|9:54 AM, Apr 21, 2014 • By GEOFFREY NORMAN
The Affordable Care Act was designed and written chiefly by lawyers – Congress is full of them and if you throw a rock in Washington, you’ll hit one – so it is not so very surprising that among its effects is a trend among doctors to work fast and bill by the hour. As Roni Caryn Rabin of the Kaiser Institute writes in USA Today:
These days … patients — and physicians — say they feel the time crunch as never before as doctors rush through appointments as if on roller skates to see more patients and perform more procedures to make up for flat or declining reimbursements.
As one expert quoted by Rabin says:
"Doctors have one eye on the patient, and one eye on the clock.”
By all accounts, short visits take a toll on the doctor-patient relationship, which is considered a key ingredient of good care, and may represent a missed opportunity for getting patients more actively involved in their own health. There is less of a dialogue between patient and doctor, studies show, increasing the odds patients will leave the office frustrated.
Frustrated? Well, get over it, says the president. This thing is settled business and it is time to move on.
7:51 AM, Apr 21, 2014 • By DANIEL HALPER
NBC has been so alarmed at Meet the Press's decline, the network hired a "psychological consultant" to assess the host, David Gregory. The Washington Post reports:
Last year, the network undertook an unusual assessment of the 43-year-old journalist, commissioning a psychological consultant to interview his friends and even his wife. The idea, according to a network spokeswoman, Meghan Pianta, was “to get perspective and insight from people who know him best.” But the research project struck some at NBC as odd, given that Gregory has been employed there for nearly 20 years.
Around the same time, the network appointed a new executive producer at “MTP,” Rob Yarin, a veteran media consultant. Yarin, who had worked with Gregory on an MSNBC show, “Race for the White House,” during the 2008 campaign, succeeded Betsy Fischer Martin, who reigned over “MTP” for 11 years. Fischer Martin had helped Russert soar to glory, but had disagreed with Gregory over matters of style and substance (she was promoted to oversee all of NBC’s political coverage).
7:07 AM, Apr 21, 2014 • By JAY COST
Since Obamacare “hit” its “enrollment” “target,” Democrats, liberals, and their friends in the press have enjoyed some old-fashioned taunting of Republicans. This would be justifiable if a.) Republicans had destroyed the website that needed fixing or b.) predicted that nobody would sign up for the program in the first place.
Neither condition holds, of course. The website was totally the design of CMS, HHS, and the White House, which are all run by Democrats. Meanwhile, as Michael Cannon argued, it is no big feat to get people to sign up for a heavily subsidized product.
All of this Democratic triumphalism makes it a good time to restate in summary form the conservative case against Obamacare.
For starters, its recent success is grossly overstated.
Eight million “enrollments” is an enormous exaggeration, so much so that you cannot in good faith say that Obamacare “beat” its expectations. In fact, last week the Congressional Budget Office stuck with its most recent prediction of 6 million enrollments:
CBO and JCT estimate that, over the course of calendar year 2014, an average of 6 million people will be covered by insurance obtained through the exchanges. The total number who will have such coverage at some points during the year is expected to be more than the average because some people will be covered for only part of the year.
The 6 million number is not, and apparently never was, the number of paid subscribers arrived at when the enrollment period ended. And why should it be? That has become a politically important number, but from a federal budgetary perspective, a coverage perspective, or an insurer financial perspective, it has no value. What really matters is the annual average.
So, is CBO’s 6 million still justifiable as an estimate? If we take the administration at face value on its monthly enrollment numbers, assume that 90 percent of initial enrollees pay their first month premium, and then a 1 percent non-payment rate thereafter, the annual average for 2014 would be about 5.5 million, and the final enrollment as of December would be about 6.6 million.
It is worth noting on this front that a study from the U.C. Berkeley Labor Center projects that 40 percent of enrollees in Covered California will leave the individual market by the end of the year, either migrating to employment based insurance or Medicaid.
3:33 PM, Apr 20, 2014 • By GEOFFREY NORMAN
Amid the usual news stories this Easter Sunday – accounts of the president’s family attending church and the pope addressing multitudes – there is this startling and vastly hopeful headline:
China on course to become 'world's most Christian nation' within 15 years
According to Tom Phillips, writing in the Telegraph:
Christian congregations ... have skyrocketed since churches began reopening when Chairman Mao's death in 1976 signalled the end of the Cultural Revolution. Less than four decades later, some believe China is now poised to become not just the world's number one economy but also its most numerous Christian nation.
