Medicaid cuts...people will die

Eight years ago, when the Affordable Care Act (ACA) was up for repeal, then-Governor Jim Justice and Senator Capito helped walk the nation back from the brink.

 Justice described the consequences of undoing Medicaid expansion, which covered around 175,000 West Virginians at the time, as “beyond catastrophic.” Capito said that “I have serious concerns about how we continue to provide affordable care to those who have benefitted from West Virginia’s decision to expand Medicaid, especially in light of the growing opioid crisis.”

They were right then and still are today.

Recently, public health experts from Yale University and the University of Pennsylvania calculated the butcher’s bill that would happen if the House version of the budget bill passes as is and it’s pretty awful. They estimate that proposed Medicaid cuts could cause 51,000 premature deaths per year, just to pay for tax cuts for the rich.

That’s more than the combined populations of Calhoun, Tucker, Gilmer, Pleasants, Doddridge, Pocahontas, and Clay counties. Or several thousand more than the populations of either Charleston or Huntington. 

According to the Yale School of Public Health, “The researchers estimate that 42,500 lives could be lost each year from disenrollments in Medicaid and Marketplace coverage and the rollback of nursing home staffing rules. An additional 8,811 deaths are projected from the expiration of the enhanced Affordable Care Act (ACA) Premium Tax Credits, bringing the total to more than 51,000.

To be specific, 7.7 million people would lose Medicaid or ACA marketplace coverage, with a loss of an estimated 11,300 deaths per year. 

Eliminating the Medicare Savings Program would disenroll 1.38 million seniors, at a cost of 18,200 deaths per year. 

Ending nursing home staffing rules could cost 13,000 lives. 

Ending ACA premium tax credits is likely to push another 5 million off, at a cost of over 8,800 preventable deaths a year. 

In addition, the bill’s failure to extend the ACA’s enhanced premium tax credits is expected to push another 5 million Americans into uninsurance, resulting in 8,811 more deaths each year.

This isn’t a matter of random number generation. According to Yale, researchers relied on peer-reviewed studies that “quantifying the relationship between insurance coverage, access to prescription drug subsidies, and nursing home staffing levels with all-cause mortality.” This data was then applied to projections released in May by the nonpartisan Congressional Budget Office.

Recently, Iowa Representative Joni Ernst stirred up controversy by dismissing concerns like these, saying “we are all going to die.”

Maybe so. But working class people don’t have to die prematurely in the tens of thousands every year just to enrich the wealthiest. 

This is totally preventable.

(This appeared as an op-ed in the Charleston Gazette-Mail.)

Good news on health care

 It’s not obvious from the title, but the recently passed Inflation Reduction Act (IRA) is the biggest federal health care legislation in a dozen years, one that will directly benefit over one in four West Virginians.

For starters, the law permanently extends the Black Lung Excise Tax, which provides benefits for over 4,400 West Virginia families impacted by that terrible disease caused by breathing coal dust. Nationwide nearly 26,000 families will benefit, including over 18,000 primary beneficiaries and around 7,000 dependents. According to the Brookings Institution, Black Lung is most prevalent in central Appalachia, with 20.6 percent of miners affected. 

In the late 1960s, a historic grassroots movement spearheaded by West Virginia coal miners and supporters brought the issue to national attention and won federal legislation to establish the benefit, although its funding was in jeopardy in recent years until the bill was passed.

The IRA also extends Affordable Care Act (ACA) marketplace subsidies for three years for people who purchase insurance plans on the exchange, which will help around 23,000 West Virginians and over 14 million people nationwide.  

People who buy care through the ACA marketplace have traditionally been the hardest group to find health care since they aren’t covered by employer-based insurance and don’t qualify for public programs such as Medicare, Medicaid, Tri-Care, or VA benefits. Thanks largely to ACA subsidies and Medicaid expansion, the number of uninsured Americans reached an all time low of eight percent this summer: still too high but a big improvement.

The biggest impact of the bill will be on people receiving Medicare, which covers over 440,000 West Virginians and around 64 million Americans, although these changes will be rolled out over time. 

According to the Kaiser Family Foundation, in 2023 insulin will be capped at $35 a month on the Medicare Part D prescription drug program; drug companies have to offer rebates if prices increase above inflation; and cost sharing for adult vaccines under Part D and Medicaid will be eliminated.

