“We Invent, Experiment, And Fix What Has To Be Fixed”: Why You Shouldn’t Succumb To Defeatism About The Affordable Care Act
Whatever happened to American can-do optimism? Even before the Affordable Care Act covers its first beneficiary, the nattering nabobs of negativism are out in full force.
“Tens of millions more Americans will lose their coverage and find that new ObamaCare plans have higher premiums, larger deductibles, and fewer doctors,” predicts Republican operative Karl Rove. “Enrollment numbers will be smaller than projected and budget outlays will be higher.”
Rove is joined by a chorus of conservative Cassandra’s, from Fox News to the editorial pages of the Wall Street Journal, all warning that the new law will be a disaster.
Robert Laszewski, president of Health Policy and Strategy Associates, anticipates a shortage of doctors. “There just aren’t going to be enough of them.”
Professor John Cochrane of the University of Chicago predicts the individual mandate will “unravel” when “we see how sick the people are who signed up on exchanges, and if our government really is going to penalize voters for not buying health insurance.”
The round-the-clock nay-saying is having an effect. Support for the law has plummeted to 35 percent of those questioned in a recent CNN poll, a 5-point drop in less than a month. Sixty-two percent now say they oppose the law, up four points from November.
Even liberal-leaning commentators are openly worrying. On ABC’s “This Week,” Cokie Roberts responded to my view that the law eventually would prove popular by warning of “a whole other wave of reaction against it” if employers start dropping their insurance.
Some congressional Democrats are getting cold feet. West Virginia Senator Joe Manchin recently fretted that “if it’s so much more expensive than what we anticipated and if the coverage is not as good as what we had, you’ve got a complete meltdown.”
Get a grip.
If the past is any guide, some fixes will probably be necessary – but so what? Our current healthcare system is the real disaster — the most expensive and least effective among all developed countries, according Bloomberg’s recent ranking. We’d be collectively insane if we didn’t try to overhaul it.
But we won’t get it perfect immediately. What needs fixing can be fixed. And over time we can learn how to do it better.
If enrollments are lower than anticipated, the proper response is to keep at it until larger numbers are enrolled. CHIP, the Children’s Health Insurance Program, got off to a slow start in 1998. The Congressional Research Service reported “general disappointment … with low enrollment rates early in the program.” CHIP didn’t reach its target level of enrollment for five years. Now it enrolls nearly ninety percent of all eligible children.
Richard Nixon’s Supplemental Security Income program of 1974 – designed to standardize welfare benefits to the poor — was widely scorned at the time, and many states were reluctant to sign up. Even two years after its launch, only about half of eligible recipients had enrolled. Today, more than 8 million Americans are covered.
If mistakes are made implementing the Affordable Care Act, the appropriate response is to fix them. When George W. Bush’s Medicare Part D drug benefit was launched, large numbers of low-income seniors had to be switched from Medicaid. Many needed their prescriptions filled before the switch had been completed, causing loud complaints. The website for the plan initially malfunctioned. Pharmacies got the wrong information. Other complications led even Republican Representative John Boehner to call it “horrendous.” But the transition was managed, and Medicare Part D is now a firm fixture in the Medicare firmament.
If young people don’t sign up for the Affordable Care Act in sufficient numbers and costs rise too fast, other ways can be found to encourage their enrollment and control costs. If there aren’t enough doctors initially, medical staffs can be utilized more efficiently. If employers begin to drop their own insurance, incentives can be altered so they don’t.
Why be defeatist before we begin? Even Social Security — the most popular of all government programs — had problems when it was launched in 1935. A full year later, Alf Landon, the Republican presidential candidate, called it “a fraud on the workingman.” Former President Herbert Hoover said it would imprison the elderly in the equivalent of “a national zoo.” Americans were slow to sign up. Not until the 1970s did Social Security cover most working-age Americans.
As Alexis de Tocqueville recognized as early as the 1830s, what distinguishes America is our pragmatism, resilience, and optimism. We invent, experiment, and fix what has to be fixed.
Of course there will be problems implementing the Affordable Care Act. But if we’re determined to create a system that’s cheaper and more effective at keeping Americans healthy than the one we have now – and, in truth, we have no choice – we have every chance of succeeding.
