretty soon in conjunction with the CR, we can't raise any more money from the Chinese to pay for government anyway. So there is a double-witching hour going on here at the end of the month, September, 2013.

If Congress doesn't do both, pass the CR and the debt ceiling, the government will shut down and granny will not get her SS or Medicare checks. Neither will the soldiers in the Middle East etc. Obamacare won't be funded either but that will be the least of any Republican Congressman's worries when he/she faces the wrath of some of the 45+ million senior citizens now dependent on Social Security and Medicare.

Guess what seniors have the most time to do? Vote. Early and often. And they do so. They will remember who voted to cut off their SS checks and Medicare. If they forget, the Democrats will be there to remind them come election time.

There is no conceivable way that a CR will pass that will fund 98% of government....except Obamacare. The choice is either pass a CR and debt ceiling hike to allow government to continue operations in total....or not.

And that is where the Republicans will get smashed in the face by 45 million seniors next year and possibly lose the House. There will be no hope left at all for anything to be done about Obamacare through the normal appropriations/authorizations process.

I just got off the phone with a former staff director of the House Budget Committee who called me out of the blue after not talking for about 10 years at least.  I asked him what it was like in 1995 and 1996 when the GOP shut down the government not once but twice over a 6-month period.
'Well, all the people who thought it was such a great idea before we did it, we couldn't find them after the crap hit the fan! John Kasich (now Governor of Ohio by the way) was left all alone out on the limb to try to explain why granny was not getting her SS checks on time among other things.'
There you have it in a nutshell. It sounds like a 'good idea' to 'shut down guvmint, dadgumit!'...until you do it and it actually happens. We have been there. We have seen it happen. We know.

We don't mind people being brave. We admire bravery. A lot. We just think brains need to be combined with bravery so you can win.

Otherwise, you will be left dead like the brave kamikaze pilots of Japan at the tail end of the Pacific War against the United States. To no avail and no reason.

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Tuesday, September 17, 2013

'Pay As I Go' Pledge For All Elected Officials

'I wonder if I should run for Congress....'
We have beaten up on The Tax Pledge by Grover Norquist in the past just as we have beaten up on 'pledges' of most any kind in the political world.


Because the only oath that makes any sense is the one in the Constitution that says, and we quote:
“I do solemnly swear (or affirm) that I will faithfully execute the Office of President of the United States, and will to the best of my Ability, preserve, protect and defend the Constitution of the United States.”

'To the best of my ability' are the operative words here.

We don't live in a dictatorship, nor do we live in a pure democracy where simple majorities rule. The Founding Brothers (author Joseph Ellis' term) hated both of them; they saw great fault-lines over history in almost every case where they were tried and discarded for the 'next' best thing.

Winston Churchill said: "Democracy is the worst form of government, except for every other'. We would amend that to say 'Democratic Republicanism' is the worst form of government except for any other' since that more accurately describes American civil government.

But getting back to the oaths and pledges, we think there needs to be a new 'pledge' that the burgeoning majority of Independent and Unaffiliated voters can send to their elected officials and any candidate that will more adequately reflect their views that our government must operate in a sane, coherent manner unlike the totally insane way we have run the federal fisc over the past 13 years now for sure and the vast majority of years since 1965.

It used to be a decision between 'guns' and 'butter'. Now it is no decision...just buy more butter, go to war any time a president feels like it and borrow from the Chinese to pay for the imbalance. No more higher taxes on everyone to pay for any of it; that is passe thinking.

We think it can be different. We think it should be different.

And with Independents and Unaffiliateds soon to account for 41% of the official voting population of North Carolina at least in 2016 according to experts we know, we think the time is ripe for a new 'pledge' to be sent to and signed by every elected person and candidate which will more realistically express the view of these growing hordes of independent thinkers. (*NC is one of the few states where people can officially register as Unaffiliated)

Here's the 'pledge':

'I will not vote for any higher spending in any federal program without raising taxes or cut a similar amount in other programs to pay for it.

I will not vote for any tax cuts without cutting spending to pay for it.'

Call it the 'Pay As I Go' Tax and Spending Pledge. Or just plain common sense, truth be told.

I. Here's the insanity of the Tax Pledge by Grover Norquist for the Republicans:

Over time, it has given them a complete pass when it comes to making any substantive spending cuts that would lower deficits and the national debt purely by definition. Less spending is always part and parcel of any balanced budget.

Why has it given the GOP a complete pass? Because while they have been lulled into the fantasies that they are 'starving the beast' by denying needed revenue to pay for spending at the federal level, all they are really doing is 'increasing the debt' by not agreeing to any deal that might have a smidgen of tax hikes in it.