The Medicare diabetes cap is a big deal, although a ruling by the senate parliamentarian blocked its application to private insurance. According to the American Academy of Family Physicians, which supported several IRA medical provisions, “More than 37 million Americans have diabetes, and an estimated one-quarter of people with diabetes in the United States ration their insulin due to costs. In 2021, U.S. diabetes deaths exceeded 100,000 for the second consecutive year.” The WV Department of Health and Human Resources estimates that 240,626 West Virginians have that disease with undiagnosed cases 65,210.

In 2024, the IRA caps Medicare premium increases to six percent a year through 2030; eliminates a part D co-pay for catastrophic coverage; and expands eligibility for the low-income Part D subsidy to 150 percent of the federal poverty level. In 2025, it caps drug costs for Medicare beneficiaries at $2,000 per year. And between 2026 and 2029, it will negotiate costs for an increasing number of expensive medicines each year.

While health care is only part of the IRA, which also addresses climate change and tax fairness, those are significant steps in the right direction and Senator Manchin was instrumental in sealing the deal. Of course, no legislation is perfect. Lots of West Virginians, myself included, worked hard on what would become the IRA for the last year or so. We didn’t get all we wanted and got some of what we didn’t, but there are still things to celebrate.

(This ran as an op-ed in the Charleston Gazette Mail last week.)

Good news if the deal is sealed

 By now, I'm guessing most interested people have heard of the deal reportedly struck by Senators Schumer and Manchin on climate, prescription drugs, and health care. It was quite a reversal of fortune from the last two weeks.

Here's a brief statement in response penned by yours truly and AFSC DC colleague Peniel Ibe about the deal on Twitter:

Me:

Over the last year, many West Virginians worked hard to push a reconciliation bill across the line. While the outlines of the potential deal are not as bold as many hoped in addressing family economic security, we are optimistic and relieved to learn that an agreement on addressing climate change is within reach and appreciate protections for health care.  

Certain provisions in this bill will have tremendous benefits for the children and families in the Mountain State. Looking forward, we will continue to work with the Senator to ensure that components not included in the package, such as the Child Tax Credit, are enacted to provide even more support for West Virginia’s families and children.  

Peniel:

The existence of this bill is a testament to the commitment for advocates across the country to delivering much needed relief for our communities.  

The wins are hard fought, delivering on provisions to lower health care costs, reduce the deficit, tax wealthy corporations, and invest in some clean energy projects and the environment.  

But the losses are just as painful. As negotiations stalled, critical investments included in the initial package were cut, sacrificial compromises were made, and countless people lost out. The bill currently includes some counterproductive provisions that further entrench the use of fossil fuels into our society- disregarding the intensity of the climate crisis and calls from front line communities.  

Yet this plan to begin to address the needs in our communities’ wellbeing is still at risk of being cut to a point beyond meaningful impact. We call on all Senators to focus on delivering relief now as there is more to do. We have waited too long and we must no longer leave our communities needs unaddressed.  

Today, many people across the U.S. struggle to make ends meet—especially amid soaring costs of housing, groceries, and other goods. We must continue to call for massive investments in a robust care infrastructure, including monthly Child Tax Credit payments, paid family/medical leave, closing the Medicaid coverage gap and more. 

This is the only way to build vibrant communities. 

I'm still nervous and will be until the deal is actually sealed, but this was welcome news in tough times. 

 

Not all bad

 Whenever there's a bit of good news on the economic justice front, admittedly not an everyday occurrence, I try to notice it. Here's the latest:

According to the Centers for Medicare and Medicaid Services (CMS for short) a record number of Americans now receive health insurance through the Affordable Care Act (ACA)...and what a fight it was to enact and protect it all these years. Specifically, more than 35 million people are either covered through the health exchange or marketplace, expanded Medicaid (21 million in states that expanded Medicaid as WV did in 2013), or basic coverage.

That's more than one out of ten Americans in a total population of around 332+ million. It's an even bigger achievement when we factor in who got that coverage. The US health care system does a pretty good job of covering the elderly via Medicare. Close to 95 percent of children are covered via CHIP, traditional Medicaid or their parents' insurance. Low income people with disabilities are likewise often covered by traditional Medicaid. Those covered by the ACA, on the other hand, are working age adults not eligible for other kinds of insurance--and those most likely to lack coverage before the ACA. 