By: Robert Reich, The Robert Reich Blog, December 27, 2013
“Please Proceed, Republicans”: With No Regard For Facts, Do They Have The Capacity For Shame?
Well, lookee here:
Months of investigation by The New York Times, centered on extensive interviews with Libyans in Benghazi who had direct knowledge of the attack there and its context, turned up no evidence that Al Qaeda or other international terrorist groups had any role in the assault. The attack was led, instead, by fighters who had benefited directly from NATO’s extensive air power and logistics support during the uprising against Colonel Qaddafi. And contrary to claims by some members of Congress, it was fueled in large part by anger at an American-made video denigrating Islam.
Let’s go back to that infamous appearance that Susan Rice made on Meet the Press the Sunday following the Benghazi attacks:
DAVID GREGORY: The images as you well know are jarring to Americans watching all of this play out this week, and we’ll share the map of all of this turmoil with our viewers to show the scale of it across not just the Arab world, but the entire Islamic world and flashpoints as well. In Egypt, of course, the protests outside the U.S. embassy there that Egyptian officials were slow to put down. This weekend in Pakistan, protests as well there. More anti-American rage. Also protests against the drone strikes. In Yemen, you also had arrests and some deaths outside of our U.S. embassy there. How much longer can Americans expect to see these troubling images and these protests go forward?
MS. RICE: Well, David, we can’t predict with any certainty. But let’s remember what has transpired over the last several days. This is a response to a hateful and offensive video that was widely disseminated throughout the Arab and Muslim world. Obviously, our view is that there is absolutely no excuse for violence and that– what has happened is condemnable, but this is a– a spontaneous reaction to a video, and it’s not dissimilar but, perhaps, on a slightly larger scale than what we have seen in the past with The Satanic Verses with the cartoons of the Prophet Muhammad. Now, the United States has made very clear and the president has been very plain that our top priority is the protection of American personnel in our facilities and bringing to justice those who…
GREGORY: All right.
MS. RICE: …attacked our facility in Benghazi.
I seem to recall that Ms. Rice received some criticism for those remarks. Yet, the New York Times reports:
Benghazi was not infiltrated by Al Qaeda, but nonetheless contained grave local threats to American interests. The attack does not appear to have been meticulously planned, but neither was it spontaneous or without warning signs…
…There is no doubt that anger over the video motivated many attackers. A Libyan journalist working for The New York Times was blocked from entering by the sentries outside, and he learned of the film from the fighters who stopped him. Other Libyan witnesses, too, said they received lectures from the attackers about the evil of the film and the virtue of defending the prophet.
So, to recap, the attacks in Benghazi were not carried out by al-Qaeda, were not meticulously planned, and the motivation to participate in them was largely “a spontaneous reaction to a video.”
It appears that Ms. Rice’s comments weren’t all that far off the mark.
The lack of an al-Qaeda role is particularly damaging to the Republicans because their main conspiracy theory all along has been that the administration blamed the whole thing on the Innocence of Muslims movie to deflect from the fact that they had not eradicated the terrorist organization by eliminating their leader, Usama bin-Laden. Supposedly, the real problem in Benghazi wasn’t insufficient security but the actual identity of the attackers.
But it wasn’t the administration that politicized the tragedy. It was Mitt Romney and the Republican Party, behind in the polls and smelling blood, that tried everything they could think of to gain an advantage.
I wonder if they have the capacity for shame.
By: Martin Longman, Washington Monthly Political Animal, December 28, 2013
“Paul Ryan Lectures The Pope”: After All, “The Guy” Is From Argentina And Doesn’t Understand Capitalism
When 1.3 million Americans lose their unemployment benefits on Saturday, they can thank Rep. Paul Ryan. He took the lead in negotiating a bipartisan budget deal with Democratic Sen. Patty Murray, and on behalf of his party, held the line against continuing extended unemployment benefits for the long-term jobless.
