Category: Health Care

Preparing for Trump

Yesterday was Super Tuesday. The results will tell us lots about the state of the Democratic Party, but despite the outcome on Tuesday, Democrats have a variety of issues worth thinking about heading into the general election this November. In this primary cycle, Democratic primary voters just aren’t showing up. Democrats in 2016 primaries are only voting at two-thirds of the rate that they did eight years ago. All told, about 1.18 million Democrats across those first four states went to the polls in 2008. Just under 870,000 showed up this time. That’s 26% fewer voters engaged.

But, you’d think that Sanders, who’s message is a political revolution, could energize the disaffected in great numbers, but it just hasn’t happened. Perhaps it is the right message, but the wrong messenger. And no evidence of a “political revolution.”

Yet Trump is doing just that. GOP turnout in primaries is up 24% over 2008. It is a safe bet that if The Donald is the GOP nominee, there will be a big Republican turnout in November.

There are other concerns: With the Sanders vs. Clinton contest, the Democratic Party is also at risk of imploding, right along with the GOP in its tussle with Trump.

Sanders is seen as unusually honest for someone who’s been a politician for much of his life, and he advocates a refreshingly anti-establishment view on core issues that matter to an increasing number of Americans. These include American militarism, Wall Street bailouts, a two-tiered justice system, the prohibitive cost of college education, healthcare insecurity and a “rigged economy.”

OTOH, Hillary is committed to a third Obama term and incremental change. She has been forced by Sanders to move left, and is paying lip service to some of his issues. Once the general election season begins, it is likely that Hillary will be the candidate for America’s political status quo, vs. the radical alternative of Donald Trump.

Bernie’s supporters understand this, and may or may not go compliantly into the voting booth to elect Hillary, despite the terrifying prospects of a Trump presidency.

Tea Party Republicans understand that the GOP Establishment offers them little. And more and more rank and file Republicans have come to the same conclusion, which is precisely why the GOP nomination is now Trump’s to lose.

Democrats are teetering on the same precipice. The Dem Establishment, this time represented by Hillary, offers weak tea. The Sanders wing could easily sit this one out, and by late summer, when polls show that Hillary is in a death struggle with a political novice, political pundits will be tripping over each other to write about the death of the Democratic Party.

Democrats are in a bind. They want progressive politics, but offered by an Establishment leader.

Dems are always looking for that. In 2008, they selected Obama because he represented change and empowerment for average people over Hillary, the Democratic Establishment candidate. People wanted something new and different. Obama’s presidency wasn’t a failure, unless Democrats accept nothing less than ideological purity from their presidents.

Or, look back at recent presidential elections. Oh the glee among Democrats in 2001 when GWB won the nomination. It was gonna be a cakewalk for Mr. Democratic Establishment Al Gore. Gore did win the popular vote, but lacked an influential brother in Florida. With Establishment candidate John Kerry in 2004, his vote for the Iraq war was his downfall. How do you run successfully against an incumbent when you agreed with the incumbent’s major disaster? Saying you were “for it before you were against it” was an epic fail. Kerry never figured that out, and lost.

The 2008 election was easy for not-quite Establishment Obama, since the GOP was badly wounded by the GWB administration and GOP Establishment McCain lacked the personal horsepower to defeat him.

If 2016 is an Establishment Clinton v. an anti-establishment Trump, some of the Establishment GOP may choose sit it out. There is a small possibility they could go full anti-McGovern, as Establishment Dems did in 1972. If anti-establishment Sanders is the nominee, the GOP Establishment will find a way to make a deal with Trump, and the Dem Establishment probably won’t do enough to prevent Sanders from losing.

If the US economy hits a rough patch before November (and there are several reasons to expect that), Clinton as the Establishment nominee could be dead meat. Sanders, OTOH, could end up a stronger candidate because of it. We also need to remember that Donald Trump is not an ideologue. He brings no core convictions to the table, other than ego, so he will continue to say whatever works with his fans.

Will a Trump win kill America? That depends on whether our country’s immune system, that body of informed citizens who are engaged, and who bother to vote, can effectively fight the infection.

