Medicare Spending Gap Falls Again

For quite some time now, the Deficit Hawks in the greater American punditocracy have waved their fear flags about Medicare and how it was going to send the nation down the slippery slope of Greekification.  Better to let each oldster and handicapped person work it out on their own, or depend on relatives or churches, or the side-walks, like the good old days!

Well the latest data shows the worry has been overwhelming their prognostication.  Not that they will stop shrieking of course.  But anyway, here it is:

You’re looking at the biggest story involving the federal budget and a crucial one for the future of the American economy. Every year for the last six years in a row, the Congressional Budget Office has reduced its estimate for how much the federal government will need to spend on Medicare in coming years. The latest reduction came in a report from the budget office on Wednesday morning.

The changes are big. The difference between the current estimate for Medicare’s 2019 budget and the estimate for the 2019 budget four years ago is about $95 billion.

Some of the recent reductions in Medicare spending are because of differences in estimates about the economy and demographics that affect the program.

And some are because of cuts in health care spending passed by Congress. The Affordable Care Act, in particular, made significant reductions to Medicare’s spending on hospitals and private Medicare plans, to help subsidize insurance coverage for low- and middle-income Americans. The Budget Control Act, which Congress passed in 2011, also made some across-the-board cuts to Medicare spending.


Torture: After it Stops, It’s Not Over

The obituary today for Helen Bamber, a long time healer to those who had been tortured, reminds us of the very best humans have to offer one another, and the worst.

Helen Bamber, whose volunteering to comfort broken survivors of a Nazi concentration camp when she was 19 inspired her to devote her next seven decades to helping more than 50,000 victims of torture in 90 countries, died on Aug. 21 in London. She was 89.

… Ms. Bamber said the worst toll of torture was psychic — “the act of killing a man without dying,” a survivor once told her. Torture, she wrote in an autobiography for her foundation, constitutes “a total perversion of all that is good in human relationships.”

“It is designed to destroy not only the physical and psychological integrity of one individual, but with every blow, with every electrode, his or her family and the next generation,” she continued. “The body betrays and is often discarded, a body to be hated for its scars and injuries, a body which is a constant reminder even if there are no scars or remaining injuries.”

Her approach was to treat the whole person, often in group therapy, which she saw as giving alienated victims a sense of community. She recruited dozens of professionals to treat more than 2,000 victims a year, and worked with many patients herself as a psychotherapist — which she became through experience, she said, rather than an academic degree.

Her method involved revisiting victims’ worst horrors and letting them “vomit” them out.

“You have to move into the torture chamber with them,” she told the British newspaper The Observer in 1999. “You almost have to be tortured with them.”

The next step, she told The Irish Times in 1995, is to work with the “noble and good” qualities that can enable a victim to survive. It was enough, she said, to take a victim’s story, hold it and say, “Yes, I believe you.”

Her theory, and practice, of immersion with the sufferer, back into the horror and repetitively talking it out, is much the same as that which has helped those gripped by traumatic stress (PTSD).  As Daniel Shay in his ground breaking book Achilles in Vietnam, says, “healing from trauma depends upon communication of the trauma–being able safely to tell the story to someone who is listening and who can be trusted to retell it truthfully to others in the community.”

The two faces of war trauma, both responsive to re-connecting with the human community that was lost.

Another teacher gone, but a legacy left of those who can carry on the work.


Where ISIS Came From

In thinking about ISIS and their campaign of terror, I don’t have any better ideas about the best response than anyone else I’ve read recently.  I do notice however several things about their origins:

At the top the organization is the self-declared leader of all Muslims, Abu Bakr al-Baghdadi, a radical chief executive officer of sorts, who 1) handpicked many of his deputies from among the men he met while a prisoner in American custody at the Camp Bucca detention center a decade ago.

He had a preference for military men, and so his leadership team 2) includes many officers from Saddam Hussein’s long-disbanded army. (Disbanded by the US invasion)

They include former Iraqi officers like Fadel al-Hayali, the top deputy for Iraq, who once served Mr. Hussein as a lieutenant colonel, and Adnan al-Sweidawi, a former lieutenant colonel who now heads the group’s military council.

The pedigree of its leadership, outlined by an Iraqi who has seen documents seized by the Iraqi military, as well as by American intelligence officials, helps explain its battlefield successes: Its leaders augmented traditional military skill with 3) terrorist techniques refined through years of fighting American troops, while also having deep local knowledge and contacts. ISIS is in effect a hybrid of terrorists and an army.