Sure, a lot of Republicans share blame with Ryan. But he deserves extra-special (negative) credit for the deal, because he has lately had the audacity to depict himself as the new face of “compassionate conservatism,” insisting Republicans must pay attention to the problems of the poor. Friends say the man who once worshipped Ayn Rand now takes Pope Francis as his moral role model. Except he can’t help treating his new role model with arrogance and contempt.
It’s true that while knuckle-draggers like Rush Limbaugh attack the pope as a Marxist, Ryan has praised him, which I guess takes a tiny bit of courage since normally Republicans don’t like to buck the leader of their party. “What I love about the pope is he is triggering the exact kind of dialogue we ought to be having,” Ryan told the Milwaukee Journal-Sentinel. “People need to get involved in their communities to make a difference, to fix problems soul to soul.”
But he couldn’t suppress either his right-wing politics or his supreme capacity for condescension for very long. “The guy is from Argentina, they haven’t had real capitalism in Argentina,” Ryan said (referring to the pope as “the guy” is a nice folksy touch.) “They have crony capitalism in Argentina. They don’t have a true free enterprise system.”
Beltway journalists would have us believe Ryan’s love for the guy from Argentina is triggering genuine new interest in helping the poor. “My bet is that he’s on Pope Francis’ team,” a former Romney-Ryan advisor told BuzzFeed’s McKay Coppins, for a worshipful Ryan profile headlined “Paul Ryan finds God.”
I admit, I have been immune to Ryan’s various efforts to brand himself as a bright and innovative Republican over the years – and I continue to be. Let’s recall: The guy who impressed Ezra Klein as a serious albeit deficit-obsessed budget wonk turned out to be terrible at math – his heralded “Roadmap,” the Ryan budget, busted out the deficit for years and didn’t balance the budget until 2040, thanks to its generous tax cuts for the wealthy and corporations.
Now we’re supposed to believe Ryan is going to deliver an anti-poverty agenda as soon as the spring. “This is my next ‘Roadmap,’” Ryan told an aide, according to Coppins. “I want to figure out a way for conservatives to come up with solutions to poverty. I have to do this.”
Excuse me if I remain a skeptic. Ryan’s prescription for the poor is, and always has been, a dose of discipline. Even in 2010, with unemployment in his own district hovering around 12 percent, he voted against extending unemployment benefits on the grounds that they’d increase the deficit – and then reversed himself when they were coupled with an extension of Bush tax cuts, which of course added far more to the deficit than extended benefits.
Ryan has always defended his stinginess on safety net issues as tough love for the poor, giving them “incentives” to take a job, any job, to support their families.
“We have an incentive-based system where people want to get up and make the most of their lives, for themselves and their kids,” he says. “We don’t want to turn this safety net into a hammock that ends up lulling people in their lives into dependency and complacency. That’s the big debate we’re having right now.”
I don’t think Pope Francis would call our threadbare safety net a hammock.
Today, Ryan’s guide on the road to a GOP poverty agenda is the same man who has guided generations of Republicans into political self-congratulation and little else: Bob Woodson, a conservative proponent of what used to be touted as “black capitalism.” Now 75, Woodson runs the Center for Neighborhood Enterprise, and he helped inspire the dead-end “enterprise zone” movement beloved by some Republicans back in the 1980s and ’90s. Enterprise zones, which lowered taxes and created other incentives for businesses to invest and hire in low-income neighborhoods, were championed by the late Rep. Jack Kemp, who is one of Ryan’s political mentors. They have repeatedly been found to have “negligible” effects on employment, earnings and business creation in urban neighborhoods.
But Woodson apparently finds Ryan a one-man enterprise zone for restoring his national profile. (He last made headlines for attacking African-American Democrats at the GOP’s 50th anniversary of the March on Washington commemoration, insisting they let black issues languish while gays and immigrants became priorities.) Woodson is the star of Coppins’s Ryan piece, vouching for the Republican’s “authenticity” on poverty issues.
“The criminal lifestyle makes you very discerning, and everywhere I’ve taken Paul, these very discerning people have given me a thumbs up,” Woodson told Coppins. “You can’t lip synch authenticity around people like that.”
