“The Moral Case For President Obama”: The Exercise Of Conscience And Judgment
We’ve talked a lot of policy on the Dish this election cycle – airing legitimate differences on how to handle foreign policy, or taxes, or how best to run a healthcare system. And that’s absolutely part of an election, and I fully accept the validity of the views of those who legitimately disagree with me on what are essentially prudential judgments. I’ve supported Democrats and Republicans in my adult life, for different prudential reasons at different moments in time. In politics, I’m a conservative; not an ideologue.
But there is another dimension to politics and it’s about morality. Some issues are not subject to prudential or utilitarian reasoning, but are fundamental a priori moral questions. Let me cite three areas where I think the difference between Obama and Romney is a deep and moral one and requires the exercize of conscience as well as judgment.
The first is universal access to healthcare. I’ve long been a fan of the great parts of America’s private healthcare system: its treatment of patients as customers they want to keep, as opposed to human beings they are simply mandated to treat; the innovation of the pharmaceutical companies in a free market; private hospitals and doctors. But the fact that tens of millions of human beings cannot afford access to this often excellent private healthcare, even in a basic form, remains, to my mind, a scandal. That there are two nations in this country – one with the security of healthcare and one with no security at all – remains, to my mind, a moral disgrace.
That view comes ultimately from my Catholic faith. But it also comes from my surviving a plague and seeing so many die in often unbelievable neglect. It comes from realizing that if I encounter a sick person, every particle of my being wants to see that person get care, and it’s only by looking away that I can ignore this core truth. It comes from understanding that as someone with a pre-existing condition, I would be bankrupted if I ever lost insurance through an employer. And I am so much more privileged than so many.
I don’t believe in the kind of socialized medicine they have in my home country, where the government really does run the industry. But I do believe as a core moral principle in universal access to basic healthcare in wealthy countries.
This election is really asking you: do you believe everyone should be able to have access to private health insurance or not? When I examine my conscience, my answer has to be yes.
I believe in equal human dignity, and denying someone medicine to live healthily denies that dignity. To run a campaign in favor of removing that kind of security for tens of millions of Americans and replacing it with nothing remotely comparable is simply, deeply, morally wrong.
Torture is also a non-negotiable issue for me. It is simply unacceptable. It is the negation of the West’s entire founding principles. Any candidate of any party who supports it rules himself out for me on that ground alone. Romney will bring it back. He will make America a torturing nation again. He would employ the former war criminals of the dark years of Bush-Cheney and legitimize them still further. He would reinforce the idea, propagated by Cheney, that torture is a “no-brainer”, giving comfort to every vicious dictator on the planet to do the same. This was not the case in 2008, when both candidates disavowed torture, and one of them had actually suffered by the exact torture techniques approved by Bush-Cheney.
Finally, I cannot reconcile a pre-emptive war against a country that only has the technical ability to make a nuclear bomb, but has not weaponized it or threatened its use, with any reading of just war theory.
I have no illusions about the evil in the Tehran regime. This page was obsessed with the suppressed Iranian revolution three years ago and covered it like no other. I despise theocracy perhaps more than any other form of government – because it is a blasphemy as well as a dictatorship. But when the Supreme Leader of that theocracy publicly declares as religious doctrine that using a nuclear bomb is a sin, and when the opposition in Iran favors the nuclear program as a matter of national pride, and when Iran’s nuclear capability would still be no match for Israel’s massive and fully actionable nuclear apparatus, then pre-emptive war is morally unconscionable. To use an expression like “mowing the lawn” to decribe such acts of war that would kill countless people makes me sick to my stomach.
If the Iranian theocrats were to constuct an actual nuclear bomb and directed it toward other countries, I still would favor containment. I believe in the doctrine of deterrence. But I can see, given the evil nature of the regime, especially its disgusting anti-Semitism, why some may disagree with that view, including the president. I can also see why the Jewish people, given the enormities they have suffered and the extraordinary achievement of their dynamic, tiny state, would lean on the side of extreme caution. But to launch a war with necessary ground troops and brutal bunker-busting bombs simply because a country has the technical capability to enrich enough material for a nuclear bomb – that’s immoral. It’s unjust. When that country poses no threat to the United States itself, it’s way outside the parameters of a just war.
