mykeystrokes.com

"Do or Do not. There is no try."

“Jeb Bush Pushes To ‘Phase Out’ Medicare”: Slow Learner’s? Ignorance? There’s Just ‘Something’ About Republican Politicians

Republican presidential hopeful Jeb Bush appeared at a New Hampshire event last night sponsored by the Koch brothers’ Americans for Prosperity, and the former governor raised a few eyebrows with his comments on the future of Medicare.

“The left needs to join the conversation, but they haven’t. I mean, when [Rep. Paul Ryan] came up with, one of his proposals as it relates to Medicare, the first thing I saw was a TV ad of a guy that looked just like Paul Ryan … that was pushing an elderly person off the cliff in a wheelchair. That’s their response.

“And I think we need to be vigilant about this and persuade people that our, when your volunteers go door to door, and they talk to people, people understand this. They know, and I think a lot of people recognize that we need to make sure we fulfill the commitment to people that have already received the benefits, that are receiving the benefits. But that we need to figure out a way to phase out this program for others and move to a new system that allows them to have something – because they’re not going to have anything.”

Remember, Jeb Bush is the ostensible moderate candidate in the massive GOP presidential field. It says something important about Republican politics in 2015 when the most mainstream candidate is also the candidate who wants to scrap Medicare altogether.

Regardless, there’s quite a bit wrong with his take on the issue, both as a matter of politics and policy. Let’s start with the former.

The Florida Republican is convinced that “people understand” the need to get rid of Medicare. He’s mistaken. Given the polling from the last several years, what people understand is that Medicare is a popular and successful program, and a pillar of modern American life.

Previous attempts to “phase out” the program have met with widespread public scorn and if Jeb Bush believes he can “persuade people” to get rid of Medicare, he’s likely to be disappointed.

As for the policy, there’s no point in denying that the Medicare system faces long-term fiscal challenges, but to argue, as Jeb Bush does, that Democrats have ignored the conversation is plainly incorrect. On the contrary, while Republicans fight to eliminate the Medicare program, Democrats have had great success in strengthening Medicare finances and extending its fiscal health for many years to come.

The secret, apparently, was passing the Affordable Care Act.

Before “Obamacare” was passed, Medicare was projected to face a serious fiscal shortfall in 2017. As of yesterday, Medicare trustees now believe the system is fiscally secure through 2030.

Kevin Drum noted the slowdown in costs, which is “spectacularly good news.”

Ten years ago, Medicare was a runaway freight train. Spending was projected to increase indefinitely, rising to 13 percent of GDP by 2080. This year, spending is projected to slow down around 2040, and reaches only 6 percent of GDP by 2090.

Six percent! That’s half what we thought a mere decade ago. If that isn’t spectacular, I don’t know what is.

Obviously, all of these projections come with caveats because no one can say with certainty what will happen in the future, but the projections are encouraging – and far more heartening than they were before the ACA passed.

But Jeb Bush is under the impression that Medicare is, without a doubt, doomed, so we might as well get rid of the program now and see what Paul Ryan has in store for seniors in his far-right bag of tricks.

There’s a better way. Medicare’s future is looking brighter, it’s as popular as ever, and its fiscal challenges can be addressed without tearing down the entire system. It’s a matter of political will – either elected policymakers will fight to protect Medicare or they’ll push to eliminate it.

 

By: Steve Benen, The Maddow Blog, July 21, 2015

March 24, 2015 Posted by | Conservatives, GOP Presidential Candidates, Jeb Bush, Medicare | , , , , | Leave a comment

“Completely Erroneous Impressions”: The Race Between Slander And Reality On Obamacare

Speaking of million pixel images, Sarah Kliff has an important piece at Vox today about perceptions of Obamacare five years in, and the big takeaway is how little has changed, in no small part because people with no direct experience of the new system have internalized the (mostly negative) propaganda they’ve heard. That is particularly true with respect to completely erroneous impressions of the net cost of Obamacare:

Forty-two percent of Americans think Obamacare has gotten more expensive over the past five years. Only 5 percent of poll respondents hit on the right answer: budget estimates for the Affordable Care Act have consistently fallen since it became a law.

