The Amazing ObamaCARES News Buried Inside A 283-Page Medicare Report.


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The amazing news buried inside a 283-page Medicare report

 

From VOX.com  By 

 

This is arguably the most unexpected piece of news in the new Medicare Trustees report: the government’s hospital insurance program might be spending less money to cover more beneficiaries than it did a year ago.

 

Tele-consultation between the neurology department in Besancon hospital, France and A&E in Dole hospital, France. Dole hospital doesn't have a neurology department which makes detecting a CVA a difficult task. Telemedicine allows A&E doctors at Dole

 

Medicare’s hospital insurance program — known to wonks as Medicare Part A — spent $266.8 billion covering 50.3 million people in 2012. In 2013, the the same program spent $266.2 billion to cover 51.9 million people. These figures come from Table II B.1 in the 2012 and 2013 reports.

 

Medicare’s hospital insurance program is gigantic; it spends more money in a given year than the entire state of Wisconsin. In that context, $600 million is not much more than a rounding error. And some senior administration officials I spoke with cautioned against reading too much into these particular figures; receipts for services rendered in 2013, for example, might trickle after the year has ended.

 

But what’s definitely clear — and what’s driving this trend — is that Medicare is spending significantly less per person than they did two years ago. And this report expects that trend to continue for another two years going forward.

 

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By 2015, the Medicare Trustees’ Report projects that the program will spend less per person on hospital care than it did in 2008. This doesn’t happen much in health care: not just slower growth, but the actual dollar amount spent on a given type of care dropping.

 

These figures only represent the hospital insurance part of Medicare (this is Medicare Part A). The government insurance program has separate programs for doctor visits (Medicare Part B) and prescription drug coverage (Medicare Part D).

 

But even when you look at the overall picture, it generally looks pretty good: per-person Medicare spending has grown by an average of 0.8 percent since 2009. That’s a lot slower than the rest of the economy, which has grown at an average 3.1 percent rate. Between 2012 and 2013, it was even slower: Medicare’s per person costs stayed exactly the same.

 

As Health and Human Services Secretary Sylvia Mathews Burwell put it at a press briefing today, “that is a growth rate of 0 percent.”

 

As to why this is happening, that’s the big question. There has been an overall slowdown in health care spending, some of which is likely due to the recession: when people have less money to spend, they don’t buy as many medical services.

 

But Medicare beneficiaries should be somewhat insulated from the economy. They don’t lose insurance coverage during economic downturns, for example, as many who lose their jobs do. Many live on a more fixed income, too.

 

Its certainly possible that the overall economic climate might have impacted seniors’ decisions about health care. And its possible the health care law, and its changes to the Medicare system (this report estimates there are 165 of them) have had an impact as well.

 

The Affordable Care Act, for example, penalizes preventable readmissions — times when seniors turn up at the hospital a second time after something goes wrong during their first visit. Readmissions have been falling pretty steadily for the last few years, and those reductions could be showing up in the lower per-person spending.

 

readmission_rates

 

 

Last, the downward shift in hospital spending could just reflect larger trends in how doctors deliver medicine. As new innovations happen, procedures that used to be more invasive — and require a hospital stay — improve, become easier and shift into an inpatient setting, or can be treated with prescription drugs. You see that change below, with hospital care, since the early 1980s, becoming a slightly smaller portion of the country’s overall medical bill.

 

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(California Healthcare Foundation)

 

Overall, this report suggests a pretty positive trend for Medicare spending — it just doesn’t totally explain the forces that are driving it.

 

CARD 6 OF 15 LAUNCH CARDS

How much of health-care spending is wasteful?

A lot: about one-third of all health-care spending — $785 billion — goes to things that aren’t making us any healthier, according to a massive Institute of Medicine study published in 2012.

 

Most of the waste comes from the way the United States delivers medical care, with a fragmented system that delivers a lot of care that isn’t needed. The IOM estimates that we spend about $210 billion on unnecessary care, with doctors delivering care that isn’t recommended by medical guidelines. Unnecessary care can be harmful to patients, too, especially when it involves surgical procedures that didn’t need to happen.

 

Administrative costs are another huge driver of wasteful spending in the United States. Every doctor typically takes in payments from numerous health insurers, and need to employ lots of billing staff to handle the deluge of paperwork. The average doctor in the United States spends $82,975 dealing with insurers each year.

 

Last but not least, the American health-care system tends to have much higher prices than other countries. Most developed countries have some form of government rate-setting in health care, where bureaucrats set a specific price for any given medical treatment. The United States doesn’t have that — and also has thousands of health insurance plans, each negotiating their own price with doctors and hospitals. This helps explain why an appendectomy costs $8,156, on average, here — and $4,498 in the Netherlands.

 

 

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An Interview With The President: Barack Obama Talks To The Economist.


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AS HE prepares to host a summit in Washington, DC, that will bring together leaders from across Africa, how does Barack Obama see the continent’s future (see article)? Does he feel let down by Vladimir Putin? Could he have designed a more elegant health-care law? And why don’t more business leaders admit that they have lunch with him?

 

In his cabin aboard Air Force One, returning to Washington from Kansas City, where he had been speaking about economic policy, the president talked with John Micklethwait, editor-in-chief of The Economist, and Edward Carr, our foreign editor. The prompt for the interview was the Africa summit, but the conversation ranged widely through the emerging world, China and Russia and the principles underlying his foreign policy. It ended with a lengthy riposte to those, including The Economist, who have criticised the White House for its treatment of business. Mr Obama was unusually relaxed and contemplative, buoyed by the recent economic numbers and looking towards his legacy as well as the mid-term elections and his wrangles with Congress.

