“Give Me Liberty And Give You Death”: How The GOP Embraced Being The Party Of Death
As part of their long-standing war on the Affordable Care Act, conservatives have filed a lawsuit willfully misreading the statute to deny upward of 10 million people subsidies to purchase insurance. This denial of insurance will almost certainly lead to significant amounts of preventable death and suffering.
Michael Strain of the American Enterprise Institute doesn’t deny any of this. Instead, he argues that some suffering and death may well be a price worth paying:
In a world of scarce resources, a slightly higher mortality rate is an acceptable price to pay for certain goals — including more cash for other programs, such as those that help the poor; less government coercion and more individual liberty; more health-care choice for consumers, allowing them to find plans that better fit their needs; more money for taxpayers to spend themselves; and less federal health-care spending. This opinion is not immoral. Such choices are inevitable. They are made all the time. [The Washington Post]
At a high enough level of abstraction, what Strain is saying isn’t wrong. Not all public policy can function on the basis of keeping mortality rates to the lowest possible number. Some lifesaving treatments might help so few people and cost so much that they might not be worth it. Even major infrastructure projects entail some risk of injury or death on the part of workers, but few people would argue that any such risk is unacceptable.
But the fact that the costs of the ACA might theoretically exceed the benefits doesn’t get us very far. What benefits, exactly, would accrue if millions of people were denied medical coverage because the ACA is seriously damaged or destroyed? It’s here that Strain’s argument falls apart.
One potential line against the ACA is the radical libertarian one, holding that any effort by the government to provide health care to the non-affluent represents an unacceptable level of state coercion. The problem here is that the “freedom” to die of preventable illnesses and injuries is not one the vast majority of people value very highly. A Republican Party committed to these principles would be transformed into an electoral coalition that would make Barry Goldwater’s 52 electoral votes in 1964 look robust.
Since the people responsible for the anti-ACA effort know this perfectly well, the constitutional arguments against the ACA have the advantage of not logically requiring the Supreme Court to rule the entire modern regulatory state unconstitutional. The disadvantage is that they ask the court to deny many millions of people health coverage based on liberty interests that are ludicrously trivial.
The litigants challenging the constitutionality of the ACA do not contend that the federal government cannot regulate national health-care markets. Rather, their constitutional argument boils down to an assertion that the government has the authority to assess a tax to compel people to purchase health insurance, but not a penalty. It’s pretty hard to argue that the fate of liberty in America hinges on this formal limitation on federal power.
The more successful federalist argument launched against the Affordable Care Act is similarly unattractive. Chief Justice John Roberts’ inept rewriting of the ACA’s Medicaid expansion allowed states to opt out. Republican-controlled states have eagerly rejected the large amounts of federal money on offer to insure more poor residents, something that is likely to result in the unnecessary deaths of more than 5,000 people a year.
I don’t think this particular protection of state autonomy is worth that many lives (or, indeed, a single life). But here’s the kicker: The Supreme Court’s decision does not even meaningfully protect state sovereignty. Under the court’s theory, Congress could have enacted the ACA’s Medicaid expansion by repealing the pre-existing Medicaid entirely. This, apparently, would be completely constitutional. There may be things worth 5,000 lives a year; an incoherent legal argument that doesn’t even really protect states’ rights isn’t one of them.
Strain’s arguments have similar problems. To his credit, he’s not a libertarian radical who asserts that the federal government cannot play any role in expanding health-care coverage. Rather, “universal coverage should concern itself with the catastrophic expenses associated with serious medical events that will affect a minority of the population.” The affluent, or people with good jobs, can get real medical coverage; the non-affluent might get some protection for disasters, but would have to pay through the nose for common medical procedures. Whether or not one prefers this policy alternative — which I think is far worse — there’s not a lot of meaningful protection of “freedom” going on here. The number of lives worth sacrificing so that people can choose between a few more insurance alternatives — or between the “freedom” to pay for checkups for their children or their electric bill — strikes me as “zero.”
And, of course, even this is too generous to the Republican reformers. The ACA isn’t unpopular because it provides subsidies that are too generous or because the exchanges offer insurance that cover too many things. The Republican alternatives Strain discusses will all disappear should the ACA be destroyed, because the trade-offs involved will outrage many voters. The actual Republican alternative Strain thinks it’s worth killing a lot of people for is “nothing.”
