“Rand Paul’s Crazy Word Salad On Obamacare”: A Symbol Of GOP’s Larger Mess
Sen. Rand Paul made national news this weekend when he refused to say precisely whether he wanted to repeal Kentucky’s version of the Affordable Care Act, Kynect, along with the federal act itself. He bobbed and weaved like his boy Mitch McConnell, and most people have left it at that: another scared Republican afraid to tell the voters what he really thinks about a program that’s helped many of them. Reporters are used to that. Nobody except liberals even criticize it anymore, sadly.
But I want to look at Paul’s entire ludicrous soliloquy on Obamacare, Kynect and healthcare generally, because it shows how fundamentally unserious he is about domestic policy. Or if he is serious, he’s seriously delusional. It was every bit the nonsensical word salad we are used to being served by Sarah Palin, but maybe it’s sexism: Paul is never called out on it or mocked the way the former Alaska governor was. He ought to be.
I’ve written before that “Paul is what you get when traditional and corrosive American nepotism meets the 21st century GOP echo chamber: a pampered princeling whose dumb ideas have never been challenged by reality.” Ron Paul’s son has a tendency to look proud of himself whenever he shows a passing familiarity with facts and figures and ideas, even if he’s conflating or distorting them beyond any resemblance to reality. It’s on display in this interview with Kentucky reporters.
The junior senator from Kentucky starts out by acknowledging that Kynect gets a lot of praise, locally and nationally.
I think the real question that we have in Kentucky is people seem to be very much complimenting our exchange because of the functionality of it, but there are still the unknown questions or what’s going to happen with so many new people.
OK. Let’s take a look at “what’s going to happen with so many new people.” Here Paul rolls out some brand-new GOP anti-ACA scare tactics. First: The rapid expansion of Medicaid, he claims, is costing jobs.
I mean it’s basically about a 50 percent increase in Medicaid in one year. That’s a dramatic shot to a system. And my question is what will happen to local hospitals. If you look at [Glasgow, Kentucky, hospital] TJ Samson laid off 50 people and they’re saying they can’t afford the huge burden of Medicaid.
Oops, stop right there. While the hospital’s CEO did in fact link the layoff of 49 staffers to Obamacare in April, days later the Kentucky Cabinet for Health and Family Services disputed that account. It said the hospital would take in hundreds of thousands of dollars more in Medicaid funding annually, because it’s now being reimbursed for uninsured patients it used to treat without payment. Asked about the discrepancy, Paul just pointed to earlier reporting about the Samson CEO’s remarks and said: “All I know is what I read in the papers.”
So for President Rand Paul, the buck would presumably stop with the papers.
Then Paul raised the specter of folks getting their private health insurance subsidized under the Affordable Care Act, but with such high deductibles that they ultimately won’t be able to pay.
That’s gonna mean … you’re still just a non-payer, probably. And hospitals are going to have to figure out, we won’t know this for six months to a year, how many people who show up with subsidized insurance will actually be able to pay [their] deductible.
This could conceivably be a problem – actually, it was a big problem before the ACA – but Paul has no evidence the ACA made the problem worse. More likely it has helped some, because even with a high deductible plan, many preventive services are now provided without a co-pay. The point is, there’s no evidence of such a problem yet; Paul is just throwing trash at Obamacare to see what will stick. And there’s more:
How many of the new people on Medicaid, how many of those people may have actually had insurance before? Did they go from being a non-payer to being a government payer? Or did they maybe have insurance, but now they’re on Medicaid because it’s easier than having insurance?
Paul could probably find out the answers to these questions, with staff work and a little consultation with the Kentucky Cabinet for Health and Family Services, but he would never bother. After hearing all of this bad news, much of it invented, a local reporter asked the senator the obvious question:
With all those unknowns, do you think Kynect should be dismantled?
And here Paul joins McConnell and punts. Or lies, since it’s pretty sure from his answer he thinks Kynect should be dismantled.
You know I’m not sure — there’s going to be … how we unravel or how we change things. I would rather —I always tell people there’s a fork in the road.
Oh, that fork in the road. Paul turns to boilerplate conservative rhetoric:
We could have gone one of two directions. One was towards more competition and more marketplace and one was toward more government control. The people who think that the government can efficiently distribute medicine need to explain why the VA’s been struggling for decade after decade in a much smaller system.