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Angry Men Now a Political Force

The spin after the SOTU was about how angry voters are, and the political opening that creates, despite the genuine good news on the economy. Here is Mr. Obama from the SOTU:

Most of all, democracy breaks down when the average person feels their voice doesn’t matter; that the system is rigged in favor of the rich or the powerful or some narrow interest.

We can’t change the fact that some people are angry, but this article from the Washington Monthly by Andrew Yarrow points to some stunning facts about how men in particular have been left by the wayside of American life:

At least 20% of the nation’s 90 million white men have been pushed to the sidelines, either retreating or storming out of the mainstream of American life. They are not the men you see at work, who play with their children, go out with their wives or partners, are involved in their communities, and earn a living to save for their children’s education and their own retirement. What they do doesn’t register in…the gross domestic product…

Yarrow continues:

We know that they are out there. But they don’t fit old stereotypes of failure, so we’ve had trouble coming to grips with who they are or naming the problem. Parts of their stories have garnered significant attention, but we don’t see that what have been treated as separate problems are closely related.

Here are a few statistics from the article that merit your attention:

• Today, fewer than seven out of ten American men work; in the 1950s, nine out of ten worked.
• Since the 1970s, inflation-adjusted incomes for the bottom 80% of men have fallen, with the most dramatic declines occurring among the bottom 40%, most of whom do not have a college education.
• Today, just half of men are husbands; in 1960, three-fourths of men were married.
• As Barack Obama leaves office, only two out of three children live with their fathers; when John Kennedy was elected President, nine out of ten children lived with their fathers.
• Today, 43% of 18-to-34-year-old American men live with their parents (compared to 36% of millennial women); in 1960, about 28% lived at home.
• There are 36% more women in college than men, whereas in 1970, there were about 35% more men than women in college.
• Men are 50% less likely to trust government than women.
• In recent years, there has been a roughly 20-point gender voting gap, with white men being much more likely not only to vote for Republicans but to express disillusionment and anger toward government; until about 1980, men and women voted roughly evenly for Democrats and Republicans.

The point is that a lot has gone wrong for many white men, a demographic that once was the epitome of privilege and high expectations. And while politicians discuss stagnant wages, broken families and inequality, few notice, much less talk about the probable linkages between these issues and the impact of angry males on our politics.

Some may be thinking that this is a manufactured issue. After all, men still out-earn women, and they still hold most of the CEO and board–level jobs. And none of this white male angst should obscure the continuing struggles of women and people of color, including men of color. African-American and Latino men have had it worse than white men for a very long time.

But we ignore any group’s anger at our peril. The Bundy Brigade’s antics in Utah and Oregon is just one recent example. Many men are mad as hell, and their anger is often turned on scapegoats: Government in the case of the Bundys; Muslims, immigrants, African Americans, and Latinos in the case of others.

In 2016 we are seeing several presidential candidates feeding from the trough of this anger. Playing to the inchoate anger of a sizable minority of white men who have been benched economically, or who simply left the field, is a dangerous demagoguery, one that only benefits the demagogues.

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Soon, Antibiotics Won’t Work

It’s estimated that more people will die from bacterial infections than from cancer by 2050. Two disparate factors are driving this. First, scientists in China say they’ve identified a gene that makes common, dangerous bacteria resistant to “last-resort” antibiotics called polymyxins. The mutated gene, called mcr-1, was found in the Enterobacteriaceae germ in both pigs and people in South China, according to a report published in The Lancet.

Study author Jian-Hua Liu, a professor at South China Agricultural University in Guangzhou, China, said:

The polymyxins (colistin and polymyxin B) were the last class of antibiotics in which resistance was incapable of spreading from cell to cell…

The new gene was found on mobile forms of DNA that are easily copied and transferred between different bacteria. According to the researchers, this suggests a much greater potential for the gene to spread and diversify in different types of bacteria.

Liu went on to say that the discovery points to the emergence of a gene which can create multidrug resistance that:

is readily passed between common bacteria, including E. coli and the Klebsiella pneumoniae germ, which can cause deadly pneumonias or bloodstream infections.