China is, of course, still a one-party state following the transition from Madman Mao to the more technocrat totalitarians of today. While they may be less ferocious than the Dear Leader, they still recognize a threat when they see one:
China's leadership worry about how the religious landscape might shape its political future, and its possible impact on the Communist Party's grip on power, despite the clause in the country's 1982 constitution that guarantees citizens the right to engage in "normal religious activities".
As a result, a close watch is still kept on churchgoers, and preachers are routinely monitored to ensure their sermons do not diverge from what the Party considers acceptable.
They may also be wise enough to realize that they are on the losing side of something even larger than history.
On page one.1:11 PM, Apr 20, 2014 • By DANIEL HALPER
The front page of today's Denver Post skips Easter. Its main focus? Marijuana.
"All weed, no Easter on Denver Post's page one," says media reporter Jim Romenesko.
12:21 PM, Apr 20, 2014 • By DANIEL HALPER
Via the White House pool report:
...Easter worship at Nineteenth Street Baptist Church, DC
First family arrived at church through tented entrance at 10:05 am, and sat in second pew in mostly, but not completely filled church. POOL estimates about 250 people celebrating Easter here.
President, wearing a light khaki suit, is rocking his head back and forth to the fabulous choir and chewing something. Malia is wearing spring yellow dress, and Sasha, her hand to her chin, appears to be in pale gray or pale blue. …
Pastor Dr. Derrick Harkins of Nineteenth Street Baptist Church welcomed newcomers Sunday (grapevine apparently produced worshippers for Easter who are not regulars).
Harkins prompted standing applause in welcoming "the president of the United States." After calling on everyone to stand, turn and welcome their neighbors -- but remain in place -- Harkins watched with amusement some collective disobedience.
The Obamas greeted each other, and the president turned to shake hands behind him with one of a collection of Secret Service agents in the pews. Then 5 minutes of crowd crush took place in which every smart phone, iPad and baby came forth. The president and Mrs. Obama greeted everyone they could. Obama high-fived a baby boy, hugged and kissed women, and Michelle blew kisses from inside their pew.
Pastor Harkins got everyone back in their seats with "Amens" and a joke: "I didn't know we had as many people seated in this front section!"
"Isn't our first family gracious?" he added.
President Obama dropped a white paper or envelope into the silver contribution plate as ushers distributed them through the pews.
More rousing music from the chorus followed... (There are two keyboards, an organ, a saxophone, a harp, drums, and a guitar near the pulpit today, next to the 24-member chorus. The church interior is white and very simple, with six tall leaded windows, three large silver-colored crosses on the wall behind the pulpit, but minimal adornment. One large pot of Easter lilies behind the altar....)
At 11:05 am, an older gentleman stood up from his seat some distance from the president and raised his arm and yelled, "God Bless President Obama!" The worshippers applauded loudly. The president smiled.
Pastor Harkins' urged everyone to join in prayer and offered thanks to God for providing comfort to those in need, including the sick and struggling. He asked that God give Obama "every measure of encouragement" and "wisdom," and "tend to his spirit" under the weight of criticism. Loud "yes" responses from worshippers after each sentence.
Harkins also offered prayers for Malia and Sasha and the first lady.
During a Bible reading/excerpt at 11:25 am -- with the worshippers and first family standing -- Malia rested her head on her dad's left shoulder and he had his arm draped around his tall daughter.
After more terrific music and singing, at 11:35, Pastor Harkins moved into his Easter sermon. Dressed in a striking red robe with black accents, the pastor talked about supporting people "living in the shadows and the margins," including "LGBT" people.
On resurrection Sunday, he talked about how Easter is a time when people can pause, reflect and say "I can rise."
10:40 AM, Apr 19, 2014 • By GEOFFREY NORMAN
The news that the administration would like kept quiet, and which it therefore announced in the afternoon, on Good Friday is that it has:
... further delayed its decision on the controversial Keystone XL pipeline project ...
This means, as Patrick Rucker of Reuters reports:
The legal process will likely continue past November and might stretch into next year, meaning more delays for the politically-charged issue that has been on the drawing board for more than five years.
If the administration wanted the pipeline built, construction would have long since been underway. We aren’t talking about the Panama Canal and while none would confuse President Obama with TR, when he wants something done, he isn’t deterred by the technicalities. Witness the numerous executive fiats regarding the implementation of Obamacare.