NY Times; Hubbard and Schmitt

These three points can be expanded by several others.  Not only 3) techniques but logistics of 4) supply and 5) delivery have been developed against American forces.  They know where to get guns, gas, food and water, and how to get all of it to blitzkrieging company sized units.  As any student of warfare can tell you, these are not incidental to taking and holding territory and killing the enemies, they are central.  Had the Americans not invaded Iraq, or carried out the war they way they did, it seems safe to say the practices honed thereby would not exist — at least to such a high degree. These points do not even mention the high-grade and heavy equipment and ammunition left, which have been scooped up and used with some degree of skill. So, 6 ways in which ISIS sprang from American actions.

I’m not of either of  the two camps currently giving ‘expert’ advice on what should be done about the carnage, neither those who claim that had Obama been tougher in Syria two years ago this would not have happened, and so the lesson is to Get Tough Now, nor with those who say a) this has nothing to do with American interests, or b) American intervention will only fuck it up more, therefore, from both at this end: do nothing.

I come from the ‘citizen of the world’ camp, which used to be a commonplace among many of my friends.  The threatened and the dead along the ISIS trail are not neighbors as near as those in California, but they are neighbors nonetheless.  What should, and what can, be done to stop the carnage?  What is available to those out of danger to help those deeply in it, which will not repeat the catastrophic errors enumerated at the top?  How can the guns, gas, water and food to the fighters be pinched and choked off until their threshing machine comes to a halt?  How can the fuel of war-is-wonderful, god approves, be diluted?


De-escalating On American Streets

From The Daily Banter

Police protocol in America allows police officers to apply lethal force when there is “probable cause to believe that the suspect poses a threat of serious physical harm … to the officer or to others.” So a police officer can basically say, “I thought the guy was a threat, so I killed him”. It’s incredibly subjective, and the broad definition and has lead to the death of around 400 people a year in America, a massively disproportionate number being black. That is compared to zero deaths from police shootings in the England and Wales for 2013/14, and zero police officers killed by attackers.

Sometimes the police just move out of the way, and keep talking.  And a sharp baton whack on the shins will bring most people to the ground, if it comes to that.  Not only does the military hardware have to be pulled of the streets but the fire-fight mentality changed in training, policies and minds.  In work places all over American are safety exhortations: 103 days since the last injury accident!  How many do we see in police stations: 1, 229 days since the last officer involved shooting!  I wonder if at police trainings, stories about innovative ways of calming people down are swapped with anything like the fervor of death-on-death encounter?

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Daily Banter also has some nice pix of people, happy in the streets of Ferguson, here.


Dangerous Escalation in the Ukraine

It is not far from my mind how WW I began, 100 years ago: Austria marched its troops into Serbia in retaliation, the King said, for Serbia’s role in supporting the suicide-terrorists who had assassinated the soon-to-be king, Archduke Franz Joseph. With the “Teutons” marching on the “Slavs,” Russian felt obliged to mobilize; with the “Slavs” ["this unorganized Asiatic mass"] in motion the Germans, with militarism the guiding light of the Kaiser and his general Moltke, were happy to oblige — and marched into Russia, and of course France who was vowed to help the Russians.

Now again, troops are crossing borders.  After weeks of threats, bluffs and massing on the border, it seems that Russia has sent two columns into the Ukraine — against the express wishes of that government.

The Russian military has moved artillery units manned by Russian personnel inside Ukrainian territory in recent days and is using them to fire at Ukrainian forces, NATO officials said on Friday.

The West has long accused Russia of supporting the separatist forces in eastern Ukraine, but this is the first time it has said it had evidence of the direct involvement of the Russian military.

The Russian move represents a significant escalation of the Kremlin’s involvement in the fighting there and comes as a convoy of Russian trucks with humanitarian provisions has crossed into Ukrainian territory without Kiev’s permission.

Artillery into the Ukraine

And neither NATO nor the Europeans seem to have an idea how to respond.  Putin sees an advantage and not yet, enough downside to cease and desist.  What, short of armed resistance, will upend the equation to signal Russian/Putin loss instead of gain?

German Prime Minister Angela Merkel [Global Post] is to arrive in Kiev on Saturday, perhaps more persuaded than last time she was there, that serious economic measures have to be taken against Russia.

“We are in the process of a fundamental change in how we see Russia,” [Stefan Meister of the German Council on Foreign Relations.] said in a telephone interview. “You have to understand the policy of the last 20-25 years has failed.”

That policy, marked by regular personal interactions between Merkel and Putin, was intended to nudge and cajole the former communist state to adopt democratic reforms through ever-greater economic ties.

But as the Ukraine crisis has escalated, especially after the downing of Malaysia Airlines Flight 17, Merkel has steadily taken an ever-stronger stance and now appears to have won support for broad economic sanctions from the once-reluctant German business community.


Artic Ice Thinning; Reindeer Seeking Shelter

“One of Norway’s hottest summers on record has caused overheated reindeer to take refuge in a highway tunnel located in the far north of the country.” from Earthweek

“…measurements show the snowpack has thinned from 14 inches to 9 inches in the western Arctic and from 13 inches to 6 inches in the Beaufort and Chukchi seas, north and west of Alaska.”  from Earthweek


Arming The Rebels? Laughable Nonsense

Give Tom Friedman his due.  His response to the recent Hillary Clinton slam on President Obama’s decisions years ago to not arm Syrian rebels against Dictator Assad, not only has a great soundbite, it has 6 questions to be understood:

“The notion that the only reason that the Islamist militias emerged in Syria is because we created a vacuum by not adequately arming the secular rebels is laughable nonsense.”

and the questions, here.

Those hoping for an HRC presidency had better get her thinking about the real world and less about the campaign trail.


Participatory Surveillance

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One of George Orwell’s great insights and fears was not, as in 1984, a draconian dictatorship imposed on the populace but of a participatory one. For the proper benefits (even if only perceived) men will join most anything.  We can see this in many ways in the modern world, accelerating with social media of all kinds.  Well here comes another chance:

Surveil Me!  Surveil Me!

An increasing number of the nation’s auto insurance companies have a new proposition: Let them track every second of your driving in exchange for an annual discount that can reach into the hundreds of dollars if you behave yourself on the road.

In theory, everyone wins here. Progressive, Allstate and State Farm — among the most aggressive of the larger companies that are pursuing this strategy — attract better drivers who crash less often. Customers who sign up for the optional programs can pay premiums based more on how they drive and less on their age, gender or credit history.

At the moment, State Farm and Progressive are not raising rates on people who sign up for monitoring and prove to be terrible drivers. Participation is voluntary, and Progressive, the early adopter in usage-based insurance, says that close to 15 percent of its customers are already enrolled.

Still, as more people sign up, the standard rate will start to feel like a penalty for those who decline to participate…

NYTimes Lieber

Of course somewhere in the big data every purchase I make is being tracked, my preferences, locations, size of purchase…  But we all better start wondering where the line is to be drawn


Algae to Diesel: The Next Big Thing?

I’ve posted about Algae Systems before and am glad to see the New York Times picking up on what is going on in Mobile Bay.  Besides having an interest in another tool to slow the saturation of the atmosphere with CO2 I have a personal interest: my brother is part of the development team. [The big floating greenhouses are his design and implementation.]

Climate Algae Systems

…a Nevada company, Algae Systems, has a pilot plant in Alabama that, it says, can turn a profit making diesel fuel from algae by simultaneously performing three other tasks: making clean water from municipal sewage (which it uses to fertilize the algae), using the carbon-heavy residue as fertilizer and generating valuable credits for advanced biofuels.

If it works, the company says, the process will remove more carbon from the atmosphere than is added when the fuel is burned.

NY Times:Matthew Wald

Hope this proves out… the preliminary, 1/2 scale model seems to be working. Now, on to a full-scale beta, perhaps on a Pacific island which needs an energy source and can provide warm water, human waste and not too many hurricanes!


Libertarian Flim Flam

Paul Krugman is on to the “Libertarian Moment” being proclaimed in some quarters.

Is libertarian economics at all realistic?

The answer is no. And the reason can be summed up in one word: phosphorus.

As you’ve probably heard, the City of Toledo recently warned its residents not to drink the water. Why? Contamination from toxic algae blooms in Lake Erie, largely caused by the runoff of phosphorus from farms.

When I read about that, it rang a bell. Last week many Republican heavy hitters spoke at a conference sponsored by the blog Red State — and I remembered an antigovernment rant a few years back from Erick Erickson, the blog’s founder. Mr. Erickson suggested that oppressive government regulation had reached the point where citizens might want to “march down to their state legislator’s house, pull him outside, and beat him to a bloody pulp.” And the source of his rage? A ban on phosphates in dishwasher detergent. After all, why would government officials want to do such a thing?

And in his on-line blog he reminds us of the cloth from which Paul Ryan is cut:

Brad DeLong reminds us of the original Ryan budget plan — or actually “plan”, as I’ll explain — and emphasizes its dire warnings about a looming debt crisis that wasn’t. But pointing out that the debt panic was unjustified only gets at part of what was wrong with that Ryan budget (and all his subsequent proposals). For the fact is that it wasn’t a proposal made in good faith.

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And, as to the idea that there is a libertarian tide rising, floating the boat of one Rand Paul, Ed Kilgore offers a corrective over at Talking Points Memo.

…to the extent there is something that can be called a “libertarian moment” in the Republican Party and the conservative movement, it owes less to the work of the Cato Institute than to a force genuine libertarians clutching their copies of Atlas Shrugged are typically horrified by: the Christian Right. In the emerging ideological enterprise of “constitutional conservatism,” theocrats are the senior partners, just as they have largely been in the Tea Party Movement, even though libertarians often get more attention.

And here, Kilgore offers a short summary of the above.