Mitt vs. Newt Won’t Be Like Hillary vs. Barack
The 2012 Republican primary probably won’t be much like the 2008 Democratic primary, but Mitt Romney’s campaign is organizing just in case the nomination fight against Newt Gingrich lasts all the way into the spring. The New York Times‘ Trip Gabriel and Jeff Zeleny report that if neither Romney or Gingrich have decisive victories in the early voting states, “Gingrich could be faced with the ultimate challenge to his campaign: the need to survive a war of attrition of the sort for which he is unprepared at the moment.” Romney’s organized in Alabama, Indiana, Delaware, and lots of other later-voting states, while Gingrich’s campaign didn’t file the paperwork in time to get on the Missouri caucus ballot. The Washington Post‘s Philip Rucker, too, reports that Gingrich’s campaign is trying to create a huge organization in just a couple weeks, with staffers sending all-caps emergency emails to Republicans in Ohio to get enough signatures to get on that state’s ballot. Ohio votes in March, though, and it doesn’t seem likely that both guys will be around by then. Not only does Gingrich not have the organization of Obama, he doesn’t have the message Republicans want to hear or an army of new voters to help him win in late-voting states.
The establishment candidate is also the organized candidate
Outsider Obama outmaneuvered frontrunner Clinton by organizing in late-voting states, and by having a strong organization in the Iowa caucuses. But this year, the well-organized candidate is also the establishment choice: Romney. Obama’s surprise victory in Iowa was thanks to his organization — really important for Democrats, as Matthew Dowd, who was chief strategist for George W. Bush in 2004, explains at ABC News. But that organization isn’t important for Republicans in the state, he says. The Democratic caucus “involves meeting certain mandated thresholds, convening in groups at each caucus, reconvening, and using various mathematical equations that are instrumental to choosing a winner,” Dowd writes, but Republicans just show up and vote, and then those votes are counted. That means enthusiasm matters as much as organization.
The Post reports that Gingrich has hired Bush veteran Gordon C. James to build his organization, saying, “I’m just banking on 33 years with the Bush family and all those friends I’ve made to help us do that.” But while James might have a lot of friends, Gingrich has a ton of enemies. Sen. Tom Coburn, who was first elected in 1994 — Gingrich’s Republican Revolution — said on Fox News Sunday that he wasn’t “inclined” to support Gingrich. Coburn explained, “There’s all types of leaders. Leaders that instill confidence, leaders that are somewhat abrupt and brisk. Leaders that have one standard for the people that they’re leading and a different standard for themselves. I just found his leadership lacking.”
Obama’s secret weapon was young people, Gingrich’s is old people
Obama was able to bring in new voters outside of the traditional groups that lined up behind Clinton: young people. But Gingrich’s “secret weapon,” as Talking Points Memo’s Benjy Sarlin put it, is old people. Enthusiasm for Gingrich is not among insurgent activists, but seniors.
Gingrich will have a hard time attacking Romney on health care
Another problem Gingrich will have in sustaining the enthusiasm of the piss-off Republican party base is that he’s weak on the issue they care about most. Obama had the advantage of a record of being against the Iraq war early on, which appealed to Democrats frustrated by eight years of the Bush administration, while Clinton had voted to authorize the war in 2002. Clinton was seen as much more hawkish. But Gingrich can’t make a similar contrast Romney, because in the 1990s he endorsed the part of Obama’s health care overhaul — the individual mandate — that Republicans hate the most.
Obama had a disciplined campaign, Gingrich doesn’t
Obama’s campaign valued loyalty — and no leaking to the press. Obama strategist David Axelrod even told Politico, “There are no assholes. There are going to be no assholes on this campaign.” That helped limit stories about internal bickering that plagued Clinton’s campaign. By contrast, Gingrich’s campaign staff quit on him this summer, and then proceeded to talk mad smack about him in the press for days.
A long primary gave Obama a lot of time to introduce himself to people who’d never heard of him, while a long primary gives Gingrich a chance to remind people why he was run out of town in 1998
A four- or five-month long process means there’d be lots of time to rehash the Gingrich years: impeachment, ethics probe, marriages, the government shutdown. And a long nomination fight means Gingrich will have more opportunities to indulge in one of his weaknesses — saying things that make Republicans really mad. Gingrich famously called a Republican plan to overhaul Medicare “right-wing social engineering,” and it nearly killed his campaign. In the last couple weeks, Gingrich has already floated amnesty for some illegal immigrants and ending child labor laws.
