Another Activist Conservative Judge Attempts To Destroy Obamacare

A federal judge in Oklahoma, appointed by George W. Bush, has repeated the same ridiculous argument given by previous activist conservative judges to attempt to stop Obamacare. The claim is that the Affordable Care Act only provides for subsidies for policies purchased on state-run exchanges and not the federal exchange. This is based upon taking one portion of the law, which is poorly written and might suggest this, while ignoring all the other portions of the law which do not make such limitations on who can qualify to receive subsidies.

Previously the 4th Circuit Court of Appeals in Richmond, Virginia ruled that subsidies should be available for policy holders regardless of whether they were purchased on a state or the federally run exchange.  The D.C. Court of Appeals ruled in the opposite direction, with two Republicans voting that subsidies should be limited to policies purchased on state exchanges and one Democrat backing the Affordable Care Act. Subsequently the court vacated that decision in order to have the full court rule on this.

Think Progress has more on the case, and the arguments against the view which has only been supported by Republican judges.

The partisan divide on this issue raises some concern about how the Supreme Court might rule. I suspect that Chief Justice John Roberts would again break with the other Republicans and oppose such an effort which would destroy Obamacare as he has done in the past. If for no other reason, he might not want his court to go down in history for keeping the United States as the only major industrial nation without anything approaching universal health care based upon such a frivolous argument. However it is not entirely reassuring to have to hope that Roberts will vote in a reasonable manner.

While Republicans in public would probably support destroying Obamacare in this manner, those who are not totally out of touch with reality might actually prefer that this case does not succeed. While they wouldn’t mind seeing their party take credit for destroying Obamacare in general, despite how successful the law has been, would they really want to be responsible for increasing taxes on millions of Americans by taking away their tax subsidies which help pay for health care coverage?

Republican backers in the insurance industry are also likely to want to see this case fail. The worst case scenario for the insurance industry would be if they are required to provide health insurance to everyone who applies without regard to pre-existing conditions but if they don’t see increased business, and expansion of the risk pool, from sales to those receiving subsidies.

 

Republicans Losing The Culture War, Helping Democratic Candidates

In past elections, Republicans have turned to social issues to get their supporters out to vote. This year some Democratic candidates are doing the reverse–using social issues in the hopes of getting more women to turn out to vote. The New York Times discussed this in an editorial:

The decision to go on the offensive is in part designed to incite the anger of women and draw support in the November elections, particularly that of single women, who tend to vote in small numbers in midterms. But it is also a reflection of the growing obsolescence of traditional Republican wedge issues in state after state. For a younger generation of voters, the old right-wing nostrums about the “sanctity of life” and the “sanctity of marriage” have lost their power, revealed as intrusions on human freedom. Democrats “did win the culture war,” Alex Castellanos, a Republican strategist, admitted to The New York Times recently.

That’s not necessarily true in the most conservative states. In Louisiana and Arkansas this year, two endangered Democratic senators, Mary Landrieu and Mark Pryor, have not been as outspoken in attacking their opponents’ anti-abortion positions. But even there, Republicans have not campaigned against same-sex marriage.

One of the most telling signs of the cultural change is the number of Republicans who are bucking conservative activists and trying to soft-pedal or even retreat from their ideology. Mr. Gardner now says he opposes a similar bill on the ballot this year in Colorado. It apparently came as a surprise to him that the bill would effectively ban certain kinds of birth control, which he says is the reason for his switch. Several other Republican candidates are trumpeting their support for over-the-counter birth control pills, though they remain opposed to the insurance coverage of contraception required by the Affordable Care Act.

Of course it must be kept in mind that the Republicans who support making birth control pills available over-the-counter might not be doing this out of an increased sense of tolerance. As I recently discussed, making them over-the-counter could mean that they wouldn’t be covered by insurance, and wind up reducing access.

The editorial concludes, “The shift in public opinion might not be enough for Democrats to keep the Senate this year. But over time, it may help spell an end to the politics of cultural division.”

Yes, due to fundamentals involving this year’s election, the Republicans should do better than the Democrats. Polling does show that the Republicans have an excellent chance for taking control of the Senate this year unless Democrats manage to win in some of the races which are currently leaning Republican, but it could be a dead cat bounce for the Republicans. Voters are now far more likely to oppose Republican attempts to increase government intrusion in the private lives of individuals, and less likely to fall for phoney Republican claims of supporting smaller government and greater freedom. This should result in either the Republicans making major changes in their agenda or, more likely, significant Republican loses in 2016 when the fundamentals will again favor the Democrats.

In addition, as more voters support liberal attitudes on social issues, they are more likely to have a favorable view of other liberal ideas. If they already realize that the Republicans are selling a false line about limited government when it comes to social issues, they are more likely to be open to facts about how Republicans, rather than supporting economic freedom as they claim, are actually pursuing an agenda of using government to transfer wealth from the middle class to the wealthy. Once voters figure this out, there might be little support left for the authoritarian right.

