From Gen. David Petraeus, asked if he believes Donald Trump is mentally fit to serve as president:

I think it’s immaterial.

We are doomed. Petraeus would remove a fireteam leader if he thought the guy was mentally unstable. But the commander-in-chief? Meh. He’s got good people around him. They’ll keep him on a leash. Probably.

Via AEI and the Washington Post, here’s the gender pay gap among White House staffers during the Obama and Trump administrations:

During the Obama years, the average disparity was 13 cents on the dollar. Under Trump, it’s 37 cents. But before you jump to any conclusions, I don’t think this is because Trump believes women should be paid less than men for the same work. He’s not a neanderthal. He just doesn’t like to hire women for senior roles in the first place. What’s wrong with that? There’s nothing nefarious about it, so all you humorless feminists need to back off.

But here’s what I really wonder: what would this number look like if you didn’t include the communications folks? 50 cents? 60 cents? I don’t know the answer to that, but I can say this: if you exclude women whose job is primarily communications, who will shortly be exiled to Singapore, or who are on Melania’s staff, the Trump White House employs a grand total of two (2) women out of 34 in the top two pay grades: Dina Powell and Marcia Kelly. That’s 94 percent men. In its own way, this is actually kind of an impressive accomplishment, what with this being 2017 and all.

I don’t know. No matter what we say, maybe we all like having a reality-TV president:

I don’t think CNN did anything wrong in tracking down and reporting on the Reddit guy. But the “we reserve” sentence was a colossal mistake.

— John Podhoretz (@jpodhoretz) July 5, 2017

What’s this all about? Well, you remember the dumb video that Donald Trump posted on Sunday? The one where he’s body slamming a wrestler whose head has been replaced by the CNN logo? We all decided to get outraged over that. This was dumbness level 1.

Then we tracked down the origin of the video. It came from someone named HanAssholeSolo on the alt-right reddit sewer r/The_Donald. It turned out that Han had also posted some inane anti-semitic memes, so we all decided to get outraged over that. This was dumbness level 2.

Then CNN tracked down the actual person behind HanAssholeSolo. Unsurprisingly, it turned out to be some dude who had been acting out and was terrified at the prospect of becoming national news just because our president was stupid enough to retweet his stuff. So CNN decided not to publish his name “because he is a private citizen who has issued an extensive statement of apology, showed his remorse by saying he has taken down all his offending posts, and because he said he is not going to repeat this ugly behavior on social media again.”

However, CNN also said it “reserves the right to publish his identity should any of that change.” This sounded like a threat, so we all decided to get outraged over that. This was dumbness level 3.

Is there anything we won’t use as an excuse to get outraged? Trump’s tweet was puerile, but it was just a joke, not a call to violence. HanAssholeSolo is an idiot, but he’s just one of millions of individual idiots, not someone with any power or influence unless we give it to him. And under anything but the most hostile reading, CNN obviously wasn’t threatening anyone. They were just covering themselves: If it turned out that Han was playing them, they were under no obligation to maintain his anonymity.

Not that it matters. If CNN can track this guy down, so can someone else. He’ll be viral on Twitter before long no matter how abjectly he’s apologized.

President Trump says variously that Obamacare is dead, failed, broken, and in a “death spiral.” But as Jon Chait points out, “death spiral isn’t just a term people who hate Obamacare get to use to predict that the law is going to fail because they hate it.” It has a specific meaning, and Trump’s own administration agrees with the CBO that Obamacare isn’t in a death spiral.

But what is a death spiral, anyway? It’s pretty simple. Suppose you have a health care market with five people in it. Their average annual medical expenses are $1, $3, $5, $7, and $9:

The average medical expense is $5, and in our fantasy world insurance companies don’t need to make a profit. This means our five customers each pay $5 for their health insurance. But Ariel thinks this is too much, because she hardly ever sees a doctor for anything. So she drops out:

Now there’s four people left, and the average premium goes up to $6. But this is now too rich for Banquo, who was willing to take a bit of a hit in order to reduce his risk, but not that big a hit. So he drops out too:

Three people are left, and now Cassius is fed up. His premiums keep going up, and at this price he feels like he’s hugely overpaying for the care he gets. So he drops out too:

And here’s where we end up. Desdemona and Edward will probably keep getting insurance, but it’s hardly insurance at all anymore. They’re both paying very nearly what their care would cost them if they just handed a pile of Krugerrands directly to their doctors. In all, 60 percent of the market has dropped out and the other 40 percent is barely getting any benefit. And the insurance company is probably not doing so well either. By the time we get to this point, they might decide to abandon the market entirely, leaving Desdemona and Edward out of luck too.

