Archive for the ‘Conservatives’ category

When People Think Differently

August 8, 2017

The idea of “universal, single payer” healthcare seems so obvious as both the most efficient and least costly method of delivering a nation’s basic healthcare, it seems incredible that there are so many Americans who do not embrace this notion. Why would that be?

Fewer and fewer Americans remember the time before the wide spread availability of insurance company provided healthcare. Yet the US system of “for profit” healthcare insurers is a relatively recent happening. Following WWII, employers began offering health insurance as an employee benefit designed to retain employees in a period of relatively full employment. Health insurance as a benefit caught on and employers have found it difficult to retain workers without offering health insurance. Hmmm.

Also escaping most Americans knowledge is the cottage industry which is necessary to support the multitudes of healthcare insurers. Healthcare service providers (doctors, hospitals and drug companies for example) must carefully keep track of each patient and how much service that patient has consumers, report those services using each insurers different set of codes on each insurers specific form, and then argue with each of these insurers to insure they receive reimbursement for the services already provided. This entails millions of more healthcare workers who do not themselves provide healthcare. Hmmm.

More than two dozen other modern countries (like Germany, France, England, Japan, and Canada) utilize a single payer, universal healthcare service delivery system. These countries all offer “best in class” healthcare services at about one half the total cost experienced in the US. These countries also report excellent healthcare outcomes and boast longer life expectancies than the US. Oh, and these countries provide this healthcare to all residents. Hmmm.

So, why would anyone not be in favor of universal healthcare?

In the US there are many who decry the idea of universal healthcare. They predict unacceptably long wait times to see a doctor or receive treatments. They ask the question “if healthcare is so good in other countries, why do people from Canada travel to the US for medical care?”, and “Why should we put the government between you and your doctor?”, the ask.

The politics of healthcare is even more fascinating and not easy to understand. Progressives are for a universal system and conservatives are not. Conservatives point to Progressive’s record of entitlements and using taxes to fund the cost. Conservatives see creeping socialism behind the call for universal healthcare and the resulting dependency of Americans to look for government to solve all their problems. And worse, universal healthcare will bloat the government making what is already (in their opinion) too big, even bigger. And even worse, conservatives don’t want their tax dollars going to pay for healthcare for someone else. Hmmm.

Hmmm. What could be simpler. Big government, less choice, poorer quality, and offering out of control cost increases, conservatives claim.

Why do conservatives think that way when there are so many examples around the world that prove otherwise? Why don’t conservatives recognize that some Americans already have “universal healthcare”. These Americans, of course, are over 65 and are enrolled in Medicare.

Is this a subject of “the glass is half empty, or half full”? Do progressives and conservatives see the same problem (basic healthcare available to all Americans) or do they see different solutions to different problems (basic right versus small government with low taxes)?

If Americans see the same problem, conservatives may still view the delivery of basic healthcare too difficult a task for “American thinking” and from their perspective, a universal healthcare system must inevitably end up with poorer healthcare and higher costs. Progressives could, alternatively, see no problem too great for Government to solve and therefore discount totally conservatives’ warnings.

The recent Congressional fight over repeal and replace for Obamacare should make conservatives take notice. The conservative sponsored alternatives largely failed because they offered less coverage for the poor, those with pre-existing conditions, and the elderly.   Voters representing those groups made their views known. Progressives and conservatives would be wise to heed this warning.

Healthcare is not free and does require funding. Most other countries employ a “prevention” oriented healthcare philosophy, inhibitions towards uncontrolled price increases, and utilize a consumption tax (value added tax) to fund healthcare along with modest co-pay requirements.

Obamacare could be a starting point were Republicans to acknowledge that Obamacare was based upon Romneycare (Massachusetts) and that was based on a proposal from the conservative Heritage Foundation think tank.

If conservatives can’t agree with progressives on what the problem really is, voters make make the choice for them. The 2016 Presidential elections was a clear sign that the electorate was dissatisfied with both parties and threw its support to a total outsider.

What will voters do next time?

Up Next, Tax Reform

August 7, 2017

The President and the Republican controlled Congress agree (for now) that “tax reform” is the next target for action. Tax reform is a umbrella term, and like any good umbrella, tax reform could mean many different things. Soon Americans will know what Republicans have in mind.

