Archive for the ‘federal debt’ category

Heated Rhetoric

June 16, 2017

Following the baseball field shooting of Republican legislators, bi-partisan cries have gone out calling for an end to heated (often misguided and misinformed) rhetoric. “Enough”, cry some of the most practiced in the art of partisan politics. Does anyone really mean those words? Doubtful.

Why doubtful?

While those words calling for a return to civility were echoing through Congressional halls, Senate Republicans were huddling behind closed doors attempting to cobble together a healthcare plan which met the test of reducing healthcare coverage and still keeping a Republican majority to pass the bill. No public hearings, no open discussion, no Democrat input. Do you think that is bipartisan behavior?

Like climate change and the abdication of the Paris Agreement, or the pending “huge” tax cut for the wealthy, or the private sector infrastructure proposal designed to put money is special pockets, Republicans are stacking the deck with intentions favorable to a few, neutral to a few more, and dangerous to the many.

Criticism opposing legislation kept in secret is called heated rhetoric by some. One wonders why?

Special interests?

Our elected officials are called politicians for a reason. Congress members first must convince enough citizens in their districts to choose them over their opposition. Promises are usually part of the bargain and in that lies the seeds for the problems we see today.

Instead of advocating for rebuilding the infrastructure, it is preferred to call for tax cuts. Instead of warning about global warming and taken specific steps towards control, it is easier to question the science and play for time. Instead of calling for basic healthcare availability, it seems wiser to claim (falsely) that America is exceptional and has the world’s greatest healthcare system.

Heated rhetoric could be a “generation thing”. In other words, current public officials inherited a wealthy country have done little or nothing themselves to create national wealth. With no practical experience in what it takes to build a nation, it should not be a surprise that Congress members’ sphere of vision is simply themselves. The role of today is to survive and worry about the future tomorrow. Hmmm.

While there are plenty of examples to support this theory, there is also a more sinister hypothesis. Americans are people. People are by nature greedy. Politicians are people and therefore without adequate checks, are greedy too.

Share that realization with clever and also greedy wealthy citizens and in not too much time, politicians learn to promise one thing but do another (and what they do is what their financial backers want).

Heated rhetoric may simply be the natural end which occurs when politicians make one false claim after another, long enough. Explaining behavior which leads no where can only be done so long before citizens sense dishonesty or incompetence. Raising the tempo, going negative, and if necessary, using “dog whistles” of race, religious, or national origin helps mold the electorate into “we” and “them”. Hmmm.

IMO, Congress reflects middle and upper class American. Congress’ ineffectiveness and willingness to engage in “heated rhetoric” is what any of us would do if public life were our chosen field. Fortunately, most Americans do not seek public office and the power to change government lies in our hands.

Ask the simple question, “what is the problem awaiting a fix”?

The problem is not necessarily that the US is spending too much money as those who say “the Federal Government” is too large. Rather, if there is a problem, one must cite the problem first.

For example, Medicare is often cited as a major contributor to the growing federal debt. Why not collect more fees and taxes to eliminate the deficit? The problem, rather is not the spending amount, it is whether there a need for Medicare at all.

Once there is agreement on why some healthcare subsidy for those on fixed incomes is fair and warranted, then the discussion on how Medicare should be paid for should begin. The same applies to Medicaid, Social Security, and healthcare in general.

Each American can figure out whether the incumbent is interested in the problem or just some special interest outcome (like paying less in taxes). Term limits by voting the incumbent out of office is the fastest way to get Congress members’ attention and to begin to lessen this problem.

I bet, however, that “heated rhetoric” will rule the day until Americans use the ballot box to over come “dark money” and other special interests.

Free Market Health Care

June 11, 2017

When President Obama set in motion steps to expand healthcare coverage, in the wealthiest country in the world, for more Americans than ever before, he and his aides made a questionable decision to build the expansion around traditional healthcare insurance companies, like Aetna, Cigna, Anthem, etc. These cowardly chickens are now coming home to roost.

The Obama White House convinced the legacy healthcare insurers that their margins would be protected when they were presented with new enrollees who might not be able to pay for the entire premium. There would be government subsidies in other words.  That promise was enough to get the insurance companies loyalty.

With this promise (and recognition that there would be another 7 years with a President Obama), healthcare insurers signed on citing the importance of new customers and their dedication to improving Americans’ health.

