The Drug War Extends To Medicare Patients

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.”

Democratic Pundit Disputes Myth That Progressives Are Less Electable Than More Conservative Democrats

Democrats suffered serious losses in Congressional and state races in 2010 and 2014 after running as a Republican-lite party. Despite trying to shift the blame to Russia and others, Democrats lost the 2016 election to a candidate as terrible as Donald Trump by nominating a corrupt conservative warmonger who has spent her career undermining liberal values. Finally we are seeing people question the conventional wisdom that nominating more conservative candidates will increase the chances for Democrats to win. I looked at this issue yesterday, and found that Bud Budowsky, a Democratic columnist at The Hill, has written a column on the same topic.

Budowsky wrote that A Sanders-Warren ticket could win big in 2020. Besides this ticket, Budowsky discussed two other hypothetical Democratic tickets, Joe Biden-Amy Klobuchar and Joe Kennedy III with either California Attorney General Xavier Becerra or Senator Kamala Harris. He wrote the following in favor of a more progressive ticket:

Behind the scenes of the national Democratic Party, it is commonly accepted wisdom, though not proven by facts, that the most progressive candidates are not the most electable candidates. In some states and districts this might be true.

But, in terms of winning the national popular vote and an electoral vote majority, there is a credible case that the most clearly progressive and politically aggressive Democrats can indeed win, and potentially win big.

The most important and powerfully persuasive data in modern American politics is that virtually every poll in 2016 showed Sanders defeating Donald Trump by 10 percent or more. In the Real Clear Politics summary of 2016 polling, Sanders ran ahead of Trump by an average margin of more than 10 percent and often by much larger margins.

Whether one supports Sanders or any other potential candidate in 2020, the case is clear that a strong progressive program and message would give Democrats a decided advantage in any campaign against the scandal-ridden and crony-capitalist-dominated presidency of Trump and his GOP allies in Congress…

While I could support Sanders, Warren or any of the progressive Democratic change candidates who could run on the ticket in 2020, it is important to disabuse the false notion, which is contrary to the facts demonstrated by national polling throughout 2016 and beyond, that progressive candidates are less electable.

Americans want a clear message of progressive change and would enthusiastically support a Sanders-Warren ticket, or any other ticket running on a similar program in 2020.

I agree with nominating candidates who have a clear message and stand for change. My one nitpick is that I would not limit this to progressive economic ideas. While Bernie Sanders did concentrate on this message in 2016, there were other factors which led many to support him over Hillary Clinton. It was partially over character, but there were other issues too. One study argues that Clinton lost because of being a warmonger. While I question if this was the main factor, foreign policy is important. Democrats attracted new voters when they opposed neoconservatives while George Bush was in office. They lost votes when they nominated a neocon interventionist such as Hillary Clinton, whose policies have caused considerable death and suffering around the world.

Sanders’ views on social and cultural issues were also far more attractive to voters than than Clinton’s socially conservative views. Many voters, especially young voters, are more socially libertarian. Democrats might be preferable to Republicans on reproductive rights, but fail to consistently support policies to reduce the role of government in the private lives of individuals. In addition to Clinton’s support for military interventionism, and the toleration of this by establishment Democrats, there is their support for the drug war. Clinton did not change her views on same-sex marriage until it became politically inexpedient to continue to oppose it. While it is still a government program, support for single payer healthcare, which Clinton campaigned against and the DCCC continues to oppose, is far more acceptable than government mandates pushed by Clinton to purchase private insurance plans with outrageous deductibles.

It is a good sign that more Democrats are paying attention to Bernie Sanders’ criticism of corporate Democrats, along with his support for Medicare-for-All.  If Democrats are to rebuild a winning majority, they should more consistently challenge establishment views in other areas too.

Bernie Sanders’ Response To The State Of The Union Address (Including Full Transcript)

Last night Bernie Sanders was one of five Democratic responses to the State of the Union Address, including Joe Kennedy III’s official response. Sanders criticized Trump for promising to provide “health insurance for everybody,” with “much lower deductibles,” but instead supporting legislation that “would  thrown up to 32 million people off of the health care they had while, at the same time, substantially raising premiums for older Americans.”

Sanders noted that Trump had promised “promised not to cut Social Security, Medicare or Medicaid.” Instead, “he supported a Republican Budget Resolution that proposed slashing Medicaid by $1 trillion and cutting Medicare by $500 billion. Further, President Trump’s own budget called for cutting Social Security Disability Insurance by $64 billion.”

In addition to calling out Trump for breaking his campaign promises, Sanders noted many things which Trump failed to talk about, including climate change and voter suppression.

