Category Archives: Politics

The Morning After (Part 2)

16 March 2015

The Health Care Plan Republicans Always Wanted-Until They Got It

J.S. Chavez

As Robert Reich noted (link below) Obamacare is almost exactly the sort of health care reform that Republicans have said they always wanted, going all the way back to President Nixon. (Yes, that Nixon and yes, the situation is really that bad.) Reich points out that it is Republicans who have always insisted on private insurers rather than a Medicare-Social Security based system. 

It was Republicans who came up with the idea of an individual mandate, which Mitt Romney successfully carried through in Massachusetts. Reich concluded by noting that since Democrats had to pass the ACA without Republican support they could have held out for a single-payer, Medicare-based system that would have actually worked.  Possibly. But Republicans would surely be apoplectic over any health care plan that Obama (or any other Democrat) came up with. And there’s the problem, for both the Republican party and the people of the US.

Just about everyone you ask, Democrats and Republicans alike, will tell you that universal health care should be a right. 

So, if the ACA is essentially the plan Republicans would have come up with if they had to come up with a plan, how come they’ve lined up against it as though it were the anti-Christ? Follow the money: Health care in the US is a business—a very good business.  Average per capita spending on health care in the US is over $8,000 per year. Republicans don’t want health care reform, many even claim it isn’t needed.  They also claim that if market forces are given free reign then competition will drive costs down.

Medical care in the US is basically a cartel.

Insurance companies, not patients, are the consumers. And they’re part of the cartel.  They don’t care if Big Medicine charges exorbitant prices.  They can just raise their premiums.  Their cut comes off the top so they always get paid.

Try calling up a hospital and getting a price for a surgical procedure.  Ask about something  simple, like a hernia operation.  They won’t tell you because the real answer is “it depends.” (See the “possible exception to the rule” link.) Mostly, it depends on your insurance (like whether you even have insurance). If they were to be honest with you (they won’t be) they would tell you that the price is “as much as we can get.” In other words, it’s a negotiation—but not with you, because you aren’t the consumer. 

The negotiation is with your insurance company. Your insurance company decides what your co-pay will be.  Your insurance company decides which hospital you can use.  This is based on the deal the insurance company worked out with the hospital. You have no say in the matter, even though you’re paying for it.  There is no other business arrangement in the world where this would be tolerated.  Would you hire an electrician to rewire your house if the price he quoted was “it depends?”

There is a critical point that most people do not seem to understand:

Insurance companies are not in the business of paying for health care.  Insurance companies are in the business of collecting premiums.

Insurance companies are the consumers of medical care.   The insured (you) are the consumers of insurance.   All the money that goes into the pockets of insurance companies comes from you, whether you pay them directly or your employer pays a share. 

And about that; any insurance provided by your employer is part of your compensation as an employee.  It is not a gift provided out of the goodness of your employer’s heart.  When Hobby Lobby claims that they shouldn’t have to pay for contraceptives because it runs contrary to their religious beliefs, what they’re really trying to do is foist their religious beliefs onto you, forcing you to adhere to their religious principles as a condition of your employment. 

That’s the conservative version of religious freedom. You, as an employee, are free to adopt the religious beliefs of your employer.  Conservatives complain about the nanny state but they’re fine with the fundamentalist feudal state.

It’s pretty simple: Republicans hate Obamacare, mostly because Obama, a black Democrat, got it passed. The Affordable Care Act is deeply flawed, precisely because it is more of a Republican plan than a Democratic one—but it’s a start—an essential start. Republicans don’t want to talk about any kind of health care reform because they know that the only one that makes sense (based on our own experiences and those of just about all the OECD countries) is a single-payer system. 

Medicare, our Medicare, (the so-called “entitlement program” that we pay into all of our working lives) is way more efficient than private insurers, doing a much better job of containing costs.

Just prior to the implementation of the ACA, our “system” of health care was financially unsustainable.  And Republicans couldn’t have cared less.  They’re happy to ride us all into the ground and bleed us of every last dime.  That’s the Republican version of health care reform.

The fact is Republicans offer nothing.  Nothing. They are the party of “No.” The party of No obstructs, obfuscates, obliterates and offends.  The party of No does not solve problems.

