“An Undead Policy Idea”: Rand Paul Pulls Out His Dog-Eared Playbook
Sen. Rand Paul decamped in Detroit today to open a new GOP office (good luck with that), and while he was at it, pulled out his thin, dog-eared playbook of conservative urban policy ideas, as reported by Slate‘s Emma Roller:
Paul’s real mission in Detroit is his new plan to stimulate the bankrupt city’s economy. In a call with reporters Thursday, Paul announced a bill that he insists is not a stimulus. The gist: radically lower taxes for areas that have 1.5 times the national unemployment rate, or roughly 11 percent. As of August, unemployment in Wayne County was at 11.1 percent, and 17.7 percent in Detroit proper.
Yes, it’s “enterprise zones,” the crown jewel of 1980s-style Republican expressions of concern for urban areas, associated especially with HUD secretary and conservative warhorse Jack Kemp. As Roller notes, it hasn’t been a particularly successful idea:
Would insanely low corporate taxes convince Jeff Bezos to build Amazon’s next warehouse in some long-abandoned Detroit building? Would they even convince business owners in adjacent Macomb County—which has an only 9.5 percent unemployment rate—to venture into the city? Critics (as they are wont to be) are skeptical:
“Enterprise zones are not especially effective at increasing overall economic activity or raising incomes for the poor,” said Len Burman, director of the Urban-Brookings Tax Policy Center and a former Clinton administration official. “They just seem to move the locus of activity across the zone’s boundary — reducing activity outside the zone and increasing it inside.”
Burman might well know, because probably the most extensive application of the enterprise zone concept was actually as a small element of the Clinton administration’s “empowerment zone” initiative, which packaged federal grants with tax concessions in urban areas agreeing to undertake a comprehensive strategy for self-improvement. This was not one of my favorite Clinton policies (as I expressed once in a magazine op-ed that enraged the initiative’s majordomo, a guy named Andrew Cuomo), but it was a lot better than the original GOP model.
But here it is again, a truly undead policy idea.
Once when I was involved in rural development efforts in Georgia I wrote (for the private amusement of my colleagues at the state agency where I worked) a savage parody of enterprise zones by “proposing” that we offer poor counties the opportunity to legalize every kind of income-producing vice: prostitution, gambling, drugs, you name it. They’d be called “erogenous zones.” A quarter century later, enterprise zones haven’t become any less worthy of ridicule.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, December 5, 2013
“We Are All Fragile Beings”: Obamacare Saved My Family From Financial Ruin
House Speaker John Boehner and his tea party friends shut down the U.S. government because of people like me. I am the mother of an insurance hog, someone who could have blown through his lifetime limit of health coverage by the time he was 14. My son has managed to survive despite seemingly insurmountable challenges, and he wears his preexisting condition like a Super Bowl ring.
Mason, now 16, was probably born with his brain tumor. We discovered it six years ago. Biopsies showed a slow-growing mass, which was the good news. The bad news was that the tumor could not be removed because it had grown around essential structures in his brain. Under the care of some of the country’s finest specialists, Mason had frequent scans. There was little we could do between tests but hope for the best. Like other children his age, Mason played basketball, argued with his siblings and avoided cleaning his bedroom. He managed to undergo chemotherapy for eight months without getting too sick. He insisted on finding ways to laugh, saying things like: “I have brain cancer. What’s your problem?” It was an uneasy peace — until the tumor ruptured in December 2010, three years after his initial diagnosis, and Mason suffered a massive cerebral hemorrhage.
Mason spent most of eighth grade in the hospital. In the six months he was hospitalized, he spent 65 days in the pediatric intensive care unit. He underwent four brain surgeries. Halfway through his hospitalization, the Affordable Care Act was passed, alleviating lifetime limits on coverage and saving us from the financial abyss. Mason moved to a rehabilitation hospital where he was retaught the most basic skills — sitting up, eating and standing. We faithfully paid the premiums on the employer-sponsored plan through which our family is covered, along with the rest of our bills, thanking God and whoever else would listen for our good fortune to have coverage.
The biggest fear for families such as mine is that we will lose our health insurance and be rendered uninsurable because one of us has been sick. The Affordable Care Act does away with dreaded clauses barring preexisting conditions. It also enables us to keep Mason on our insurance until he is 26; then, he will be able to purchase his own coverage on an insurance exchange. At least, that was the plan until last Tuesday, when the government was shut down in protest of such excesses.
As far as the brain tumor goes, our family might have drawn the short straw. Maybe our story lacks a certain universal appeal. People might be thinking to themselves, “I’m so sorry that happened to you, but odds are it won’t happen to me.” I hope it doesn’t, really.
But having lived in hospitals with Mason for months, I have seen that bad things — accidents, freak illnesses — happen to smart, cautious and otherwise undeserving people. It’s one thing we all have in common. We are fragile beings. So what is wrong with allowing us to purchase a financial safety net? What’s so un-American about that?