That’s a death spiral. That’s what dead, failing, and broken mean. It’s not happening with Obamacare now, and it won’t happen in the future unless Trump and his fellow Republicans deliberately sabotage it.

Our local fireworks show wasn’t as good this year as it’s been in the past, but I made up for that with a more serious effort to get a good picture of it. This shot was captured at a shutter speed of 1.6 seconds, with the camera steadied by my trusty beanbag. I like it, a good ol’ red, white, and blue extravaganza in the sky above Irvine. Happy Birthday, America.

You’ve probably signed away your right to sue your cell phone carrier, your cable company, and maybe your doctor and dentist too. Instead, if you have a complaint, you’re required to take it to arbitration, whether you want to or not.

How do they get away with this? Mostly by giving you no choice. You probably have only one cable company to choose from. There are four big cell phone carriers, but they all mandate arbitration. And it’s so common among doctors that you’d have a hard time finding one who doesn’t require it. In practice, they require it because they have enough market power to make it stick.

It’s ironic, then, that nursing homes don’t like it when someone with even more market power than them turns the tables:

In October 2016, the Centers for Medicare and Medicaid Services (CMS) decided to push back on mandatory arbitration. By rule, CMS adopted a novel “condition of participation” for Medicare and Medicaid. Nursing homes that participate in the programs—which is to say, all nursing homes—could no longer ask their residents to sign away their right to sue upon entering the nursing home.

….Predictably, the nursing home industry sued, arguing that the rule exceeded CMS’s authority….Then President Trump took office. In early June, with little fanfare or notice, the administration dismissed the appeal and proposed to undo the change altogether. “Upon reconsideration, we believe that arbitration agreements are, in fact, advantageous to both providers and beneficiaries because they allow for the expeditious resolution of claims without the costs and expense of litigation.”

That’s from Nicholas Bagley, who says, “With health reform dominating the news, this volte-face has been overlooked. That’s a shame: it’s a big deal.” He promises to dive into it in more depth over the next couple of weeks.

The Trump White House has been unusually quiet about its campaign to defeat ISIS. Kimberly Dozier might have an explanation:

U.S. special operations forces have removed roughly 50 top ISIS leaders off the battlefield since President Donald Trump took office, down from 80 killed in the last six months of the Obama administration, according to figures obtained by The Daily Beast. “The pace and the way they have gone about going after these HVT’s [High-value targets] hasn’t changed,” said coalition spokesman Col. Ryan Dillon of the U.S. special operations’ campaign to take ISIS commanders off the Iraqi and Syrian battlefields.

….Trump’s changes to the campaign so far have been tactical—namely, giving the military more autonomy to strike, including special operators….That’s presented a dilemma for those working on the Trump anti-ISIS strategy and slowed its public unveiling, U.S. officials tell The Daily Beast. The White House has asked defense officials to come up with new ideas to help brand the Trump campaign as different from its predecessor, according to two U.S. officials and one senior administration official. They spoke on condition of anonymity to discuss the sensitive debates.

The senior administration official described Trump’s plan as “relying even more” on special operations working together with local partner forces. “But that’s nuanced, like most of the suggested changes” and doesn’t easily translate to a talking point, he said. That could help explain why Trump has twice missed his own deadline for unveiling the new anti-ISIS strategy.

I can hardly wait for the new branding campaign. But I’m surprised it’s taken this long. Whatever else you can say about Trump, he’s a master marketer and slogan creator. He has an almost animal cunning for drilling in on weak points and inventing Twitter-friendly catchphrases to bring them to the masses (“low energy,” “lock her up”).

Maybe he’s off his game because he’s too busy stewing about CNN or something. But he should get with it. There’s a whole army of Trump defenders out there who are waiting to take whatever he makes up and parrot it far and wide on every media channel in the galaxy.

I know the White House probably has a handy explanation teed up just in case someone asks, but, um, what is Donald Trump doing here?

