Saturday, April 09, 2011

Unplanned, unwarranted, unbelievable

I don't agree with everything this toon portrays; I just don't think Boehner is all that bothered by being manipulated in this fashion. Nor does most of the rest of the Republican party, for that matter.

Oh sure, there are exceptions -- even in Texas, like Bob Deuell and Jane Nelson -- but generally the GOP is more like Mike Pence and Jon Kyl: they want to force women to bear children and then starve both mother and child to death. They don't want to pay for their medicine and they damn sure don't want to pay for their education. And they will tell any lie they can think of to advance their cause.

But hey, elections have consequences. When we elect weak-ass conservative Democrats to negotiate with terrorists (declaring the resolution of the budget stalemate last night  a victory, for example), we can't be too shocked about the outcome.

Wednesday, April 06, 2011

Texas Medicaid cuts will result in thousands of job losses and pharmacy closures

The Texas Legislature's intention to cut the state's share of Medicaid expenses will -- as with every other measure they are considering to fill a $27 billion hole without raising taxes -- result in thousands of lost jobs. It will also result in the closure of many (mostly rural) pharmacies across the state, limiting access to medications for everyone. From Pharmacy Choice and Access Now's press release:

Lawmakers are planning to introduce a large, bureaucratic middleman known as a “Pharmacy Benefit Manager” to administer 80 percent of Medicaid’s prescription drugs through a restricted managed network. In addition, they are proposing extreme cuts to Medicaid reimbursement rates paid to pharmacies. These cuts would take the form of significant reductions to dispensing fees, which are used to cover the overhead of pharmacies already operating on razor-thin margins. Without open access networks and adequate reimbursement levels as the cornerstones of Texas' pharmacy Medicaid program, community pharmacies could find themselves no longer able to serve Medicaid patients or even to stay in business.

Faced with a grave budget scenario, rising numbers of Medicaid patients, and the always-increasing costs of medicine, Texas Republicans are squeezed in a vise of their own making. And when they close and bar the door to any tax increases or revenue enhancements, that leaves only one bad choice.

Dr. Ray Perryman has an executive summary (.pdf) focusing on the economic implications of the proposed legislation. It lays out three scenarios based on various cost-reduction proposals. Each scenario shows that a large numbers of community-based pharmacies will be forced to close, consequently leading to decreased access to service not just for Medicaid patients, but for all those needing medicine.

"While it is easy to claim superficial efficiencies now, our analysis indicates that this proposal will ultimately hurt patients, taxpayers, community pharmacies and, ultimately, the economy of Texas."

"If these proposals become law, our state’s neediest patients will not be able to get their medications from their local pharmacy -- from the people they know and trust,” explained Tammy Gray, owner of Buda Drugstore and PCAN spokesperson. “Local pharmacies have been the cornerstone of communities for generations, and local pharmacists know their customers the best. We can’t let bureaucracy get in the way of patient care. And this isn’t just about Medicaid recipients. If the local pharmacy shuts down, it will impact the entire community."

Dr. Perryman's analysis found that the economic impact was severe: the worst case scenario estimated $4.7 billion in lost revenues and over 64,000 permanent job losses if dispensing fees and Medicaid 'carve-in' proposals are adopted.

"This proposal is being falsely promoted as a cost-saving measure, yet as presently structured, it represents a new bureaucratic layer that will mean duplicated efforts and actually increase costs,” said Dr. Perryman.

Even a Republican objects.

Rep. Fred Brown (R-College Station) echoed concerns that the cuts are too drastic and will hurt patient access and harm the local and state economies.

"The Texas legislature should reject short-sighted proposals that will reduce patients’ access to prescription drugs and will increase costs long-term when access to Medicaid services is restricted,” said Rep. Brown. "Current proposals to move Medicaid to pharmacy benefit managers unnecessarily adds waste and bureaucracy. We already have a Medicaid pharmacy vendor program that works. The pharmacy benefit managers and their allies, the big pharmaceutical companies, have a long history of acting against the best interests of the State of Texas. Since 2000, the Texas Attorney General has sued “big pharma” for overcharges in Medicaid, for over $420 million. We've had a hard time keeping them out of the state's cookie jar, and now we're just going to hand it to them? Texans deserve better."

Contact your elected officials and tell them that cuts to Medicaid are unacceptable.

(cross-posted at PCAN)

Not In.

Jon Stewart speaks for me.

Mark Morford also. The first part, anyway.

And suddenly we come to the crux of the problem: What shall we do about Barack in 2012? Have you heard this question recently? Have you felt its icy breath on your neck, its uncomfortable presence in your day, your heart, your daily media grind? I bet you have. Right now, it looms bright and large. For our fair president has just announced, via slick email/tweet/video clip showing all sorts of dorky postcard Americana -- red barns, fluttery flags, babies on a stick, $9 coffee drinks -- that he is officially running for re-election. Yes, already. This is apparently now how it works in American politics: You are allowed no more than 2.4 years of impossibly difficult service as redeemer president, shouldering the overwhelming burden of failure foisted on you by your pathetic predecessor, before you have to start fundraising, glad-handing and talking wistfully about your Kenyan father all over again.

He turns on those of us wallowing in our ennui in a hurry after that.

In short, Obama has failed. He has not at all been the delicious chocolatey superjesus of radical sociopolitical transformation most on the hard left hoped, prayed and sacrificed precious Prius bumper ad space he would be. Hence, the conundrum. Given all this mealy disappointment, how now to best rally the troops and get out the vote in 2012 with anything resembling the passion and fervor of 2008, so as to defy any further sickening GOP onslaught? How to champion a guy who has been such a general liberal letdown ...?