 

Because the interview took place on board a plane with three people hunched round a microphone, the sound quality is less than perfect. You can listen to edited highlights of the president’s thoughts on Africa, Russia,China, multilateralism and American business, or listen to the full interview here. A full transcript, lightly edited for clarity, is available below.

 

Barack Obama talks to The Economist

 

Published on Aug 2, 2014

An interview with the president. The Economist’s editor-in-chief and foreign editor talked to Barack Obama aboard Air Force One on August 1st, 2014 as he returned to Washington from Kansas City. The conversation ranged widely through the emerging world, China and Russia and the principles underlying his foreign policy. It ended with a lengthy riposte to those, including The Economist, who have criticised the White House for its treatment of business. You can listen to the full interview here or view the transcript via our website: The Economist.

 

 

 

The Economist: Our starting point, on Africa, is we think Africa is the next big emerging opportunity. You don’t have to convince us at all that the narrative has changed, that this is a completely new thing. And we’ve been writing about that a lot. But it strikes me that in Africa you have an opportunity. You have Lagos, an amazing place, full of entrepreneurs, but you also have northern Nigeria, where you’ve got threats aplenty. I look back at American foreign policy in the past—at emerging Asia. Asia came out, but America really guided it—Kissinger went to China, he helped move it. Do you think America is up for Africa? Do you think America is able to guide it through the next period?

 

Barack Obama: I think America is not going to do it alone, but I think America can be central in moving Africa into the next stage of growth and integrating it into the world economy in a way in which it’s benefitting the people of Africa and it’s not just a source of natural resources.

 

And there are a couple of reasons why I think America can be central in this process. First of all, American companies continue to be an enormous force in the global economy, and in talking to US companies, there is a real recognition of opportunity there. Secondly, I do think that the American traditions of transparency, accountability, rule of law, property rights are ingredients that are critical to unlocking Africa’s future. Third, America was, and continues to be, an economy based on ideas, and as we move deeper into the 21st century, our emphasis on developing human capital is something that Africa very much wants and we’re good at it.

 

And finally, what’s fascinating about African development is the opportunities that they have to leapfrog certain technologies and skip certain phases of development, and we are very good at the technologies that allow countries to potentially leapfrog development. So a classic example being in the telecommunications sector. We invented smartphones and there are smartphones everywhere in Africa.

 

The Economist: They’re very good at doing mobile money, though, aren’t they? They’re much better at banking than—

 

Mr Obama: Well, when we were out the last time—I started in Senegal during my tour, and talking to small farmers about how they’re now getting weather reports, market reports, information on the latest seed technologies, all through their smartphone—those are the kinds of things that we excel at. And to meet a woman who started off with a small plot, who’s able to leverage that into a thriving—still small, but profitable operation, those are the kinds of things that I think we can do better than just about anybody else.

 

The Economist: Your second point about what the US has to bring in, in terms of governance—of course, one of the big factors in Africa and the economy’s emergence has been Chinese investment. And they bring a different model. They don’t have governence. Is that something that—on the other hand, is that a problem for you? Is that something that you need to confront, or is—actually, at this stage, just the capital and the foreign direct investment all that really matters?

 

Mr Obama: My view is the more the merrier. When I was in Africa, the question of China often came up, and my attitude was every country that sees investment opportunities and is willing to partner with African countries should be welcomed. The caution is to make sure that African governments negotiate a good deal with whoever they’re partnering with. And that is true whether it’s the United States; that’s true whether it’s China.

 

And I do think that China has certain capacity, for example, to build infrastructure in Africa that’s critical. They’ve got a lot of capital and they may be less constrained than the United States is fiscally in helping roads get built and bridges and ports. On the other hand, China obviously has a need for natural resources that colours their investments in a way that’s less true for the United States.

 

And so my advice to African leaders is to make sure that if, in fact, China is putting in roads and bridges, number one, that they’re hiring African workers; number two, that the roads don’t just lead from the mine to the port to Shanghai, but that there’s an ability for the African governments to shape how this infrastructure is going to benefit them in the long term.

 

And one of the interesting things we talked about at what was then a G8 summit—the one in Northern Ireland—was how the G7 countries could assist African governments who do have natural resources to build in transparency mechanisms that ensured any infrastructure and any architecture for extraction, in fact, redounded to the benefit of the populations.

 

The Economist: The other advantage the Chinese have is they don’t have Congress. Well, they have a congress but it’s somehow more compliant, to use your word this morning. We could both agree that one of the great things would be to have more free trade in Africa if you could push people. But you face the danger that Congress may give up on the Export-Import Bank and may also get in the way of the African Growth and Opportunity Act (AGOA). These could frustrate your policy.

 

Mr Obama: There’s no doubt that—

 

The Economist: You’d rather be a dictator. (Laughter.)

 

Mr Obama: Let’s just make sure that we note that that was not my quote. (Laughter.)

 

There is no doubt that a thread has emerged in the Republican Party of anti-globalisation that runs contrary to the party’s traditional support for free trade. How the Export-Import Bank and the Overseas Private Investment Corporation (OPIC) became targets for Tea Party wrath is a little strange to me. But I do think there remains a consensus within the American business community that ultimately we benefit from trade. I am confident that we can get AGOA reauthorised and refined, given the lessons learned from the first round of AGOA. And the truth is that the amount of trade between the United States and Africa is so small relative to our overall economy that in no way should it be perceived as a threat.

 

I am more concerned about the prospect, for example, that Ex-Im was not reauthorised because I think it will hurt US companies. I’m less concerned about its impact on Africa because I guarantee you that there will be German companies and Chinese companies and Indian companies who rush to fill that void. So when you’re talking about a continent with six of the ten fastest-growing economies, we would be cutting off our nose to spite our face to not be engaged and not to encourage strong trade relations. And the business community understands that.

