“Sentimental Storytelling”: Beware Of Mitt Romney’s “Softer Side”
Everyone is talking about Mitt Romney’s “softer side.”
That’s how some reporters are characterizing a recent shift in Romney’s stump speeches.
Because Governor Romney has started talking about dead people: the Navy SEAL who died in Benghazi. The 14-year-old boy who died of leukemia (profiled at the Convention). The long-lost friend stricken with multiple disabilities, who drags himself to meet Mitt Romney at a campaign rally. And dies the next day.
The New York Times reports Romney’s stump speech: “I reached down and I put my hand on Billy’s shoulder and I whispered into his ear, and I said, ‘Billy, God bless you, I love you.’ And he whispered right back to me—and I couldn’t quite hear what he said… [He] died the next day.”
And a hush fell over the crowd.
What does this have to do with running for president?
Look, people tell tear-jerkers about dead people all the time. Dying moms and kids especially.
Glenn Beck did it with his book The Christmas Sweater, in which a boy turns up his nose at a particularly unattractive but dearly-bought sweater his mother gifted him for Christmas.
And she dies in a fiery car crash a few pages later.
Beck learned the genre, I once argued, from a particularly bruising subgenre of Mormon sentimentality: Sunday School manual anecdotes and movies that circle like vultures around accidental, lonely, and untimely deaths. Just to make us cry.
This sentimental storytelling is an American tradition dating back at least to the nineteenth century. It encourages us to zero-in on the anecdote—to identify with and shed tears for the helplessness of the victim—and lose complete sight of the big picture.
Is there anything in Romney’s foreign policy that will ensure that more Navy SEALS, sailors, and soldiers will come home quickly?
Does the Romney-Ryan budget maintain the social safety net on which disabled people depend?
And how will repealing the Affordable Health Care Act help out the thousands upon thousands of American families who don’t have access to medical care or who face medical bankruptcy as their loved ones fight cancer?
Time to ask harder questions about the “softer side.”
By: Joanna Brooks, Religion Dispatches, October 11, 2012
“The Campaign’s Moral Hole”: Budgets And Elections Have Moral Consequences
Does our presidential campaign lack a moral core?
The question arises in the wake of last week’s presidential debate. However you analyze it in electoral terms, the exchange between President Obama and Mitt Romney was most striking as a festival of technocratic mush — dueling studies mashed in with competing statistics. In many ways, the encounter offered voters the worst of all worlds: a great deal of indecipherable wonkery and remarkably little clarity about where each would lead the country.
But there are forces working to make the campaign about something more than a suffocating battle to influence tiny slivers of the electorate. One of my favorite pressure groups, Nuns on the Bus, will be launching a five-day tour on Wednesday through the red, blue and purple parts of Ohio.
Who better than a group of women who have consecrated their lives to the Almighty to remind us that our decisions in November have ethical consequences? Those who serve the impoverished, the sick and the dying know rather a lot about what matters — in life, and in elections.
If some of the nation’s Roman Catholic bishops often give the impression that they constitute the Republican Party at prayer, the activist nuns often seem like Democrats at the barricades. And it’s quite true that a struggle is on for the political soul of American Catholicism. Those among the faithful who see the abortion issue as trumping all others are in a quarrel with their brethren who place more emphasis on the church’s long-standing commitment to social justice.
Nuns on the Bus, led by Sister Simone Campbell, are very much players in this dialogue, and Sister Simone addressed the Democratic National Convention last month. Yet she was careful in her speech to emphasize that what she has been saying about government’s obligation to the poor — and about the problems with Rep. Paul Ryan’s budget — reflected what the bishops have been saying, too.
She also noted in an interview last week that she had laid down some conditions before she spoke in Charlotte. “I would talk if I could say that I was pro-life, that I could lift up the people who live in poverty and that the Democrats have a big tent,” she said.
The nuns’ message on poverty got some reinforcement in a statement late last month from Cardinal Archbishop Timothy Dolan of New York and Bishop Nicholas DiMarzio of Brooklyn. “There are very dark clouds,” they wrote. “Too much rhetoric in the country portrays poor people in a very negative way.”
They argued that the economy is not only failing to “provide sufficient jobs for poor people to earn a decent living to support themselves,” but is also offering fewer “resources for government to do its part for Americans in need.” The situation, they concluded, is “devastating to struggling families throughout the country.”
It’s no accident that the nuns are waging their Ohio campaign against the Ryan budget during the week of the vice presidential debate. One would like to hope that Thursday’s tussle between Ryan and Vice President Joe Biden will be less a parade of numbers and obfuscating talk of “baselines” and concentrate instead on why voters should actually care about what’s in the federal budget.
Sister Simone points to a study from Bread for the World, a genuinely nonpartisan group that advocates on hunger issues, to suggest one useful line of questioning. To make up for the food-stamp cuts in Ryan’s budget, the group found, “every church in the country would have to come up with approximately $50,000 dedicated to feeding people — every year for the next 10 years.” Can government walk away like this? Can we realistically expect our houses of worship to pick up such a tab?
