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“Who Hates Obamacare?”: Progressives Should Not Be Trash-Talking Progress And Impugning Motives Of People On Their Side

Ted Cruz had a teachable moment in Iowa, although he himself will learn nothing from it. A voter told Mr. Cruz the story of his brother-in-law, a barber who had never been able to afford health insurance. He finally got insurance thanks to Obamacare — and discovered that it was too late. He had terminal cancer, and nothing could be done.

The voter asked how the candidate would replace the law that might have saved his brother-in-law if it had been in effect earlier. Needless to say, all he got was boilerplate about government regulations and the usual false claims that Obamacare has destroyed “millions of jobs” and caused premiums to “skyrocket.”

For the record, job growth since the Affordable Care Act went fully into effect has been the best since the 1990s, and health costs have risen much more slowly than before.

So Mr. Cruz has a truth problem. But what else can we learn from this encounter? That the Affordable Care Act is already doing enormous good. It came too late to save one man’s life, but it will surely save many others. Why, then, do we hear not just conservatives but also many progressives trashing President Obama’s biggest policy achievement?

Part of the answer is that Bernie Sanders has chosen to make re-litigating reform, and trying for single-payer, a centerpiece of his presidential campaign. So some Sanders supporters have taken to attacking Obamacare as a failed system.

We saw something similar back in 2008, when some Obama supporters temporarily became bitter opponents of the individual mandate — the requirement that everyone buy insurance — which Hillary Clinton supported but Mr. Obama opposed. (Once in office, he in effect conceded that she had been right, and included the mandate in his initiative.)

But the truth is, Mr. Sanders is just amplifying left-wing critiques of health reform that were already out there. And some of these critiques have merit. Others don’t.

Let’s start with the good critiques, which involve coverage and cost.

The number of uninsured Americans has dropped sharply, especially in states that have tried to make the law work. But millions are still uncovered, and in some cases high deductibles make coverage less useful than it should be.

This isn’t inherent in a non-single-payer system: Other countries with Obamacare-type systems, like the Netherlands and Switzerland, do have near-universal coverage even though they rely on private insurers. But Obamacare as currently constituted doesn’t seem likely to get there, perhaps because it’s somewhat underfunded.

Meanwhile, although cost control is looking better than even reform advocates expected, America’s health care remains much more expensive than anyone else’s.

So yes, there are real issues with Obamacare. The question is how to address those issues in a politically feasible way.

But a lot of what I hear from the left is not so much a complaint about how the reform falls short as outrage that private insurers get to play any role. The idea seems to be that any role for the profit motive taints the whole effort.

That is, however, a really bad critique. Yes, Obamacare did preserve private insurance — mainly to avoid big, politically risky changes for Americans who already had good insurance, but also to buy support or at least quiescence from the insurance industry. But the fact that some insurers are making money from reform (and their profits are not, by the way, all that large) isn’t a reason to oppose that reform. The point is to help the uninsured, not to punish or demonize insurance companies.

And speaking of demonization: One unpleasant, ugly side of this debate has been the tendency of some Sanders supporters, and sometimes the campaign itself, to suggest that anyone raising questions about the senator’s proposals must be a corrupt tool of vested interests.

Recently Kenneth Thorpe, a respected health policy expert and a longtime supporter of reform, tried to put numbers on the Sanders plan, and concluded that it would cost substantially more than the campaign says. He may or may not be right, although most of the health wonks I know have reached similar conclusions.

But the campaign’s policy director immediately attacked Mr. Thorpe’s integrity: “It’s coming from a gentleman that worked for Blue Cross Blue Shield. It’s exactly what you would expect somebody who worked for B.C.B.S. to come up with.” Oh, boy.

And let’s be clear: This kind of thing can do real harm. The truth is that whomever the Democrats nominate, the general election is mainly going to be a referendum on whether we preserve the real if incomplete progress we’ve made on health, financial reform and the environment. The last thing progressives should be doing is trash-talking that progress and impugning the motives of people who are fundamentally on their side.

 

By: Paul Krugman, Op-Ed Columnist, The New York Times, February 5, 2016

February 6, 2016 Posted by | Affordable Care Act, Bernie Sanders, Obamacare, Progressives | , , , , , , , | 1 Comment

Age Gap: The GOP’s Generational Weapon In The Medicare Fight

To senior citizens at town hall meetings angry or worried about their plan to convert Medicare to a private insurance scheme, Republicans have a simple answer: It’s not about you. You’ll be fine. This is for “the next generation.”