But, hey, the next upper-class Republican tax cut could be even larger, and it’s not going to be elite Republicans who pay the price. As the writer Roy Edroso puts it, Strain’s argument can be summarized as “give me liberty and give you death.” I think we can see why Republicans would prefer for the Supreme Court to do their dirty work.
By: Scott Lemieux, The Week, January 29, 2015
“Paths To The Presidency”: John Kasich And The Road Less Taken, Because It Goes Nowhere
Last month I spent a few minutes mocking a Cleveland Plain Dealer story that suggested big donors might hunt down Ohio Gov. John Kasich as he traipsed around the Mountain West plumping for a balanced budget constitutional amendment, and beg him to become the 2016 Republican presidential nominee. I half-thought the story was the product of somebody in Kashichland funnin’ a local reporter. I mean, really, a guy as seasoned as Kasich didn’t really think that was a viable strategy for becoming Leader of the Free World, did he?
But now we have a Wall Street Journal piece from the veteran national political reporter Janet Hook reporting the same madness:
If Ohio Gov. John Kasich is thinking of running for president, he’s taking a very circuitous route. Mr. Kasich, one of several Republican governors seen as potential candidates, is spending much of this week traveling through six sparsely populated Western states to promote balancing the budget.
Fresh off his inauguration to a second term as governor, Mr. Kasich is travelling from South Dakota to Wyoming to Idaho in a tour that ends Friday. He is trying to round up support for a constitutional amendment requiring a balanced federal budget — even as fiscal issues seem to be fading in Congress.
But then, after reporting that Kasich doesn’t admit this odd out-of-state travel schedule means he’s running for president, Hook cites it as one of several “paths to the presidency,” alongside those more conventional candidates are pursuing:
Mr. Kasich is part of a distinct posse of potential candidates — Republican governors that include Wisconsin Gov. Scott Walker, Indiana Gov. Mike Pence and outgoing Texas Gov. Rick Perry — who are angling to use their states’ records as calling cards in a bid for national office.
Mr. Kasich is proud of Ohio’s economic turnaround, and of his 2014 re-election by more than 30 percentage points. He has been trying to espouse a new brand of compassionate conservatism, supporting an expansion of Medicaid in his first term and saying in his second inaugural address, “Somehow we have lost the beautiful sound of our neighbors’ voices. Moving beyond ourselves and trying to share in the experience of others helps us open our minds, allows us to grow as people.”
But he is pairing that big-hearted message with fiscal conservatism, his trademark issue during his 18 years in Congress when he played a lead role in crafting a 1997 deal to eliminate the federal budget deficit.
So Ohio Record (including the kryptonite-to-conservatives Medicaid expansion) plus Balanced Budget somehow equals viable candidacy. It’s not easy to understand how, mechanically, anyone would win the nomination this way, unless Hook is buying the idea big donors will track him down somewhere in the Rockies and beg him to run.
You know what I think? A lot of MSM types think Kasich ought to be the kind of candidate the Republicans nominate, and that fiscal hawkery–the only part of the Constitutional Conservative ideology they understand–could be his ticket to ride.
Beyond that, there are an awful lot of people who think the current presidential nominating process, and particularly the role of the early states, is absurd, and would love to see someone defy it. But it keeps not happening. The last two serious candidates who tried to skip the early states–Democrat Al Gore in 1988 and Rudy Giuliani in 2008 (well, he didn’t originally plan to skip the early states but shifted away from them when support was not forthcoming) went nowhere. Perhaps someone with a massive national following and special credibility with the conservative activists who view the early states as their God-given choke point on the GOP nomination could get away with starting late and elsewhere. But not John Kasich.
By: Ed Kilgore, Contributing Writer, Political Animal Blog, The Washington Monthly, January 23, 2015
“It’s Good To Be A Bush”: How The GOP Presidential Candidates Will Talk About Obamacare
One of my favorite factoids from the 2012 presidential race emerged when Mitt Romney released his 2011 tax return. There may not have been much scandalous contained therein, but Romney’s sources of income were so varied and intricate that the return ran to a mind-boggling 379 pages. And it’s starting to appear that Jeb Bush may have a similarly complex financial life, which he’s starting to unravel as he prepares for a potential presidential run. There’s one particularly interesting source of income, as this article in the Los Angeles Times explains:
And on Wednesday, Bush resigned from the board of directors of Tenet Healthcare Corp., also effective Dec. 31, according to a corporate filing. The Dallas-based company actively supported the 2010 Affordable Care Act, and has seen its revenue rise from it, an issue that could draw fire in Republican primaries.