There will be two parts to the reform, corporate and individual tax codes. For corporate taxes, there is a rich world of exceptions, exemptions, and deductions which could make anyone dizzy trying to figure out which ones apply to which businesses. Not surprisingly, President Trump has promised to lower corporate rates from 35% to 15% claiming the current US tax rate of 35% is the highest in the world and puts American businesses at a significant competitive disadvantage. Hmmm. (I wonder what the President will propose about the existing dog’s breakfast of loopholes, deductions, exemptions etc which contribute to the current average business tax rate of 14%, far below the starting point of 35%. Which buasinesses will be winners and which one will not?)

An important aspect of corporate tax deals with pass through taxes and carried interest taxes. Both of these options create tax favorable situations for certain wealthy business owners (lowering their overall tax liability). What will the GOP propose for these during tax reform considerations?

For the individual tax code, it is hard to imagine a more complicated set of rules. The individual tax code is used to generate tax revenue on earned income after certain exemptions and deductions are taken into account. When the adjusted income level is determined, individuals fall into tax brackets and the tax is calculated. For many tax payers (but still a minority over all), pass through and carried interest income plays a role in lower the overall bracket.

Some very wealthy Republicans want a straight “flat” tax of say 10% on all income, no exceptions, and no deductions of any kind. Others argue for less deductions and lower bracket rates but, of course, argue certain deductions are still important. Hmmm.

What is normally never discussed under the heading “tax reform” is what would be the consequences. On the plus side, tax reform is often argued as a route to stimulating the economy.  Some even say a tax cut (their idea of a reform) would pay for itself by growing the tax revenue even at lower tax rates.  Yes, believe it or not, a free lunch.

And unmistakably, there are those who plead for tax reform for various purposefully sounding reasons, in truth only seek a tax cut for themselves.

The more insidious consequence resides in what the government will not be able to afford on lower tax revenues.  Will a GOP controlled Congress lobby for healthcare and entitlements cuts too?

The current tax code has something for everyone to find wanting. The tax code seems to complex. There must be something wrong when an average person needs the help of tax experts to file ones income tax.  Corporate taxes are too high we are told yet American business, on average pay about the same tax rate as foreign businesses.  And, the tax code seems unfair to both the wealthy and the average person.  So “reform” seems a reasonable goal.

The mystery is what will the GOP think constitutes reform?

Take A Breath, And Think This Time

July 29, 2017

“Pause and reflect” might be good advice for Republican Congress members. But it is possible pause and reflect may still miss the foolishness of yesterday’s vote on Obamacare “skinny” repeal. The vote confirmed, with little room for argument, Congress is not fully under the control of the Republican Party. There is no Republican Party and Americans had better wake up to that fact.

Those who claim membership in the party in power are not of one mind other than wanting to get reelected. In other words, GOP membership is about winning elections and profiting personally from those elections as best one can. And with the amount of money floating around Capitol Hill, it would take a pretty dumb Congress Member to not increase their personal worth while in office.

For Congress members, unfortunately, there are strings tied to getting elected. Congress members must surrender their right to vote their conscience and instead march to the drum of the big money that financed their campaign. Besides the Congress members’ integrity, the main casualty is the absence of a functioning body invested in the 21st century problems facing America.

Healthcare is a perfect poster child.

Republicans have called out against the rising costs (premiums and deductables) of the individual market. Instead of offering solutions to this problem, Republicans, in essence, have said, if you think the price is too high for a whole loaf, we will offer you a half a loaf at a lower price. Shameful.

The skinny repeal bill took the Republican position even further into the absurd. Republican Senators were asked to vote for a bill which over turned the Obamacare requirements for individual mandate, employer mandated coverage, and certain taxes on makers of medical devices. The bill makes no sense as it would have destabilized the individual insurance market even more and posed the risk of significantly more Americans losing coverage.

Possibly even worse, the skinny bill was never intended to become law. Imagine, grown up elected officials seeking to pass a bill they believed would never become law. Why would that be necessary? Why not try to pass any bill, regardless of how flawed, that was Republicans true intent?

The Republican mysterious behavior has its roots in what basic principles underfoot healthcare. Is healthcare a right or is it a privilege?

Given the opinion polls and most of the nation’s Governors, Americans are trending towards healthcare is a right. (Now be careful and do not confuse, a right and being free.) Healthcare is expensive and the method of paying for it is not straight forward.
The inevitable end point will be a universal, single payer system, as most modern countries have already adopted.

Like most large social changes, US healthcare may still require more baby steps. But other than disgust with the GOP efforts, the defeat of the skinny bill has not brought us closer to any improvement. That work remains.