We have all heard that extensive use of antibiotics in agriculture may contribute to this resistance gene. Liu’s team said that pigs were more likely than people to have bacteria with mcr-1 gene-related colistin resistance. That suggests that the resistance originated in animals and then spread to people.

The discovery bodes ill for public health worldwide. Timothy Walsh, Professor at the University of Cardiff in Wales, told BBC News: (emphasis by the Wrongologist)

All the key players are now in place to make the post-antibiotic world a reality. If MCR-1 becomes global, which is a case of when not if, and the gene aligns itself with other antibiotic resistance genes, which is inevitable, then we will have very likely reached the start of the post-antibiotic era.

According to the Review on Antimicrobial Resistance, drug-resistant infections could kill an extra 10 million people across the world every year by 2050 if new antibiotics are not found. That’s 350 million people lost. By 2050, this could cost the world around $100 trillion in lost output: That’s more than the size of the current world economy, and roughly equivalent to the world losing the output of the UK economy every year, for 35 years. Here is a graphic representation of the scale of the problem:

Anti Mocrobial Resistance

The second factor driving this disaster is our Bad Corporate Citizens. There are two classes of these bad actors. The food conglomerates that feed antibiotics to animals raised for meat, so that pig farmers can make more profit, and the Big Pharma companies that spend their intellectual calories on corporate inversions (such as Pfizer is doing in its merger with Allergan) rather than on antibiotic research. As David Cox reports about drug company research:

They’re happy to sell existing antibiotics, but they’re not interested in researching and developing new ones.

Professor William Fenical at the Scripps Institute of Oceanography in San Diego discovered a new antibiotic capable of attacking the bacteria MRSA, a hospital superbug. However, most large pharmaceutical companies abandoned their antibiotic programs by 1995. And even though we know that animals raised with no antibiotics are less likely to contain drug-resistant bacteria than those routinely given antibiotics, about 80% percent of antibiotics sold in the US are given to animals raised for food production.

So, we have a perfect storm brewing: To enhance corporate profits, we give antibiotics to animals, weakening the value of those antibiotics in controlling human disease. And we look the other way when the big drug companies use innovation to avoid taxes, while saying that research into new antibiotics is “too risky” for their shareholders.

Again, the strategy of big business is “privatize the gains, socialize the losses.” And maybe when you get sick, the doctor will only be able to prescribe you a pork chop.

The world needs a new capitalism. Mr. Market isn’t going to fix this.

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Democrats: Where the White Voters At?

Yesterday, we examined the fact that the poorest Americans are the least likely to vote, so they cede the policy agenda to those who do support the weakening of America’s social safety net, and who use low voter turnout as a key election strategy.

Do the Democrats have a strategy to counter the election strategy of the GOP? If they do it isn’t evident.

Dems think that they have a permanent Electoral College presidential majority, and that changing American demographics will help them build majorities in both houses of Congress by the mid-2040’s. They are apparently willing to wait for demographics to become destiny: The numbers of white working-class voters will dip to just 30% of all voters by 2020 and 44% of white voters.

This is a dramatic decline from 1988, when white working-class voters were 54% of all voters and 64% of white voters.

But, in the last three presidential elections, the Democratic candidate lost among white working-class (non-college) voters by an average of 22 points, and by 26 points in 2012 (62%-36%). Despite Mr. Obama winning two terms, his “Obama coalition” will not insure a Democratic majority in Congress, or even provide with certainty the election of a Democratic president again in 2016.

In fact, PPP, a Democrat-leaning polling firm with a great record for accuracy, says this about 2016:

Early general election contests are shaping up to be very competitive with Hillary Clinton polling within 2 points of 5 out of 6 Republicans that we tested against her. The only GOP hopeful to actually lead Clinton is Marco Rubio at 45/43. Rubio is also the only candidate in the field with a positive favorability rating among the overall electorate, at 39/37.