Over at the New York Times, Nikil Saval asks, ‘Who Wants to Be ‘Liberal’ Anymore?” According to Pew Research, here’s the answer:

Nearly half of millennial Democrats are willing to identify themselves as liberal, and the overall share of Democrats who call themselves liberal has been rising steadily since 2000.

The question Saval is asking is at least as old as the 60s, maybe older (though I’m too lazy to check): is the label “liberal” so associated with mainstream Democrats that it’s anathema to young lefties? Back then, the Vietnam War turned young activists against big labor and establishment Democrats, represented by people like Hubert Humphrey, Robert McNamara, George Meany, and so forth. Today, we have a new generation of Bernie admirers who feel the same way about contemorary Democrats like Hillary Clinton, Rahm Emanuel, and John Kerry—and sometimes even Barack Obama, who doesn’t always earn a pass for being the first black president.

So in 50 years we’ve gone from the SDS to Chapo Trap House, which may or may not be an improvement. But it’s nothing new. In the meantime, whether you want to call it liberalism or progressivism or anything else, Democrats have gotten a lot more friendly toward it over the past decade.

The big social media news of the weekend was Donald Trump’s posting of a video that showed him tackling and beating up a man with a CNN logo for a head. This was criticized as (a) unpresidential (duh) and (b) a call for violence against the media. I’m not so sure about that, but in any case I managed to avoid wasting time on it.

But no more! The sleuths at CNN have tracked down the guy who originally created the video that Trump retweeted. See if you can spot the part that had me in stitches:

Now the user is apologizing, writing in a lengthy post on Reddit that he does not advocate violence against the press and expressing remorse there and in an interview with CNN for other posts he made that were racist and anti-Semitic.

…. “The meme was created purely as satire, it was not meant to be a call to violence against CNN or any other news affiliation,” he wrote. “I had no idea anyone would take it and put sound to it and then have it put up on the President’s Twitter feed. It was a prank, nothing more.”

….The apology has since been taken down by the moderators of /The_Donald subreddit.

Reddit is famously the Wild West of the internet, opposed to censorship of any kind, but apparently we’ve finally plumbed the edges of their tolerance. Racism, anti-semitism, and violent misogyny are all OK. But apologizing for them? That’s going too far.

Welcome to Reddit, ladies and gentlemen.

Is it lunchtime already? Sure! It’s July 4th! Have a happy and safe day.

Avik Roy finally explains in plain language why he’s really so enthusiastic about the Senate version of Trumpcare:

Repealing and replacing Obamacare does very little to address the fundamental trajectory of the growth of federal involvement in our health care system. To do that, you have to tackle the two big Great Society entitlements: Medicare and Medicaid.

Unfortunately, the Senate is barred from using the reconciliation process to change Medicare. And even if it wasn’t, President Trump has made clear his opposition to Medicare reform. But the Senate bill does historic work to rein in the Medicaid program, putting it on a fiscally sustainable path and reducing its future spending by trillions of dollars.

Most of us think that slashing Medicaid is a bad thing that will devastate the poor, but to Roy it’s the main reason to support the Republican bill.

In fairness, Roy has been sounding the alarm about Medicaid and Medicare pretty much forever, so this is nothing new. But there’s still an odd thing here. The reason to favor Medicaid cuts in the first place is to improve the country’s finances, which the Republican bill doesn’t do. It just hands the money over to the rich. But Roy is enthusiastic anyway. Conversely, he never seemed all that thrilled with Obamacare’s cuts to Medicare, even though they were actually done right: they reined in spending growth by cutting payment levels to doctors and hospitals rather than reducing benefits or tossing people out of the program. The result was a significant boost to the solvency of the Medicare trust fund according to both the CBO and the Medicare trustees.

In any case, even if the rest of the bill is disappointing, kicking 15 million people off Medicaid and saving $772 billion apparently makes the whole thing worth it. Hooray.

Republicans want to kill off Obamacare’s individual mandate:

Congress is moving to prevent the Internal Revenue Service from enforcing one of the more unpopular provisions of the Affordable Care Act, which requires most Americans to have health insurance or pay a tax penalty.

The plan is separate from Republican efforts to repeal the health care law….In case that effort fails or bogs down, the House Committee on Appropriations has drafted a provision to stop the I.R.S. from enforcing the mandate. The restrictions, for the fiscal year that starts Oct. 1, are included in an appropriations bill that was approved on Thursday by the Subcommittee on Financial Services and General Government.