But when asked what Ryan has done tangibly for the poor, the Republican came up with one word: neckties. Apparently, according to Woodson, Ryan sent neckties to a classroom of teenagers after one admired his while he was visiting. So where conservatives used to preach that the poor should lift themselves up by their bootstraps, their new anti-poverty agenda involves neckties.
In the spirit of the holiday season, I have to admit there’s something a little bit touching about Ryan’s insistence that the GOP needs an anti-poverty agenda. Honestly, Jack Kemp would be a welcome addition to the modern Republican Party, which prefers to demonize the poor rather than empathize.
But forgive me if I can’t entirely believe in Paul Ryan’s “authenticity” on these issues. A guy so prideful that he thinks he can lecture the pope about capitalism doesn’t strike me as capable of the humility required to rethink his political beliefs. I have no doubt Pope Francis would support extended unemployment benefits, and a host of other policies to make life easier for poor people and help them find genuine opportunity. I don’t think he’d be satisfied with sending them neckties.
By: Joan Walsh, Editor at Large, Salon, December 28, 2013
“No Fools On Our Ticket”: A Battle Between The GOP Outsiders And Insiders
Just over the last few months, we’ve seen reports from the New York Times, Bloomberg News, and the Washington Post on the simmering tensions between Corporate America and Tea Party Republicans, driving a wedge into the GOP coalition. With party primaries looming, talk of a “Republican civil war” abounds.
Some of the party’s major players are even putting their money where their mouths are. This Wall Street Journal piece yesterday was circulated far and wide in Republican circles.
Republican leaders and their corporate allies have launched an array of efforts aimed at diminishing the clout of the party’s most conservative activists and promoting legislation instead of confrontation next year. […]
The U.S. Chamber of Commerce early next year plans to roll out an aggressive effort – expected to cost at least $50 million – to support establishment, business-friendly candidates in primaries and the general election, with an aim of trying to win a Republican Senate majority.
“Our No. 1 focus is to make sure, when it comes to the Senate, that we have no loser candidates,” said the business group’s top political strategist, Scott Reed. “That will be our mantra: No fools on our ticket.”
Though Reed did not specify who would qualify as a “fool,” it’s not hard to look back at major Senate races from the last couple of cycles and know exactly the kind of candidates he’s referencing (O’Donnell, Akin, Mourdock, Angle, et al). In other words, when Reed and the Republican Party’s Chamber of Commerce wing talk about “loser candidates” and “fools,” they’re obviously talking about right-wing Tea Party favorites.
Also note, there’s been ample analysis this year noting that Corporate America may want to overcome extremist candidates in GOP primaries, but if this wing of the party doesn’t commit real resources, Tea Partiers will prevail. It’s worth acknowledging, then, that $50 million in support of establishment candidates is a considerable sum.
But as word of the Chamber’s intentions spread, the backlash soon followed. “Special interests in Washington will do whatever it takes to protect big government Republicans,” Senate Conservatives Fund Executive Director Matt Hoskins told TPM yesterday. “Their ability to get future bailouts, kickbacks, and other favors depends on it.”
Club for Growth senior fellow Tom Borrelli added, “This is a battle between the outsiders and insiders and insiders include big bucks and establishment Republicans.”
Remember, primary season hasn’t really begun in earnest, which means these disputes are likely to intensify very soon. For many Democrats, hoping to see Republicans at each other’s throats during an election year, the popcorn is already being popped.
By: Steve Benen, The Maddow Blog, December 27, 2013
“Sometimes Things Don’t Work Out As Planned”: UPS’s Christmas Screw Up Is Comeuppance For Private-Sector Triumphalists
At the heart of the great big pile-on of ridicule for the flawed healthcare.gov rollout the past few months was a large helping of private-sector triumphalism. Just imagine, the chorus went, if tech giants like Amazon or Google had been in charge of the Web site instead of those clueless, fusty bureaucrats – first, the problems would not have happened in the first place, but even if they had, the private sector would have held those responsible for the mistakes to account.