The percent of uninsured Americans is now at an all time low of around 8.8 percent. Still too many by far, but it shows the benefits of this signature legislation of the Obama administration. And a lot of people in West Virginia worked hard to make that happen here. I hope the 12 holdout states--Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming--see the light and expand Medicaid soon (did anyone else notice that eight of those were also part of the Confederacy?). I know lots of people in those states are working on it. 

This may not last forever the way things are going, but I'll celebrate this for now anyway.

Gearing up

Most people who read this blog know that everything is going to be on the table-and nearly everyone is going to be on the menu in the next presidential administration. We know that Paul Ryan wants to kill Medicare in its current form. But in this NY Times piece, Gene Sperling warns us not to take our eyes off Medicaid. We can expect a major push to block grant the program and cut it hugely over several years. It would also threaten CHIP, the popular Children's' Health Insurance Program.

Who would this hurt? Very low income parents receiving temporary assistance. Kids in families earning up to 300 percent of the federal poverty level. The millions of working Americans earning less than 138 percent of the federal poverty level who gained coverage under the Medicaid Expansion provision of the Affordable Care Act. People with disabilities. And elderly people who worked hard all their lives but burned through assets when they needed long term care. Not to mention the millions of people who work in the field of health and long term care.

If you care about things like this, it's probably time to do the whole loins/girding up thing. Like now.

Sticking it to which man?

This op-ed of mine ran in Tuesday's Charleston Gazette-Mail, although for some reason it didn't get posted online:

There’s a lot of talk lately about the working class. In an ordinary year, I’d be ecstatic because this is something I care about.  But this isn’t an ordinary year.

Lately, the term is often racialized, which is never a good sign. The Electoral College victory of the president elect is attributed to the white working class. While there are lots of ways of parsing the results, let’s assume that’s true and consider how working people are likely to fare now.

I guess we could start by saying that white working class people probably won’t have their names added to a registry, face mass deportations, or have travel restricted for reasons other than lack of money. There’s that anyway, although I kind of doubt this would have happened in any case.

But a number of policies now on the agenda could be harmful to working people.

Let’s start with the Affordable Care Act.  Around 30 million Americans could lose coverage if it is fully repealed without being replaced. Of these, over half are white, most of whom work for a living.

 In WV, Medicaid expansion alone covers nearly 180,000 people, about one out of ten. That doesn’t include people with disabilities or the tiny TANF or welfare population.  Around 37,000 working West Virginians got covered through the exchange.  Around 18,000 young people up to age 26 are now covered on their parent’s insurance. These people are overwhelmingly in working families. White ones too.

Losing expansion funding would be a devastating blow to hospitals and health care providers here and would result in job losses in one of the few growing industries.

The new administration could breathe new life into House Speaker Paul Ryan’s plan to turn Medicare into a voucher program. Medicare is a health care program for people age 65 and older who have worked and paid into the system. It provides coverage to over 55 million Americans and around 400,000 here, over 1/5 of the population. We’re tied with Maine in having the highest percentage of beneficiaries.

Ryan has also proposed block granting—and effectively cutting--programs such as SNAP and traditional Medicaid, both of which benefit working families. The Center on Budget and Policy Priorities says the data shows that “The overwhelming majority of SNAP recipients who can work do so.”  SNAP benefits go straight to local businesses and help support thousands of retail and agriculture jobs.

Traditional Medicaid covers 70 million, including long term care for the elderly and people with disabilities. Many seniors who worked all their lives run out of savings when they need long term care. Medicaid picks up the slack. With block granting, some would have to quit jobs to care for elderly family members, even though they may be unequipped to do this. More seniors who worked all their lives will be in danger of abuse or neglect.

This would also mean losing federal matching funds, again with job impact. More than 10 years ago the WV Bureau of Business and Economic Research found that Medicaid spending supported economic activity that generated nearly 33,000 jobs. That number has only gone up since.

Medicaid and CHIP provide health care to children in many working families earning up to 300 percent of the federal poverty level—and most workers want their kids to live and be healthy. The programs also bring millions of dollars to local communities and sustain jobs.

The latest round of proposed tax cuts—a remedy that has yet to produce impressive results--would likely benefit the very wealthy, increase inequality, and reduce the ability of the federal government to respond to the needs of working families—for example by making vocational and post-secondary education more affordable.