SciFi Weekend: Tuesday Shows Go Dark (SHIELD and Person of Interest); Sleepy Hollow; Under The Dome (“Nothing But A Giant Suck Hole”); Doctor Who; Outlander; Arrow; Gotham; Shatner Star Trek Rumors; If Ayn Rand Wrote Buffy

Shield Go Dark

Tuesday night featured the return of two television shows which have both changed for the post-Snowden era, Agents of SHIELD and Person of Interest. On each show the heroes are now working in secret, or even greater secrecy than they had operated in the past.

The premiere of Agents of SHIELD was not as good as the final episodes of the first season following Captain America: The Winter Soldier but did show promise of setting up a far better second season than the first was.  A couple problems from the first season are now solved. No longer can the team theoretically call upon the vast resources of SHIELD. This group is also easier to root for in the post-Snowden era. There is no doubt that the old SHIELD would have been listening in on our phone calls, reading our email, and have no problem with extraordinary rendition or even torture. That SHIELD no longer exists. We can dislike General Talbot as the nominally good protagonist (wondering if Bruce Banner is also in the neighborhood) and root for SHIELD in opposing him.

The episode started with a flashback of Agent Carter, including a glimpse of a green being in a box, suggesting the alien which was used to save Coulson, and later Skye (who works far better as an agent rather than the outsider) along with connecting to Guardians of the Galaxy.The show now makes mention of multiple Marvel characters, and included a super-villain, which gives the show much more the feel of being in the Marvel universe than seen in the first season. Lucy Lawless made her appearance as Isabelle  Hartley and lost her arm if not her life. There is certainly the possibility of her return on a show where two characters have returned from death or near-death, and now we have Dr. Whitehall, who hasn’t aged since seen in 1945.

While we don’t know whether Lucy Lawless will return, there is news that Adrianne Palecki of Friday Night Lights (and who almost became Wonder Woman) will be guest starring as Mockingbird later this season.

There were additional consequences to the events of last season beyond the breakup of SHIELD. Fitz is more interesting than last season now that we found that he did not recover from the lack of oxygen to his brain, and is imagining that Simmons is with him after she left. I would anticipate some recovery on his part and probably a Fitzsimmons reunion down the road. Agent Ward is also a bit nuts compared to last season, and may or may not really know anything about Skye’s father. I suspect he really does, and we might be in store for some Hannibal/Clarice type scenes between Ward and Skye this season.

Person of Interest s04e01

Go Dark was the strategic order from Director Coulson on Agents of SHIELD, and also describes the strategy Root devised with the Machine to keep everyone alive and hidden from Samaritan on Person of Interest.  The increased concern over the dangers of the surveillance state has been fortuitous for the show. Initially the Machine’s surveillance was primarily a gimmick to get the heroes into the story of the week, but last season the show transitioned far more into a series about the dangers of government surveillance and artificial intelligence in the wrong hands. The show has largely been rebooted this season, and shows promise of being even better than previous seasons.

Series co-creator Greg Plageman compared artificial intelligence to the creation of the atomic bomb at San Diego Comic-Con:

I think when we started out this show we were answering a lot of questions about the Orwellian surveillance state and people asking us if that was science fiction and now, in a post-Snowden era, no one’s asking those questions anymore. So what does the show become now?

I think the most interesting question in terms of our show and technology that is emerging is artificial intelligence. We’re living in a world now where not just nation states—Israel, United States, the Russians, whoever—are trying to build an artificial intelligent. The thing closest to this was the Manhattan Project, the greatest existential risk the world has ever faced: the development of the atomic bomb, and the race to get it, and who was going to get it first and what that meant in terms of ending World War II.

We are now at a similar crossroads with artificial intelligence. The only difference is it’s not just DARPA. It’s not just nation states. It’s a bunch of billionaires in their 30s up in Silicon Valley who are buying up all the artificial intelligence companies. It’s fascinating. Look up ‘Deep Mind,’ see what’s going on. No one really knows.

Harold Finch built a machine, an artificial intelligence, that he supposed was sympathetic to humankind. But what if someone built one that didn’t take that into consideration at all? And I think we’re dealing with the next great existential risk to the world and I think that’s something our show can deal with in a really cool way.

The Blacklist was among other shows which returned, once again turning what would otherwise be a mediocre show into a hit due to the presence of James Spader. Mary Louise Parker makes an excellent addition as his ex-wife.

Sleepy Hollow also returned with a strong season premiere. This is a series which I am reluctant to write much about as any description of the show sounds absurd. They manage to pull off its absurdities very well (far better than Under the Dome does). It is always fun to see what they come up with to tie early American history into their mythology, such as revealing that they key used on Benjamin Franklin’s kite is used to unlock Purgatory. As I said, it sounds like it makes no sense, but the show is so much fun.

Under the Dome Season 2 Finale

Under the Dome ended and the series could be summed up by what Noreen said: “It’s nothing but a giant killer suck hole!” The giant suck hole appeared the previous week after Melanie, a character who came back from the dead, was apparently killed a second time. In other recent episodes there was a tunnel under the school in which people could jump off a cliff and appear in another city, until Big Jim messed that up. Recently it became cold and nobody in town had any warm clothes to put on. The Dome started contracting, and when they began to time the contractions I wondered if next they were going to say the Dome was pregnant.