Pew found that those who are most unlikely to vote are demographically distinct from likely voters:

• 34% of nonvoters are younger than 30 years old
• 43% of nonvoters are Hispanic, African American, or other racial and ethnic minorities
• 46% of nonvoters have family incomes less than $30,000 per year, while only 19% of likely voters are from low-income families
• 72% of likely voters have completed at least some college, while 54% of non-voters did not attend college

On the subject of the white working class voter, The Democratic Strategist produced an analysis about the subject, “Roundtable on Progressives and the White Working Class”, which asked the question: “What do you think is the most important single step progressives and Democrats can take to regain support among white working class Americans?”

One thing stood out in their deliberations: It was clear from surveys that white working-class voters support public action to address chronic joblessness, income disparities, and unequal education and social opportunities. They cited the study on the 50th anniversary of the War on Poverty conducted by the Center for American Progress, which found that more than two-thirds of white non-college voters supported 11 out of 11 policies to fight poverty, including:

• An increase in the minimum wage
• Subsidized child care
• Expanded Earned Income Tax Credit
• A national jobs program to combat unemployment

Support among this cohort topped 80% for universal pre-k, expanded Pell grants for low-income families, and affordable child care, and was basically on par with the views of African Americans and Latinos.

That indicates that there is a path for Democrats to gain a larger share of white working class voters, but The Democratic establishment does not have a serious plan that shows white non-college voters that they see the real problems facing Americans the same way.

Here is a modest program to improve Democrats’ chances with white working class voters:

1. The old guard Democratic leaders must go: Why would any Democratic candidate want to brand themselves with a party leadership that tells them to run content-free campaigns?
2. They should look at the political landscape: People are discontented, in part, because incomes haven’t risen in 15 years. What have Democrats done in response? Virtually nothing.
3. Democratic politicians need to listen to constituents. Democrats will never appeal to the majority of working Americans by primarily making more promises to enact new civil rights rules, or environmental laws. They have to deal with incomes.

The economic struggles of the white working class, combined with a feeling of powerlessness, have undoubtedly made them susceptible to right-wing rhetoric, a major coup for Republicans. The key to Democrats winning over this demographic is more about calls for straightforward job creation, wage increases, and benefits for working-aged families, and less about ploys that superficially connect to them.

We should remember that “low income white” is not a synonym for “Republican.”

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Monday Wake-Up Call – September 14, 2015

Gov. Bobby Jindal, a Republican contender for the presidency, moved to cut off $730,000 in Medicaid reimbursements to the state’s two Planned Parenthood clinics in late August. The question then arose, where would Louisiana women get these services in the event the funding was cancelled? From MoJo:

The task seems straightforward: Make a list of health care providers that would fill the void if Louisiana succeeded in defunding Planned Parenthood. But the state, which is fighting a court battle to strip the group of hundreds of thousands of dollars in Medicaid funds, is struggling to figure out who would provide poor women with family planning care if not Planned Parenthood.

So the state’s attorneys did some research. They said in a court declaration that there are 2,000 family planning providers ready to accommodate new female patients. John deGravelles, a federal judge who reviewed the list in a September 2nd court hearing, found hundreds of entries for specialists such as ophthalmologists; nursing home caregivers; dentists; ear, nose, and throat doctors; and even cosmetic surgeons. From Judge deGravelles:

It strikes me as extremely odd that you have a dermatologist, an audiologist, a dentist who are billing for family planning services…But that is what you’re representing to the court? You’re telling me that they can provide family planning and related services?

Dentists? Don’t dentists who do “Pap smears” wind up losing their licenses?

Anyway, the judge’s disbelief sent the state back to the drawing board. They came forward with a new list that did not include dentists, dermatologists, ophthalmologists and others. You will be shocked to learn the state was lying: Their new filing listed just 29 health care providers.

But even with this pared down list, it only got worse. MoJo reports that in Baton Rouge, the site of one of two Louisiana Planned Parenthood clinics, the state lists five alternate providers. But according to the state’s own filing, only three of those offer contraception, and two of those have wait times ranging from two to seven weeks. One of the Baton Rouge clinics the state suggested is not accepting any new patients for STI, breast cancer, or cervical cancer screenings.

Since Reagan, Republicans have been able to say whatever stupid or completely false thing they want. They keep doing it because their supporters don’t mind, and they almost never get called on it by the media. It’s been “regarding shape of the earth, opinions differ” for decades.