 

Now, one thing that I want to make sure we emphasise, that multilateral institutions emphasise, and that African governments emphasise is not just trade with the advanced economies but intra-African trade. It is easier now to send a shipment of goods from Nairobi to Amsterdam than it is to send those goods to many parts of Africa. And that is an impediment to trade.

 

You mentioned Asia as a model. Part of what Asia was able to do was not simply open up markets to the West for cheaper goods, it was also able to foster homegrown businesses in Asia with regional markets that gave an opportunity for businesses to get better, to develop better products, to in some ways avoid competition on the global scale right away. Essentially, you can operate off-Broadway before you open the show on Broadway.

 

And so the more we can do to also encourage intra-African trade, the better. And we’re experimenting with that with the East Africa Trade Initiative that we are helping Tanzania, Kenya, Uganda and other countries move forward on—synchronising their regulatory schemes, reducing some of the bureaucracy and paperwork between borders, planning for joint infrastructure, planning for joint power generation.

 

We’re really excited about Power Africa as a potential transformative effort—the idea that we can double the amount of electricity in sub-Saharan Africa, which can transform everything from businesses to schools.

 

And there are a whole bunch of different models for generating power. In some cases, particularly in rural areas, if we’re building a small power plant, the key is going to be making sure that Kenya and Tanzania, for example, have some sort of cooperative agreement, so that like the Tennessee Valley Authority, it’s helping a region and you’ve got enough customers to justify the economics of the investment. That’s the kind of effort that, again, I think America can play a unique role in.

 

The Economist: The other bit where it could play a unique role is security. I mean, you are the main provider. I’ve seen a couple of European leaders recently who’ve said that they think that you see African security as their area, as their backyard, they should be dealing with it. Is that fair or is that the wrong way to depict it? That you would be prepared to expend blood and treasure to help create this new Africa in the same way as America did for Asia?

 

Mr Obama: It’s interesting. The US security presence is always a source of ambivalence everywhere in the world. If we’re not there, people think we’re neglecting them. If we’re there, then they think we’re militarising a region. Right now I think we got it about right. Our theory is that we very much need to partner with African countries, first and foremost, and regional African organisations.

 

And one of the main topics in the summit will be finding ways to strengthen peacekeeping and conflict-resolution efforts by Africans. There are certain countries that carry a very heavy load when it comes to peacekeeping and conflict resolution. And for us to engage in the African Union and ECOWAS to find ways to improve their capabilities so that they are able to police their own neighbourhood can make a huge difference.

 

We also think that we need to have a much more intentional, explicit plan for NATO to engage with African countries and regional organisations, not because the United States is not prepared to invest in security efforts in Africa, but rather to ensure that we are not perceived as trying to dominate the continent. Rather, we want to make sure that we’re seen as a reliable partner. And there are some advantages to some European countries with historical ties being engaged and taking advantage of relationships—

 

The Economist: So France might be able to—

 

Mr Obama: France—the Francophone countries—obviously is going to be able to do certain things better than we can. And one of the things we want to make sure of, though, is that when the average African thinks about US engagement in Africa, I don’t want them to think that our only interest is avoiding terrorists from spilling out into the world stage. Rather, we want them to see the partnership as comprehensive, and security being one part of our broader agenda.

 

The Economist: Can I push you a bit on that—using Africa as an example for a thing about general foreign policy? You worked really hard on this idea of getting responsible powers to work together. And I suppose as you look back, you might say the two problems you’ve had are, first, dealing with people who aren’t rational or are extremely difficult to deal with—like Mr Putin—or secondly, the problem is allies who aren’t prepared to put stuff in. And South Africa would seem to be emblematic of other new emerging powers. You’ve got South Africa, you’ve got Indonesia, you’ve got India. A lot of things you’ve tried to get them to back, they haven’t. And why do you think that is? Is that a phase they’re going through? What’s changing?

 

Mr Obama: Well, look, there’s no doubt that a robust, interventionist foreign policy on behalf of certain principles, ideals or international rules is not a tradition that most countries embrace. And in the 20th century and in the early stages of the 21st century, the United States continues to be the one indispensable power that is willing to spend blood and treasure on that. And part of my job has been to try to persuade countries that the United States will always shoulder a greater burden than others, but we still cannot do it alone given the complexity and
interconnectedness of today’s world.

 

So when it comes to South Africa, we recognise a suspicion they may have about meddling too much in the affairs of Zimbabwe, for example. But my argument to them would be, ultimately, as a key regional power, if they fail to invest in the kind of international order or regional order that helps ordinary Zimbabweans thrive, then they’re going to have an immigration problem—which they already do. That, in turn, is going to put more pressure on them and their economies. And ultimately, those chickens will come home to roost.

 

I think there’s a recognition that that may be the case, but I think there’s still a worry on the part of many regional powers that if they are too meddlesome then they’re also exposing themselves to criticism from the outside. And so there’s a little bit of a north-south, traditional, non-aligned culture that dates back 20, 30 years that may take some time and may require a new generation of leadership to discard so that they can move forward in a more effective way.

 

The Economist: It’s kind of depressing, because you don’t see those powers, not even regionally, but globally, standing up to clear abuses and unravelling of the norms. And, in fact, you see countries like China creating a BRICS bank, for instance—institutions that seem to be parallel with the system—and potentially putting pressure on the system rather than adding to it and strengthening it. Now, China you can understand. But India, Brazil, South Africa—those are countries that really belong in the system, that benefit from the system.

