Archive for the ‘Barack Obama’ category

Public Option?

April 21, 2017

The GOP and the Trump White House are beating the healthcare drum again. The President promises a really good plan for replacing Obamacare. According to a report in the Washington Post, Trump said, “We’re doing very well on health care.” “The plan gets better and better and better, and it’s gotten really good, and a lot of people are liking it a lot.”  “We have a good chance of getting it soon. I’d like to say next week, but we will get it.” Hmmm.

I suspect those Americans who loose their coverage or those who subsequently find out their coverage covers a lot less will not think their health plan got “better and better”.

Republicans are now debating behind closed doors a plan which seeks to bring together conservatives (Freedom Caucus who do not want any hint of entitlements in healthcare and would prefer for the government to not be involved at all), and moderates (The Tuesday Group who fear sharp political retribution if the benefits of Obamacare are rescinded). The Tuesday crowd are offering weasel words that would allow States to opt out of certain Obamacare services. Hmmm.

The overall facts appear unchanged. The American Health Care Act, even as amended, will provide less coverages to fewer Americans than Obamacare and will provide huge tax savings for the wealthiest Americans. The GOP’s embrace of “the best healthcare money can buy” is a sad replacement for the Affordable Care Act (Obamacare). Is that the best we can hope for?

Here’s a dream.  “Medicare for all” could be a next step in healthcare. Compared to the “oh so many” for-profit insurance companies today (which stand between you and your doctor), Medicare, which insures post 65 year old Americans, and fits seamlessly into existing doctors, hospitals, and pharmacies, could offer “a ready to go” alternative.

Of course Medicare is not without some problems, namely how it is funded. Republicans will decry the expansion of government and seek ways to defund Medicare. Cooler minds, however, might see Medicare as the ideal vehicle to determine what is basic healthcare and how to pay for it, especially if Medicare became the standard package for employer provided healthcare.

No sane discussion of healthcare reform should avoid the obvious elephant in the room. Americans spend more on healthcare than any other country in the world and receive mediocre healthcare outcomes in return. The difference in cost is significant (greater than two times).

An additional revelation is that balancing the Federal Budget can not be achieved unless there is a fix for Medicare and Medicaid, both of which collect less in tax revenues than they spend on healthcare benefits. With “Medicare for All” there is one program providing basic coverage with significant negotiating power with healthcare providers. Existing insurance companies could continue to “administer” Medicare benefits but would be unable to set different conditions around services.

Most likely efficiencies associated with a single payer would be insufficient to assure Medicare would be solvent. Consequently tax reform coupled with healthcare reform could be seen as reforms aimed at serving all Americans and not as ploys to pass on huge tax breaks to the already very wealthy.

Despite wrong headed GOP motivation on both tax reform and healthcare, Democrats, unfortunately, appear willing to simply play for a tie (defined as thwarting the American Health Care Act thereby keeping Obamacare) and rejecting tax reform unless the proposal is revenue neutral or positive.  Hmmm.

The can is poise for another kick down the road.

The Fog Of Syria

April 8, 2017

President Trump ordered a military strike against a Syrian airbase in response to horrific pictures of a Syrian Government suspected Sarin gas attack on defenseless Syrian civilians. Initially most members of Congress welcomed the action and those who did not, kept quiet because the tide of public opinion was demanding some US response. Now as the dust is settling, other voices are being raised. Hmmm.

Supporters of President Trump’s actions (actually the specific plans are the product of the Defense Department, not the President) describe the airbase attack as proportional and an appropriate first step. Supporters are also quick to say they hope this action was not be lost on the North Koreans or the Chinese. No more President Obama – Mr Nice Guy – foreign policy, they say. Hmmm.

Other observers point out that the Sarin gas may have come from stock piles held by terrorists and were released when an errant bomb hit the stash. Possible, and an extremely important point if true. But, rebel held chemical weapons seems highly unlikely while Syria has already admitted to possessing chemical weapons in the past.

What’s next?

Bashar Assad’s opponents point out that innocent civilians are dying everyday when Syrian forces drop conventional barrel bombs. What is the difference (gas or bombs) for defenseless people?

This line of reasoning supports the US taking further steps, like disabling other airbases, establishing no fly zones, or even partitioning Syria thereby liberating areas for Assad opponents to set up government. Sound reasonable?

No sooner have such proposals been made than others point out that ISIS, al Qaeda, Hezbollah, and other similar groups make up some of those who think one of the partitioned Syrian areas would be just fine for their control. Is that what President Trump is thinking?

Yesterday, about 150 protesters blocked traffic in Philadelphia as a protest against President Trump’s Syrian airstrike. The protesters were against the use of force. I wonder what these people think about the nature of the Syrian civil war?