The party of No is the problem.

So, why does health care in the US cost so much?  The graph below tells a big part of the story. Mid-life and end of life (EOL) care costs are far higher in the US than anywhere else.  In 2011, 28% of Medicare spending was for care in the last 6 months of life. Just what are we getting for these insane expenditures? Has anyone ever gotten out of this life alive?

Health-care-costs-by-age-and-country.png

(Source: Forbes.com)

Do you suppose that these huge EOL expenditures buy us more time and better quality of life?  It doesn’t appear so.   The US ranks about 33rd in life expectancy in the world (not far behind Costa Rica and Cuba). Average life expectancy in the US is 78 years.  Average per capita health care spending in Cuba is about 1/20 what it is in the US. Most Americans say they would prefer to die at home but 75% of us die in hospitals or nursing homes.

  Source Links and More Information: 

Robert Reich  Obamacare is a Republican Plan / Robert Reich Blog /  Kaiser Health Care / Co$t of Dying / Bloomberg / Rand /NIH /Bitter Pill /Exception to the Rule?

The Morning After (Part 1)

9 March 2015

Credit where Credit is Due: Senator Ted Cruz Saved Obamacare

By J. S. Chavez

The Affordable Care Act (ACA), a.k.a. Obamacare, website was in shambles in November of 2013 as technicians worked 24/7 to fix the hardware and spinmeisters in the West wing worked 24/7 to shore up its image. Millions of dollars intended to fund an advertising blitz to drive people to the Healthcare.gov website were (understandably) on hold.  Secretary of Health and Human Services,  Kathleen Sebelius, took a well deserved drubbing from Congress for her part in the debacle and the site continued to limp along, harassed by higher-than-expected traffic and inadequate administrative and technical support. It was ugly, but they muddled through, and somewhere along the way Obamacare arrived. Still, this is not how you treat the signature legislation of a two-term presidency. You don’t leave your first new car, the one you bought with the money you scrimped and saved by working three part time jobs, forgoing parties, forsaking friends, and denying yourself a single new outfit for a whole year, parked in the street next to the crack den on Saturday night with the doors unlocked and the keys in the ignition. You wouldn’t do that, right? You’d pamper that car.  You’d drive five miles per hour under the speed limit, avoiding potholed streets and fresh asphalt. You’d lovingly scratch the squashed bugs off the windshield with your own self-manicured fingernails. You’d wash it everyday, with warm water and mild soap and carefully chamois the water off. You’d be sure to keep the tires properly inflated and you’d park it in the shade so as not to fade the interior or age the paint.   

YOU WOULDN’T TAKE ANY CHANCES THAT SOMETHING BAD WOULD HAPPEN TO RUIN WHAT YOU WORKED SO LONG AND HARD FOR! Right?

President Obama, Kathleen Sebelius, the Centers for Medicare and Medicaid Services and the rest of the hapless hacks whose job it was to launch the Affordable Care Act (ACA) should be lining up to give Senator Ted Cruz a big, sloppy wet kiss. That the Obamacare team should find itself in bed with Cruz after the collapse of the Obamacare site is one thing but that they should be grateful for his company would have been impossible to predict when they hooked up in October of 20113. They should take pictures of themselves screwing the ACA pooch while Cruz looks on. I’m not sure this would rise to the definition of bestiality but it works as evidence. Ponder the alternate political reality we would all be living had Cruz not put his own self interest ahead of that of his party and his country, and had Speaker John Boehner actually led the House rather that pandering to it’s basest elements. Right, too far-fetched but, suppose, just suppose, that Republican House members had agreed to a reasonable budget in time to avoid a shutdown. The Healthcare.gov site would have imploded anyway and Republicans, instead of doing the walk of shame, would look like the reasonable, responsible legislators they so often pretend to be. Given how difficult it is for them to “effectively connect with voters” (see 16 Days in October, Part 4) they are not likely to get another opportunity like that for, well, ever.  I mean, what the hell was the administration thinking? The White House spent weeks dodging, weaving, spinning, vacillating between mea culpas and passing the buck, but generally having to acknowledge that they screwed up, if not quite owning the screw up. Seldom have we seen so much freely given political capital (the shutdown) dissipated so quickly, wantonly, and extravagantly. And so it went as one of the most profound unforced errors in the history of American social policy staggered through its painful, incompetent debut. 

