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FOCUS: Obamacare Hits a Bump Print
Friday, 19 August 2016 10:35

Krugman writes: "Some real problems are cropping up. They're problems that would be relatively easy to fix in a normal political system, one in which parties can compromise to make government work."

Paul Krugman. (photo: Bloomberg)
Paul Krugman. (photo: Bloomberg)


Obamacare Hits a Bump

By Paul Krugman, The New York Times

19 August 16

 

ore than two and a half years have gone by since the Affordable Care Act, a.k.a. Obamacare, went fully into effect. Most of the news about health reform since then has been good, defying the dire predictions of right-wing doomsayers. But this week has brought some genuine bad news: The giant insurer Aetna announced that it would be pulling out of many of the “exchanges,” the special insurance markets the law established.

This doesn’t mean that the reform is about to collapse. But some real problems are cropping up. They’re problems that would be relatively easy to fix in a normal political system, one in which parties can compromise to make government work. But they won’t get resolved if we elect a clueless president (although he’d turn to terrific people, the best people, for advice, believe me. Not.). And they’ll be difficult to resolve even with a knowledgeable, competent president if she faces scorched-earth opposition from a hostile Congress.

The story so far: Since Obamacare took full effect in January 2014, two things have happened. First, the percentage of Americans who are uninsured has dropped sharply. Second, the growth of health costs has slowed sharply, so that the law is costing both consumers and taxpayers less than expected.


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Aetna Shows Why We Need a Single Payer Print
Friday, 19 August 2016 08:53

Reich writes: "The best argument for a single-payer health plan is the recent decision by giant health insurer Aetna to bail out next year from 11 of the 15 states where it sells Obamacare plans."

Robert Reich. (photo: Getty)
Robert Reich. (photo: Getty)


Aetna Shows Why We Need a Single Payer

By Robert Reich, Robert Reich's Blog

19 August 16

 

he best argument for a single-payer health plan is the recent decision by giant health insurer Aetna to bail out next year from 11 of the 15 states where it sells Obamacare plans.

Aetna’s decision follows similar moves by UnitedHealth Group, the nation’s largest insurer, and Humana, one of the other giants.

All claim they’re not making enough money because too many people with serious health problems are using the Obamacare exchanges, and not enough healthy people are signing up.

The problem isn’t Obamacare per se. It’s in the structure of private markets for health insurance – which creates powerful incentives to avoid sick people and attract healthy ones. Obamacare is just making the structural problem more obvious.

In a nutshell, the more sick people and the fewer healthy people a private for-profit insurer attracts, the less competitive that insurer becomes relative to other insurers that don’t attract as high a percentage of the sick but a higher percentage of the healthy. Eventually, insurers that take in too many sick and too few healthy people are driven out of business.

If insurers had no idea who’d be sick and who’d be healthy when they sign up for insurance (and keep them insured at the same price even after they become sick), this wouldn’t be a problem. But they do know – and they’re developing more and more sophisticated ways of finding out.

It’s not just people with pre-existing conditions who have caused insurers to run for the happy hills of healthy customers. It’s also people with genetic predispositions toward certain illnesses that are expensive to treat, like heart disease and cancer. And people who don’t exercise enough, or have unhealthy habits, or live in unhealthy places.

So health insurers spend lots of time, effort, and money trying to attract people who have high odds of staying healthy (the young and the fit) while doing whatever they can to fend off those who have high odds of getting sick (the older, infirm, and the unfit).

As a result we end up with the most bizarre health-insurance system imaginable: One ever more carefully designed to avoid sick people.

If this weren’t enough to convince rational people to do what most other advanced nations have done and create a single-payer system, consider that America’s giant health insurers are now busily consolidating into ever-larger behemoths. UnitedHealth is already humongous. Aetna, meanwhile, is trying to buy Humana.

Insurers say they’re doing this in order to reap economies of scale, but there’s little evidence that large size generates cost savings.

In reality, they’re becoming very big to get more bargaining leverage over everyone they do business with – hospitals, doctors, employers, the government, and consumers. That way they make even bigger profits.

But these bigger profits come at the expense of hospitals, doctors, employers, the government, and, ultimately, taxpayers and consumers.

So the real choice in the future is becoming clear. Obamacare is only smoking it out. One alternative is a public single-payer system. The other is a hugely-expensive for-profit oligopoly with the market power to charge high prices even to healthy people – and to charge sick people (or those likely to be sick) an arm and a leg.