While overall a good speech, there were things which I wish Sanders had said, and one thing statement which was misleading. As has generally been the case with Democrats, there was nothing said about restrictions of civil liberties–passed with the cooperation of many Democrats. Nor were there protests over the never-ending war which Democrats are now accepting as the status quo. Nothing was said about the drug war, while Joe Kennedy III , among other Democrats, has been on the wrong side of this issue. This is what I want to see from a true resistance.

Sanders also stated that the Russians “interfered in our election in 2016, is interfering in democratic elections all over the world.” While technically true, this plays into the hysteria being spread by Democrats, often based upon misinformation. While true that Russia meddled in our election, this must be kept in context that Russia has meddled in elections for decades–just as the United States has frequently meddled in foreign elections. Russian meddling has also been highly exaggerated. There is also no evidence that Russia had any effect on the election results. The information obtained through the Congressional hearings has shown that claims about Russian tampering with the election have been have been of little consequence. Similarly, multiple media reports of Russian hacking were subsequently retracted as false. I would hope that Sanders would know better to play into the misleading claims of Democrats who are distorting the facts to deny the blame they deserve for losing to Donald Trump due to choosing a candidate as terrible as Hillary Clinton, along with playing into the hands of neocons who are distorting Russian electoral interference as they used false claims of WMD in Iraq to promote their goal of regime change in Russia.

The video can be seen here and the full text of Sanders’ speech is below:

(more…)

Porn Star Running For Democratic Nomination & Other Political Briefs

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.

Drug War Gone Wrong: Cops Fighting Cops

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.”

Repeal And Replace Fails–Perhaps Congress Had The Wrong Target

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?

Trump Supporter Roger Stone Forming Coalition To Push For Legalizing Marijuana

As has been the case with other issues, Donald Trump has been inconsistent in his statements and actions related to marijuana. One longtime adviser, Roger Stone, plans to work with people of various political ideologies to push for legalization of marijuana. Another goal is to have marijuana rescheduled to Schedule I so that it can be prescribed by doctors. Business Insider reports:

Longtime Trump adviser and staunch conservative Roger Stone has a new mission: legalizing marijuana nationwide.

Stone announced on Friday at the Cannabis World Congress and Business Expo in New York the formation of the bipartisan United States Cannabis Coalition, an advocacy group with the express purpose of protecting state’s rights to legalize and regulate marijuana…

“I am going to be working with a coalition of Republicans and Democrats, progressives and libertarians, liberals, and conservatives to persuade the president to keep his campaign pledge,” Stone said in a talk on Friday, “and to remind the president that he took a strong and forthright position on this issue in the election.”

Former Minnesota Gov. Jesse Ventura will join Stone in the advocacy group, as well as a host of both Republican and Democrat political strategists.

Stone pointed to the decreased rates of incarceration for low-level drug offenses and opioid-related overdoses in states that have legalized marijuana, along with the boon in tax revenue and job creation.

During the campaign, Trump told The Washington Post that legalizing marijuana should be a “state issue,” and he expressed “100%” support for medical marijuana in an interview with Bill O’Reilly in 2016…

Trump hasn’t been friendly to marijuana since he took office. Attorney General Jeff Sessions is a noted opponent of marijuana legalization, and he asked Congress in recent days to roll back federal protections for medical marijuana.

The protections in question, the Rohrabacher-Farr Amendment, directs the Department of Justice to refrain from spending money to enforce federal medicinal marijuana laws.

Sessions has also called for a review of a 2013 directive from the Obama Administration, known as the Cole Memo, which stipulates that the Justice Department place “low priority” on enforcing marijuana laws against businesses and organizations that comply with state law.

“In all honesty it’s time for [President Trump] to tell Attorney General Jeff Sessions to cut the shit,” Stone added.

Stone also called out Homeland Secretary John Kelly, who has called for a federal crackdown on legal marijuana.

Geek.com has more, but prefaced this with a look at Stone’s record:

Roger Stone is bad. This is known.

The depths of the veteran Republican strategist’s consummate shittiness are like a rotting onion. Layer upon layer of dirty political tricks and cons from a conspiracy theorist and serial liar who has found his way behind the scenes into most of the major political controversies and scandals of the past 40-plus years. The Nixon acolyte been allegedly involved in everything from Watergate and the 2000 Florida recount to the Eliot Spitzer prostitution scandal and of course, his decades-long friendship and association with President Donald Trump (and alleged back-channel involvement with WikiLeaks in the current Russian hacking scandal).

