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“And Here We Go Again”: Republicans Are Really, Really Bad At Hostage Negotiations

For some time, I’ve been arguing that we should not just extend the debt ceiling but get rid of it altogether. It’s a weird historical anomaly that serves no practical purpose other than allowing the opposition party, should it be sufficiently reckless, to threaten global economic catastrophe if it doesn’t get its way. I assumed that your average Washington Democrat would share this view, but now I’m beginning to think that if you’re someone like Nancy Pelosi or Barack Obama, the debt ceiling is actually quite helpful, and you’d be sorry to see it go.

Because here’s what keeps happening: The debt ceiling approaches. Republicans begin making threats to torpedo the country’s economy by not raising it, and thereby sending the United States government into default, if their demands aren’t met. We then have a couple of weeks of debate, disagreement, and hand-wringing. Republican infighting grows more intense, and their reputation as a bunch of radicals who are willing to burn down the country to serve their extreme ideology is reinforced. At the end of it, the Republicans cave, the ceiling is raised for some period, and we do it all again in a few months.

And here we go again. The debt ceiling is going to have to be raised in the next month or so. Since the deficit is now at its lowest point since Barack Obama took office, it’s hard for Republicans to say that slashing the budget is so urgent that it justifies threatening to send America off an economic cliff. So what will they demand as their price for assenting to a debt ceiling increase? The answer is…they can’t decide. Yesterday, the House leadership proposed that they demand either a repeal of the “risk corridor” provision in the Affordable Care Act, which protects against a “death spiral” in the individual insurance market (here’s a good explainer on that), or approval of the Keystone pipeline. As Jonathan Chait pointed out, “Republicans have decided that one of these policy demands is so vital that they can insist its fulfillment justifies the threat of global economic calamity. They’re just not sure yet which one.” But it turned out that they couldn’t even unite around one of those two things, and that proposal of the leadership’s is now dead.

So here’s where we are. The Republican position is that something or other, let’s call it the Policy Change To Be Named Later, is so urgent, so pressing, so essential to the future of this great nation that if they don’t get it, whatever it turns out to be, they will force the government into default. And as soon as they figure out what the PCTBNL is, they’ll let us know.

Meanwhile, the Democrats’ position is simple: the debt ceiling needs to be raised, without conditions. Period. And that’s just what’s going to happen. There’ll be some hemming and hawing between now and then, but Democrats are going to win this, and Republicans are going to lose, and look like fools. Given that, if you were Barack Obama, wouldn’t you be perfectly happy to go through this routine a few more times?


By: Paul Waldman, Contributing Editor, The American Prospect, February 5, 2014

February 7, 2014 Posted by | Debt Ceiling, Republicans | , , , , , , , | Leave a comment

“How To Stop Heroin Deaths”: Up To 85 Percent Of Users Overdose In The Presence Of Others

Philip Seymour Hoffman who died of an apparent heroin overdose on Sunday, was just one of hundreds of New Yorkers who fall victim to this drug each year. Heroin-related deaths increased 84 percent from 2010 to 2012 in New York City and occur at a higher rate — 52 percent — than overdose deaths involving any other substance.

I am an emergency physician at NYU Langone Medical Center and Bellevue Hospital, but I rarely see victims die of heroin overdose because most fatalities occur before patients get to the hospital. Overdoses often take place over one to three hours. People just slowly stop breathing; often they are assumed to be sleeping deeply, or they are alone.

The most frustrating part is that each of these deaths is preventable, because there is an antidote to heroin overdose that is nearly universally effective. Naloxone, an opioid antidote, is a simple compound that has been in clinical use for more than 30 years. It can be administered via needle or as a nasal spray, and it works by displacing heroin from its receptors in the brain and rapidly restoring the overdose victim to consciousness and normal breathing.

An analysis in the Annals of Internal Medicine last year suggested that up to 85 percent of users overdose in the presence of others. This provides an opportunity for friends, family and other non-health care providers to intervene. In New York State, it has been legal to distribute naloxone to ordinary citizens since 2006. But the distribution has to be done with medical supervision. Naloxone is purchased by the city and state health departments, which then distribute the antidote through hospitals, harm-reduction programs and other outlets at no cost to patients.

Some New York City hospitals are now distributing kits containing naloxone to users and their friends and families. For the past three years, the New York City Department of Homeless Services has administered naloxone in shelters. And a new pilot program on Staten Island — which has the highest rate of heroin overdose deaths in New York City — is supplying the antidote through the Police Department’s 120th Precinct there.