However, the Obama administration seems to have gotten away with it, as a practical matter.  ACA enrollments are ahead of predictions, premiums are being paid, costs of premiums are not going through the roof, enough young people are signing up to ensure the viability of the program, and a healthy majority of people who have taken part, including those who identify themselves as Republicans, have been satisfied with their coverage.

As a political matter, it seems unlikely that the Right  will move on from here.  On the other hand, few seem to believe that the ACA is likely to be undone, even at this early stage.  By 2016, the prospect  of going back to the way things were is not likely to be any more tenable. Still, the Tea Party is alive, if not entirely well, and still flexing their muscle. 

One day soon, the passage and implementation of the ACA may go down as one of the greatest political achievements of all time. And we have Ted Cruz to thank for that.

16 Days in October (Part 4)

9 February 2015

The Party of God, Profanity, and Anarchy

“The white establishment is now the minority…The demographics are changing. It’s not a traditional America anymore.”
-Bill O’Reilly, FOX news commentator, 2012.

So-called moderates in the Republican party will occasionally talk about “adjusting” their message so as not to alienate—well, everyone—except middle-aged, upper class white males. 

“It’s not about nominating less conservative candidates, moderating our messaging or changing our principles. It’s about effectively connecting with voters on issues they care about,”

-Phil Cox, executive director of the Republican Governors association (2 November 2013, Politico), a few days before the Virginia Governor’s election. (The Republican candidate lost.)

How, exactly, do you go about “effectively connecting with voters” when your message is racist, sexist, xenophobic, homophobic, and elitist? How do you spin bending over backwards to deport 11,000,000 Hispanic immigrants, denying minorities their voting rights, intruding on women’s rights to make reproductive decisions, and denying equal rights to homosexual couples? And climate change isn’t real? Still? What about gravity? When you deny the laws of physics even your friends will shake their heads and walk away.

Over the last 30 years, Republicans, with the complicity of many Democrats, have systematically gutted the financial regulatory system while securing major tax advantages for the 1%, all the while whining about how government regulations are ruining their lives.  Please. They’ve never had it so good.  In fact, it looks like they’ve already won.  But no, they find themselves to be sorely abused. They portray themselves as victims, invoking the notion of “class warfare.”  They think we can’t tell we’re losing?

The GOP has stoked the largely religious Know Nothing wing of the party to such a fevered pitch that they can no longer be controlled.  The Know Nothings are not going away, but the problem for mainstream Republicans is not that they disagree with the views of the Know Nothings.  Rather, it is the opposite.  O’Reilly is right. He also said that, 20 years ago, a Romney-esque candidate would have defeated Obama.  Right again. 

And so long as O’Reilly, and most of the rest of the GOP, continue to wax nostalgic for the days when their party was the party of the white establishment, they are likely to continue their frustrated decline, kicking and screaming perhaps, into irrelevancy. People adopt conservative values when they are comfortable with the status quo. The majority of blacks, Hispanics, women, gays, and perhaps just young people in general, are anything but comfortable with the Republican party.

Democrats should not see this as good news.  Given the early promise of the Obama presidency many liberals feel disappointed, even betrayed. Then again, the Know Nothings’ sole aim since Obama assumed office has been to obstruct.  Obstructing is not leadership. The 80 Know Nothings who signed the shutdown letter sent to John Boehner care little for democratic process.

They claim to be Constitutionalists but run roughshod over that sacred document when it suits their purpose. They do not contribute; they only proscribe. They do not negotiate; they only blackmail. They preach God and country while practicing profanity and anarchy. They feel disconnected from the world and from their countrymen who defend their right to behave irresponsibly. They are a minority, but they are a force to be reckoned with because they have the unreasoned self-righteousness of religious zealots who know the true way.

International observers exercised their prerogative to look down their noses at us as they contemplated the wisdom of the US dollar as the default world currency. Writing for Xinhua, the official Chinese news agency, Liu Chang suggested the need for a “de-Americanized world” and writers from Athens to London wondered that the world economy could be placed at risk by an unsophisticated minority of US lawmakers who don’t seem to “get it.” The opinions of others matter—outside the bubble.