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Does the US Ignore Its Civilian Casualties in Iraq and Syria? Print
Friday, 19 August 2016 08:31

Woods writes: "During July, the number of reported civilian casualties from coalition airstrikes reached the highest level since the air war began in August 2014."

F15 fighter jet patrols northern Iraq. (photo: Getty)
F15 fighter jet patrols northern Iraq. (photo: Getty)


Does the US Ignore Its Civilian Casualties in Iraq and Syria?

By Chris Woods, The New York Times

19 August 16

 

n barely a generation, air power has shifted from indiscriminate to discriminating. Thanks to advances in precision guidance, American bombs and missiles now generally get to where they’re intended. But human or machine error, bad luck or faulty military math still lead to unforeseen civilian deaths. And as the United States and its allies continue their bombing campaign against the Islamic State in Iraq and Syria, many more noncombatants are perishing than they seem prepared to admit.

During July, the number of reported civilian casualties from coalition airstrikes reached the highest level since the air war began in August 2014. On July 19, 78 or more civilians were reported killed near the Islamic State-occupied city of Manbij, Syria, many of them women and children. In the successful battle for Manbij alone, at least 200 civilians were reportedly killed.

The United States and its allies have taken care to mitigate harm to civilians, and the United States Central Command is investigating the July 19 incident. But with the fight moving deeper into the towns and cities of Iraq and Syria — where millions remain under the Islamic State’s thumb — the risk is rising. Denmark, a member of the coalition, recently warned that civilian deaths might be “unavoidable” in this new phase of the war. Yet the allies appear poorly equipped to properly assess the numbers already being killed.

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Letting Trump Be Trump Is the Only Strategy Left Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=6853"><span class="small">Frank Rich, New York Magazine</span></a>   
Thursday, 18 August 2016 13:32

Rich writes: "Trump is indeed beyond coaching, and, with Manafort sidelined, Trump is free to be Trump full-time again. Bannon and Ailes are both pugilists likely to pump his volume back up to the full Mussolini-Giuliani timbre. It may not make a difference come November, but I'd argue it's the only way for Trump to go."

Donald Trump. (photo: Getty)
Donald Trump. (photo: Getty)


Letting Trump Be Trump Is the Only Strategy Left

By Frank Rich, New York Magazine

18 August 16

 

Most weeks, New York Magazine writer-at-large Frank Rich speaks with contributor Alex Carp about the biggest stories in politics and culture. Today: Trump’s campaign shake-up, Paul Manafort’s Ukraine ties, and the cancellation of The Nightly Show With Larry Wilmore.

onald Trump is trying to bounce back from his lousy August by adding two potent personalities to his team this week. Stephen Bannon of Breitbart News is the new campaign chief executive, usurping Paul Manafort, and Roger Ailes has reportedly been recruited to prepare Trump for the presidential debates. Will either be able to prove that Trump is not, as other advisers have recently opined, “beyond coaching”?

Those dreary Trump “presidential” speeches — the “policy” addresses he has lately been reading listlessly from teleprompters — have bought him nothing. Trump is indeed beyond coaching, and, with Manafort sidelined, Trump is free to be Trump full-time again. Bannon and Ailes are both pugilists likely to pump his volume back up to the full Mussolini-Giuliani timbre. It may not make a difference come November, but I’d argue it’s the only way for Trump to go.

As we’ve learned over the past year, Trump’s supporters don’t care about the journalistic investigations debunking his career and ethics, or about his complete disregard for facts, or about his chilling, unworkable, and destructive prescriptions to “make America great again.” When he said that he “could stand in the middle of Fifth Avenue and shoot somebody” and still hold on to his hard-core base, he had a point. So he might just as well be as outrageous and noisy as he possibly can. Reaching every conceivable aggrieved white American out there, particularly the “poorly educated” whom he admires and particularly those who might not be regular voters, is his best hope, however faint, for achieving a putsch. (Particularly if some October surprise upends his opponent.) The time for Trump to woo, say, undecided suburban voters by attempting (incompetently) to mimic lunchtime speakers at the Council on Foreign Relations is over. Indeed, given Breitbart’s history of hurling abuse at GOP elites, it’s not inconceivable that Trump will soon name Paul Ryan and John McCain as additional co-founders of ISIS.

