New York Times Reports, “Democrats Embrace Liberal Insurgents, Demanding New Face for Party”

The Democratic Party establishment has desired to nominate more moderate candidates, even in safe Democratic areas where they could not use their questionable arguments that more moderate candidates are more electable. Earlier in the year we saw examples of how the party establishment has attempted to suppress insurgent candidates. The New York Times notes how the Democratic Party establishment is having problems this year:

…Democratic voters and activists have increasingly succeeded at transforming their party into a more ambitious liberal force. In key races, they have also replaced elected leaders with newcomers who look and sound like the diverse, youthful base that the party relies on in presidential elections but that asserts itself sparingly in midterm elections and down-ballot primaries.

Should that mood of insurgency prevail on Election Day, it could set the stage for an even more tumultuous phase of redefinition next year: A liberal base that feels validated after November may be unlikely to heed calls from party leaders to pick their battles in the new Congress, or to approach the 2020 race with sensitivity to more conservative sections of the country. The next presidential primaries could become a climactic test for the awakened Democratic base, with women and candidates of color holding an appeal others might struggle to match.

Martin T. Meehan, a former member of Congress from Massachusetts, a state rocked on Tuesday by primary upsets, said Mr. Trump had helped fuse once-fractious Democratic constituencies into a powerful alliance for primary season. Mr. Meehan, now the president of the University of Massachusetts, likened it to earlier moments of political realignment, when ethnic groups like Italian-, Irish- and Greek-American voters learned to work together in the middle of last century…

The most dramatic upsets have come in New York, where Alexandria Ocasio-Cortez, a 28-year-old activist and former bartender, defeated Representative Joseph Crowley, a Democratic boss in Queens and Washington, in a June primary; and Massachusetts, where Ayanna Pressley, a 44-year-old member of the Boston City Council, on Tuesday wrested the nomination away from Representative Michael Capuano, a 10-term progressive she branded as passive and conventional. Both women channeled liberal alarm at Mr. Trump and at social inequality in their own communities, and promised an unyielding fight for change…

In some revealing open-seat races, Democratic voters have also flouted the directives of party leaders and embraced inspiring activists. They nominated Jahana Hayes, an African-American educator, for Congress in Connecticut over a candidate approved by the state Democratic Party, and picked Andrew Gillum, the African-American mayor of Tallahassee, for governor of Florida over a field of better-funded candidates that included the scion of an imposing dynasty.

…Democratic insurgents predict that the party’s shifting attitude toward primary elections is more likely to intensify than recede. As Republican power brokers have found in recent years, once-potent instruments for enforcing partisan hierarchy have diminished in value: Political newcomers have deftly used online fund-raising and social media-based campaign tactics to replace the access to big donors and television airwaves that party leaders can more easily control.

And in Washington, as the number of Democratic upstarts elected to Congress grows, party leaders may face new pressures in navigating primary elections..

In keeping with Massachusetts political convention, Mr. Capuano mobilized a set of muscular institutions behind him, drawing endorsements from labor unions and influential Democrats including Boston’s mayor, Martin J. Walsh; Deval Patrick, the state’s first African-American governor; and black congressional leaders like John Lewis and Maxine Waters.

All that support was not decisive, and Ms. Pressley won by 17 points.

Sam Yoon, a former member of the Boston City Council, said Ms. Pressley’s victory had exposed a momentous cultural transition in the party. Mr. Yoon, 48, mounted a campaign nearly a decade ago against the legendarily iron-fisted former mayor, Thomas M. Menino, attempting unsuccessfully to energize young progressives and minority communities in a movement for change.

“I think the dynamic is just wide-open now,” Mr. Yoon said. “The establishment doesn’t have the hold that it used to.”

While we are undoubtedly seeing a reaction against Donald Trump, the changes in the Democratic Party are likely to be more a reaction to how the party leaders forced a candidate as conservative as Hillary Clinton on the party in 2016–and the excitement created by the campaign run by Bernie Sanders. The winners this year also make a mockery of the bogus “Bernie Bros” smears used by Clinton supporters against the left. Alexandria Ocasio-Cortez, Ayanna Pressley, Jahana Hayes, and Andrew Gillum are certainly not the stereotypical white male Bernie Bros which Clinton supporters falsely claimed made up their opposition.