Make no mistake: Obamacare spends a lot of money on its tax credits and Medicaid expansion. It recoups some, but not all, of that new spending with hundreds of billions of dollars in Medicare cuts, which reduce federal health spending. The bulk of the remainder is made up with tax increases. But back when the law was passing, Republicans argued up, down, and sideways that the Congressional Budget Office was sharply underestimating the amount of money Obamacare spends.

In fact, the CBO overestimated the cost of Obamacare — and by quite a lot. In April 2014, it marked down its Obamacare projection by more than $100 billion. Much of the revision comes down to the fact that health-care costs have grown very slowly during 2009, meaning it’s less expensive for the government to help millions of Americans purchase coverage. Just this month, CBO released new projections showing that Obamacare’s subsidies would cost 20 percent less over the next decade than initially expected.

The government is now spending less on health care than CBO had projected back in January 2010 — a projection that didn’t include any Affordable Care Act spending at all.

Another problem is that people attribute to the Affordable Care Act phenomena that would have occurred anyway, especially rising (though more slowly rising) premiums and disruption of individual insurance policies–and even the long, long trend away from fee-for-service medicine delivered by doctors of one’s own choice.

Assuming it is not crippled by the U.S. Supreme Court or repealed by a Republican Congress and president, Obamacare will slowly or surely chip away at the misconceptions. It is, sad to say, a sign of progress that (according to the Vox survey) that only 26% of self-identified Republicans believe in the “death panel” meme. The bigger question is how long it might take for Republican politicians to end their propaganda and treat Obamacare as part of the national landscape–as something to change, not kill–and whether that will precede their next turn in real power.

 

By: Ed Kilgore, Contributing Writer, Political Animal Blog, The Washington Monthly, March 23, 2015

March 24, 2015 Posted by | Affordable Care Act, Conservatives, Obamacare | , , , , , , | Leave a comment

“Why They Are Dead, Horribly Wrong”: What Democrats Whine About When They Whine About ObamaCare

Democrats have reacted to crushing losses in November’s midterm elections in the usual manner: with a circular firing squad. And one of the targets has been the signature policy of the Obama administration, the Affordable Care Act.

Sen. Chuck Schumer of New York took the lead earlier this month, arguing that it was a mistake for Democrats to pass comprehensive health care reform. Retiring Sen. Tom Harkin (Iowa) has come to the same conclusion for different reasons.

While it’s not surprising that this argument has intensified after the midterm bloodbath, it isn’t a new one. Massachusetts congressman Barney Frank was saying the same things in 2012, and former White House Chief of Staff Rahm Emmanuel urged Obama to abandon health care reform in 2010, after the election of Scott Brown to the Senate cost Democrats their brief filibuster-proof majority.

But whether made now or at the time, whether from the left, right, or center, whether driven by policy or pragmatism, all of these arguments have one thing in common: they’re dead wrong. Horribly wrong. Wrong about the ACA, wrong about what was possible in 2010, and wrong about American political history in general.

Before analyzing each variation of the claim that Democrats were wrong to pass the ACA, it’s important to start with this: the ACA has been a remarkable policy success. It has substantially reduced the number of Americans without health insurance, and in so doing has alleviated a great deal of needless suffering, anxiety, and financial stress. It has slowed the growth in health care costs. And its medley of wonky reforms has improved health outcomes.

Furthermore, had it been allowed to work as intended, rather than having its Medicaid expansion ineptly re-written by the Supreme Court and obstructed by Republican statehouses, the scope of the achievement would be even greater.

The ACA doesn’t represent optimal health care policy by any means — to find a better one you need only throw a dart at a map of Western Europe. But it’s a success that Democrats should be very proud of, one that can stand alongside the great achievements of the New Deal and the Great Society.

Arguments that Democrats should not have done health care face a very, very high burden of proof. And they don’t even come close.

Democrats should have focused on something else.
This is a recurring theme in the anti-ACA arguments being made by Democrats. Schumer says Democrats should have focused on the “middle class” rather than health care reform, while Frank argued that the Democrats should have emphasized financial reform instead.

The main problem with these arguments is that no alternative course of action would be remotely worth trading for the ACA. As Paul Krugman points out, “focusing” on the economy in and of itself has no value, and Schumer can’t point to any concrete policy that would have passed had the Democrats not pursued comprehensive health care reform. There was not going to be a second major round of stimulus no matter what. The Obama administration didn’t do nearly enough for underwater homeowners, but this failure was independent of the ACA.