II. Here's the insanity of the 'Protect Social Security, Medicare, Medicaid, Public Education, Higher Education, Welfare, Environmental Protection, Transportation (insert favorite issue here) Pledge':

Over time, it gives mostly Democrats the cover to say to their constituents: 'I can't possibly vote for any reduction/change/reform/improvement in any social domestic program because I made a promise I would never do such a thing!'

And then, to top it off, they won't raise taxes on everyone to pay for the increases they always want in each of these programs!

It is a wonder of nature that the United States has not gone the way of Zimbabwe or Brazil or any of the other nations that couldn't manage their fisc or federal budget and then saw inflation and interest rates destroy their currencies and then their economies in short order.

We think every Independent registered voter should copy the afore-mentioned 'pledge' and send it to their congressman and senator in Washington and ask them to sign it and send it back to you as their 'promise' to balance the budget in our lifetimes once again.

They can't do it on their own. They will not do it on their own.

They WILL do it if 41% of their constituents who vote in their election and re-election sends them this 'pledge' and forces them to sign it and return it for safe-keeping.

It will mark a return to sanity, good judgement, adult leadership and a reduction of the idiotic public policy decisions our elective leaders have made with absolutely zero fiscal conservatism or balance in mind.

That in and of itself is reason enough to support it.

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Sunday, September 15, 2013

'Hey, Mikey! He Likes It!'

We have alluded to the issue of managed care being an integral part of any Medicaid reform going forward in North Carolina as it is now being done in 19 other states around the nation.

So this is not something that is brand-new, untried and untested by any means on the ground in any state which is where any public policy question really matters. In truth and in fact.

We just received the following data from some folks in Mississippi who are now administering managed care for Medicaid in the Magnolia State.

Take a good look at not only the savings but the higher degree of quality healthcare delivery across the state. These are below poverty level people in Mississippi, not normally the folks that the big insurance companies and health systems cater to simply because they don't have the money to pay for a lot of health care in the first place and secondly, they typically have a lot of health problems that are costly to correct:

Medicaid Managed Care in Mississippi has the following savings:

  • 2011 Outpatient Savings of $33,655,478 over the projected costs for the population
  • 2011 Inpatient Savings of $14,458,995 over the projected costs for the population (This is final data.)
  • 2011 Total Savings of $48,114,473 over the projected costs for the population
  • 2012 Outpatient Savings of $14,289,317 over the projected costs (This was prior to the expansion)
  • 2012 Inpatient Savings of $8,059,668 over the projected costs (This is using only prelim data.  No final data available yet.)

Total projected savings for 2011 and 2012 from Magnolia alone $118,577,931. ($118.57 million)

From a Quality standpoint, Managed Care for Medicaid patients:

  1. Improvement in almost all HEDIS measures over the baseline year.
  2. 84.3% of patients appropriately monitored for medication adherence
  3. 43% increase in women screened for breast cancer
  4. 15% increase in women screened for cervical cancer
  5. 72% increase in LDL cholesterol screening for members with Cardiovascular Disease
  6. 31% increase in diabetics with control of their diabetes
  7. 12% increase in diabetics who received the appropriate eye exams
  8. 44% increase in the number of diabetics with blood pressure control
  9. 46% increase in members with High Blood Pressure who had the blood pressure under control
  10. 34% increase in the appropriate follow-up of children with ADHD who just started medication therapy
  11. 27% increase in the appropriate follow-up of children who had been on ADHD medication.
  12. 81% improvement in members with Asthma using appropriate medication
  13. 35% increase in the number of members counseled for appropriate nutrition
  14. 24% increase in the number of members counseled for physical activity.

From an access to care standpoint:

  • Medicaid Managed Care meets all contractual standards for access to care for members.
  • Case management staff works regularly with all provider types to ensure appropriate access for all of our members

It is important to note that prior to Medicaid Managed Care being implemented in the great state of Mississippi, there was a protracted fight to keep managed care operators out of the state. None were more adamant in their opposition that the African-American medical society of Jackson, Mississippi.

Today, representatives of the African-American medical society of Jackson, Mississippi are among the most ardent advocates of Medicaid managed care in the state.

Just take a look at the numbers above! Medicaid recipients, heretofore somewhat ignored and forgotten until they entered the emergency room with advanced stages of diabetes, obesity, heart disease or cancer, are now receiving tons of preventive care, counseling and training to take care of their own health before it becomes a huge burden on the state Medicaid program.