In the second season, and hopefully series, finale, everyone in town who could make it went through a tunnel where the giant suck hole had appeared. The final moment showed Melanie once again back from the dead, saying “Follow me, we’re going home.”But isn’t Chester’s Mill their home? If the show returns next summer, we will presumably see where Melanie leads them. I wouldn’t be surprised if they follow her, perhaps to an intermediate destination, and they ultimately wind up back in Chester’s Mill, like Patrick McGoohan trying to leave The Village. I imagine that if it doesn’t return, we can just assume that they escape, possibly coming back to rescue those who didn’t make it.

Doctor Who The Caretaker

On Doctor Who, The Caretaker returned to its 1963 roots at Coal Hill School, and Gareth Roberts, writer of episodes such as The Lodger, once again showed the Doctor attempting to blend in with humans. The killer alien story was weak, and primarily existed as a vehicle to have the Doctor finally meet Danny Pink. Along the way the Doctor got mislead when seeing Clara speaking with a fellow school teacher wearing a bow tie, thinking that she had fallen for someone who looks like his previous regeneration. While we had long been led to believe we will have another couple in the TARDIS, with Clara and Danny replacing Amy and Rory, it now looks like there once again might be two schoolteachers and a student, with Courtney joining along, at least temporarily, despite being a disturbance:

Clara: “I would say, yes, I’m afraid Courtney is a disruptive influence.”

Response: “Yeah, but last year you said she was a very disruptive influence. So I suppose that counts as an improvement.”

Courtney discovered the TARDIS after ignoring the Doctor’s sign to keep out, or more precisely, “Go Away Humans.”

The meeting between the Doctor and Danny Pink didn’t go very well. The Doctor continues to object to soldiers, apparently forgetting all the time he spent with UNIT, along with many other individual soldiers over the centuries. Danny sees the Doctor as an arrogant aristocrat, concentrating on the Lord part of Time Lord. He also wondered about about Clara (“Are you a space woman?”).

The episode also introduced another gadget for the Doctor, an invisibility watch. This raises the question of why this was never used on many occasions when it could have come in handy in the past, and whether it will be used again. Another plot hole which we will just have to ignore.

Among other top lines of the episode:  “You’re running out of time.” “For what?” “Everything! Human beings have incredibly short lifespans. Frankly, you should all be in a constant state of panic. Tick tock, tick tock.”

After not seeing this in recent episodes, The Caretaker also showed a character who died in the episode wind up in the Nethersphere, or perhaps Heaven.

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Saturday night’s other time travel series, Outlander, got deeper into time travel in the mid-season finale. Frank heard of the possibility of time travel at Craig na Dun, and by the end of the  episode was willing to accept it as a possibility. In addition to seeing a poster with a reward for information related to Claire, there was another poster in Frank’s era seeking information about someone who sure looks like Jaime, suggesting that he might also wind up traveling in time.

It was surprising that a spy like Frank would fall into such an obvious trap when seeking information about Claire, but he was quite well prepared to take care of himself. He seemed to enjoy beating up his attackers too much, perhaps intending to show a comparison between the violence of his evil ancestor and Frank. Are we to question which husband Claire is really best off with?

The episode had a tease that Claire might return home. At very least she did hear Frank calling out to her through time, but it was intentionally left ambiguous as to whether Frank could hear Claire calling back. Just before getting a chance to return, she fell into the hands of Black Jack once again, with her attempts to deceive him failing. We don’t know  how Jaime managed to get into his window, but he came to attempt to save Claire just before she might have received an involuntary mastectomy. We will see what happens next when Outlander returns in April.

Arrow Oliver and Felicity

Arrow returns October 8 and Marc Guggenheim has discussed the upcoming season:

“He is going to get some new toys to play with,” Guggenheim said. “One of them is a new bow that looks identical to the old bow, but it does something that you’ve never seen before.” Guggenheim disclosed that the explanation behind Oliver’s new equipment will be detailed in DC Comics‘ currently unfolding digital-first series “Arrow: Season 2.5,” taking place between the second and third seasons.

While “Arrow” has traditionally been more grounded, the show’s second season embraced superpowers a bit more, both in laying the groundwork for spinoff “The Flash” and in Slade Wilson and his Mirakuru-fueld army that served as primary antagonists. With “The Flash” now its own series on The CW, Guggenheim stated that “Arrow” will return to a more realistic direction.

“We’re not really planning on revisiting superpowers or enhanced abilities during season three,” Guggenheim told Weiland. “We are really returning to the show’s roots of a very grounded world where it’s very realistic. We may take occasional artistic license with things, but for the most part, everything is pretty well and truly grounded in real-life things and real-life science.”

Another DC comic-based series began with the premiere of Gotham. I think we will need to see more to determine if is worth watching a show with Bruce Wayne before he became Batman. While it includes the origins of several villains, I think we will have to view this as another version of the legend, not connected chronologically with other Batman stories. While we think of the murder of Bruce’s parents as occurring years ago, Gotham appears to take place in the present (or a parallel universe were cell phones have been around a lot longer).

