The Sabotage of Obamacare...

Great article by Norm Ornstein in the National Review.

A preview:

But to do everything possible to undercut and destroy its implementation—which in this case means finding ways to deny coverage to many who lack any health insurance; to keep millions who might be able to get better and cheaper coverage in the dark about their new options; to create disruption for the health providers who are trying to implement the law, including insurers, hospitals, and physicians; to threaten the even greater disruption via a government shutdown or breach of the debt limit in order to blackmail the president into abandoning the law; and to hope to benefit politically from all the resulting turmoil—is simply unacceptable, even contemptible. One might expect this kind of behavior from a few grenade-throwing firebrands. That the effort is spearheaded by the Republican leaders of the House and Senate—even if Speaker John Boehner is motivated by fear of his caucus, and McConnell and Cornyn by fear of Kentucky and Texas Republican activists—takes one's breath away.

Its really worth a few moments of your time.  Click here to read the whole thing...

Source: 

http://www.nationaljournal.com/columns/washington-inside-out/the-unprecedented-and-contemptible-attempts-to-sabotage-obamacare-20130724?wpisrc=nl_wonk_b

Will ACA implementation succeed or fail? - Health Stew - Boston.com

Great read from John McDonough/Health Stew Blog....

"Must read article in the Washington Post this week by Ezra Klein and Sarah Kliff on the implementation of the Affordable Care Act/Obamacare: Obama's last campaign: Inside the White House plan to sell Obamacare. The ACA is the most complex domestic policy implementation in U.S. history, and chances for screw-ups are significant, especially when the opposition is doing everything in its power to encourage screw-ups, and then to blame the Administration for them."

Will ACA implementation succeed or fail? - Health Stew - Boston.com:

How ESPN/ABC News Won the Services of Nate Silver...

 Sunday's Politico Playbook has a interesting write-up on how ESPN/ABC News lured stat whiz Nate Silver to their team, over his former partner, The New York Times. Is this a big deal? Probably. The Times badly wanted Silver to remain on board and was willing to increase their commitment to his work substantially. ESPN, however, also has deep pockets and in the end, Silver decided he liked the offer from the sports network/ABC News combination more than he did from the Times.

 Politico's Mike Allen lays it out...

BEHIND THE CURTAIN - COURTING NATE SILVER : The battle for data whiz Nate Silver, fought secretly and aggressively by several of the nation's top news executives for the better part of a year, was won by ESPN and ABC News (both part of The Walt Disney Company) after the 35-year-old was promised extensive air time, a role in the Oscars (airing on ABC through at least 2020), and a digital empire that may include websites devoted to weather, education, economics and other topics. When it came to money, Silver was aggressive but not greedy, according to people familiar with the negotiations. Instead, he was focused on how he could expand the franchise he had built around FiveThirtyEight (the total number of electoral votes). FiveThirtyEight.com began as a standalone blog in 2008, and became part of NYTimes.com in 2010 as part of a three-year licensing agreement that ends next month.

In a stroke of luck for Silver , the negotiations began shortly after the frenzy over his 2012 forecasts showing President Obama would be easily reelected, which had become a running topic on cable news and late-night television - and even drew a shout-out from the president himself. There was early interest from NBC and Bloomberg. But for many months, Silver's conversations have pitted ESPN/ABC against The Times. Executive Editor Jill Abramson led the Times negotiations, and retaining Silver was such as high priority that publisher and chairman Arthur Ochs Sulzberger Jr. and CEO Mark Thompson were involved. The reasons Times executives were so obsessed with Silver were both financial and psychic:

--On the financial side, Silver was a huge traffic driver for NYTimes.com in political years . On Election Day 2012, The New Republic's Mark Tracy called Silver a "One-Man Traffic Machine for the Times" and "The Times's biggest brand": ""FiveThirtyEight is drawing huge traffic,' ... Abramson told me ... 'What's interesting is a lot of the traffic is coming just for Nate.' ... [E]arlier this year, somewhere between 10 and 20 percent of [visits to The Times's politics coverage] included a stop at FiveThirtyEight, last week that figure was 71 percent. ... Silver's blog has buoyed more than just the politics coverage, becoming a significant traffic-driver for the site as a whole. Earlier this year, approximately 1 percent of visits to the New York Times included FiveThirtyEight. ... Yesterday, it was 20 percent."

--On the psychic side, Abramson and Washington Bureau Chief David Leonhardt, another key player in the drive to keep Silver, saw his brand-within-a-brand as a wave of the future. They wanted Silver to bring his secret sauce to other areas of coverage. And they want to develop other Nate Silvers, in the mold of Andrew Ross Sorkin's pioneering DealBook. So Silver's role as the template increased his value to The Times.