The arrival of Ailes as debate adviser should give the Clinton campaign pause. Thanks to the Herculean reportage of my colleague Gabriel Sherman, we are finally starting to see Ailes’s full Bill Cosby–like dimensions as a human being. But Democrats shouldn’t now forget that Ailes is also brilliant and ruthless at what he does professionally: plotting and executing scorched-earth attacks on television. And he has been perfecting that dark art for nearly a half-century, back to the day when he took the skills he’d learned in his 20s as a producer of Mike Douglas’s second-tier daytime talk show to the 1968 Nixon campaign to help make one of the most uncomfortable television performers in the history of the medium palatable to a mass audience. With Trump, unlike Nixon, Ailes will be working with an accomplished television performer. Hillary Clinton, not a natural in that arena, will need to arrive with her best game. Her campaign must reach well beyond the usual list of presidential debate coaches.

Another asset that Ailes brings to the debates is his unique knowledge of Fox News and its personalities. One of Sherman’s most important scoops was the revelation that the network’s star anchor Megyn Kelly was among those who accused Ailes of sexual harassment; it’s possible that she as much as anyone brought him down. If Kelly is a debate moderator, and if she once again roils Trump with questions he doesn’t like, it’s a safe bet that Trump will be armed with opposition research, courtesy of Ailes, to try to knock her out.

Investigators in Ukraine found evidence of millions of dollars of secret cash payments from a local pro-Russian political party to Paul Manafort, then a Washington fixer, between 2007 and 2012. Will Manafort’s denials and his demotion be enough to squelch the issue?

Where is Trey Gowdy, the Inspector Javert (or, more accurately, Inspector Clouseau) of the GOP House when we need him? He and all of the others on the right who have spent years trying and failing to find Clinton guilty of murder at Benghazi have fallen completely silent about the seemingly widespread collusion between the Republican presidential standard-bearer and his erstwhile campaign manager and Vladimir Putin’s Russia. Even before the latest Manafort revelations, the longtime CIA hand Michael Morell was suggesting that Putin had recruited Trump “as an unwitting agent of the Russian Federation.” The use of “unwitting,” it is becoming clearer by the day, may have been generous on Morell’s part. While there are many reasons why Trump is hiding his tax returns, it’s possible that his financial connections to Russian oligarchs in the Putin coterie are the most explosive.

But you’ll notice the cowardly silence of Ryan and Mitch McConnell, of McCain and Kelly Ayotte, and all of the other supposedly national-security-conscious Washington Republicans who have endorsed Trump. Unless and until they and other Republicans like them in power acknowledge that they are supporting a man who is a national-security risk, this issue will be on hold, if not squelched. A party that during the Joe McCarthy era prided itself on rooting secret Communists (real or imagined) out of the federal government is now looking the other way when its own presidential candidate and one of his top operatives are in open, even proud, cahoots with a Kremlin hostile to America’s national interests.

Comedy Central announced that The Nightly Show With Larry Wilmore will end this week, after a year and a half on the air. Why wasn’t Wilmore able to use this campaign cycle to become a star?

Larry Wilmore is a funny writer with a sharp social conscience whose show was no more uneven than most of his competitors’. Like Trevor Noah at The Daily Show, he had a tough act to follow — an act so tough to follow that even Stephen Colbert himself hasn’t been able to follow it in his post–Colbert Report iteration as a late-night host at CBS. If there’s a television format lesson to be learned from the Nightly Show’s failings, it’s that panels are truly wearing out their welcome, at least in my opinion. They can be problematic on Bill Maher’s show, too: everyone trying and often failing to get a word in edgewise, too many panelists bringing talking points (or prefab jokes) to the table, too little focus. I’d also argue that it’s very hard to do a smart solo monologue of comic political commentary four nights a week. Colbert didn’t do “The Word” every night; John Oliver has a week to craft and perfect his Sunday night tours de force.

But what probably contributed most to Wilmore’s failure to resonate (as Comedy Central characterized his shortfall) had nothing to do with any of this, and neither did it have to do with his race, which he wielded as a comic asset and which made his commentary distinct and often fresh. I’d argue that the elephant in the room in this case is age. Wilmore is 54; his comic beats and sensibility, at least as expressed in his show, don’t lend themselves to viral replays the morning after. That’s not a criticism or a fault. He was true to who he is, and, as he has demonstrated in his other work as a television creator and producer (Black-ish and Issa Rae’s coming HBO series Insecure), his more natural forum may be prime time, and his natural audience may be more likely to congregate there than in late night. 

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The Importance of Cheering for Caster Semenya Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=39316"><span class="small">Lindsay Gibbs, ThinkProgress</span></a>   
Thursday, 18 August 2016 13:16

Gibbs writes: "Over the last seven years, the narrative surrounding Semenya has taken on a life of its own. She's no longer viewed as a human being; she's merely a concept to debate."

