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The Wrongologist

Geopolitics, Power and Political Economy

Is a Single-Payer Experiment on the Horizon?

The Daily Escape:

Breaking the Ramadan fast, Dubai – photo by Francois Nel

From Sarah Kliff:

Nevada, with little fanfare or notice, is inching toward a massive health insurance expansion — one that would give the state’s 2.8 million residents access to a public health insurance option.

The Nevada legislature passed a bill Friday that would allow anyone to buy into Medicaid, the public program that covers low-income Americans. It would be the first state to open the government-run program to all residents, regardless of their income or health status.

This is “Medicaid for All”, not “Medicare for All”, which several Democrats have proposed over the years. Medicare for all has always fizzled out, due to a lack of political support.

Medicaid for all offers an interesting alternative. Medicaid coverage generally costs less than Medicare for all because the program pays doctors lower rates. This could make it cheaper for low-income price-sensitive consumers who can’t afford the Obamacare monthly premiums. More from Sarah Kliff:

Nevada’s bill to allow a broader Medicaid buy-in is short, running just four pages. It would allow any state resident who lacks health insurance coverage to buy into the state Medicaid program, which would sell under the name the Nevada Care Plan.

Under the Nevada bill, people who qualify for tax credits under the Affordable Care Act would be able to use those credits to buy Medicaid coverage instead. People who don’t qualify for credits would be able to use their own money to buy in. It is likely that the plan would be sold on Nevada’s health insurance marketplace, making it a public option that competed against the private health insurance plans selling there.

Early versions of the Affordable Care Act included a buy-in provision. But the Senate was forced to drop the Medicare buy-in from its bill when it couldn’t get the entire Democratic caucus behind the idea. Health insurers fought aggressively against the idea, which disadvantages insurers by reducing their market share.

After Trump’s election, health policy experts started to explore whether it might make more sense to build a national health care system around Medicaid rather than Medicare.

Medicaid and Medicare are similar programs in that they are large and publicly run, covering 62 million and 43 million Americans, respectively. They use their large membership to negotiate lower prices with hospitals and doctors. Medicaid tends to have the lowest payment rates. On average, Medicaid pays 66% of what Medicare pays doctors. In Nevada, Medicaid pays 81% of Medicare rates.

This means Medicaid is a relatively lower-cost program, but some doctors do not accept Medicaid’s lower rates. A recent federal survey estimates that 69% of doctors are accepting new Medicaid patients, compared to 85% accepting new patients with private insurance.

States have significant control over how their health insurance programs work and whom they cover. Thirty-two states participate in a Medicaid buy-in program that lets certain disabled Americans who don’t otherwise qualify for coverage, buy into the program.

This flexibility provides an opportunity for states that want to experiment with a public program by tacking on a buy-in option. If Nevada’s bill does become law, it will show other states how such a program might work, and if it works well, other states may be inclined to try it.

States that want to enroll new populations into their Medicaid programs will need permission from the federal government. This means that the Trump administration — which has proposed slashing the Medicaid budget in half — would need to get on board with a significant expansion of the program, perhaps a doubtful possibility. But as Kliff says: (brackets by the Wrongologist)

The Nevada idea in theory shouldn’t expand federal costs. Individuals would be responsible for paying their own way onto the program, although it will likely be a challenge to set the right premium [rates] to ensure this outcome.

California is considering a single-payer bill as well. Whether other states might follow the Nevada example will depend on what outcomes it produces.

Here is another tune from the One Love Manchester concert. Watch “Happy” by Pharrell Williams and Miley Cyrus, who turn the song into a soul number, something closer to Motown than to Disney. They make it something more than it was when it was so popular. Also, the whole audience sings along, and that’s fun:

Those who read the Wrongologist in email can view the video here.

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Ariana Grande

The Daily Escape:

Lawn mowing in a tornado, Alberta Canada – June 2, 2017 – photo by Cecilia Wessels

Wrongo was only dimly aware of Ariana Grande before the bombing at her show in Manchester on May 22. He knew that her audience was largely young girls and women, and that her songs were affirming for young women.