The next generation is everyone 55 or under, since the plan would not start for ten years and would affect only newly eligible seniors. The stated logic of the ten-year delay is that it takes time to put the system in place and that people need time to plan. But if “premium support” (a euphemism right up there with “enhanced interrogation”) were ever going to work, it could be implemented as quickly as the Affordable Care Act (four years) or Medicare’s prescription drug coverage (two years). Presumably, the delay is mostly a political kludge, intended to avoid a backlash from those now or soon to be dependent on Medicare by affecting only those young enough to be giving little thought to retirement health coverage.

But the line they chose is more than a gimmick: The 55-and-over cutoff marks a sharp and significant generational divide. Those over 55 will continue to benefit from one of the triumphs of social insurance in the Great Society, while the rest of us will be on our own, with a coupon for private health insurance. If you consider what it means to be 55 years old in 2011, you’ll see the significance of the line.

Today’s 55-year-old was born in 1956. That’s not generally considered a major break in the generations. It’s smack in the middle of the Baby Boom (the peak of the boom, in fact), with almost a decade to go before the first Gen-Xers were born, dreaming of Winona Ryder. But the difference between early and later Boomers, especially in their experience of the economy, is dramatic.

A baby born in 1956 would have graduated from high school in about 1974, from college in 1978 or so. Look at almost any historical chart of the American economy, and you see two sharp breaks in the 1970s. First, in 1974, household incomes, which had been rising since World War II, flattened. Real wages started to stagnate. The poverty rate stopped falling. Health insurance coverage stopped rising. Those trends have continued ever since.

Second, a little later in the decade, around the time today’s 55-year-olds graduated from college (if they did—fewer than 30 percent have a four-year degree), inequality began its sharp rise, and the share of national income going to the bottom 40 percent began to fall. Productivity and wages, which had tended to keep pace, began to diverge, meaning that workers began seeing little of the benefits of their own productivity gains. The number of jobs in manufacturing peaked and began to drop sharply. Defined benefit pensions, which provide a secure base of income in retirement, began to give way to 401(k)s and similar schemes that depend on the worker to save and the stock market to perform. While the benefits of higher education rose, college tuitions started to rise even faster. Those trends, too, have continued.

If there was ever going to be a generational war in this country, that high school class of ’74 would be its Mason-Dixon line. It’s the moment when Bill Clinton’s promise—“if you work hard and play by the rules you’ll get ahead”—began to lose its value. Today’s seniors and near-seniors spent much of their working lives in that postwar world, with their incomes rising, investments gaining, their health increasingly secure, and their retirements predictable. Everyone 55 and younger spent his or her entire working life in an economy where all those trends had stalled or reversed. To borrow former White House economist Jared Bernstein’s phrase, it was the “You’re On Your Own” economy. Finally, those 55-year-olds are spending several of what should be their peak earning years, years when they should be salting away money in their 401(k)s and IRAs, in a period of deep recession and very slow recovery.

The Ryan plan, in other words, delivers to the older generation exactly what they’ve had all their lives—secure and predictable benefits—and to the next generation, more of what they’ve known—insecurity and risk. It’s hardly the first generational fight the GOP has started. The previous one was just last fall, when they campaigned for Medicare, and against the $500 billion in cuts (mostly by getting rid of the overgenerous subsidies to private insurers in an experimental program) passed as part of the Affordable Care Act. With an off-year electorate that was overwhelmingly older, they could put all their bets on the older side, knowing that seniors would see little benefit from the Affordable Care Act and were naturally worried about any change to the health system they enjoyed.

Heading into the 2012 election, however, the electorate is likely to shift back to one in which younger and middle-aged voters vote in proportion to their share of the population, so a “Mediscare” campaign won’t work. This time, the GOP hopes to play both sides of the generational war, gambling that while seniors want security, younger voters never expected the certainty of Medicare, just as they don’t expect reliable pensions or Social Security benefits, and thus will embrace a plan that sounds innovative, flexible, and market-based. Contending that the only alternative to premium support is the end of Medicare entirely, they are offering a generation that is accustomed to getting less than their parents a little bit, rather than nothing.

This strategy is a variation on the generational conflict the Bush Administration tried to launch in 2005 over Social Security privatization. Although it never reached the level of specificity that Ryan achieved, the calculus was the same: Younger voters would welcome the opportunity to take advantage of the stock market for their retirement, rather than the stodgy and predictable system their parents and grandparents liked.