There’s more here than meets the eye. Sure, eliminating enforcement of the individual mandate would be politically popular, but that’s only part of the reason for this. You see, back in March the CBO handed Republicans an unpleasant surprise: it turns out that they take the individual mandate very seriously. Here’s what CBO’s analysis of the very first House health care bill says:

CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law. Most of that increase would stem from repealing the penalties associated with the individual mandate.

What is “most”? CBO doesn’t say, but it’s probably 10-12 million. Add in a little bit more for the years after 2018, and elimination of the mandate is probably responsible for around 12 million or so out of the total 24 million who would be newly uninsured by the Republican bill.

CBO is required to base its estimates on current law. If Republicans do away with the mandate, that’s the baseline CBO has to use. So if Republicans fail this year but re-introduce a health care fill next year, CBO will compare it to a baseline in which the mandate doesn’t exist. This is a win-win for Republicans. If they fail to repeal Obamacare this year and decide to pack it in, killing the mandate is still good politics. But if they decide not to give up, it means their next bill will automatically get a much better score. Compared to a world where the mandate is already gone, their bill won’t take away insurance from 24 million, it will take it away from 12 million or so. Fiddle around with Medicaid funding and maybe you get that down to 5 million.

To you and me, that’s still a lot. But in newspaper headlines it’s far less dramatic. Bottom line: even if Republicans fail this year, Obamacare isn’t safe. Republicans can spend the next year sabotaging Obamacare¹ and giving some real thought to a new replacement bill. They’ve learned a lot about how CBO scores things, and that will allow them to craft a bill that’s carefully tailored to get the best possible score while still reducing taxes the maximum amount. No matter what happens with Trumpcare this year, the fat lady has definitely not sung.

¹As a bonus, killing the mandate helps with this. It mostly affects healthy folks who are buying insurance only because the law says they have to. Get rid of the mandate and they stop buying insurance. This will unbalance the Obamacare insurance pool even more and lead to premium increases for everyone else.

Donald Trump has finally figured out that China doesn’t plan to do much about North Korea, so today he told the Chinese president that the US was prepared to act unilaterally. A few hours later North Korea launched another missile into the ocean. Trump’s response was to tweet, “Hard to believe that South Korea and Japan will put up with this much longer.”

OK then.

I’ve been a little negligent about these updates, but that’s because nothing much is happening. My M-protein level, which is a good proxy for the total cancer load in my plasma, has been stable for the past three months, with a slight uptick in the most recent test:

I saw my doctor today, and he seemed happy enough with everything, especially since my lactate dehydrogenase levels were also OK. I’ve never heard of this before, but apparently if it’s high it indicates cell damage, so a low number is good. All the other test results have also been nice and stable over the past three months.

The only side effects of the chemo are tiredness, which is normal, and a slowly increasing case of peripheral neuropathy, which is also normal. The neuropathy is more-or-less untreatable, and a couple of months ago I started to feel it in my hands for the first time (it usually affects the feet first). My doctor suggested a couple of OTC remedies that some of his patients have reported success with. Unfortunately, he agreed when I told him I’d looked at some of those and there was no clinical evidence that they had any effect. I’d be happy to take them as a placebo, but I suppose that won’t work if I don’t believe in them to begin with. This is one of the downsides of having access to clinical literature via the internet. Oh well.

Total vehicle sales were down again in June:

The Wall Street Journal says this is because of a “newfound discipline” among domestic automakers, who now resist the urge to dump excess cars on rental car companies at cut-rate prices. Maybe so. But dealer inventories are rising, and the reason fleet sales are declining in the first place is because rental companies are wary of depressed resale prices. Either way, vehicle sales are now at their lowest level since the beginning of 2014. Hum de hum.

This young man is surveying the vastness of the Pacific Ocean and pondering the meaning of humankind’s existence in the face of such overwhelming power. Is it evidence of God’s infinite presence, as the theologians tell us? Or merely the chance confluence of heavy elements created in the fiery furnace of distant supernovae and then agglomerated under the force of gravity, as the physicists tell us? Will we ever know? Can we know? Will the theologians and the physicists ever get their shit together?

Actually, our young hero was waiting for the waves to roll in, and then running gleefully away just before the water could touch his toes. It was pretty cute. But really, who knows what was going through his mind while he waited?