He did not know that her music videos have been viewed more than seven billion times online. Then came the bombing at the conclusion of her concert in Manchester, and the rest of the middle-aged male world knew of her too.

On Sunday, Ariana Grande was back in Manchester at a different venue, the Old Trafford stadium, to give a concert to memorialize the victims of the bombing. Grande visited injured fans in the hospital before the concert, and met the mother of Olivia Campbell, one of those killed during the Manchester attack.

She also offered 14,000 free tickets to those who had attended her May 22 concert. About 50,000 attended Sunday’s sold-out One Love Manchester concert, and $13 million was raised for the We Love Manchester Emergency Fund, the AP reported.

Millions watched around the world on a variety of platforms. The concert averaged 10.9 million viewers on BBC One, peaking at just under 15 million. The concert was also streamed over various commercial radio stations and broadcast in over 50 countries around the world. Facebook, Twitter, and YouTube also hosted various streams.

The concert, like Live Aid and others before it, showed how uniquely powerful pop music can be, a space where emotions are expressed, processed and worked through. Pop music is often read as shallow, but events like this show how valuable it can be in the healing process for many young people.

The concert came less than 24 hours after another terrorist attack rocked London, which is about 200 miles away. It was impossible not to be moved by Grande’s duet with Miley Cyrus, re-creating their version of “Don’t Dream It’s Over” by Crowded House. In it, they showed that it’s ok for singers who are friends to play it a little loose:

After singing with Cyrus, Grande said:

I want to thank you so much for coming together and being so loving and strong and unified…I love you guys so much, and I think that all the love and unity you’re displaying is the medicine the world needs right now.

Those who read the Wrongologist in email can view the video here.

She closed the show Sunday night with a tearful rendition of “Somewhere Over the Rainbow,” a fittingly desperate plea for a better tomorrow. She breaks down a bit, and the British audience rallies around her and she is able to finish the song. Wrongo loves European audiences, they are the best thing about live concerts online:

Those who read the Wrongologist in email can view the video here.

So, give Ariana Grande a listen. She is creating a forthright kind of R&B pop, and has shown herself to be socially engaged. Her conduct after the attack, bringing together this concert and hosting it with élan, provides another reason to get acquainted.

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Monday Wake Up Call – June 5, 2017

The Daily Escape:

Pink Katydid – a 1 in 500 mutation – photo from Nature Photos

Few of us have ever heard of the non-profit organization Vetpaw. It provides employment to post-9/11 veterans in support of anti-poaching efforts in South Africa. Vetpaw works on a dozen private game reserves covering a total of around 200,000 hectares in South Africa’s northernmost province, Limpopo. They support local anti-poaching rangers. But, if one aim of Vetpaw is to counter poaching, another is to help US combat veterans with their PTSD. Vetpaw’s founder, Marine veteran Ryan Tate, says:

Everyone gets PTSD when they come back from war…you are never going to get the brotherhood, the intensity again… [There are] all these veterans with billions of dollars of training and the government doesn’t use them. I saw a need in two places and just put them together…

Vetpaw’s job in a remote northern part of South Africa is simple: keep the rhinos and the rest of the game in the bush around their remote base alive. South Africa is home to 80% of the world’s wild rhinos. Only 13 were poached in 2007. By 2015, the total was nearly 1,200. From the Guardian: (brackets by the Wrongologist)

A kilo [of Rhino horn] is worth up to $65,000. The demand comes from East Asia, where rhino horn is seen as a potent natural medicine and status symbol, and is met by international networks linking dirt-poor villages in southern Africa with traffickers and eventually buyers. Patchy law enforcement, corruption and poverty combine to exacerbate the problem.

