Something Encouraging For a Change

In today’s news, Senator Turtle Face (formally known as Addison Mitchell McConnell, Jr., Republican of Kentucky) delayed the vote on the “Less Money for Health Insurance Equals More Money for Rich People” bill. Presumably, he didn’t have enough Yes votes to pass legislation that nobody (except him and a few rich people?) likes.

This will either give the Republicans a few days to find the necessary Yes votes, or it will give opponents of the bill (of which there are many) the chance to create more No votes. Since the Senate Majority Leader had planned a quick vote on a bill he tried to keep as secret as possible, the postponement appears on balance to be a welcome development.

Proving again that he is indeed the Master Negotiator, the President put on a show at the White House today with Republican Senators, at which he announced:

This will be great if we get it done. And if we don’t get it done, it’s just going to be something that we’re not going to like, and that’s OK, and I understand that very well.

As far as we know, the President has not yet demonstrated in a single case whatsoever that he has any understanding at all of the the American healthcare system, the Affordable Care Act, or the Republican effort to repeal or replace it. Clearly, he is a Big Picture guy.

Consistent with the possibility that this is not Hell, some observers think the Republicans’ struggles are a sign of better things to come. Paul Waldman of The Washington Post writes:

The Republican health-care bill is not dead yet, but it’s in rough shape. Whether it passes or not, it has been an utter debacle for the GOP, making the Affordable Care Act they’re trying to undo more popular than ever, energizing the Democratic base, complicating the relationship between President [DT] and Congress and sowing justified distrust of Republican motives among the broader public.

It has also done something else: moved the debate on health care in America to the left and made single payer much more likely.

Even if the Senate bill fails, Republicans give up and move on to tax reform, and the status quo remains in place, this debate will have had profound effects on our politics. While the Democratic Party may have been moving to the left on health care anyway, its momentum in that direction may now be unstoppable. And the entire country will be more receptive than ever to the arguments Democrats will make. This, by the way, will also be the case if the GOP repeal effort succeeds, because it will make so much that people hate about our health-care system a lot worse.

Let me point to one politician as an illustration. For years, Sen. Elizabeth Warren’s position on single payer has essentially been “Maybe someday” — not opposed to it, but focused in the short term on the more urgent priority of defending and enhancing the ACA. But in an article in today’s Wall Street Journal, we learn that she is now ready to take that plunge:

“President Obama tried to move us forward with health-care coverage by using a conservative model that came from one of the conservative think tanks that had been advanced by a Republican governor in Massachusetts,” she said during an interview in her Senate office last week. “Now it’s time for the next step. And the next step is single payer.”

Warren is not going to be the last Democrat to take this step. In fact, any Democrat who runs for president in 2020 — and there will be a lot of them — will have a hard time explaining to the primary electorate why they don’t want single payer, and most or all of them will probably say they do.

We can make an analogy with what happened in the GOP after the failure of comprehensive immigration reform [in 2013]…. The situations aren’t exactly the same, but … a dramatic political failure — whether it’s yours or the other party’s — can have profound effects on the choices politicians make about how to approach the electorate. And it’s important to understand that while there are some Democratic politicians who emphatically favor single payer and would be unsatisfied with anything less, most of them would be willing to advocate for a range of policy options, depending on what looks politically achievable and what their base demands at a particular moment.

All the ups and downs of the past eight years, from the beginning of the debate on the ACA to the end of the debate on Republican repeal plans, hold many lessons for Democrats who are still eager to address the problems in the American health-care system. Among other things, we know that voters are risk-averse, that they’re extremely sensitive to out-of-pocket costs, that they want security and that arguments about the glories of the free market aren’t going to be persuasive to them. After seeing how desperately unpopular this Republican plan is, Democrats are going to be much less afraid to defend government health care and advocate its expansion.

And they know that whatever they propose next has to be simple and understandable. We can debate whether the ACA had to be as complex as it was, but next time around, no Democrat is going to believe that you can take on President Trump with a technocratic approach to health care. Saying “Here are the 10 tweaks I’d make to the ACA” isn’t going to cut it.

That isn’t to say that whatever plans they propose won’t be fully fleshed out under the hood, but they’ll have to be presented in a way that is easy for voters to understand. And, yes, Republicans will cry about “Washington bureaucrats making decisions for you,” but Democrats are less likely to be intimidated. Ask your parents or grandparents on Medicare how they feel about their coverage — Medicare is the most popular health insurance program we have, and it’s run by Washington bureaucrats.