 

Mr Obama: Well, this is why I say there may be some generational shifts that need to take place. I mean, if you think about a Brazil, an India, a South Africa, much of the leadership in those governments came of age when those countries had very different attitudes towards the global economic system. To their credit, they have made incredible adjustments. If you think about somebody like former Prime Minister Singh of India really dragging this massive, incredibly complicated but incredibly innovative society kicking and screaming into the world marketplace, and below him, though, you’ve got an entire bureaucracy that was trained in thinking that—

 

The Economist: By the British? (Laughter.)

 

Mr Obama:—well, but also that may have been schooled by economists who were experts on dependency theory but not necessarily on how are we going to unleash innovation.

 

The Economist: What’s their incentive to learn?

 

Mr Obama: So there will be time I think for that to happen. Their incentive is that—is what you just identified—they benefit from the global system.

 

I mean, ironically, today, if India, Brazil, Indonesia—these emerging countries are to succeed and to absorb very young populations that are seeing what’s possible through the internet and have ambitions of the sort that their parents and grandparents never had, the only way to meet those expectations is to dive head first into a global system that is organised, that is fair, that is transparent. And that means that these emerging powers have to be partners in underwriting that order.

 

Another way of thinking about it is, is that the post-World War II order was necessarily a creation of the United States. There had been times where the United States took advantage of that post-World War II order to extend the reach of its companies and to extend the reach of its products, but now it really belongs to everybody. It’s an ecosystem that’s been built for everyone.

 

And when we look at something like the Trans-Pacific Partnership, for example, yes, we think it’s good for the United States, but we also think it’s good for a country like Vietnam who, in the absence of these kinds of rules, is going to have a very difficult time negotiating with its giant neighbour and getting decent terms of trade. We think it’s going to be good for a country like Malaysia that has an interest in maintaining navigation and freedom of movement in the South China Sea.

 

And I do think that what’s happening in the ASEAN countries and their concerns about the Chinese posture on maritime issues is instructive. You’ve seen many of those countries say, we want great relations with China, we don’t want to have to choose between China and the United States; on the other hand, we don’t want to be bullied just because we’re small.

 

The Economist: Because that is the key issue, whether China ends up inside that system or challenging it. That’s the really big issue of our times, I think.

 

Mr Obama: It is. And I think it’s important for the United States and Europe to continue to welcome China as a full partner in these international norms. It’s important for us to recognise that there are going to be times where there are tensions and conflicts. But I think those are manageable.

 

And it’s my belief that as China shifts its economy away from simply being the low-cost manufacturer of the world to wanting to move up the value chain, then suddenly issues like protecting intellectual property become more relevant to their companies, not just to US companies.

 

One thing I will say about China, though, is you also have to be pretty firm with them, because they will push as hard as they can until they meet resistance. They’re not sentimental, and they are not interested in abstractions. And so simple appeals to international norms are insufficient. There have to be mechanisms both to be tough with them when we think that they’re breaching international norms, but also to show them the potential benefits over the long term. And what is true for China then becomes an analogy for many of the other emerging markets.

 

The Economist: What about the people who are just outright difficult? Russia being the obvious example at the moment. You tried to “reset” with Russia. Angela Merkel spent the whole time telephoning Vladimir Putin. To what extent do you feel let down almost personally by what’s happened?

 

Mr Obama: I don’t feel let down. We had a very productive relationship with President Medvedev. We got a lot of things done that we needed to get done. Russia I think has always had a Janus-like quality, both looking east and west, and I think President Putin represents a deep strain in Russia that is probably harmful to Russia over the long term, but in the short term can be politically popular at home and very troublesome abroad.

 

But I do think it’s important to keep perspective. Russia doesn’t make anything. Immigrants aren’t rushing to Moscow in search of opportunity. The life expectancy of the Russian male is around 60 years old. The population is shrinking. And so we have to respond with resolve in what are effectively regional challenges that Russia presents. We have to make sure that they don’t escalate where suddenly nuclear weapons are back in the discussion of foreign policy. And as long as we do that, then I think history is on our side.

Anything on the US economy? I noticed the occasional cover story saying how unfriendly to business we are.

 

The Economist: Yes, tell us about that. We see a lot of business people and they do complain about regulation.

 

Mr Obama: They always complain about regulation. That’s their job. Let’s look at the track record. Let’s look at the facts. Since I have come into office, there’s almost no economic metric by which you couldn’t say that the US economy is better and that corporate bottom lines are better. None.

 

So if, in fact, our policies have produced a record stock market, record corporate profits, 52 months of consecutive job growth, 10m new jobs, the deficit being cut by more than half, an energy sector that’s booming, a clean-energy sector that’s booming, a reduction of carbon pollution greater than the Europeans or any other country, a housing market that has bounced back, and an unemployment rate that is now lower than it was pre-Lehman—I think you’d have to say that we’ve managed the economy pretty well and business has done okay.

 

There are always going to be areas where business does not want to be regulated because regulations are inconvenient.

 

The Economist: When you look at things like Dodd-Frank and health-care reform—both of which we supported in principle—that they could have been much simpler?

 

Mr Obama: Of course. This goes back to the old adage of Churchill—democracy is the worst form of government except for all the alternatives. (Laughter.) It’s messy.

 

And so could we have designed a far more elegant health-care law? Of course. Would I have greatly preferred a blank canvas in which to design financial regulations post-2008 and consolidated agencies and simplified oversight? Absolutely. But the truth of the matter is, is that we saved the financial system. It continues to be extraordinarily profitable. And essentially, what we did was to provide an additional cushion so that if and when people make bad decisions with large sums of money—which they inevitably do—the risks to the system are reduced.

 

And on health care, as messy as the whole process has been, here’s what I know—that we have millions of people [insured] who didn’t have insurance before, and health-care inflation is the lowest it’s been in 50 years, for four consecutive years, corresponding to when we passed the law.

