“The GOP Trickle Down Effect”: Sequestration Takes A Toll On Cancer And Medicare Patients
A funny thing happened on Rush Limbaugh’s radio show yesterday. The Republican host was complaining about a Washington Post report on sequestration cuts hurting cancer patients in the Medicare program, and told his listeners to ignore the news. “All of this is manufactured and made up,” Limbaugh said. How does he know? Because the sequester didn’t include “any cuts in Medicare,” he added.
And then Limbaugh got a call from a conservative oncologist — in this case, a physician who apparently shares the host’s worldview and has no use for the Washington Post — who conceded that the report is, in fact, accurate, forcing Limbaugh to change the subject.
Sequestration cuts are affecting Medicare — though not as much as some other programs — and as Sarah Kliff explained, cancer clinics really are turning away thousands of patients as a result of the Republican spending cuts.
Oncologists say the reduced funding, which took effect for Medicare on April 1, makes it impossible to administer expensive chemotherapy drugs while staying afloat financially.
Patients at these clinics would need to seek treatment elsewhere, such as at hospitals that might not have the capacity to accommodate them.
Kliff talked to one Long Island oncologist who said he and his staff held an emergency meeting earlier this week and decided they would no longer see one-third of their 16,000 Medicare patients. “It’s a choice between seeing these patients and staying in business,” Jeff Vacirca, chief executive of North Shore Hematology Oncology Associates said.
But if Medicare was supposed to be shielded from the sequestration policy, how is this happening? It has to do with how medical offices are reimbursed for medications that need to be administered by a physician — such as those given to cancer patients.
The New York Daily News reported today:
The so-called sequester cuts will force three-quarters of the thousands of cancer clinics nationwide to start referring Medicare patients to hospitals, according to the American Society of Clinical Oncology and other cancer treatment groups, which have appealed to the White House and Congress for help.
Elderly cancer patients are being hit hard because their drugs are among the handful of pharmaceuticals that were affected by the sequester cuts.
Medicare reimbursed oncologists for the cost of chemo drugs, plus 6%. But under the sequester, the federal government is now providing only 4% on top of the drugs’ cost, which can run $900 to $15,000 for a full course, depending on the cancer.
That 2% difference may not sound like much, but given the costs involved, it’s an enormous pay cut for the cancer clinics, which some are now saying is a prohibitive new expense they can’t afford.
Ted Okon, director of the Community Oncology Alliance, told Kliff, “If you get cut on the service side, you can either absorb it or make do with fewer nurses. This is a drug that we’re purchasing. The costs don’t change and you can’t do without it. There isn’t really wiggle room.”
Note, this doesn’t mean the sequester is necessarily cutting off cancer patients, but rather, it means these patients are being told by their local oncology clinics that they’ll have to seek care at hospitals — where the care will be less efficient and more expensive.
In case anyone’s forgotten, it’s within Congress’ power to simply turn the sequester off. The whole thing could take five minutes. But for now, congressional Republicans have ruled out the possibility of turning it off, and have also ruled out the possibility of a compromise to replace these brutal spending cuts.
With each passing day, we learn of increasingly drastic consequences associated with the policy.
By: Steve Benen, The Maddow Blog, April 5, 2013
“Salted Nuts”: The “Nutters” Push Back Against The RNC Blueprint
Reflecting on the Republican National Committee’s “Growth and Opportunity Project,” Dave Weigel noted that the blueprint “is less a program of reform than a rough blueprint about how to marginalize the nutters.”
That’s clearly true. The structural reforms are intended to “marginalize the nutters” in terms of their electoral influence; the rhetorical reforms are intended to “marginalize the nutters” in terms of public perceptions of the party; and the policy reforms are intended to “marginalize the nutters” who are pushing Republicans to embrace an even more radical policy agenda.
At times, Reince Priebus and his report aren’t subtle on this, specifically criticizing “third-party groups that promote purity.”
With this in mind, the simmering intra-party “civil war” between the Republican base and the party establishment is intensifying, right on cue.
“It looks like a system of the establishment, by the establishment, and for the establishment,” said conservative P.R. executive Greg Mueller, a veteran of Pat Buchanan’s campaigns. […]
Davie Bossie, head of the conservative group Citizens United, fretted that the proposals would mean conservative grassroots candidates, already outmatched organizationally and financially against the GOP establishment on the presidential level, “even less opportunity to break through.”
“I don’t think that is a good thing for the party and I definitely don’t think it’s a good thing for the conservative movement,” said Bossie.
Rush Limbaugh wasn’t happy, either, saying Republican leaders have been “bamboozled” by focus groups. “They think they’ve gotta rebrand and it’s all predictable,” the radio host said. “They gotta reach out to minorities. They gotta moderate their tone here and moderate their tone there. And that’s not at all what they’ve gotta do. The Republican Party lost because it’s not conservative.”
