Blogs

Medicare Just Keeps Producing Great Budget News

| Wed Jul. 9, 2014 2:20 PM EDT

Medicare has been a bastion of good news lately. Every year, the CBO reduces its baseline estimate of Medicare costs, which have dropped by more than $1,000 since 2010. So what's going on? Tricia Neuman and Juliette Cubanski of the Kaiser Family Foundation round up the evidence:

It is clear that the Medicare savings provisions in the ACA, such as reductions in provider payment updates and Medicare Advantage payments, have played a major role....In addition, the Budget Control Act of 2011 also exerted downward pressure on Medicare spending through sequestration that reduced payments to providers and plans by 2 percent beginning in 2013.  And yet even after incorporating these scheduled payment reductions in the baseline, CBO has continued to lower its projections of Medicare spending.

So what else might be going on here? In addition to scheduled reductions in Medicare’s more formulaic payment rates, providers may be tightening their belts and looking to deliver care more efficiently in response to financial incentives included in the ACA, and it is possible that these changes are having a bigger effect than expected. For example, CMS recently reported that hospital readmission rates dropped by 130,000 between January 2012 and August 2013. It is also possible that hospitals and other providers are using data and other analytic tools more successfully to track utilization and spending and to reduce excess costs. Another more straightforward factor is that several expensive and popular brand-name drugs have gone off patent in recent years, which has helped to keep Medicare drug spending in check.

No one knows for sure if these reductions are permanent, or whether high growth rates will reappear in the future. But even if the low growth rates of the past few years can't be sustained, I suspect that Medicare growth will continue to be lower than anyone expected. There are two reasons for this. First, the growth rate of medical costs in general has been declining steadily for the past 30 years, and this has now been going on long enough that it's highly unlikely to be a statistical blip. After a surge in the 80s and 90s, we really are returning to the growth rates that were common earlier in the century, and obviously this will affect Medicare.

Second, Obamacare really will have an impact. Not everything in it will work, but it includes a lot of different cost-cutting measures and some of them will turn out to be pretty effective. And who knows? If Republicans ever stop pouting over Obamacare, we might even be able to experiment with different kinds of cost reductions.

There's a fair amount of year-to-year variability in health care inflation, and we should expect to have some years of high growth. But I'll bet the average over the next decade is somewhere around 2 percent above the general inflation rate. That's not too bad.

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George R.R. Martin Has 2 Words for People Scared He'll Die Before Finishing "Game Of Thrones" Series

| Wed Jul. 9, 2014 1:38 PM EDT
Ball so hard.

Game of Thrones author George R.R. Martin is 65 years old. Because of this, some of his fans are deeply worried that he won't finish writing his A Song of Ice And Fire fantasy book series (which began in 1996, and is the basis for the hit HBO show) before he dies. (See: the case of fellow fantasy author Robert Jordan.)

Well, he was asked about this during a recent interview with Swiss newspaper Tages-Anzeiger. Here's his response:

Well, I find that question, you know, pretty offensive, frankly, when people start speculating about my death and my health. So, 'fuck you' to those people. [Laughs.]

You can watch the "fuck you"—and Martin's accompanying flipped middle finger—here.

This isn't the first time Martin has addressed this concern among his readers. In 2012, he wrote a blog post trolling his fans who are so obsessed with the series that they routinely berate him for working on other projects. It reads:

Reading. I just finished THE KING'S BLOOD, the second volume of Daniel Abraham's "Dagger and Coin" series. Books like this remind me why I love epic fantasy. Yes, I'm prejudiced, Daniel is a friend and sometime collaborator... but damn, that was a good book. Great world, great characters, thoroughly engrossing story. The only problem was, it ended too soon. I want more. I want to know what happens to Cithrin, and Marcus, and Geder, and Clara. And I want to know NOW. God damn you, Daniel Abraham. I know for a fact that you are writing more Expanse books with Ty, and more urban fantasies as M.L.N. Hanover, and doing short stories for some hack anthologist, and scripting some goddamn COMIC BOOK, and even sleeping with your wife and playing with your daughter. STOP ALL THAT AT ONCE, and get to writing on the next Dagger and Coin. I refuse to wait.