The only alternative policy course that could have arguably been preferable to the ACA would have been legislation addressing climate change. But given the Senate’s heavy tilt towards conservative fossil-fuel states, cap-and-trade legislation was always going to be stillborn. The idea that two Democratic senators from North Dakota, two Democratic senators from Montana, Mary “I’m going to my political grave defending the Keystone pipeline” Landrieu, and other relatively conservative Democrats were all going to vote for major climate change legislation is fantastical. In addition, much of what cap-and-trade would have accomplished can be addressed through regulatory action, which is not the case with health care.

Democrats should have waited for a pony.
Harkin’s argument is somewhat different — and is superficially more appealing — than Schumer’s. Instead of arguing that health care reform was a misguided priority, Harkin argues that the ACA wasn’t good enough. “We should have either done it the correct way or not done anything at all,” he asserts. Democrats should have tried for “single-payer right from the get go or at least put a public option [which] would have simplified a lot.”

This is like saying that Democrats should have gotten “two weeks at the penthouse suite at the Ritz-Carlton in San Francisco…or at least a night at the Motel 6 in Tulsa.” It misleadingly conflates two very different policies with two different political possibilities. Single-payer would certainly have been a better policy than the ACA, but it would be hard to get 20 votes for it in the Senate, let alone 60. (It’s worth noting that Sen. Bernie Sanders’ 2009 single-payer bill had a grand total of zero co-sponsors.)

The question of the public option is more complicated. There are variants of the public option — most obviously a universally available Medicare buy-in — that would have been major reforms, representing a pathway to single-payer. But that is precisely why a robust public option was as DOA in Congress as single-payer itself. The public option in the House bill — which would not have been universally available or cheaper than private alternatives — was small potatoes that would not have made the ACA simpler, more popular, or significantly more progressive. And even so, there almost certainly weren’t the votes in the Senate to pass even the neutered version of the public option.

Should the Democrats have just given up then, as Harkin suggests?

No. Let’s put this in historical perspective. Harry Truman tried and failed to pass comprehensive health care reform. Lyndon Johnson, in extraordinarily favorable circumstances, failed to pass comprehensive health care reform. Ted Kennedy’s efforts under the Nixon administration failed. Bill Clinton’s efforts failed. The idea that Democrats will nationalize the health insurance industry the next chance they get is just the purest wishful thinking. And the idea that millions of people should be denied health insurance for such a long-odds gamble is not merely wrong but immoral.

Democrats would have avoided big losses in the midterms.
At the core of these arguments is the fact that the ACA is unpopular, which presumably played a major role in the Democratic Party losing big in the 2010 and 2014 midterms. This argument might be the least convincing of all.

Let’s set aside the fact that Democrats held on to the Senate in 2010 and 2012, despite the ACA’s unpopularity, as well as the presidency. The argument, at its core, is deeply problematic. It presumes that Democrats should maintain power as an end in itself. But it’s not an end in itself — the point of being elected is to do things that benefit your constituents. What’s the point of political capital if you don’t spend it?

Again, it’s worth putting things in historical perspective. The problem with waiting for the perfect, risk-free time to pass major reform legislation is that there’s never a perfect time. There have been three major periods of progressive reform legislation in Congress between the Civil War and 2008. (The fact that there have been only three should give pause to those who think that Obama, Reid, and Nancy Pelosi are worthless sellouts because they failed to completely transform the American political economy in Obama’s first two years.) In 1966, Great Society Democrats lost 47 seats in the House and three in the Senate, a preview of the crack-up of the Democratic coalition that would (with a detour created by Watergate) lead to the election of Ronald Reagan in 1980. In 1938, New Deal Democrats lost 72 seats in the House and seven in the Senate, and this tally doesn’t account for the failure of FDR’s efforts to defeat anti-New Deal Democrats in the primaries. In 1874, the Reconstruction-era Republicans lost 93 (out of 293) seats in the House and a net of seven seats in the Senate, effectively ending Reconstruction.

Does this mean that Lyndon Johnson shouldn’t have signed the Civil Rights Act? That FDR should have waited until he didn’t need Southern segregationists to pass New Deal legislation? That Republicans should have nominated Andrew Johnson rather than Ulysses S. Grant in 1868? Of course not.