Points for working in the VA, the Obama scandal du jour. Let’s leave that alone, it’s a story in itself. Continue, Sen. Paul:
And they also need to explain, even though I think we all want Medicare to work better, why Medicare is $35 trillion short.
Huh? First of all, Paul doesn’t “want Medicare to work better,” he wants to repeal it. That’s something you don’t hear much about, but he sponsored a bill with Utah Tea Party Sen. Mike Lee to replace Medicare with the Congressional Health Care Plan members of Congress buy in to, essentially privatizing it. The bill would also raise the age of eligibility from 65 to 70. That ought to go over well with the GOP’s rapidly aging white base. That’s why Paul is forced to lie about his own Medicare position.
And the allegation that Medicare is “$35 trillion short”? I could find no documentation for it besides a Heritage Foundation blog post, and a ton of YouTube videos where Rand Paul makes the claim on Fox News. It seems to refer to a 2011 estimate by Medicare trustees that the Part A Trust Fund would face a shortfall by 2026 unless payroll taxes were raised or program costs were trimmed – and the Affordable Care Act has been trimming them. It’s bunk.
Then Paul turns briefly to the question of Kynect:
There’s a lot of questions that are big questions that are beyond the exchange and the Kynect and things like that. It’s whether or not how we’re going to fund these things.
But then he detours again, to take us back to the already debunked example of TJ Samson hospital’s Medicaid-induced “layoffs.”
If they lose 50 good paying jobs in the hospital, is that good? Then we’ve got more people in the wagon, and less people pulling the wagon.
With that profound Kentucky take on Paul Ryan’s “makers vs. takers” narrative, he walks away. And we’re back to Mitt Romney’s deriding the “47 percent.” In Paul’s more colorful telling, the problem is that some of us pull the wagon, while freeloaders and layabouts just lounge in it. For 50 years, Republicans have tried to tell voters the folks “in the wagon” are minorities. But in Kentucky, which is 88 percent white, they’re mainly white. So Rand Paul, the great 2016 hope, is really a prisoner of the elitist 2012 narrative that cost the GOP the White House.
Even though there’s so much to explore in Paul’s Kynect two-step – delusion, ideology, outright lies – the media mostly ignored it. Those who’ve paid attention simply covered the admittedly newsworthy Obamacare evasion. But I think Paul’s entire stand-up act, his performance art — Being a Very Serious Senator, or at least playing one on TV — deserves more attention. It’s only the soft bigotry of the media’s low expectations for Republicans, and maybe a little of society’s sexism, that makes Rand Paul someone to contend with in 2016, when Sarah Palin is widely just a punch line.
By: Joan Walsh, Editor at Large, Salon, June 2, 2014
“Fake Political Outrage Is The Real V.A. Scandal”: Voters Should Blame Hypocrites And Deficit Hawks In Washington
Since the Afghanistan war began in 2001, over 2,700 veterans have taken their own lives. Data from the Department of Veterans Affairs showed that in 2010 alone, 22 veterans committed suicide each day — that’s another wounded warrior gone every 65 minutes. Luckily for Army Reserve veteran Kye Hardy of Ashland, Kentucky, who served for a year in Afghanistan’s Helmand Province, none of the soldiers he fought alongside have taken that drastic step yet.
“I was lucky to join a unit of men who knew how to keep younger veteran soldiers safe even after coming home,” Hardy said. “I don’t go a week without calling or receiving a call from someone I deployed with just to chat for a bit.”
Hardy, an E-4 specialist, is diagnosed with muscle damage and potential spinal damage, and qualifies for VA services. However, the years-long backlog has kept him from applying, as he wants those with more serious injuries to get the treatment they’ve been waiting for rather than adding to the backlog. Hardy doesn’t believe politicians’ outrage over the VA backlog is genuine. Rather than the resignation of top VA officials like the recent exit of General Shinseki and a continued top-down bureaucratic structure, Hardy instead wants to see a more community-based, veteran-led approach to VA services.
“Wounded warriors who are on disability for the remainder of their lives oftentimes have serious trouble readjusting to civilian life,” Hardy said. “[They] seem to improve when they’re communicating with other veterans.”
However, the Republicans feigning the most concern for veterans are the ones most at fault for the crisis in veterans’ health care. Paul Ryan, author of three separate GOP-approved budget plans that severely cut VA services, has made no bones about his plans to privatize Medicare and turn it into a voucher system. He’s also called for changes in VA services that would cut off care for 1.3 million vets. Outrage over the VA scandal could also be manipulated by Ryan and his ilk to force a similar privatization over veterans’ health care.