Silver had told The Times that he wanted to expand to weather, economics and anyplace else at The Times that had statistics and numbers he could bring to life. He had already begun doing that, with "Claims on I.R.S. Are Challenged By Probability," which ran in the paper, as did an examination of Chief Justice John Roberts's use of statistics, along with "Health Care Drives Increase in Government Spending" and "Congressional Proposal Could Create 'Tax Bubble.'" In December, Silver had his first front-page story in the print paper.

Early this year , The Times laid out a plan that would give Silver a staff of six to 12 bloggers to focus on a variety of topics, modeled on Ezra Klein's Wonkblog at The Washington Post. The plan was so specific that it named Megan Liberman, an up-and-coming deputy news editor at The Times, as Silver's editor. As recently as last month, some executives at The Times were confident Silver would stay, mainly because they had given him everything he had asked for. Silver is very interested in prestige, and the prestige of The Times was a huge deal to him. But Silver, who first made his name with forecasts for Major League Baseball players, still loves sports. At times, he felt unwelcome in the Times Sports section, and seemed to struggle to fit into its culture. The section is among the most innovative at the paper, but not in the areas that are Silver's wheelhouse.

ESPN's recruitment drive was led by President John Skipper and John Walsh, executive vice president and executive editor, who have brought a more literate style to ESPN and are pushing the organization in a more analytical direction. Silver's youth and credibility were hugely attractive. The model they proposed to Silver was Bill Simmons, "The Sports Guy," who has a personal megabrand within the ESPN brand through his "B.S. Report," blogs and podcasts. ESPN kept Simmons in part by making him editor-in-chief of a new ESPN website, Grantland.com, devoted to long-form journalism. In the quest for Silver, ESPN enlisted ABC News, which could provide a high-profile platform during elections and conventions. And Silver clicked with ABC's political personalities: George Stephanopoulos, Jonathan Karl, Jeff Zeleny and Rick Klein.

ESPN has deep pockets , and the rich, multi-platform offer to Silver, funded mostly by ESPN, is a drop in the bucket. Under the deal, to be announced soon, his flagship will return to FiveThirtyEight.com, which currently clicks through to NYTimes.com. The business model mirrors Grantland's: a strong, independent brand that ladders up to the bigger brand of ESPN (and, in this case, ABC News). Nate will appear on the air on ESPN and ABC, and will get "verticals," or web hubs, devoted to a variety of new topics. He's very interested in education, so there's been a lot of conversation about that. And, of course, weather and economics. His Oscars predictions did well for The Times, and now he'll work for the TV home of the Oscars.

Silver informed Abramson of his decision on Friday. She was none too pleased - a yearlong strategy, up in smoke. And Abramson is sensitive to the perception of Disney raiding The Times: Don Van Natta Jr., who was part of two Pulitzer-winning teams at the Times and produced muscular exposés on the British tabloid hacking scandal, became a senior writer for ESPN at the beginning of 2012. And Times correspondents Jeff Zeleny and Susan Saulny were named ABC correspondents in February. In response for a request to comment, The Times provided a 21-word statement: "We valued our partnership with Nate, particularly during the 2012 election campaign, and we wish him every success in the future."

How Doctors Die (A Must read from the Health Care Blog)

"How Doctors Die," an outstanding essay from The Health Care Blog, looks at how physicians often choose to die, even when they have virtually carte blanche in terms of what they could ask for and receive. An exploration of a common problem. Do I want more care and effort to keep me alive no matter what or do I have limits? What is the effect of trying everything versus trying very little, or focusing on comfort instead of cure?

Written by Ken Murray, MD at USC, its a well written, thoughtful discussion of a controversial and very personal issue.

An excerpt:

Several years ago, my older cousin Torch (born at home by the light of a flashlight—or torch) had a seizure that turned out to be the result of lung cancer that had gone to his brain. I arranged for him to see various specialists, and we learned that with aggressive treatment of his condition, including three to five hospital visits a week for chemotherapy, he would live perhaps four months. Ultimately, Torch decided against any treatment and simply took pills for brain swelling. He moved in with me.

We spent the next eight months doing a bunch of things that he enjoyed, having fun together like we hadn’t had in decades. We went to Disneyland, his first time. We’d hang out at home. Torch was a sports nut, and he was very happy to watch sports and eat my cooking. He even gained a bit of weight, eating his favorite foods rather than hospital foods. He had no serious pain, and he remained high-spirited. One day, he didn’t wake up. He spent the next three days in a coma-like sleep and then died. The cost of his medical care for those eight months, for the one drug he was taking, was about $20.

Torch was no doctor, but he knew he wanted a life of quality, not just quantity. Don’t most of us? If there is a state of the art of end-of-life care, it is this: death with dignity. As for me, my physician has my choices. They were easy to make, as they are for most physicians. There will be no heroics, and I will go gentle into that good night. Like my mentor Charlie. Like my cousin Torch. Like my fellow doctors.

