Blog Credo

The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.

H.L. Mencken

Friday, March 23, 2012

Because I Have Nothing Better To Say Today

Of course, every time I say there's nothing to talk about, Rush Limbaugh decides to go full neanderthal or the House assembly in Nebraska begins issuing 15 day hunting licenses for ob/gyns that perform abortions.  So, I'm reticent...

Anyway, R-Money is locking this thing up, even as the Etch-A-Sketch comment is firmly cementing people's ideas of who he is (or isn't).  It seems like a Kinsey Gaffe (a gaffe that is damaging because it admits the truth).  I'm surprised Whatshisface still has a job.  I thought Mitt liked firing people?

Anyway, I'm going to try and avoid what all political writers do: go full horse race.  But first, let me go full horse race.

Rasmussen, who has a pronounced and measured GOP "house effect", has Obama winning Virginia handily.  Yeah, yeah, seven months out, blah blah blah.  But I don't think it's complicated why Obama is winning Virginia.  First, he has a very mobilized African American community there.  Second, he has a LOT of government workers who have to be put off by the constant attacks on the government and its workers.  As a result, I have high hopes that not only will Obama win Virginia, but he will carry Kaine into the Senate to replace Webb.  National polls - which are even less predictive than state polls - have Obama up about 5-7 points on Romney, but still around 50%.  Technically, he needs to be over 50% as an incumbent. But when you go into the so-called battleground states, his numbers improve.  If Obama wins Ohio and Virginia, I don't see a path to 270 for Romney.  Given the states Obama pretty much has locked up, winning Ohio, Virginia and Pennsylvania gets him to 263.  If he wins Wisconsin he wins.  If he wins New Hampshire and Iowa, New  Mexico or Nevada he wins.  If he wins Colorado, he wins.  Needless to say if he wins Florida he wins.

Taking Virginia and Ohio makes it really easy for Obama to get those last seven electoral votes.

On a policy side, ACA is having its third birthday party today.

Over at Ezra Klein's House O' Wonk, Sarah Kliff walks through how ACA will make substantial changes in medical care in the US.  Medical expenses and the patchwork private system we were using was incredibly expensive and produced mediocre results in the aggregate.  Most of ACA will address how to bring costs down and improve care (which also brings costs down).

Here's a key segment:

The Affordable Care Act ultimately included 45 delivery system reforms. Fifteen of those change how Medicare doctors and hospitals are paid, according to an analysis by Sen. Sheldon Whitehouse (D-R.I.). The six that have rolled out thus far are largely voluntary, allowing those who think they can deliver more cost-efficient care to opt-in to new payment models.
But the remaining changes will be mandatory. Beginning in October, hospitals stand to lose 1 percent of their Medicare revenue if they can’t hit key metrics on “preventable readmissions” — patients who turn up at the hospital with a complication from an earlier procedure. That’s a big change from the current, volume-based system in which those readmissions generate additional revenue for a hospital.
Although it’s not fully implemented, some say the Affordable Care Act has already significantly catalyzedthe health-care system. Leaders know where Medicare wants to go, even if they didn’t chart an especially aggressive path for how it would get there. “Forever and a day, everybody had been saying we had to change the way we paid for health care,” Roades says. “Now, we have a sense of direction of where the country’s biggest payer is headed. And that provides cover for everybody else to move in that direction.”

And what does that movement look like?

Roades calls the past two years ones of “breathtaking change.” When the Advisory Board Co. surveyed 69 hospital executives in November, just 16 percent said they had bundled payments in place. But of those who didn’t, 75 percent expected to within two years. Two-thirds expected they would have such payment arrangements with Medicare.

To some degree, any change in the way we pay for health care has to be an improvement.

Running on baby steps isn't the best way to capitalize on this issue for the Obama campaign.  Contraception is working fine for now though.  But then again, Romney isn't the best GOP spokesman to attack Obama on ACA, either.

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