The extreme rightists who control the House of Representatives don’t want to privatize the VA to help veterans – if the Republican majority truly cared about veterans, they wouldn’t have repeatedly voted against bills providing jobs, homes, and health care to veterans and their families. The budget deal that Ryan and Senator Patty Murray approved last year cut veterans’ pensions by $6 billion. The GOP actually wants to see the VA fail to score more political points.
By continuously cutting VA services, the far-right wants to reinforce their anti-government narrative by cementing the idea into people’s heads that government is bloated and inefficient, and that private companies unaccountable to voters should seize control of public assets. This is why GOP leaders in Congress don’t seem to mind that the approval rating of Congress has slipped consistently in the polls – they’re counting on voters to blame the president and his party in the months before the next Congressional elections. They’re also counting on voters to grow increasingly mistrustful of government and public services in general.
When Republicans held the White House between 2000 and 2008, they demanded that everyone stand with the troops that they sent overseas to fight a costly war waged on false premises. As President Bush stated, Americans could either stand with the president and his war or be considered sympathizers with the enemy. But now that troops have left Iraq and are soon to be leaving Afghanistan, veterans coming home with multiple physical and mental health issues have been left by the Republican-led House and a relentlessly-filibustering Senate minority to fend for themselves. It’s similar to the GOP’s belief in fighting for children while they’re still growing fetuses in a womb, but cutting off their Medicaid, WIC, and food stamps once they’re born. They’re pro-war, but anti-vets. They’re pro-life, but anti-children.
The American public must not allow themselves to be fooled by the GOP’s blustering over the VA backlog. It’s certainly a tragedy that 40 vets died while waiting for health care in Phoenix, but instead of blaming overworked and underpaid medical staff and an administration dealing with an uncooperative Congress that’s trying its best to make the government fail the people, voters should blame hypocrites and deficit hawks in Washington who have allowed a longtime crisis to turn into a scandal. When someone runs for office on a platform of cutting government services to pieces, it shouldn’t be a surprise to anyone that government services under their leadership have been cut to pieces.
By: Carl Gibson, The Huffington Post Blog, June 2, 2014; (This article originally appeared on Reader Supported News.)
“On Inequality Denial”: Good Ideas Don’t Need To Be Sold On False Pretenses
A while back I published an article titled “The Rich, the Right, and the Facts,” in which I described politically motivated efforts to deny the obvious — the sharp rise in U.S. inequality, especially at the very top of the income scale. It probably won’t surprise you to hear that I found a lot of statistical malpractice in high places.
Nor will it surprise you to learn that nothing much has changed. Not only do the usual suspects continue to deny the obvious, but they keep rolling out the same discredited arguments: Inequality isn’t really rising; O.K., it’s rising, but it doesn’t matter because we have so much social mobility; anyway, it’s a good thing, and anyone who suggests that it’s a problem is a Marxist.
What may surprise you is the year in which I published that article: 1992.
Which brings me to the latest intellectual scuffle, set off by an article by Chris Giles, the economics editor of The Financial Times, attacking the credibility of Thomas Piketty’s best-selling “Capital in the Twenty-First Century.” Mr. Giles claimed that Mr. Piketty’s work made “a series of errors that skew his findings,” and that there is in fact no clear evidence of rising concentration of wealth. And like just about everyone who has followed such controversies over the years, I thought, “Here we go again.”
Sure enough, the subsequent discussion has not gone well for Mr. Giles. The alleged errors were actually the kinds of data adjustments that are normal in any research that relies on a variety of sources. And the crucial assertion that there is no clear trend toward increased concentration of wealth rested on a known fallacy, an apples-to-oranges comparison that experts have long warned about — and that I identified in that 1992 article.
At the risk of giving too much information, here’s the issue. We have two sources of evidence on both income and wealth: surveys, in which people are asked about their finances, and tax data. Survey data, while useful for tracking the poor and the middle class, notoriously understate top incomes and wealth — loosely speaking, because it’s hard to interview enough billionaires. So studies of the 1 percent, the 0.1 percent, and so on rely mainly on tax data. The Financial Times critique, however, compared older estimates of wealth concentration based on tax data with more recent estimates based on surveys; this produced an automatic bias against finding an upward trend.
