The midterms were a mixed success for the Democrats in 2018. Most notably the Democrats took control of the House, but unfortunately this probably means Nancy Peolsi returns as Speaker. They also regained about three hundred of the near one thousand seats in state legislatures they lost over the past decade, have a majority of state attorney generals in the nation, and won some key governorship battles, especially in the midwest. On the other hand, despite a Republican president as terrible as Donald Trump, their midterm gains in the House were historically not terribly impressive for the party out of power, and they did poorly in the high profile battles in the Senate. (I’m waiting to hear Rachel Maddow explain why the Russians meddled in the Senate races but not the House races this year.)
This was far more a slap on the wrist than a shallacking for Donald Trump.
The Senate map was undoubtedly very unfavorable for Democrats, but it will be so virtually every year as long as Democrats are unable to come up with a message to win in the smaller states beyond the east coast. The system of giving two Senators to each state regardless of size makes the Senate extraordinarily unrepresentative. Still, don’t be tempted to repeat the memes showing up since the election regarding winning the popular vote. They are misleading as the entire nation did not vote for Senate, and this can be tilted by which states do vote. This was especially true in 2018 as California had two Democrats running for Senate due to a system where the two leaders in the primary get on the November ballot regardless of party. This leads to a tremendous number of Democratic votes if the mythical Senate popular vote is counted, but only one Democratic Senator.
Democrats are always far quicker to list off the problems which make it more difficult to win than to change their strategy. They showed once again that moving to the right in the hopes of attracting Republican votes does not work. Nor did recruiting veterans help them do any better than expected. I would prefer to see Democrats be more consistent in supporting a reduction in the role of government in the private lives of individuals–an attitude which might make defense of reproductive rights part of a consistent philosophy that might be accepted in the more libertarian minded portions of the country. Taking a rational anti-war line, as opposed to acting as if they are apologizing for appearing weak on national security, might also help in those areas which are hurt by perpetual warfare–and rejected Hillary Clinton in 2016.
This does note mean that the Democrats don’t have many valid complaints, including regarding voter suppression and gerrymandering. Some of the election results will help, including increasing their strength in several state governments before the next redistricting. While the high profile races in Florida did not turn out as hoped (how badly did campaigning with Hillary Clinton hurt Andrew Gillum?), but there was a victory in passing a ballot initiative to restore voting rights to convicted felons who have served their time.
While Democrats continued to struggle in Florida and Ohio, their hopes for Pennsylvania, Michigan, and Wisconsin being more blue in 2018 look favorable after Tuesday’s results, including the defeat of Scott Walker in Wisconsin. Besides possibly giving the Democrats their electoral votes again in 2020, there might be an increased number of representatives as the heavily gerrymandered system of drawing Congressional districts will be replaced by an independent redistricting commission in Michigan.
Other ballot proposals passing in Michigan will make it easier to vote and legalized marijuana for recreational use. Newly elected Governor Gretchen Whitmer is looking at legislation or issuing executive orders to free prisoners convicted for marijuana related charges which will no longer be crimes after the ballot proposal passed. I did hold my nose and vote for Whitmer, despite her reliance on dark money and financing by Blue Cross Blue Shield of Michigan. Action such as this will make me happier that I did so. A judge has already put some new marijuana cases on hold.
Medicaid expansion passed in Idaho, Nebraska, and Utah, and is also expected in Kansas due to the victory for a Democratic governor. While there is no chance of it becoming law imminently, there are also more Democratic supporters of Medicare for All in the House.
There were victories for various groups. The media has covered extensively how there are more women and people of color in the House. In addition, seven more scientists were elected to the House–all Democrats as the Republican war on science continues.
It remains to be seen how some issues will play out now that the midterms are over. Are we still supposed to be terrified by the caravan? Donald Trump quickly took advantage of having control of the Senate by firing Jeff Sessions. I never would have guessed that I would see this as a bad thing when Sessions first became Attorney General. On the one hand, Sessions might have been the worst Attorney General in history. On the other hand, Sessions was absolutely right in his dispute with Trump in recusing himself from Mueller’s investigation, and his firing could be a sign that Trump plans to take action against Mueller. I suspect that Mueller has prepared for this by being ready to turn over evidence of financial crimes committed by Trump and his cronies to state prosecutors. Congressional Democrats will also be able to take over the investigation if needed. Hopefully they concentrate on Trump’s financial crimes and obstruction of justice, as opposed to the dubious conspiracy theories popular among many Democrats blaming Russia for Hillary Clinton’s loss.