Syfy has renewed both Defiance and Dominion.

CaptainKirkShatner_1

There have been a number of rumors, denials, and perhaps an admission that J.J. Abrams has spoken to William Shatner about doing a cameo for his third Star Trek movie. I have my doubts as to whether it is a good idea, but it is more plausible now than in the first Abrams movie in which Spock from the original time line went back in time. Kirk could not do that because in that time line he was dead. However this doesn’t prevent a future Kirk from being seen from the Abrams time line.

There is yet another rumor that the next Avengers movie will be split into two parts.

If Ayn Rand wrote Buffy The Vampire Slayer

Quote of the Day: David Letterman on the Latte Salute

“There’s a picture of President Obama getting off his helicopter and he’s got a cup of coffee in his hand, and he salutes the Marine guards with the cup of coffee. It’s all part of the new Jerry Seinfeld series, ‘Presidents in Helicopters Getting Coffee.'” –David Letterman

Small Business Exchanges Providing Coverage To Small Business At Lower Cost

SHOP Marketplace

With Obamacare having been such a success on the individual market, providing coverage for millions of people, generally at a lower cost than previously, some opponents of health care reform have concentrated on scare stories claiming that the cost of coverage will harm small business. While not many states had the small business exchanges operational in the first year, a study has now shown that the small business exchanges are offering coverage at a lower cost where available:

Health plans available to small businesses on the law’s new health marketplaces are on average about 7 percent cheaper than comparable plans offered elsewhere, according to analysis conducted by a team of researchers at the National Opinion Research Center at the University of Chicago. For middle-tier plans, for instance, the disparity translates into about $220 in annual premium savings for plans purchased on the SHOP exchanges.

“It’s definitely surprising,” said Jon Gabel, a senior fellow at the center, noting that many insurers had expressed disinterest in selling plans on the SHOP exchanges. “So, I expected them to price those plans higher than the plans sold off the SHOP, but it didn’t turn out that way — in fact, just the opposite.”

Gabel’s team conducted the analysis using information pulled from state insurance databases in 26 states, 15 of which built their own exchanges and 11 of which defaulted to the marketplace built and run by the federal government. States not included in the study were ones in which health insurance data wasn’t made available.

So what’s behind the lower rates on the new exchanges? In part, Gabel said, the results can likely be attributed to the one of underlying premises behind the exchanges — that is, to drive up competition among insurance carriers by placing their rates next to one another for shopping comparison. Indeed, health officials have reported cases of insurers revising their rates on the marketplaces after seeing lower prices from their competitors.

However, there are likely some other factors at play, too. In many cases, Gabel said, the plans available on the exchanges may have a more narrow provider network, which would drive down the price but perhaps leaving small employers and their workers with more limited options when they need to visit a physician. In addition, he noted that some of the plans offered in the non-exchange marketplace may offer more non-essential benefits.

Despite the potential trade-offs, offering plans at even slightly lower rates than what’s available in the private market could make all the difference for the SHOP exchanges, most of which have thus far failed to gain any real traction with employers. Another recent study conducted by research center showed that, among small business owners who do not currently offer health coverage, 82 percent said their decision to start providing insurance would depend on prices being lower than they are today.

In addition, 83 percent said that the availability of tax credits would be an important factor and 90 percent say they would want to send only one check per month to cover all their workers’ premiums — both features that available to small businesses only through SHOP marketplaces. More than four in five said being able to compare different plans online would make a difference — an option that will eventually be available nationwide.

Allowing small businesses to obtain less expensive health  care insurance will help them become more competitive in hiring compared to larger businesses, which historically have been able to obtain insurance coverage for their employees at a lower cost.

Of course all the benefits of the Affordable Care Act won’t stop conservatives from continuing to attempt to cripple Obamacare.

Republicans Remained Obsessed With The Sexual Activities Of Others

Periodically there is talk from some Republicans about letting up on the culture wars, especially as social issues are alienating Republicans from large segments of the electorate. Unfortunately there are always social conservatives who will react negatively to this:

Conservative activists are launching “an unprecedented campaign” against three Republican candidates — two of whom are out gay men — because of their support for marriage equality and abortion.

The National Organization for Marriage, Family Research Council Action, and CitizenLink “will mount a concerted effort to urge voters to refuse to cast ballots” for Republican House candidates Carl DeMaio in California and Richard Tisei in Massachusetts and Republican Senate candidate Monica Wehby in Oregon, according to a letter sent to Republican congressional and campaign leaders on Thursday.

“We cannot in good conscience urge our members and fellow citizens to support candidates like DeMaio, Tisei or Wehby,” the presidents of the three groups write. “They are wrong on critical, foundational issues of importance to the American people. Worse, as occupants of high office they will secure a platform in the media to advance their flawed ideology and serve as terrible role models for young people who will inevitably be encouraged to emulate them.”

DeMaio and Tisei are the only out LGBT federal candidates from the Republican Party to be appearing on the ballot this fall.

“The Republican Party platform is a ‘statement of who we are and what we believe.’ Thus, the platform supports the truth of marriage as the union of husband and wife, and recognizes the sanctity and dignity of human life,” NOM President Brian S. Brown said in a statement.