That wager didn’t work, however: It turned out that older voters were terrified of Social Security privatization and younger voters unenthusiastic. Within five months, the radical move that every pundit thought was a near-certainty when George W. Bush declared “I’ve got political capital and I intend to use it,” had disappeared, never even introduced as legislation. And despite this week’s relaunch of the Ryan plan, it’s likely to end in the same result. If Social Security is any precedent, younger voters will be indifferent, while older voters won’t believe they’re exempt. The Republicans will again walk away from the conflict, hoping to get credit for being “serious” without bearing a political price for the error.

For Democrats, the defeat of the Ryan plan, like the failed Social Security privatization before it, will be regarded as a great victory, and an opportunity to get a fresh start with worried older voters. But they should not ignore the generational divide revealed by Ryan’s cutoff. If progressive politics has nothing to offer the late Boomers and the generations that follow except the same old programs, and nothing that responds to their distinctive experience of the economy, then eventually they’ll fall for one of these gimmicks from the right.

 

By: Mark Schmitt, The New Republic; Senior Fellow, Roosevelt Institute, May 20, 2011

May 29, 2011 Posted by | Affordable Care Act, Class Warfare, Congress, Conservatives, Consumers, Economy, Elections, GOP, Government, Health Care, Ideologues, Ideology, Income Gap, Jobs, Lawmakers, Medicare, Middle Class, Politics, Rep Paul Ryan, Republicans, Right Wing, Seniors, Social Security, Voters | , , , , , , , , , , , , | Leave a comment

Health Care Hypocrisy: How Paul Ryan And House Republicans Are Contradicting Themselves Over Medicare

In the debate over the House Republicans’ budget plan championed by Representative Paul Ryan, it’s been remarkable to watch the contortions and contradictions in the GOP on the issue of health care. The cornerstone of the Republican critique of the Affordable Care Act over the past year or so has been that it would lead to rationing. While Republicans initially manufactured lies about this issue—anyone remember death panels?—they eventually focused on one provision in the bill that was focused on cutting costs: the Independent Payment Advisory Board (IPAB). As specified in the legislation, the IPAB is a 15-member board of medical experts who are appointed by the president, confirmed by the Senate, and tasked with cutting costs in the Medicare system, unless Congress acts to alter the proposal or discontinue automatic implementation. The legislation also specifies that a goal of such cost-cutting should be to actually improve access for beneficiaries. At a time when rising health care costs are a concern for families’ pocketbooks and the federal budget, the IPAB was a means to maintain public oversight of Medicare but insulate it from the normal politics of congressional decision-making, thus helping ensure that best medicine was the driver of cost reductions.

Republicans, however, viciously attacked the IPAB as being a bunch of unelected bureaucrats making decisions to cut costs at the expense of the quality of care seniors would receive. The rhetoric became quite heated: Congressman Phil Roe went so far as to call the IPAB the “real death panel.” Other Republicans, like Representative John Fleming, likened the IPAB to communism, saying, “It will take you back to the old Soviet Union, that’s the way they did things—with a central planning committee that set prices, targeted costs.”

Now, more than a year after health care reform passed, Paul Ryan, facing stiff opposition to his plan to end Medicare as we know it, has taken to attacking the IPAB as a way to rebut his critics. He’s arguing that, while his plan would keep Medicare the same for current beneficiaries, the IPAB “puts a board in charge of cutting costs in Medicare” that will “automatically put price controls in Medicare” and “diminish the quality of care seniors receive.” It’s this sort of dishonest vitriol that has led to 73 House Republicans, as well as some Democrats, to cosponsor legislation to eliminate the IPAB.

What’s fascinating about the posture of these cosponsors is that it runs into direct conflict to the vote the House took mere days ago on the overall Ryan budget, which passed thanks to broad Republican support. Indeed, the budget, which the co-sponsors voted for, changes Medicare into a voucher program in which seniors can only choose from among private insurance options, eliminating the public insurance that is currently at the heart of Medicare. In other words, rather than public officials, elected or unelected, making decisions as to what is covered in Medicare, the Republicans just voted to more or less privatize the program. So, , after all of their complaining about how the IPAB moved too far away from public accountability, they’ve just proposed eliminating all such accountability, insisting instead that private insurance companies know best.

Would Americans really feel better with insurance companies deciding whether they or their parents get the care they need? Probably not. The truth is that Republicans are not actually worried about accountability or giving Americans more health care options. They are not even worried about cutting costs: Medicare has a much lower cost per beneficiary than private health care now, so it makes no sense to privatize it in order to lower costs. What they are worried about is public health care; they can’t stand it—and are even willing to contradict themselves and hand people’s health over to unelected, private insurers to defeat it.