From the earliest days of the republic, working people fought for a free public education for their children, which is likely to be undermined by a secretary of education committed to undermining it with a system of vouchers and privatization schemes. Speaking of labor history, another key demand of the past was the abolition of child labor, which has been praised by a group the newly appointed education chief has supported.

Then there’s trade, a major issue for working people. I’m not mourning the death of the Trans Pacific Partnership and I support revisiting trade deals to ensure workers’ rights and save American jobs. But a heavy handed approach could set off a trade war which the conservative Peterson Institute described as “horribly destructive.” Peterson estimated that this could cost between 1.3 and 4 million jobs. Progressive groups that ordinarily oppose Peterson on trade issues, such as the Economic Policy Institute, share similar concerns.

If the US ignores the dangers of climate change, working people will be hit the hardest by extreme weather events, like those that hit much of the state this summer. Scientific models project more droughts, floods, food shortages, wildfires, disease epidemics, etc. While we’re at it, if the US goes to war with the known universe over perceived slights on Twitter, it’s a pretty safe bet that working people would pay the highest price.

Then there’s the pick for secretary of labor, a fast food baron who opposes the minimum wage and talks about replacing workers with robots, saying that the latter are ““always polite, they always upsell, they never take a vacation, they never show up late, there’s never a slip-and-fall, or an age, sex or race discrimination case”

Sorry, but If this is a case of sticking it to the man, I’d have to ask, which man would that be? From where I’m sitting, it seems to be the one who is living paycheck to paycheck.

I think a real pro-working class program would be based on solidarity, not scapegoating. It would include such things as full employment and trade policies to strengthen the middle class; patching the holes in our pension and health care system, ensuring paid sick days and family leave; making debt-free post high-school job training and education a reality; strengthening K-12 public education; investing in things like early childhood programs and infrastructure; and guaranteeing the right of workers to organize. And, since widespread poverty exerts a downward pressure on everyone’s wages, it would support an increase in the minimum wage indexed to inflation.

It would recognize that an injury to one is the concern of all, just as the labor movement of the 1800s came to recognize that free labor could never prosper while slavery persisted. And it would promote international policies that would guarantee fair trade, a sustainable future, and what Lincoln called “a just and lasting peace among ourselves and with all nations.”

I haven’t heard a lot of that.

Up in smoke

West Virginia has made some strides in the direction of reason in its criminal justice system, but there is still huge room for improvement. The Charleston Gazette recently reported that marijuana arrests accounted for over half of the drug busts in the state.

For the record, El Cabrero is no stoner. I figure if alcohol was good enough for my old man and my hillbillly and Scotch Irish ancestors, it's good enough for me. But still...there's got to be a better way.

THE CRISIS THAT WASN'T. For years, deficit scolds like Paul Ryan have been warning that Medicare costs, like those of Social Security and Medicaid, are growing at an unsustainable rate. That turns out to be BS too, thanks in part to the Affordable Care Act.

ANOTHER CIVILIZED STATE? Could it be that even a state like Tennessee is considering expanding Medicaid?

ANOTHER GAP BETWEEN RICH AND POOR is in the quality of food.

GOAT ROPE ADVISORY LEVEL: ELEVATED

Short load

West Virginia was the subject of a long and gloomy article in the Washington Post recently. Some other reflections on changes in the state over time can be found in this Gazette editorial.

Meanwhile, here's a good one by E.J. Dionne about why Congress has been trying to fix the wrong problem for the last few years and one more by Krugman about how ideology can sabotage government services.

Unkindest cut

It looks like the federal deficit and programs for the elderly like Social Security and Medicare aren't as dire as the deficit hawks wanted them to be. Paul Krugman made a great point today in his NY Times column.
He acknowledges that there may eventually be a shortfall in the programs,

...and the usual suspects insist that we must move right now to reduce scheduled benefits. But I've never understood the logic of this demand. The risk is that we might, at some point in the future, have to cut benefits; to avoid this risk of future benefit cuts, we are supposed to act pre-emptively by...cutting benefits. What problem, exactly are we solving here?

Meanwhile, it is beyond belief that Congress is contemplating cutting food stamp benefits for children. Here are some reasons why this is a really bad idea.