South Africa's Caster Semenya reacts after finishing in second place in the women's 800-meters final at the 2012 Summer Olympics, London. (photo: Lee Jin-Man/AP)
South Africa's Caster Semenya reacts after finishing in second place in the women's 800-meters final at the 2012 Summer Olympics, London. (photo: Lee Jin-Man/AP)


The Importance of Cheering for Caster Semenya

By Lindsay Gibbs, ThinkProgress

18 August 16

 

ou might not know the name Caster Semenya, but it’s likely you’ve heard her story.

When she was only 18 years old, the South African runner won gold at the 2009 world championships in the 800 meters. She went on to win the silver medal at the London Olympics, and is the overwhelming favorite in Rio.

But, unlike her record-setting peers on the track, Semenya isn’t best known for her speed.

Semenya is allegedly intersex. Ever since three hours before her world championship race in 2009?—?when news unacceptably leaked that the International Association of Athletics Foundation (IAAF) was going to subject her to a gender test?—?she has been more famous for her naturally-occurring testosterone levels than her talent.

Over the last seven years, the narrative surrounding Semenya has taken on a life of its own. She’s no longer viewed as a human being; she’s merely a concept to debate. While others get fawning Sports Illustrated covers when they dominate their sports, Semenya gets ridiculed and questioned, poked and prodded.

When the controversy over her gender erupted, it took Semenya and those close to her by surprise. According to the Guardian, at the world championships, she “was so overwhelmed by the global controversy that she had to be persuaded to accept her gold medal.”

Still, through it all, Semenya just keeps running, and refuses to apologize for the body she was given.

“God made me the way I am and I accept myself,” she said back in 2009, when intimate details about her body first became a talking point for pundits.

“I can’t stop running because of people,” Semenya said to the BBC last year, as reported by ESPN. “If you have a problem with it, come straight to me and tell me. I cannot stop because people say no she looks like a man this and that. It’s their problem, not mine.”

That attitude in itself is worth celebrating.

Now, before we continue, let’s get a few of the facts straight.

The IAAF cleared Semenya to compete in 2010, and the following year, it implemented new regulations for women with hyperandrogenism, or elevated testosterone levels. The purpose of the new rule was to maintain the division between men’s and women’s sports, based on the belief that the primary reason that elite male athletes are better than elite female athletes is testosterone.

If women tested had testosterone levels higher than the new rules permitted, they had to artificially lower them through medication or invasive surgery in order to keep competing against other women.

However, in 2015, the Court of Arbitration for Sport (CAS) ordered the IAAF to suspend those regulations, because they found there was not sufficient scientific evidence that elevated testosterone levels are directly related to athletic superiority. CAS gave the IAAF and International Olympic Committee until 2017 to find better scientific proof to back up their claims.

Thus, Semenya’s presence in Rio is completely by the rules. Furthermore, it’s crucial to note that she has never been suspected of doping or cheating in any way; her condition has never been officially confirmed or detailed; and there is no definitive proof that she took anything to lower her testosterone levels between 2011 and 2015 in order to comply with IAAF regulations.

However, from 2010 to 2015, most of Semenya’s times in the 800m were great but not other-worldly, and this year, she is running even faster than she did in 2009. While there are multiple explanations for her career renaissance?—?she just started to work with a new coach; she is finally healthy after dealing with injuries for a few years; she is taking her fitness and training more seriously than she did earlier in her career— many assume it is because she no longer has to artificially suppress her testosterone levels.

So how did we get here, to the place where a quiet 25-year-old from a small village in South Africa is the poster child for gender limits in sport?

Well, back in 2009, IAAF officials said they were forced to gender test Semenya because her time in the 800m dropped seven seconds in less than nine months and they had to make sure she didn’t have an “unfair advantage.” But that was not the sole reason.

“Just look at her,” Russian Mariya Savinova, who finished fifth in the 2009 world championship, told reporters after the race. (If that name sounds familiar, it’s because Savinova just happens to be known as “the face of Russia’s doping scandal.”)

Unlike drug tests, gender tests (or testosterone tests, if you will) are not carried out at random. And Semenya happens to be tall, muscular, flat-chested, and black. This is not a coincidence. According to Katrina Karkazis, a senior research scholar at the Center for Biomedical Ethics at Stanford University, in the past, IAAF specifically singled out female athletes who “display masculine traits” for testosterone tests, while the International Olympic Committee (IOC) has encouraged its national charters to “actively investigate” any “perceived deviation” in gender.

In practice, gender testing is far more about policing women’s bodies than protecting women’s sports.