D.R. Tucker points me to EPA administrator Scott Pruitt’s latest brainstorm for cooking up skepticism about climate change:

The program will use “red team, blue team” exercises to conduct an “at-length evaluation of U.S. climate science,” the official said, referring to a concept developed by the military to identify vulnerabilities in field operations.

“The administrator believes that we will be able to recruit the best in the fields which study climate and will organize a specific process in which these individuals … provide back-and-forth critique of specific new reports on climate science,” the source said.

“We are in fact very excited about this initiative,” the official added. “Climate science, like other fields of science, is constantly changing. A new, fresh and transparent evaluation is something everyone should support doing.”

Let me translate: this is a program designed to use taxpayer money to create reports on EPA letterhead that regurgitate all the usual claptrap of the climate deniers. In the interest of “fairness,” actual climate scientists will be allowed to write rebuttals, but no one will care about them since climate scientists have been writing that stuff forever. The real point is to get all the skeptic rubbish collected in one place and made available to the public with an official federal government imprimatur.

I suppose they can start off with this:

A new paper just published in the Journal of Climate is a stunning setback for the darling of cherry-picking for contrarian scientists and elected officials….Much of their position relies upon finding evidence that the current observations of warming are not great. That is, the Earth is not warming as fast as predictions.

To support this incorrect (and intellectually dishonest) position, contrarians have scoured the data for any evidence at all that suggests the Earth is not warming. They have skipped oceans…Earth’s surface temperature…ice loss…sea level rise, and in fact ignore everything except some select regions of the atmosphere. Their fallback position is that since a part of the atmosphere seems not to be warming very fast, this means the Earth isn’t warming or that climate models cannot be trusted.

Long story short, a new look at the atmospheric data shows that, in fact, it matches the surface data pretty well. If anything, the corrected satellite data suggests that the lower troposphere is slightly warmer than the surface:

Not to worry, though. The deniers will figure out some reason why this conclusion is wrong. Or else they’ll decide that atmospheric measurements aren’t important after all, and we should really be looking at the anomalies in tree ring measurements in 16th century Moldavia. And Scott Pruitt will be there to hand them a megaphone.

The Washington Post asks an intriguing question about our president:

Trump has spoken out repeatedly during his tenure about the shortcomings of Obamacare, which he brands a “disaster.” But he has made relatively little effort to detail for the public why Republican replacement plans — which fare dismally in public opinion polls — would improve on the former president’s signature initiative….“It’s a mystery,” said Barry Bennett, a Republican operative who advised Trump’s campaign last year and remains close to the White House. “I don’t know what they’re doing.”

Hmmm. That’s a chin scratcher, all right. What possible reason could there be for Trump to avoid talking in more detail about the Republican plan? What could it be? What, oh what, could it be?

POSTSCRIPT: For those of you slow on the uptake the answer is: (a) there is nothing good to say about the Republican plan, which is why no one else is trying to sell it either, and (b) Trump has no clue what the Republican plan does anyway.

I suppose we’re all used to it by now, but the brazenness of the lies from the Trump administration is pretty jaw dropping. Here’s the latest:

Actually, over 20 million people have been insured by the Affordable Care Act, not 10.3 million, but that’s sort of a garden-variety Trump lie. The real chutzpah comes from his crocodile tears over the fact that 28 million people remain uninsured. Here’s what the numbers look like under Obamacare and Trumpcare, as estimated by the CDC and the CBO:

Obamacare reduced the number of uninsured from 44 million to 28 million. Trump is right that this is still too many, but Trumpcare would increase the number to 47 million within five years of passage.

Oh, and Obamacare didn’t raise average family premiums by $3,000 either. The best comparison I can find is for individual premiums, and Brookings estimates that they decreased about $700 after Obamacare went into effect. Add in an average subsidy of about $400, and individual premiums went down $1,100. Family premiums followed the same trajectory, and probably decreased about $3,000 or so.

Obamacare is hardly faultless, but overall it’s been enormously successful. It delivered insurance to millions who couldn’t get it before; it reduced premiums for most people; it required health care policies to deliver decent coverage; and it prohibited insurance companies from turning down people with pre-existing conditions. Trumpcare would undo all of that. All of it.

UPDATE: I almost forgot: that 28 million number includes 10 million undocumented immigrants. Is Trump suddenly outraged that they aren’t covered by Obamacare?

Actually, I did forget. Thanks to reader RB for reminding me.