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“Makes More Sense Than Critics Admit”: The Brave Politics Of Clinton’s Medicare Buy-In Proposal

Predictably, much of the commentary about Hillary Clinton’s newly expressed interest in making a Medicare buy-in option available to people near retirement age is treating it as another calibrated “move to the left” to head off Bernie Sanders or placate his supporters. The unstated assumption is that anything other than a full-on single-payer system (the only creditable progressive proposal, you see) is a half measure reflecting either political cowardice or corrupt kowtowing to private insurance interests.

Here’s the thing, though. People who love to cite polls showing the popularity of “Medicare for all” (the favored buzz-phrase for single-payer) should be aware that the popularity of the venerable retirement program is based on its current characteristics as an “earned entitlement” program for which working Americans pay payroll taxes and then, after becoming beneficiaries, premiums. The “buy-in” proposal, by targeting people who have (a) presumably been paying those same payroll taxes and will continue to do so until retirement if they are employed, and (b) will immediately pay relatively steep premiums (though not as steep, in most cases, as private insurance premiums), does minimal violence to the structure, financing and original purpose of Medicare. “Medicare for all,” once it is a tangible proposal rather than a bumper-sticker slogan, changes Medicare in all these respects, and might make it unrecognizable. The financing challenge alone for a single-payer system — which never much gets mentioned in the polling — makes the incremental approach, via a combination of Medicare, “Obamacare”-subsidized private insurance, and Medicaid, a much easier reach financially and politically.

Perhaps I’m wrong and perhaps Hillary Clinton is wrong in feeling this way. But one thing’s for sure: Expanding Medicare and providing a “public option” under Obamacare are not popular ideas in the private insurance industry. That’s certainly not the constituency Clinton is representing here. And anyone who doubts the political courage it takes to achieve universal health coverage incrementally, instead of just intoning “Medicare for all” until the walls fall down like Jericho’s, hasn’t been paying much attention the last quarter-century.

 

By: Ed Kilgore, Daily Intelligencer, New York Magazine, May 11, 2016

May 14, 2016 Posted by | Bernie Sanders, Hillary Clinton, Universal Health Care | , , , , , , , , | Leave a comment

“The Worst Has Yet To Come”: Scrambling To Clean Up A Failed Republican Governor’s Mess

In November, Louisiana’s John Bel Edwards received some great news: by a wide margin, the Democrat had been elected governor. At the same time, however, he also received some rather dreadful news: Edwards was now the governor of Louisiana, responsible for cleaning up a catastrophic mess left by Republican Bobby Jindal.

As the New York Times reported yesterday, Pelican State policymakers – a Democratic governor’s office working with a Republican-led legislature – are moving forward with a plan to undo some of what Jindal did, at least temporarily.

Facing the threat of layoffs, cancellation of university classes and a suspension of health care services, state lawmakers avoided more than $900 million in budget cuts by passing a package of tax increases and spending reductions Wednesday in the closing moments of a special session.

But large shortfalls still plague the state and will continue to play out as a regular session convenes on Monday.

The package includes restructuring the state sales tax – removing exemptions and increasing it a penny – but at Republicans’ insistence, the increases are temporary. The New York Times article added that the new agreement also includes “higher taxes on cigarettes, alcohol, car rentals, cellphones, landlines and short-term rooms booked through websites.” Policymakers also “rolled back a tax credit enjoyed by the insurance industry, and they approved a framework for collecting sales taxes from online retailers.”

Despite this, the package didn’t close all of the state’s massive budget shortfall, and more cuts are on the way.

Bobby Jindal’s failures were just that bad. The Washington Post added last week:

Already, the state of Louisiana had gutted university spending and depleted its rainy-day funds. It had cut 30,000 employees and furloughed others. It had slashed the number of child services staffers, including those devoted to foster family recruitment, and young abuse victims for the first time were spending nights at government offices.

And then, the state’s new governor, John Bel Edwards (D), came on TV and said the worst was yet to come.

The source of the crisis is hardly a mystery. As the Post reported, experts have found that Louisiana’s structural budget deficit “emerged and then grew under former governor Bobby Jindal, who, during his eight years in office, reduced the state’s revenue by offering tax breaks to the middle class and wealthy. He also created new subsidies aimed at luring and keeping businesses. Those policies, state data show, didn’t deliver the desired economic growth.”

In other words, a right-wing governor, working with a Republican legislature, tried to implement a conservative governing agenda. The result is a disaster Louisiana is going to struggle for years to clean up.

If you missed Rachel’s segment last week on states damaged by Republican governance, it’s worth revisiting – especially for its focus on Louisiana.

 

By: Steve Benen, The Maddow Blog, March 11, 2016

March 13, 2016 Posted by | Bobby Jindal, Louisiana, Republicans | , , , , , , , , | Leave a comment

“Sanders’ ‘Medicare For All'”: The Devil Is In The Details

Bernie Sanders is a proud and self-described socialist, a veteran Vermont senator who wants to bring some European ideas to the United States. One of those ideas is a single-payer health care system: a government-funded program in which the patient bears little to no cost. Sanders describes it as “Medicare for all.”