IMO, there were many Republican Senators who did see healthcare as a government benefit akin to meeting an individual’s right. Regretably, these Senators caved to special interests pressure. There are other Republicans who deny anyone’s right to healthcare unless they can afford it. They seek the best healthcare money can buy. Hence the fundamental schism.

The brightest face one can attach to the failed GOP effort is “some” Republicans working with Democrats could pass modifications to Obamacare which would stabilize the individual nsurance market and return premium costs to real world levels. A necessary fix, but a fix far short of what’s possible and what is ultimately the goal.

“Skinny” option. Hmmm. What will they think of next?

A Big Fat Nothing Sandwich

July 4, 2017

On this “Independence Day” holiday, Americans are taking stock of their blessings. Through the years, other Americans have sacrificed much, often their lives, in order to defend the liberties we too often take for granted. This year, Americans do not have to rely upon memories of past valor to appreciate the deeds of past generations. Instead, we can open our eyes and witness a President Trump and Republican Party’s attack on what has made America Great.

The President ran on the campaign promise to Make America Great Again, and most Republicans ran on the idea of “taking back their freedom”. President Trump’s slogan pre-supposes Americans agree that America has slipped or that Donald Trump’s vision is greater than our past.   The Republican Party’s charge of taking back their freedoms similarly supposes that whatever constitutes a “freedom” was theirs to take back. It might be more appropriate to say “take the average person’s freedom and give it to the wealthy”.

The Trump White House’s first six months have marked a bazaar chapter in American history. President Trump’s advisors seem set upon the appearance of keeping campaign promises regardless of whether any of them are in the best interest of the average American.

  • Lower healthcare insurance costs sounds attractive but some 20+ million fellow Americans must lose their coverage while the top earners pocket a huge tax reduction.
  • The world is currently awash in oil. Yet, the President has moved to “drill, baby drill”, no matter what the cost. Could this policy be for the benefit of the average American, or maybe just for the fossil fuel industry barons who stand shoulder, wallets open, for Trump in 2020?
  • President Trump has not restricted himself to just domestic issues. His “bull in the china shop” approach to trade and international relations is poised to sell out most all Americans. Either his naivety or his incompetent has the US ready to begin trade wars on many fronts. In trade wars there are no winners, especially the average American consumer.
  • America is a land of immigrants as most Americans can realize if they research their family tree. Making immigrants the enemy is completely out of touch with our history, not to mention our current economic needs. Without a growing population (immigrants plus birthrate), GDP growth must be low or potentially even negative.
  • But by far the greatest danger facing Americans on this 4th of July is President Trump’s child-like assault upon free speech and the freedom of the press. The President’s endless streak of demonstrably false statements will have the effect of trivializing all public officials speech.  Meanwhile, President Trump’s invocation of “fake news”, while patently unprovable, never the less poisons his supporters thinking and increases the odds that real data and facts won’t interfere with their prejudges and false beliefs. History has shown that free speech and freedom of the press are the first casualties of a budding authoritarian regime.

President Trump demonstrates each day that our Country’s best days are behind us.

So, as Americans celebrate July 4th, and gather around the barbecue grill, the President is sending you “a big fat nothing sandwich”.

 

Democracy’s Message

June 20, 2017

When Donald Trump was elected President, the US democratic process spoke loudly. Americans had elected someone inexperienced, uninformed, and some said unqualified emotionally to become President by a narrow electoral college margin (Trump lost the popular vote by 3 million votes). What was democracy’s message?

American democracy approximates one man, one vote but it actually reflects the popular vote in each State times the number of House and Senate members apportioned to that State. Therefore it is possible to win the popular vote but lose in the electoral college. So is that why Donald Trump is President?

There’s more. Along with electing Donald Trump, voters returned the Republican Party to majorities in both the House and the Senate. And with these majorities, GOP leaders feel a mandate to roll back much of what constitutes “entitlements” and “excessive regulations”.

Republicans favor less healthcare coverage, less Medicaid spending, and have proposed large changes to Medicaid and even Social Security. On the regulatory front, Republicans are pro-fossil fuels, less regulations on banking and industry, and anti-labor. How can this type of negative, past looking policies appeal to a majority of Americans regardless of which State they reside in?

As usual, there is another way to see life. Republicans claim that best government policy is that which is originated closest to the people (State and local levels). Therefore by definition, healthcare, tax levying, and regulations should be done at the lowest government level which is practical.  Since the governing process is complicated, this simple explanation has appeal. Hmmm.