In short, this latest attempt to debunk the notion that we’ve become a vastly more unequal society has itself been debunked. And you should have expected that. There are so many independent indicators pointing to sharply rising inequality, from the soaring prices of high-end real estate to the booming markets for luxury goods, that any claim that inequality isn’t rising almost has to be based on faulty data analysis.
Yet inequality denial persists, for pretty much the same reasons that climate change denial persists: there are powerful groups with a strong interest in rejecting the facts, or at least creating a fog of doubt. Indeed, you can be sure that the claim “The Piketty numbers are all wrong” will be endlessly repeated even though that claim quickly collapsed under scrutiny.
By the way, I’m not accusing Mr. Giles of being a hired gun for the plutocracy, although there are some self-proclaimed experts who fit that description. And nobody’s work should be considered above criticism. But on politically charged issues, critics of the consensus need to be self-aware; they need to ask whether they’re really seeking intellectual honesty, or are effectively acting as concern trolls, professional debunkers of liberal pieties. (Strange to say, there are no trolls on the right debunking conservative pieties. Funny how that works.)
So here’s what you need to know: Yes, the concentration of both income and wealth in the hands of a few people has increased greatly over the past few decades. No, the people receiving that income and owning that wealth aren’t an ever-shifting group: People move fairly often from the bottom of the 1 percent to the top of the next percentile and vice versa, but both rags to riches and riches to rags stories are rare — inequality in average incomes over multiple years isn’t much less than inequality in a given year. No, taxes and benefits don’t greatly change the picture — in fact, since the 1970s big tax cuts at the top have caused after-tax inequality to rise faster than inequality before taxes.
This picture makes some people uncomfortable, because it plays into populist demands for higher taxes on the rich. But good ideas don’t need to be sold on false pretenses. If the argument against populism rests on bogus claims about inequality, you should consider the possibility that the populists are right.
By: Paul Krugman, Op-Ed Columnist, The New York Times, June 1, 2014
“Will Congress Be As Brave As Shinseki?”: Will The Honorable Politicians Please Stand Up?
If you want a prime example of what’s wrong with our politics, study the response to the veterans’ health-care scandal. You would think from the coverage that the only issue that mattered to politicians was whether Gen. Eric Shinseki should be fired.
Shinseki is a true patriot, and his resignation as Veterans Affairs secretary on Friday calls Congress’s bluff. He played his part in a Washington sacrificial ritual. Will the politicians now be honorable enough to account for their own mistakes?
Thanks to Shinseki’s latest selfless act for his country, you can at least hope that we will move on to the underlying questions here, to wit: Why was the shortage of primary care doctors in the VA system not highlighted much earlier? Why did it take a scandal to make us face up to the vast increase in the number of veterans who need medical attention? And why don’t we think enough about how abstract budget numbers connect to the missions we’re asking government agencies to carry out?
It’s an election year, so it’s not surprising that the Republicans are using the scandal against President Obama and the Democrats, though there is a certain shamelessness about the ads they’ve been running, given the failures of the previous administration.
Shinseki and Obama might have averted this by pushing Congress much harder, much earlier to give the agency the tools it needed to do right by vets. And as a general matter, I wish Obama spent more time than he has on fixing government and improving administration. Progressives rightly assert that active, competent government can make things better — which means they need to place a high priority on making it work better. This would include, as The Post editorialized, a serious engagement with civil service reform.
It’s also fair to ask why Shinseki did not move faster elsewhere, notably on what the Iraq and Afghanistan Veterans of America called the department’s “egregious failure to process the claims of our veterans” in a timely and effective way. (For what it’s worth, I raised this concern in a column in November 2012.)
But this is where the story gets more complicated. Shinseki eventually made real progress on the claims issue and other inherited messes. He got little public credit, though many friends of veterans saw him as a reformer and refused to join the resignation chorus. Both House Speaker John Boehner and Minority Leader Nancy Pelosi deserve praise for insisting to the end that Shinseki’s departure wouldn’t solve the system’s problems.
The most important of these is not that VA employees falsified data about the excessive waiting times for veterans seeking appointments with doctors, as outrageous as this was. It is, as the New York Times reported last week, “an acute shortage of doctors, particularly primary care ones, to handle a patient population swelled both by aging veterans from the Vietnam War and younger ones who served in Iraq and Afghanistan.” Dealing with this isn’t sexy, just essential.