When the Democrats lost control of Congress, the wheels soon began to come off the Affordable Care Act wagon. Republicans tried their best to outright repeal Obamacare and when not possible, the GOP tried to jeopardize the subsidy streams. Any uncertainties about rate coverage was enough to send healthcare insurer CEOs into orbit.

“Oh my, our shareholders simply won’t accept that”, these CEOs moaned.

In quieter moments, healthcare insurers raised rates and cited the “higher than expected” number of “sicker than average” enrollees. Imagine, these big name insurance companies were finding that previously uninsured Americans were devouring healthcare services at amounts greater than the average American?

After thought (and realization that not much more money was coming from the government), these insurance companies proposed a resolution. They would exit the market!

The Aetna’s of this world would no longer sell policies to exchanges and abandon the exchange market to someone else. So, unless the government renewed its pledge to provide adequate subsidies, these newly healthcare covered Americans would join the ranks of the uninsured again.

So much for these insurance companies’ concern about individual healthcare.

One might fantasize that a Government truly interested in its citizens’ healthcare might say to these companies that they might as well withdraw from the rest of the State’s health insurance business. Cheery picking is not in the publics best interest.

Should that hard ball tactic not convince the insurance company to stay, then employing the “public option” might win the day. Expanding Medicare (with its requirement for paying premiums) would be quick and easy to roll out. Insurance companies might then think carefully on whether they needed to become more efficient or face the creeping invasion of “single payer” insurance.

Republicans might jump up and say “how is the government going to fund the public option?  Of course the answer is through taxes combined with individual payments.  And if the Affordable Care Act is repealed or simple succumbs to the death spiral, how is the cost of the 25 million or so Americans without coverage to be covered?

How about taxes and higher doctor and hospital payments?  Which path seems more humane?  Oh, I forgot the Republicans want to cut taxes, not increase them.  Take a hike you 25 million soon to be without insurance Americans.

Hmmm.

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?

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.

Negotiating 101

March 18, 2017

In 1973, Robert J Ringer, wrote a book titled “Winning Through Intimidation”, a self help book describing ways to be more successful in the art of selling. For someone who approached business as a “tell it as it is, win-win” person, Ringer’s examples were eye opening. The picture Ringer painted of unsavory, but successful characters one would have to deal with in the business world was shocking. Why would anyone waste their time dealing with intimidators and not prefer honest brokers? Hmmm.

President Trump (and his senior advisors) are giving Americans a refresher “Winning Through Intimidation” course. For the Trump Administration, there appear to be no limits on veracity and no retreat from prima facia falsehoods. Yet, four of Trump’s favorite words are “believe me, it’s true”.

Trump’s budget proposal is a clear example of a 21st century negotiation using 1970’s tactics. (I have carefully avoided using the word “strategy” because at this point there are no indications of what the Trump Administration’s objectives and strategies might be.) Trump’s “Winning Through Intimidation” tactic opens with proposed draconian cuts in order to boost Defense and Homeland security spending.

For example, the President has proposed increasing the defense budget about 10%, and offsetting those costs by decreasing a host of Federal programs (including support for science, the arts, and poverty programs). Budget cuts are also to include 30% decreases to the State Department and EPA’s budgets. What is the President thinking?

The President must privately realize that the “mess” he inherited is not former President Obama’s mess. Congress, and more specifically the fundamental division among Republicans, has produced a deadlock and Congress is incapable of making budgetary decisions. The more conservative Republican elements seem ready to throw the baby out with the bath water if that would reduce the size of government.

Medicare and Medicaid make up the largest drivers in both size of government and the deficit components. Although, healthcare reforms similar to healthcare systems in two dozen other “best in class” foreign countries, where effort is put into cost control (doctors, hospitals, and drug companies), and where the waste associated with “for profit” insurance administrators is eliminated, could dramatically reduce healthcare costs, lower the size of government, and in the process secure the benefits of Medicare and Medicaid for years to come. Why no mention of these expenditures yet?

So, let’s speculate.

The President and his advisors want tax reform (read tax cuts for the wealthy) and want a second term. They connect both of these with more jobs and a growing economy. Unfortunately, more jobs (if ever possible) and growth will take time. What can the Trump White House do in the interim to keep his faithful supporters quiet? Hmmm.

Let’s make the EPA and other regulatory agencies the “bad guys”. Let’s debunk science and focus short term on job promises. Let’s emphasize “America First” in a world where an isolationist retreat will stall the economy (but most voters don’t understand that), and buy time.