Click here to read the entire article....

Source:

http://thehealthcareblog.com/blog/2012/08/06/how-doctors-die/

Thoughts on the Trayvon Martin/George Zimmerman Ruling...

If you're of the mind that George Zimmerman should've been found guilty of, well something this weekend, you're not alone. A jury of adults sat through the five week trial, listened to all the evidence, and in the end decided he was not guilty of the charges the State of Florida had claimed he was.

As the verdict was announced Saturday evening, social media exploded with strong words from all directions. The Martin sympathizers felt George Zimmerman had gotten away with the murder of a young African American boy who had broke no laws and hadn't initiated the conflict that night. The Zimmerman camp let out a huge sigh of relief as the burden of proof, which apparently hadn't been met according to the jury, largely explained Mr. Zimmerman being cleared of all charges.

I too, chimed in with this on facebook:

It boggles my mind how after being told to not pursue Trayvon Martin, George Zimmerman ignored those instructions and went after him anyway. Something transpired...and TM was shot...and died. 

I know there's likely Civil actions coming up, for which GZ WILL probably pay a pretty penny, but I'm feeling something failed in this process.

Let me be clear. I do not want any man convicted of a crime he hasn't been found guilty of in a Court of Law. I reject the mob mentality that seems to be forgetting that we have due process in this Country. The case, to me at least, seemed to be a difficult one for the State to prove from the start. Reasonable doubt wasn't all that hard to achieve for the defense.

I do think the prosecution seemed to over-reach with its charges of 2nd degree murder and manslaughter, especially given the lack of evidence they had. Some legal experts have suggested that with no eyewitness, no video recording, etc., a lessor charge such as stalking might've been more in order. I won't presume to know why the State of Florida went the route they did. Was there a pressure, direct or otherwise, to pursue the more severe charges against Zimmerman to appease some racial concerns? I don't know...A 17 yr. old kid gets gunned down by someone older and with a different skin color. Perhaps its a fine line. What's the right level of charges? Was it thought they'd aim high and give themselves room to negotiate a plea deal downward? Who knows?

On some level, I feel in my heart that if Mr. Zimmerman had made different choices that night, Trayvon Martin would still be alive. It must also be said that perhaps those words can apply to Mr. Martin as well. I am able to construct a possible chain of events where Martin feared for his safety and decided he needed to fight Zimmerman then and there. Once he started to get the best of the older man, Zimmerman pulls out his gun and shoots Martin to save himself. If Martin had kept walking or done something other than "allegedly" respond at some point in a physical way, might he be alive? Perhaps.

After giving this a lot of thought over the weekend and reading a wide range of opinions on the shooting and verdict, my bottom line is this.

The adult should have showed more restraint, especially after the instructions from the 911 operator. Martin never sought him out to set things in motion. Zimmerman, under the guise of a neighborhood watchman role, saw him walking and then took the steps he did. If I'm asked to excuse an adult for poor restraint and bad judgement, the 17 year boy also gets at least the same courtesy.

Race was clearly a part of this trial but I'm not sure exactly how. Did Zimmerman shoot Martin because he was Black? Maybe, but I can't say for sure. Did the prosecution aim too high so not to appear uncaring to the Black community? Maybe, but I can't say for sure.

There's plenty of outrageous voices from both sides saying some outrageous things since the verdict was announced. On some level, perhaps we wanted it to really be all about race for some reason. Americans have a real appetite for these sort of stories. We'll tune in every night to watch the latest television shows that promise us "up to date information and analysis." If we didn't tune in, and support it - it wouldn't be shown. Period.

I don't even think this is a particularly critical case in terms of gun violence. Bottom line, one person died in this shooting. There have been thousands of other shootings in the country since this one, and we don't know names, places, etc. Again, I think the racial component...however forced...is a big reason why this case came to the forefront.

I'm ok with the jury finding George Zimmerman innocent based on the evidence. I also would've been ok if they'd found him guilty, based on the evidence. As I've said, I think he made several poor choices that evening. If his actions don't meet a criminal threshold, fine...I hope the Martin family pursues their civil prosecution rights and enjoy a different outcome.

A final word on the United States Justice Department filing any hate crimes against Zimmerman. Tread carefully, don't over-reach. If the facts, not suspicions, but the facts justify it, then proceed. To file charges and then fail in securing a guilty verdict would be damaging to overall best interests of the country. A lot of people are going to wonder why the Government would go after someone a Court just ruled was innocent. You better have a helluva strong case and you better present it convincingly. Some will say that perhaps like the prosecution, these charges, should they actually be pursued, might be an example of over-reach.

Please get it right and for the right reasons.