Romney favors such a pre-emptive war based merely on Iran’s capability. Obama favors it based on the actual decision to construct a nuclear weapon. Both, I believe, are morally troublesme, from a just war perspective. But Romney’s is far worse. I’m no pacifist. But I also deeply oppose war except in self-defense with as few civilian casualties as is possible.
I’m not citing civil rights issues, but they of course factor in. The GOP’s institutional bigotry toward gay people and our lives and families and its stated intent to keep a whole class of us disenfranchized from the basic right to marry the person you love appalls me. But I understand this is a state matter, not a federal one. And I’m addressing presidential decisions here. I endorsed George W. Bush and Bob Dole who explicitly opposed marriage equality. Heck, I supported a Democrat named Barack Obama who did at the time as well. But I believe in federalism on this. And always have.
On the universality of access to healthcare, on torture, and on pre-emptive war, my conscience therefore requires me to withhold support for the Republican candidate. I disagree with him on many prudential policy grounds – but none reach the level of moral seriousness of the above. Yes, a lot of this comes from my faith in the teachings of Jesus and the social teaching of the Catholic tradition in its primary concern for the poor and weak and the sick – rather than praising, as Romney and Ryan do, the superior morality of the prosperous and strong and healthy. But on all three topics, a purely secular argument also applies, simply based on the core dignity and equality of the human person, and the fragile advances we have made as a civilization against barbarism like torture.
That matters. It matters in a way that nothing else does.
By: Andrew Sullivan, The Daily Beast, October 26, 2012
“Completely Ignorant”: Senate Candidate Josh Mandel Offers Most Nonsensical Plan Yet To Cover Pre-Existing Conditions
Republicans who want to repeal the Affordable Care Act—that is, all of them—have a really difficult time explaining how they would preserve popular elements of the legislation, such as the provisions that ban insurers from denying coverage based on pre-existing conditions, or requirements that young people remain covered for longer on their parents’ policy.
In a lunchtime debate on Monday, Josh Mandel, the Republican trying to unseat Senator Sherrod Brown in Ohio, gave easily the most confusing “plan” we’ve heard so far:
Q: How would you, and with specificity please, how would you maintain those benefits without the requirement of people buying insurance?
MANDEL: Well you have to make cuts in the other part of the government. In order to pay to cover folks with pre-existing conditions, to your question, and for younger folks on their parents’ insurance, if there’s leaders in Washington want to do that without Obamacare on the books—you’ve got to make significant cuts. A lot of Republicans will say, don’t touch defense, don’t touch the military. Listen, if we’re going to have a good-faith conversation about strong health care, about a balanced budget, we need to actually make cuts in defense. I mentioned some of my ideas in respect to Europe. Another place I’d like to cut—I mentioned Pakistan but I’d like to get more specific. A few weeks ago, in Egypt, our embassy was overrun. In Libya our ambassador was killed. Why in the world is Sherrod Brown, and other politicians in Washington, voting to give our tax dollars to countries that harbor terrorists, when we need that money here to pay for healthcare, to protect Medicare, to protect Social Security. It doesn’t make any sense. They’re going to hate us without us paying them to do that. We don’t need to pay them to hate us.
Mandel’s answer, which somehow ends up on the embassy deaths in Libya, betrays a complete ignorance of what “Obamacare” does.
What it does not do is simply pay insurers to cover people with pre-existing conditions. The ACA has an individual mandate to buy insurance, which broadens the consumer pool for insurance companies, while also banning insurers from denying coverage to people with pre-existing conditions and using community ratings to ensure everyone is offered fair prices for coverage.
If you repeal the individual mandate in Obamacare, which Mandel indisputably wants to do, then how do you keep people from simply waiting until they get sick to buy coverage for which they cannot be denied—something that would send the health insurance industry into a fatal tailspin?
That’s what the moderator was clearly asking, and Mandel squares that circle by… cutting defense spending.