Brown called it “extremely disappointing” to see candidates supported “who reject the party’s principled positions on these and other core issues.”

Of the effort to urge people to oppose DeMaio, Tisei, and Wehby, he said, “We cannot sit by when people calling themselves Republicans seek high office while espousing positions that are antithetical to the overwhelming majority of Republicans.”

The letter was sent to House Speaker John Boehner, Senate Minority Leader Mitch McConnell, National Republican Congressional Campaign Committee Chairman Greg Walden, National Republican Senatorial Committee Chairman Jerry Moran, and others in Republican congressional leadership.

In it, the three conservative groups also warned that it is a “grave error” for the party to be supporting “candidates who do not hold core Republican beliefs and, in fact, are working to actively alienate the Republican base.”

In opposing gay marriage, these conservatives are looking at consensual behavior between others which does not affect them and desire to use the power of government to limit the choices of those who do not share their religious views. They also fail to recognize the right of a woman to control her own body.

Social conservative groups have considerable influence in the Republican Party and it will be interesting to see how the Republican establishment respond to this.

Such obsession with the sexual activities of others is not limited to a single faction of the conservative movement. The Heritage Foundation held a conference on the future of liberalism. As would be expected, they hold a very warped view of what liberalism is:

“Give up your economic freedom, give up your political freedom, and you will be rewarded with license,” said Heritage’s David Azerrad, describing the reigning philosophy of the left. “It’s all sex all the time. It’s not just the sex itself—it’s the permission to indulge.”

They totally miss the point. It is not a question of whether we should be promoting more sex, or less sex. Liberals believe government should stay out of the private lives of individuals, and let people make such decisions for themselves.

While they advocate restricting individual liberty and greater intrusion of government in the private lives of individuals, they promote a Bizarro World version of freedom. On social issues, freedom means their freedom to impose their views upon others. Economic freedom means freedom from necessary regulation along with freedom of taxation, but limited to the rich. While they preach keeping government out of economic matters, they actually support using government to rig the system to benefit the ultra-wealthy at the cost of the middle class.

The primary political freedom they support is a right for the rich to spend unlimited amounts of money on elections, failing to recognize that regulation of conduct related to spending on  elections is not the same as restrictions on free speech. While a libertarian argument could certainly be made against restricting spending on political contributions, they hardly show any consistent support of political freedom when they use voter suppression tactics to promote their goals.

Two Successes For Obamacare In Reducing Health Care Costs

Two stories today show further areas where the Affordable Care Act was successful, with both helping to reduce health care costs. While conservatives claim that Obamacare is a government takeover of health care, it actually expands market choices. In the past it was very common for one insurance company to dominate an area, contributing to high prices. Selling health policies through exchanges, and expanding the market of those having coverage, is leading to more insurance companies which plan to sell insurance. From Kaiser Health News:

The number of health insurance companies offering plans in the marketplaces this fall will increase by 25 percent, giving consumers more choices for coverage, Health and Human Services Secretary Sylvia Burwell announced Tuesday.

When the marketplace enrollment reopens in November, 77 new insurers will be offering coverage in the 44 states for which HHS had data, which includes the 36 states that use the federal marketplace and eight states that run their own, the department reported.

The number of competitors on the marketplaces is considered important because it signifies the vitality of the exchange and can mean increased competition and lower prices for consumers. It also means that insurers see the health law’s online marketplaces or exchanges, as a good business opportunity, senior HHS officials said…

Burwell sought to cast the increase as one of a number of recent announcements suggesting that the 2010 health law has been successful in improving health care options for Americans.  She pointed to figures announced last week that 7.3 million people who signed up for the exchanges and paid their premiums, findings that HHS released Monday that 8 million people enrolled in Medicaid or the Children’s Health Insurance Program since the beginning of open enrollment last year, and a 26 percent reduction of uninsured adults.

“I think we need a bit of a course correction in this country when it comes to how we talk about these issues — and it starts with collectively turning down the volume a bit,” she said. “Surely, we’d all agree that the back-and-forth hasn’t been particularly helpful to anyone — least of all the hardworking families who we all want to help.”

She also said that backers of the law “haven’t done a very good job of explaining why middle-class families who already had insurance are better off.” Families are paying less for coverage, Burwell said, and they benefit from knowing they “no longer have to worry about losing their homes or having their hard-earned savings wiped-out by an accident, or unexpected diagnosis.”

The New York Times showed how Accountable Care Organizations which were organized under the Affordable Care Act can save money:

IT may have been the most influential magazine article of the past decade. In June of 2009, the doctor and writer Atul Gawande published a piece in The New Yorker called “The Cost Conundrum,” which examined why the small border city of McAllen, Tex., was the most expensive place for health care in the United States.

The article became mandatory reading in the White House. President Obama convened an Oval Office meeting to discuss its key finding that the high cost of health care in the country was directly tied to a system that rewarded the overuse of care. The president also brought up the article at a meeting with Democratic senators, emphasizing that McAllen represented the problem that needed to be fixed.