The city’s health department is conducting a large study following people who get naloxone to assess how frequently the antidote is used to reverse overdose. In 2012, the health department filed a public letter to the Food and Drug Administration recommending that the F.D.A. approve naloxone for over-the-counter use. The letter stated that more than 20,000 kits had been distributed in New York City. It also noted that more than 500 overdose reversals had been reported by civilians who had administered the antidote.

Some people might argue that the widespread distribution of a safe, effective and inexpensive antidote might actually encourage drug use. But that’s like suggesting that air bags and seatbelts encourage unsafe driving. Naloxone is a public-health method of intervening when a life is in the balance. Its distribution is endorsed by the American Medical Association.

A new bill that would make it easier for users to obtain naloxone was introduced in the New York State Legislature just last week, and on Tuesday it passed the State Senate Health Committee. It would increase access to the antidote by allowing doctors and nurses to write standing orders — prescriptions that can be used for anyone — and issue them to community-based drug treatment programs. The programs would then train people on the signs of overdose and provide them with the naloxone kits. This means that the programs would not have to have a doctor present to distribute the antidote, overcoming one major hurdle that impedes widespread distribution.

This bill empowers a community to protect itself and others. If the bill becomes law, it would be one step closer to making naloxone available over the counter — as it already is in Italy.

According to the Centers for Disease Control and Prevention, drug overdose is now the leading cause of injury-related fatalities in the United States, ahead of motor-vehicle collisions and firearms accidents. We make cars safer by having speed limits, seatbelts, crumple zones and D.W.I. laws. We make it harder to buy a firearm with background checks and waiting periods, and we teach gun safety and sometimes mandate trigger locks. We can make heroin safer, too, by supplying methadone or buprenorphine as medications to treat physical dependence, providing clean needles to help prevent the spread of hepatitis and H.I.V., and facilitating the wide availability of naloxone to counteract overdoses.

While Mr. Hoffman’s death was without a doubt a tragedy, it is also emblematic of a societal need to take action to prevent the hundreds of deaths that otherwise go largely unnoticed. We can’t control heroin — that’s the job of law enforcement — but we can make it safer.

By: Robert S, Hoffman, Emergency Physician, NYU Langone Medical Center and Bellevue Hospital; Director of the Division of Medical Toxicology at New York University School of Medicine, Op-Ed Contributor, The New York Times, February 6, 2014

February 7, 2014 Posted by | Public Health, Public Safety | , , , , , , , | 1 Comment

“Pitting The Poor Against The Other Poor”: America Should Treat All Poor People As Well As It Treats Poor Veterans

The message about American soldiers is almost always the same across partisan lines: They are hard-working, courageous, brave heroes, the essence of upstanding, wholesome, and industrious citizenry.

This picture may well be true. But there’s a troubling underbelly to this ideal: Our culture’s respect and admiration for the troops is matched in extremity by its disrespect for the poor.

The poor in this country are often described in polar opposite terms of those employed to exalt soldiers. The poor are takers, morally degenerate, lazy, and so welfare-addicted that they can’t even have life dreams and projects. In our depictions of soldiers and veterans, we construct paragons of virtue. In our depictions of the poor and downtrodden, we construct paragons of vice.

However, lurking behind this contrast is an uncomfortable reality: The two groups substantially overlap.

In 2011, nearly 1 in 7 of our country’s homeless were veterans, nearly 1 in 3 veterans between the ages 18 and 24 were unemployed, and veterans lived in 1 in 5 households poor enough to qualify for low-income heating assistance. Last year, nearly 1 million veterans were on food stamps, and many more doubtlessly received low-income transfer payments like the Earned Income Tax Credit, the kinds of transfers being pilloried by those who decry the “47 percent.”

The poor are often veterans, and veterans are often poor.

This fact occasionally puts conservative lawmakers and commentators who heap disdain on the poor in very tough spots. After all, how do you level rhetorical attacks on the poor and the programs that serve them without also attacking the poor veterans whom we lionize in their capacity as former soldiers?

One way conservatives deal with this tension is to just flatly exclude veterans from their welfare bashing. So for instance, when Senate Republicans sought an accounting of all of the means-tested benefits paid out by the federal government each year, they directed the Congressional Research Service to specifically exclude means-tested welfare programs for veterans. After all, if you are going to construct a list of programs that you intend to trash as wasteful, you can’t have it include means-tested veterans’ health care and means-tested veterans’ pensions. That would be far too disrespectful and intolerably dissonant with pro-troop messaging.

On the liberal side of the aisle, the existence of poor and economically suffering veterans presents a huge rhetorical opportunity, but one that the left constantly manages to bungle. Right now, big name Democrats talk about poor veterans in ways that tend to preserve the notion that they are particularly special. So for instance, when Cory Booker discussed the impact of cutting unemployment insurance on veterans, he emphasized that this was a special crime because “these men and women who fought for our country … are not lazy.” Instead of using this opportunity to defend the poor at large, we get special pleading based on the notion that poor and struggling veterans are somehow different from and more virtuous than the other program beneficiaries.