It’s an excellent idea. The United States is the richest country in the world, and it ought to grant every citizen guaranteed access to doctors and hospitals. That’s what Canada, Japan and the countries of Western Europe have all done.

But Sanders is vague — and his supporters quite naive — about the prospects of bringing a single-payer system to the United States. He insists that he could accomplish that in a prospective first term “if many millions of people demand it.”

Here’s the rub: They won’t — at least not in the systematic and sustained manner that would be required to bring about that sort of, well, revolutionary change to the American medical-industrial complex.

There’s a reason that the U.S. doesn’t have “Medicare for all”: politics. Do Sanders and his supporters remember the epic battle to pass the Affordable Care Act?

Democrats have been trying to pass a version of universal health care since the days of Franklin Delano Roosevelt. But conservatives have fought every proposal that would increase access for ordinary Americans, including Medicare; Ronald Reagan, then a neophyte political activist, toured the country campaigning against it.

Bill Clinton made universal health care a cornerstone of his presidential campaign in 1992, and he appointed his wife, Hillary, to head a task force to propose legislation after he won. They tried mightily to pass it, but conservatives denounced it, and the insurance industry spent millions to defeat it.

That’s why President Barack Obama brought the insurance industry on board when he started toward the Affordable Care Act. He knew he needed their support to have a prayer of passage. So the ACA preserves the business of selling health insurance through private companies.

Still, it has helped millions of families; nearly 9 million more Americans had health insurance in 2014 than the year before, according to government data. Moreover, the ACA prevents insurance companies from banning patients because they are sick and prohibits insurers from placing “lifetime caps” on the amount of money any person can collect for health care.

Would a single-payer plan have been even better? You bet. But listen to Obama’s former aide, David Axelrod, describe the difficulties of trying to pass such a proposal.

“I support single-payer health care, but having gone through health reform, we couldn’t even get a national consensus around the public option! It was Democratic votes that were ultimately missing on that issue,” Axelrod remembered. (The public option was a proposal for a government-run health insurance plan to compete with private health insurers.)

History shows that Obama and his allies spent months trying to make the ACA more palatable to conservatives to entice a few GOP votes. Actually, the mandate requiring that all adults have health insurance was originally a conservative idea. While the federal government provides subsidies to help families with modest incomes buy insurance, it doesn’t pay the full cost. (Obamacare also sets aside billions for states to expand Medicaid, but the Supreme Court made that optional, and many states have refused to expand.)

Still, the ACA did not get a single Republican vote in the end — not one. Republicans are still trying to repeal the law, taking more than 60 votes in Congress and going to the Supreme Court with challenges. Most of those Republicans will be easily re-elected to Congress.

Given recent history, it’s clear that Sanders’ plan would face very long odds — and that’s before details become clear. The Vermont senator proposes an extraordinary range of patient care — dental and vision coverage, mental health care, long-term care — while, he says, saving trillions of dollars. Many health care experts say that can’t be done, so health care spending would likely increase. You don’t have to be a conservative voter to fear where that would lead us.

If Vermont’s audacious senator has a plan for overcoming an ultraconservative GOP caucus in Congress, a right-leaning U.S. Supreme Court, and millions of voters who still flinch from the word “socialist,” he ought to lay it out. It would be quite a revolutionary plan, indeed.

 

By: Cynthia Tucker Haynes, Pulitzer Prize Winner for commentary in 2007: The National Memo, February 13, 2016

February 14, 2016 Posted by | Bernie Sanders, Medicare for All, Single Payer | , , , , , , , , | 1 Comment

“Money Talks”: A Climate Change Argument That May Even Work On Conservatives

We may find out if Republicans actually do trust the free market.

For years, activists have been touting the fact that 97 percent of climate scientists agree that climate change is manmade, hoping that would inspire Republicans — who first advanced the idea of a cap-and-trade system to slow carbon emissions — to break their pledge to the Koch brothers and do something about the coming climate crisis.

It didn’t work.

A recent poll found a majority of Republicans — 58 percent — believe that climate change is a hoax. This explains why the right-wing media regularly laughs at the idea of doing anything to slow carbon emissions.

But there’s one group that seems to believe 100 percent that climate change is real and a serious threat to their existence. It’s the group that has the most to lose if we do nothing: the insurance industry.

The Weekly Standard‘s Eli Lehrer explains:

Indeed, if free-market conservatives really want evidence of climate change, they ought to look towards the insurance markets that would bear much of the cost of catastrophic climate change. All three of the major insurance modeling firms and every global insurance company incorporate human-caused climate change into their projections of current and future weather patterns. The big business that has the most to lose from climate change, and that would reap the biggest rewards if it were somehow solved tomorrow, has universally decided that climate change is a real problem. An insurance company that ignored climate change predictions could, in the short term, make a lot of money by underpricing its competition on a wide range of products. Not a single firm has done this.