Good point

We hear a whole lot in this political season about President Obama's "War on Coal," which is basically a cynical way to assign the blame for the industry's woes, many of which are due to basic market forces, on a person who just happens not to be white. The specific political subtext in all this is the assumption that if the president's opponent wins, everything will be all good here all the time.

Meanwhile, nobody around here seems to have noticed that programs like Social Security, Medicare and Medicaid, which Romeny/Ryan have targeted for gutting, have an even bigger impact on the state's economy than the coal industry.

The folks at the WV Center on Budget and Policy point out here that

...in 2011 approximately $12.7 billion or 20.5 percent of the state’s $62 billion in personal income came from Medicare, Medicaid, and Social Security. The U.S. average was 12.8 percent...

For comparison, only 5.5 percent or $3.4 billion of personal income in 2011 was derived from coal mining and natural gas extraction – two of the largest industries in the state.

I don't mean to belittle the economic hardships in the coalfields. These need to be faced in a proactive way rather than used to score dubious political points. But imagine how bad things would look in places like southern West Virginia if drastic cuts to the bedrock safety net--Social Security, Medicare, Medicaid--went hand in hand with market-driven declines in mining.

MORE ON THAT here.

A TALE OF TWO STORMS. Krugman does a heckuva job contrasting Katrina and Sandy.

IT'S ALREADY WORKING. Here's a cheer for the Affordable Care Act.

GOAT ROPE ADVISORY LEVEL: ELEVATED

The universal thump

"For my part, I abominate all honorable respectable toils, trials and tribulations of every kind whatsoever."--Ishmael in Moby-Dick.

Here's yet another reason why everyone should read this greatest American novel: most of us are grunts one way or another and the book basically sings the greatness of gruntdom. And even if you have a good gig, you gotta serve somebody, as Dylan sang. Ishmael takes great pride in taking to sea as a simple sailor, even though it means getting ordered about and yelled at.

In his view, the human condition is such that we are all in one way or another a grunt at the disposal of some arbitrary power, even if it is simply that of an indifferent universe:

What of it, if some old hunks of a sea-captain orders me to get a broom and sweep down the decks? What does that indignity amount to weighed, I mean, in the scales of the New Testament? Do you think the archangel Gabriel thinks anything the less of me, because I promptly and respectfully obey that old hunks in that particular instance? Who ain't a slave? Tell me that. Well, then, however the old sea-captains may order me about-however they may thump and punch me about, I have the satisfaction of knowing that it is all right; that everybody else is one way or other served in much the same way-either in a physical or metaphysical point of view, that is; and so the universal thump is passed round, and all hands should rub each other's shoulder blades, and be content.

I don't think I have Ishmael's confidence that things equal out over time, but I appreciate the generosity of his sentiment.

WHAT HE SAID. WV's senior senator goes off on the Ryan budget here.

GRANDMOTHERS made us what we are today. Maybe even literally.

THE DONALD HATCHES A DUD. Not much of a Trump card. (Full disclosure: the Spousal Unit and I used to dream of a 2012 Trump/Palin ticket purely for the entertainment value. You betcha.)

GOAT ROPE ADVISORY LEVEL: ELEVATED

SOS

 There are lots of things worse than getting an irritating song stuck in your head. One such thing, I have discovered, is getting a little league cheer stuck in your head.

Allow me to explain. My grandson recently starting playing little league football. I've been to two games so far. The cheerleaders seem fiercer than the players on his team, so far anyway. And one of the cheers has wormed its way into my brain like some kind of tropical parasite.

Here's how it goes:

Big fat apples, skinny bananas
We're the girls from Alabama
That's a lie, here's the truth
We're the might Panthers
Aren't we cute?

Both my daughter (a former raging cheerleader) and the Spousal Unit think this is the Best Cheer Ever. I'm ashamed to say we even make up various Spanish versions of it. The saddest part is, I know the hand moves that go with it.

Help me...quickly.

FROM CURSE TO BLESSING. Here's my latest rant in the Gazette. This one is about how WV needs to change the mineral extraction game and create a Future Fund.

THE SCARE IN MEDICARE. E.J. Dionne's got this one.

WHAT THE WORLD NEEDS NOW is a better toilet?

