But in the broken-down rural hinterlands, EHR and other novelties make it more lucrative for surviving medical centers to prioritize federal paperwork over patient care. For example, there’s a lot of prescription-drug abuse in this country, and so the feds award “meaningful use” bonuses for providing records that will assist them in determining whether a guy with a prescription for painkillers in New Hampshire also has a prescription for painkillers with another doctor over the Connecticut River in Vermont. So in practice every new patient in this part of the world now undergoes a background check before getting anywhere near a doctor. It doesn’t do much for your health, but it does wonders for an ever more sclerotic bureaucracy.
Sadly, this column seems even more scary to one just getting over a very nasty case of the flu – untreated by a doctor, incidentally.
The ironic geography of the Democratic drive can be seen most clearly by examining the distribution of the classes now targeted by the coming purge. The top 10 states with the largest percentage of “rich” households under the Obama formula include true blue bastions Washington, D.C., which has the highest concentration of big earners, Connecticut, New Jersey, Maryland, Massachusetts, New York, California and Hawaii. The only historic “swing state” in the top six is Virginia, due largely to the presence of the affluent suburbs of the capital. These same states, according to the Tax Foundation, would benefit the most from an extension of the much-lambasted Bush tax cuts.
The pattern of distribution of “the rich” is even more marked when we focus on metropolitan areas. Big metro areas supported Obama, particularly their core cities, by margins as high as four to one. Besides New York, the metro areas with the highest percentage of high-earning households include such lockstep blue cities as San Francisco, Washington, San Jose, Atlanta and Los Angeles.
Kotkin likens the new “rich” to the kulaks targeted by Stalin. (This is not the first time I have seen that comparison.) The “rich” that will pay are not rich by any reasonable standard given the cost of living in the deep blue states and cities.
Once again, the republicans should immediately pass a bill out of the House making all but the top two bracket tax cuts permanent and repealing the AMT. Right now. Mention Obama’s determination to restore the Clinton tax rates on the “rich”. Then make some popcorn. It’ll be a riot to watch.
Police in Victoria, Australia, issued a warning Monday discouraging iPhone users from relying on Apple’s map app after rescuing several people who became stranded in recent weeks in the wilderness following the app’s directions — some who were stranded 24 hours without adequate food and water.
Maybe they should shut it down until it’s safe to use?
What the West took from its defeat of the East was that it must accept the model of the state as social engineer in order to avert any future threat to freedom. Capitalism would only be tolerated if government distributed its wealth evenly across society. The original concept of social security and welfare provision – that no one should be allowed to sink into destitution or real want – had to be revisited. The new ideal was that there should not be inequalities of wealth. The roaring success of the free market created such unprecedented levels of mass prosperity that absolute poverty became virtually extinct in western democracies, so it had to be replaced as a social evil by “relative poverty”. It was not enough that no one should be genuinely poor (hungry and without basic necessities): what was demanded now was that no one should be much worse (or better) off than anyone else. The job of government was to create a society in which there were no significant disparities in earnings or standards of living. So it was not just the unemployed who were given assistance: the low paid had their wages supplemented by working tax credits and in-work benefits so that their earnings could be brought up to the arbitrary level which the state had decided constituted not-poverty.
And so the perverse incentives have become standard. Hard work and success are to be punished by draconian taxation. Sloth is to be rewarded.
This is why socialism has never – and can never – work.
In the American republic, even the dogs cost more. The Queen is a famous corgi lover and has been breeding them since she was a young girl. Now in her late eighties she’s slowing down and only keeps four. The president has one pooch, a photo-op accessory called Bo, who, unlike the corgis, requires a full-time handler. In contrast to the stingy remuneration offered by the Royal Household, the presidential dog-walker is one of 226 White House staff earning over $100,000 a year. For many centuries, the King had a courtier whose somewhat intimate duties were reflected in his title: the Groom of the Stool, a position abolished in 1559. Now, after two and a third centuries, the American Presidency has evolved to the point that it has a full-time six-figure Groom of the Canine Stool. Will he be accompanying the President on Air Force One to liaise with the Keeper of the Privy Flatscreen over screenings of “Lassie”?
The American media doesn’t even question multi-million dollar jaunts in a huge jet for a minor speech. (Actually several jets, for all the staff and hangers on.) Or 40 car motorcades. Or motorcades for Senators and staffers.