The more sensible move here, both on the merits and politically, is not to sequester poor veterans off into their own special category of poor people. Such hiving off only reinforces the toxic and illegitimate distinction we make between the deserving and undeserving poor. Instead of separating veterans out, they should be depicted as being very much like most people who find themselves in economic trouble.

The reason why veterans — people who in prior years proved themselves capable of adhering to extreme discipline and undertaking grueling amounts of difficult labor — wind up poor or unemployed is because poverty and unemployment are mainstream conditions that affect huge swaths of our population, not just some mythical class of degenerate scum. Four out of five Americans spend at least one year of their adult life in or near poverty, jobless, or reliant on welfare. Over half of American adults spend at least one year of their life in poverty and nearly 1 in 7 Americans report having been homeless at some point in their life.

As the the President’s Commission on Income Maintenance Programs pointed out in 1969, “our economic and social structure virtually guarantees poverty for millions of Americans. Unemployment and underemployment are basic facts of American life.”

It’s time to reform mainstream understanding of the poor. Ask yourself: If the exemplars of greatness in our society can fall into poverty and unemployment, then who else might be in those ranks alongside them?


By: Matt Bruenig, The Week, February 6, 2014

February 7, 2014 Posted by | Poverty, Veterans | , , , , , , , | Leave a comment

“Running Out Of Excuses”: Boehner’s ‘Trust’ Issues On Immigration

The odds of congressional success on immigration reform tend to swing wildly from one day to the next. Reform’s chances are either “likely” or a “long shot” depending on the latest quote, headline, hearing, poll, or rumor.

But this morning, the man who largely has the future of the policy in his hands made it sound as if immigration reform simply will not happen anytime soon.

House Speaker John Boehner said Thursday that House leaders cannot move immigration reform legislation until President Barack Obama restores “trust” among Republicans.

But the GOP leader did not say what rebuilding that trust might entail.

The Speaker told reporters, “There’s widespread doubt about whether this administration can be trusted to enforce our laws. And it’s going to be difficult to move any immigration legislation until that changes.”

Boehner added, “The president’s asking us to move one of the biggest bills of his presidency, and yet he’s shown very little willingness to work with us on the smallest of things.”

As a factual matter, some of this is just odd. Obama has generally shown overwhelming willingness to work with Congress on just about anything, large or small. There’s probably a reason Boehner didn’t mention any examples to bolster his argument.

But the real significance of the Speaker’s comments were their likely bearing on the immigration debate. As Boehner sees it, House Republicans aren’t confident that the Obama administration will enforce federal law, and as such, they don’t want to vote for reform. As the argument goes, even if Congress approves sweeping border-security measures intended to satisfy GOP lawmakers’ demands, Obama may simply blow off laws (or parts of laws) whenever it strikes his fancy.

Indeed, it’s not just Boehner making this argument. House Majority Leader Eric Cantor (R-Va.) and House Budget Committee Chairman Paul Ryan (R-Wis.) pushed the same case on the Sunday shows.

It’s a deeply flawed argument, though the motivation behind it is quite clear.

Note, if the argument sounds familiar, there’s a good reason – the “we can’t pass immigration reform because Obama’s an untrustworthy tyrant” tack first came up last summer. At the time, some congressional Republicans argued that a delay in the implementation of Affordable Care Act provisions was undeniable proof that “we have a president that picks and chooses the laws that he wants to obey and enforce. That makes him a ruler. He’s not a president, he’s a ruler.”

As we discussed at the time, the complaint isn’t persuasive. When it comes to the Affordable Care Act, the administration has some discretion in implementing various provisions. It’s not unusual and it’s not unique to health care. Plenty of parts of the Dodd/Frank financial-regulatory reform law were delayed, too. This has long been the norm, and using it as an excuse not to trust the entire executive branch on literally every issue is kind of silly.

As Brian Beutler wrote in July:

The administration isn’t unlawfully writing the employer mandate out of existence, just like it wouldn’t unlawfully refuse to send thousands of agents to the border if an immigration reform law required them to.

And because immigration reform will be a bipartisan law if it passes, Republicans in Congress will have less incentive to stand in the way if the implementation process reveals real problems with its drafting. Which means the administration won’t be left, as it is with the ACA, facing a suboptimal choice between implementing the law poorly or taking clunky administrative steps to smooth the process out.