The White House political tacticians probably war-gamed it this way:
* Building it doesn’t buy us anything. Not after five years. No votes and no campaign dough.
* Delay keeps the environmentalists happy and that $100 million of Tom Steyer's money in play.
* This gives Mary Landrieu a handy club which she can apply up the side of our head.
* The unions will complain but where will they go.
* The oil will get here anyway, even if trucks and trains are less efficient.
* It’s a hard shot on the Canadians … but, hey, they don’t vote.
* Now, let’s knock off for the weekend.
12:00 AM, Apr 19, 2014 • By IRWIN M. STELZER
A few weeks ago I suggested that we now know when Federal Reserve Board chair Janet Yellen will raise interest rates: never. Her first formal monetary policy speech can be read to support that view, or at least that “normal” interest rates are what the Economist describes as “a distant prospect.” It will take more than the recent spate of good news to stay Yellen from her course.
The Beige Book, a survey of the 12 Federal Reserve districts, was released on the same day as Yellen addressed the New York Economic Club. “Economic activity increased in most [ten] regions of the country ….Consumer spending increased in most Districts … the transportation sector generally strengthened… manufacturing improved… home prices rose modestly and inventory [the stock of unsold houses] remained low….loan demand strengthened … labor market conditions were mixed but generally positive.” Not too shabby as the ‘tweens like to say, in other connections, of course.
Retail sales in March recorded their best gain in a year and a half (+1.1 percent over the previous month), and estimates for January and February were revised upward. That prompted Goldman Sachs’ economists to raise their guess as to what the overall growth figures for the first quarter will show, and Bank of Tokyo-Mitsubishi chief financial economist Chris Rupkey to tell the press, “The linchpin of economic growth, the consumer, is back.” Some analysts doubt whether the pace of the last two months can be maintained, in which case the economy will continue to plod along at a 2 percent growth rate or less. But many mall operators report increased foot traffic, and Mike Jackson, CEO of AutoNation, America’s largest car retailer, says he expects vehicle sales this year to hit 16 million units, topping the 15.6 million cars and light trucks sold last year, which was “a boffo year” according to the industry press.
Other signs are just about as good. Industrial production in March rose smartly, and the manufacturing sector more than regained the sharp, weather-related losses it experienced in January. The much-watched Thompson/Reuters/University of Michigan index of consumer sentiment is at its highest level since July of last year. Those who worry about the government’s deficit found relief from the non-partisan Congressional Budget Office (CBO), which lowered its prediction of the red ink the government will spill both this year and later in the decade.
Finally, more and more companies now say they will stop buying back shares, increasing dividends, and squirrelling away every last penny, and instead increase spending on plant and equipment. Such spending, which rose by a mere 1 percent in 2013, looks set to rise by 6 percent this year, according to data provided by FactSet. The rule of thumb has been that when the economy is producing at 80 percent of capacity, businesses have to expand to meet demand. It is now operating at 78.8 percent of capacity.
3:27 PM, Apr 18, 2014 • By GEOFFREY NORMAN
Politicians looking for work and calling themselves “Democrats” are being advised to avoid using the word “recovery.” As the AP reports:
Election-year memo to Democratic candidates … Stan Greenberg, James Carville and others wrote that in head-to-head polling tests the mere mention of the word "recovery" is trumped by a Republican assertion that the Obama administration has had six years to get the economy moving and its policies haven't worked.
So you talk about how well the Affordable Care Act has worked. And about the War on Women. Whatever …Didn’t Mr. Carville once famously say something to somebody named “Stupid” about the economy?
2:08 PM, Apr 18, 2014 • By MICHAEL WARREN
Republican governor Paul LePage of Maine has a slight lead over his Democratic challenger, House member Mike Michaud, according to a new poll of the race. Here's more from the Portland Press-Herald:
The poll of 400 Maine residents by the Portland-based Pan Atlantic SMS Group shows LePage with a 1.3 percentage-point lead over Michaud, 38.6 percent to 37.3 percent, and independent Eliot Cutler trailing with 20.3 percent.
The poll’s margin of error is 4.9 percentage points, meaning it shows LePage and Michaud in a virtual tie about seven months before the election.
LePage is clearly benefitting from the independent candidacy of Cutler, who also ran for governor in 2010. That year, Cutler actually outperfomed the Democratic candidate, giving LePage the opening to win a narrow victory.