Stone has routinely made racist, sexist, and Islamophobic statements in public and on Twitter, which led to a ban from appearing as a commentator on CNN and MSNBC. Stone showed up to President Trump’s inauguration in an outfit that can only be described as 19th-century robber baron Mr. Peanut meets Oswald Cobblepot. He has a website called the Stone Zone. These trifles alone are irrevocable proof of his objective shittiness.

Nonetheless, Roger Stone may be one of our best hopes for marijuana legalization in this the Year Of Our Lord 2017…at least while Donald Trump is still running the show.

This is an issue which crosses party lines, as Stone himself noted when he praised Bernie Sanders and chastised Hillary Clinton, who has also been a hard line opponent of ending marijuana prohibition and was the most conservative candidate on the issue during the last presidential campaign:

“I’ve looked, I can’t find Hillary Clinton ever coming out for the legalization of cannabis, and this astounds me. I salute Bernie Sanders because he had the courage to say it. I salute Gary Johnson and Dr. Jill Stein; they had the courage to say it. Donald Trump had the courage to stand up for medical marijuana on a states’ rights basis. Where was Hillary?”

While Stone was right that Clinton was too conservative on this (along with other social/cultural issues), Donald Trump has not done any better in turning the matter over to others who are conservative on the issue. It is unknown whether Stone has enough influence on Trump to change this. His description of the political spectrum is also flawed:

“The essence of old-fashioned Barry Goldwater-style conservatism is I don’t want the government telling me what I can smoke,” said Stone. “To me, when the government tells you how to live, what you can ingest, well that’s the essence of big government liberalism, which I oppose.”

His claim of “big government liberalism” being on the other side of the issue might apply to some liberals, but in general polls have shown that liberals are more likely than conservatives to support legalization. Fortunately Stone does understand this enough to be forming an alliance with liberals along with conservatives and libertarians.

Democratic Party Stronger Without The Clintons

The 2016 election was unique in which, while their partisans might not realize it, each party would be better off if their candidate lost the presidential election. Both parties had horrible candidates, and each party would pay a price if their candidate was president. The damage to the Republican brand since Trump has been elected has been obvious. This distracts from noticing the benefits to Democrats from not being dragged further to the right by DLC Democrats such as the Clintons.

Democrats have misread recent politics in seeing Bill Clinton’s victory as evidence that the path of the Democratic Leadership Conference was the way to win. In reality, Bill Clinton won due to his own personal political skills, not by his desire to turn the Democratic Party into a Republican-Lite Party. The Clinton/DLC philosophy too conservative and out of date in the 1990’s, and it is even less relevant to the 21st century. Democrats lost off year elections in 2010 and 2014 by running as Republican-Lite and refusing to stand for anything. This culminated in nominating Hillary Clinton, who managed to lose to Donald Trump.

While Clinton partisans will never agree, polling data and the election results presents a pretty strong case that if the Democrats had nominate Bernie Sanders instead of Clinton they could have won the White House, and probably taken control of the Senate. The Democratic establishment has totally misread the mood of the country and were misled by an out-dated left/right linear political spectrum, failing to see that many independents would vote for Sanders, but not for Clinton.

While the Democratic establishment still desires to exclude Sanders, others are giving him credit for revitalizing the Democratic Party. Buzz Feed editor Ben Smith writes, While You Were Watching Trump, The Democratic Party Changed: Bernie Sanders lost the primary but reshaped his party.

“What happened in the presidential campaign is that Bernie ran explicitly in support of a Medicare-for-all approach” — a simple framework for single-payer — “and what the politicians saw is that voters were fine with that,” said Vermont Rep. Peter Welch, a longtime advocate of single payer.

“It’s inclusive and it doesn’t get us into the identity politics divisions that are problematic,” he said. “It gets us into inclusive politics.”

And if Sanders made single-payer safe for Democrats, Trump’s extremely unpopular foray into health care policy with the American Health Care Act has created a new landscape. Democrats’ blend of private-sector structures with government money and incentives, Obamacare, never became truly popular. A Republican version of that hybrid system, tilted toward the markets and away from guarantees, isn’t popular either.

“Then the default becomes, well the private market doesn’t work, the next thing is single-payer,” said an insurance industry executive close to the politics of the issue, who noted that the CEO of Aetna recently shocked the industry by calling for a serious debate about what single-payer would look like. (To the insurance industry, it could look like a new sluice of predictable revenue.)

“This is probably going to be like what happened with Republicans on immigration,” the insurance industry official said. “You may even have a bigger swath of Democrats who are not for single-payer but the single-payer group is becoming so outspoken that other voices are muted.”

It remains to be seen whether the Democratic Party will really change for the better, but there was little or no hope if a politician as conservative as Hillary Clinton had won and had the opportunity to shape the party. While she claims at times to be a progressive, she is a “progressive” who fights for conservative results. Clinton was hardly progressive when she supported making flag burning a felony, censoring video games, supported restricting freedom of speech to fight terrorism, defended the use of cluster bombs in civilian areas, supported parental notification laws, making abortion rare (a statement which stigmatizes women who have abortions and plays into GOP attempts to restrict abortions), leaving gay marriage up to the states (a position she finally changed but lagging behind the country tremendously), the Patriot Act, the discriminatory Workplace Religious Freedom Act, working with the Fellowship in the Senate to increase the role of religion in public policy and undermine the principle of separation of church and state, opposed single payer health care, opposed needle exchange programs, supported a hard line on the drug war, promoted increased government secrecy, supported going to war in Iraq war based upon false claims of a connection between Saddam and al Qaeda (without even bothering to read the intelligence material made available for members of the Senate), pushed for military intervention in Libya and Syria, and resuming the Cold War with Russia.

If Clinton was president, far too many Democrats would be rationalizing and defending Clinton’s views and actions. Instead, the defeat of Clinton opens the door for a more liberal Democratic Party. It also increases the chances of Democratic gains in 2018. If Clinton had been elected, we would probably see a continuation of Democratic loses in Congress and state governments. Instead there is talk of a possible Democratic wave in 2018. For many matters, the state government has more day to day impact on our lives than the federal government. For those of us who saw our state governments get taken over by Republicans since 2010, the defeat of Clinton gives hope of throwing the Republicans out.

With Trump in the White House, we have terrible policies, but also massive opposition to him. Plus with Trump in the White House, we have the added benefit of seeing the Republican president being the subject of scandals and possible impeachment, instead of the inevitable scandals to be seen under Hillary Clinton. The manner in which she spent the last couple of years repeatedly lying about the email and Foundations scandals should provide additional warnings about what could be expected with Clinton in the White House.

Donald Trump has been a terrible president, but it would have been a disaster regardless of who won. At least there is now  hope for a better future.

A Failed Administration: Both President And Attorney General May Have Committed Impeachable Offenses

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.”

Hypocritical Attacks On Sanders From The Clinton Camp

I supported Bernie Sanders for the 2016 presidential nomination. As will probably always be the case, this was because he was the best choice available, not because I agree with him on all matters. One major area where we differed  was in Sanders’ stressing economic matters, while my support for Sanders was more heavily influenced by opposition to Clinton-style military interventionism and on social issues. Despite the manner in which Sanders prioritized economic issues, he did have strong liberal positions in other areas, including being more liberal than Hillary Clinton on abortion rights.

I have my doubts about Sanders campaigning for an anti-abortion candidate in Omaha, but this has no bearing on wanting to see the Democratic Party move in the direction of Sanders as opposed to moving to the right with Hillary Clinton and her supporters. In contrast, many Clinton supporters are using this as yet another reason to attack Sanders.

I understand the problems some Clinton supporters have with Bernie Sanders campaigning for a candidate with Heath Mello’s position on abortion. However, I would have more respect for their position if they didn’t support a candidate like Hillary Clinton who supported greater military intervention in Iraq, Libya, and Syria, pushed for a resumption of cold war tensions with Russia, has supported suppression of civil liberties to supposedly fight terrorism, introduced legislation to make flag burning by protesters a felony, opposed same-sex marriage until this was no longer a position which she could survive with politically, sided with Republicans in blocking legislation to ban cluster bombs in civilian areas, has supported mass incarceration and remains hawkish on the drug war, opposed needle exchange programs, opposed programs to distribute free condoms to reduce the spread of AIDS, worked with the Fellowship while in the Senate to increase the role of religion in public policy, has strongly opposed government transparency, supported the Workplace Religious Freedom Act, has engaged in influence peddling, has opposed single-payer health care, ran as a “pro-gun churchgoer” in 2008, has supported restrictions on abortion herself, and has repeatedly acted to protect the corrupting influence of money in politics.

It is rather hypocritical that they can ignore all of this with Clinton, but now demand ideological purity from Bernie Sanders. Fighting the Republican attempts to restrict reproductive rights is important, as are the other issues I mentioned above. Considering how conservative Hillary Clinton is on foreign policy, First Amendment issues, and social/cultural issues, and how she has spent much of her career undermining liberal goals, nobody who supports Hillary Clinton is in any position to criticize Sanders over campaigning for Mello.