In all the dissections of Obama’s performance in the first debate, not enough attention has been paid to the real problem with his self-presentation: his failure to convey passion for the purposes of government, the requirements of justice and the point of his presidency. “The president,” says Sister Simone, “has gotten disconnected from the people he cares about.”
Nuns on the Bus will no doubt be criticized from the right for intervening in a political campaign, something that doesn’t bother conservatives when religious figures engage on their side. But the nuns’ most important message is to Obama and Biden: Don’t be afraid of reminding voters that budgets and elections have moral consequences. Doing so just might keep debate-watchers from changing the channel.
By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, October 7, 2012
“A Fateful Misposition”: Romney Didn’t Change Fast Or Far Enough
If you want to understand the recent, present, and probably future direction of the conservative movement and its wholly owned subsidiary, the Republican Party, it’s important to understand how thoroughly and rapidly it has engineered a revolution in the GOP, now that dissent from The Truth is ill-tolerated. A useful way to get a grip on this phenomenon is, of course, to look at Mitt Romney’s efforts to accommodate himself to the ever-changing zeitgeist. Sometimes you get the impression that Romney was this solid moderate Republican the day before yesterday, and only became “severely conservative” in this cycle. But as Steve Kornacki reminds us today at Salon, Mitt started repositioning himself to the right a long time ago–just not fast and far enough:
Romney began making moves toward a White House run nearly a decade ago, shifting away from his moderate Massachusetts roots and positioning himself to meet the national GOP’s various ideological tests. The Massachusetts healthcare law was to play a key role in this self-reinvention. It would give Romney a major bipartisan gubernatorial achievement, burnish his credentials as a forward-looking leader (and not just a simple panderer), and give him a huge general election asset – a universal coverage law that he could use to deflate the inevitable Democratic attacks about his lack of compassion and to stir hope among voters that he knew how to accomplish Big Things.
So Romneycare was not a legacy of RINO moderate heresy (you have to look back at the things he said during his 1994 Senate race against Ted Kennedy to find a lot of items that send conservatives completely over the wall), but a token of then-prevailing conservative orthodoxy. For two interlocking reasons–the decision by conservatives that any efforts to achieve universal health coverage were inherently “socialistic,” and the strategic decision to oppose everything proposed by Barack Obama as a step down the road to totalitarianism–Romney’s positioning turned out to be wrong. It’s worth remembering that his most serious “true conservative” rivals for the nomination, Rick Perry, Newt Gingrich and Rick Santorum, made similar mistakes.
In Romney’s case, however, this mispositioning has been especially fateful because it knocked the props from beneath his slender record of accomplishment, as Kornacki notes:
When Obama embraced RomneyCare and the GOP embraced reflexive opposition, it left Rommney with nothing to say.
And that’s where he is today, alternating between a failing “economic referendum on Obama” message and serial broken promises to lay out a positive agenda that isn’t the Ryan Budget with a side dish of Christian Right cultural extremism. If there was a Bain Capital for politicians, it would probably tell Mitt he needs to blow it all up and start over.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, September 27, 2012
“Promoting Untrue Choice”: Paul Ryan’s Health Care Proposal Would Shrink The Medicare Doctor Pool
The federal budget proposed by Representative Paul Ryan, the Republican vice-presidential nominee, extols the benefits of “promoting true choice” for Medicare beneficiaries.
In truth, though, the Ryan plan would substantially reduce choice for many people on Medicare — by cutting them off from their current doctors.
Doctors see Medicare patients, despite the relatively low payments they receive for doing so, partly because Medicare represents such a large share of the health-care market.
If a substantial number of beneficiaries moved out of Medicare and into private plans, as Ryan proposes, doctors would have much less incentive to see Medicare patients. And the elderly who want to remain in traditional Medicare would risk being stranded.
The evidence suggests that, in time, this problem could well affect a large share of Medicare beneficiaries. To put that evidence in context, though, it helps to first review the history of the Ryan plan.
The proposal has changed since it was presented in 2011. In the original version, traditional Medicare was eventually to be replaced in its entirety by private plans. The Congressional Budget Office found that this shift would raise health-care costs drastically because the private plans wouldn’t be large enough to enjoy Medicare’s leverage in negotiating prices with hospitals and other large providers. The savings that private plans could achieve because beneficiaries would share more of the costs, and therefore economize more, would be more than offset by that loss of leverage — and by the private plans’ higher overhead and need to turn a profit.
Ryan Revision
In response to the devastating CBO report, Ryan revised his proposal. Under Ryan 2.0, private plans would co-exist with traditional Medicare. (The CBO hasn’t fully evaluated the revised plan yet.)
Many supporters argue that the new plan can’t be as big a problem as the old one, since beneficiaries could always choose to remain in traditional Medicare. In health care, however, choice isn’t always innocuous — and can sometimes be harmful.