This is probably going to get worse before it gets better — and for a party in transition, it’s a fight that’s probably unavoidable.
Priebus’ plan is not necessarily going to be what the party does in the near future. The RNC’s membership will need to debate and approve any changes, and that will take place over the course of several months, starting in April at the party’s spring meeting in Los Angeles. One assumes those meetings will be quite lively, with the fights playing out in public.
And here’s the kicker: that’s not necessarily a bad thing, since the Republican Party really does need to have these fights. At the presidential level, the GOP has lost the national popular vote in five of the last six elections. The electorate has elected a Democratic Senate majority for four consecutive elections. The party hasn’t been this unpopular since Watergate; its ideas are struggling for public support; and with no real leaders, it’s not even clear what the party’s core beliefs are in several key areas.
There are still about 19 months before the midterm elections and nearly three years before the party begins choosing its new standard bearer. This is, in other words, an ideal time for the party to have a knock-down, drag-out fight over what the party intends to be.
It won’t be pleasant, and some party contingents won’t be pleased with the results, but it’s arguably a worthwhile endeavor for the party’s long-term health.
By: Steve Benen, The Maddow Blog, March 19, 2013
“Muting Women”: Like A Sailboat On A Lake With No Wind, The Status Of Women Is Stuck In A Lull
What a surprise. Men are drowning out women in the public conversation, a new report from the Women’s Media Center tells us.
Actually, it is a surprise to learn just how bad it is, as if there never was a women’s movement launched by Betty Friedan’s classic, The Feminine Mystique, 50 years ago, which decried the quiet desperation of domestic suburbia.
Fifty years ago is long enough for a cultural forgetfulness to fall over us and long enough for a hostile camp of enemies to make their living mocking women’s empowerment—and yes, I mean you, Rush Limbaugh, most of all. You are the self-appointed keeper of the patriarchy’s keys. The medieval archbishops of the Catholic Church are vigilant in the war on women. The mean-spirited men of the Supreme Court can be counted on, too, ready to usurp our human rights if the “right” opportunity presents itself. Meanwhile, Michelle Obama has new bangs.
In other words, ladies, things are not getting better for us in the 21st century. The recession has been rough on everyone, but especially for our place in the workplace world. As a journalist, let me share some numbers that show you how the conversational monopoly works. In the 2012 presidential campaign, male bylines outnumbered female bylines by nearly three to one, according to he Women’s Media Center. Newspaper decision-makers are usually male in these tight times, as are the subjects of most front-page stories, even obituaries. Then the echo chamber takes effect, because men are far more likely to be quoted than their female colleagues in public discussions—especially on politics.
The Sunday talk shows, the power listening posts of the Washington establishment, predominantly invite men as their guests. But here’s the thing: only 14 percent of the interviewed guests and 29 percent of the roundtable guests are women, according to the report. The hosts conducting the dialogue are predominantly male. Avuncular, authoritative Bob Schieffer of Face the Nation is by far the best of ’em.
Women protested this state of affairs at the ballot box last fall. Twenty women senators are now serving, more than ever before. Is this a critical mass that will change the conversation, or the conversationalists? Let’s see.
I remember being in a panel cable interview after the State of the Union with two good guys—Howard Fineman and Steve Roberts. I had something sparkling to say but even I was drowned out by these older silver-tongued pros, who later apologized for being “the two biggest airhogs in Washington.” It’s a salty slice of memory. Men are just used to talking over women, just as boys talk over girls, like breathing. It happens all the time in Washington. What made Hillary Clinton’s verbal victory over her attacking jousters in her valedictory Senate hearing so extraordinary was because it was, well, extraordinary in this talkative town. She lifted morale all over for Washington women.
To our rescue comes Sheryl Sandberg of Facebook, who is lighting a match to start a “Lean In” movement. More on that another day as it gets underway. Consider the Oscars: Daniel Day-Lewis was honored for playing the greatest president and humanitarian in our history while Jennifer Lawrence won for playing a wifely female stereotype. As I listened to two male critics from the New York Times website comment on every single Academy scene in the show, it felt relentlessly normal. We are such good listeners.
The status of women is stuck in a lull, like a sailboat on a lake with no wind. And we are the ones who have to start speaking our views and telling our stories—to borrow from radical abolitionist William Lloyd Garrison—so that we will be heard.