This tendency to make shit up or say ridiculous things is particularly pronounced whenever the subject is abortion, birth control, or any other aspect of female sexuality. Sadly, the notion that patients could turn elsewhere remains a key rationale when Republicans attempt to strip Planned Parenthood of $528 million in federal funding as part of this month’s budget talks.

So what Jindal’s minions are attempting is more of the same. But, perhaps you remember Mr. Jindal saying in 2013 that the GOP had to “stop being the stupid party”? He didn’t mean that. The GOP reserves the right to be as anti-abortion, anti-women, and anti-science as they want to be.

Let’s make an effort to wake up Mr. Jindal and his fellow GOP’ers, even if it may be futile. Here is Bon Jovi with “We Weren’t Born to Follow”, a top 10 hit for them in 2009:

For those who read the Wrongologist in email, you can view the video here.

Sample Lyrics:
We weren’t born to follow
Come on and get up off your knees
When life is a bitter pill to swallow
You gotta hold on to what you believe
Believe that the sun will shine tomorrow
And that your saints and sinners bleed
We weren’t born to follow
You gotta stand up for what you believe

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The Scourge of Anchor Babies

No time for in-depth blogging today, but because Wrongo lived in Southern California for 10 years, he often heard stories about pregnant Chinese women traveling to the US so that their children could be born here. Orange County was often rumored to be the (forgive the pun) hotbed of Chinese births. According to the LA Times, the correct term for this is “maternity tourism.” Whatever.

The LA Times reported:

The website of one birthing center suggested that 4,000 Chinese women had been served since 1999. The crackdown included one birthing center in Irvine. According to an affidavit, more than 400 women associated with the Irvine location have given birth at one Orange County hospital since 2013.

So, we really have no overall handle on the numbers of Chinese tourist births. Of course, these tourist births have the added benefit of making those kids American citizens.

One underreported part of this story is that the one child policy in China may be behind many of these births. An illegal second child would be stateless in China, with little hope of education or good employment, so for wealthy Chinese families in this situation, a few month’s visit to the US on a tourist visa gets the baby citizenship, and a place to go to school when the time comes. Still, aren’t the Chinese exploiting a loophole to get their kids citizenship?

No, it isn’t a loophole. It’s right there in the Constitution.

Tom Toles in the WaPo linked Asian anchor babies to the Panda births in DC:

COW Anchor babies

 

 

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Monday Wake Up Call – August 3, 2015

Today’s wake up is for the US neo-con policy makers who made so many mistakes in the 1960’s and 1970’s that some are still being uncovered. Last week, NHK Tokyo had a report about the US’ operation of a secret experimental nuclear reactor in South Vietnam during the Vietnam War.

We put a nuclear reactor in Vietnam? When there was a war underway?

The site was in the city of Da Lat, 120 miles northeast of Saigon, where Americans had installed a research reactor. It was a General Atomics TRIGA Mark II model. We began building the TRIGA in the 1960s as another example of President Eisenhower’s “Atoms for Peace” campaign at the end of the 1950s, just like the reactor we sent to Iran in 1967.

So many neutrons, so little peace.

According to NHK, as the North Vietnamese Army was approaching, Henry Kissinger ordered the site dismantled to keep the technology out of communist hands. The big news: In the event of an inability to dismantle the reactor, the NHK reports that, as a last-ditch measure, Kissinger ordered that the radioactive core be blown up rather than fall to the North Vietnamese.

NHK interviewed Wally Hendrikson, now elderly, who in 1975 was a nuclear fuel specialist at the Idaho National Laboratory. He was on the small team sent to recover the reactor’s fuel. When Hendrikson arrived at the US Embassy in Saigon:

We were told distinctly that if we could not remove the fuel and get it out of the country, we were to make it inaccessible and to pour concrete…to cover the core.

If all else failed, Hendrikson says,

We were to dynamite the core

Luckily, the team got the fuel out of Vietnam without needing to create a nuclear disaster. Vietnam later rebuilt the reactor, using technology and nuclear fuel from the Soviet Union. Today, the facility remains the only functioning research reactor in Vietnam.