"Fuck you" is more succinct.

(h/t Gawker)

Is Montana More Corrupt Than Miami?

| Wed Jul. 9, 2014 12:44 PM EDT

For such a sparsely populated state, Montana has managed to generate some outsize headlines lately. There's the GOP Senate candidate who made news by suggesting that creationism should be taught in public schools. Then there's Missoula's reputation as the "rape capital" of the world, thanks to, among other things, serious allegations of sexual assault committed by University of Montana football players. And continuing that theme, there's also the Justice Department's investigation of the Missoula County Attorney's office alleging that prosecutors had been systematically discriminating against female sexual-abuse victims.

Now comes new data showing that Montana is leading the country in public corruption prosecutions, suggesting that the state's reputation for graft (dating back to the days of the Copper Kings) hasn't changed much. Clocking in with 18 active cases, the federal judicial district of Montana has had more public corruption prosecutions in 2014 than those in South Florida, Southern California, and even New Jersey, according to data crunched by the Transactional Records Access Clearinghouse at Syracuse University.

How is it that such a small state has so many prosecutions? "Why prosecutors do what they do is a mystery," says TRAC's David Burnham. But the prosecutors in Montana have a good explanation: They've recently organized a major crackdown on corruption on American Indian reservations, of which the state has seven. 

A recent AP investigation concluded that, nationally, tribal governments are five times more likely to have "material weaknesses" in their administration that make corruption possible, and reporters for years have been sounding alarms that federal prosecutors have largely turned a blind eye to these problems. Montana decided to change that trend, at a time when millions in additional federal dollars have flowed into tribal governments thanks to the federal stimulus package enacted after the financial collapse in 2008.

In 2011, the US Attorney's office launched a task force, dubbed the Guardians Project, with the FBI, the IRS, and inspectors general of various federal agencies, to target corruption on American Indian reservations. The results have been telling: In 2012, Montana had only one official corruption prosecution, but by August of last year, the Guardians Project had netted 25 indictments against people who'd allegedly done all sorts of devious things to keep federal money from reaching those it was supposed to help.

Prosecutors promised there would be more to come, and there have been. Just last month, four members of the Blackfeet tribe were sentenced to prison for involvement in a scheme to steal federal mental-health and substance abuse treatment funds from a $9 million contract. More than $225,000 intended for the program ended up being spent on travel and gambling, among other things.

Six people have pleaded guilty to embezzling federal dollars from a $361 million pipeline project designed to bring freshwater to the Rocky Boy's Indian Reservation. Another seven people from the Crow reservation were indicted for stealing at least a half-million dollars from the tribe in a double-billing scheme operated out of the tribe's historic preservation office. One of the people convicted in the scheme allowed a coal company to take a backhoe to a 2,000-year-old sacred bison burial site. The corruption investigations have already ensnared a former state representative and Chippewa Cree tribe official, Tony Belcourt, who in April pleaded guilty to bribery, theft, and tax-evasion charges related to the water project, as well as construction of a multimillion-dollar clinic.

Overall, though, Montana itself probably isn't more scandal-plagued than New Jersey or Miami. Montana's US attorney has just taken a harder line on prosecuting the abuses on its reservations, and all those cases have added up to boost Montana to the top of the rankings in terms of public corruption prosecutions. "These figures from Syracuse reflect only a portion of our effort," US Attorney Mike Cotter said in a statement Tuesday. "Many of the public corruption indictments brought in Montana were initiated before last October. Relatively speaking, Montana is a small office; a David among Goliaths. But the Guardians have done truly remarkable work. Their efforts have unearthed widespread criminal activity and flagrant abuses of trust with regard to federal programs and grants designed to provide for the common good of our Indian communities."