Inconveniently for President Trump, Republicans have made a “do or die” issue out of repeal and replace Obamacare. President Trump and his advisors realize that a replacement is politically near impossible. They realize there is no way “replace” can happen (60 votes in Senate) with drastic cuts in healthcare benefits or increasing the national debt (which is politically toxic amongst most Republicans). Hmmm.

President Trump is cleverly drawing Republican leadership further out on the “replace” limb knowing that an option acceptable to moderates will be unacceptable to conservatives and vice versa. At some opportune time in the near future, President Trump will inform Republican Congressional leaders that he is about to cut them loose and walk away from their plan because it’s wrong for the people. Of course, Congress could support an Obama-Lite alternative, keep his support, and move onto tax reform which could garner enough support to pass (at the end of the day, all Congress members like to tell their constituents they voted for lower taxes).

President Trump will show Congress members how lower taxes will stimulate the economy and generate new tax revenue, even at lower marginal rates, thereby not increasing the debt. While factually this is extremely unlikely, too many voters will believe it to justify a Congress member taking the chance of going against the President. Hmmm.

“Winning Through Intimidation” will become a must read during the Trump Administration. The Republican Party is a misnomer and will eventually break apart. Unfortunately, during the next four years a lot of unwise actions could take place.

Keep your eyes open and double check what ever you hears. There is a new sheriff in town.

Ready, Set, Fire, Aim

January 16, 2017

With only a few days left before President-elect Trump becomes President Trump, the feeling is like the calm before the storm. On Friday, January 20th, 2017, the Republican Party gets a full house and a friendly President to boot. The GOP wish is to undo the last 8 years and make the future like the past, the distant past. The public has been advised “to fasten their seat belts” and watch our elected leaders make things happen beginning on the very first day.

Hmmm.

We can remove some mystery about any consequences from GOP actions. There will be massive reductions in taxes paid by the top 1%. Even the irresponsible repeal of Obamacare is at its core a tax cut for the wealthy.

Corporate tax rate reduction unless accompanied with elimination of business tax deductions, exemptions, and loopholes will accrue more money for the wealthy. And eliminating the myriad of regulations which we are told are hamstringing our economy, will put even more money in the wealthiest’s pockets.

So for at least some Americans, January 20th should be a red letter day.

Every action has a reaction too. Repeal of Obamacare will immediately beg the question what happens to those insured by the Affordable Care Act? The GOP will attempt to keep enough of current Obamacare recipients covered that they can look the camera in the eye and say, “see we replace Obamacare with patient centered, not Washington centered healthcare”.

But two facts will emerge. (1) The GOP will have to find money to cover whatever parts of the ACA it puts forward as “patient centered care” and will most likely hide their healthcare subsidies. With no new taxes, the healthcare costs will go straight to the national debt.  The GOP will adamantly deny this with a look of sincerity.

And, (2) The number of people covered will shrink as will the quality of their coverage.  The “free” market will offer reduced coverage to those unable to pay the going price for standard coverage. Those impacted the most will be the most vulnerable and, not surprisingly, those least able to garner public sympathy.

This is a pretty sad commentary on the Grand Old Party.

But there’s more.    IMO, Trump will support juicing the economy with tax cuts and government spending so that his prediction of greater economic growth can materialize. Trump, however, will run into opposition from fiscal conservatives who want to see the debt decreased, not increased. Trump, the deal maker, will step forward offering to trade his support for much of the GOP agenda, despite his own preferences, in return for support of new spending.  You scratch my back, I will scratch yours. Hmmm.

With “Ready, Set, Fire, Aim”, Republicans will run unnecessary risks. Unintended consequences and collateral damage are almost assured with current GOP plans. As the first 100 days domestic casualties begin to mount up, voters view of President Trump will become tarnished.  At that point, President Trump will make sure everyone knows he favored this or that, and instead those in Congress, much over rated, all talk and no action did not follow his advise and are to blame. Hmmm.

Most of the Republican game plan will hurt small groups… initially. For example, the 20 million ACA subscribers pale in comparison to the greater 340 million US population. Increasing the Federal Debt won’t impact anyone at first. The subsequent risk, however, is the building pressure to reduce other Government spending… like Medicare, Medicaid, Social Security, and a myriad of social safety network programs. And as these messy regulations are revoked, freeing up America’s great capitalist engine and creating jobs on every corner, conditions for another financial meltdown, run away inflation, and renewed disillusionment with Washington will gratuitously appear.

President Trump has an initial White House lease for 1461 days. It would be a shame for the Trump Administration to let hubris in the first 100 days help destroy the next 1361.