It’s important to keep in mind that “single payer” isn’t one thing — if you look around the world at highly developed countries, there is a spectrum of health systems with various levels of public and private involvement. But what they have in common is that they achieve universal coverage while working better and costing less than ours. We could well have 15 Democratic presidential candidates proposing 15 different kinds of single payer. Some may be highly socialized systems — what Bernie Sanders would likely advocate if he runs again — but the ones that are most appealing could be hybrid systems of the kind that have been successful in countries such as France. The way it works is that there’s a government plan that covers everyone’s basic needs, but you can also buy supplemental private insurance to get as many more benefits as you want.

Among the advantages of a hybrid system is that one can actually see a path from where we are now to there. That path runs through Medicaid, which now covers nearly 75 million Americans. What if we auto-enrolled everyone under 65 in Medicaid — it’s there if you need it, but if you have different insurance you’d prefer, go ahead and use that instead. No one would be without coverage. Private insurance would evolve into something you buy to fill in the gaps and get perks that Medicaid wouldn’t provide. Instead of covering all your health care, employers could provide the supplemental private insurance.

As a political matter, you could sell this as something that we could transition to over an extended period, and as a system that satisfies the goals of both liberals and conservatives. Liberals get the universal coverage and security they want, and conservatives get the freedom they want — if you’re rich enough to buy a supplemental plan that includes deliveries of Dom Perignon during any hospitalization, go right ahead.

That isn’t to say that Republicans wouldn’t resist and there won’t be more intense arguments about health care, because they would and there will be. But by handling this debate so terribly and proposing something so monstrous, Republicans have opened up the space for Democrats to go much further than they’ve been willing to before. It’s not impossible to foresee Democrats winning the House in 2018, then taking the presidency and the Senate in 2020 — and then taking the first steps toward making single-payer health care in America a reality. 

End quote.

What People Need to Know About Medicaid

Please share this 20-minute video, even with Americans who hate politics. It might reach people in Alaska, Arizona, Colorado, Louisiana, Maine, Nevada, Ohio or West Virginia who will call their relatively sane Republican Senators and demand that they vote No on the Better Healthcare Reconciliation Act, also known as the Senate healthcare bill or Trumpcare. We need to stop this abomination now.

I Did the Reading, So Now I’m Sharing

I read too many articles on the internet about politics. Instead of having one subscription to a high-quality newspaper that used to land on our driveway every morning, I now subscribe to three quality newspapers that I read online. I also visit a number of websites that offer interesting political news and commentary. All you need to give them is your time (although that, of course, is more precious than your money).

Ordinarily, I wouldn’t spend so much time reading about politics, but I want to understand what the hell is going on, i.e., why America is so screwed up. And after I read something, I sometimes feel the need to share. This reading and sharing might be a big waste of time, but it feels like something I should do.  

This explains why I read three long-ish articles in the past few days that I’m now going to mention and very briefly describe. Then I’m going to share a funny video. And then I’m going to share a little good news for a change.

The first article I read was “Donald Trump and the Rise of Tribal Epistemology”. The title isn’t quite accurate, because epistemology is the philosophical theory or study of knowledge. The title should really be something like “Trump and the Rise of Right-Wing Propaganda as a Source of Supposed News for Millions of Americans and the Ill Effects Thereof”. Another title might be “Here’s Why Our Country Is So Screwed Up: Many Americans Don’t Trust the Only Institutions We Have That Do a Fairly Decent Job of Describing Reality, and Is There Anything We Can Do About It?”. I recommend reading the whole thing, which isn’t really seven million words long, despite what the author says.

A link in that article led me to a 2016, pre-election article called “The Rise of American Authoritarianism”. It’s about people with authoritarian personalities, and how they aren’t necessarily bigots or stupid, but how they tend to be afraid of strangers and change, and when they’re especially afraid, they look for “strong” leaders who will protect them by building walls, putting people in jail and blowing things up. There are more of these authoritarians than you might expect and they’re the strongest supporters of the current President, for obvious reasons (“I alone can fix it”).

An interesting point is that the social scientists cited in the article don’t identify people with authoritarian tendencies by asking them about politics. They ask them about child-rearing, posing questions like these:

  • Please tell me which one you think is more important for a child to have: independence or respect for elders?
  • Please tell me which one you think is more important for a child to have: obedience or self-reliance?
  • Please tell me which one you think is more important for a child to have: to be considerate or to be well-behaved?
  • Please tell me which one you think is more important for a child to have: curiosity or good manners?

Authoritarians tend to answer these questions differently than the rest of us. Furthermore, they supposedly tell the truth when asked about raising children, which they might not do if asked about politics.

Another point made in the article is that many people have authoritarian tendencies, but those tendencies only come into play when these potential authoritarians are sufficiently scared, and sufficiently scared by people whom they think are dangerous in some way, either dangerous to their physical persons or to their preferred way of life. 