By: Elspeth Reeve, The Atlantic Wire, December 5, 2011
Sharp Rise In Premiums Exposes Health Insurers’ Greed
According to a study released today by the Kaiser Family Foundation, 2011 health insurance premiums for employer-sponsored family healthcare benefits rose 9 percent over last year’s prices, leaving employees to pay, on average, $4,129 and employer contributions at $10,944. The number represents a surprising rise given that increases experienced in 2010 were just 3 percent.
So, why the sudden increase?
We know that Americans are using fewer medical services since the economy took a dive as people are staying away from the doctor and putting off non-life saving surgeries, such as knee and hip replacements, until they have more confidence that they will have the money required to pay deductibles and co-pays. We also know that fewer medical services are being utilized as a result of the increased popularity of Health Safety Accounts which require deductibles in excess of $2,000 per family, and employer provided policies that have increasingly large deductibles and co-pays.
As a result, can it possibly make sense that medical costs are increasing by the 9 percent reflected in the hefty premium hikes? In a word, no.
That will not stop the anti-Obamacare forces, of course, from putting the blame squarely on healthcare reform. In a sense, I suppose the Affordable Care Act does bear some of the responsibility—if you can consider motivating the health insurers to falsely inflate their prices, by forcing them to do the right thing, to be a blamable offense.
Beginning next year, health insurers will be required to justify any increases in premium rates above 10 percent. They will further be obligated to refund money to customers if an insurer is found to have spent less than 85 percent of their premium income on medical expenses. Thus, it is hardly a stretch to conclude that the insurers are simply taking their last chance to raise premium rates before they find themselves having to be more accountable to the government, particularly when they are pretty much admitting to as much.
As noted by Reed Ableson in The New York Times:
Throughout this year, major health insurers have defended higher premiums—and higher profits—saying that their expenses would rise once the economy recovered and people believed they could again afford medical care. The struggling economy will probably keep suppressing demand for medical care, particularly as people pay a larger share of their own medical bills through higher deductibles and co-payments, according to benefits consultants and others. About three-quarters of workers now pay part of the bill when they go see a doctor, and nearly a third have a deductible of at least $1,000 if they have single coverage, up from just one in 10 in 2006, according Kaiser.
So, the insurance company defense is that they expect prices to rise sometime in the future (clearly an undefined period) and they want to be ready. Somehow, this justifies them to dramatically raise their premium prices now, at time when their costs are actually less and their profits are through the roof.
Not only is such behavior astoundingly predatory, the insurers are playing a major role in keeping the economy in the dumps, as it is precisely this sort of unnecessary premium increase that causes employers to avoid hiring more employees.
For those who believe that we should leave it to the free market to establish the prices in the medical system (of which insurance will always be a necessary part), maybe they can explain how the system is working in this instance? In a time where patient control has risen dramatically as consumers decide if and how they will—or will not—spend on medical services now that they have greatly increased responsibility for the familiy medical bills as a result of much higher deductibles, and at a moment where there are substantially reduced claims coming onto health insurers’ balance sheets due to diminished use of medical services, exactly what is the free market concept that justifies an insurance company raising their premium rates? What’s more, at a time when fewer people are using physician’s services, why would costs go up?
Free market principles would suggest that lower demand should produce lower prices. But that is clearly not what is happening.
I know what some of you are thinking—but before you say it’s all the government’s fault, I would hasten to point out that, with an apples-to-apples comparison, there are no substantial new regulations hitting physicians this year that did not exist last year. And before you blame the president’s health care reform program for the insurance companies’ usurious behavior, note that the two million young people who have been added to the insurance roles as a result of Obamacare’s permitting these people to stay on the family insurance policy, would not increase an insurance company’s costs by 9% over last year’s prices. Indeed, adding all of these healthy kids to the insurance pools should help insurers spread risk more effectively while collecting additional premium revenues.
The bottom line is that there is absolutely no justification whatsoever for the health insurance industry hitting employers with a 9 percent increase. It is a simple matter of greed and it is precisely that greed that has long made access to healthcare continuously more difficult for middle class Americans.
By: Rick Ungar, Mother Jones, September 27, 2011
Government Shutdown: It’s Not Really About Spending
If the federal government shuts down at midnight on Friday — which seems likely unless negotiations take a sudden turn toward rationality — it will not be because of disagreements over spending. It will be because Republicans are refusing to budge on these ideological demands:
• No federal financing for Planned Parenthood because it performs abortions. Instead, state administration of federal family planning funds, which means that Republican governors and legislatures will not spend them.