The perfect response to these kind of arguments was made by Pelosi: “We come here to do a job, not keep a job. There are more than 14 million reasons why that’s wrong.” This is exactly right. The window for progressive reform in the United States is always narrow and treacherous — you get the best you can get when you have the chance. The unpopularity of the greatest progressive achievement passed by Congress in nearly five decades is unfortunate, but misguided Monday-morning quarterbacking isn’t the right response.

 

By: Scott Lemieux, Professor of Political Science at the College of Saint Rose in Albany, N.Y.; The Week, December 11, 2014

December 12, 2014 Posted by | Affordable Care Act, Democrats, Obamacare | , , , , , , , | Leave a comment

“Democrats Against Reform”: Democrats Should Be Celebrating The Fact That They Did The Right Thing

It’s easy to understand why Republicans wish health reform had never happened, and are now hoping that the Supreme Court will abandon its principles and undermine the law. But it’s more puzzling — and disturbing — when Democrats like Charles Schumer, senator from New York, declare that the Obama administration’s signature achievement was a mistake.

In a minute I’ll take on Mr. Schumer’s recent remarks. But first, an update on Obamacare — not the politics, but the actual policy, which continues to rack up remarkable (and largely unreported) successes.

Earlier this week, the independent Urban Institute released new estimates of the number of Americans without health insurance, and the positive results of Obamacare’s first year are striking. Remember all those claims that more people would lose coverage than would gain it? Well, the institute finds a sharp drop in the number of uninsured adults, with more than 10 million people gaining coverage since last year. This is in line with what multiple other estimates show. The primary goal of health reform, to give Americans access to the health care they need, is very much on track.

And while some of the policies offered under Obamacare don’t offer as much protection as we might like, a huge majority of the newly insured are pleased with their coverage, according to a recent Gallup poll.

What about costs? There were many predictions of soaring premiums. But health reform’s efforts to create meaningful competition among insurers are working better than almost anyone (myself included) expected. Premiums for 2014 came in well below expectations, and independent estimates show a very modest increase — 4 percent or less — for average premiums in 2015.

In short, if you think of Obamacare as a policy intended to improve American lives, it’s going really well. Yet it has not, of course, been a political winner for Democrats. Which brings us to Mr. Schumer.

The Schumer critique — he certainly isn’t the first to say these things, but he is the most prominent Democrat to say them — calls health reform a mistake because it only benefits a minority of Americans, and that’s not enough to win elections. What President Obama should have done, claims Mr. Schumer, was focus on improving the economy as a whole.

This is deeply wrongheaded in at least three ways.

First, while it’s true that most Americans have insurance through Medicare, Medicaid, and employment-based coverage, that doesn’t mean that only the current uninsured benefit from a program that guarantees affordable care. Maybe you have good coverage now, but what happens if you’re fired, or your employer goes bust, or it cancels its insurance program? What if you want to change jobs for whatever reason, but can’t find a new job that comes with insurance?

The point is that the pre-Obamacare system put many Americans at the constant risk of going without insurance, many more than the number of uninsured at any given time, and limited freedom of employment for millions more. So health reform helps a much larger share of the population than those currently uninsured — and those beneficiaries have relatives and friends. This is not a policy targeted on a small minority.

Second, whenever someone says that Mr. Obama should have focused on the economy, my question is, what do you mean by that? Should he have tried for a bigger stimulus? I’d say yes, but that fight took place in the very first months of his administration, before the push for health reform got underway. After that, and especially after 2010, scorched-earth Republican opposition killed just about every economic policy he proposed. Do you think this would have been different without health reform? Seriously?

Look, economic management is about substance, not theater. Having the president walk around muttering “I’m focused on the economy” wouldn’t have accomplished anything. And I’ve never seen any plausible explanation of how abandoning health reform would have made any difference at all to the political possibilities for economic policy.

Finally, we need to ask, what is the purpose of winning elections? The answer, I hope, is to do good — not simply to set yourself up to win the next election. In 2009-10, Democrats had their first chance in a generation to do what we should have done three generations ago, and ensure adequate health care for all of our citizens. It would have been incredibly cynical not to have seized that opportunity, and Democrats should be celebrating the fact that they did the right thing.

And one related observation: If more Democrats had been willing to defend the best thing they’ve done in decades, rather than run away from their own achievement and implicitly concede that the smears against health reform were right, the politics of the issue might look very different today.