Bush earned cash and stock awards worth nearly $300,000 from Tenet in 2013, according to corporate filings. He also sold Tenet stock worth $1.1 million that year, the records show.
If it’s like other big corporations, the services for which he was paid $300,000 by Tenet probably involved little more than going to a couple of meetings every year. It’s good to be a Bush. But let’s try to imagine the fire he might draw in the primaries over his association with the company. Are politicians from the party of capitalism and business really going to criticize him for making a ton of money, even if it involved the hated Affordable Care Act?
Yeah, they probably will. Which raises the question of exactly how the 2016 GOP candidates are going to address the ACA, which even as it becomes further embedded in our health-care system is still on many Republicans’ minds. Chances are they’re going to talk about it in the most general terms they can, in a discussion that stays at a symbolic level and avoids any specifics.
That’s because there are many more Americans who have a negative view of the ACA as an abstraction than there are who dislike the things it actually does. Members of the public are about evenly split when you just ask them what they think of the law. (In the latest Kaiser Family Foundation poll, 45 percent say we should move forward with the law or expand it, while 43 percent say scale it back or repeal it.) But with the exception of the individual mandate to acquire coverage, the specific provisions of the law are all supported by strong majorities. Even majorities of Republicans support elements such as the creation of the exchanges, the expansion of Medicaid and the provision of subsidies to help people afford insurance.
So if you’re a Republican candidate, you have to seek safe harbor on the terrain of the general and symbolic. Otherwise, you’d end up like Mitch McConnell did during the last campaign, insisting that while he wanted to repeal the ACA “root and branch,” he also wanted to keep almost everything the law does.
At the moment, lots of Republicans remain psychologically trapped in the days right after the problematic rollout of Healthcare.gov convinced them all that the ACA would collapse in a matter of weeks or months. At the time, they could barely contain their glee. As Ramesh Ponnuru and Yuval Levin — widely considered two of the more sober conservatives on issues like these — wrote at the time, “As ObamaCare’s failures and victims mount by the day, Republicans have so far mostly been watching in amazement. They expected the law to fail, but even among its most ardent opponents few imagined the scale and speed of the fiasco.”
Even if that was your honest assessment back then, you’d have to be in the grips of a nearly psychotic level of denial to believe it today. Every result of the law may not be perfect, but it has been an overwhelming success. Just about every prediction Republicans made has turned out false. The economy hasn’t tanked, 10 million people were newly insured even before this year’s open enrollment, premium increases are slowing, overall health costs are slowing, and conservatives looking for specific evidence of the law’s failure don’t quite know what to say.
So criticizing something like the fact that one of your opponents sat on the board of a company that benefited from the ACA offers a way to tell voters that you still hate Obamacare with every fiber of your being — and that opponent obviously doesn’t — without having to talk about what the law has accomplished.
Now let’s imagine something fanciful. What if one of the GOP candidates said something like this:
I opposed Obamacare. I wish it had never passed. But now it has been implemented, and just repealing the whole thing isn’t an option anymore. Too many people are now on either Medicaid or plans they got through the exchanges, and it would be wrong to just toss them off their coverage. And there are some things in the law that both conservatives and liberals support. So here’s a plan to keep what’s right about it and fix what’s wrong about it.
We all assume that if a candidate said that, he’d be condemned by his opponents as a traitor and all Republican voters would turn against him. The former would certainly occur, but the latter might not. He might be able to pull the other candidates into a discussion about the specifics of the law, where — if he were the only one with a plan actually grounded in the real world — he could win the argument.
But the truth is, that’s not too likely. If Romney, whose Massachusetts health insurance reform provided the model for the ACA, could win the nomination just shaking his fist at President Obama and insisting that his reform was nothing like Obama’s — which not a single person, Republican or Democrat, actually believed — then why take that chance? If you’re Jeb Bush, you can leave the board of Tenet and repeat over and over that your loathing for the ACA is as strong as anybody’s. In the primaries at least, that will probably be enough to neutralize the issue.
By: Paul Waldman, Contributing Editor, The American Prospect; Contributing Writer, The Plum Line Blog, The Washington Post, December 26, 2014
“Vote For Yourself Tuesday”: When The 99% Vote, They’re More Likely To Get What They Want From Politicians
The rich always vote for themselves. They go for their self-interest, their tax breaks, their liability escapes (think Wall Street). Meanwhile, they’ve relentlessly instructed the non-rich that they too must vote for the rich.