 

So my belief is that if, in fact, we can see a reduction in some of the political temperature around Obamacare or around Dodd-Frank, then it’s an iterative process. We can go back at it and further refine it, learn lessons from things that aren’t working as well, make it simpler, make it better. That does require, though, an attitude on the part of Congress, as well as on the part of the business community, that says you don’t just get 100% of what you want.

 

The business community does have broader responsibilities to the system as a whole. And although the general view today is that the only responsibility that a corporate CEO has is to his shareholders, I think the American people generally sense—

 

The Economist: Do you really think that’s true? Because when I talk to corporate CEOs, that’s one of their complaints. If you ask for a complaint about the White House, they’ll say it is the attitude. Every CEO nowadays is involved in nine different social responsibility things—it’s ingrained in most public—

 

Mr Obama: Well, I think—here’s what’s interesting. There’s a huge gap between the professed values and visions of corporate CEOs and how their lobbyists operate in Washington. And I’ve said this to various CEOs. When they come and they have lunch with me—which they do more often than they probably care to admit (laughter)—and they’ll say, you know what, we really care about the environment, and we really care about education, and we really care about getting immigration reform done—then my challenge to them consistently is, is your lobbyist working as hard on those issues as he or she is on preserving that tax break that you’ve got? And if the answer is no, then you don’t care about it as much as you say.

 

Now, to their credit, I think on an issue like immigration reform, for example, companies did step up. And what they’re discovering is the problem is not the regulatory zealotry of the Obama administration; what they’re discovering is the dysfunction of a Republican Party that knows we need immigration reform, knows that it would actually be good for its long-term prospects, but is captive to the nativist elements in its party.

 

And the same I think goes for a whole range of other issues like climate change, for example. There aren’t any corporate CEOs that you talk to at least outside of maybe—no, I will include CEOs of the fossil-fuel industries—who are still denying that climate change is a factor. What they want is some certainty around the regulations so that they can start planning. Given the capital investments that they have to make, they’re looking at 20-, 30-year investments. They’ve got to know now are we pricing carbon? Are we serious about this? But none of them are engaging in some of the nonsense that you’re hearing out of the climate-change denialists. Denialists?

 

Eric Schultz (deputy press secretary): Deniers.

 

The Economist: Deniers.

 

Mr Obama: Deniers—thank you.

 

The Economist: Denialists sounds better. (laughter.)

 

Mr Obama: It does have more of a ring to it.

 

So the point, though, is that I would take the complaints of the corporate community with a grain of salt. If you look at what our policies have been, they have generally been friendly towards business, while at the same time recognising there are certain core interests—fiscal interests, environmental interests, interests in maintaining stability of the financial system—where, yes, we’re placing constraints on them. It probably cuts into certain profit centres in their businesses. I understand why they would be frustrated by it, but the flip side of it is that they’d be even more unhappy if the global financial system unravels. Nobody has more of a stake in it than them.

 

Last point I’ll make on this: If you look at what’s happened over the last four or five years, the folks who don’t have a right to complain are the folks at the top. Where we have made less progress than I would like, and is my obsession since I came into office and will continue to be my obsession until I leave office and afterwards, is the broader trend of an increasingly bifurcated economy where those at the top are getting a larger and larger share of GDP, increased productivity, corporate profits, and middle-class and working-class families are stuck. Their wages and incomes are stagnant. They’ve been stagnant for almost two decades now. This is not a phenomenon unique to the United States, but it is global.

 

And this to me is the big challenge: How do we preserve the incredible dynamism of the capitalist system while making sure that the distribution of wealth and incomes and goods and services in that system is broadly based, is widely spread?

 

And the reason I’m concerned about this is not in any way a punitive notion. Oftentimes, you’ll hear some hedge-fund manager say, ‘Oh, he’s just trying to stir class resentment’. No. Feel free to keep your house in the Hamptons and your corporate jet, etc. I’m not concerned about how you’re living. I am concerned about making sure that we have a system in which the ordinary person who is working hard and is being responsible can get ahead and are seeing modest improvements in their life prospects, if not for themselves, then certainly for the next generation.

 

And I believe that that’s the big challenge, not just for the United States, but that’s the big challenge for everybody.

 

And we got to go because we’re all parked. Alright?

 

The Economist: Thank you.

 

Mr Obama: That was a good conversation. I enjoyed it.

 

 

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U.S. Announces Delegation To Africa: Ebola Virus Humanitarian Effort, “Conservative Politicians For 3rd World Nations Relief.”


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From VOX.com and Julia Belluz:

 

“A violent virus”: views from Ebola‘s ground zero

 

Aid worker Ishmeal Alfred Charles says getting abducted as a child soldier during Sierra Leone‘s bloody civil war when he was 15-years-old was less scary than living there now under the Ebola threat.

 

“You knew the rebels were coming,” said the Freetown native in a recent interview from Sierra Leone, where he is among hundreds of aid workers trying to beat back the deadly virus in what is now the biggest-ever outbreak and the first to hit West Africa. “They’d attack a town, and so you made a move. You knew to hide.”

Now, he can’t flee. It’s too expensive to fly elsewhere. And he can’t hide from an enemy that could be lurking anywhere. Instead, he has stopped shaking people’s hands and he installed a hand-washing station—a bucket filled with chlorinated water—outside his house.

 

“You don’t know if the person you’re sitting next to is infected with Ebola, so all you’re trying to do is be as conscious as you can. Because we have heard of situations where whole families get infected… and you lose everyone in the family.”

 

For most people, Ebola is a distant threat, a nightmarish word that conjures up images of sudden and violent hemorrhaging. But for West Africans like Charles, it’s now an everyday possibility. “Wherever you go—on Facebook, in the community, on the phone, in Whatsapp messages—people are talking about Ebola.”