We're Still at War: Photo of the Day for July 9, 2014

Wed Jul. 9, 2014 11:31 AM EDT

The 173rd Airborne Brigade Paratroopers participate in a ceremonial rotation of forces in Latvia. (US Army National Guard Photo by Spc. Cassandra Simonton, 116th Public Affairs Detachment)

This Is the Democratic Plan to Reverse the Hobby Lobby Decision

| Wed Jul. 9, 2014 11:02 AM EDT

On Monday, Senate Majority Leader Harry Reid promised "to do something" about the Supreme Court's recent Hobby Lobby decision. Now two members of his caucus say they are preparing a bill that would reverse some of the controversial aspects of last week's decision.

Take it away, TPM:

The legislation will be sponsored by Sens. Patty Murray (D-WA) and Mark Udall (D-CO). According to a summary reviewed by TPM, it prohibits employers from refusing to provide health services, including contraception, to their employees if required by federal law. It clarifies that the Religious Freedom Restoration Act, the basis for the Supreme Court's ruling against the mandate, and all other federal laws don't permit businesses to opt out of the Obamacare requirement.
...

This bill will restore the original legal guarantee that women have access to contraceptive coverage through their employment-based insurance plans and will protect coverage of other health services from employer objections as well, according to the summary.

This is all well and good, but unfortunately this bill will never survive a cloture vote in the Senate; even if it did, it would be dead on arrival in the House of Representatives. The only way that Hobby Lobby stands even a chance of being overturned legislatively is if John Boehner is forced to hand over the Speaker's gavel to a Democrat. That's probably something someone at the DCCC should remind people of as we head into the midterms.

Vladimir Putin Abandons His Erstwhile Allies

| Wed Jul. 9, 2014 10:31 AM EDT

Julia Ioffe writes about the latest from Ukraine:

As the Ukrainian army chases separatists from the strongholds they've held for months, Moscow has barely said anything—despite its springtime rants about protecting Russians wherever they may be in the world....As I wrote back in May, now that he's sown chaos in Ukraine—but uneager to participate in someone else's civil war—President Vladimir Putin has thrown the rebels under the bus. In June, rebel leader Igor Strelkov said that "Putin betrayed us," and that betrayal has only deepened as Kiev launched its all-out offensive last week. Moscow, having started all this, has offered no help to the rebels.

The betrayal, it seems, may be even nastier than that. According to a Ukrainian security council spokesman, the Russians have sealed their border, shutting down three key crossings. Not only are they not letting men and materiel into Ukraine from Russia, but they're also blocking men and materiel from flowing in the opposite direction. That is, the very men that Moscow has riled up to the extent that they have taken up arms and are ready to die in order to get the region out of Ukraine and into Russia are not welcome to seek refuge in Russia. (Not even, it seems, the ones originally from Russia.) A group of 300 fleeing rebels reportedly even came under fire by the Russians as they tried to escape into Russia.

That Putin. He's quite the guy, isn't he? It appears that he eventually figured out that Ukraine wasn't going to fall neatly into his lap, and the cost of fomenting an all-out war there was simply too great. It turned out that Ukrainians themselves didn't support secession; Western powers were clearly willing to ramp up sanctions if things got too nasty; and the payoff for victory was too small even if he had succeeded. So now he's had to swallow a new, more pro-Western Ukraine—the very thing that started this whole affair—along with the prospect of renewed anti-Russian enmity from practically every country on his border.

But he got Crimea out of the deal. Maybe that made it worth it.

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Check Out These New Emojis for Foodies

| Wed Jul. 9, 2014 6:00 AM EDT
Can you guess what these images mean? See below.

On a frigid Sunday morning in Manhattan this past March, several dozen people, many of them design students, gathered at the School of Visual Art's building in Chelsea. Their task: to perform a bit of pro-bono marketing for non-corporate food producers—the kind of small and mid-sized farms that grow produce without poisonous chemicals and tend their animals on pasture, not in fetid, polluting feedlots.