So, if “we don’t trust Obama” is such a weak pretense for killing immigration reform, why are congressional Republicans so heavily invested in it? A few reasons, actually.

First, the GOP desperately hopes to convince the American mainstream that the president is an out-of-control, “lawless” radical. It’s not true – Obama’s actually a fairly moderate technocrat – but the manufactured narrative has become a convenient way for Republicans to raise money, rile up the base, and kill popular legislation.

Second, as a policy matter, it’s possible GOP lawmakers hope to use this excuse to tilt the policy playing field in their favor. As Greg Sargent noted on Monday, Republicans may very well insist that increased border security begin well in advance of any other part of immigration reform, insisting that it’s the only way for Obama to prove his “trustworthiness.” In other words, the legislation would give Republicans everything they want, with the understanding that other provisions could come later, once GOP lawmakers are satisfied the president isn’t a big liar.

And finally, let’s not lose sight of the blame game. Congressional Republicans, who have zero major legislative accomplishments since the 2010 midterms, are prepared to kill a popular, bipartisan immigration-reform effort that’s been endorsed by business leaders, labor leaders, economists, immigration advocates, and the faith community. If they refuse to pass legislation, as now appears likely, GOP leaders will need an extraordinary excuse to justify failure on this level.

According to Boehner, Cantor, and Ryan, that excuse effectively boils down to this: “Republicans don’t like Obama.” If they think that’ll work in persuading the public, they may want to consider a back-up plan.


By: Steve Benen, The Maddow Blog, February 6, 2014

February 7, 2014 Posted by | Immigration Reform, John Boehner | , , , , , , | Leave a comment

“Something To Celebrate”: Affordable Care Act Gives Workers Freedom, Republicans Enraged

Since I wrote about postal banking this morning, I’ve decided to continue the day’s shameless, lowest-common-denominator clickbaiting by talking about a new Congressional Budget Office report and the Affordable Care Act. Hang on to your hats.

With all the hype of a new Beyonce album, the CBO dropped its latest report on government finances and other related topics, which includes the news that the deficit has dropped to its lowest level since Barack Obama took office. This may prove inconvenient for Republicans still invested in fomenting deficit panic, but they’ll be helped by the fact that most Americans actually believe the deficit has gone up in the Obama years. According to a new poll from the Huffington Post, not only do 54 percent of people think so, but 85 percent (!) of Republicans think so.

In any case, the part of the CBO’s report that’s getting more attention is their projection that as a result of the ACA, the labor force will be reduced by 2 million in 2017, rising to 2.5 million in 2024. Unsurprisingly, Republicans rushed to the trumpets to shout that “Obamacare is going to cost 2.5 million jobs!!!” even though that’s not actually what the CBO said. Even news organizations who ought to know better made the mistake; earlier today, a headline at the Washington Post‘s web site read, “CBO: Health Law to Mean 2 Million Fewer Jobs” (it has since been corrected to read, “CBO: Health Law to Mean 2 Million Fewer Workers”).

The important thing to understand about the reduction in the labor force is that this is exactly what was supposed to happen. When you eliminate “job lock,” where people who’d like to leave their jobs can’t because if they do they won’t have health insurance, a certain number of people are going to take advantage of their newfound mobility. In some cases you might be able to construe it as a loss to the economy, say if a productive full-time worker cuts back to part time because she can. But in many cases it’s something to celebrate: an American exercising their freedom.

Imagine, for instance, a couple. The wife is a lawyer in private practice; the husband is an accountant at a large firm. Since she’s a cancer survivor, he has stayed at his job for the health insurance it provides, because if he didn’t they wouldn’t have been able to get coverage, what with her pre-existing condition. But now, he can make a different choice. And it happens that her business is doing pretty well, and he’d rather stay home with the kids and work on his novel than be an accountant. So he has the freedom to quit his job, and they can still get covered. When he does so, he’s no longer in the labor force. But that doesn’t mean there’s one fewer job in the economy. His firm will just hire someone else.

That isn’t to say there will be zero net loss to the economy; without his income, the couple will probably spend less. But their children may also grow up happier and more well-adjusted, and who knows, he might write the next great young-adult dystopian fight-to-the-death trilogy with the extra time he has between 9 and 3 every day. These are good things.

That’s just one kind of person who leaves the labor force because of the ACA; there will also be lots of people who leave jobs to start their own businesses, and some who decide to retire early because now they can. If people are making those decisions freely—just like people have the freedom to do in every other advanced economy in the world—it would be crazy to think of it as something to be lamented.


By: Paul Waldman, Contributing Editor, The American Prospect, February 4, 2014

February 7, 2014 Posted by | Affordable Care Act, Freedom, Republicans | , , , , , , , | Leave a comment

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