And the locals are on both sides of the problem. Poachers coerce local communities into providing safe houses or other support. While some resist, it is vastly more difficult without support from local police. More from the Guardian:

One advantage for local landowners is the protection heavily armed combat veterans provide against the violent break-ins feared by so many South Africans, particularly on isolated rural farmsteads. The team has also run training courses for local guides and security staff.

Tate says he has selected combat veterans because they will resist the temptation to use lethal force. Poachers are told to put down their arms, and then handed over to the police. Another team member says:

This is textbook counterinsurgency…Its unconventional warfare…Shooting and killing is easy. The hardest thing is not shooting but figuring stuff out…if you kill someone do you turn a family, a village against you?

So, maybe some of the counterinsurgency lessons paid for by US blood and treasure in Afghanistan and Iraq will save the Rhinos of South Africa. Kevin, a Vetpaw team member, says:

After what I’ve done, I couldn’t just go and do a nine to five. I’ve never had nightmares or flashbacks or anything… [But] after years of doing what I’ve done, this is good for the soul…It’s in a good cause and you get to watch the African sunset.

So, a cause to rally around. Something that helps a few vets and a few Rhinos. A good news story for a Monday, when there is so little to be happy about in Trumpland.

Time for a wake up tune. In honor of the Orange Tweeter, here is Linda Ronstadt performing “You’re No Good”, live in Germany in 1976. She was at the height of her powers. That’s Andrew Gold on the guitar solo:

Those who read the Wrongologist in email can view the video here.

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Sunday Cartoon Blogging – June 4, 2017

Re: The Trump severed head “joke”: Kathy Griffin isn’t funny, and this wasn’t a joke. Here’s the problem with what Griffin did: A joke has to be funny, and this simply wasn’t. The only message you can take from her severed Trump head photo is: “look at me, I’m Kathy Griffin!” Griffin is getting what she deserves for putting her desire for attention ahead of everything else.

Yes, she has the right to produce the image, but that doesn’t mean it has to be accepted by the rest of us. If you mimic what ISIS does to their victims, you deserve to lose your job on CNN. She needs to grow up; CNN did the right thing.

On to cartoons. Quite the week for climate change drama. Trump’s action on Paris could have been inspired by the Saudi sword dance, but it is it different than Griffin’s?

Trump said he was elected to represent Pittsburgh, not Paris. Trump lost Pittsburgh to Clinton, and Pittsburg’s mayor says the city will follow the Paris Accords. But, in Trump speak:

Trump seems intent on completely eradicating the Obama legacy:

The news about back-channel communications with Russia leads to Jared Kushner:

The medicine in Trumpcare II is no better than in Trumpcare I:

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Saturday Soother – June 3, 2017

The Daily Escape:

Trolltunga (Troll’s Tongue) Norway – photo by B. Krustev

What is left to say about Trump pulling out of the Paris Climate Agreement? The world is looking at a post-agreement future as if we were standing on the edge of Troll’s Tongue. The Paris deal wasn’t a binding agreement, it was aspirational, with voluntary targets and no mechanism for enforcement. But, this quote from Abu Ivanka tells all:

At what point does America get demeaned? At what point do they start laughing at us as a country? We want fair treatment. We don’t want other countries and other leaders to laugh at us anymore.

This is the core problem with Trump’s view of the world: He and the members of his Party see the world agenda as a zero-sum game, in which only one nation can win. Therefore, we gotta win, or else we lose, and God forbid, we can’t lose. At anything.

Zero-sum thinking is what causes voluntary agreements to fail; they require non-zero sum thinking to succeed.

But, in a zero-sum world, there will always be someone in some country who thinks, rightly or wrongly, that they’re being screwed over, that other countries are using the climate issue to pursue an economic advantage.

In this case, Trump gets into power. He then abandons the agreement, or attempts to renegotiate it.

The new terms on offer will be unacceptable, possibly even designed to fail. So it will be with Trump, who is looking to force both China and India into binding targets in order to continue with the agreement. That’s what Republicans consider “fair treatment”.

In other climate news, the Tampa Bay Times points out that the hurricane season started with nobody in charge at FEMA or NOAA.