Five years later, the situation has changed. Where McAllen once illustrated the problem of American health care, the city is now showing us how the problem can be solved, largely because of the Affordable Care Act that Mr. Obama signed into law in 2010…

One of its provisions created the Medicare Shared Savings Program, which rewards doctors for keeping their patients healthy. Participation in the program requires primary care doctors to create networks, called accountable care organizations, or A.C.O.s, to better coordinate patient care. These networks are reimbursed for delivering high-quality care below a baseline of historical Medicare costs.

In 2012, doctors in McAllen formed the Rio Grande Valley Accountable Care Organization Health Providers, and signed up for this experiment. The early results are in, and they are stunning: From April 2012 to the end of 2013, the Rio Grande Valley A.C.O. saved more than $20 million from its Medicare baseline.

This is just two more ways in which the real world successes for Obamacare show a totally different picture than the right wing media has been portraying.

With Climate Changes, Alaska, The Northwest, And Detroit Might Be Among The Best Places To Live

Cities Climate Change

Climate change raises questions of where would be the best place to live in the future. Some areas might wind up under water, suffer from droughts, or just be too hot to be comfortable. Canada and Alaska might be much more desirable places to live in a warmer climate. Some portions of the continental United States are likely to have less adverse impact, such as the Northwest and parts of the Midwest. The New York Times looked at which cities might be the safest.

One geography professor recommended Alaska:

“If you do not like it hot and do not want to be hit by a hurricane, the options of where to go are very limited,” said Camilo Mora, a geography professor at the University of Hawaii and lead author of a paper published in Nature last year predicting that unprecedented high temperatures will become the norm worldwide by 2047.

“The best place really is Alaska,” he added. “Alaska is going to be the next Florida by the end of the century.”

The Pacific Northwest might be a good alternative if you don’t want to go as far as Florida, especially if you like wine:

“The answer is the Pacific Northwest, and probably especially west of the Cascades,” said Ben Strauss, vice president for climate impacts and director of the program on sea level rise at Climate Central, a research collaboration of scientists and journalists. “Actually, the strip of coastal land running from Canada down to the Bay Area is probably the best,” he added. “You see a lot less extreme heat; it’s the one place in the West where there’s no real expectation of major water stress, and while sea level will rise there as everywhere, the land rises steeply out of the ocean, so it’s a relatively small factor.”

Clifford E. Mass, a professor of atmospheric science at the University of Washington, writes a popular weather blog in which he predicts that the Pacific Northwest will be “a potential climate refuge” as global warming progresses. A Seattle resident, he foresees that “climate change migrants” will start heading to his city and to Portland, Ore., and surrounding areas.

“The Pacific Ocean is like our natural air conditioning,” Professor Mass said in a telephone interview. “We don’t get humidity like the East Coast does.”

As for the water supply? “Water is important, and we will have it,” Professor Mass declared. “All in all, it’s a pretty benign situation for us — in fact, warming up just a little bit might be a little bit welcome around here.”

Already, he said, Washington State is gearing up to become the next Napa Valley as California’s wine country heats up and dries out.

There are also some places which you might have been less likely to guess would become desirable, such as Detroit:

There may be other refuges to the east. Don’t count out the elevated inland cities in the country’s midsection, like Minneapolis, Salt Lake City, Milwaukee and Detroit, said Matthew E. Kahn, a professor of environmental economics at the University of California, Los Angeles.

“I predict we’re going to have millions of people moving to those areas,” he said in a telephone interview.

In his 2010 book “Climatopolis,” Professor Kahn predicts that when things get bad enough in any given location — not just the temperatures and extreme weather, but also the cost of insurance and so forth — people will become “environmental refugees,” fleeing cities like Phoenix, Los Angeles and San Diego. By 2100, he writes, Detroit will be one of the nation’s most desirable cities.

In that case, maybe businesses should look to the future and come rebuild Detroit, which could really use the help well before 2100.

Hillary Clinton Was Born In Kenya

The right wing has come up with letters tying Hillary to Saul Alinsky when young–just like Muslim Socialist Barack Obama. It is only a matter of time until someone uncover’s Hillary Clinton’s secret Kenyan birth certificate.

The right wing blogosphere is salivating over these letters. To them, this proves she is a radical leftist, no matter how conservative the left considers Clinton to be. The average voter is asking, “Saul who?” or perhaps “Is he the guy Carrie hung out with on Homeland?” or maybe “Isn’t Saul Walter White’s lawyer?”

It is also strange that to the right these  innocuous letters suggest that she is secretly a radical leftist, but her past as a Goldwater Girl doesn’t mean she is  secretly a Goldwater conservative.

Meanwhile Hillary Clinton, following her recent trip to Iowa, is next going to New Hampshire. To believe she is mounting a campaign for the nomination is certainly not a wacky conspiracy theory.

