[AMV] Amerikaanse politiek #482 Silence before the Stormy

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CMS Faces Blowback Over Effort To Limit Prescription Opioids.
The New York Times (3/27, Hoffman, Subscription Publication) reports Centers for Medicare and Medicaid Services officials plan to “refuse to pay for long-term, high-dose prescriptions” with a rule expected to be approved on April 2. However, the proposal has “drawn a broad and clamorous blowback from many people who would be directly affected by it, including patients with chronic pain, primary care doctors and experts in pain management and addiction medicine.” Opponents criticized the move as injecting “the government into the doctor-patient relationship” and warned it “could throw patients who lost access to the drugs into withdrawal or even provoke them to buy dangerous street drugs.” While a Department of Health and Human Services inspector general report last July raised concerns about “extreme use and questionable prescribing” of opioids to Medicare recipients, “experts say that Medicare misread the recommendations” of the CDC by insufficiently differentiating between opioid-naive patients with acute pain and patients suffering from long-term chronic pain.

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In a last-minute move that would give Republicans an advantage in maintaining control of the House of Representatives, the Trump administration is reinstating a question about citizenship to the 2020 census. Coming from an administration that has expressed incredible hostility toward immigrants, the change was not surprising, but it’s galling nonetheless.

The commerce secretary, Wilbur Ross, announced the decision late Monday, less than a week before the Census Bureau, which his agency oversees, is supposed to send a final list of questions for the 2020 census to Congress. If the decision stands — the attorney general of California, Xavier Becerra, has filed a lawsuit seeking to block it, and other elected officials are preparing to do so, too — it would be the first time in nearly 70 years that the federal government has asked people filling out census forms to list their citizenship status.

This is important because the census count determines how many House seats each state gets. The census is also used to determine how more than $600 billion in federal spending is allocated across the country, including Medicaid, food stamps and grants to schools. Asking about citizenship will reduce responses from immigrant families, which are already less likely than others to answer government surveys and are today terrified by President Trump’s anti-immigrant policies and rhetoric. An inaccurate count is likely to provide more representation to states with fewer immigrants and relatively higher response rates and take seats away from states like California where response rates would be relatively lower. Given the geography of American politics, that would probably lead to more power for Republicans, and less for Democrats. Experts say response rates will fall even from citizens and permanent residents because they may have family members who are undocumented immigrants.

Mr. Ross’s decision was based on the disingenuous argument that the Department of Justice needs to know the citizenship status of residents in each census tract so it can better protect the rights of minority voters under the Voting Rights Act. Even putting aside the laughable notion that this administration cares about minority voting rights, this argument is bunkum — the Justice Department has been enforcing that law without access to such data for decades. The last census that asked people to report their citizenship status was conducted in 1950, 15 years before the Voting Rights Act became law. What’s more, the Justice Department already has access to citizenship data through the American Community Survey, which is conducted every year.

The timing of this change is highly suspect. It comes too late to be included in a field test of the 2020 census that the government is conducting right now with 275,000 households in Providence County, R.I. In his memo, Mr. Ross sought to downplay concerns that the citizenship question would reduce response rates by claiming there was no “empirical evidence” to back up that argument. Yet, by seeking to insert the question so late in the process, he himself has prevented officials from empirically testing how people will react to it.

The evidence that does exist shows that the concerns about the citizenship question curbing participation are legitimate. The Census Bureau reported in a September memo that its surveyors were encountering significant resistance from immigrants about providing personal information to the government because they feared it would not be kept confidential. “The immigrant is not going to trust the census employee when they are continuously hearing a contradicting message from the media every day threatening to deport immigrants,” one Arabic-speaking respondent told the bureau.

Continue reading the main story
Even Mr. Ross acknowledged in an October House hearing that adding questions to the census reduced response rates because “the more things you ask in those forms, the less likely you are to get them in.”

This is not the first time the Trump administration has sought to compromise the integrity of the census. Last year, the Census Bureau reduced its field test to just Rhode Island after discarding test locations in Washington State and West Virginia, citing a lack of funds. In his budget request to Congress, the president asked for a modest increase in the census budget, far less than what most experts say is needed. (Lawmakers largely ignored his request last week when they increased the bureau’s budget by $1.34 billion, about twice as much as he had sought.) The administration has also undermined the Census Bureau by failing to nominate a leader for the agency since its last permanent director left last summer. And, until recently, the administration was considering nominating as deputy director a political-science professor who has argued in favor of partisan gerrymandering and against competitive elections.

y now, many people have come to expect that Mr. Trump will inject politics into every policy decision. But even by this administration’s low standards, trifling with the census, which is required by the Constitution and is a fundamental building block of American democracy, represents a serious breach of trust.

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Op woensdag 28 maart 2018 14:30 schreef klappernootopreis het volgende:

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Heel leuk en aardig, maar deze reeks had allang een stille dood gestorven als Clinton president zou zijn geworden.

Het FEIT is dat er nu een staatshoofd aan het roer van de grootste democratie ter wereld staat die volledig ontoerekeningsvatbaar is, en die een bende vastgoed proleten en had-je-me-maars met zich mee het witte huis in heeft gelokt waar schijnheiligheid, corruptie en nepotisme hoogtij voeren. En dit niet vaak genoeg gezegd worden. No offence.

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Op woensdag 28 maart 2018 14:30 schreef klappernootopreis het volgende:

[..]

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Heel leuk en aardig, maar deze reeks had allang een stille dood gestorven als Clinton president zou zijn geworden.

Het FEIT is dat er nu een staatshoofd aan het roer van de grootste democratie ter wereld staat die volledig ontoerekeningsvatbaar is, en die een bende vastgoed proleten en had-je-me-maars met zich mee het witte huis in heeft gelokt waar schijnheiligheid, corruptie en nepotisme hoogtij voeren. En dit niet vaak genoeg gezegd worden. No offence.

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Op woensdag 28 maart 2018 14:30 schreef klappernootopreis het volgende:

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Heel leuk en aardig, maar deze reeks had allang een stille dood gestorven als Clinton president zou zijn geworden.

Het FEIT is dat er nu een staatshoofd aan het roer van de grootste democratie ter wereld staat die volledig ontoerekeningsvatbaar is, en die een bende vastgoed proleten en had-je-me-maars met zich mee het witte huis in heeft gelokt waar schijnheiligheid, corruptie en nepotisme hoogtij voeren. En dit niet vaak genoeg gezegd worden. No offence.

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Op woensdag 28 maart 2018 14:36 schreef clumsy_clown het volgende:

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Helemaal mee eens ja. Al die idiote cartoons en memes kunnen elders.

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Op woensdag 28 maart 2018 14:35 schreef Re het volgende:
is er ergens een achtergrond over wat nou precies die question is over citizenship

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Op woensdag 28 maart 2018 14:36 schreef klappernootopreis het volgende:

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Als dat zo is, denk ik dat eerder het congres hier achter zit. Trump is nou niet bepaald een schoolvoorbeeld van een gedegen republikein.

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Op woensdag 28 maart 2018 14:40 schreef clumsy_clown het volgende:

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Ja, hartstikke leuk hoor en als het bij een cartoon in de week zou blijven oid zou het nog te doen zijn, maar dat is niet het geval. Ik hoef niet te zien welke karikatuur er nu weer van Trump is getekend, hou het lekker bij de feiten. Voor lollige plaatjes kun je naar imgur.