By: Jamie Stiehm, U. S. News and World Report, February 25, 2013
“Rage-Driven Fanaticism”: Deluded Republican Reformers
Conservative pundits and intellectuals have spent the past week or two—ever since the publication in Commentary magazine of Peter Wehner and Michael Gerson’s “How to Save the Republican Party”—talking about, well, how to save the Republican Party. They have lots of ideas—some good, some not so good, most very sober-minded policy prescriptions. I wrote a short blog post about this on Thursday. But then I reflected: This topic needs a longer treatment. The party they purport to support and care about has been engaged in burning down the house of American politics for three or four years now, and they are saying nothing about it; and until they say something about it, everything else they say is close to meaningless.
As I’ve written many times, the conventional view of what’s wrong with the GOP gets at only a portion of the truth. When The New York Times or Politico does such a story, the story inevitably focuses on policy positions. Immigration. Same-sex marriage. Climate change. Tinker with these positions, several sages are quoted as saying, and the GOP will be back in the game.
God knows, policy positions are a problem. But they are not the problem. The problem is that the party is fanatical—a machine of rage, hate, and resentment. People are free to scoff and pretend it isn’t so, but I don’t think honest people can deny that we’ve never seen anything like this in the modern history of our country. There’s a symbiosis of malevolence between the extreme parts of the GOP base and Washington lawmakers, and it is destroying the Republican Party. That’s fine with me, although I am constantly mystified as to why it’s all right with the people I’m talking about. But it’s also destroying the country and our democratic institutions and processes, which is not fine with me.
The party can change all the positions it wants, but until people stand up and yell “Stop!” to this fanaticism, it won’t mean anything. In fact, the problems feed into each other, because the idea that today’s Republican Party can change its stripes on same-sex marriage or immigration is absurd, and it is absurd precisely because of the rage and fanaticism I’m talking about, much of which is directed at brown people and gay people. Such a party cannot change its stripes on these issues until the mindset and world view are changed.
Immigration, you say? I’ll believe it when I see it. In fact, I’ll make a prediction now: I bet the House is likely to break immigration reform into two pieces, enforcement and path-to-citizenship. Maybe more, but for now let’s say two. A big majority of Republicans will support the former. The latter will pass, if it does, with a small number of Republicans joining nearly all Democrats, and therefore only with John Boehner breaking the Hastert Rule once again. And the haters will go on hating.
And the following people will write nothing about it: David Brooks; Ross Douthat; the aforementioned Wehner and Gerson; Reihan Salam; Yuval Levin; Ramesh Ponnuru. Now I know most of these gentlemen, and I like them. But they’ve been participants to varying degrees in these recent conversations I’m talking about, and frankly, they are wasting their own and their readers’ time. They’re like a family in deep denial at the Thanksgiving table. Guys, debating the best way to cook brussels sprouts is of marginal utility. Whether Cousin Ruthie wears her hair this way or that way is not worth dwelling on. The overwhelming fact at hand is that Uncle Ralph is drunk again, and he’s being a belligerent racist homophobic ass again, and he is preventing any civility and progress from taking place, and it’s been this way for four Thanksgivings in a row, and you are intentionally choosing to say nothing about it.
I do not understand how they can watch this and let it happen—to their party!—without saying anything. This past week, we have had four Republican senators—Ted Cruz, Lindsey Graham, Kelly Ayotte, and Rand Paul—in essence demand that a cabinet nominee, Chuck Hagel, disprove rumors against him. It’s one thing for Breitbart bloggers to do that. But senators? Using tactics that are straightforward McCarthyism? If one of the above named or some other prominent conservative pundit criticized that quartet, then good for them. But I sure didn’t see it, and I think I would have.
Like me, I’m sure many of you were aghast at those people who cheered John McCain when he lectured the parent of the son who was killed in the Colorado shooting. There was blood lust in that cheer, just like the blood lust in the boos back in the presidential primary season of that gay soldier. Are any conservative thinkers writing that this kind of thing makes them sick and ashamed?
We all know the problem. It’s Rush Limbaugh and his imitators and Roger Ailes and his network. They drive this hatred daily, and they intentionally misinform and lie; you think it’s an accident that polls always find Fox viewers the least connected to empirical reality? Pushing this fury and constructing this alternate reality is great for business. But it’s horrible for America. And the “serious” conservative pundits by and large try to pretend it doesn’t exist, or it’s not that bad, or MSNBC does the same thing in reverse. Well, it does exist, it is that bad, and no, MSNBC does not do the same thing in reverse. MSNBC has an agenda, but it doesn’t craft its messages in such a way as to make it viewers hate half the country.
This is the poison in our politics. Nothing changes until it changes. Somebody has to initiate it, and the people I named are the only people who can. Of conservative thinkers—and I apologize to him in advance for naming him, because I’m sure praise from me in this context will make him wince—only David Frum has addressed this problem. His 2011 New York magazine essay “When Did the GOP Lose Touch With Reality?” said it well. He understands that this problem is one of the central facts of our current historical moment.