 

As a program manager with the Catholic aid agency Caritas, Charles now works to educate people about a virus that only recently emerged in Sierra Leone. He goes door to door, school to school, church to church; he talks to everyone he can reach about the disease; and he hands out hand sanitizer and chlorine. Sometimes, he uses megaphones in town squares, relaying public-health messages about sanitation and prevention. It’s a tedious process, he says, but it’s necessary.

 

“A lot of people still have denial about Ebola,” Charles says. “That’s one of the biggest challenges.”

 

Stories about medical personnel and the government trying to kill or capture Africans circulate, and it doesn’t help that when patients are taken into quarantine, they most often never return.

 

Dispelling these myths isn’t easy. “We show them films, photos of Ebola,” says Charles. “We try to make sure they understand, first and foremost, there’s a virus called Ebola and it’s real.”

 

So far in the current outbreak, there have been 1,323 confirmed and suspected cases of Ebola, and 729 deaths. No one knows why the virus sometimes jumps from the fruit bat—which most scientists believe is its animal host—into the human population. But bad infrastructure and the lack of sanitation practices in what are some of the poorest countries on earth don’t help with its containment.

 

The shortage of resources has made the work very difficult, says Monia Sayah, a nurse with Doctors Without Borders.

 

Sayah, who normally resides in Brooklyn, New York, has just finished two stints on the front line in Guinea, the West African nation where the disease first reemerged in March.

 

When she arrived, she said her biggest challenge was not trying to get people to believe the disease is real: it was figuring out how to care for the reality of so many sick patients.

 

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“The workload was very high,” she says of dealing with up to a dozen Ebola patients in quarantine. So was the mortality rate: at the beginning, about eight in ten patients were dying, close to the numbers in previous outbreaks of the Zaire Ebola virus, which killed 79 percent of those infected. (The death rate in the current outbreak has dropped to around 60 percent.)

 

“It’s very stressful because you’re constantly on alert: a patient here, a patient there. The physical stress of working is very hard because you lose a lot of fluid (wearing protective clothing), and get very tired in the heat as well.” All the while, trying to make sure she didn’t expose herself to the virus or accidentally cross-contaminate any person or thing.

 

When she’d arrive at the treatment facility in the morning, she’d put on a gown and then a waterproof and airtight suit, headgear, goggles, two pairs of gloves, and rubber boots. “Every inch of the body is covered,” she says. When she left 12 hours later, everything except for her rubber boots—which get decontaminated with choline solution—was burned.

 

Since there is no treatment or cure for Ebola, caring for patients meant hydrating them, feeding and washing them, helping them walk, and giving them antibiotics to ward off any bacterial infection so that their immune systems can fight the virus.

 

It also meant touching and comforting them. “They’re alone. They are isolated. Normally in this part of Africa people are never alone when they’re sick.” Most commonly, family members care for their loved ones at home—not strangers in a containment facility.

 

“We take them away from their families,” says Sayah. “We know we’re bringing them to a treatment facility, the place they should be to receive the best care, to isolate the virus. But the virus is inside a person.”

 

The other tricky thing about Ebola is how quickly it can overtake its host. “We have patients asking for lunch, and we would go to see them a few hours later, and suddenly they would just die. It’s a violent virus. You never know what’s going to happen.”

 

Since working in the field, she has seen people lose their entire families. She has watched teenagers perish before her eyes. In another case, she says, “I went to see a woman in the community, and she was lying in a pool of blood. I thought she had a miscarriage there was so much blood.” The medical team was able to get her to a treatment facility, and stop the bleeding, but she was already very weak and died shortly thereafter.

 

What’s so critical about Ebola, too, is making a differential diagnosis between what might be the lethal virus and any other number of diseases that have a similar profile at first.

 

“Trying to make a differential diagnosis is difficult because you’re in a village,” Sayah explained, “you have nothing with you. All you have is a thermometer.”  If you misdiagnose a negative patient, that can mean unnecessary isolation and trauma. If a positive patient is passed, that’s another potential site of infection—and more spread.

 

Ebola specialists believe one of the key reasons this outbreak has spread so far is because of the shortage of health-care personnel to deal with it: if you don’t have enough people on the ground doing the labor-intensive job of tracing the contacts of positive patients and ensuring they are identified before becoming ill too, each missed case is the new beginning of more human-to-human spread.

 

Those missed cases are what worries Tarik Jasarevic, a World Health Organization worker on the ground in Guinea. He says that because of the geographic dispersal of the current outbreak—the demand for so many specialists in a relatively rare disease over several countries—mobilizing people and getting systems in place to care for everyone is problematic.

 

According to Jasarevic, you need these basic resources to contain an Ebola outbreak: “You need to have enough treatment centers so infected persons can be treated in adequate conditions. You need to have surveillance systems. You need to have a system where suspect cases and deaths are being reported so we can go in very safely and check on suspect sick people. We need to have lab capacity to make sure the people infected are identified.”

 

The WHO and other aid organizations have been short on many of these fronts right now, and the UN just pledged $100-million to help quell the current outbreak.

 

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For now, Jasarevic says he’s doing what he can in a very uncertain environment. “You try to wash your hands as much as you can. You try to make sure you don’t touch people who are sick. But you just don’t know who may be in contact with the virus.”

 

Thank you VOX.com and Julia Belluz

 

satiretv

U.S. Announces Delegation To Africa: Ebola Virus Humanitarian Effort, “Conservative Politicians For 3rd World Nations Relief.”