    

16 Days in October (Part 3)

 30 January 2015

An Incestuous Bubble of Babble

 The 47% Majority

“Is this just math you do as a Republican to make yourself feel better?”
-Megan Kelly, FOX news anchor’s on-air question to Karl Rove, Republican strategist, on election night 2012. Rove was insisting that Romney would win the election. (Rove didn’t care for the question.)

The technology that moves data across the country at near light speed facilitates such an orgy of available information that consumers are overwhelmed by venues of content. Unlike the plain vanilla media landscape of the 1960s, when news was read by distinguished, Midwestern, middle-aged white males, cloned from Edward R. Morrow, today we can choose to receive our news content from a veritable rainbow of humanity.  If their presentation offends our sensibilities we can easily switch to one who will tailor the information in a way that makes us feel good about ourselves.

The right still complains incessantly about “liberal media bias”  even though they have FOX News, The Wall Street Journal, the Drudge report and a plethora of far right rabble-rousers on talk radio and television.  These conservative “news” organizations (which conservatives claim are balanced) are “necessary to set the record straight” and “disseminate facts the liberal media suppress.”  As conservatives gained control of more news outlets they became bolder, shriller, and wandered farther from the truth in their quest to reshape the world into what they think it should be.

The mainstream GOP tacitly condones the hate-mongering and disinformation disseminated by the likes of Rush Limbaugh, Glenn Beck, FOX news, the NRA, et al.  Occasionally, they will attempt to distance themselves from a particularly offensive remark but overall they are pleased as punch to let these “unauthorized” provocateurs serve up raw meat to the homophobic, zenophobic, racist, sexist, climate-change-denying elements of their party which they are happy to welcome under their tent. The Republican Party owns these attack dogs, though they have long refused to take responsibility for them.  It seems a delicious irony, then, that their refusal to muzzle their dogs has allowed those dogs to turn on their masters.

The constant drumbeat of protest from the right over supposed liberal media bias has taken a toll on mainstream media. Mainstream news outlets, fearful of being labeled “liberal” bend over backwards to be balanced, to the point where they are afraid to call a spade a spade.  Indeed, as media outlets have become concentrated in fewer hands, and profitability of news organizations becomes increasingly elusive,  what possible motivation could there be for a liberal bias at the expense of profit? If anything, news media are indulging a conservative bias, the motivation for which would be preservation of the bottom line.

The take-over of a large chunk of news outlets by right wing provocateurs has not “balanced”  the information wars so much as it has facilitated the rise of an alternate reality populated by paranoid unicorns, revisionist historians and fiscal fairies. The Know Nothings embrace this 1950s never land, where there are two chickens in every pot, the only people of color are domestics, and wives and mistresses are destined never to meet. All the while they dutifully consume large quantities of Kool-aid brewed up by disconnected nabobs who take their orders directly from God.  Strangely, God seems to have trouble getting his facts straight.

For all their whining about the liberal media’s suppression of “the truth,” when conservatives research, analyze and disseminate their own, “unadulterated” version, it is often inaccurate.  I’m not talking about spin here.  It matters little if conservatives choose to live in an incestuous bubble of babble.  It matters little that they believe Obama is a Muslim, that John McCain works for Al Qaeda and that death panels will decide who receives medical care at the end. (We’ve had death panels for years; we call them insurance companies.)

Problems arise, though, when conservatives venture outside the bubble. Throughout the government shutdown in October of 2013, the Know Nothing Party justified their actions by saying they were representing the will of “the American People.” The true representatives of “the American people” were the ones who passed the Affordable Care Act.  These true representatives of the American people got the job by getting elected. That’s how it works outside the bubble.

It seems that conservatives would be better served if they placed their faith in, and based their campaign strategy on, information disseminated by the “liberal” mainstream media.  On election night, 2012, well-heeled Republican donors descended on New York City and DC, expecting to party the night away celebrating a Romney victory—of which they had been assured. Really. How in the world did these people ever amass enough wealth to buy so many politicians?  The mainstream, sorry, liberal news outlets, were all predicting an Obama victory.  Romney’s pollsters declared they were shocked, shocked, mind you, blindsided; no idea what happened.