• No local financing for abortion services in the District of Columbia.
• No foreign aid to countries that might use the money for abortion or family planning. And no aid to the United Nations Population Fund, which supports family-planning services.
• No regulation of greenhouse gases by the Environmental Protection Agency.
• No funds for health care reform or the new consumer protection bureau established in the wake of the financial collapse.
Abortion. Environmental protection. Health care. Nothing to do with jobs or the economy; instead, all the hoary greatest hits of the Republican Party, only this time it has the power to wreak national havoc: furloughing 800,000 federal workers, suspending paychecks for soldiers and punishing millions of Americans who will have to wait for tax refunds, Social Security applications, small-business loans, and even most city services in Washington. The damage to a brittle economy will be substantial.
Democrats have already gone much too far in giving in to the House demands for spending cuts. The $33 billion that they have agreed to cut will pull an enormous amount of money from the economy at exactly the wrong time, and will damage dozens of vital programs.
But it turns out that all those excessive cuts they volunteered were worth far less to the Republicans than the policy riders that are the real holdup to a deal. After President Obama appeared on television late Wednesday night to urge the two sides to keep talking, negotiators say, the issue of the spending cuts barely even came up. All the talk was about the abortion demands and the other issues.
Democrats in the White House and the Senate say they will not give in to this policy extortion, and we hope they do not weaken. These issues have no place in a stopgap spending bill a few minutes from midnight.
A measure to prohibit the Environmental Protection Agency from regulating greenhouse gas emissions came up for a Senate vote on Wednesday and failed. If Republicans want to have yet another legislative debate about abortion and family planning, let them try to pass a separate bill containing their restrictions. But that bill would fail, too, and they know it, so they have chosen extortion.
The lack of seriousness in the House is reflected in the taunting bill it passed on Thursday to keep the government open for another week at an absurdly high cost of $12 billion in cuts and the ban on District of Columbia abortion financing. The Senate and the White House said it was a nonstarter. Many of the same House members who earlier had said they would refuse to approve another short-term spending bill voted for this one, clearly hoping they could use its inevitable failure in the Senate to blame the Democrats for the shutdown. What could be more cynical?
The public is not going to be fooled once it sees what the Republicans, pushed by Tea Party members, were really holding out for. There are a few hours left to stop this dangerous game, and for the Republicans to start doing their job, which, if they’ve forgotten, is to serve the American people.
By: Editorial, The New York Times, April 8, 2011
Whatever Happened To Uncertainty?
With the House passing a two-week funding extension and Harry Reid promising the Senate will do likewise, it looks like we have at least until March 18th before any federal agencies have to shut their doors. But then there’s a shutdown risk. And there’s another one coming as early as April 15th, when the Treasury bumps into the the debt ceiling and needs Congress to lift it in order to avoid default. Federal budget policy over the next few months is going to be like a weekend with Charlie Sheen: A constant effort to avoid blackouts (yes, Wonkbook went there).
Prior to winning the election in November, the GOP spoke often about the pressing need to reduce “uncertainty” in the economy. This was a core principle of their plan to restore economic confidence and create jobs. As Rep. Paul Ryan put it to me in July, “uncertainty is a new economic buzzword, but for good reason: If we can reduce it, we’ll unlock capital.” If businesses and individuals could be confident about what government was doing, what taxes would look like, and what regulators would ask of them, they could start investing again.
So are they succeeding at their own promise of reducing uncertainty? It’s hard to see how. Budget experts on both sides of the aisle have sharply upgraded their estimate of how likely a government shutdown is in the next few months, either over the continuing resolution for 2011 or the debt limit or both. There’s an ongoing effort to starve health-care reform of implementation funds and a promise to “replace” it with some policy that hasn’t yet been written — no one in the health space would say that the shape of health-care policy over the coming years looks more certain now than it did six months ago. The GOP chose a tax deal that lowered all rates for two years rather than a tax deal that lowered most rates permanently, so there’s uncertainty over future tax rates. The tax and health-care policies would both do much more to increase the deficit than anything else on the list would do to reduce it, ensuring that concern continues to loom. So for what definition of “uncertainty” has the GOP succeeded in reducing its prevalence in the economy?