 

On Friday the White House announced a massive humanitarian effort to help the African nations dealing with the Ebola Virus. The White House releaded the following statement:

 

The White House Office of the Press Secretary

August 01, 2014

 

The Obama Administration’s Government-Wide Response to The Ebola Virus Outbreak In Africa

 

In conjunction with the worldwide effort to address the Ebola virus outbreak in Africa, I have instructed the following AmeriKKKans to be immediately drafted into service in our joint efforts to assist this horrific virus in Africa. I put out a nationwide call to all “patriots” in my concern that the homeland of all civilization, be saved from this tragedy effecting Africa.

 

Since the month of August has been unofficially designated as “lazy ass politician vacation time”, I choose this month to ship all these “embarrassment to America fools”, off to Africa.

 

The List Of Conservative “Volunteers”:

 

War Whore Senator John McCain

 

Ladyboy Senator Lindsey Graham

 

Batshit Crazy Rep. Michelle Bachman

 

Canadian Immigrant Senator Ted Cruz

 

Drunk House Speaker John Boehner

 

Outgoing Idiot Eric Cantor

 

Moron Rep Louie Gohmert

 

Dumbass Rep Steve King

 

Misogynist Mitch McConnell

 

The following civilians have been enlisted to accompany the politicians on this humanitarian effort….

 

Ted Nugent

 

Sarah Palin

 

Rush Limbaugh

 

Glenn Beck

 

Ann Coulter

 

Sean Hannity

 

The Complete Fox News Staff

 

Don Lemon

 

Andrea Mitchell

 

Wolf Blitzer

 

Jake Tapper

 

Chuck Todd

 

Allen West

 

Wayne LaPierre

 

George Zimmerman

 

The Koch Brothers have graciously volunteered their jet plane for the travel accommodations and have agreed to accompany this delegation to Ebola infected Africa.

 

The citizens of The United States Of America applaud these brave AmeriKKKans and our thoughts & prayers are with them.

 

If they return from this humanitarian voyage and are not infected with the deadly Ebola Virus, the FAA has made arrangements for this delegation to travel over the Ukraine war zone, in hopes the great Vlad Putin will shoot the aircraft down, using Russian supplied surface to air missiles.

 

God Bless The United States of America, and these brave selfless AmeriKKKans.

 

 

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TheObamaCrat SoapBox™: The Illegitimate Presidency Of Barack Hussein Obama.


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From Think Progress:

 

Think Tank ‘Analyst’ Says ‘Being Hung, Drawn, And Quartered Is Probably Too Good’ For Obama

 

 

A senior policy analyst from an immigration-restrictionist think tank wants to see President Barack Obama not just impeached, but publicly executed, he told a sympathetic audience last week. During a talk at a Tea Party organization in Sebring, Florida, Center for Immigration Studies (CIS) analyst Stephen Steinlight said that Obama’s supposed executive overreach couldn’t be reined in by a lawsuit and that “being hung, drawn, and quartered is probably too good for him,” Imagine 2050 first reported. He then joked that Obama’s head should be on a skewer.

 

Talking with members of the Highlands Tea Party, Steinlightsaid that Boehner’s lawsuit against Obama to faithfully execute the law would not prevent the President from taking executive action on immigration.

 

Anti Immigration Bigot Says Brutal Execution “Too Good” for Pres Obama

 

 

“There’s no court that will stop Obama from doing anything,” Steinlight said to members of the Highlands Tea Party. “And we all know, if there ever was a president that deserved to be impeached, it’s this guy. Alright? And I wouldn’t stop. I would think being hung, drawn, and quartered is probably too good for him. But you know, this man who wants to rule by the use of a pen, a telephone, let us not forget his teleprompter … the fact is that it would backfire very badly and we’ve got to be grownups and accept that we can’t have everything we want, you know, [like] his head on a skewer.”

 

Highland Tea Party members could be heard applauding and laughing in the background. Steinlight also alluded to the child migrant situation, saying that many of them are gang bangers and that “there are a lot more like them.”

 

According to his biography on the CIS website, Steinlight previously provided expert testimony on immigration for the Judiciary Committee of the United States. The work of his organization, CIS, is heavily cited by conservatives like Sen Jeff Sessions (R-AL) and House Judiciary Committee Chairman Bob Goodlatte (R-VA).

 

This is not the first time that Steinlight has made inflammatory comments — he once advocated banning Muslim immigration and said that immigration reform is a psychotic plot against America.

 

Thank you Think Progress.

 

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I usually don’t give space on my blog to dumbfuckery…but the incident listed above goes to a bigger issue some racist caucasian AmeriKKKans seem to have with our twice duly elected President Of The United States, Barack Hussein Obama.

 

I’ve heard many of these racist caucasian AmeriKKKans say that Barack is not a legitimate POTUSA. That opinion is solely based on Barack’s skin tone. See, no Negro can legitimately hold the highest office in “their” land if he is not caucasian or male. Sad and pathetic I know, but this mindset is an All AmeriKKKan thought process. If you’re white, you’re alright. If you’re brown, stick around. If you’re Black, you don’t exist.

 

The threats to our President of The United States Of ALL America are so numerous that it is humorous. I would wager that in the history of Presidents, none of the past 43 have ever had such blatant hatred directed toward this office…..or the office holder. But then again racism is a disease. Any disease must be removed by surgery or medicine, before it kills the body’s cell structure. The structure of America is terminal.

 

To say that Barack Hussein Obama’s Presidency is not legal, is illegitimate or goes against the U.S. Constitution simply because he is a Black man doing whats best for every American, whether you voted for him or not….is as asinine as believing you can stop him from using his powers of Executive Order/Action just because you don’t like his Executive Orders/Actions, by suing him. Barack is the 44th POTUSA. Barack has implemented The Patient Protection and Affordable Care Act.