Taxes must go up to pay for more imperial perks. But smile America! Barry’s taking $3 million vacations on your behalf.
This is why he sent Treasury Secretary Tim Geithner to the Republicans to convey not a negotiating offer but a demand for unconditional surrender. House Speaker John Boehner had made a peace offering of $800 billion in new revenue. Geithner pocketed Boehner’s $800 billion, doubled it to $1.6 trillion, offered risible cuts that in 2013 would actually be exceeded by new stimulus spending and then demanded that Congress turn over to the president all power over the debt ceiling.
Boehner was stunned. Mitch McConnell laughed out loud. In nobler days, they’d have offered Geithner a pistol and an early-morning appointment at Weehawken. Alas, Boehner gave again, coming back a week later with spending-cut suggestions — as demanded by Geithner — only to have them dismissed with a wave of the hand.
What’s going on here? Having taken Boehner’s sword, and then his shirt, Obama sent Geithner to demand Boehner’s trousers. Perhaps this is what Obama means by a balanced approach.
I think that’s right. Obama has no intention of making a deal of any sort. The republicans have to start from that assumption and figure out what they can do with that – without falling into the trap Obama has set for them. Obama wants the Clinton tax rates back – all of them, not just on the rich.
So pass a bill out of the House making all but the top bracket cuts permanent and repealing the AMT. Then watch the fun begin.
Presidents, kings, queens, generals all have accomplished a modus vivendi with their opponents and mortal enemies. Until now. What deal of Clintonesque majesty has Barack Obama ever pulled off?
The fiscal-cliff negotiation is a train driven by an engineer who doesn’t know how to use the brake, doesn’t know where the brake is and doesn’t care. His idea of politics is giving campaign speeches outside Washington to assemble a Sandy of public sentiment that will blow congressional Republicans off the cliff.
Politics ain’t beanbag, but it also isn’t just about politics. While Barack Obama may think his election mandate includes the ruin of the Republican Party, Republicans seeking a strategy of self-preservation should assert their refusal to participate in the ruin of the nation. As it is, the fiscal cliff has degenerated into a familiar Beltway melodrama in which the media reduce the whole thing to which party gets shafted. As to the health of the gasping American economy, well, whatever.
And this should be a reminder to the republicans of the 2010 elections – and why they won. They got a straight up monster victory because the people wanted spending controlled.
It would be a really bad idea to forget that right now. Really, really bad.
Start from the assumption that Barack Obama wants to go over the cliff. Work from there.
In light of that, Republicans should continue to act in a reasonable and responsible way, as Speaker Boehner has with his offer to raise tax revenues in exchange for spending cuts and some steps toward entitlement reform. It may be that the president comes to his senses, and if so they should be ready to deal. But if not, and if the president insists that the GOP jettison its beliefs and simply accede to Mr. Obama’s liberal wish list, Republicans should — in a respectful but firm way — say no thanks. If they do so, Republicans shouldn’t pretend that going over the cliff won’t hurt them. But they shouldn’t be blind to the fact that it will also hurt Mr. Obama, and perhaps permanently.
I can’t stress this enough: the republicans must not take the advice of the media. They are not their friends, as this last election showed quite obviously.
They are in a no-win here and need to start thinking very creatively. How about introducing a bill to make all the Bush tax cuts permanent for all but the highest earners along with a permanent end to the AMT? Get that done right now. Pass it out of the House.
“It is exceptionally difficult — for all practical purposes, impossible,” writes Eberstadt, “for a medical professional to disprove a patient’s claim that he or she is suffering from sad feelings or back pain.”
In other words, many people are gaming or defrauding the system. This includes not only disability recipients but health care professionals, lawyers and others who run ads promising to get you disability benefits.
Between 1996 and 2011, the private sector generated 8.8 million new jobs, and 4.1 million people entered the disability rolls.
The ratio of disability cases to new jobs has been even worse during the sluggish recovery from the 2007-09 recession. Between January 2010 and December 2011, there were 1,730,000 new jobs and 790,000 new people collecting disability.
Those people gaming the system are virtually certain never to start working for a living again. They are for all intents wards of the state and will remain so.
This cheats the people who genuinely need the support of disability.