August 2024 – Page 5

“The US does have significantly fewer doctors per capita than some other wealthy nations, such as Germany and Sweden. But America’s physician-to-patient ratio is actually about the same as other developed countries — Canada, the United Kingdom, Japan, France — that still generally rank better on measures of health care quality than the US does. So aggregate numbers alone are not enough to explain the access problems that patients face, and experts disagree over whether we need to boost the overall supply of providers in the short term.
The bigger problem is misallocation in the US physician workforce, Coffman told me last year. We know that we don’t have enough doctors in certain important specialties: primary care, obstetrics, and psychiatry, for example. We also don’t have nearly enough providers in a broad swath of specialties practicing in rural and other low-income communities. Between 2010 and 2017, while large urban counties added 10 doctors per 100,000 people on average, rural counties lost three. As a result, metro regions had 125 doctors per 100,00 patients, while rural areas had 60.

America is littered with doctor deserts, areas where there are not enough primary care providers, much less specialists or hospital-level services. The federal government estimates that 80 percent of rural Americans live in medically underserved communities.

In the long term, the US will undoubtedly need more doctors in rural and urban areas alike. Groups like the Association of American Medical Colleges continue to project long-term workforce shortages, as boomer-generation doctors reach retirement age and the population of seniors requiring medical care swells.”

https://www.vox.com/future-perfect/361620/bloomberg-johns-hopkins-free-medical-school-doctor-shortage

The RNC clarified Trump’s 2024 persona: Moderate authoritarian weirdo

Posted on August 22, 2024August 22, 2024 by Lone Candle

“At the behest of Trump and his allies, the RNC approved a new GOP platform, one free of calls for federal abortion bans or any explicit opposition to same-sex marriage. The Republicans’ official agenda also forswears any cuts to Medicare and Social Security, including increases to the retirement age. All of these stances contradict longstanding conservative movement goals, and all three bring the Republican Party into closer alignment with public opinion.
Meanwhile, Trump used some of the RNC’s primetime speaking slots to signal sympathy for nonwhite voters, younger Americans, and union members. The biracial model and rapper Amber Rose gave a speech that invited young, historically liberal voters to rethink their skepticism of Trump and his party. “The truth is that the media has lied to us about Donald Trump. I know this because for a long time I believed those lies,” Rose declared, explaining that she eventually realized, “Donald Trump and his supporters don’t care if you’re Black, white, gay, or straight. It’s all love. And that’s when it hit me. These are my people.”

The RNC’s outreach to union voters was even more concerted. On the convention’s first night, Teamsters president Sean O’Brien enjoyed the most prominent speaking slot. The union leader did not actually endorse Trump and spent much of his address on diatribes against corporate greed that received tepid support in the convention hall.

To all but the most attentive viewers, however, O’Brien’s status as the keynote speaker overshadowed the absence of a formal endorsement: By all appearances, the head of one of America’s largest unions was vouching for Trump’s commitment to workers’ interests.

Taken together, the RNC’s four-day infomercial for Trump’s GOP was far more professionally orchestrated and broadly accessible than its 2020 and 2016 predecessors, which often seemed to be made by and for Fox News addicts.

Yet other aspects of the convention betrayed the strange, illiberal, and authoritarian character of Trump’s politics. As well-managed as the Trump campaign has been to this point, it cannot escape the inherent liabilities of the man it’s trying to sell.”

…

“Vance is among the most openly authoritarian Republicans in Washington. He has said that he would have helped Trump overturn the 2020 election results, raised money for January 6 rioters, called on the DOJ to launch a criminal investigation against an anti-Trump Washington Post columnist, touted plans for consolidating the president’s authority over the federal bureaucracy, and argued that Trump should simply defy any court orders that obstruct such a power grab.

Traditionally, presidential candidates use their VP picks to assuage potential concerns that swing voters might have about them or balance out the ticket demographically. Vance’s selection, by contrast, exacerbates Trump’s biggest political liabilities: the perception that he is an authoritarian extremist whose election would threaten abortion rights.