By: Neera Tanden, Chief Operating Officer, Center for American Progress, April 30, 2011

May 1, 2011 Posted by | Affordable Care Act, Conservatives, Death Panels, Federal Budget, GOP, Health Care, Health Care Costs, Health Reform, Insurance Companies, Medicare, Middle Class, Politics, Public Health, Rep Paul Ryan, Republicans, Right Wing, Seniors, Uninsured | , , , , , , , , , , | Leave a comment

GOP Medicare Proposal Doesn’t Work Like Members of Congress’ Health Care As Republicans Claim

The Center for American Progress has previously pointed out that the House Republican budget for fiscal year 2012 forces future beneficiaries out of Medicare into more expensive private plans. One of the ways Republicans are trying to sell their Medicare proposal is by claiming that beneficiaries would “be enrolled in the same kind of health-care program that members of Congress enjoy.” That claim is false. In fact, if the rate of growth under this Medicare proposal were applied to federal employees’ most popular health option, the Blue Cross Blue Shield Standard Option, federal workers, including members of Congress, with family coverage would have to pay another $3,330 for the care they enjoy today. Those with individual coverage would have to pay another $1,555.

Most federal workers receive their health coverage through the Federal Employees Health Benefits Plan, or FEHBP. The government contributes a portion of their health premium. That portion is set by law and applied to the weighted average of actual premiums charged in any given year. Beneficiaries make up the rest of the cost.

The Republican budget replaces the traditional fee-for-service Medicare for future beneficiaries with a voucher to private insurance companies that is established on very different terms. Unlike FEHBP, which has a consistent government contribution based on actual premiums charged in any given year, the amount of the voucher is determined independent of actual premiums. Its growth is instead tied to the rate of the consumer price index for all urban consumers, or CPI-U. Because health costs have typically increased faster than inflation, the level of government support from the voucher would become a lower share of actual premium costs over time. In other words, Medicare beneficiaries would be left holding the bag.

What would happen if FEHBP operated like the GOP Medicare proposal?

We examined what would happen if FEHBP had operated like the Republican Medicare proposal over the last decade. We used data from the Office of Personnel and Management to look at the annual premiums for federal workers enrolled in the Blue Cross Blue Shield Service Benefit Plan (Standard Family and Standard Individual). We chose this plan because nearly 60 percent of those enrolled in FEHBP have Blue Cross Blue Shield, and the Standard Option is the most popular FEHBP plan. We increased government support for the individual and family plans by the rate of growth in the CPI-U index from 2002 to 2011. We then compared the difference between the government’s share and the actual total premium in each year—which is the amount the beneficiary would pay—under the Republican proposal and the real FEHBP.

The result: A typical federal worker, or member of Congress, enrolled in family coverage in the Blue Cross Blue Shield Standard Option, would have had to pay an additional $3,330.36 for the same level of coverage they have today. Those with individual coverage would have had to pay $1,555 more.

By: Nicole Cafarella, Payment Reform Manager and Policy Analyst and Tony Clark, Policy Analyst, Center for American Progress, April 27, 2011

April 28, 2011 Posted by | Affordable Care Act, Congress, Consumers, Government, Health Care Costs, Health Reform, Medicare, Politics | , , , , , , , , , , , , , , , | Leave a comment

Wisconsin Supreme Court Race Throws A Spanner In The Works Of Wisconsin Wingnuts

While Wisconsin Congressman Paul Ryan prepares to shut down the federal government to prove that government is bad, analysts say the radical agenda of Wisconsin Governor Scott Walker suffered a major set back today as his good friend incumbent Justice David Prosser was defeated for Wisconsin Supreme Court. The AP unofficial vote count, with 100 percent of the precincts reporting, puts challenger Joanne Kloppenburg ahead by slightly more than 200. A recount is doubtless on the way.

In a state that has never unseated a conservative Supreme Court justice, people power fueled a concentrated effort to deny the Imperial Walker one branch of government. Walker’s opponents hope a Kloppenburg victory will swing the Supreme Court in a more independent direction and set the stage for the court to strike down Walker’s controversial collective bargaining law. While the fate of the law is uncertain, Kloppenburg’s three week sprint from dead-in-the-water to victor may give Walker, Ryan and other Wisconsin politicians pause as they rush to radically reshape government to benefit the privatizers and profiteers. 