Testosterone tests tend to target women who don’t fit into the ideal Western standards of what a woman should look like?—?delicate and overtly feminine, white and lithe. This includes women like Dutee Chand, an Indian sprinter who was selected for gender testing after her success at the 2012 under-18 national championships and 2013 Asian Championships.

The tests Chand was forced to undergo?—?without explanation, mind you?—?were extremely invasive. As reported by the New York Times, it involved an MRI and a gynecological exam that included “measuring and palpating the clitoris, vagina and labia, as well as evaluating breast size and pubic hair scored on an illustrated five-grade scale.”

She was subsequently banned from competition, and wasn’t given a reason until she found out through the media that she produced more testosterone than most women.

To echo Jessica Luther of Excelle Sports, “ How is this in any way okay? How can we care more about some old racist, transphobic, and sexist imperial idea of ‘woman’ than about the lives of these actual women?”

But instead of undergoing an operation like four elite athletes from “rural or mountainous regions of developing countries” were allegedly forced to undergo before the London games, or taking medication to alter her body’s natural chemistry, Chand decided to fight the ruling.

Thanks to Chand’s legal challenge, the CAS overturned the hypoandrogenism regulations last year. And this year, Chand made it all the way to Rio, with her natural body in tact.

But, significantly, Chand did not win the gold medal in her 100m Olympic race this week. In fact, she didn’t even advance to the semifinals, let alone the final. She finished seventh out of eight in her heat, with a time of 11.68 seconds.

Her naturally elevated testosterone levels did not launch her directly to the top of the podium, or automatically separate her from the rest of the field. Among other athletes on the Olympic stage, she was simply one of the many elites watching the handful of exceptionals breeze past them.

Chand still made the most of her trip to Rio, though, by meeting one of her idols.

You’d think that Chand’s rather mortal performance would put this argument over elevated T levels into perspective. Of course, it hasn’t.

There is literally a sense of trepidation in the air ahead of Semenya’s 800m final on Saturday. Everyone is already discussing what it will mean if Semenya wins, and, heaven forbid, beats the world record time of 1:53.28. (Which at 33 years old is the longest-standing record in track and field.)

The Associated Press calls Semenya as a “dilemma.” Denise Lewis wrote in wrote in Telegraph Sport that Semenya’s inclusion is “not a healthy situation for the sport.” Tom Fordyce of the BBC wrote if Semenya breaks the world record in Rio, it could spell the end of her career because of the attention it would bring to her condition.

And Paula Radcliffe, a ridiculously dominant marathon runner in her time who currently holds the world record in the sport, says Semenya is an affront to the entire competition.

“When we talk about it in terms of fully expecting no other result than Caster Semenya to win that 800m, then it’s no longer sport,” Radcliffe told the BBC.

But all of this pearl-clutching and fear-mongering is as absurd as it is demeaning.

After all, sports are supposed to reward freak-of-nature athletes. Looking across the Olympic games, it’s clear that there is no one “right way” to have an Olympic body, especially for women. There are super skinny and flexible synchronized swimmers, short gymnasts, plus-size weight lifters, and abnormally tall basketball players. Every elite athlete has some sort of physical advantage they were born with.

And the most dominant athletes? They really have the physical gifts. Michael Phelps has feet and hands that are practically fins. Usain Bolt is much taller than most sprinters. Simone Biles is even shorter and more muscular than the majority of the gymnastics field.

These stars have found ways to maximize the gifts they were given and take their sports to the next level. Their dominance isn’t seen as boring; it’s seen as extraordinary. How is what Semenya is doing any different? The concept of a level playing field has always been a myth. From bodies to coaches, economics to nationality, a lot of luck and chance goes into who turns into an Olympic athlete and who doesn’t.

For that reason, Semenya should not be seen as a threat; she should be seen as a treat. After all, a woman running in the body she was born with and setting records is not an affront to the sanctity of sport. It is the entire purpose of sport. We should be marveling at it.

The public flogging Semenya has endured would have broken most people. Her trip to the world championships in Berlin was only her second trip away from home, and it ended with bookmakers offering odds on her gender. Shy and private, she’s tried to stay away from the spotlight that’s followed her over the last decade, but she’s never given up her love for and dedication to her sport.

“Running is what I will always do,” Semenya said.

“Even if, maybe, the authorities could have stopped me from running in 2009, they could not have stopped me in the fields. I would have carried on with my running, it doesn’t matter. When I run I feel free, my mind is free.”

There are two more chances to see Semenya run in Rio: the 800m semifinals on Thursday night and the final on Saturday night. Cherish it, because her races are truly something special?—?not because of her gender, because of her greatness.

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