My excerpting greatly mimimizes the flagellation Morford administers to progressives here. His point -- which is sharp and sticky also -- is that Obama's shortcomings pale like a Teabagger's springtime shins compared to his potential rivals ...

The solution to this conundrum is actually very easy. If you're unsure of Obama because he's been less the demigod superhero studbunny you hoped for, well, you have but to merely glance at the competition. Across the board and down the line, the GOP contenders for 2012 so far are laughingstocks and charlatans, complete caricatures of actual humans with brains. The Palins and the Bachmans, the Huckabees and the Newts, the Trumps and the Romneys -- it's all birthers and paranoids, adulterous slugs and ditzball sociopaths, fringers and terrified Mormons, a bloody madhouse clown car of cutesy whiffleball glop. I can hardly wait for the debates.

Yep; it's probably the biggest bunch of jokes and losers ever assembled by the GOP. And that alone is an amazing accomplishment. But back to Morford and his beatdown.

So while libs can whine all they want about Obama's imperfections and so-called failures, the instant you turn it all around and look at the alternatives, and then hitch them to the current GOP-led House's plans to gut the budget and spew hate on women and gays, the arts and the poor, promote Islamophobia and kowtow to the rich, well, suddenly Obama shines all over again like the gleaming savior we all want him to be. Suddenly all the complaining turns into nitpicking. Suddenly that vague dissatisfaction is instantly overshadowed by this shuddering, sour tang deep in the gut that just about screams OMFG, thank God Obama's there, how much worse off we'd be without him, how much good he's actually accomplished, how blessed his articulate intelligence, how proud we are every time he travels abroad -- please, please, please don't ever leave and sorry we complained in the first place and oh my God please don't leave.

Yes, it's moral and political relativism, writ large. Who cares? What else could it ever be?

So count your presidential blessings, libs, for while they may be tattered and rashy and often pinch and ride up, they are, on the whole, still plentiful and hugely impressive and just shockingly better than any alternative you can name, much less vote for. And you know it.

But see, Mark, all of those libs who worked so hard four years ago for the hope and change on the come just aren't going to buy in this go-round. That leaves a whole lot of other people to make the calls and walk the blocks and knock the doors. The disillusionment is compounded in Texas; we'll likely have a Democratic nominee for Senator to the right of West Virginia's Joe Manchin and Nebraska's Ben Nelson (which is light years better than a Republican to the right of John Cornyn and Rand Paul, but that's still a Hobson's choice). In Houston, our mayor's up for re-election too, and she thinks she has to do the same thing as Obama: appeal to conservatives.

The difference between Obama's base in 2012, and those who rearranged their lives to get him elected in 2008, it would appear, is the people who will vote for him because he seems honest and well-meaning most of the time and he doesn't embarrass us when he goes to other nations.

The original base was folks who opened their homes to Obama staff volunteers, made calls, gave financially out of family funds that were tight even then. People who had community meetings in their homes, proudly displayed Obama shirts and stickers, and gave more than they ever had to a candidate. There were the peace advocates who were desperate to have someone in the White House who would stop the Iraq war and close the illegal prisons and torture chambers.

And then there were those who felt strongly that the * Administration should be examined and held accountable for war crimes and crimes against our Constitution. Or just ending the warrantless wiretapping, for one small thing.

The dirty effing hippies. Or the effing retards, as Rahm Emanuel said. The "professional left", as Robert Gibbs noted.

I wish Obama well with his re-election campaign. Despite the efforts of the Republicans and the Teas, a lot has changed, but then... a lot has stayed the same.

(All of this will be to the benefit of the Texas Greens, on the ballot top to bottom for the first time in many years, and will perhaps pull the Texas Democratic Party back from its rightward tilt. Maybe. Eventually.)

Having said all that, I'm out on choosing the least worst of two options. Which is why I'm not in.

Update: Paul Krugman is perplexed.

Monday, April 04, 2011

The Weekly Wrangle

The Texas Progressive Alliance would have voted against HB1 as well. Here's this week's blog roundup.

Off the Kuff notes that when one Bradley goes away, another one gets nominated.

Three Wise Men examines the possibility of a federal government shutdown and what Republicans are doing with the budget in Texas.

Musings rounds up news on teacher layoffs across Texas.

Presenting the comedy gold of the Honorable Anthony Weiner of The Bronx, NY, now showing for a limited time at Brains and Eggs.

CouldBeTrue of South Texas Chisme says you just have to read the paper to see how Republicans are destroying every thing and everybody they can.

WCNews at Eye On Williamson says It’s time for the left to join the class war.

At TexasKaos, more on Rick Perry's assault on our beloved state. See GOP Robs Texas of its Future. If this doesn't make clear what Perry is doing, Texans will never get it.

Marking the 43rd anniversary of the death of Martin Luther King, Neil at Texas Liberal reposted his 2011 MLK Reading & Reference List. Every day is the right day to be hopeful. Study MLK's life and make the decsion to take action for a better America. Nobody will do the work of freedom and democracy for you.

Who would have guessed that the biggest problem we have in the US is that taxes are too low? Turns out, McBlogger says, that's THE problem ... not spending.

After a weekend of masochistically watching the House debate the state budget, TexasVox pointed out several billion dollars in untapped and environmentally friendly revenue that we've left on the table, while the natural gas industry whines that without their corporate welfare check they'll have to move more of their drilling operations out of state to other states like Pennsylvania. Awww, poor babies.