Former President Obama assessed the Syrian situation as one not amenable to western, non-Muslim intervention. Peace would return to the Middle East only when local leaders agreed to live together in harmony. Obama was willing to supply training and coordinating help but severely limited the direct US fighting involvement.

Under Obama, the US policy was still pregnant, but much less than obvious than a full fledged occupation.

Some foreign policy wonks describe the Syrian conflict as a proxy war for the Iranian-Saudi relationship. With Russia’s involvement, there is the possibility of a resumption of the old East-West proxy wars. And some only see the Syrian mess as a conflict between Sunni and Shiite or a battle waged by a greedy authoritarian family against a poor population. Hmmm.

Former President Obama’s strategy may have been wise but it did not “feel” good, it was not decisive in nature. President Trump’s quick and timely response feels better. Only time will reveal whether President Trump has acted wisely or whether his actions will help or hinder a resolution to the Syrian civil war.

Not much is clear in the Syrian fog of war.

Republican Healthcare Secret

April 6, 2017

Today there were reports that the unofficial  second effort to repeal and replace Obamacare had collapsed. It appears that potential changes to the initial failed repeal and replace (American Health Care Act), while encouraging to the Freedom Caucus was unacceptable to moderate Republicans. In other words original no votes that were willing to change to yes votes were offset by original yes votes who would now vote no. Hmmm.

These healthcare deliberations speak volumes about the Republican Party. For the better part of seven years the standard Republican Obamacare line has been “job killer”, “a disaster”, and “we will fix healthcare”. Through the buzz of political speak, one can see that there never was a Republican Plan. Many different Republicans may have had plans but as a Party there was never agreement on anything other than the value of insinuating that the Affordable Care Act was in someways defective and by association, Democrats were also defective. Hmmm.

Republicans are now revealing (1) they are not a party of one mind, and (2) the Freedom Caucus hold views which are mean spirited, ill informed about basic healthcare, and really represent a third party, not a faction of the larger Republican Party.

Around the world, other modern countries have settled on healthcare models which provide basic healthcare to their residents. These countries have found that preventive care and reasonable controls on healthcare provider’s profit incentives produce superior health outcomes for their residents and much much lower costs to boot.

The Freedom Caucus is claiming they won’t agree to any Obamacare changes unless there is a reason to believe healthcare premiums will decrease. On the surface this sounds reasonable. But when one considers the Freedom Caucus approach (eliminate Federal mandates over what services healthcare policies must cover), one suddenly realizes that the Freedom Caucus is comfortable with insurance companies reestablishing pre-existing condition limits and embracing stripped down policies (like catastrophic care only) which provide no access to basic preventative healthcare. The Freedom Caucus has written the book on “the best healthcare money can buy”.

The Republican Healthcare Secret is much more about the party itself than healthcare. The Freedom Caucus would also seek to not just roll back (or moderate) recent gains in civil rights, human rights, and environmental protections, the Freedom Caucus would seek to deny there is any basis for these rights to exist or protections to be implemented.

One might think the right thing for Republicans to do would be to expel the FC from the Party. But the Freedom Caucus has been beneficial to the GOP also. Caucusing with the Republican Party, the combination has been able to “control” Congress, and thereby chair the major committees. While the GOP was the Party in opposition, there was always a greater danger than ideology, the other Party. Now the Republican Party has control of the executive and Congress and can no longer ignore the role of responsible governance.

Damn that Freedom Caucus.

Trump’s Syria

April 5, 2017

How many people do you know, besides yourself, who wished they could take back something they may have said in haste? Plenty I bet. Former President Obama is surely one of them too. His unfortunate “red line” warning is a good example.

Former President Obama was quite on the mark when he expressed outrage that anyone, and in particular, the Syrian Government would use chemical warfare, and use these outlawed weapons on its own people. Obama’s issuing of a warning he could not enforce was at its best like pulling for an inside straight. There was no way the treat would alter the behavior of a regime fighting for its life. At it worst, Obama’s red line reinforced the impression that the US would not act in any decisive manner to end the Syrian insurrection.

A lot has happened since the former President’s ill fated words. Russia’s entry into the conflict seems to have tilted power back into the Syrian Government’s hands. While needless deaths have continued, there seems to have been every indication that the civil war was heading to a conclusion. And then yesterday, Syria used chemical weapons again.

Pictures of the aftermath are horrific. Shown are defenseless civilians, including children, reacting to the painful and life threatening effects of these weapons (believed to be sarin gas). In what had already been documented as a war against humanity, a new outrageous chapter was opened.

President Trump now has the spotlight on him. What will the President do?

President Trump, in a pattern which seems genuinely him, immediately blamed someone else, this time President Obama. If President Trump really believes these words, America and Americans are really in trouble.

Lest we not forget, in another place on the globe, North Korea has continued to act provocatively on President Trump’s watch and other than words, the President has done nothing. Now President Trump has two failed States acting up and both apparently uninterested in making any deal with the great deal maker.