Traditionally, two key Republican Party segments have been the wealthy and business/banking leadership. Not surprisingly, lower taxes, more fossil fuels, more dependence upon healthcare insurance companies, and anti-labor policies directly benefit these groups. But strangely Republican policies put far more regular people at risk. So, once again, how did American democracy elected a Republican majority and a President of questionable ability?

Hmmm.

  • Could there have been too many litmus issues? Like is a woman’s right to choose, or the protection of individual rights of other Americans regardless of sex, gender preference, or gender identity.  Are these considerations more important than healthcare, a progressive tax code, or reasonable controls (checks and balances) on banking and industry?
  • Could it be that many Americans choose to believe what their elected officials tell them and do not fact check their assertions?
  • Could it be that too many Americans want it all but do not want to do the hard work of paying for what they receive?

Democrats lost the 2016 election mainly because they could not, and would not tell the voter what the voter needed to hear. Democrats equivocated on the big issues and pander on the social issues.

And by the narrowest of majorities, Americans have gotten what democracy delivers, this time an incompetent President who harbors no agenda, a Congress with a shameful agenda currently split along serious fault lines but teetering on choosing the darkest options, presenting the average America with no reasonable outlook for good jobs, more discretionary income, or hopes for a secure future.

Democrats need to wake up. Rather than stand by and watch Republicans promise the moon and deliver dirt, Democrats need to tell voters what is realistic to expect and why Americans can expect a Democrat to deliver.  That was democracy’s message in the 2016 election.

End Game?

May 15, 2017

There seems to be much reporting and analysis these days concerning how President Trump will become ex-President Trump. For those who were neutral or opposed to his candidacy, the option of an ex-President Trump is tantalizingly attractive. For those who supported his candidacy, somewhat surprisingly over 90% of them still think the Trumpeter is performing well and meeting their expectations. So, why the talk of “ex-President Trump?

President Trump has given his supporters all they could hope for. Reverend Jerry Falwell said this weekend at Liberty University’s Graduation in Roanoke, Virginia that “President Trump is the real deal and unlike previous Republican Presidential candidates (Mitt Romney and John McCain), Trump has delivered” (or words to that effect). (Evangelicals may have an advantage versus the rest of the secular America since Evangelicals believe God is listening only to them.)

One must assume President Trump’s supporters believe there should be immigration and entry barriers for Muslims and see President Trump’s so far failed actions as heroic never the less. (I wonder whether these religious champions have thought about which religious group would be next after the Muslims, or if his Muslim bans becomes implemented, what should the Country do with current lawful Muslim residents and citizens?)

Evangelicals must also cheer when they read about the American Health Care Act which cuts healthcare for the neediest. (Sound like lover thy neighbor?). And I wonder whether evangelicals think about the future. After AHCA, can a re-do of Medicare, Medicaid, and Social Security be far behind?

The Trump proposed tax reform must echo sympathetically amongst their church’s pews. The potential of huge tax reductions for the wealthy (corporate or individual), again overlooking the poorest Americans, must inspire these evangelicals to lift their voices in songs of heavenly thanks.

Of course, evangelicals may be thinking that “god helps those who help themselves”, and surely there is every indication that President Trump, his family members, and his richest supporters are helping themselves and buy into this myth wholeheartedly.

If one is objective about the Trump Presidency, one must admit the President has shown no signs of adjusting his ways despite a hail of criticism and push back. If tweets do not work, then a campaign style rally might. Or, a threat against this person or organization followed by a slam against a foreign country (friend or not) serves to distract the 7/24 news cycle as well as most citizens.

Environmental policy is under attack. Let’s have more oil wells, pipe lines, and even coal fields.  The Justice system has signaled it will be blind to individual liberties (especially voting rights) and instead focus on refilling out Federal prisons. Labor, Education, and HHS are all headed by individuals who are on record of opposing those departments’ previous policy direction. Hmmm.

And let us not forget that the overriding factors that got President Trump elected were two myths, (1) the US economy was flagging, and (2) only President Trump could make it great again.

Both of these myths were and are completely false. With the President’s rants over trade, his stress of keeping American manufacturing jobs in America with one hand and his destruction of jobs with budget and policy decisions with the other, there is more than a reasonable chance that the US economy will begin to slow and soon contract. If that happens, get ready for the wolves to come out.