The importance of the fear factor leads to the third article, “How Fox News Changed American Media and Political Dynamics”. I confess I didn’t read the whole thing, because it was too depressing. It was written two years ago by a former Republican and is mostly historical. It describes the undoing of the Federal Communications Commission’s Fairness Doctrine, the rise of right-wing talk radio and the amazing success of Fox News, the result being that your authoritarian cousin and your potentially authoritarian plumber are convinced that liberals, scientists, the “mainstream media” and other lowlifes are out to destroy America. That makes your cousin and your plumber very angry and/or very, very afraid. 

So here’s the funny video: Randy Rainbow singing “Covfefe: The Broadway Medley”! If nothing else, watching it will mean that, for four glorious minutes, you won’t be reading about politics on the internet. 

I’ve watched this video many times, because, aside from the pleasure of watching and listening to Mr. Rainbow, and hearing those wonderful melodies again, if you do anything for four minutes, over and over again, it does add up. 

Lastly, the good news:  “Nevada Is Considering a Revolutionary Healthcare Experiment”. The Nevada legislature has passed a bill that would allow anyone in the state who doesn’t have health insurance to buy in to the state’s Medicaid program. Details need to be worked out and the Governor might not sign the bill, but it’s an encouraging sign that America might turn the corner one day.

“Covfefe, I just met a girl named Covfefe…”

Selected Reading On The Mess We’re In

Historian Sean Wilentz makes a forceful argument in favor of Obama invoking the 14th Amendment to protect the world’s economy:

… the president would have done his constitutional duty, saved the country and undoubtedly earned the gratitude of a relieved people. Then the people would find the opportunity to punish those who vandalized the Constitution and brought the country to the brink of ruin.

http://www.nytimes.com/2013/10/08/opinion/obamas-options.html?pagewanted=2&hp

The New York Times editorial board is justifiably outraged that many people living in Republican-run states will still lack health insurance next year — they’ll earn too little to be covered by the Affordable Care Act and too much to be covered by Medicaid:

Their plight is a result of the Supreme Court’s decision last year that struck down the reform law’s mandatory expansion of Medicaid and made expansion optional. Every state in the Deep South except Arkansas has rejected expansion, as have Republican-led states elsewhere, [although] there is no provision in the ACA to provide health insurance subsidies for anyone below the poverty line … those people are supposed to be covered by Medicaid… Eight million Americans who are impoverished and uninsured will be ineligible for help of either kind.

http://www.nytimes.com/2013/10/04/opinion/a-population-betrayed.html?ref=opinion

Of course, Congress could easily fix this problem, but that would require You Know Who to cooperate.

At Jacobin, Shawn Gude writes about the fundamental tension between capitalism and democracy, in the context of living-wage legislation in the District of Columbia:

The controversy throws into sharp relief one of our era’s great unspoken truths: Capitalist democracy, if not an oxymoron, is less a placid pairing than an acrimonious amalgamation. The marriage that Francis Fukuyama famously pronounced eternal is in fact a union of opposites. Inherent to capitalism is inequality, fundamental to democracy is equality. Class stratification, the lifeblood of capitalism, leaves democracy comatose. The economic “base,” to put it in classical Marxian terms, actively undermines the purported values of the political superstructure.

http://jacobinmag.com/2013/08/capitalism-vs-democracy/

And finally, Nobel Prize-winning economist Joseph Stiglitz argues that we can undo the decisions that got us into this mess:

We have become the advanced country with the highest level of inequality, with the greatest divide between the rich and the poor… The central message of my book, The Price of Inequality, is that all of us, rich and poor, are footing the bill for this yawning gap. And that this inequality is not inevitable. It is not … like the weather, something that just happens to us. It is not the result of the laws of nature or the laws of economics. Rather, it is something that we create, by our policies, by what we do.  

We created this inequality—chose it, really—with laws that weakened unions, that eroded our minimum wage to the lowest level, in real terms, since the 1950s, with laws that allowed CEO’s to take a bigger slice of the corporate pie, bankruptcy laws that put Wall Street’s toxic innovations ahead of workers. We made it nearly impossible for student debt to be forgiven. We underinvested in education. We taxed gamblers in the stock market at lower rates than workers, and encouraged investment overseas rather than at home.

http://www.alternet.org/economy/joe-stiglitz-people-who-break-rules-have-raked-huge-profits-and-wealth-and-its-sickening-our

Meanwhile, the Swiss are voting on whether to guarantee everybody a minimum monthly income of $2500 francs ($2800 dollars). They’re also voting on a proposal to limit executive pay to no more than 12 times what the company’s lowest-paid workers earn. Who knew that the businesslike, orderly Swiss were a bunch of commies? Or maybe they’re just fed up with rising inequality, even in Switzerland.

http://www.reuters.com/article/2013/10/04/us-swiss-pay-idUSBRE9930O620131004