It stands to reason that if a government program, or any private program, can help keep people healthy that their health costs will stay in check, doesn't it?

Well, that is what Medicaid Managed Care ultimately aims to do. What could be more fair, just and compassionate than that to every affected party?

The Medicaid patient receives quality health care and lives healthier, happier lives. The hospitals are released to treat people with acute care and not the routine health care of Medicaid clients who might only have a cold or the flu. And the state taxpayer is relieved of double-digit annual increases in Medicaid costs which only strips money away from the state public education and higher public ed budgets almost dollar-for-dollar in some cases.

We have had health care experts at the very top of their game and their profession tell us point-blank when we were serving in the US Congress:

'35-50% of all health care costs in America could be avoided if the following actions were taken:
  • People quit smoking.
  • Quit over-drinking. 
  • Stopped overeating and lost maybe 10-20 pounds on average. (Obese people would have to lose more).
  • Walked or exercised at least 30 minutes per day or climbed stairs at work.'
Well, ladies and gentlemen, saving 50% of all health care costs in America today would be close to an astounding $1.4 TRILLION per year! We currently spend close to 18% of our entire GDP on health care in America!  The federal government 'only' spends about 23% of GDP today and close to 3/8th's of that is in Medicare and Medicaid alone! (when state spending for Medicaid is added in)

We do know this based on facts, statistics and empirical evidence over the past 48 years since Medicaid was put into place in the LBJ 'Great Society' programs of the '60's:

As well-intentioned as it may have been and the good that Medicaid has done for millions of poverty-stricken people in the USA, it is currently unsustainable in its current form and operation.

Needless to say, Medicaid Managed Care has a lot of positives going for it. We think North Carolina should be the next state to try it. We might 'like it', as the old Life cereal commercials with 'Mikey' used to say:

Saturday, September 7, 2013

'Well, President Obama Has 'Won' When It Comes To Transforming American Jobs

Coach Frank Howard of Clemson
The latest jobs report is out. President Obama has officially 'won' when it comes to 'changing' America, that is for sure.

Just a few highlights (lowlights?) from the NY Times article (the flipping NEW YORK TIMES printed this)

  • Perhaps the most striking was a plunge in the share of Americans who are either working or looking for work, which fell to its lowest level since 1978.
  • Earlier estimates of job growth in July and June were revised sharply downward
  • Unemployment, however, fell for the “wrong reasons,” because people dropped out of the labor force and so were no longer counted as unemployed, and not because more unemployed people found jobs.
  • There were 7.9 million Americans who wanted to work full-time but could find only part-time work. 
  • When these workers and people who want a job but have stopped looking are included, the total underemployment rate rises to 13.7 percent.
  • The big decline in the labor force in August was tied entirely to men dropping out; the number of women in the work force actually grew.
Presidents typically blame their predecessor for the troubles they inherited from them.

President Obama has certainly inherited a lot of economic-related problems. From himself.

There will be those who will say this is the inevitable trend of older Boomers retiring and going out to pasture for their golden years. If true, then, why is it only women who are finding more work in the workforce and not men?

As hard as it is to believe, the generational cohorts following the Boomers is in fact larger than the Boomers! Why isn't the number of young people entering the workforce more than replacing the older, aging hippie/flower children of the '60s who are leaving it?

The young people can't find jobs either!  Teenage unemployment this summer was abysmal according to former Obama economic advisor Christina Romer. The jobs number is 'nothing to crow about' she said on CNBC yesterday and 'we have still got a long way to go'.

That is like the coach of the Duke football team in 2006 after a winless season saying: 'We have nothing to crow about' but then not giving their fans any hope by saying 'we still have a long way to go'.

Coach Frank Howard of Clemson once was asked about the returning letterman from the previous year's 1-9 Tigers football team.
'You have a lot of experience returning, Coach' said one of the reporters.
'Yeah, we got a lotta experience coming back this year' drawled Coach Howard in his gruff, gravelly southern accent from Barlow Bend, Alabama, 'but it is all bad'.

Same with President Obama. Not only did he initiate the wrong policies during his first 4 years in office, he was determined to pursue the same wrong-headed policies in his second term.

And yet the American people voted for him decisively to do so.

Now with his determination to send cruise missiles into Syria probably regardless of what Congress says when they return this week, we have to wonder out loud how many of his ardent supporters are entirely happy with his performance in the White House so far?

These job numbers are his and his alone. Presidents are judged, fairly or not, by the numbers of jobs that were created under their watch and whether they presided over general economic prosperity and peace or not.

5 years is a long time to be waiting for the upturn to begin, don't you agree?

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