Is there no one in the GOP political machine who understands the meaning of the word “fact?” Is it possible that what conservatives call “liberal media bias” is what the rest of humanity refers to as “the truth?” Conservative journalist Christopher Ruddy, in a post mortem of the 2012 election, blamed the candidate himself, the liberal media, other Republicans, the weather, et al., for Romney’s defeat.   While the extreme right rioted over Romney’s lack of true conservative credentials, most of the rest of the country (47% and then some) seized on the  faux conservative credentials he did have—and rejected them.

16 Days in October (Part 2)

 20 January 2015

There goes the neighborhood…

The Know Nothing/Do Nothing 113th Congress may have been noteworthy for their lack of legislative accomplishments but I fear that they may not suffer by comparison to their immediate successors.  The intransigence of Know Nothing Republicans is not likely to be tempered by the failed coup of October 2013.  The districts that elected the 80 Know Nothing Representatives who held the country hostage will still be safe Republican districts, probably even after the coming mid-term elections.

Yes, Republican gerrymandering played a role in 2012, but those gerrymandered districts were mostly drawn in Republican strongholds anyway.  (See Nate Cohn’s take) Our country is self-segregating.  Many aging baby boomers are migrating to urban areas for easier access to cultural venues and a less automobile-oriented lifestyle. Overall, the US is becoming more diverse, racially and culturally. But many rural Republican districts are actually becoming “whiter.” Constituents in these homogeneous communities fret about the threat to an American way of life (that never really existed), posed by illegal immigrants, abortion rights, “death panels,” government regulation, and yes, Socialists.

There seems to be a popular perception that the Tea Party sprang up, spontaneously, in 2009, shortly after the election of America’s first black president. But present day social conservatives have much in common with the late Jerry Falwell’s Moral Majority back in 1976. The present day Know Nothings put politics just ahead of religion whereas the Moral Majority had it the other way around.

Back in the late ’70s there were pundits who felt that the naifs who made up the Moral Majority were being taken for a ride by the GOP establishment, that they had been seduced by a superficial conservative social agenda and were unwittingly advancing a grander agenda which they didn’t fully understand and couldn’t participate in. Some observers even went so far as to say that, eventually, the Moral Majority constituents would recognize that the political ideologies of the Democrats were more to their liking than those of the Republicans. (So, who was naïve there?)

The mainstream GOP has long and masterfully outmaneuvered the Democrats by exploiting working class, rural, and under educated voters, who realized little benefit from the fiscal policies promoted by the likes of the Koch brothers, Heritage Action, and others who spend big on the extreme right, by appealing to their latent fears and prejudices. Mitt Romney’s classically daft “47%” comment is cited by some as the deciding factor in the 2012 election. However, given the demographics of the people in that 47% group, it’s likely that most of those 47% (the ones who actually voted) voted for Romney anyway, despite his outright disdain for them.  

16 Days in October (Part 1)

12 January 2015

The Dodo is Extinct…The Wacko Bird is Alive and Well

“You do not take a hostage you are not going to for sure shoot, and we will not for sure shoot this hostage.”

Senator Tom Coburn (R-OK)

Another national election season is upon us and the field of potential Republican presidential candidates is as thick as locusts. Given Republicans’ approach to problem solving (remember the government shutdown?) does the GOP candidate exist who would not alienate the vast majority of the electorate?

There used to be a saying in national politics: Democrats fall in love; Republicans fall in line.  The first part is probably still true. Democrats are less likely to vote for a candidate purely because he/she is their party’s nominee if the candidate does not inspire passion. Republicans, on the other hand could always be counted on to turn out the vote, weather be damned, no matter who their nominee was, because theirs was a top-down organization. This disciplined approach to electioneering served the party well for decades and that, coupled with their fund-raising advantage and superior knack for appealing to the everyman, made them a force to be reckoned with.

Something has changed. These days the Republican party looks a lot like the maniacal melange of characters gleefully portrayed by Tony Collett, whose protagonist, Tara, suffers from dissociative identity disorder (DID) in Showtime’s “The United States of Tara.” The title of the show is ironic but, then, so is the GOP, self-identified as the party of fiscal responsibility.