In each case, of course, the GOP has a good argument for the choice it’s made: Lower tax rates on large estates and income over $250,000 were judged more important than tax certainty or deficit reduction. The health-reform law is so unwise that repealing it should be a top priority. The prospect of a government shutdown and/or default provides leverage to extract spending cuts, which are more important right now than assuring the market that there won’t be some sort of shutdown or default. It’s all fair enough, at least on its own terms. But it’s meant that the post-election GOP takes the risk of uncertainty a lot less seriously than the pre-election GOP did. It’s a tension I’d like to hear more of them comment on.
By: Ezra Klein-The Washington Post, March 2, 2011
Remember The Uninsured?
In February 2007, Deamonte Driver died of an infected tooth. But he didn’t really die of an infected tooth. He died because he didn’t have consistent insurance. If he’d had an Aetna card, a dentist would’ve removed the tooth earlier, and the bacteria that filled the abscess would never have spread to his brain.
Deamonte Driver was 12. His insurance status wasn’t his fault.
If all you knew about the Affordable Care Act was what you gleaned from watching the Republicans make their case against it, you probably would not know that the legislation means health-care coverage for more than 30 million Americans. Or, if you did know that, you’d be forgiven for not realizing it’s relevant: It almost never gets mentioned (see this congressman’s rundown of the bill’s contents, for instance), and the repeal legislation the Republicans are pushing does nothing to replace the coverage the Affordable Care Act would give to those people.
The lack of concern for how more than 30 million Americans will get their health-care coverage makes for an ugly contrast with the intense concern that Rep. Andy Harris — a proponent of repeal — found when he heard that his congressional health-care coverage wouldn’t begin until a month after he took the oath of office. “He stood up and asked the two ladies who were answering questions why it had to take so long, what he would do without 28 days of health care,” recalled one of the session’s attendees. He knows his taxpayer-subsidized insurance is important. But what about Driver’s?
We have a tendency to let the conversation over health-care reform become a bloodless, abstract discussion over cost curves and CBO models. We do that for two reasons: First, cost is important. Second, it’s important to the people who have political power, which is, by and large, not the same group who doesn’t have health-care insurance. Someone involved in the 2008 campaign once told me he’d seen numbers showing that 95 percent of Obama’s voters were insured. The numbers for McCain were, presumably, similarly high, or even higher. These are the people the political system is responsive too.
But that doesn’t make the plight of the uninsured any less wrenching. The Urban Institute estimated that 22,000 people died in 2006 because they didn’t have health-care insurance. John Ayanian, a professor of medicine and health-care policy at Harvard Medical School, testified before Congress on this issue. “Uninsured adults are 25 percent more likely to die prematurely than insured adults overall,” he said, “and with serious conditions such as heart disease, diabetes or cancer, their risk of premature death can be 40 to 50 percent higher.” And none of that takes into account the unnecessary suffering and physical damage that flourishes in the absence of effective medical care. Nor does it speak to the economic devastation that illness unleashes on uninsured families.
These numbers shouldn’t surprise us: We pay a lot of money for health-care insurance. We’ve directed the government to spend even more money subsidizing that insurance for the elderly, the disabled, some of the poor and everyone who gets health-care coverage through their employer. We value this product so highly for a reason: Most of us would agree that being able to afford to see a doctor isn’t a luxury. It’s a necessity. Rep. Harris certainly feels that way.
The same goes for the uninsured. In fact, it’s often more true for them, as many haven’t received reliable care for some time and have multiple health problems that haven’t been effectively treated. That’s why, when a temporary free clinic set up shop in Los Angeles, 3,000 people lined up for treatment. It’s why the famed RAND health insurance experiment found the people who benefited from insurance most clearly were the poor, as they were often plagued by easy-to-treat conditions like hypertension.
The Affordable Care Act covers the vast majority of the uninsured. It covers everyone who makes less than the poverty line, and almost everyone who makes less than 300 percent of the poverty line. It does all this while spending about 4 percent of what our health-care system currently spends in a year, and it offsets that spending — and more — to make sure the deficit doesn’t bear the burden of society’s compassion. Perhaps there’s a better way to achieve those goals that can pass Congress. If so, I’m open to hearing about it. But to repeal the bill without another solution for the Deamonte Drivers of the world? And to do it while barely mentioning them? We’re a better country than that. Or so I like to think.
By: Ezra Klein, The Washington Post, January 19, 2011
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