It’s a completely nonsensical response. (Brown wryly noted that “That was about a specific an answer on healthcare as he’s given throughout the whole campaign.”) Interpreted literally, it seems Mandel is actually proposing a new federal program that would directly subsidize insurers for covering those with pre-existing conditions and young people who want to stay on their parents’ plans—funded by cuts in defense and foreign aid to places like Libya and Egypt.
But since nobody anywhere has proposed anything like that before—most notably, Mandel hasn’t—what’s more likely is that he’s trading on the common misperception of Obamacare as a massive taxpayer-funded boondoggle that simply throws public money at various problems. Under that understanding of Obamacare, I suppose you could re-fund the “pre-existing conditions coverage” line in the federal budget with defense cuts—but that line doesn’t exist. It’s not how the law works.
Mandel either doesn’t understand that, or wants to willfully mislead voters about the legislation and what he could do for them if it’s repealed.
It’s a tough question for Republicans to answer—Mitt Romney has simply declared that he would magically cover people with pre-existing conditions without offering any details. (This lead an economist at the right-wing American Enterprise Institute to say last week that “It’s a complete mystery what [Romney]’s talking about. He’s clearly asserting that he’s got a new policy, but he hasn’t said what it is.”)
Given how ridiculous Mandel sounded while attempting to flesh out a plan, perhaps Mitt is onto something here. But the bottom line remains that Republicans like Mandel and Romney have no serious plan for maintaining coverage for people with pre-existing conditions.
By: George Zornick, The Nation, October 15, 2012
Why Mitt Likes To Say “I Like”: Destroying The Things He Supposedly Likes
I’m not sure if I like the way Mitt Romney likes things. As the newly empathic candidate was promising to kill Big Bird at Wednesday’s debate, did you notice how he backed into it?
“I like PBS,” Romney started out. “I love Big Bird. I actually like you [to moderator Jim Lehrer] too. But I’m not going to—I’m not going to keep on spending money on things to borrow money from China to pay for it. That’s number one.”
“Like” is a decaffeinated form of “love” when Mitt uses it, but it’s also a mild protest, a plea for understanding. He usually lays a slight stress on the word, as if he’s revealing some vaguely surprising truth—“You may see me as an unfeeling, uncaring, bottom-line guy, but let me tell you, I enjoy life. I like things.” This man, who is so buttoned-up he can’t be honest about what he’s running on—like whether or not he’d cut taxes for the rich or cover pre-existing conditions in his health plan—uses like to establish his personal bona fides. I’m like you, he’s saying, I have “likes.”
Of course, it helps that like is such a flexible word, meaning “similar,” “approve” and just acting as a rhetorical placeholder, like, well, whatever. Mitt does like (indeed, he requires) a certain flexibility about what he means when he uses words. And because some of his most awkward moments during the campaign have hung from his “I like” tic, you have to wonder what he’s really saying:
“I like grits,” he said, “Strange things are happening to me.”
“I like seeing the lakes. I love the lakes. There’s something very special here. The Great Lakes, but also all the little inland lakes that dot the parts of Michigan…”
At Wednesday’s debate, we learned a few more of Mitt’s most likable things:
“And by the way, I like coal.”
“I like the way we did it in Massachusetts. I like the fact that in my state, we had Republicans and Democrats come together and work together.”
“Now, I like green energy as well…”
And it’s true, all those things are meant to be slightly surprising, particularly when listed by a man at a podium who’s running for president, and worthy of the faint stress he lays upon the word. He’s often pandering, as any politician will. But I also think Mitt is working hard to redefine the word. The most famous example is, of course:
“I like being able to fire people who provide services to me.” And as PBS, Big Bird, and surely now even Jim Lehrer know, every man destroys the thing he likes.
By: Leslie Savan, The Nation, October 7, 2012
“Trust Me, I’ll Figure It Out”: Mitt Romney Re-Explains Why He Can’t Be Trusted On Health Care
Over the weekend, Mitt Romney muddied the waters about where he stands on health-care reform with a series of vague statements from himself and his campaign about health insurance for people with pre-existing conditions.