There is wide spread consensus that opiates were overused in the past, and their use has been greatly curtailed in recent years. Many people were placed on high doses for chronic pain when this was considered the standard of care, and the pharmaceutical industry did all it could to promote this practice. The problem is many people who are using high doses safely and responsibly are now being targeted by government efforts to decrease opiate use. While it makes sense to limit new prescriptions, and decrease their use in long-time users when possible, the government has been going overboard in intervening in patient care to decrease their use.
Both in January 2016 and January 2017 I encountered cases where Medicare drug plans abruptly reduced the doses of pain medications they would approve, and Medicare is now considering far more draconian cuts as of January 2018. This is largely based upon distorting recommendations from the Centers for Disease Control, with even writers of those guidelines protesting actions by the Medicare plans. Some patients have tried to get around this by paying for part of their prescriptions, but I have recently been informed by local pharmacists that they are now under pressure to stop filling prescriptions for amounts beyond what is approved. This is driving some to the use of cheaper street drugs such as heroin, increasing the risk of overdoses, contrary to the stated goals of regulations to reduce opiate use.
The New York Times has an excellent article on the situation. I have some excerpts below, but recommend reading the full article.
Medicare officials thought they had finally figured out how to do their part to fix the troubling problem of opioids being overprescribed to the old and disabled: In 2016, a staggering one in three of 43.6 million beneficiaries of the federal health insurance program had been prescribed the painkillers.
Medicare, they decided, would now refuse to pay for long-term, high-dose prescriptions; a rule to that effect is expected to be approved on April 2. Some medical experts have praised the regulation as a check on addiction.
But the proposal has also drawn a broad and clamorous blowback from many people who would be directly affected by it, including patients with chronic pain, primary care doctors and experts in pain management and addiction medicine.
Critics say the rule would inject the government into the doctor-patient relationship and could throw patients who lost access to the drugs into withdrawal or even provoke them to buy dangerous street drugs. Although the number of opioid prescriptions has been declining since 2011, they noted, the rate of overdoses attributed to the painkillers and, increasingly, illegal fentanyl and heroin, has escalated.
“The decision to taper opioids should be based on whether the benefits for pain and function outweigh the harm for that patient,” said Dr. Joanna L. Starrels, an opioid researcher and associate professor at Albert Einstein College of Medicine. “That takes a lot of clinical judgment. It’s individualized and nuanced. We can’t codify it with an arbitrary threshold.”
…Dr. Stefan G. Kertesz, who teaches addiction medicine at the University of Alabama at Birmingham, submitted a letter in opposition, signed by 220 professors in academic medicine, experts in addiction treatment and pain management, and patient advocacy groups.
His patients include formerly homeless veterans, many of whom have a constellation of physical and mental health challenges, and struggle with opioid dependence. For them, he said, tapering opioids does not equate with health improvement; on the contrary, he said, some patients contemplate suicide at the prospect of suddenly being plunged into withdrawal.
“A lot of the opioid dose escalation between 2006 and 2011 was terribly ill advised,” Dr. Kertesz said. “But every week I’m trying to mitigate the trauma that results when patients are taken off opioids by clinicians who feel scared. There are superb doctors who taper as part of a consensual process that involves setting up a true care plan. But this isn’t it.”
Some two dozen states and a host of private insurers have already put limits on opioids, and Medicare has been under pressure to do something, too. Last July, a report by the inspector general at the Department of Health and Human Services raised concerns about “extreme use and questionable prescribing” of opioids to Medicare recipients. In November, a report from the Government Accountability Office took Medicare to task, urging greater oversight of opioid prescriptions…
Opponents of the new limit say that doctors are already overwhelmed with time-consuming paperwork and that many will simply throw up their hands and stop prescribing the drugs altogether.
A delay or denial would put chronic pain patients — or those with inflammatory joint diseases, complex shrapnel injuries or sickle cell disease — at risk of precipitous withdrawal and resurgence of pain, doctors said.
The Medicare proposal relies on guidelines from the Centers for Disease Control and Prevention that say doctors should not increase an opioid to a dose that is the equivalent of 90 milligrams of morphine.