Bret Stephens wrote an entire column in the Wall Street Journal listing all the ways that the kludgy healthcare.gov launch had failed to live up to Amazonian standards: “For an ‘Amazon-like’ experience, it isn’t enough to have a website that functions on the front end, the back end and in between. Nor is it enough to have a site that can handle 800,000 users a day without crashing, as the administration now boasts of the health site. Amazon.com handled 26.5 million purchases on Nov. 26, 2012, a company record and a rate of 306 items per second. You also need an Amazon-like culture, which is the product of other Amazon-like realities. Such as: Jeff Bezos as the boss, demanding results and innovation from his employees, providing results and satisfaction for his customers and shareholders.” California congresswoman Anne Eshoo, a Democrat, questioned the contractors’ excuse that the website’s problems had been exacerbated by the large number of visitors after the launch: “There are thousands of websites that handle concurrent volumes far larger than what HealthCare.gov was faced with,” she said. “Amazon and eBay don’t crash the week before Christmas, and ProFlowers doesn’t crash on Valentine’s Day.” And the Washington Examiner’s Philip Klein mocked healthcare.gov’s performance by noting that during the 2011 holiday shopping season, “nearly half of [large retail] websites (such as Amazon and eBay) were up 100 percent of the time. The lowest performing was Foot Locker, which was at 98.573 percent.” He added: “Imagine what a disaster it would be for sales if, during the holiday shopping season, Amazon’s website were down for about a day and a half.”
Yes, just imagine the disaster: the presents might not make it to people’s homes on time!
Oh, wait, what’s this I see in today’s papers?
A surge in online shopping this holiday season left stores breaking promises to deliver packages by Christmas, suggesting that retailers and shipping companies still haven’t fully figured out consumers’ buying patterns in the Internet era. Companies from Amazon.com Inc. to Kohl’s Corp. and Wal-Mart Stores Inc., having promised to deliver items before Dec. 25, missed some delivery target dates. United Parcel Service Inc. determined late Tuesday that it wouldn’t deliver some goods in time for Christmas, as a spike in last-minute shopping overwhelmed its system. “The volume of air packages in the UPS system did exceed capacity as demand was much greater than our forecast,” a UPS spokeswoman said…. Although weather, Web glitches and late deliveries from manufacturers played a part in late deliveries, the sheer unanticipated volume of holiday buying this year may have been the biggest problem, retail analysts said.
…In notifications to some Amazon customers, UPS said there were some shipping delays because it had “not yet received the package from the shipper.” “Amazon fulfillment centers processed and tendered customer orders to delivery carriers on time for holiday delivery,” said an Amazon spokeswoman Wednesday. “We are reviewing the performance of the delivery carriers.” The spokeswoman also said Amazon refunded any shipping charges associated with the impacted shipment and provided a $20 gift card. She declined to say how many customers had been impacted or offered such a rebate.
On Christmas Eve, Brandon Scott was still waiting for a 46-inch Samsung TV and Kate Spade watch he ordered from Amazon on Saturday. “I’m frustrated because these items could have easily been purchased at various retailers in my area, something I would have gladly done had Amazon not ‘guaranteed’ their arrival before Christmas,” said Mr. Scott, of Ann Arbor, Mich.
Well, then. There’s little schadenfreude to be had in people being left empty-handed of presents to give their family and friends, or in underpaid, overworked warehouse employees and drivers rushing unsuccessfully to get the goods to their destinations on time. And as my colleague Jonathan Cohn noted recently, the comparison between healthcare.gov and Amazon was deeply flawed from the outset. But still, the Great Christmas Delivery Screwup of 2013 should inject a bit of perspective and humility into the ranks of the loudest private-sector champions. The fact is, the clichés are true: life is complicated, stuff happens and sometimes things don’t work out as planned. As amazing and wonderful as technology is, there are still limits to what is possible in narrow windows of time – sometimes you just need a few more weeks to get the complex new health insurance Web site for 36 states working properly, or you just run out of hours to beat Santa to the house – to millions and millions of houses. (And sometimes it’s not just the government web site that struggles with keeping personal information secure, but also one of the largest retailers in the country, in a breach far wider and more potentially damaging than anything that has happened with healthcare.gov.)
So, how about it: if not an outright truce, maybe some de-escalation of the anti-government triumphalism. And a little forgiveness all around. Happy Boxing Day.
By: Alec MacGinnis, The New Republic, December 26, 2013
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