They’ve promised for decades that if the 99 percent just comply with the wishes of the wealthy, bow down, kiss their feet, shine their shoes, then some paltry portion of the bucket-loads of dough that the rich are amassing will dribble down upon the 99 percent.
That trickle-down trick didn’t work for the vast majority of Americans. The rich got richer, all right. But the rest slid backwards. Now income inequality is worse than it was during the era of robber barons. It’s time to turn that around. Political leaders must focus on the needs of the 99 percent. For that to happen, the 99 percent must vote for themselves on Tuesday. They must go for their self-interest, their wages, their health insurance, their Social Security.
Vote for higher wages for the 99 percent.
Minimum wage workers in the United States are paid so little that taxpayers subsidize the likes of Walmart and Wendy’s through government programs such as food stamps and Medicaid. That doesn’t happen everywhere.
As the New York Times pointed out last week, McDonald’s, Burger King and Starbucks all pay their workers in Denmark at least $20 an hour and provide paid vacations and pensions. And the companies still make profits.
The one percenter CEOs of these companies, who demand millions in pay for themselves, have squashed efforts to raise the U.S minimum wage, a pittance stuck five years at $7.25. Instead of improving paychecks, McDonald’s told its workers to get second jobs, forego heat in their homes and find health insurance for $20 a month.
When the minimum wage rises, it bumps up pay for everyone else. The 99 percent benefit. And the majority supports lifting the wage.
Voting for raises means voting for Democrats. President Obama has called for an increase, and U.S. Labor Secretary Tom Perez said the U.S. minimum wage is an international embarrassment. “I mean, we suck. We really do,” he said.
Republicans have consistently blocked a raise. New Jersey’s GOP Gov. Chris Christie, the nation’s fourth highest paid governor at $175,000 a year, said last month that he is “tired of hearing about the minimum wage.”
Vote for health insurance for the 99 percent.
The majority of Americans believe that health insurance should be accessible to everyone. The Affordable Care Act moved the nation closer to that, enabling tens of millions to get covered.
It prevented insurers from dumping clients when they get sick and from denying coverage to those with pre-existing conditions, like diabetes. It covered millions of young people to age 26 on their parents’ plans. It protected millions with an expansion of Medicaid.
National surveys have shown that low-income Americans are obtaining health insurance at a faster rate than the rich. There are two reasons for this. The rich already were covered. And the law was designed to help the working poor. This is creating fairness in access to medical care.
Republicans hate the law. Two dozen GOP governors refused to expand Medicaid in their states, and those places now suffer from the highest rate of uninsured residents. Republicans are so intent on denying health care to the working poor that they rejected a program that would cost them nothing for three years.
Now, Mitch McConnell, the Republican minority leader in the Senate, has again pledged to repeal the Affordable Care Act if the GOP takes control of his chamber. Republicans want to regress to higher inequality in health insurance coverage.
Vote to preserve and expand Social Security and Medicare.
These programs are not priorities of the rich. The wealthy are riding high on golden parachutes, gilded pensions, tax-sheltered off-shore accounts, and the built-in security of immense salaries. Social Security wouldn’t pay their country club fees.
For the rest, however, Social Security and Medicare mean fear relief. They’re crucial to the 99 percent.
For years now, however, Republicans have tried to privatize, cut and destroy these programs. U.S. Rep. Paul Ryan, the ranking Republican on the House Budget Committee, repeatedly has issued a “roadmap” for an America in which the rich drive new Ferraris bought with tax breaks and the rest forfeit their wheels because of cuts to Social Security, Medicaid and Medicare.
The overwhelming majority of Americans oppose cuts. Among Democrats, there’s a movement to increase benefits by lifting the $117,000 cap, after which income no longer is taxed for Social Security. The cap means that the rich pay proportionately less into Social Security than the rest.
Vote for the overwhelming majority, the non-rich, to get their needs met.
The nation’s richest are more politically engaged and get easier access to high-level politicians than the 99 percent. That isn’t just obvious. It’s also according to surveys and interviews of one-percenters conducted by three university professors. They are Northwestern University’s Benjamin I. Page and Jason Seawright and Vanderbilt’s Larry M. Bartels. Their report is called Democracy and the Policy Preferences of Wealthy Americans.