Among those now excited by the successes of the left are Barack Obama, who has returned to public life this week in a speech praising Medicare for all: “Democrats aren’t just running on good, old ideas like a higher minimum wage. They’re running on good, new ideas like Medicare for all,” Obama said. Perhaps Obama should have backed Sanders in 2016 over the Clinton, who campaigned against the plan. At very least, someone who had become president with promises of hope and change should have realized that a candidate as conservative and corrupt as Hillary Clinton was a poor choice in a year when voters demanded change.

Abdul El-Sayed Attempting To Bring Progressive Wave To Michigan In Key Primary This Week

The goal this year must not only be to elect candidates to oppose Trump, but to also reform the Democratic Party (which is responsible for the situation in 2016 which enabled Trump to be elected president). Tuesday provides an opportunity for another progressive upset in Michigan, but it will be a challenge due to the presence of both a real progressive (Abdul El-Sayed) and a faux progressive (Shri Thanedar) who will divide the vote against establishment candidate Gretchen Whitmer.

El-Sayed is running on a platform similar to that of Bernie Sanders. Sanders has endorsed El-Sayed, and came to Michigan to campaign for him on Sunday. The previous weekend, Alexandria Ocasio-Cortez, who was responsible for a major upset over the Democratic establishment, came to campaign for El-Sayed. He was also recently endorsed by The Nation and previously received endorsements from groups including  Justice DemocratsOur RevolutionThe People for BernieOur Revolution, the Progressive Caucus of the Michigan Democratic Party, and Democracy for America.

El-Sayed is behind in the polls, but victory might be within reach. Progressives are encouraged by the greater enthusiasm seen for his campaign as compared to his opponents. Progressives are also encouraged by the memories of Bernie Sanders coming back from twenty-points behind just prior to the Michigan Democratic primary in 2016 to upset Hillary Clinton. The polls missed support for a progressive alternative to the Democratic establishment then, and could be doing so again.

The front runner, Gretchen Whitmer, is the daughter of a former president and  CEO of Blue Cross Blue Shield of Michigan, and the recipient of their money. She is also the only Democratic candidate who opposes single payer health care. She has also benefited from dark money contributions, which has become an issue in the race.  When she twisted the facts to respond to El-Sayed, the Truth Squad at a Michigan newspaper called her claims “mostly inaccurate” as she tried to equate contributions from private individuals with her corporate contributions.

The task of upsetting the establishment candidate is made more difficult by the presence of faux-progressive Shri Thanedar, who is running as a progressive for strategic reasons, and has put $10 million of his own money into the race.  Hopefully the efforts of Bernie Sanders, Alexandria Ocasio-Cortez, and several progressive groups will lead to progressives coming out to vote for the true progressive candidate in the race, Abdul El-Sayed.

Two Candidates Running As Bernie Sanders Style Progressives In Michigan Threaten To Split Vote, With Only One Worthy Of Progressive Support

There has been a lot of talk lately about an anti-establishment fervor in the Democratic Party, largely fueled by both dissatisfaction with the status quo and the manner in which the DNC rigged the rules to block challengers to Hillary Clinton in 2016. Clinton’s inability to beat a candidate as terrible as Donald Trump cast more doubt on the party establishment’s strategy of promoting moderate candidates. Alexandria Ocasio-Cortez’s victory over party insider Joseph Crowley in New York’s 14th congressional district Democratic primary gave additional hope for progressive and true liberal Democrats hoping to beat the party establishment. In Michigan efforts to beat establishment candidate Gretchen Whitmer (who would still be far preferable to GOP front runner Bill Schuette) for the nomination for Governor might be thwarted by two candidates running as progressives in Michigan who are likely to split the vote.  However, only one is a true progressive.

While both Abdul El-Sayed and Shri Thanedar are running as Bernie Sanders style progressives, only El-Sayed looks like the real deal. The Intercept has had multiple articles exposing Thanedar as an opportunist. In a new article today, The Intercept shows how they differ on health care, but first recapped the case against Thanedar:

In Michigan, businessperson Shri Thanedar has spent millions of dollars on television ads casting himself as “the most progressive Democrat running for governor,” and promising that he would bring single-payer health care to Michigan.

“Health care is not a privilege; it is our fundamental right. I will bring single-payer health care to Michigan,” Thanedar says in a TV commercial. “Agree? Vote for Shri.”

But there’s reason to be skeptical.

Over the last year, investigations by The Intercept have revealed many facts which cast doubt on Thanedar’s progressive branding. He donated thousands of dollars to Sen. John McCain’s presidential campaign, he was spotted clapping and nodding approvingly at a Marco Rubio presidential rally, and several Michigan political consultants have claimed that Thanedar once consulted them about possibly running as a Republican.

The Intercept interviewed Thanedar and found that “Thanedar’s much touted single-payer health care ‘plan’ appears to be nonexistent.” In contrast, they found that former Detroit Public Health chief Abdul El-Sayed “has a detailed strategy for how to accomplish it.” However, Thanedar is likely to split the progressive vote due to having spent much more on advertising. The Intercept notes:

Last month, he released a plan to establish “Michicare,” which would levy payroll and business taxes to establish state-funded public coverage for all Michigan residents…

But despite having a more well-developed plan, El-Sayed’s middle-class background means he does not have the same resources to advertise his health care plan as does Thanedar, who, not without controversy, made a fortune in the chemical testing industry.

As a result, there’s a real risk that the public might be misled.

The article also notes how this will impact the race against establishment candidate Gretchen Whitmer:

But by coopting a progressive message and splitting the progressive vote, Thanedar has helped Whitmer, an establishment candidate, take a comfortable lead.

Whitmer is the daughter of former Blue Cross Blue Shield CEO Richard Whitmer. She’s the only Democratic candidate in the race who does not back single-payer, saying that it’s not “realistic” in Michigan at this time. BCBS Michigan lobbyists threw a fundraiser for Whitmer earlier this year. And she’s currently taking heat from an unidentified group who have paid for ads attacking her from accepting “big money” from insurance companies.

El-Sayed has been endorsed by Justice Democrats, Our Revolution, The People for Bernie, Our Revolution, the Progressive Caucus of the Michigan Democratic Party, Democracy for America, and after her victory in New York, by Alexandria Ocasio-Cortez. Whitmer has a long list of establishment endorsements. I am not aware of any significant endorsements for Thanedar but the Grosse Pointe Democratic Club has issued an anti-endorsement for Thanedar warning Democrats NOT to vote for him.

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.”

Small Government Foolishness–CDC To Cut Efforts To Reduce World Disease Outbreak By 80%

In the right situation, I’m all for limited government. Reduce foreign interventionism and the surveillance state. Get government out of the private lives of individuals–including regulation of reproductive rights. Unfortunately, when Republicans talk about limited government it generally turns out to be reducing the safety net or cutting important functions which often represent a very small part of the budget. The Wall Street Journal reports, CDC to Scale Back Work in Dozens of Foreign Countries Amid Funding Worries:

The Centers for Disease Control and Prevention plans to scale back or discontinue its work to prevent infectious-disease epidemics and other health threats in 39 foreign countries because it expects funding for the work to end, the agency told employees.

The CDC currently works in 49 countries as part of an initiative called the global health security agenda, to prevent, detect and respond to dangerous infectious disease threats. It helps expand surveillance for new viruses and​ ​drug-resistant bacteria, modernize laboratories to detect dangerous pathogens​and train workers who respond to epidemics.

The Washington Post adds:

Global health organizations said critical momentum will be lost if epidemic prevention funding is reduced, leaving the world unprepared for the next outbreak. The risks of deadly and costly pandemic threats are higher than ever, especially in low- and middle-income countries with the weakest public health systems, experts say. A rapid response by a country can mean the difference between an isolated outbreak and a global catastrophe. In less than 36 hours, infectious disease and pathogens can travel from a remote village to major cities on any continent to become a global crisis.

On Monday, a coalition of global health organizations representing more than 200 groups and companies sent a letter to U.S. Health and Human Services Secretary Alex Azar asking the administration to reconsider the planned reductions to programs they described as essential to health and national security.

“Not only will CDC be forced to narrow its countries of operations, but the U.S. also stands to lose vital information about epidemic threats garnered on the ground through trusted relationships, real-time surveillance, and research,” wrote the coalition, which included the Global Health Security Agenda Consortium and the Global Health Council.

The coalition also warned that complacency after outbreaks have been contained leads to funding cuts, followed by ever more costly outbreaks. The Ebola outbreak cost U.S. taxpayers $5.4 billion in emergency supplemental funding, forced several U.S. cities to spend millions in containment, disrupted global business and required the deployment of the U.S. military to address the threat.