GOAT ROPE ADVISORY LEVEL: ELEVATED

Happy anniversary, Social Security

“We can never insure one-hundred percent of the population against one-hundred percent of the hazards and vicissitudes of life. But we have tried to frame a law which will give some measure of protection to the average citizen and to his family against the loss of a job and against poverty-ridden old age. This law, too, represents a cornerstone in a structure which is being built but is by no means complete. It is a structure intended to lessen the force of possible future depressions. It will act as a protection to future Administrations against the necessity of going deeply into debt to furnish relief to the needy. The law will flatten out the peaks and valleys of deflation and of inflation. It is, in short, a law that will take care of human needs and at the same time provide for the united States an economic structure of vastly greater soundness.”
—Franklin D. Roosevelt, August 14, 1935

Today I hosted an event celebrating the 77th anniversary of the signing of the Social Security Act at a crowded Carpenter's local union hall in Huntington. Medicare and Medicaid hit their 47th anniversary a couple weeks back on July 30.

Congressman Nick Joe Rahall attended the event. A strong supporter of all three programs, Rahall said

 "... Social Security is a fortress of reliability. It has never missed a payment. Every dollar and benefit has been paid out on time and in full - how many 401-ks can tout that same record? Social security and Medicare are not the cause of our current budgetary woes and they should not be used as a piggy bank for unrelated spending, especially paying for more tax cuts for millionaires."

WV's senior senator Jay Rockefeller was not able to attend but sent a specially made video for the event, saying,

"I am so glad West Virginians from across the state are joining together to celebrate this important day in history. Seventy-seven years ago, on August 14, 1935, President Franklin Delano Roosevelt passed a landmark piece of legislation creating our nation’s Social Security program. It is a program that protects so many West Virginians and has lifted millions of people out of poverty. Social Security was created during the Great Depression, a crucial time in our nation’s history. And, since then, it has provided life-saving benefits to widows, the children of deceased workers, people who are disabled, and the elderly. Social Security has proven to be one of our nation’s most successful programs, serving 451,000 West Virginians – including 41,000 children where one or both parents are deceased, disabled, or retired – and more than 50 million Americans each year. It is something we should all celebrate.”

Today's celebration took on a special significance in light of presidential candidate Mitt Romney's selection of congressman Paul Ryan as running mate. Ryan was an architect of President Bush's failed effort to privatize Social Security and has crafted similar or worse plans for Medicare and Medicaid.

Things are going to  get interesting, alas.

The logic of climate change denial

Despite living in a weather-disaster-of-the-week world, major segments of the ruling class of El Cabrero's beloved state of West Virginia and the United States as a whole remain invested (pun intended) in denying climate change, or at least delaying action on it until it's too late and then saying that nothing can be done.

Truth or science has nothing to do with it; it's all about the money.

The sad thing is that there is a good chance they can get away with it, although that probably won't win them a lot of gratitude from future generations.

Recently, however, Senator James Inhofe, intentionally or not, opened a window on the real mindset of denial. While appearing on Rachel Maddow's show on MSNBC, Inhofe said of climate change

I was actually on your side of this issue when I was chairing that committee and I first heard about this. I thought it must be true until I found out what it cost.

There you have it.

WAR WITH IRAN would be a big drag, economically speaking. Probably in other ways as well.

HEALTH CARE REFORM means big savings for Medicare.

MORE ON THAT here.

GOAT ROPE ADVISORY LEVEL: ELEVATED

The word of the day is...

...austerity. You hear calls for it all the time from the crew that runs Congress these days. Apparently, these folks are unaware that things are already pretty austere for the nearly 25 million Americans who are un- or under-employed or the nearly 50 million without health insurance.

If these people have their way, things will get even more austere for the millions of seniors who depend on Medicare and Social Security and the tens of millions of Americans who rely on Medicaid for everything from pre-natal to nursing home care.

AUSTERITY is bad medicine at a time when the world economy is sliding towards a double dip recess.

SPEAKING OF AUSTERITY, you won't find a whole lot of it amongst the very wealthy.

STILL SPEAKING OF AUSTERITY, conservative ideologues seem to want to destroy the economy in order to save it.

GOAT ROPE ADVISORY LEVEL: ELEVATED

Back in paradise

Well, I'm back from a week in Italy. The trip was great. The getting there and back, not so much. The picture above was me after a particularly hellish airport day on the return trip.