His floundering is a subset of a larger problem: He has committed himself to a set of positions that won’t allow for a replacement of Obamacare with something that actually fixes the problem of tens of millions of Americans without health insurance, including those with pre-existing conditions.
Sarah Kliff of the Washington Post describes Romney’s progression on pre-existing conditions:
It started with the Republican presidential candidate saying during an appearance on “Meet the Press” that he liked the Affordable Care Act’s provision that requires insurers to cover preexisting conditions, and would support something similar. Hours later, his campaign clarified he did not, however, support a federal ban against denying coverage for preexisting conditions. Around 10 p.m., the Romney camp had circled back to the same position it held back in March: that the governor supports coverage for preexisting conditions for people who have had continuous coverage.
The “continuous coverage” distinction is key: In order to retain the right to insurance that covers your pre-existing condition, you need to make sure to pay health insurance premiums every month. But often, the reason people lose health insurance because they have lost their job. Telling the recently unemployed to pay out of pocket for continuous coverage, typically at a cost of several hundred dollars a month for an individual or more than $1,000 for a family, is often not viable.
It’s worth noting that the purpose of the continuous coverage requirement is similar to the purpose of the individual mandate: It provides an incentive for healthy people to stay in insurance pools, avoiding a “death spiral” in which only sick people buy insurance.
Unaffordability is not a fatal problem for Romney’s continuous coverage proposal. It could be fixed with a range of subsidies that make it affordable for people to maintain continuous health coverage. Essentially, that’s what Obamacare does, and what Romney’s health plan in Massachusetts did.
For a conservative approach to fix at least part of the affordability problem, see this article from National Affairs by James Capretta and Tom Miller. Capretta and Miller propose to combine a Romney-style proposal on pre-existing conditions with significantly expanded funding for high-risk insurance pools, in hopes of covering up to 4 million uninsured Americans with pre-existing conditions.
But Capretta and Miller estimate that their plan would cost somewhere on the order of $200 billion over 10 years. Where is the indication that Romney plans to make such a significant financial commitment, let alone get one out of a Republican Congress? Romney’s platform is full of expensive promises — restore $700 billion in Medicare cuts, grow defense spending to 4 percent of GDP, cut tax rates. It funds these promises in part by drastically cutting spending on health care for the non-elderly. Implementing something like the Capretta-Miller proposal would be a significant reversal of course.
And what about the tens of millions of Americans who are uninsured not because they have pre-existing conditions but simply because they cannot afford insurance coverage? Romney says he wants to replace Obamacare, but his plans do not signal much help for them.
Romney has talked about leveling the playing field for individual purchasers of insurance, so they would get the same favorable tax treatment as businesses buying insurance for their employees. This would make it easier for individuals to buy their own health plans, but it’s not a substitute for Obamacare-style subsidies. Any way you structure a tax incentive, it’s likely to over-subsidize the wealthy and under-subsidize the poor, leaving huge swaths of America still unable to afford insurance.
Romney hasn’t said exactly how his tax incentive would work. But it would probably be a tax credit (whose value is static across incomes) or a tax deduction (whose value rises with income). In 2008, John McCain proposed a $5,000 per family tax credit for health insurance. Scaled up for health-care inflation, that would likely be closer to $6,000 today.
The average health plan premium for a family is now $15,745. Some middle- and upper-middle-income families can be expected to cover a gap of about $9,000. But poorer people need a larger subsidy if we hope to get them covered.
(It is also worth noting that if Romney plans to convert the existing tax exclusion for employer-provided health care into some other health-care subsidy, he cannot also use it as an area for tax-base broadening to pay for his cuts in tax rates, and he needs a lot of base-broadening to make his tax-cut math work.)
The key to the subsidy structure in both Romney’s Massachusetts plan and Obamacare is that the subsidies decline in value as people’s incomes rise. Under Obamacare, people with incomes up to 133 percent of the poverty line get Medicaid, which has very little cost to the beneficiary. Above that, they get sliding-scale subsidies for private insurance; the poorest beneficiaries pay just 2 percent of their incomes. Middle-income people get smaller subsidies, and wealthy people have to pay their own way.