(Post revised when cross posted at The Moderate Voice)

SciFi Weekend: Doctor Who; Outlander; Extant and You’re The Worst Finales; Pineapple Mystery From How I Met Your Mother Solved; Gillian Jacobs Gets New Show; Supergirl; Suicide Squad; Star Trek

Doctor Who Time Heist

Saturday night featured The Wedding on Outlander while Doctor Who combined at least two old plot ideas. On the surface, Time Heist is a classic Ocean’s Eleven bank robbery, plus throw in a little of The Bourne Identity. It was obvious something big would happen after the Doctor said, “It’s just a phone Clara, nothing happens when you answer the phone.” Suddenly there were four people in a room with their memories wiped (with their consent) and placed in a position where they had no choice but to go through with robbing a bank. (“I’m an amnesiac robbing a bank.”) The Doctor led the gang. Why? “Basically, it’s the eyebrows.” Plus the Doctor has experience as a thief, dating back to when he stole the TARDIS.

But this is Doctor Who, not Bonnie and Clyde. In the end it turned out not to really be a bank heist at all, but a plan arranged by the Doctor and initiated with a call from the future from the head of the bank, Director Karabraxos, who took the Doctor’s phone number on a note saying he is a Time Traveler, with the advice, “You’ll be old and full of regret for the things you can’t change.” In a way, Director Karabraxos is this episode’s Sally Sparrow, as Doctor Who repeated an idea from Blink and Listen, with the events of the story being a self-contained wibbly wobbly timey wimey time loop. Instead of “Don’t Blink” the warning is “Don’t Think” when The Teller is around. It is not entirely clear how the Architect/the Doctor, managed to set this all up, or why it had to be this complex, but this week’s plot holes are still not as bad as Robot of Sherwood’s golden arrow.

To pull of the non-heist, the Doctor and Clara had the assistance of two recruits, Psi and Saibra . I wouldn’t be surprised they show up in a future episode (perhaps in their past), like the Paternoster Gang. Once again Doctor Who also took advantage of paying homage to its past. When Psi reviewed the universe’s worst criminals, several old Doctor Who villains were included. The new, less flashy Peter Capaldi Doctor also looked back and mocked earlier regenerations played by Tom Baker and Matt Smith: “Big scarf. Bow tie. Bit embarrassing.” Plus the episode began with answering a phone, which led to a reminder of the still-unanswered question of who gave Clara the Doctor’s phone number in The Bells of Saint John.

Above is the Doctor Who Extra for Time Heist.

The Heist is the last episode which leaked out before the start of the season, so the only spoilers out now are those officially released. Next week we return to where it all began for the Doctor on earth, and Clara’s current place of employment, as the Doctor becomes The Caretaker at Coal Hill School. Time Heist did little to advance the storyline between Clara and Danny, but presumably this changes next week. For someone who has spent so many years traveling through space and time, often on his own, the Doctor sure has a tough time figuring out what to do when Clara and Danny are out on a date. For someone who has spent so much time on earth, he also has a difficult time understanding both women and dating:

The Doctor : Are you taller?
Clara : Heels.
The Doctor : What, do you have to reach a high shelf?
Clara : Right, got to go, going to be late.
The Doctor : For a shelf?

Outlander The Wedding

The consummation of the marriage was far more important on Outlander than the wedding this week. Sam Heughan discussed filming the sex scenes with The Hollywood Reporter:

Those who have read the first Outlander book have been anticipating Jamie and Claire’s wedding episode for a while. Was this an episode that you circled on the calendar? How important was it to get the intricacies of the wedding and the aftermath right?

The wedding is a big episode for Jamie and for Claire. There are many big moments we have to get right and going back to the flogging that was another big one that we have to mark right. How we get from one to the next the writers have a bit more freedom in the way we portray it. Yeah, we got to get it right. But the subject matter — Caitriona [Balfe] and I have never done anything like this before, so it was a bit of a learning curve. We were lucky that the director, Anna Foerster, was good. We did a lot of rehearsals. We discussed how we wanted it to work. When you watch the episode there is a progression in the way that Jamie and Claire get to know each other. Their relationship grows quite quickly so by the end of the episode, you can see that they’re basically making love, it’s not just consummating the marriage. Their friendship and their relationship is really bonded, but is also left in a place where Claire is reminded of her husband, Frank, back in the future. That leaves a wonderful discord at the end of the episode.

You mentioned that you had never really done an episode like this before. How comfortable were you with the nudity? 

Caitriona and I had already filmed a scene from episode 10. When we were filming, we shot two episodes ahead so we did a scene after [the wedding] — a big breakup. It was very physical and lustful. To do this somehow felt easier, but more intimate because this was more about discovering each other. Yeah, we were both slightly nervous, which I think helps. In the scene, it’s part of them finding each other. We worked it out in rehearsals what we wanted the viewer to see and not see and how we wanted it to be portrayed. Again, we don’t want [the sex] to be gratuitous but it’s very important for the characters and what happens to their relationship.

We get a sense, too, of Jamie’s naivete when it comes to sex, which is a source of humor. Plus, it’s a nice role reversal to see Claire being the one who is more experienced sexually rather than Jamie, who hasn’t reached that level yet.