But experts say that Medicare misread the recommendations — that the C.D.C.’s 90-milligram red flag is for patients in acute pain who are just starting opioid therapy, not patients with chronic pain who have been taking opioids long-term. The acute pain patient, the guidelines say, should first be offered treatments like acetaminophen or ibuprofen. A short course of a low-dose opioid should be a last resort.
“We didn’t take a specific position on people who were already on high doses,” said Dr. Lewis S. Nelson, the chairman of emergency medicine at Rutgers New Jersey Medical School and University Hospital, who worked on the guidelines.
“We did say that established, high-dose patients might consider dosage reduction to be anxiety-provoking, but that these patients should be offered counseling to re-evaluate,” he added. “There is a difference between a C.D.C. guideline for doctors and a C.M.S. hard stop for insurers and pharmacists.”
Dr. Erin E. Krebs recently released a comprehensive study showing that patients with severe knee pain and back pain who took opioid alternatives did just as well, if not better than, those who took opioids. Nonetheless, she and seven others who worked on the C.D.C. guidelines signed the letter opposing the Medicare rule.
“My concern is that our results could be used to justify aggressive tapering or immediate discontinuation in patients, and that could harm people — even if opioids have no benefit for their pain,” said Dr. Krebs, an associate professor of medicine at the University of Minnesota.
“Even if we walk away from using opioids for back and knee pain, we can’t walk away from patients who have been treated with opioids for years or even decades now,” she added. “We have created a double tragedy for these people.”
The Guardian reports on another study showing a decrease in crime with legalization of marijuana:
The introduction of medical marijuana laws has led to a sharp reduction in violent crime in US states that border Mexico, according to new research.
According to the study, Is Legal Pot Crippling Mexican Drug Trafficking Organizations? The Effect of Medical Marijuana Laws on US Crime, when a state on the Mexican border legalised medical use of the drug, violent crime fell by 13% on average. Most of the marijuana consumed in the US originates in Mexico, where seven major cartels control the illicit drug trade.
“These laws allow local farmers to grow marijuana that can then be sold to dispensaries where it is sold legally,” said the economist Evelina Gavrilova, one of the study’s authors. “These growers are in direct competition with Mexican drug cartels that are smuggling the marijuana into the US. As a result, the cartels get much less business.”
The knock-on effect is a reduction in levels of drug-related violence. “The cartels are in competition with one another,” Gavrilova explained. “They compete for territory, but it’s also easy to steal product from the other cartels and sell it themselves, so they fight for the product. They also have to defend their territory and ensure there are no bystanders, no witnesses to the activities of the cartel.
“Whenever there is a medical marijuana law we observe that crime at the border decreases because suddenly there is a lot less smuggling and a lot less violence associated with that.”
In other words, the experience with marijuana prohibition is similar to what we experienced with alcohol prohibition.
This also shows a failure of our political system. Despite ending prohibition being both the sensible choice, and a choice favored by a large majority of Americans, there has been little pressure to change the system from either major political party. While the two parties find plenty to fight over, there is little difference over what they parties actually do on far too many issues.
Are we now Italy? The Hill reports that a porn star has announced her candidacy for the Democratic nomination:
A porn star and a rapper say they have what it takes to win the White House in 2020.
Cherie DeVille, who’s starred in such videos as “Ass Planet” and “Hot Tub Hottie,” says she was inspired to run for office out of her “personal frustration for the current political climate.”
When Donald Trump won the election last year, DeVille — who’s running alongside rapper Coolio — says she sobbed. “I didn’t cry because I hated [Trump] specifically, I cried because of what I felt that meant for the direction our country was going in.”
“We’re voting for people as if we’re on a reality television show, and my concern is if we continue to purely vote for celebrities, or political figures, or the most entertaining, they’re not always going to be quality politicians,” DeVille told ITK on Tuesday.
So the 39-year-old adult film performer decided to toss her hat in the political ring, saying she’s planning on running as a Democrat.
“If our criteria now for becoming a political official is minor celebrity, I have that,” says DeVille, who boasts 190,000 Twitter followers. “I feel like I can be potentially what I’m feeling the American people — for better or for worse — want, which is interesting news, scandalous news, you know, not ‘boring’ political news.”