Sen. Bernie Sanders (I-Vt.), the chairman of the Senate Veterans’ Affairs Committee who wanted Shinseki to stay, is trying to push the discussion in the right direction. A Sanders bill to expand VA funding across a wide range of areas went down in a Republican filibuster in February. The new bill he hopes will come up for a vote this week focuses specifically on the health system.
It would authorize private care for veterans facing emergencies, which is similar to a House Republican idea. But Sanders would also broaden veterans’ access to other forms of government health care, fund 27 new VA facilities, and use scholarships or loan forgiveness to entice medical students to serve in the VA program.
Shinseki himself proposed other reforms in a speech he gave just before he quit, among them an end to incentives that have encouraged agency supervisors to produce fake information on waiting times.
If there is any cause that should be bipartisan, it’s care for our veterans. But too often, what passes for bipartisanship is the cheap and easy stuff. It tells you how political this process has been so far that so many of the Democrats who joined Republicans in asking for Shinseki to go are in tough election races this fall.
Now that Shinseki is gone, there are no excuses for avoiding the administrative challenges that Obama needs to confront and the policy errors for which Congress must also take responsibility.
By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, June 1, 2014
“Ignoring The Bigger Picture”: Shinseki’s Resignation Doesn’t Change The VA’s Daunting Problems
The resignation of Veterans Affairs Secretary Eric Shinseki was a foregone conclusion by the time it happened on Friday morning. After shocking problems at a VA hospital were revealed in an election year (in Arizona, no less, represented by Senator John McCain, one of the administration’s most powerful foils inside the Beltway) and the heavy suggestion that more mismanagement across the country will soon be made public, Democrats in what promise to be razor-thin House and Senate races had virtually no choice but to call for his resignation as a tide of desperate, angry veterans flooded cable news airwaves and local newspapers.
There was then no way Shinseki could have stayed on in the face of these calls from the very party to whom he owed his nomination; his resignation was the only way to simmer down the scandal that filled up most of the news hole over the past few weeks. (Note that the two most powerful people in Washington not calling on Shinseki to resign were John Boehner and Eric Cantor. They knew that every day he stayed was a good one for Republicans.)
It doesn’t mean his resignation was the right thing to do in practice—in fact, it very well may delay implementation of solutions and make the VA’s problems worse—but it was simply a fact of nature in the political ecosystem.
Now the VA will be set on a new course, and it’s crucial that attention is paid to the true scandal: the overwhelming medical and mental burden suffered by thousands of young men and women returning from largely elective wars in Iraq and Afghanistan, and our continuing inability to fully care for them.
Last year, the Institute of Medicine released a Congressionally-mandated 794-page study outlining the challenges facing these veterans. Though the findings didn’t result in the same media firestorm, they should have:
More than 16,000 troops were wounded in Afghanistan and 32,000 in Iraq.
In contrast with virtually every previous American conflict, “the all-volunteer military has experienced numerous deployments of individual service members; has seen increased deployments of women, parents of young children, and reserve and National Guard troops; and in some cases has been subject to longer deployments and shorter times at home between deployments.”
Scientific literature shows as many as 22.8 percent of these returning vets—nearly a quarter—suffer from mild traumatic brain injuries, while as many as 20 percent suffer with post-traumatic stress disorder. Up to 37 percent struggle with combat-related depression, and 39 percent for problematic alcohol use.
For many recent years, the unemployment rate for returning vets was nearly double that of the civilian population, which of course isn’t particularly low. (It has been coming down some recently).
As many as 45 percent of female troops experienced sexual trauma in the military, which is driving quite a bit of PTSD in those troops above and beyond what they would have experienced because of combat.
The unfolding VA scandal involves unacceptable cover-ups of coverage problems at VA hospitals, but that is not mutually exclusive with a system that is fundamentally unable to deal with the problems at hand. In fact, the latter may have fostered the former. We don’t fully know yet, and the upcoming investigations should shed light on these issues.
But over the coming weeks, the politicians that have been rushing to appear on camera along with the outlets eager to cover this story should focus on the bigger picture: the crisis facing returning veterans and the current inability of the federal government to help them. There are many reasons why this has happened. And at the heart of all this is yet another scandal, one that continues to echo through American politics over a decade after it began: the decision to commit, and keep, American troops involved in two messy ground wars with unclear goals and uncertain, at best, benefits.
By: George Zornick, The Nation, May 30, 2014
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