In most TV dramas and films, it’s normally the other way around. It’s the guy [with more experience] than the woman, so it’s kind of turned on its head. Jamie’s very willing to learn and Claire is a very good teacher. (Laughs.) He couldn’t ask for better really. But it’s wonderful that they do have that kind of relationship. It’s very physical; there are no barriers. That’s what made their bond even stronger. I think he grows up very quickly and learns a lot, but it is lovely his humor. He’s learned a lot from looking at farmyard animals [which] is slightly disturbing. (Laughs.)

Now Claire has two rings and two husbands, and after all that sex finally remembers that she is supposed to be trying to return home to her first husband.

Extant-Ethan-about-to-explode

There were finales of some summer shows this week, including Extant and You’re The Worst. Extant‘s end was not spectacular but did a decent job of concluding the story. The entire series could have been better if a few hours had been cut (and those which aired were better written). The show did tie together the two big story lines of Halie Berry’s impregnation in space and the artificial intelligence kid. I was wondering if they were going for some sort of high concept ending, showing two possible successors to the human race, or at least do more to question what it means to be human. Instead they tied them together in a simpler manner, having Ethan be the one “person” immune to the alien’s mind control as he is not  human. The anti-AI terrorist plot with Odin played into this as it created a new dilemma when Ethan decided to warm himself up to appear human to override the computer control on the spaceship Halie Berry was on.

The series was billed as a single season show, but we have seen such shows turn into multi-year series as with Helix and Under the Dome. I doubt this will happen due to Extant‘s poor ratings, but they left open the possibility with both the alien kid and Ethan’s’s mind still around at the end. While these loose ends were clearly intentional, presumably to leave open the possibility of a sequel, I suspect other loose ends were more from sloppy writing. For example, Molly and Sean should both have been infected by the alien spores, and now infecting others on earth. We also don’t know what happened to Yasumoto. Did he wind up dying after running out of that alien substance?

That’s too many questions. I don’t want anyone to get the idea of doing a second season to attempt to answer them.

You're The Worst Finale

While Extant was seriously flawed, You’re the Worst was the best, including the season finale. The finale was the perfect ending for what has turned into the best new sit-com in years. If the show is not renewed, it turns the ten episodes into what would feel like an excellent romantic comedy movie if watched in one sitting–which I would recommend for those who have the time and have not seen it yet–even if you don’t normally like romantic comedies. If you are above romantic comedies, think of what would happen if Dan Harmon wrote one. The show has very sharp writing and excellent performances by the cast, led by Chris Geere and Aya Cash, which manage to explode many of the clichés of the genre and television in general, while being extremely funny.

The episode shows how the series has begun to create its own universe, rather than relying on the stars alone. It provides what could serve as and end for the stories of both the main characters and side kicks (who in one episode even went meta and recognized their role). Besides altering the relationships of the various couples on the show, we saw the consequences of Gretchen’s habit of plugging her vibrator into a chain of Christmas lights, as well as what happened to the cat in the book store. While it works as a conclusion for the series, preferably this season finale will be a lead in to a second season, having introduced some changes in the situation of the characters to keep things fresh.

After You’re the Worst, I fear that the upcoming season’s new romantic comedies, such as A to Z and Manhattan Love Story, will seem quite lame.

how-i-met-your-mother-pineapple

How I Met Your Mother is another sit-com which developed its own universe, and a complex mythology. One mystery which was never solved occurred when Ted woke up with a hangover and no memory of the woman in bed with him or how a pineapple wound up on his nightstand. A deleted scene from the entire series DVD explains this. BuzzFeed has the scene, with the explanation involving the Captain who placed pineapples outside his homes: “It’s an old sea captain’s tradition, you put a pineapple on your porch as a symbol of hospitality. I keep one here and one outside my townhouse in the city.” Drunk Ted picked up the one outside his townhouse in the city. I imagine it was a matter of time, as this scene both resolves a long-standing mystery and contains a threat that fits in so well with the dynamic between Ted and the Captain.

Gillian-Jacobs

Gillian Jacobs of Community appears on the upcoming season of Girls. Working with Judd Apatow led to her being cast on a new show he is producing for Netflix:

Netflix has given an eye-popping two-season commitment to a comedy series from Judd Apatow and “Girls” alum Lesley Arfin that offers an unvarnished take on a modern relationship.

“Love,” produced by Legendary TV, will star “Community” player Gillian Jacobs and Paul Rust in the lead roles of Mickey and Gus, a couple in the throes of experiencing the “exhilarations and humiliations of intimacy, commitment, and other things they were hoping to avoid.” The series is targeted for debut in 2016.

“Love” garnered Neftlix’s biggest upfront commitment to an original series since drama “House of Cards’ went on the market in 2012 and landed a two-season order. Since then, the netcaster has built up a solid roster of original series.  Netflix has ordered 10 episodes for “Love’s” first season and 12 for the following season a year later.

It sounds like it might be more serious than You’re The Worst, but I wonder if it can do as well in providing its take on a modern relationship.

CBS has decided to pick up Supergirl.

The Suicide Squad, seen last season on Arrow, is being considered for a movie.

Zachary Quinto says that filming might begin on Star Trek 3 in the next six months.

Update: Emma Watson is even more awesome than Hermione Granger. Check out the link to her speech before the United Nations on gender equality.