If that were my party or movement, I promise you I would criticize it (and I did, in a book in 1996, as Brooks and others know). I sure wouldn’t be wearing blinders and pretending that my side could solve its problems with the right kind of EITC expansion. I’d be glowering at Uncle Ralph as he poured himself another, getting surlier and surlier, and I’d be scheming to take the bottle away.
By: Michael Tomasky, The Daily Beast, February 23, 2013
“Dire Consequences And Denial”: With Their Jobs Secure, Republicans Could Less About The Rest Of America
The sequester’s automatic, across-the-board spending cuts are set to go into effect on Friday, and there is no plan as yet to stop it.
America, this is your feeble government at its most ineffective and self-destructive.
The White House favors a balanced plan that would include spending cuts and some tax increases for the wealthy. Republicans reject any solution that includes tax increases.
These are two fundamentally different perspectives, only one of which is supported by a majority of Americans.
A Pew Research Center/USA Today survey released Thursday found that only 19 percent of Americans believe that the focus of deficit reduction should be only on spending cuts. Seventy-six percent want a combination of spending cuts and tax increases, with more emphasis on the former than the latter.
But the impasse could have dire consequences. A study last year by Stephen S. Fuller, a professor at George Mason University, estimates that the sequester could cost 2.14 million jobs and add 1.5 percentage points to the unemployment rate. Fuller’s analysis was cited in a Congressional Research Service report prepared for members of Congress.
What’s more, the sequester would reduce military spending by $42.7 billion; nonmilitary discretionary spending would drop $28.7 billion, in addition to a mandatory $9.9 billion reduction in Medicare, according to the Congressional Budget Office.
In anticipation of the very real possibility that the sequester could come to pass, some Republicans are leaning on the shoulder of an old friend: denial.
This week on CNN, Senator Rand Paul pronounced the $85 billion in mandated cuts a “pittance” and a “yawn” that is “just really nibbling at the edges.” He also called President Obama’s warnings about the sequester’s impact “histrionics,” “ridiculousness” and “emotionalism.”
What a perfect segue to Rush Limbaugh, who took to the air this week to denounce predictions about the sequester’s effects as a “manufactured” crisis, saying that “for the first time in my life, I am ashamed of my country.”
Limbaugh continued:
“In truth, we’re gonna spend more this year than we spent last year. We’re just not gonna spend as much as was projected. It’s all baseline budgeting. There is no real cut below a baseline of zero. There just isn’t. Yet here they come, sucking us in, roping us in. Panic here, fear there: Crisis, destruction, no meat inspection, no cops, no teachers, no firefighters, no air traffic control. I’m sorry, my days of getting roped into all this are over.”
Those not denying the crisis are hoping to exploit it.
Karl Rove, writing in The Wall Street Journal on Thursday, called the president “a once-in-a-generation demagogue with a compliant press corps” who will subject the American people in the short term to a “slew of presidential photo-ops with those whom he claims will lose jobs.” Mr. Rove advised House Republicans to “pass a continuing resolution next week to fund the government for the balance of the fiscal year at the lower level dictated by the sequester — with language granting the executive branch the flexibility to move funds from less vital activities to more important ones.”
Rove supports the steep cuts but wants to allow the president “flexibility” in applying them. That Rove is as slick as an eel. In other words, he wants to force the president to rob Peter to pay Paul and take the flak for making all the tough choices.
Another Pew Research Poll released this week found that although many Americans favor cutting government spending in the abstract, most don’t agree with cuts to specific programs. “For 18 of 19 programs tested, majorities want either to increase spending or maintain it at current levels,” Pew found. “The only exception is assistance for needy people around the world.”
Ah, foreign aid, the tired old whipping horse that would do virtually nothing to reduce the deficit, as it accounts for a paltry 1 percent of the federal budget.
Rove’s plan to shift to the president the burden of choosing where to bring down the ax is Rove’s way of getting Republicans “to win public opinion to their side.” That is a roundabout way of acknowledging that right now they’re losing. A Bloomberg poll released this week found the president’s job-approval rating at its highest level and the Republican Party’s favorable rating at its lowest since September 2009.
Furthermore, the Pew/USA Today survey found that if a deal isn’t reached in time, about half the public will blame Congressional Republicans while fewer than a third will blame the president.
And if the sequester happens, we’ll all lose. It will be a disaster for the job market and the economy. But no one can accuse these politicians and pundits of caring about such things as long as their own jobs are secure.
By: Charles M. Blow, Op-Ed Columnist, The New York Times, February 22, 2013
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