I have previously described two downsides to expanding private plans in Medicare. First, it would undercut Medicare’s ability to help move the payment system away from fee-for- service reimbursement and toward payments based on value, because no private plan is large enough to accomplish that shift by itself. Second, the mechanism for adjusting premiums to even out the health risks of individual beneficiaries is far from perfect, so plans can easily game the system, raising total costs. In effect, the plans would end up being overpaid.
The reduced choice of doctors for those who remain in traditional Medicare is a third adverse consequence of moving beneficiaries out of the program.
Currently, Medicare beneficiaries almost universally enjoy excellent access to doctors. And the great majority of beneficiaries never have to wait long for a routine appointment, the Medicare Payment Advisory Commission has found. Roughly 90 percent of doctors accept new Medicare patients.
Doctors provide this access even though they are reimbursed by Medicare at rates that are only about 80 percent of commercial rates — partly because Medicare is such a large share of the market. Which brings us to the concern about the Ryan plan.
Medicare Doctors
How important is Medicare’s market share in influencing physician participation? The evidence is limited, but the best study to date suggests it is significant. In the 1990s, Peter Damiano, Elizabeth Momany, Jean Willard and Gerald Jogerst, all associated with the University of Iowa, surveyed Iowa physicians and examined variation among counties. They found that for each percentage-point increase in the share of Medicare beneficiaries in a county’s population, doctors were 16 percent more likely to accept patients on Medicare. The only other study I know of on this topic, an unpublished analysis by Matthew Eisenberg of Carnegie Mellon University, also found an effect from Medicare’s market share, albeit one that was substantially smaller than the one Damiano and his colleagues found.
About 10 percent of the U.S. population is now enrolled in traditional Medicare, and an additional 5 percent has private Medicare plans. Let’s assume, for the sake of argument, that the Ryan plan would cause another 5 percent of the population to shift, and to be conservative let’s cut in half the Damiano estimate of the impact from that reduction in Medicare’s market share. Then the chance that a doctor is willing to see traditional Medicare patients would be expected to decline by a whopping 40 percent. The share of doctors accepting Medicare would fall from about 90 percent to 54 percent.
To be even more conservative, let’s average the reduced Damiano estimate (already been cut in half and applied only to today’s market share rather than the higher one that will exist in the future when more people are on Medicare) with the Eisenberg estimate. Still, about 20 percent of doctors would be expected to stop accepting Medicare patients.
Supporters of the Ryan approach might argue that fewer people would shift into the private plans, so the impact would not be that great. After all, the existing Medicare program already offers Medicare Advantage plans, so perhaps anyone who wants private insurance already has it. But then, what is the point of Ryan’s Medicare reform?
Another defense might be that the government could simply raise doctor-reimbursement rates to encourage providers to continue treating a shrinking population of traditional Medicare patients. And that’s true. However, Ryan has not included the extra cost in his budget.
So, which is it, Mr. Ryan? Will your plan cause Medicare beneficiaries to lose access to their doctors, or are your budget numbers too rosy because you haven’t counted the extra payments needed to keep doctors in the program?
By: Peter Orszag, Council on Foreign Policy, Business Insider, September 24, 2012
“Dual Eligible’s”: Cut Medicaid And You Cut Health Care For The Elderly And Disabled
Gov. Romney and Rep. Ryan have been adamant that their Medicare proposals won’t affect people over 55. That may be true. But their Medicaid proposals sure will. A lot of health care for the elderly comes from Medicaid. We call those people “dual-eligibles”, because they qualify for both Medicare and Medicaid. Some dual-eligible are younger disabled people, but about two-thirds are 65 or older. The Kaiser Family Foundation reports:
Dual eligibles as a share of total Medicaid enrollees ranged from a low of 10 percent in Arizona and Utah to a high of 26 percent in Maine, due to demographic differences and policy preferences across the states. Similarly, spending on dual eligibles as a percentage of total Medicaid spending ranged from a low of 18 percent in Arizona to a high of 59 percent in North Dakota.
Lots of Medicaid money goes to the elderly. Cut Medicaid, and you likely cut some of that. Here’s more:
One quarter (25%) of Medicaid spending for dual eligibles went toward Medicare premiums and cost-sharing for Medicare services in 2008. Five percent of spending for duals was for acute care services not covered by Medicare (e.g., dental, vision, and hearing services). Another 1 percent of Medicaid dual eligible spending was for prescription drugs, a percentage that has fallen significantly since coverage for nearly all prescribed drugs for duals was shifted from Medicaid to Medicare Part D in 2006. The remaining 69% of Medicaid spending was for long-term care services, which are generally not covered by Medicare or private insurance.
That Medicaid money is going to Medicare premiums! It’s also going to actual care. Cut Medicaid, and you likely cut some of that.
It’s about time someone pointed that out. The health care proposals of Gov. Romney and Rep. Ryan will absolutely impact some elderly people way earlier than a decade. Unless they’ve changed their minds again.
By: Aaron Carroll, Washington Monthly Political Animal, September 7, 2012
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