1:48 PM, Apr 18, 2014 • By GEOFFREY NORMAN
Charles Thomas of ABC’s WLS in Chicago reports:
A plan to spend $100 million to build a Barack Obama presidential library in Chicago has taken a step forward. Thursday an Illinois House executive committee approved House Speaker Michael Madigan's bill to construct the library honoring President Obama. Despite the state's precarious fiscal situation, this bill sailed through the committee by a nine to zero vote.
That “precarious” is a nice way of saying “broke” and “bankrupted by the corruption of its political class.”
The high-minded like to call taxes “the price we pay for civilization.”
In Illinois, they call them something else.
12:24 PM, Apr 18, 2014 • By DANIEL HALPER
Kathleen Sebelius is "not considering" a run for Senate, a new report claims.
"A spokeswoman says departing U.S. Health and Human Services Secretary Kathleen Sebelius is not considering running for the U.S. Senate," reads the report from the AP.
HHS spokeswoman Dori Salcido said in an email Thursday night to The Associated Press that Sebelius is continuing her work at the federal agency and isn't considering a Senate campaign.
Sebelius announced April 11 that she was stepping down as HHS secretary. President Barack Obama immediately nominated White House budget director Sylvia Mathews Burwell to replace her.
The New York Times reported this week that Sebelius was considering a run for the Senate seat now held by Kansas Republican Pat Roberts. Sebelius is a former two-term Kansas governor.
12:15 PM, Apr 18, 2014 • By GEOFFREY NORMAN
Beau Biden, son of Joe, will, as Sean Sullivan of the Washington Post reports, be running for governor in Delaware in 2016, further confirming that the impulse to a career in “public service” is genetic and hereditary.
There is Nunn of Georgia. Bush (at least one) of Texas. Cuomo of New York. Paul of Kentucky. And, of course, the young Clinton of … well, the world. She recently announced that she does not rule out a career in politics and that she is expecting. So unto this generation and even the next …
This dynastic trend in American politics cannot be good for the Republic, though it is almost certainly good for the political class, which has been singing in unison the praises of a Bush/Clinton contest for president in 2016. It would make networking so much easier for consultants and advisors and policy types. And having been long in the business, the candidates would know exactly how it is played and would not have to be housebroken.
One almost suspects that in a generation or two or three, after there has been a marriage between the clans Bush and Clinton, we will get a version of American politics that resembles a watered down knock-off of Game of Thrones. Rival clans, then, instead of competing visions.
Unless some descendent of Andrew Jackson comes along, first, and breaks up all the furniture.
10:23 AM, Apr 18, 2014 • By MICHAEL WARREN
Jack Kingston, the Savannah-based Republican congressman running for the U.S. Senate, has been endorsed by the U.S. Chamber of Commerce. Here's more from the Washington Post:
"Now more than ever we need conservative leaders with a demonstrated record of fighting for Georgia jobs, and that leader is Jack Kingston. As senator, Jack will help lead America’s comeback and lay the groundwork for more jobs, more growth, and a generation of prosperity," said Rob Engstrom, the business group's political director.
The chamber's endorsement is important because the group has been known to spend significant money on behalf of candidates it supports.
Kingston is in a five-way primary for the Republican nomination, facing businessman David Perdue, former secretary of state Karen Handel, and two of his House colleagues: Paul Broun and Phil Gingrey. Kingston has earned the endorsement of Sean Hannity, and is considered a favorite among Republican strategists in Washington. The well-funded Kingston campaign released a 30-second TV ad this week, focused on his plan to get more welfare and food-stamp recipients back to work. Watch it below:
A poll released Thursday found Kingston in second place in the GOP primary, with 15 percent support, behind David Perdue at 19 percent. Perdue was the first primary candidate to run TV ads, though his campaign hit a snag recently after video footage was released showing the businessman (and cousin of former governor Sonny Perdue) criticizing one of his opponents for only having a high school diploma. That candidate was Karen Handel, who polled not far behind Kingston with 13 percent support. Handel has been buoyed in her underfunded campaign by endorsements from Sarah Palin and Arizona governor Jan Brewer, as well as the fallout from the Perdue video.
The Republicans are running to succeed retiring GOP senator Saxby Chambliss. The primary will be on May 20, and in this crowded field, no candidate is likely to get the requisite 50 percent support. The top two vote-getters will advance to a July 22 runoff, the winner of which will face presumptive Democratic nominee Michelle Nunn.
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