 

ALL You dumbass racist caucasian TeaTardedRepubliCANT Pseudo-Freudian, Psycho-Sexual, Pro-caucasian, Pro-Racist, Anti-LGBTQA1, Anti-Feminist, Reich Wing GOPretender Conselfishservative, NRA-Gun Loving, Nut Bag, bottom feeding, racist, ass backwards, white supremacists, Koch Brothers & A.L.E.C. controlled morons, greedy, wealthy, caucasian, special interest groups, asshole Party Members, can dig up all the federal judges you can find to say “defund ObamaCares”…..remember they are members of the Judicial Branch of government. They have no authority over the Legislative Branch of government, or what The Executive Branch of government does, especially the Office of The President.

 

High school Civics, 101.

 

So, in closing, for all you morons, idiots, racist & dumbasses…..your will was defeated twice in elections that put this guy………..

 

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………….in your White Man’s House. Get over yourselves. Racism is not going to win out this time around. The man pictured above is more intelligent, more street smart, more savvy and much more qualified than you guys. So stop with this bullshit not the “real President” garbage. Barack Hussein Obama IS the real deal.  He’s the best damn POTUSA in my lifetime. His First Lady, and their daughters, are the best ever to occupy the White House. Even the Mother-In-Law is spectacular. Jealous much?

 

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Where In The World Is Barack™: California.


By Jueseppi B. The Militant Negro

By Jueseppi B. The Militant Negro

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White House Schedule – July 23, 2014

 

President Barack Obama on Wednesday is in California, on a fundraising swing to benefit Democratic political operations.

 

THE WHITE HOUSE
Office of the Press Secretary
FOR IMMEDIATE RELEASE
HuMpDaY July 23rd, 2014

 

DAILY GUIDANCE AND SCHEDULE FOR
HuMpDaY, JULY 23rd, 2014

 

In the morning, the President will attend a House Majority PAC event at the Four Seasons Hotel San Francisco. This event is closed press.

 

In the afternoon, the President will attend a DCCC event at a private residence. There will be print pool coverage for remarks only.

 

Afterward, the President will depart San Francisco en route Los Angeles, California. The President’s departure from San Francisco International Airport and arrival at Los Angeles International Airport are open to pre-credentialed media.

 

Later in the afternoon, the President will attend a DNC event at a private residence. There will be print pool coverage for remarks only.

 

The President will remain overnight in Los Angeles.

 

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Wednesday, July 23 2014  All Times ET

 

12:10 AM: The President arrives San Francisco. Local Event Time:9:10 PM, San Francisco International Airport.

 

12:20 PM: The President attends a House Majority PAC event. Local Event Time:9:20 AM. Four Seasons – San Francisco.

 

2:00 PM: The Vice President delivers remarks to the NAACP National Convention. Local Event Time:11:00 AM. Mandalay Bay Convention Center – Las Vegas.

July 23, 2014 2:00 PM EDT

Vice President Biden Speaks at the NAACP National Convention

Audio Only

Las Vegas, Nevada,  White House LIVE Streaming

 

3:00 PM: The President delivers remarks and answers questions at a DCCC event. Local Event Time:12:00 PM. Private Residence – Los Altos Hills.

 

4:20 PM: The President departs San Francisco. Local Event Time:1:20 PM. San Francisco International Airport.

 

4:30 PM: The Vice President delivers remarks at a rally for Congressional candidate Erin Bilbray. Local Event Time:1:30 PM. Henderson Convention Center – Las Vegas.

 

5:30 PM: The President arrives Los Angeles. Local Event Time:2:30 PM. San Francisco International Airport.

 

7:55 PM: The President attends a DNC event. Local Event Time:4:55 PM. Private Residence – Los Angeles.

 

The President will remain overnight in Los Angeles.

 

 

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On Thursday, the President will visit a community college in Los Angeles to deliver remarks on the importance of job-driven skills training, particularly for fast-growing sectors such as health care. Later, he will attend a DNC event. Further details about the President’s travel to Washington and California will be made available in the coming days.

 

On Friday, the President and the Vice President will welcome President Otto Perez Molina of Guatemala, President Juan Orlando Hernandez of Honduras, and President Salvador Sanchez Ceren of El Salvador to the White House. The four leaders and Vice President Biden will discuss how to reinforce our ongoing collaboration to stem the flow of undocumented migrants from Central America to Mexico and the United States.

 

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Speeches and Remarks/Statements and Releases- July 23rd, 2014

 

Readout of the President’s Call with Indonesian President-Elect Widodo

 

Remarks by the First Lady at a “Drink Up” Event

 

Remarks by the President at the Embassy of the Netherlands

 

Presidential Nomination Sent to the Senate

 

President Obama Signs Washington Emergency Declaration

 

Readout of the President’s Call with Prime Minister Rutte of the Netherlands

 

Readout of the Administration’s Call With Governors on the Situation at the Border

 

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TheObamaCrat™ News.

 

breakingnews

Plane Crashes in Taiwan, 47 Trapped, Feared Dead

 

Published on Jul 23, 2014

A plane landing in stormy weather crashed outside an airport on a small Taiwanese island late Wednesday, and a transport minister said 47 people were trapped and feared dead.

 

 

 

Secretary of State John Kerry arrives in Tel Aviv to push for a cease-fire

 

Published on Jul 23, 2014

Secretary of State John Kerry traveled to Israel on Wednesday, to push for a cease-fire to end the fighting between Israel and Hamas

 

 

 

FOXNews Outraged That 911 Helps Dying Refugees

 

 

 

Typhoon downs trees, threatens landslides

 

Published on Jul 23, 2014

Typhoon Matmo brought heavy rain and high winds as it slammed into Taiwan. The island also faces the threat of landslides

 

 

 

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