Republican rejection of the Medicaid expansion is especially problematic, because Medicaid is cheaper than private insurance, and people earning less than 133 percent of the poverty line have almost no money of their own to contribute toward premiums.
Telling these people the federal government will pay 40 percent of their health insurance premiums will not get them insured. The options aside from Medicaid are to provide them private insurance at significantly higher taxpayer cost than in Obamacare, or leave them uninsured. It is easy to guess which option Republicans in Congress would prefer.
Romney doesn’t want to get into these details about who will get what subsidies. But the details are important. They are the difference between expanding health insurance coverage to the vast majority of Americans, and leaving tens of millions of Americans without access to the health care they need. And they are the difference between actually making it possible for people with pre-existing conditions to get the coverage they need, and not making it possible.
As on so many issues, Romney’s line on health reform is essentially, “Trust me, I’ll figure it out.” But uninsured Americans stand to gain a lot from the implementation of Obamacare. They have no particular reason to believe that Romney’s vague alternative would bring them similar benefits.
By: Josh Barro, Bloomberg, September 13, 2012
“A Pathetic Scam”: Boehner On Health Care, “Everything Must Go”
For about three years now, congressional Republicans have sworn up and down that they’re hard at work on a health care reform package of their own. It’s going to be awesome, they said, and will meet Obamacare’s goals without all that unpopular stuff.
Sensible people gave up on actually seeing this vaporware quite a while ago, realizing that “repeal and replace” was a rather pathetic scam. But with the Supreme Court ruling on the Affordable Care Act due fairly soon, and with the possibility of a Republican White House and a Republican Congress on the horizon, there’s renewed interest in what, exactly, GOP policymakers intend to do on the issue.
There was some talk this week that Republicans, fearing a public backlash, would “draw up bills to keep the popular, consumer-friendly portions in place — like allowing adult children to remain on parents’ health care plans until age 26, and forcing insurance companies to provide coverage for people with pre-existing conditions.” (The interconnectivity of the popular and unpopular parts are generally as lost on Republicans as they are on the general public.)
The GOP’s base immediately said this would be outrageous. Yesterday, House Speaker John Boehner (R-Ohio) joined them, making it clear that Republicans intend to kill the whole law, including the parts Americans like, want, and have come to expect.
House Speaker John Boehner (R-Ohio) reiterated Thursday that he wants to repeal all of President Obama’s healthcare law if the Supreme Court doesn’t toss out the entire statute.
“We voted to fully repeal the president’s healthcare law as one of our first acts as a new House majority, and our plan remains to repeal the law in its entirety,” Boehner said to reporters. “Anything short of that is unacceptable.”
Let’s not brush past too quickly exactly what this means. The only “acceptable” outcome for Romney is one in which tens of millions of Americans lose their health care coverage, seniors pay higher prescription drug costs, small businesses lose their tax breaks, and the deficit goes up by hundreds of billions of dollars over the next decade.
But there’s another point that’s gone largely forgotten: we’ve gone from a policy landscape in which Republicans agreed with 80% of Obamacare to one in which Republicans agree with 0% of Obamacare.
No one seems to remember this, but in September 2009, Louisiana Rep. Charles Boustany (R), the Republican who delivered the official GOP response to President Obama’s speech on health care reform, made an interesting declaration, telling MSNBC “about 80%” of the Democratic proposal is acceptable to Republicans.
Soon after, none other than Eric Cantor, now the House Majority Leader, said Republicans and Democrats agree on 80% of the health care reform measures.
Keep in mind, these comments came when the public option was still a key component of the Democratic plan — which suggests by the time the proposal was being voted on, Republicans liked more than 80% of Obamamcare.
This, of course, leads us to a few questions for Boehner and his cohorts. One, how is it congressional Republicans went from 80% to 0%, when the reform package itself did not move to the left? And two, if Republicans intend to get rid of “the entirety” of the law, including parts that enjoy overwhelming public support, why should voters back GOP candidates?
By: Steve Benen, The Maddow Blog, May 18, 2012
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