Nevertheless, Trump picked him precisely because Vance’s current ideology closely mirrors his own. According to the Atlantic’s Tim Alberta, the Trump campaign had initially planned to pick a milquetoast, unthreatening running mate, such as North Dakota Gov. Doug Burgum. But Trump was eventually persuaded that he needed a fellow true-believing populist to help him enact his most far-reaching ambitions.”

…

“The Republican nominee’s acceptance speech was the longest ever given, meandering across 92 bizarre and tedious minutes. This excess was a direct reflection of the authoritarian nature of Trump’s candidacy. The nominee of a healthy democratic political party must balance their own narcissistic appetite for attention against the interests of the various constituencies they represent.

Having consolidated his personality cult’s control of the GOP, Trump faced no such constraint. His speech did not stretch to marathon length because of its abundance of substantive content. Rather, it consumed so much time because Trump allowed himself to supplement nearly every passage with pointless and tiresome ad-libbing, after detailing his own narrowly averted assassination in painstaking detail.

A less weird and authoritarian Republican nominee might have also drummed up panic about undocumented immigration. But they probably wouldn’t have paused in the middle of such demagogy to ask the crowd, “Has anyone seen The Silence of the Lambs?” and then say, incongruously, “The late, great Hannibal Lecter.”

Trump’s endless, self-indulgent rambling was alienating enough in and of itself. Even more unnerving was the spectacle of an increasingly bored crowd struggling to humor their dear leader with increasingly strained outbursts of enthusiasm.”

https://www.vox.com/politics/361751/rnc-trump-speech-vance-2024

Harris isn’t her party’s best candidate. Biden was still right to endorse her.

Posted on August 22, 2024August 22, 2024 by Lone Candle

“Democratic delegates are largely volunteers who speak for no one beyond the primary voters in their areas. In this context, a contested convention could be chaotic, and its nominee lacking in democratic legitimacy.
To be sure, anointing Harris is not especially democratic either. She was not elected by primary voters, any more than any other non-Biden Democrat. But the US electorate did vote to make her the president’s heir apparent, and this gives her a source of legitimacy that any other selection would lack.

Second, and more importantly, failing to coalesce behind a nominee today would have left Democrats without a standard-bearer for a month. This would inhibit fundraising, at a time when the Trump-Vance ticket is taking in serious cash. And it would mean ceding swing-state airwaves to the Republican message — or else, running exclusively negative advertising — for the next four weeks. This is especially risky in a context where Democrats face the challenge of introducing a new nominee to the country.

As Biden’s default replacement, having been elected to fill in for him in the event of his death or disability, Harris was uniquely capable of becoming her party’s consensus nominee in the absence of a protracted process.

Finally, Harris would have been highly likely to win an open convention, anyway. Before Biden dropped out, South Carolina Rep. Jim Clyburn — a highly influential member of the Congressional Black Caucus (CBC) — let it be known that he would favor Harris were Biden to drop out.”

…

“although Harris has weaknesses, she is not devoid of political gifts. At 59, she is young by the standards of American politics. She is an able speaker, whose recent appearances have brimmed with more vitality and coherence than either Biden or Trump have mustered in years. Her recent remarks debunking the GOP’s claims of being the party of “unity” were especially effective.

Harris does have a negative approval rating. But it is nevertheless better than Biden’s. And the public’s disapproval of her is less strongly held. As the political consultant Sarah Longwell has reported, voters in focus groups tend to have a negative impression of Harris — but it is just that, an impression, rather than a deep-seated evaluation. They do not know much about her and are aware of that fact.”

https://www.vox.com/politics/362033/biden-drop-out-endorse-harris-open-convention

Why Did Americans Stop Caring About the National Debt?

Posted on August 22, 2024August 22, 2024 by Lone Candle

“Paradoxically, the faster government debt escalates toward an inevitable debt crisis, the less politicians and voters seem to care.”

…

“Why are we no longer responding to soaring debt and its economic consequences? While there are many factors, the three most important are these: 1) We’ve convinced ourselves that deficits do not matter; 2) partisan politics and the collapse of lawmaking have turned deficits into a weapon to be politicized rather than a problem to be solved; and 3) few of us are willing to face the unpopular reality that this issue cannot be resolved without fundamentally reforming Social Security, Medicare, and middle-class taxes.”