Sleepy Court Race Electrifies the State

While it may seem odd to many Americans, Wisconsinites like to elect their judges. Although an elected judiciary has its problems (namely, unseemly high-dollar elections), the ballot box sometimes hands citizens a rare opportunity to un-elect judges — and that is what many Wisconsinites decided to do today.  Prosser, a former Republican Assembly Speaker, stumbled when his campaign embraced Walker’s election.

The Kloppenburg victory is stunning. Six weeks ago, sitting Judge David Prosser was a shoo-in and the challenge by Assistant Attorney General Kloppenburg was a snooze fest. But something happened on the way to the high court. A governor, who was elected to create jobs, took office and quickly moved to disenfranchise voters and kneecap unions so they could no longer be a viable force in state elections. The raw power grab sparked a spontaneous uprising, the likes of which this state has never seen, and the Supreme Court race was the next vehicle for people to have their voices heard.

Proxy Fight Over Worker Rights

The whole country took notice when firefighters, teachers and cops stood with working families across Wisconsin to say ‘no’ to Walker’s radical plans to bust unions, cut $1 billion from schools and privatize the university system.

When his “budget repair bill” was passed March 9th, many national observers thought the fight was over.  With large margins in both houses, Walker’s stranglehold on government seemed invincible.

But irate Wisconsinites fought back on multiple fronts, filing lawsuits over the way in which Senate leaders rammed the bill through with less than the requisite notice required under the state open meetings law, blocking the bill’s implementation. They filed recall petitions against eight Wisconsin senators and this week delivered the requisite signatures for two of those recalls well ahead of schedule. They turned their attention to the heretofor unnoticed race for Wisconsin Supreme Court. Within days, handmade signs for Joanne Kloppenburg popped up across the state. Many voters understood that to win any of the battles ahead over worker rights, over the recalls, over redistricting and more, a more balanced judiciary was needed.

Kloppenburg went from being a long-shot to victory in a three-week sprint marked by huge independent expenditures on both sides. The anticipated recount will keep the juices flowing and will fuel the remaining recall fights.

Shock Doctrine at Work

While some voters believe the court will act as a check and balance on the madness at the state level, they are concerned that Paul Ryan continues to run amok at the federal level — threatening a complete government shut down. At the same time that Walker was working to obliterate unions and privatize public schools, Ryan, Chair of the House Budget Committee, decided to go after Grandma with the complete privatization of Medicare. His radical budget bill, unveiled this week, slashes trillions of dollars from America’s social safety net and throws the elderly into the private insurance market with a “voucher” in their pocket.

Less interested in balancing the budget than redistributing wealth, his budget plan would funnel billions into the pockets of big insurance firms while also giving a ten percent tax break to corporations and the very richest Americans.

What is really going on here? Naomi Klein warned in her groundbreaking book “Shock Doctrine” that the right-wing excels at creating crises, real and imagined, to viciously advance their pro-corporate anti-government agenda. She credits economist Milton Friedman who observed that “only a crisis—actual or perceived—produces real changes. When the crisis occurs, the actions that are taken depend on the ideas that are lying around. That, I believe, is out basic function: to develop alternatives to existing policies to keep them alive and available until the politically impossible becomes politically inevitable.”

UW Professor Joel Rogers wrote recently:  “As explained by Grover Norquist and Karl Rove, this project aims at national repeal of most of democratic achievements of the 20th century, a return to business domination of public life not seen since the Gilded Age and McKinley.”

The Wall Street financial crisis caused by years of deregulation and lack of government oversight cost Americans eight million jobs, tanking federal and state tax receipts and creating budget shortfalls. Ryan and Walker are moving to take advantage this real jobs crisis to cook up a fake deficit crisis to advance a radical agenda that is hostile to the very idea of government – the idea that sometimes services are best provided and things are best accomplished collectively, for the public good, and not for corporate profit.

Today, many voters believe that this agenda was checked in Wisconsin. While another recount battle looms, voters of Wisconsin are pledging that they will not allow this victory to be stolen.

By: Mary Bottari, Center For Media And Democracy, April 6, 2011

April 6, 2011 Posted by | Banks, Collective Bargaining, Corporations, Debt Crisis, Deficits, Democracy, Economy, Elections, GOP, Gov Scott Walker, Government Shut Down, Labor, Medicare, Middle Class, Politics, Public Employees, Rep Paul Ryan, Republicans, Right Wing, Union Busting, Unions, Voters, Wisconsin, Wisconsin Republicans | , , , , , , , , , | Leave a comment

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