In fact, a recent report from the Geneva Association, “Warming of the Oceans and Implication for the (Re)insurance Industry,” suggests that climate change is making certain regions — including Florida and the United Kingdom — uninsurable.

Lehrer argues that the free market way to deal with a free market problem is the same solution offered by pioneering climate scientist James Hansen — a carbon tax:

Since carbon emissions do present a real problem, simply repealing the current regulations without replacing them would be both unwise and politically impossible. The least-intrusive and most economically beneficial way to deal with the problem appears to be a carbon tax, particularly a revenue-neutral carbon tax that could be used to offset and/or replace other taxes.

According to that Koch pledge, which has been signed by a majority of Republicans in Congress, any carbon tax would have to be matched by an “equivalent amount of tax cuts,” which would likely violate Grover Norquist’s tax pledge. It’s a predicament that typifies the structural obstruction that binds the modern GOP.

But money talks. Perhaps when they can’t insure their Palm Beach homes, the cost of inaction will be too much for even this Republican Party.

 

By: Jason Sattler, The National Memo, July 8, 2013

July 9, 2013 Posted by | Climate Change | , , , , , , , , | Leave a comment

“And The Rich Get Richer”: Massive Insurance Industry Profits For Republicans In Ryan Medicare Scheme

Insurance companies that would benefit from a Medicare privatization program supported by GOP candidates Mitt Romney and Paul Ryan and nearly every congressional Republican are filling their campaign coffers and raising questions about whom they really work for – constituents or big insurance and Wall Street donors. The privatization scheme, designed by Ryan, would end Medicare as we know it and leave seniors without protection from soaring out-of-pocket medical costs.

The insurance industry and HMOs so far in the 2012 election cycle have given at least $14 million in campaign contributions to U.S. House members who voted for the Ryan plan to privatize Medicare, according to a new report prepared by Public Campaign Action Fund and Health Care for America Now utilizing data downloaded and coded by the Center for Responsive Politics. Mitt Romney, the Republican presidential candidate, has received $2.7 million from insurance interests this cycle alone. Taking the long view, members of Congress who voted for the Ryan budget collected $49.7 million in campaign contributions from the insurance industry over their careers – far more than those voting against the plan, the report said.

For the insurance industry, the political spending is an investment that could reap enormous returns. The market value of Wall Street-run health insurance companies will increase by $12 billion to $25 billion if the Republicans win the Senate and the White House, and by 2030 the industry would post $16 billion to $26 billion in increased annual profits attributable to the Medicare privatization, the report said.

“Americans want quality and guaranteed Medicare, but when we have a Congress on the auction block, they’ll put Medicare on the chopping block,” said David Donnelly, executive director of Public Campaign Action Fund. “This report allows voters to connect the dots for themselves by showing the members of Congress who voted for Ryan’s plan to privatize Medicare while scooping up checks from the insurance industry that would benefit.”

“The Republican plan to privatize and voucherize Medicare would increase costs for seniors and turn the most effective and cost-efficient health insurance program over to the insurance industry,” said Ethan Rome, executive director of Health Care for America Now, the nation’s largest grassroots health care advocacy organization. “It’s disturbing, though not surprising, that the GOP is bankrolled by the insurance industry – the special interests that would reap staggering profits from this plan. When the GOP and health insurance companies win, consumers lose.”

New polling shows that seniors are extremely sensitive about the alliance between the health insurance industry and the Republican Party. More than half – 55 percent – of voters said they would be less likely to vote for a candidate who supports the budget that includes the privatization scheme, according to Democracy Corps, Greenberg Quinlan Rosner Research and Public Campaign Action Fund. But that swelled to 70 percent when voters were asked if they would be less likely to vote for that candidate if he or she also took thousands in campaign donations from insurance executives, lobbyists and political action committees.

“Along with their systematic effort to undermine Medicare, the Republicans are working to repeal the Affordable Care Act and decimate Medicaid,” Rome said. “The GOP’s plan is to put seniors and their families at the mercy of the private health insurance industry without adequate coverage, without their choice of doctor and without protection from huge new out-of-pocket costs.”

“Policy in Washington is too often decided by those who give the most money at the expense of everyday Americans,” said Donnelly. “Insurance interests are pouring money into campaigns because it’s in their narrow interest to privatize Medicare and maximize profits. The problem is, Americans of all political stripes don’t have the same power and influence to shape policy. That’s why we have to hold our members of Congress accountable and it’s why we need fundamental changes to our campaign finance system.”

 

By: Adam Smith, Health Care For America Now, October 10, 2012

October 14, 2012 Posted by | Election 2012 | , , , , , , , , | 1 Comment

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