“This is the front line against terrible organisms,” said Tom Frieden, the former CDC director who led the agency during the Ebola and Zika outbreaks. He now heads Resolve to Save Lives, a global initiative to prevent epidemics. Referring to dangerous pathogens, he said: “Like terrorism, you can’t fight it just within our borders. You’ve got to fight epidemic diseases where they emerge.”

…Officials at the CDC, the Department of Health and Human Services and the National Security Council pushed for more funding in the president’s fiscal 2019 budget to be released this month.

Trump’s First Year Was Terrible, But Things Could Have Been Worse

It is fitting that Donald Trump, who claimed that “I alone can fix it,” couldn’t make it through his entire first year without breaking the government. Donald Trump has been among the worst presidents ever. However, while the past year under Trump might have been the worst of times, it was not the worst of all possible times. Trump’s first year has been terrible, but we must also be appreciative all those spared from dying in Hillary’s wars over the past year.

Donald Trump and the Republicans have been terrible on many issues, including health care, race, and immigration. As I had previously predicted, Trump has been totally incoherent on foreign policy. He has escalated a potential nuclear crisis in North Korea, but we also must not forget that Hillary Clinton was largely responsible for the situation and peace would have probably have been impossible if she was in the White House. Clinton’s push to overthrow Muammar Qaddafi based upon lies after he surrendered his nuclear weapons, along with her joining with her neocon allies in lying us into the  Iraq war, have been cited by both Kim Jong-un and Vladimir Putin as reasons for their nuclear buildup and other foreign policy actions.

Donald Trump’s relations with Russia have been mixed, and evidence has grown of both a history of financial crimes and an attempt at a cover-up over the past year. At least Trump’s financial crimes are under investigation, while Democrats regularly make excuses for the influence peddling of Bill and Hillary Clinton.

The irony is that, after the risk of deterioration of relations with Russia and a return to a Cold War atmosphere was feared by many should Clinton become president, Clinton has managed to create hysteria over Russia without even being elected. While Trump is probably guilty of money laundering and a obstruction of justice, the evidence to date has contradicted conspiracy theories which appear to have been fabricated Clinton and the DNC to blame Clinton’s loss on Russia. With Clinton continuing to promote belligerence towards Russia even out of office, using conspiracy theories to get Democrats to embrace her neoconservative interventionism, it is of considerable concern as to how much greater harm Clinton could be doing in the White House.

Donald Trump has been terrible for civil liberties as president, including his attacks on the press. It must not be forgotten that even before the election Clinton had far right wing views on civil liberties which were not all that different from Trump’s.  Donald Trump has ignored the norms of a democratic society, but since the election Clinton has also continued her attack on civil liberties and has attacked the fundamental principles of democracy, including the legitimacy of election results. Both Clinton and Trump have cited fake news, which often means information critical of them, as justification to call for censorship.

While many Republicans have little respect for civil liberties, in the past year we have seen Democrats engage in McCarthyism as part of their anti-Russia hysteria.  The Democratic Party as a whole turned out to be worthless when faced with a vote to renew and expand warrantless surveillance as many joined with Republicans. If many Democrats were unwilling to stand up to Donald Trump on a fundamental civil liberties issue, I would expect even fewer to resist calls for increased powers by an authoritarian like Hillary Clinton.

Donald Trump has been a terrible president, but at least his faults are widely recognized, and his falsehoods are regularly exposed. Donald Trump might have authoritarian tendencies, but if so he is a very weak authoritarian. He has brought about serious damage to the entire Republican and conservative brands, likely doing far less damage than Hillary Clinton would have been capable of.

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.

Reading “What Happened” So You Do Not Have To

Reading Hillary Clinton’s memoir, What Happened, is like reading a memoir from Jesse James which makes no admission that he ever robbed a bank. She talked about trivial matters from her life, repeated her excuses blaming everyone else for her loss, and gave virtually no recognition of her dishonest actions and lifelong opposition to liberal values behind the opposition to her. What Happened  was previously used as a book title by former Bush press secretary Scott McClellan. Maybe she reused this title because Jeff Flake beat her to reusing the philosophically more honest choice, Conscience of a Conservative. Of course that would assume that she has a conscience, but she showed no signs of having one.

It is hard to see the point in this book beyond finger pointing. Clinton wrote:

At first, I had intended to keep relatively quiet. Former Presidents and former nominees often try to keep a respectful distance from the front lines of politics, at least for a while. I always admired how both George H. W. Bush and George W. Bush avoided criticizing Bill and Barack, and how Bill ended up working with George H. W. on tsunami relief in Asia and Katrina recovery on the Gulf Coast. And with George W. in Haiti after the earthquake in 2011. That’s how it’s supposed to work.

She should have ended the book right there.

In a rare moment of honesty, Clinton showed how clueless she is in writing, “in terms of fighting the previous war, I think it’s fair to say that I didn’t realize how quickly the ground was shifting under all our feet.” The only shifting Clinton has shown with the times has been to move on from blaming everything on the vast right wing conspiracy to blaming the vast left wing conspiracy against her.

She might briefly admit to a mistake, but it is quickly followed with a major but as she places the blame on Russia, James Comey, Joe Biden, Bernie Sanders, or others. If she did mention something she did wrong, it was passed over as a minor tactical error, ignoring the magnitude of her ethical lapses.

This week Bernie Sanders has been pushing for comprehensive, affordable health care for all Americans. Hillary Clinton is pushing a book which attacks the left and questions the validity of our electoral process (which she previously attacked Trump for threatening to do). She has opposed Medicare for All based upon false claims, continuing her long history of working to undermine liberal ideas.

While she launched numerous bogus attacks against others, she feels that her mistakes are too trivial to be considered. She wrote, “The truth is, everyone’s flawed. That’s the nature of human beings. But our mistakes alone shouldn’t define us. We should be judged by the totality of our work and life.”  Judging Clinton by the totality of her work and life, we must include her repeated push for neoconservative wars and regime change, her repeated advocacy of violating our First Amendment rights, her social conservatism, her support for the corrupting influence of money in politics, and her use of her position for personal financial gain–including violating the ethics agreement she entered into before being confirmed as Secretary of State.

Hillary Clinton wrote about her concern for children. In the real world, Hillary Clinton has shown her concern for children in other countries by dropping bombs on them and defending the use of cluster bombs in civilian areas. There are also those who suffered from Bill’s welfare reform at home. However, “It was a hard call. Bill and I lay awake at night talking it over.”

Clinton shows no understanding of liberal or progressive values. While she mischaracterized Bernie Sanders’ platform as offering everyone a pony, it is actually Clinton who sees liberalism as little more than government giving out ponies, even if smaller ones than she believes Bernie Sanders would. She has no understanding of how true liberal and progressives would change the status quo, no concept of the human rights we defend, and no concept of what is wrong with her interventionist views.

Her ignorance of liberal concepts of human rights would explain how she totally misunderstood the warnings of George Orwell. To an authoritarian such as Hillary Clinton the lesson of 1984 is that we should not question our political leaders, the press, or experts:

Attempting to define reality is a core feature of authoritarianism. This is what the Soviets did when they erased political dissidents from historical photos. This is what happens in George Orwell’s classic novel Nineteen Eighty-Four, when a torturer holds up four fingers and delivers electric shocks until his prisoner sees five fingers as ordered. The goal is to make you question logic and reason and to sow mistrust toward exactly the people we need to rely on: our leaders, the press, experts who seek to guide public policy based on evidence, ourselves.

On the other hand, Clinton is quite skilled in using Orwellian techniques to attack her political enemies. She uses the same types of distortions against Bernie Sanders as she did during the campaign, and as she used against Barack Obama in 2008. I have already responded to some of the attacks against Sanders here, and also recommend this rebuttal of Clinton’s arguments by Les Leopold. While reading What Happened I came across another fallacious attack on Sanders. Clinton wrote, “After the election, Bernie suggested that Democrats should be open to nominating and supporting candidates who are anti-choice.”

No, that is not what happened at all. On the other hand, the Democratic establishment has shown how they are willing to ignore reproductive rights. Clinton herself has also been to the right of Sanders on the issue, including her support for parental notification laws and expressing a willingness to compromise with Republicans. This is not surprising in light of her personal social conservatism on the issue and her mantra of keeping abortion”safe, legal, and rare,” stigmatizing women who have had an abortion.

Her attempts to falsely portray Sanders as being to the right of her on abortion are similar to her claims of being to the left of Sanders on gun control, despite having run in 2008 as a “pro-gun churchgoer.” Of course while attacking Sanders and blaming him for her loss she overlooked the degree to which Sanders campaigned for her after the primaries were over. Her antipathy towards a fair democratic process includes a visceral objection to being challenged for political office.

Clinton was no more honest in discussing the scandals which rightfully harmed her campaign. For example, she misquoted from the State Department Inspector General report to falsely make it look like the report supported her actions in the email scandal. In reality, the Inspector General report said exactly the opposite in showing how she violated policy. As we saw during the campaign, she keeps repeating the same lies about the scandal, including the statements from James Comey, regardless of how often the media fact checkers show that she is outright lying.

She attempted to open up personally, but even then wasn’t entirely honest. Among the more unbelievable lines, Clinton wrote, “For me, fund-raisers were a little more complicated than other campaign events. Even after all these years, it’s hard for me to ask for other people’s money.”

Among the other personal discussions in the book, Clinton wrote, “Bill and I bought our home in 1999 because we loved the bedroom.” Now try to get that image out of your mind.

Actually what she wrote after this was quite tame, including a description of the vaulted ceiling, windows, and photos. And then, “After waking up, I check my email and read my morning devotional from Reverend Bill Shillady, which is usually waiting in my inbox. I spend a few minutes in contemplation, organizing my thoughts and setting my priorities for the day.” The rest of us will not be able to see the writings of Bill Shillady as his publisher has pulled his planned book, entitled Strong for a Moment Like This: The Daily Devotions of Hillary Rodham Clinton, due to plagiarism.

Of course, as was inevitable, I am seeing defenses of What Happened claiming that disagreements with Clinton’s book are based upon misogyny. What an intellectually and morally bankrupt viewpoint. Do such Clinton supporters have even a shred of integrity? I am just relieved that Hillary Clinton is not in the White House, leaving us to contend with claims that our objections to whatever war she wanted to start, or whatever violation of the First Amendment she was advocating, was based only on sexism.

The Democratic Leadership Has Failed To Give A Good Reason Why Their Party Should Continue To Exist

In followup of yesterday’s post on the struggle of the Democratic leadership to revamp their party by coming up with a new slogan, Chuck Schumer has an op-ed in The New York Times on The Better Deal. As I quoted Nancy Pelosi in saying yesterday, this “is not a course correction, but it’s a presentation correction.” Democrats who turned out to willingly vote for Hillary Clinton in 2016 will be pleased, but only a major course direction will satisfy those of us who did not. This offers little to win back the votes of those of us who did not vote Democratic in 2016. That includes those of us who voted third party, and the even larger numbers who crossed over and voted for Trump over Clinton or stayed home.

These proposals leave the Democrats as a party which stands for nothing. At least they didn’t mention Russia. Unfortunately this also didn’t really discuss  health care. It is like trying to steal Bernie Sanders’ agenda while ignoring Medicare-for-all or actually getting big money influence out of politics.

Beyond this, the problem comes down to thinking they can substitute a new slogan for real policies or ideas. They hardly inspire confidence when the principles of one election, to the limited degree they express any, are ignored in the next. Running on social issues alone was not enough (especially when led by a socially conservative presidential candidate), but that does not mean they should ignore liberal social issues now.

Those of us who voted Democratic because of outrage over policies of George W. Bush are hardly going to be enthusiastic about a party which nominated a candidate who supported the worst abuses under Bush–neoconservative interventionism, restrictions on civil liberties, and increased government secrecy.  Nor is there any offer to reform the undemocratic nomination rules which make the mockery out of the primary process, making it little different than picking the nominee in the old smoked filled rooms.

The new slogan has been received with considerable derision. Jonathan Allen compares the new Democratic slogan, “A Better Deal: Better Skills, Better Jobs, Better Wages” to the pitch from Papa John’s, “Better Ingredients. Better Pizza.” Except the Democrats failed to add better ingredients.

First Read has a more serious but equally devastating criticism of Schumer and Pelosi in asking, “Can Democrats promise a ‘Better Deal’ with the same leaders in charge?”

The one thing that Democrats do have going for them in 2018 is that Donald Trump will (probably) be sitting in the White House, and Hillary Clinton will not be on the ballot. Hillary Clinton’s popularity has fallen even more than Donald Trump’s. FiveThirtyEight showed how the nomination of Hillary Clinton cost the Democrats not only the White House, but Congress:

Clinton’s unpopularity turned out to be a key factor in 2016 congressional races. Unsurprisingly, people who had a favorable view of Clinton primarily voted for Democrats in House races, while people with a favorable view of Trump primarily voted for Republican candidates. But among the 19 percent of voters who had an unfavorable view of both presidential candidates, House Republican candidates won by a margin of 30 percentage points. (Some voters may have cast a ballot for a Republican House candidate in the belief that a House controlled by the GOP would balance Clinton’s power after what most Americans thought would be a Clinton win.)

Not having Clinton on the ballot should help Democrats pick up seats in 2018, but it is likely to be a dead cat bounce, and perhaps more limited than Democrats hope, if the Democrats do not come up with more of a reason to attract voters than opposing Trump. It might be best if the Democrats could get out of the way and allow a new party to take over as a the true opposition and resistance.

Clinton’s Popularity Continues To Decline, Possibly Affecting Democratic Voter Enthusiasm

Democrats lead in the generic Congressional polls, but there are warning signs for Democrats. A new Washington Post-ABC News poll shows that by a 52 to 38 percent margin voters want Democrats to control Congress to be a check on Trump. However, 65 percent of Republicans and GOP-leaning adults say they are “almost certain to vote,” only 57 percent of Democrats and Democratic-leaning voters say they are likely to vote.

There are probably many reasons why Democratic-leaning voters are less likely to vote, but the damage to the Democratic brand caused by the nomination by of Hillary Clinton in 2016 cannot be underestimated. For those who have voted Democratic in protest against the policies of the Bush administration, it was a great disappointment to see the Democrats nominate a candidate with essentially the same agenda. The undemocratic manner in which the party establishment essentially picks the nominees, despite the charade of a primary system, creates further disenchantment with the party. As bad a choice as Donald Trump was, at least he was nominated due to beating the establishment candidates in a year in which many voters from both parties did not want another Bush/Clinton, with the Republican establishment accepting the decision of its voters.

Normally losing candidates do better in the polls after the election. With Donald Trump doing such a terrible job and dropping in the polls, if she followed traditional patterns Hillary Clinton should be seeing a boost in her support. Instead a Bloomberg National Poll shows that Clinton’s support has declined and that she is even more unpopular than Donald Trump.

This is not based upon opposition to the party in general  as Barack Obama and Joe Biden’s popularity has increased since they left office, and Bernie Sanders has become the most popular politician in the country.

The poll doesn’t provide reasons for Clinton’s further decrease in popularity. Just losing to a candidate as terrible as Donald Trump further highlights how weak a candidate she was, with reports such as those in Shattered providing further confirmation. I would also bet that many people expressed positive views of Clinton in the context of an election campaign against Donald Trump, but now that the campaign is over have no reason to hide their distaste for her.

Clinton’s actions following her loss give additional reasons for an already unpopular politician to now receive even less support. Her frequent statements blaming others for her loss, while downplaying the serious mistakes she made, shows her lack of character. While her far right wing views on civil liberties has received too little attention, her call for Congressional action against fake news, which amounts to censorship of material critical of her, is alarming in light of her long standing support for restricting freedom of speech and dissent.

Clinton’s anti-Russia hysteria, going well beyond what has been proven in the investigations to date, might be fooling some Democratic partisans, but is alarming to others. Clinton does not benefit politically from the revelations involving the Trump administration and Russia when fear of world war with Russia was a motivating factor for some who voted for her. A recent study suggests that her ultra-hawkish views might have played a significant role in her loss. News out of Syria provides further reason to oppose Clinton, considering her push for greater interventionism, even to the point of risking direct conflict with Russia.

Clinton has been out of step with more liberal voters on other issues, including economics, trade, the drug war, and health care policy. While many Democratic leaning voters support a single-payer system (as promoted by people including Bernie Sanders and Al Gore), Hillary Clinton also showed she was out of step in campaigning against  Medicare-for-all.

It is hard for many independents, along with principled Democrats, to be enthusiastic about the Democrats after nominating a candidate which so many dislike for good reason. The attacks on liberals and progressives opposing Clinton from partisan Democrats, showing a gross lack of respect for the basic principles of democracy in thinking that those who oppose her had some obligation to vote for her, further alienates potential Democratic voters. If Democrats are to expand their base and win elections, they need to show more respect for the views of those who oppose their move to the right.

Democrats have done poorly in 2010, 2014, and again in 2016 after moving to the right and running as a Republican-lite party. Bloomberg reports that Democrats are again looking at promoting more conservative candidates in 2018, failing to learn that voters see no reason to turn out to vote for candidates who do not stand for anything. The Democrats should do well in 2018 in response to the Trump disaster, but they also appear capable of pulling defeat again out of what should be sure victory.