Syria sits in the middle of the Middle East. The invasion and occupation of Iraq opened Pandora’s Box, destabilizing the entire region. Thinking that an outside force, especial a non-Muslim force, can put Humpty Dumpty together again is wishful thinking.

North Korea, which lies snuggly against China’s northeast border, represents a different but equally dangerous challenge. Like President Bashar al-Assad in Syria, Kim Jung Un is all about how to keep himself in power, and like Syria, North Korea cares little about the well being of its citizens. President Trump has said “all options are on the table” in response to North Korean provocations (striking the US west coast with a nuclear weapon). Does that sound like a red line?

Whether President Trump likes it or not, his Administration now owns North Korea and Syria. What ever goes right or wrong in either regime will be like fly paper. The great deal maker will not be able to get it off his hands.

GOP Goes Nuclear

April 4, 2017

The GOP Senate leadership appears poised to take a dangerous and unwise step this week. Senate Leader Mitch McConnell has promised to change the 100 year old Senate procedural rule governing filibusters and Supreme Court nominees. If Democrats insist upon 60 votes to confirm, McConnell promises to change the rules to a simple majority.

Since Republicans have already a Senate majority, why shouldn’t they change the rules?

The Supreme Court is a life time appointment and is already divided along ideological lines. Democrats argue that Judge Gorsuch, while well qualified in every way, has a judicial perspective which is out of the mainstream. Democrats feel a Justice Gorsuch would approach each case with a preconceived ultra conservative perspective.

Republicans respond that Gorsuch is in the mainstream and more importantly views the Constitution (as originally conceived).  It is not clear how or with whom Judge Gorsuch verifies or confirms his interpretation of original intent.

So again, why shouldn’t Republicans change the rules?

Democrats argue a Supreme Court nominee ought to get more than a simple majority given the importance of the position. Competency, good character, and an impartial mind would seem to be the desired requisites. With Judge Gorsuch, the disagreement seems to be hanging upon whether Goruch can be impartial. Hmmm.

The Gorsuch vote will underline the extreme positions of the two major parties. Conservatives who now dominate the Republican Party seek to reduce the size of government, eliminate (or at least vastly reduce) entitlements, and reverse all sorts of social changes made over the past 50 years.

Democrats largely under progressive influence seek to interpret the Constitution in modern terms reflecting over two hundred years of advancements in science, medicine, and experience. There was no internet, no antibiotics, or no airplanes/automobiles/trains in the lives of our founding fathers. The hand delivered letter, death from common illnesses, and foot or horse transportation were the norms of our founding fathers’ time. As a consequence, Democrats prefer a Justice who sees the world as they do.

The Gorsuch vote is the next step in a series of regrettable failure in Senate leadership. Conservative groups had sought during former President Obama’s term to limit how many Judges Obama could appoint. The GOP reasoning was that with fewer appointments, there would be fewer progressive leaning members of the judiciary when it came time to nominate higher court judges and ultimately Justices. To this end, Republicans filibustered Obama nominees and blocked consideration. In frustration, then Senate Leader Harry Reid changed the Senate filibuster rules on most Presidential appointees to a simple majority to end the filibuster… except for the Supreme Court where Reid left in place the 60 vote threshold.

Republicans were furious and took the next step of not even considering Judge Merritt Garland following Justice Scalia’s death. As previously done filibustering former President Obama’s nominee, Republicans upped the anti and did not even hold hearings for Judge Garland.

It is possible that Republicans think they are taking prudent action. Republicans may be so focused on what they feel is the proper ideological direction that “the ends justify the means”. Republicans, if so, could not be more wrong. History has shown that the party in power changes like the leaves on a tree. Regardless of which party is in power, voters tend to tire of that party and vote them out. Does it take much effort to think what the next Democrat controlled Senate might be like?

There is an even more serious consequence on the table if Senator McConnell changes the rules. There is no reason for either party to feel it necessary to nominate a “competent, good character, and impartial” person in the future. With the confirmation assured, why not nominate Sheldon Adelson or any other wildly rich donor, or why not Jeff Sessions if all that’s needed is a straight party vote?

Democracy has been tried by many countries around the world. In far too many, democracy has a given way to authoritarian regimes of some form or another. America’s secret has been a robust balance of powers held together by functioning checks and balances.

Merritt Garland should never have been passed over and Neil Gorsuch deserves an up or down vote (with no filibuster).  Unfortunately Garland was denied a fair vote and now it is Gorsuch’s role to take the blow back.

A wise GOP leadership would accept the blow back from their overt blocking of President Obama’s nominations and move on to their next nominee.

Instead it appears US politics are headed tribal.