On the positive side, I did get to spend a little time with the traveling Spousal Unit and to get a bit of a feel for Siena, Florence, Ravenna, and Rome and had plenty of food for thought and gullet, which will probably show up her e by and by.

In the meantime, here are some things that caught my eye after a week of being out of the loop...

MINIMUM WAGE VERSUS CEO PAY. Here's an op-ed on growing inequality by Holly Sklar.

FIGHTING FOR MEDICARE. Somebody's got to do it.

SOME THINGS SEEM TO GO TOGETHER. Like coal and poverty. Not to mention a boom and bust energy economy.

FUN AND GAMES. Some of my union friends and progressive allies are planning a tongue in cheek hot dog sale to fund tax cuts for millionaires. (We are a pretty shameless lot around here and there is no cheap stunt to which we will not resort.) Anyhow, the event got picked up by a Wall Street Journal blog.

GOAT ROPE ADVISORY LEVEL: ELEVATED

How's the weather?

I've been writing and linking things about climate change and extreme weather off and of for years now, but this weather-related news item really weirded me out.

HEALTH CARE. Here are yet more reasons to oppose privatizing Medicare.

A BETTER ALTERNATIVE. Here's another item on the People's Budget, a better alternative to the slash and burn approach.

LOST IN THE SHUFFLE. Deficit mania in DC is crowding out concern for the unemployed.

GOAT ROPE ADVISORY LEVEL: ELEVATED

Highlighting an absurdity

I apologize for late posting today. Goat Rope Farm was without electricity overnight and into the morning after a storm yesterday.

In lieu of regular random rants, here are some pictures of the Rally for the Really Rich/Bake Sale for Medicare and Medicaid, which was held in Charleston WV yesterday evening.

In addition to the bake sale, we had some fat cats to highlight the absurdity of extending the Bush tax cuts while cutting vital programs for ordinary Americans.

It was probably the only chance some of us will have to see some people in tuxes.

There was a bit of street action.

Plus, we had great music provided by the Carpenter Ants.

Our "bake sale" netted $102 for Medicare and Medicaid. Presenting that princely sum to the government will probably be our next cheap publicity stunt.

Double dipping

Lots of people have been talking about the disappointing job numbers released late last week. The private sector added only around 54,000 jobs, even while governments at various levels are laying people off.

Deficit mania, which has taken precedence over job creation, could well lead us back to a double dip recession. As many people have noted, something similar happened in 1937, when FDR cut back on public spending and wound up prolonging the Depression by several years.

THIS IS SWEET. Ayn Rand groupie Paul Ryan, would be executioner of Medicare, is getting some pushback from religious groups.

DESTROYING MEDICARE in order to "save" it.

MASSEYLAND. Ken Ward takes a hard look at Massey Energy's board of directors here.

MARCHING TO BLAIR. I hope nobody gets hurt this week.

WAXING ROMANTIC. Here's the latest edition of the Rev. Jim Lewis' Notes from Under the Fig Tree.

THE MAGIC NUMBER for friends may be 150.

GOAT ROPE ADVISORY LEVEL: ELEVATED

How long?

El Cabrero's beloved state of West Virginia is one of several places in which the ruling class has a vested interest in denying or minimizing the reality of climate change. I have a feeling that's going to get a bit harder to do as we witness more and more extreme weather events around the world.

I was as shocked as anyone watching the devastation wrought by the giant tornado that hit Joplin, Missouri, and the one before that as well. It's not just human empathy; it's also the uneasy feeling of having dodged one bullet when you know that another one out there might have your name on it.

Still, I wonder what it will take to goad the US into meaningful climate action...and whether it will be too late to do any good...and how people in the future will look at those who tried to block it.

One final thought. I know a person who likes to make jokes about global warming. He has a beautiful child. I have so far restrained my self from saying something like, "Why don't you write that down in a book and give it to your kid and let her see how funny it looks in a few years."


THE RYAN PLAN to gut Medicare has hit a snag or two lately. The fight is about to shift to Medicaid.

JUST CHECK IT. Coal related stories are coming fast and furious in the wake of the publication of the report on the Upper Big Branch mine disaster. The best way to keep up is to keep checking Ken Ward's Coal Tattoo blog.

SCARY LOOKING ANCIENT SEA MONSTER UPDATE here.

GOAT ROPE ADVISORY LEVEL: ELEVATED