How many times will we have to dodge bullets that the neo-cons and cold war warriors keep loading in guns that keep getting get pointed at America’s head? Wake up, neo-cons! To help you with your wake-up, here is #5 in our songs of summer series, Katrina and the Waves with “Walking on Sunshine”:

For those who read the Wrongologist in email, you can view the video here.

Monday’s Hot Links:

A map of American swearing usage, produced by a lecturer in forensic linguistics at Aston University in Birmingham, UK. Hell, damn and bitch are especially popular in the south and southeast. Douche is relatively common in northern states. Bastard is beloved in Maine and New Hampshire, and those states – together with a band across southern Arizona, New Mexico, and Texas – like using motherfucker. Crap is more popular inland, fuck along the coasts.

Earlier this year, Trump for President, LLC trademarked “Trumpocrat” and “Trumpublican.” Who knew that Trump wanted you to have a ball cap with “Trumpocrat” emblazoned on the front? Doesn’t Trumpocrat sound more like a plutocrat than Democrat? “Trumpocalypse” sounds correct, and has a nice ring to it, but it apparently isn’t one that they trademarked.

Exxon’s lobbying firm donated to Chris Christie’s Super PAC while Christie pushed for favorable 9to Exxon) NJ environmental settlement. Public Strategies Impact, the firm that represents Exxon’s interests in New Jersey, has donated $50,000 to “America Leads,” a super PAC supporting Christie’s presidential campaign. Christie’s proposed settlement, aims to reduce levies against ExxonMobil from $8.9 billion to just $225 million. Christie has defended the agreement as a good one for the state. NJ Democrats legislators have been seeking to block the settlement. Nothing to see here.

Ebola vaccine trial in Guinea proves 100% successful. The trials involved 4,000 people. Unlike using the randomized approach, taking a population at risk of Ebola and vaccinating half of them while giving the other half a placebo, this study used a “ring” design. When Ebola flared up in a village, researchers vaccinated all the contacts of the sick person who were willing to take the vaccine, family, friends and neighbors, and their immediate contacts. Children, adolescents and pregnant women were excluded because of an absence of safety data for them. In practice about 50% of people in these clusters were vaccinated.

To test how well the vaccine protected people, outbreaks were randomly assigned either to receive the vaccine immediately, or three weeks after an Ebola infection was confirmed. Among the 2,014 people vaccinated immediately, there were no cases of Ebola from 10 days after vaccination. In the clusters with delayed vaccination, there were 16 cases out of 2,380. Scientists, doctors, donors and drug companies collaborated to push the vaccine through a process that usually takes more than a decade in just 12 months. Merck owns the rights to the drug. Invest at your own risk.

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Obamacare: A Success?

Gallup and Healthways 2015 Q2 survey shows that the uninsured rate among US adults aged 18 and older was 11.4% in the second quarter of 2015, down from 11.9% in the first quarter. The uninsured rate has dropped nearly six percentage points since the fourth quarter of 2013, just before the requirement for Americans to carry health insurance took effect. The latest quarterly uninsured rate is the lowest Gallup and Healthways have recorded since daily tracking of this metric began in 2008. The recent Supreme Court ruling in King v. Burwell affirmed the legality of subsidies provided to those obtaining insurance through the Affordable Care Act via a federal or state exchange. Here are Gallup’s findings:
Uninsured Coverage Gallup

 

 

 

 

 

 

 

 

 

 

 

 

 

 

So, a byzantine insurance scheme originally designed by the Heritage Foundation as a way to keep the insurance cartel from suffering too much, now looks like a success, if reducing the numbers of the uninsured was the goal. But, once it went into effect, it became collectivism to Republicans, with the label “Obamacare” as if it had sprung fully formed from the mind of a Kenyan Socialist.