What could go wrong?

And farther south, a massive crack in the Antarctica ice shelf grew 11 miles in only 6 days.

But America’s coal miners gotta work. Trump is in thrall with an industry that is among those dying out in America. In March, the WaPo reported that:

The coal industry employed 76,572 people in 2014, the latest year for which data is available. That number includes not just miners but also office workers, sales staff and all of the other individuals who work at coal-mining companies.

That’s fewer people employed than at other shrinking industries, like travel agencies (99,888), used-car dealerships (138,000), or carwash employment (150,000).

Maybe Trump will gin up a reason why climate change is killing jobs in those industries as well.

You need to relax, you need to think about something other than Trump, Ivanka and Jared, or Putin and Megyn Kelly. In other words, you need to turn off your devices, sit quietly and take a long look out the window at the natural world. It helps if you can have a strong cuppa something while you kick back.

Wrongo recommends brewing some Sumatran Mandheling coffee (only $11.44 for 16 oz.) and some beautiful music. This morning, we are listening to a Russian and a Latvian singing beautifully together. Here are Anna Netrebko & Elina Garanca performing the Flower Duet by Léo Delibes at the Baden-Baden Opera Gala in 2007:

Those who read the Wrongologist in email can view the video here.

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A Hundred-Year War

The Daily Escape:

Gouldian Finch, native to Australia – photo by Melinda Moore

(This post is an expansion of the ideas in Wrongo’s Memorial Day column)

Ms. Oh So Right suggested while we were in Europe that we stop calling it the “War on Terror” and begin calling it the “Hundred Year War.” Why? Because it seems that the Middle East has an unbreakable hold on us. Tom Friedman offers this take on the Trump doctrine:

The Trump doctrine is very simple: There are just four threats in the world: terrorists who will kill us, immigrants who will rape us or take our jobs, importers and exporters who will take our industries — and North Korea.

Last week, Trump took the decision to insert the US into what promises to be a never-ending war between the Sunni and the Shia for control of the ME. Rather than try to keep a balanced political position between these two religions, Trump has tilted America towards the Sunnis. This from Paul Mulshine:

The pivotal moment on his foreign trip came when Trump cuddled up to Saudi Arabia, a country he accused of “paying ISIS” back when he was campaigning for the presidency.

ISIS is of course, a Sunni group. So is al Qaeda. And Saudi Arabia is at the center of the Sunni universe.

There was a peaceful and democratic change of power in the ME while Trump was away. It was the re-election of Hassan Rouhani in Iran. In that contest, 41.2 million voters, or 73% of the Iranian electorate, turned out to vote. So who did Trump lash out at during his speech in Riyadh? Not Saudi Arabia, but Iran:

From Lebanon to Iraq to Yemen, Iran funds, arms, and trains terrorists, militias, and other extremist groups that spread destruction and chaos across the region…

This ignores the fact that Saudi Arabia funds more terror than does Iran, and it isn’t a democracy. This despite the fact that we share with the Iranians the goal of ousting ISIS from Syria. Yet, on May 18, US planes attacked a convoy of Syrian Army forces that included Iranian militias, and probably a few Russian advisers.

Back when Trump appointed Secretary of Defense James Mattis and National Security Advisor H.R. McMaster, there was some hope that we might become more calculated in our involvement in the region. But both individuals seem to be hot to go to war with Iran. The fear is that the Trump administration will adopt the “on to Tehran” strategy the people around George W. Bush endorsed back when it seemed that Bush’s Iraq invasion had succeeded.

This is where we start getting into “Hundred Years’ War” territory. (The Hundred Years’ War was a series of conflicts waged from 1337 to 1453 by the House of Plantagenet, rulers of England, against the House of Valois, rulers of France, over the succession of the French throne.)

This is why Wrongo thinks we must re-instate the draft. Let America debate about why Trump and the neo-cons think a war with Iran is a good idea. Let them explain to draft-age kids and their parents why American should get involved in a civil war between the Shia and the Sunni.