“But at the same time [I can] do what the American people really need,” she continues, which is “having a person with integrity, and having someone listen to the people, and actually care about America in public office.”
A former physical therapist, DeVille — whose campaign slogan is “Make America F—— Awesome Again” — says a lot of people “giggle” when they learn that “Gangsta’s Paradise” rapper Coolio is running as her VP.
The Guardian has a story under the headline Christopher Steele believes his dossier on Trump-Russia is 70-90% accurate. So, in other words, he admits that his dossier, which fueled much of the Russia-gate hysteria (and which Clinton and the DNC hid the fact that they paid for) could be 30% false.
Portions of the left and libertarian right do often share some views in common. For example, CounterPunch today has a post on The Logic of Drug Legalization:
The Drug Lords of today exist because of the extraordinary profits resulting from criminalization. Estimates run in the half a trillion range globally per year. By way of comparison there are only twenty or so countries with a national economy of that size. The situation is exactly analogous to the prohibition era. When gunfights, beatings, murders and firebombs were the business strategy of choice for the pushers of alcohol. Once booze was legalized the bootleggers were immediately driven out of business. Alcohol is heavily taxed today there are however no Bootlegging Lords on the playground pushing cheaper booze on our children.
Nor would such pushers exist for any other drug that we might choose to legalize. Sure the criminals could evade the cost of taxes on their product but there are enormous costs incurred by criminal enterprises that don’t apply to legal ones. This is why marijuana today is sold for hundreds of times what it costs to grow. Our legal producers will not be faced with those costs and so can sell to us below current prices on the street. With profit margins cut to the bone the ‘dread lords and masters’ that control the illegal drug market today will simply melt away like the last snow before the advancing spring…
Matthew Yglesias writes at Vox, Bill Clinton should have resigned: What he did to Monica Lewinsky was wrong, and he should have paid the price. What is amazing about this is that it comes from a usually very pro-Democratic Party source. Now that they aren’t concerned about white washing the past for Hillary, some Democrats might be able to face the truth about at least some aspects of their party.
Also at Vox, yet another reason to oppose the Republican tax bill: Republicans’ tax bill could trigger a $25 billion cut to Medicare.
Periodically I see articles from people who have good intentions but don’t understand how health care really works argue that we should end private practice and have all doctors become employees to save costs. The reality is that this trend has increased costs rather than save money, as discussed in this article at Modern Healthcare entitled Hospital-employed physicians drain Medicare:
“When hospitals grow their physician network, with a subsidy of $150,000 to $200,000 per physician, they have to cover those costs by driving ancillary services and (getting more people) in hospital beds,” said Dr. Jeffrey LeBenger, CEO of Summit Health Management, an integrated, physician-led independent physician group that includes some 800 doctors. One of the main drivers of physician acquisitions is to increase referral networks, he said.
Prohibition of any type generally leads to failure. These police might be trying to stop drug trafficking, but their efforts did not turn out as they desired, turning into a fight between cops of Detroit’s 12th Precinct and 11th Precinct. As a Detroit television station reported:
On Thursday Detroit police certainly tried, but maybe too hard.
Sources say it started when two special ops officers from the 12th Precinct were operating a “push off” on Andover near Seven Mile. That is when two undercover officers pretend to be dope dealers, waiting for eager customers to approach, arresting potential buyers and seizing their vehicles.
But this time instead of customers – special ops officers from the 11th Precinct showed up. Not realizing they were fellow officers, they ordered the other undercover officers to the ground.
FOX 2 is told the rest of the special ops team from the 12th Precinct showed up, and officers began raiding the drug house in the 19300 block of Andover. But instead of fighting crime, officers from both precincts began fighting with each other.
Sources say guns were drawn and punches were thrown while the homeowner stood and watched. The department’s top cops were notified along with Internal Affairs. One officer was taken to the hospital.
Each officer involved is now under investigation – as the department tried to determine what went wrong.
The report called this, “A case of the good guys going after the good guys.” I’m not so sure about such a description for cops trying to capture people by such entrapment. As the libertarian magazine Reason concluded, with the battle limited to police versus police, “at least the collateral damage was kept to a minimum. Maybe this is how the war on drugs should be waged from now on.”