Here is a second data point, the use of subsidies by ACA insured by state:

Obamacare in states

Why Bloomberg thinks Massachusetts is a red state is unexplainable, despite the fact that it has a Republican governor. But, it does serve to lower the red state average a bit. Poor states use more subsidies. Not exactly a surprise:

• These are the states where workers regularly vote against unions, even when it means job losses as in the case of Volkswagen in Tennessee.
• Where else but in a red state could the US manager of the new Mercedes plant be arrested at a traffic stop as a potential illegal immigrant?
• Where else would they fly a rebel flag 150 years after surrender? Many of these same states also get large federal agricultural subsidies, but that is acceptable, because the subsidies mainly go to wealthy individuals and corporations.

But, almost half of Americans still oppose Obamacare. Failure was inevitable, success inconceivable, and therefore failure must have happened.

Now there is an agreement in principle to the Greek debt crisis after all. Here, as explained in terms of Grease the musical, is your cliff notes version of the situation. You will not be disappointed if you watch:

For those who read the Wrongologist in email, you can view the video here.

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Can Entrepreneurs Succeed in the Federal Government?

Have you ever heard of US Digital Services (USDS)? Neither had the Wrongologist before reading an interesting article in Fast Company, “Inside Obama’s Stealth Startup”, that describes how President Obama is recruiting top tech talent from companies like Google and Facebook. Their mission is to reboot how government works. Here is a first-person tidbit: (Brackets and editing by the Wrongologist)

Lisa Gelobter…got [a call] out of the blue last summer in New York, inviting her to some kind of roundtable discussion in Washington for tech leaders. Lisa had just spent time on the upper management teams at Hulu and BET. She decides, reluctantly, that she’ll go take the meeting, which includes this guy named Mikey as well as this other guy named Todd, and turns out to be in the Roosevelt Room in the West Wing. Then President Obama opens the door and surprises everyone, and over the course of 45 minutes gives the sales pitch…They need to come work for him. They will need to take a pay cut…But he doesn’t care what it takes—he will personally call their bosses, their spouses, their kids to convince them. The crowd laughs. But he gravely responds: I am completely serious. He needs them to overhaul the government’s digital infrastructure now.

‘What are you going to say to that?’ asks Lisa.

Todd and Mikey, the pair who helped bring people like Lisa Gelobter to DC are Todd Park, former chief technology officer of the US, and Mikey Dickerson, who led a team of 60 engineers at Google and supervised the crew that fixed the Healthcare.gov website last year.

Since that time, Park and Dickerson have been steadily recruiting a team of startup-savvy techies, mainly from top private-sector companies, and embedding them in agencies of the US government. Their purpose is to remake the digital systems by which government operates, to implement the kind of efficiency and agility and effectiveness that we admire at Silicon Valley’s biggest successes, across everything from the IRS to Immigration Services.

Dickerson has insights learned from the Healthcare.gov experience, which became an $800 million boondoggle, involving 55 contracting companies: (Emphasis by the Wrongologist)

And of course it didn’t work…They set aside hundreds of millions of dollars to build a website because it was a big, important website. But compare that to Twitter, which took three rounds of funding before it got to about the same number of users as Healthcare.gov—8 million to 10 million users. In those three rounds of funding, the whole thing added up to about $60 million.

OK, but Healthcare.gov may have been more complex than Twitter. Fast Company quotes President Obama regarding his big mistake in building Healthcare.gov:

When you’re dealing with IT and software and program design…It’s a creative process that can’t be treated the same way as a bulk purchase of pencils.

So, the Obama administration began USDS to recruit top tech talent to overhaul the government’s digital infrastructure. The point was not to sell these candidates on a career in government, but rather to enlist them in a stint of a year or two at USDS, or even a few months. For decades, lawyers and economists have worked in the capitol between private-sector jobs, so why not technologists? Fast Company quotes Megan Smith, the US chief technology officer:

What I think this does…is really provide a third option. In addition to joining a friend’s startup or a big company, there’s now Washington.

Fast Company reports that the idea of short-term government assignments by software entrepreneurs appeals to Mr. Obama, and that it was built into the USDS design from the start. Mr. Obama:

I’m having personal conversations with folks, meeting with them, or groups of them, and pitching them…And my pitch is that the tech community is more creative, more innovative, more collaborative and open to new ideas than any sector on earth…Is there a way for us to harness this incredible set of tools you’re developing for more than just cooler games or a quicker way for my teenage daughters to send pictures to each other?