Why will this keep us safe?

Trump is embarking on a hard-line anti-Iranian journey, precisely when Iranians re-elected a moderate to lead their country. Trump risks making a mistake that would be similar to GW Bush’s. Bush’s decision to invade Iraq and topple Saddam Hussein permitted the Iranian Shia majority to link up with the Iraqi Shia majority, thus giving the Iranians the first step towards creating the “Shia Crescent.”

If Trump takes an aggressive attitude toward Tehran, he’ll be playing into the hands of the Iranian hard-liners. Trump campaigned at least in part, on not repeating Bush’s ME mistakes. But now he is aligning himself with the Sunnis, who plan to keep the Syrian civil war going for at least another generation (25 years).

What happens then?

We’ll still have 58 years to figure it out.

Let’s close with a tune. Here are Todd Rundgren and Donald Fagan doing “Tin Foil Hat” from Todd’s new album “White Knight”. It’s a song about Donald Trump:

Those who read the Wrongologist in email can view the video here.

Takeaway Lyric:

He’s coming down the escalator

With a girl from east of here

He wants to make the country greater

We got nothing left to fear

 

Because the man in the tin foil hat

Is sitting on the throne tonight

It kinda feels like a coup d’état

But it’s gonna be great, tremendous, amazing and all that

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Wake Up Call – Memorial Day 2017

The Daily Escape:

NYC’s Grand Central Station – 1943

On Memorial Day we commemorate those who died in the military service of our country. In 1974, a sci-fi novel called “The Forever War” was released. It is military science fiction, telling the story of soldiers fighting an interstellar war. The protagonist, named Mandella, is sent across the galaxy to fight a poorly understood, apparently undefeatable foe.

Sound familiar? Today the forever war is not simply fiction. Our all-volunteer military has been fighting in the Middle East for the past 16 years in the longest war in American history. And there is little reason to hope that we will not be fighting there 16 years from now. Brian Castner, a former explosive ordnance disposal officer who served three tours in Iraq, observes:

Our country has created a self-selected and battle-hardened cohort of frequent fliers, one that is almost entirely separate from mainstream civilian culture, because service in the Forever War, as many of us call it, isn’t so much about going as returning. According to data provided by the Center for a New American Security, of the 2.7 million veterans of Iraq and Afghanistan, half have done multiple tours. More telling, 223,000 have gone at least four times, and 51,000 have done six or more deployments.

We can’t get our fill of war. In fact, since 1943, the year the picture above was taken in New York City, the US has been at peace for just five years: 1976, 1977, 1978, 1997 and 2000 were the only years with no major war.

So today, we gather to celebrate those who have died in service of our global ambitions. We watch a parade, we shop at the mall, and we attend a cookout. Perhaps we should be required to spend more time thinking about how America can increase the number of years when we are not at war.

Wrongo can’t escape the idea that if we re-instituted a military draft, and required military service of all young Americans, it would soon become impossible for the politicians and generals to justify the forever war.

So, wake up America! Instead of observing Memorial Day with another burger, get involved in a plan to re-institute the draft. It won’t stop our involvement in war, but it will unite American mothers and fathers to bring about the end of this forever war, and any future “forever war”.

To help you wake up, we also remember the death of Gregg Allman of the Allman Brothers Band. Here is “Blue Sky” from their “Eat a Peach” album. Wrongo loves the guitar interplay between the long-gone Duane Allman and Dickey Betts on this tune:

Dickey Betts wrote this about his Native American girlfriend, Sandy “Bluesky” Wabegijig.

Those who read the Wrongologist in email can view the video here.

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Sunday Cartoon Blogging – May 28, 2017

In Saudi Arabia, The LA Times’ Molly Hennessy-Fiske reports that Donald Trump is now called “Abu Ivanka”. Abu means “the father of”.  Apparently Saudi Arabia is fascinated with Ivanka Trump, and thus, The Donald gets a new title.