The Republicans have failed to repeal and replace Obamacare, primarily because they never had a sensible replacement plan. It took three Republicans to block the final attempt, with John McCain casting the deciding vote. Now that he will not be on the ballot again, it was easiest for McCain to do this, allowing other Republicans who opposed the bill to cast a politically safer party-line vote. McCain might have also felt some satisfaction in thwarting Trump’s agenda after Trump’s past attacks on McCain, claiming McCain was not a war hero because he was captured.
Hopefully attempts at repealing Obamacare are dead–at least until a more liberal Congress has the votes to pass a single payer plan to replace it. Some are still claiming that they can propose a new bill which can achieve fifty-one votes, but any new efforts will have the same problems trying to please both wings of the party.
A more hopeful sign is a bipartisan group in the House which claims to be working together to improve Obamacare rather than repeal it. So far there has been no sign of bipartisan cooperation on health care, but there is a remote chance that matters have changed now that the Senate has been unable to pass any of its attempts at repeal. Sensible Republicans should realize that they will be held accountable for the success or failure of health care. Obamacare is the law of the land. Donald Trump and the Republican Congress now own it.
Maybe repeal and replace isn’t such a bad concept after all, except that Congress had the wrong target.
How about repealing the authorization to go to war and replacing our failed foreign policy? How about repealing the Patriot Act and replacing it with a policy which provides for needed security while respecting our Constitutional rights? How about repealing the drug war and replacing it with treatment where needed?
Of course this will never happen as there will be too much opposition from both parties. Can we just repeal and replace our current dysfunctional two-party duopoly?
With Donald Trump facing considerable criticism for the firing of James Comey (along with multiple other faults), we must also keep in mind that there are other terrible people in his administration. Among them is Attorney General Jeff Sessions. The Hill reports that Democrats are questioning his role in the firing of Comey:
The top Democrats on two powerful House committees are calling for a report on possible disciplinary actions against Attorney General Jeff Sessions for his role in FBI Director James Comey’s firing.
The Democrats say Sessions may have violated his pledge to recuse himself from any investigations involving Russia’s effort to influence U.S. elections.
In a letter to Deputy Attorney General Rod Rosenstein, House Oversight Committee ranking member Elijah Cummings (D-Md.) and Judiciary Committee ranking member John Conyers Jr. (D-Mich.) pressed the Justice Department to explain Sessions’ role in President Trump’s decision to fire Comey.
“Federal law sets forth as a penalty for recusal violations removal from office, and the Attorney General’s violation in this case appears to be particularly grave,” the letter reads.
This criticism isn’t limited to Democrats. Conservative columnist Jennifer Rubin has a similar opinion:
Refusing to recuse oneself from a conflict or breaking the promise to recuse from a conflict is a serious breach of legal ethics. “Someone could file a bar complaint, and/or one with DOJ’s office of professional responsibility, if Sessions had a conflict of interest when it came to the firing decision, and if he did not follow the ethics rules, including those of DOJ by acting when he had a conflict of interest,” legal ethics expert Norman Eisen tells me. “The fact that he broke his recusal commitment, if he did, would be relevant context, and violating an agreement can sometimes in itself be an ethics violation.” In sum, Sessions has risked his law license, whether he realized it or not. He needs to testify immediately under oath; if there is no satisfactory explanation, he must resign. The alternative could be impeachment proceedings.
Yes, impeachment. The Attorney General appears to have committed grounds for impeachment. In addition, Donald Trump firing Jame Comey because he refused to pledge loyalty to him may be worse than firing him to obstruct the Russia investigation. Either way, it is grounds for impeachment, not that we can count on the Republicans to act on this.
But back to Jeff Sessions, he is also showing that he is a problem with regards to policy, seeking to escalate the failed drug war by increasing sentences for violations of current drug laws. Former Attorney General Eric Holder responded by calling Sessions’s policy “dumb on crime.”
“It is an ideologically motivated, cookie-cutter approach that has only been proven to generate unfairly long sentences that are often applied indiscriminately and do little to achieve long-term public safety.”
In the memo, Sessions told federal prosecutors to “pursue the most serious, readily provable offense” that by definition “carry the most substantial guidelines sentence, including mandatory minimums.”
Holder also said, “Abandoning this evidence-based progress and turning back the clock to discredited, emotionally motivated, ideological policy also threatens the financial stability of the federal criminal justice system.”