Today the dark money sources (read Jane Mayer’s Dark Money), conservative and libertarian hedge funds and business owners (plus a lot of wealthy individuals with inherited money) support or at least have welcomed President Trump. These enormously selfish and self centered Americans will turn on a dime if President Trump is unable to provide them the tax reform he has promised and will seek his ouster if the economy fails in such a way as to shrink their personal wealth.

So, back to end game. President Trump is building a public record replete with words, actions, and deeds worthy of supporting impeachment. And, if not impeachment, then not reelections. And if not reelections, then may be not even re-nomination.

Americans, however, need to understand that a President Pence will not change President Trump’s policies. In many regards Pence represents a greater threat than President Trump. Vice President Pence will avoid any public statements if possible which are not fully vetted.  (Pence’s alibiing for Trump’s firing of James Comes is an exception.)   Remember, cutting back on the environment, pushing tax cuts for the wealthy, marshaling aid for religious groups, opposing women’s rights, and suppressing the vote are all bread and butter policies currently supported by Vice President Pence as well as the “dark money” owned Republican party.

Americans must, for their own good, keep an eye on Trump/Republican policies.  Impeachment of President Trump and removing him from office while tempting won’t change the foul wind blowing in Washington.

Repudiation of President Trump by making him a one term President, on the other hand, is that best alternative. Only in cases of severe “malfeasance” should impeachment be considered, regardless of the smell or optics of President Trump’s behavior.  The end game must include the blunting of “dark money” and its stranglehold on the Republican Party.  President is a red herring and not the originator of these top 1% policies.

Death Spiral

May 9, 2017

A “go to” line through out Donald Trump’s campaign was to characterize the Affordable Care Act as caught in a death spiral. (House speaker Paul Ryan likes that line too.) The inference was that insurance companies were losing money and would need to raise rates so much that individuals could not afford to purchase coverage. At some point candidate Trump predicted insurance companies would simply stop participating and there would be no insurance available in the exchanges. Hmmm.

As normal for the course, Trump and other Republicans failed to mention that the GOP had consistently opposed any further government aide for insurers, as envisioned in ACA. Now, the use of “death spiral” is serving as a handy crutch to divert attention from the GOP House debacle, the American Health Care Act.

Over the weekend, several GOP Congress members tried to put a positive spin on the House AHCA by pointing out that Obamacare was about to fail (Death Spiral) and AHCA would come to the rescue. When listeners complained about the AHCA’s weakened “pre-existing condition” coverage and huge Medicaid funding reduction, GOP speakers reminded listeners that most Americans would not be in jeopardy of AHCA.

These Congress members said that most Americans had employer provided healthcare (group plans with no denials for pre-existing conditions), Medicare, and Medicaid.
While this is a true statement, I wonder what these Republicans really meant?

  • Does the GOP think Americans shouldn’t worry about the other 20-50 million without healthcare coverage?
  • Does the GOP think Americans are naive enough to overlook the possibility that even if employed today, in a recession or just normal course of business, they might be furloughed and suddenly have no healthcare insurance?
  • And what exactly does the GOP think are “pre-existing conditions”?

Libertarian GOP members are intellectually the most honest GOP faction. Libertarians reject government welfare in all forms and providing at tax payers expense healthcare insurance just doesn’t cut it with real libertarians. Then again, Social Security, Medicare, and Medicaid don’t make the Libertarian cut either. Hmmm.

The GOP is moving into dangerous voter territory. While not of their making, the continued, rise in healthcare costs (greater than the rate of inflation) will not suddenly change if Republicans prevail and pass the watered down AHCA.

The US healthcare delivery system is seriously flawed. EpiPens did not increase 400% in price due to the Affordable Care Act. Mylin’s decision to raise prices was a pure exercise of capitalism in the healthcare market. And Mylin’s actions are not an isolated exception. Almost all drug companies are driving up prices to see what the market will bare. And why is it one can buy the same prescription drugs substantially cheaper in Canada than in the US?

As frustration continues to mount, sooner or later, Americans are going to ask, “do other countries have this same cost problem?” Most Republicans know this, yet many Republicans continue to march further out on a limb, probably blinded by the tax cut appeal associated with the repeal of ACA.

ACA has opened Americans eyes to how precarious their insurance coverage is and how the widening income distribution inequity combined with rising healthcare premiums are putting the American dream further out of reach.

Will the current fight over ACA be a death spiral or a rebirth of hope for universal healthcare?