…

“The driver of this debt is no mystery. The combination of rising health care costs and 74 million retiring baby boomers is driving annual Social Security and Medicare costs far above their payroll tax and Medicare premium revenues. These annual program shortfalls—which must be funded with general tax revenues and new borrowing—will exceed $650 billion this year on their way to $2.2 trillion annually a decade from now, when including the interest costs of their deficits. Specifically, by 2034 Social Security and Medicare will be collecting $2.6 trillion annually in revenues while costing $4.8 trillion in benefits and associated interest costs.”

…

“Over 30 years, CBO data show Social Security and Medicare facing an annual shortfall of $124 trillion while the rest of the budget is roughly balanced. By 2054, these two programs will be contributing 11.3 percent of GDP to annual budget deficits, or the current equivalent of $3.2 trillion in annual program shortfalls (including the interest costs of their deficits). As for the rest of the budget, CBO projects that tax revenues will continue to rise, and other program spending to fall, as a share of the economy. This means the entire long-term deficit growth is driven by Social Security, Medicare, and the interest cost of their shortfalls.”

…

“We cannot grandfather out of reform the 74 million boomers whose costs are driving the $124 trillion shortfall. Nor can we tweak our way out of this. If the system is to be kept afloat, Social Security’s eligibility age must rise, its benefit growth formulas must be significantly curtailed for above-average earners, and its taxes may need to rise too. Medicare premiums must steeply rise for above-average earners, and its elevated costs addressed either with a new choice- and competition-based premium support system or with ambitious price and payment reforms to scale back costly procedures.”

https://reason.com/2024/07/13/the-debt-lies-we-tell-ourselves/

Stop Blaming the Attempted Assassination on Heated Anti-Trump Rhetoric

Posted on August 21, 2024August 21, 2024 by Lone Candle

“Asserting that Biden’s bullseye comment had anything to do with political violence is obviously ridiculous. Moreover, Republicans know that it is ridiculous. In fact, they rightly criticized The New York Times and other media outlets for embracing the preposterous idea that former Alaska Gov. Sarah Palin was morally responsible for the attempted assassination of Gabby Giffords. The accusation against her was remarkably similar: The media seized on a map, circulated by her political action committee, that placed target crosshairs over Giffords’ district. There is no evidence whatsoever that Giffords’ shooter ever saw the map or that he was influenced by Republican rhetoric or even motivated by conservative ideas at all.
It is absolutely fair to call out the double standard. It’s true mainstream media wholly embraced the idea that Republicans are to blame for political violence because of things like the crosshairs on the map but said nothing critical about Biden’s bullseye comment. But Republicans like Vance aren’t calling out that double standard—they are participating in it. They are doing the same thing from the other side: blaming political violence on Democratic rhetoric.

It’s true that both parties, their activists, and their acolytes in the media could all benefit the country if they turned down the overheated rhetoric. Routine accusations that such-and-such political leader is a fascist, or Hitler, or a communist, or a dictator are not making things better for anyone. But words do not have some hypnotic power to induce others to commit violence. As always, when a deranged person takes up a gun and attacks someone, we should blame that individual—not other people’s words.”

https://reason.com/2024/07/15/stop-blaming-the-attempted-assassination-on-heated-anti-trump-rhetoric/

J.D. Vance Completes Trump’s Ideological Takeover of the Republican Party

Posted on August 21, 2024 by Lone Candle

“Vance is perhaps the GOP’s leading practitioner of responding to questions about Russia’s invasion of Ukraine by pivoting to Mexico and fentanyl. “What are we talking about?” he asked at a voter forum in February 2022 as the invasion was imminent. “We’re talking about a border 5,000 miles away between Ukraine and Russia. That’s what our leaders are focused on. If we had leaders half as concerned about their own border as they were about the Ukraine-Russia border, we would not have a border crisis in this country.””

https://reason.com/2024/07/16/j-d-vance-completes-trumps-ideological-takeover-of-the-republican-party/