So, how did the party that could be counted on never to air its dirty laundry in public become the disfunctional family whose internal disagreements spill into the street and wake up the neighbors?

Dog Day Afternoon

In August of 2013, 80 House Republicans sent a letter to House Speaker John Boehner suggesting that he use the threat of a government shutdown to defund the Affordable Care Act (Obamacare).  (Charles Krauthammer dubbed them the “Suicide Caucus.”) The Suicide Caucus was largely composed of Representatives of southern and upper midwestern, (mostly) red states. None of these states are on the West coast or in the major population centers of the East coast and New England. These 80 House districts represented just 18% of the US population – though the US population they represent is not representative of the US.  These districts are whiter, more rural, and far more Republican than the country as a whole.  Despite widespread criticism of the tactic from the more moderate wing of the party, the Suicide Caucus, egged on by fellow “wacko bird” Senator Ted Cruz, took the US Government and the world economy hostage. Standard and Poors estimated that the shutdown cost the US economy $24 billion and substantially reduced fourth quarter GDP. True to it’s nickname, the Suicide Caucus went down in flames, though its demise was not nearly as dramatic, nor as noble, as they wanted it to be.

“We’re not going to be disrespected”
Representative Marlin Stutzman (R-Ind) to The Washington Examiner.

(He was wrong.)

The Suicide Caucus’s initial demand to defund Obamacare as a condition for agreeing to a budget was quickly abandoned as unobtainable, and the ensuing drama devolved into a deluge of disfunctional demands which decreased in relevance and legitimacy as the fiasco wore on.

The ransom note(s): (Courtesy of Rachel Maddow. The comments are mine.)

  • Defund Obamacare
  • Delay Obamacare
  • Delay the Individual Mandate
  • Deny Coverage for the President
  • Deny coverage for the cabinet
  • Deny coverage to congressional staffers
  • Deny birth control coverage
  • Means testing for Medicare (Actually, a good idea. How did that get in there?)
  • Change federal employee pensions
  • Approve the Keystone pipeline
  • Expand oil drilling 
  • Block net neutrality
  • Tort reform
  • Weaken regs for coal-fired power plants
  • Tax code changes (Also a good idea but not the way they intended)
  • Thwart EPA coal-ash regulations
  • Repeal the medical device tax
  • Change rules on debt ceiling

The GOP has long been the party of fiscal and social conservatism.  This, even though social conservatives, who tend to be religious, often don’t have a clue as to what fiscal conservatism is all about. And many country club Republicans only pay lip service to conservative social values, for the sake of party unity. Mainstream fiscal conservatives are more likely to live on one of the coasts rather than in the rural bible belt, the domain of social conservatives. Monied Republicans are only loosely tied to rural conservatives by a shared dread of change. Change is bad for your bottom line—or it might be.  (Why take the chance?) If you are socially conservative you don’t want change because things are the way God intended (else, why would they be this way?) and you are bound to follow God’s will.

The issue of gay marriage may be the quintessential example of the divide between the two factions. Does anyone suppose that the cause of gay marriage (which is near to becoming the law of the land) would have made the gains it has in the last few years without the support of many mainstream Republicans?  Fiscal conservatives, business people, have gone public, first with tepid expressions of tolerance of gay unions but, increasingly, with full-fledged endorsements of gay marriage.  Why? The short answer is that gay marriage is good for the economy.

Listening to the rantings of the Know Nothing Suicide Caucus one was struck by the other worldliness of their point of view.  The “keep the government’s hands off my Medicare” ignorance of Tea Party constituents would be amusing if it weren’t also echoed by their elected representatives—at least when it serves their purpose.   Mainstream Republicans are no better. After all, they don’t necessarily disagree with the Know Nothings’ point of view, only their tactics. Their insistence that Obamacare is a “train wreck” that is “doomed to fail,” that it will “bankrupt the country” and is “causing thousands of people to lose their jobs” before it was implemented, mind you, borders on delusional.  The plain fact is that the state of health care in the US was a “train wreck” that was bankrupting the country and causing thousands of people to lose their jobs.  Not to mention that it isn’t any better than health care elsewhere that costs a third as much.