Finally! Obama hits one nail on the head.

If the USDS team can successfully rebuild some of the digital infrastructure of Washington, it might not only change government’s functionality, it might transform Americans’ very poor attitudes about their government. And given our ideologically-riven Congress, success might just boost our citizens’ waning belief that America can return to a joint view of the future, but that’s a lot to ask of a group of techies.

Of course, if we have a GOP President and a GOP Congress starting in 2017, then it’ll be back to technology outsourcing, since understanding high tech and the internet is only for capitalists.

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Moving the Goal Posts on Obamacare

Gallup has an informative chart about the declining percentage of uninsured in the US:

Gallup on ACA

The percentage of uninsured Americans climbed from the mid-14% range in early 2008 and peaked at 18.0% in the third quarter of 2013. The uninsured rate has dropped sharply since Obamacare (the Affordable Care Act) took effect at the beginning of 2014.

It is possible to argue that an improving economy and a falling unemployment rate may have accelerated the steep drop in the percentage of uninsured over the past year. However, the uninsured rate is significantly lower than it was in early 2008, before the Great Recession, suggesting that the recent decline is due more to Obamacare than to just an improving economy.

From NY Magazine on this trend:

It is starting to look possible that this trend is not some random fluke that has happened six straight quarters but is somehow related to the enactment of Obamacare. So any day now, we can expect conservative politicians and intellectuals to begin publicly rethinking their analysis of this law.

They were correct. Here is the 2010-2014 short version of the Republican viewpoint on the ACA:

The ACA will not reduce the number of people without health insurance. Indeed, it might make this problem we don’t consider a problem, even worse.

Now that the ACA looks to be doing the job, the 2015 short version of the Republican viewpoint is:

Everyone knew that the ACA would result in a huge drop in the number of people without health insurance — what does that prove? Besides, how can we really know that it all isn’t a big coincidence?

This is called “Moving the Goal Posts”. Wikipedia says it means

To change the criterion (goal) of a process or competition while still in progress, in such a way that the new goal offers one side an intentional advantage or disadvantage.

Here is an example of moving the goal posts. From Cliff Asness: (emphasis by the Wrongologist)

In contrast, the rise in coverage is heralded by a myriad of Obamacare supporters as one of two major pieces of proof the law is working. But, how can something we knew before the fact be proof of anything?

Shorter: If we predict that something good will happen as a result of a new law, and that good thing happens, it doesn’t count as proof that the law served its purpose or was any good at all, unless Republicans say so.

The goal post movers also said Obamacare was a job killer. House Speaker John Boehner announced on March 17, 2010, five days before President Obama signed the ACA into law:

The President … continues to push his job-killing government takeover of health care that will hurt small businesses at a time when they need certainty, not more Washington tax hikes and mandates.

In 2011, House Republicans even passed the “Repealing the Job-Killing Health Care Law Act” — the first time that any piece of congressional legislation ever had “job-killing” in its title. Sadly for both Mr. Boehner and the House Republicans, we have added 12 million new private sector jobs since the bill was passed.

There is a new J.D. Power survey which looks at enrollee satisfaction with the ACA. It finds that people who signed up for insurance on the exchanges were slightly more satisfied (69.6%) than people with non-exchange plans, usually through employers (67.9%). People re-enrolling on the exchanges were 74.4% satisfied. New enrollees for 2015 were 5.5% more satisfied than 2014 enrollees, who endured the disastrous roll-out of healthcare.gov. So people like the subsidies and they like their actual insurance policies.

Think about it: ACA forecasted costs have been consistently revised downwards. The number of uninsured are dramatically lower. Satisfaction with Obamacare is higher, and it didn’t kill jobs.

It’s utter Tyranny.

Maybe that’s why the Senate’s top five Republican leaders have cosponsored legislation to extend Obamacare insurance subsidies until 2017. The extension will give Republicans more time to again move the goal posts.

They should try this one: Now that Republicans control Congress and most state governments, we have way fewer uninsured.

Conservative policies work!

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