The meeting, organized by an innovative Los Angeles-based design firm called the Noun Project (whose founders my colleague Tasneem Raja interviewed here) and an accomplished New York-based sustainable-food advocacy group called the Grace Communications Foundation (the force behind the Meatrix video and Sustainable Table), was modeled on the techie concept of a "hackathon"—a bunch of people getting together to solve some problem. But whereas hackathons typically result in computer code, this "iconathon" would produce images, known as icons, that can wordlessly express concepts like "grass fed" and "heritage breed," free for anyone's use under a creative-commons license.

Thailand's New Military Government Is Secretly Vacuuming Up Facebook Data

| Wed Jul. 9, 2014 6:00 AM EDT

Despite all the ways Facebook has flouted privacy standards—like how it recently experimented with 700,000 users' emotions by manipulating the positive and negative content of their newsfeeds—the company hasn't yet provided personal data to oppressive governments. But that didn't deter the Thai junta. When Facebook refused to help Thailand's newly installed military government access users' personal information, the junta created a misleading Facebook application to capture its citizens' names and email addresses. 

The military government posted that they were collecting this data to "handle more witnesses which can lead to more prosecutions and will make the online society more clean."

As you might remember, back in May, after months of anti-government protests, Thailand's military staged a coup. Once in power, the military suspended the constitution, installed a 10 p.m. curfew, banned gatherings of more than five people, and attempted to suppress dissidents—including any of the estimated 28 million Thai users on Facebook, a third of the country's population. On May 29, the new government tried to have a meeting with social-media companies, including Facebook, to discuss censoring Thailand's anti-coup dissent, but none of them showed up.

But the Thai junta didn't take this as a sign to give up on tapping into the power of social media. Instead, as the Electronic Frontier Foundation reports, the junta placed a Facebook login button to track users on more than 200 of the government's restricted websites, like the webpage of Human Rights Watch.

Fast Tracks: Beverly's "All the Things"

| Wed Jul. 9, 2014 6:00 AM EDT

TRACK 4

"All the Things"

From Beverly's Careers

KANINE

Liner notes: Urgent yet dreamy, this breathtaking dose of psychedelia mixes ethereal female harmonies, a soaring melody, and surging beats to dazzling effect.

Behind the music: The Brooklyn duo features singer Drew Citron and noise-pop vet Frankie Rose. Careers falls between the lo-fi buzz of Frankie Rose and the Outs and the cooler electronica of Rose's recent solo work.

Check it out if you like: Vivian Girls, early Dum Dum Girls, or Quilt.

This review originally appeared in the July/August 2014 Issue of Mother Jones.

Yet Another Day in Republican Scumbaggery

| Wed Jul. 9, 2014 1:00 AM EDT

Today President Obama asked Congress to approve $3.7 billion in emergency funding to help deal with the surge of minors crossing the border. You may color me unsurprised over the Republican response:

The proposal was quickly met with broad skepticism among Republican lawmakers, who were doubtful that the package would be approved quickly — if at all....GOP leaders, who have called on Obama to take stronger action, said they were reluctant to give the administration a “blank check” without ­more-detailed plans to ensure that the money would help stem the crisis at the border.

The president “is asking to use billions of taxpayer dollars without accountability or a plan in place to actually stop the border crisis,” Rep. Bob Goodlatte (R-Va.), chairman of the House Judiciary Committee, said in a statement.

Asked if he thought lawmakers would approve the proposal, Sen. Marco Rubio (R-Fla.) said, “No, given the mood here in Washington, I don’t have confidence it will happen.”

Well, of course it won't happen. The crisis along the border is tailor made for Republicans. It makes their base hopping mad, it juices their campaign fundraising, and anytime the government is unable to address a problem it makes Obama look bad. Why on earth would Republicans want to do anything to change any of this?

As long as Obama is president, chaos is good for Republicans. After all, most voters don't really know who's at fault when things go wrong, they just know there's a crisis and Obama doesn't seem to be doing anything about it. Exploiting that may be cynical and revolting, but hey, politics ain't beanbag. And in case you haven't heard, there's an election coming up.