A Week Of Eye Opening

March 26, 2017

This past week has been an eye opener for what a new Republican Congress stands for. How about “for everything” and “for nothing”? Or, maybe “for effective government” and “for ineffective” government? Or, maybe “for sincere government” and “for insincere government”? Hmmm.

This first revelation was striking. Republicans had passed legislation to repeal Obamacare about 80 times during the past 6 years and had campaigned in 2016 for the complete repeal and replacement of Obamacare. Yet when the opportunity was there, Republicans had no replacement plan.

The GOP had many plans, all disingenuous, but there was no one plan Republicans could agree upon. Hint: do you realize GOP candidates lied about their intentions?

The most popular refrain the GOP used was lowering the premium costs which “Americans” are experiencing. To some degree, in some places, this claim seems justified but Republicans were happy to leave this claim unclear. Americans receiving healthcare coverage from their employer, Medicare, or Medicaid, received no staggering premium price increases. These Americans were shielded from the increases some individuals in certain areas experienced.

So why would Republicans make such a claim? Could it be that most all Americans experience some form of uncontrolled healthcare cost increases (as they did yearly before Obamacare) and don’t understand why hospitals, doctors, and drugs cost so much?

Few, if any of our politicians called out for a universal, single payer system to replace Obamacare. Shamefully, Republicans instead called for changes to Obamacare which were designed to reduce cost increases pressure by insuring less people! How do those politicians sleep at night?

But simply reducing coverage was not good enough for some Republicans. The “Freedom Caucus” members sought to change Medicaid from an entitlement for the most needy to a capped block grant which would become the sole responsibility of States in a few years.

The “Freedom Caucus” wants to deconstruct the Federal Government and healthcare seemed an opportune way to begin the process. “Freedom Caucus” members represent a clear and present danger to modernity.

Most Americans have little skin directly in the healthcare game. Next up on Congress’ docket is likely to be “tax reform” where almost all Americans have an opinion.

While there is much good that can be achieved (like eliminating or vastly reducing the number of tax loopholes, exemptions, and deductions), changes which will lower the overall tax revenue or the progressive nature of the tax code, are sinisterly designed to reward the wealthy and to starve the Federal Government and its ability to function.

With tax reform, even more than with healthcare, it will be critical to study what any proposed changes might accomplish before voting upon any bills. The devil will almost certainly be in the details.

This past week revealed a White House and a Congress whose intentions are hidden.   On one hand, the Republicans seem unfit to govern and on the other hand, seem not a friend to the average American.

I wonder whether this GOP leadership will have learned anything that might restore faith in their intentions? I really wonder whether the White House or the Freedom Caucus care?

“Americans” Expect Us To Act

March 22, 2017

How many times have you heard GOP leaders repeat ad nauseam the mantra “the American people elected us to X or Y”, or “the American people want this or that”? The correct terminology  would be “Some American people…” with emphasis on “some”.

This type of honesty and absence of hyperbole would diminish the pomposity and self importance GOP elected officials want to present. (I fear this is a Republican disease today simply because Republicans are in the majority and in truth, Democrat leaders might fall under the same spell if roles were reversed.)

No better example of the misleading nature of “Americans expect” is the current healthcare debate. Republican Congressional leaders are moaning about those Republican Congress members who are threatening to vote against the American Health Care Act (the replace plan for Obamacare). “Americans expect us to pass this bill” leaders cry while all sorts of non-partisan studies point out that the replacement bill will maintain some popular Obamacare benefits but at the end of the day provide less coverage and insure fewer people.  No more appropriate subject does “some Americans” apply than here.  “Most Americans” are not impacted as a benefit recipient by Obamacare

For some Republican Congress members, the AHCA does go far enough in rolling back entitlements and for others, it goes too far. Hmmm, I wonder what Americans really want?

Senator Rand Paul elaborated today on his proposal which could gradually eliminate Medicare expansion and streamline the individual market. Paul has proposed creating a pool of all uninsured and the allowing the “free market” to drive down price through competition amongst insurers.  As lower policy prices emerged,  government supports would decrease until they disappeared. Hmmm.

Paul deserves credit for proposing a clever way out of the box Republicans have created for themselves. His proposal, of course, has it own set of pitfalls, the most obvious of which is whether “for profit” insurance companies will want to offer policies at prices the pool will demand and people can afford. None the less, Paul proposal deserves a careful review.

The irony of the current healthcare repeal and replace drama is that greedy Republicans are far more interested in diving into “tax reform”. We will hear again that “Americans expect us to lower taxes” when in fact “some Americans”, like the top 1 or 2% wealthiest Americans will alone reap huge benefits. Most American will see little impact and no benefit. More insidious will be the knock on effects of such a large tax cut. Where will the Government get revenues to pay its expenses?  Think there will be more cut in government services?

The Republican tax reform odyssey will make “searching for a free lunch” dinner time conversation.