The rich minority gets its way. Bartels and another researcher showed in earlier studies that federal government policy corresponds much more closely with the wishes of the rich than the needs of the rest.
Bartels, author of Unequal Democracy: The Political Economy of the New Gilded Age, has noted that no other rich country came close to the United States in cutting the budget based on class preferences. It went this way: the workers lost programs; the wealthy kept perks.
This has got to change. And it could. In states with low voter turnout inequality – that is balloting by the non-rich more closely matching participation rates by the wealthy – there are higher minimum wages, stricter anti-predatory lending laws and better health benefits for the working poor. In other words, when workers vote, they’re more likely to get what they want from politicians.
Vote for yourself on Tuesday.
By: Leo W. Gerard, International President, United Steelworkers; The Huffington Post Blog, November 3, 2014
“Obamacare Is Here To Stay”: Kentucky Is Emblematic Of The States That Have Received Substantial Assists From Obamacare
You’ve heard of Obamacare, right?
It’s that disastrous, costly and intrusive policy that President Obama and his fellow Democrats rammed down the throats of Congress back in 2010 — a failed plan that conservative Republicans have pledged to “repeal and replace.” According to its critics, it is un-American; it destroys the health care system; it burdens businesses; it hollows out Medicare. Right?
Ah, wrong. Despite what you may have heard and despite the caprice of electoral campaigns, the changes wrought by the Affordable Care Act are here to stay. That’s because it accomplishes much of what it set out to do — and its beneficiaries mostly like it.
Don’t expect Republicans to try to turn back the clock. Oh, some of them will continue to bash Obamacare and to blame it for any negative effects on the country’s dysfunctional health care “system” — including rising costs. And some will even go so far as to continue to insist that it ought to be repealed.
Take Senate Minority Leader Mitch McConnell, who expects to lead the upper chamber if Republicans claim a majority. In a debate last month with his Democratic rival, Alison Grimes, McConnell suggested that he would repeal the Affordable Care Act but leave in place Kentucky’s popular state exchange program.
“… The best interest of the country would be achieved by pulling out Obamacare, root and branch,” he said. “Now, with regard to Kynect, it’s a state exchange. They can continue it if they’d like to.”
McConnell’s pronouncement was a tour de force of dissembling, a virtuoso performance of fabrications and disinformation. The Washington Post’s fact checker awarded him three Pinocchios.
That’s because the state’s health care exchange, Kynect, is a part of Obamacare, made possible by the 2010 law. If Obamacare is ripped out “root and branch,” the state exchanges could not continue to exist. (The GOP has continually pledged to find a mechanism to replace Obamacare, but its warring factions have failed to agree on any plan that would leave state exchanges in place.)
Here’s the rub: Kynect is very popular with Kentucky’s residents, many of whom are enjoying health insurance for the first time in their lives. They have been primed by Republican politicians to hate the president and any policy he endorses — including his signature health care plan — but they don’t want to give up Obamacare’s benefits.
Kentucky is emblematic of the states that have received substantial assists from Obamacare. It is largely rural and is among the poorest states. It has also long ranked near the bottom in several health indicators, including obesity and smoking rates and cancer deaths. Obamacare has been a boon for its residents, cutting the rate of uninsured in half.
According to The New York Times, people who live in rural areas are among the biggest winners from the Affordable Care Act. Other groups who have reaped substantial benefits are blacks, Latinos, women and younger Americans between 18 and 34.
Here’s another reason that Obamacare is here to stay: Its expansion of Medicaid is a boon to the states that have taken advantage of it. After the Supreme Court ruled that Medicaid expansion was optional, most Republican governors vowed to resist it — even though the federal government will pay 100 percent of the cost for the first three years and 90 percent thereafter.
But some of those GOP governors are now having second thoughts as rural hospitals are forced to close down for lack of funds and poor people are sidelined by preventable illnesses. Several GOP governors have already expanded Medicaid — which provides health insurance for the poor — and others are considering doing so.
Last month, Ohio’s Republican governor, John Kasich, advised his GOP colleagues to stop fighting the Medicaid expansion. The opposition, he said, “was really either political or ideological. I don’t think that holds water against real flesh and blood, and real improvements in people’s lives.”
Some Republicans have trouble admitting that on the campaign trail, but they all know it’s true.
By: Cynthia Tucker, The National Memo, November 1, 2014
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