If I could get John Boehner and Ted Cruz on a conference call, I would explain this to them. I would tell them that, while they were busy trying to derail the Affordable Care Act over the past two years, Mason has again learned to walk, talk, eat and shoot a three-point basket.
By: Janine Urbaniak Reid, a writer in the San Francisco Bay Area, is working on a memoir about her son’s diagnosis; October 9, 2013; Published in The Washington Post Opinions Section, December 4, 2013
“The Last People We Should Take At Their Word”: In Shocking Development, Health Insurance Companies Still Suck
The Affordable Care Act was designed to solve the big problem of health security—namely that nobody in America had it—and find a way to get coverage for the 50 million Americans who were uninsured. It also attempted to address lots of other problems, and this week it’s a good time to remind ourselves that many of its provisions came about because, to put it bluntly, health-insurance companies are despicable scum who will literally kill people (more on this below) if it makes them more money. I bring this up because now, people in the news media are learning about a scam insurance companies are trying to pull on some of their customers, and are not only not portraying it as such, but are simply taking the insurance companies’ word and blaming the whole thing on the Obama administration.
I realize that part about “despicable scum” is a little intemperate, and without question there are employees of the insurers who are good people. But as a whole, outside of the tobacco companies or gun manufacturers it’s hard to find an industry that so frequently destroys people’s lives when they’re at their most vulnerable and fools so many people into thinking they’re safe when they aren’t. Because of the shocking behavior insurance companies are capable of, the ACA had a number of provisions meant to rein in the companies from their most horrific abuses. It made lifetime caps on coverage illegal, meaning that people with the worst illnesses and accidents won’t go bankrupt because their insurance companies abandon them. It outlawed denials for pre-existing conditions. It banned “rescission”—remember that one? That’s when you get the worst news of your life, for instance that you have cancer, and the insurance company swings into action. They start poring over every document you’ve ever signed to see if they can come up with a reason to kick you off your coverage and avoid paying for that expensive treatment. Like the woman who got a cancer diagnosis and was scheduled for a double mastectomy, then got booted from her policy because her insurance company’s diligent efforts unearthed that she had forgotten to tell them she had once been treated for acne, which allowed them to claim that her original application for insurance was fraudulent and therefore they could rescind her whole policy.
That’s what I mean when I talk about them literally killing people. If someone has a life-threatening illness and will die without treatment, and then the insurance company to which they’ve been dutifully paying premiums decides to say “screw you” and make it impossible for them to get treated, then that’s an accurate way to describe it.
And as you’ve heard, these very same companies are now sending letters to thousands of their customers, telling them that the policies they’re on (which in many cases are junk insurance that covers virtually nothing) are being cancelled, and they’ll now have to pay hundreds of dollars more every month. Those customers are naturally aghast. And reporters are running to find them and air stories about the horrible “rate shock” Obamacare is producing. What those reporters aren’t doing is asking what you’d think would be relevant questions, particularly since it’s health insurance companies we’re talking about. Questions like: Is this letter accurate? Is there something the insurance company isn’t telling this customer? Might they be trying to pull a fast one, to maximize their profits at this person’s expense?
Even though it was only last week, I think I was among the first to raise the possibility that these cancellation letters are a scam, and now it’s looking more and more like that is indeed the case. One after another of the people who have been featured on breathless news stories about insurance cancellations turns out to have much better options on the new health insurance exchanges, in many cases for better coverage at lower prices than they’re paying now. The letters appear to be an effort to lock customers into high-priced policies before they discover that they have other options available to them. But we aren’t finding out about that from the big media outlets, who just prefer to run the same credulous story over and over about the 60-year-old Florida woman with a $54 a month joke of an insurance plan whose insurance company is trying to sell her a plan for many times as much.
This whole thing should serve as a reminder that while the ACA tried to create a regulatory framework that would curb the worst abuses of the insurance industry, the whole thing was also engineered to maintain the position and profits of that very industry. And if you think they suddenly decided to value their customers’ physical and financial health over their own profits, you’ve got another thing coming.
While we’re on the topic, Brian Beutler gives us something else to think about:
Let this be a reminder to the Democrats on Capitol Hill and in the White House who killed the public option. It could’ve been designed as a default plan for cancelees. And its very existence would have imposed discipline on the system — if everyone knew they can enroll in a plan modeled on Medicare, insurers would be less inclined to swindle their customers. Ironically, but predictably, the Democrats who will face the greatest political consequences of the turbulent final throes of the old individual market are in many cases the ones responsible for leaving it in the hands of for-profit insurers. But there’s plenty of blame to go around here, including to reporters treating missives from health insurance companies as reliable testimony.
