The Poor Widow Scenario

To: Josh Marshall
Re: In Effort to Pare Medicaid, Long-Term Care Is Focus

You should read this. It appears to be the beginning of another stick it to the middle class bamboozlement. The majority of the article describes the need to recover more assets from elderly middle class people before allowing them to qualify for Medicaid for long-term care. Then we get to the last three paragraphs:

The dated notion of "Medicaid millionaires" giving away their money and draining the system was debunked last month in a report by the Health Policy Institute at Georgetown University. After an analysis of several federal studies, the report, written by Ellen O'Brien, found that people qualifying for Medicaid gave gifts of less than $5,000 on average, with a minimal impact on the program.

On the other hand, Dr. O'Brien said in an interview this week, there is compelling data on the typical trajectory to poverty from ages 65 to 85. In those two decades, Dr. O'Brien and others say, a healthy, middle-class woman spends considerable money on her husband's long-term care, is widowed and left to manage on the meager benefits of a surviving spouse, spends almost a third of her income on medical expenses not covered by Medicare, assumes she will never wind up in a nursing home and then does.

"That's the heart of the Medicaid story," Dr. O'Brien said. "It's the 'poor widow' scenario, and it's just horrible."

The effect is bizarre, perhaps reflecting a discrepancy between the current terms of the political debate (the opening) and the reality of the situation (the conclusion).

Shocker: Less Healthcare May Cost Less Money

To: Ron Brownstein and Mickey Kaus
Re: Kaus's Response to Brownstein's Article on Healthcare

You're talking past each other. Brownstein's point is to reduce the cost of a given amount of healthcare. Kaus's point is to reduce the overall cost of healthcare by discouraging utilization of healthcare. In Brownstein's article, GM is the consumer, not its employees, and it hasn't been able to reduce costs through savvy bargaining (as opposed to, say, the job Wal-Mart has done on its suppliers).

One interesting statistic from the article, though: $43bn spent for 'uncompensated care' for 45mn uninsured. I'm not sure if that means money spent in addition to whatever the uninsured were able to pay out of pocket, or the total cost of caring for them. If the latter, it's strong evidence (at less than $1000 per person per year) that lack of coverage does save money (contrary to claims that the uninsured end up costing more because they don't practice preventive medicine), and weak evidence that forcing individuals to pay out of pocket reduces costs (weak, because the uninsured are disproportionately poor. Better-off people would presumably spend more, though I don't know how much more.).

Life in the Tropics

To: Lynne Cheney
Re: Cheney Says Detainees Are Well Treated

I'm writing out of concern for your post-Second Lady happiness. Has your husband told you that he believes the Guantánamo detainees as possess "everything they could possibly want"? Could this be projection? I know you've written erotic fiction in the past, but are you prepared to tie him to a chair, smear fake menstrual blood over him, and theaten him with attack dogs -- in short, to become a full-time dominatrix, all for the chance to spend a little time on a tropical beach?

You could run for President yourself. It might keep the little devil occupied.

P.S.
A special shout-out to the NSA for forwarding this message. I was unable find an address for the Second Lady.

Republicanism Is the Viper

To: Josh Marshall
Re: Rove Criticizes Liberals on 9/11

It's worth noting the Rove's use of the bogeyman 'liberals' in his remarks gives him plausible attribution for almost any remark: it should be possible to, ex post facto, find a liberal somewhere who said anything. To turn the tables, it would be accurate (though, of course, misleading) to say: 'Conservatives responded to 9/11 by blaming America, saying it was the just wages of a sinful society; that the attacks were God's judgment and punishment.' You could cite Jerry Falwell.

The larger point is that it's difficult for Dems to win rhetorically as long as 'liberal' is a pejorative and 'conservative' is not. If you think that's a reach, try 'Republican', but there has to be a term of opprobrium big enough to cover the movement, utilized and recognized as such. Look at how hard neo-cons fought 'neo-con' once it became associated with unpopular policies. But 'neo-con' is too narrow. 'Republicanism' is the viper in my throat.

Agenda for a Republican Ethics Seminar

To: Josh Marshall
Re: CunningScam

The Republicans need to conduct an ethics seminar for their members.

Proper:

1) Do dirty work.
2) Retire.
3) Accept payoff.

See, for example, Billy Tauzin.

Improper:

1) Do dirty work.
2) Accept payoff.
3) Retire.

See, for example, Duke Cunningham (retirement pending).

Hollywood Sharks

To: Rebecca Onion
Re: Sharksploitation!

You wrote:

Real sharks, like the gray reef and bull sharks used in Open Water, are smaller and less impressively toothed than Hollywood sharks.

Sort of like real people are smaller and less impressively toothed than Hollywood stars?

Thanks for the article.

The Wedge Party, State by State

To: Mickey Kaus
Re: Dellinger on His Head

You can win a state delegation either by controlling it outright or by controlling enough seats to enable you to win it via coalition with one of the two major parties. You need to win (or tie) enough states to prevent either party from gaining an absolute majority (26), which, in practice, means preventing the Republicans from doing so (see below). Once you've deadlocked the process, you can offer the option of voting for your candidate as a compromise, who, being a centrist, is likely to be less unappealing than the other two options. Imagine the House sorting through Frist, Clinton and McCain for example. Would the Dems throw their support behind McCain if he could prevent Frist from winning outright? Republican support would also be possible, at least on a state-by-state basis.

Currently, Republicans control 30 delegations. One is Arizona, where they have a 6-2 edge, which would be an obvious target for McCain (he'd need only two seats to deadlock, with the support of Dems). Four states have only one Representative and are Republican: Alaska, Delaware, Montana, and Wyoming. Eight states have a Republican majority of one: Colorado (4-3), Connecticut (3-2), Georgia (7-6), Missouri (5-4), Nevada (2-1), New Mexico (2-1), North Carolina (7-6), and Utah (2-1). Also, there's New Hampshire (2-0), which he could deadlock by winning a single seat. Also worth mentioning are Michigan (9-6), Ohio (11-6, 1 vacancy), and Pennsylvania (12-7).

So, if McCain ran candidates in the 12 states with a majority of 1 (+ New Hampshire), he'd need to win as few as 5 out of 38 Republican seats to keep them from getting to 26 in the House. That still leaves the other possibilities mentioned (Arizona, Michigan, Ohio, Pennsylvania). Of course, such an insurgency might disrupt other incumbents, so it's hard to say -- not to mention the general chaos that would ensue the election...

But it's not impossible, and control of the House would be a hell of a consolation prize (the McCainites could win seats in NY & other states that aren't in play delegation-wise, making this a plausible goal. By 'control' I mean swing votes, of course, with no party in the majority.). Let the snowball roll!

Addendum: Idaho (2-0), Kansas (3-1), and South Carolina (4-2) could be deadlocked with a single takeaway. So there's nine more smacks at the apple.

'so-called Council of the Wise'

To: Byron Calame
Re: A New Scourge Afflicts Haiti: Kidnappings

Ginger Thompson wrote:

Danielle Magloire, a spokeswoman for Haiti's temporary governing group, the so-called Council of the Wise, agreed.

Why the sneering epithet? Would the NYT write, "Alberto Gonzales, head of the so-called Justice Department"?

In both cases, skepticism may be warranted, but not expressed in a condescending matter, in a straight news piece.

The Centrist, or Wedge, Party

To: Mickey Kaus
Re: Dellinger on His Head

I agree with Dellinger about 2008, but his point suggests a longer-term strategy for a centrist third party.

1) Run Congressional candidates first. Win enough seats that neither Republicans nor Democrats have a majority in the House. Moderate Republicans ought to be vulnerable to credible candidates who don't carry the baggage of the Democratic Party (e.g. 'we need a truly independent candidate to represent Lake Placid' -- I've lived in upstate New York. It's Republican but liberal. Mostly, the politics are driven by hatred of NYC.).

2) Then run for President... and you only have to finish third to win! That is, unless House Republicans and Democrats decide to form a coalition with each other, which... well, it's really impossible to comment on such a thing.

Actually, this could even work for McCain (your point 2), but he ought to start now: form a third party and run candidates in 2006. If they win enough to deprive the major parties of a majority in the House, that would give him enormous influence immediately, and complete credibility for 2008. I don't think he has the organizational skills, though.

Carpel Tunnel of Love

To: William Safire
Re: Chump Change

1) Shouldn't it be spelled C-A-R-P-A-L?

2) A witticism, but not a coinage. See this (unfunny) cartoon by Tom Stiglich, for example.

3) Perhaps its use should be restricted to the tunnel formed by the fingers in the posture typical of male masturbation.

Why Can't the Dems Elect an Unattractive President?

To: Mickey Kaus
Re: Dionne and the Belmonts

Since WWI, the only Dems elected President have been:

FDR, JFK, Clinton
Truman, Johnson, Carter

The first three were rock stars. Truman & Johnson inherited the office and left in disgrace (Truman's reputation has revived enormously, but as late as the Kennedy-Nixon debate in 1960, Nixon was trying to hang Truman around Kennedy's neck, and Kennedy wasn't defending him). Carter barely breaks the pattern, floating in on the post-Watergate, post-pardon tide, and leaving after one term in, more or less, disgrace.

So, why can Republicans elect everyone from heroic-but-boring Eisenhower, to outright-hideous (I mean, externally - forget about substance) Nixon, to the downright-odd George HW Bush? Reagan was their first and only rock star since TR. It may be the liberal in me talking, but I don't rate GWB, who barely beat Gore and Kerry, in that class. Which is the point: if the Dems had nominated someone with GWB's eloquence, he'd have lost.

And does Hillary have enough star power to meet the threshold in 2008?

Vouchers, Positive & Negative Rights, Corporate/Religious Welfare

To: John Tierney
Re: A Chance to Escape

I'd love to see government-supported, rather than government-run, primary and secondary education, but:

1) You might clarify for your readers whether you support public funding for education in the long run, or, like a respectable libertarian, only see vouchers as a first step to phasing it out entirely.

2) The reason the student-teacher ratio improved dramatically presumably has something to do with the fact that public school teachers are so darn hard to lay off. It's hypocritical to claim this as a success for your approach. If you succeed in breaking the teachers unions, this will no longer hold.

3) The reason religious schools are willing to accept the relatively small vouchers is that they are essentially charitable organizations. To ask a variant of 1): do you see education as a right, or do you want to force poor children to rely on charity?

4) Job security is an important component of the current compensation package for teachers. Are you willing to pay the additional money required to attract talented people to teaching in the absence of job security? If so, why no mention of the need for competitive (with what better-off parents are willing to pay) vouchers?

5) Isn't the Republican seeking to establish a religious wing to the corporate welfare structure? Whatever the merits of a particular program, isn't this worth addressing? Was the voucher amount chosen as ideal for funneling taxpayer money to religious organizations? Or were the best interests of the children uppermost? Or is there no difference (the religious-right position)?