The Saudi Pipeline:

In his speech, Trump called Saudi Arabia the country that contributes more to peace than any other Muslim country. Really? The Saudis?

Trump got the arms deal with Saudi Arabia. Now, he plans to sell off half the US oil reserve so we can once again be dependent on OPEC oil:

Trump is impressed by Wailing Wall:

When Donny visited the Pope, he received a copy of the Pope’s Climate Encyclical:

His Assholiness gives the Pope a religious education:

 

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Saturday Soother – May 27, 2017

The Daily Escape:

Baltimore Oriole

Trump returns from his international visits having moved the US into siding with the Sunnis in the Middle East. In this, he has also sided with his generals. This also puts him on the side of al Qaeda, a Sunni terror organization that did you-know-what.

Significantly, it is clear that the entire Trump foreign policy is anti-terrorism. That is one approach, but Trump’s take is mystifying: He calls Iran an enemy because they are a sponsor of terror, which is true. But he embraces Saudi Arabia, the largest sponsor of terrorism by far in the ME, and has attempted to make them his ally in the War on Terror.

The Saudis will now expect that the US will accept that their $110 billion in defense purchases and $40 billion in contributions from the Saudi state’s sovereign wealth fund will buy them enhanced power in Washington and that their demands will be greeted with great receptivity in the future.

That will probably be a difficult pill for Israel to swallow.

Siding with the Sunnis means that the “Shia Crescent” (Iran, Iraq, Egypt, and Syria) will be difficult for the US to maintain as friends, partners, or allies. In fact, it was reported this week that Russia, Syria and Iran have been proclaimed as allies by the Iraqi Interior Minister. For all the money and blood that we spent, for all of the domestic programs that we sacrificed, the US now has little to show for its last 15 years in Iraq except a huge, and under Donald Trump, a growing national debt.

We are obviously and irredeemably ignorant, and apparently determined to remain so. The Shia Crescent will be an Iranian/Shia alliance extending through Iraq, Syria and Lebanon to the sea, with Russian and Chinese backing to boot.

Whomever heads ME strategy for Trump needs to hear: “You’re fired!

Trump also met with NATO and the EU, and both relationships look less confident than at any time in recent history. In fact, European Council President Donald Tusk has said that Trump and senior European Union officials failed to find common ground on the main issues at their meeting in Brussels.

Consider this: Trump emerges from this trip as closer to Saudi Arabia, the Gulf States and Israel than he is with the democracies of Western Europe. We can now start preparing for US War on Terror Part B; followed by Sunni insurgency 3.0: now with even better weapons and funding.

Do these thoughts make you feel that you need something to help you calm down? Wrongo’s advice is stop watching or reading the news for a few days, as he did while traveling in Europe. Talk to locals in your area. Ask them about why they think as they do.

Then grab a vente cuppa chamomile tea and listen to Janine Jansen play French composer Jules Massenet’s “Meditation from Thaïs”:

Those who read the Wrongologist in email can view the video here.

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Sunday Cartoon Blogging – May 21, 2017

On Friday night in Cologne Germany, Wrongo and Ms. Right had the chance to see a great young female duo who play classical music. Sophie Moser (violin) and Katja Huhn (piano) played selections for a mostly American audience. They perform under the name Duo Moser-Huhn. Here they are playing the Romanian Folk Dances by Bartok, composed in 1915. Sophie was a child prodigy, and plays an Amati violin built in 1743. They have few YouTube performances, so hopefully, you will enjoy this:

On to cartoons. Der Donald is on his first overseas tour as president. He is in Saudi as this is written, before his big speech on Islamic Terrorism. So you will already know just how well that was received by the 50 or so heads of state in the audience.

Trump prepares for landing:

Opinions on his Middle East visit vary:

John Fugelsang called Trump’s meeting with the Pope “His Holiness meets His Assholiness”:

Trump hints at having secret tapes of Comey:

Will Trump be dropped?

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