You’ll remember the absolute horror with which Republicans greeted the possibility of a public option being included in the law. They were terrified that if Americans were allowed to choose to enter a Medicare-like program, lots of them would do it, and the insurance companies would lose customers. This was a perfectly legitimate fear; if Medicare is any indication, a public option would have likely been less expensive than private insurance and produced happy customers, and every person who chose to get their insurance from it would represent a rejection of conservative ideology. President Obama claimed he favored the inclusion of a public option, but never displayed any enthusiasm for it and seemed eager to drop it as one of the many failed gestures intended to win the Republican support that never materialized.
That may be a topic to revisit on another day. But if there’s any rule that reporters should follow when reporting on the rollout of the ACA, it’s this: Don’t take insurance companies at their word. They’ve already shown us who they are, and there’s no reason to think they’ve changed.
By: Paul Waldman, Contributing Editor, The American Prospect, November 5, 2013
“The Right’s Sickest Obamacare Lie Yet”: Republicans Believe People Who Live In Flat Places Shouldn’t Have To Buy Cars With Brakes
During Congressional hearings with Health and Human Services Secretary Kathleen Sebelius, Congresswoman Marsha Blackburn (R-Tenn.) made an interesting argument that some Americans don’t want quality health insurance. “Some people like to drive a Ford and not a Ferrari,” Blackburn asserted. But that begs the question: What kind of Ford?
As early as 1972, there were reports that when a Ford Pinto was involved in a low-speed collision, the car would spontaneously burst into flames. According to a 1977 investigation by Mother Jones magazine, Ford was aware of the problem — resulting from a flaw in the gas tank design — but instead of paying to recall and redesign the car, Ford decided it would be cheaper to pay for the lawsuits. Ultimately, at least 27 people and as many as 180 people died as a result of Pinto fires. But it took the government forcing Ford to recall the Pinto for the problem to actually be solved.
In 2009, millions of Americans lacked any health insurance whatsoever and millions more had private health insurance metaphorically designed to explode at the hint of any serious illness or pre-existing conditions or exorbitant medical costs. So, in 2009, 14,000 Americans were losing their health insurance every single day. And medical bills were prompting more than 60% of all bankruptcies in our nation. In other words, many health insurance policies were patently dangerous and unsafe.
Now, Congresswoman Blackburn and her ilk might argue that people should have been free to buy the Pinto if they wanted, without government intrusion into personal choices or private business practice — just like they seem to want to argue that Americans should be free to hold onto their inadequate, costly and reckless insurance policies that throw them off at the slightest sign of illness while forcing costs up for the rest of us. But arguably most Americans want to buy cars that are safe. Auto companies didn’t want to install seat belts and airbags, just like Ford didn’t want to fix the Pinto. That was government regulation at work, making us all more safe — even if, in some cases, it made cars more expensive. We ultimately save, in every way imaginable, when the number of traffic deaths are dramatically cut.
This is, in effect, exactly what the Affordable Care Act does with respect to some currently existing, private insurance policies. If those policies don’t meet a new, higher bar of quality coverage, then the government will no longer allow insurance companies to sell them. Instead, the 5 percent of Americans who rely on the individual insurance market for their coverage will have other options, all that provide better quality coverage and many of which are far less expensive. Plus at least half of folks on the individual market will be eligible for subsidies that further bring costs down.
A great example comes from Deborah Cavallaro, who has been making the rounds on television complaining about her current insurance plan being cancelled. Cavallaro had not looked into her other, new options under Obamacare until a Los Angeles Times reporter called. Together, they looked at Cavallaro’s options — and found a “silver” plan for Cavallaro that would cost slightly more in her monthly premium but save her tons in terms of her annual deductible and out-of-pocket costs as well as doctor visit expenses. Plus, thanks to Obamacare, this plan would not be subject to the annual payment caps or pre-existing condition clauses that have been exploding in the faces of consumers for decades. After all, it’s important to remember that in 2009, most Americans were not very satisfied with their insurance plans. People wanted better options and now, thanks to Obamacare, they’ve got ‘em!
Congresswoman Blackburn and her cohort might fire back something about young healthy men being required to pay for good insurance plans that cover maternity — one of 10 basic coverage requirements mandated under the Affordable Care Act, this one designed to undo the history of insurance plans discriminating against women and families. Perhaps Republicans might also argue that Americans who live in really flat places should be able to buy cars without breaks. But that wouldn’t be safe for drivers or the rest of us. And in the case of health care reform in particular, the point here is to bring down costs and raise the quality of care for all of us. Those young, healthy men are going to grow up and have families one day — and then eventually become elderly — and will benefit from an insurance system that keeps costs manageable throughout and doesn’t kick off the elderly or infirm. Just like we all benefit from seatbelts and airbags, even if we never get in an accident.
Nobody is forcing anyone to buy a Ferrari plan in the individual health insurance exchange. At least 6.4 million Americans will pay less than $100 per month for coverage in the Obamacare exchanges — which means there are plenty of Ford’s available. What the Affordable Care Act simply ensures is that those policies will be safe and reliable — and not catch fire when we least expect it.
By: Sally Kohn, Salon, October 31, 2013
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