 

By: Paul Krugman, Op-Ed Columnist, The New York Times, December 4, 2014

December 8, 2014 Posted by | Affordable Care Act, Democrats, Health Reform | , , , , , , | 3 Comments

“Secret Deficit Lovers”: The GOP Deficit Scolds Are Having A Hard Time Letting Go

What if they balanced the budget and nobody knew or cared?

O.K., the federal budget hasn’t actually been balanced. But the Congressional Budget Office has tallied up the totals for fiscal 2014, which ran through the end of September, and reports that the deficit plunge of the past several years continues. You still hear politicians ranting about “trillion dollar deficits,” but last year’s deficit was less than half-a-trillion dollars — or, a more meaningful number, just 2.8 percent of G.D.P. — and it’s still falling.

So where are the ticker-tape parades? For that matter, where are the front-page news reports? After all, talk about the evils of deficits and the grave fiscal danger facing America dominated Washington for years. Shouldn’t we be making a big deal of the fact that the alleged crisis is over?

Well, we aren’t, and once you understand why, you also understand what fiscal hysteria was really about.

First, ordinary Americans aren’t celebrating the deficit’s decline because they don’t know about it.

That’s not mere speculation on my part. Earlier this year, YouGov polled Americans on fiscal issues, asking among other things whether the deficit had increased or declined since President Obama took office. (In case you’re wondering, the pollsters carefully explained the difference between annual deficits and the level of accumulated debt.) More than half of those polled said it had gone up, while only 19 percent correctly said that it had gone down.

Why doesn’t the public know better? Probably because of the way much of the news media report this and other issues, with bad news played up and good news downplayed if it’s reported at all.

This has been glaringly obvious in the case of health reform, where every problem with the Affordable Care Act has been the subject of headlines, while in right-wing media — and to some extent in mainstream news sources — favorable developments go unremarked. As a result, many people — even, in my experience, liberals — have the impression that the rollout of Obamacare has been a disaster, and have no idea that enrollment is above expectations, costs are lower than expected, and the number of Americans without insurance has dropped sharply. Surely something similar has happened on the budget deficit.

But what about people who pay a lot of attention to the budget, the self-proclaimed deficit hawks? (Some of us prefer to call them deficit scolds.) They’ve spent the past few years telling us that budget shortfalls are the most important issue facing the nation, that terrible things will happen unless we act to stem the flow of red ink. Are they expressing satisfaction over the fading of that threat?

Not a chance. Far from celebrating the deficit’s decline, the usual suspects — fiscal-scold think tanks, inside-the-Beltway pundits — seem annoyed by the news. It’s a “false victory,” they declare. “Trillion dollar deficits are coming back,” they warn. And they’re furious with President Obama for saying that it’s time to get past “mindless austerity” and “manufactured crises.” He’s declaring mission accomplished, they say, when he should be making another push for entitlement reform.

All of which demonstrates a truth that has been apparent for a while, if you have been paying close attention: Deficit scolds actually love big budget deficits, and hate it when those deficits get smaller. Why? Because fears of a fiscal crisis — fears that they feed assiduously — are their best hope of getting what they really want: big cuts in social programs. A few years ago they almost managed to bully the nation into cutting Social Security and/or raising the Medicare eligibility age; they even had hopes of turning Medicare into an underfinanced voucher program. Now that window of opportunity is closing fast.

But isn’t the falling deficit just a short-term blip, with the long-run outlook as dire as ever? Actually, no. Falling deficits right now have a lot to do with a strengthening economy plus some of that “mindless austerity” the president condemned. But there has also been a dramatic slowdown in the growth of health spending — and if that continues, the long-run fiscal outlook is much better than anyone thought possible not long ago. Yes, current projections still show a rising ratio of debt to G.D.P. starting some years from now, and uncomfortable levels of debt a generation from now. But given all the clear and present dangers we face, it’s hard to see why dealing with that distant and uncertain prospect should be any kind of policy priority.

So let’s say goodbye to fiscal hysteria. I know that the deficit scolds are having a hard time letting go; they’re still trying to bring back the days when Bowles and Simpson bestrode the Beltway like colossi. But those days aren’t coming back, and we should be glad.

 

By: Paul Krugman, Op-Ed Columnist, The New York Times, October 9, 2014

October 13, 2014 Posted by | Austerity, Deficits, Federal Budget | , , , , , , | 1 Comment

%d bloggers like this: