Tuesday, January 13, 2015

Last Call For Meet The New Austerity Guy

Same as the old austerity guy.  Georgia Republican Tom Price is taking over for Paul Ryan as chair of the House Budget Committee, and where Ryan was good at lying about wanting to wreck Social Security and Medicare, Price really doesn't give a damn.

"What I’m hopeful is what the Budget Committee will be able do is to is begin to normalize the discussion and debate about Social Security. This is a program that right now on its current course will not be able to provide 75 or 80 percent of the benefits that individuals have paid into in a relatively short period of time," he said at a Heritage Action for America event in Washington, D.C., according to AJC. "That’s not a responsible position to say, ‘You don’t need to do anything to do it.’"

Price, whose predecessor Rep. Paul Ryan (R-WI) never put forward major reform proposals in his otherwise ambitious budgets, offered means-testing and increasing the eligibility age as possibilities. He also hinted at privatizing Social Security.

"All those things ought to be on the table and discussed
," he said.

Somehow I think means testing will vanish very quickly from Price's repertoire of "what's on the table".   That leaves raising the eligibility age into the 70's and of course the big one, privatization.  The key here is that Ryan was smart enough to not try to force a government shutdown over Social Security by putting it in the budget talks (and smarter still not to get involved in the clown car mess).  Price apparently is looking for that fight as soon as possible.

We'll see if Democrats can stand up to him, and what can get through the Senate.

New tag: Tom Price.  He's a pretty important guy these days.

Putting On A Clinic

While Republicans are busy trying to fight Obamacare battles from 2010, the retail world and American health consumers are both moving on toward making affordable health care more available with the rise of retail, in-store clinics in drugstores, grocery stores, and Wal-Marts.

Patients suffering everyday complaints like chest colds or ankle sprains have long faced the lamentable choice between waiting days to see their family doctors or enduring time-sucking, unpleasant and expensive visits to hospital emergency rooms, especially at night and on weekends when physicians typically aren't open for business. It's one of the most annoying aspects of the way medical care is provided in the United States.

Big chains like CVS, Walgreens and Walmart are stepping in to try to correct this market failure. These and other retailers are opening hundreds of new walk-in clinics, staffed by medical professionals such as nurse practitioners and physician assistants. They're betting that Americans craving speed, convenience and easy-to-understand prices will be willing to break their habit of expecting a doctor to handle all of their medical issues.

"People are demanding health care to react similarly to other service industries, where people have a need and they want it relatively easy," said Nancy Gagliano, a primary care physician and chief medical officer for CVS Health's MinuteClinic. "The traditional health care system really is not adequate to support the need."

Although still vastly outnumbered by doctors' offices and hospitals, retail clinics are spreading rapidly: There currently are almost 1,900 across the U.S., up more than sevenfold since 2007, according to data compiled by Merchant Medicine, a consulting firm that tracks the sector.

Remember, the Republican argument is that Obamacare was going to make health care both unaffordable and unavailable, and that Americans were going to have to wait weeks to see a doctor for even minor health issues.  The obvious solution, staffing retail clinics with physicians' assistants and nurse practitioners, frees up emergency rooms, urgent care centers, and doctor's offices for more serious medical issues.  Since the Affordable Care Act was passed, the number of these clinics have increased by more than 50%.  I've been to one myself (a Walgreen's clinic) and got prompt service, and they took my insurance.

You're going to see more of these around in the coming years I think, and it's a good thing.  And it's important to remember that the Affordable Care Act made staffing these clinics a lot easier and here in Kentucky these clinics accept Kynect health plans as well as expanded Medicaid, and the electronic medical records provisions allows these clinics to share visit information with your doctor the next time you do visit them.

It's a good idea and I think we need more of these.

The Blue Dog Class Of 2018 May Change Jobs

Given the fact that we sit at home and complain rather than vote in midterm elections, is it any wonder that red state Blue Dog Senate Dems facing a tough 2018 midterm race are instead considering a much easier 2016 gubernatorial race in their respective states?

The 2014 Republican rout left just five red-state Democrats in the Senate — and three of them are thinking about an early exit, decisions that could complicate Democrats’ plans to take back the chamber in 2016 and beyond.

Democratic Sens. Joe Manchin of West Virginia, Heidi Heitkamp of North Dakota and Claire McCaskill of Missouri, all of whom are up for reelection in 2018, are flirting with bids for governor next year instead. If they follow through and win, Democrats fear they’ll open up seats that could favor the GOP. And if they lose, their chance for reelection to the Senate could plunge too.

A McCaskill spokesman said the two-term senator is deciding which office would give her the greatest platform to deliver for Missourians, as well as how it might affect her family. Heitkamp’s office won’t address the gubernatorial rumors, but wary North Dakota Republicans are considering a plan to tinker with the state’s Senate vacancy law. Manchin has said that if the partisan fever in Washington doesn’t break soon, he’ll consider running for governor again.

All three have had gubernatorial ambitions for years: Manchin was elected to two terms as West Virginia’s governor before choosing to run in a 2010 special election to replace longtime Sen. Robert Byrd after Byrd’s death. Heitkamp was defeated in the 2000 governor’s race by Republican John Hoeven, with whom she now serves in the Senate. McCaskill lost narrowly to Matt Blunt in the 2004 gubernatorial contest and now serves alongside Blunt’s father, GOP Sen. Roy Blunt.

The three senators will weigh gubernatorial bids in 2016 against staying in the Senate and facing voters in the 2018 midterms. The past two midterms were disastrous for Democrats, though a new president in 2017 and an improving economy could scramble that dynamic. Still, the loss of up to three proven candidates — who represent states increasingly hostile to Democrats — would be, at minimum, a setback for the party.

Granted, if this is the path they choose it means this sets up battles in those states to choose replacement senators and whatnot, but given that we don't care about midterm elections (not enough to vote in them anyway) do you blame them?

The best part is these are red states, so odds are they will run and lose anyway (Manchin might actually win, but McCaskill and Heitkamp will probably lose big no matter what they do.)  We'll lose more Dem Senate seats, and that means even if we do get the Senate back in 2016, we'll give it right back in 2018.  Probably explains why after this Politico piece went up, Sen. McCaskill immediately denied she was going to run for Governor in Missouri.

Of course, if Democrats voted in midterm elections, this wouldn't be as much of a problem, now would it?


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