A tale of two parties

My recollection, and I was writing about it pretty much daily at the time, was that passing the Affordable Care Act was pretty difficult business, involving a ton of work by President Obama and congressional Democrats.
Obama held countless meetings with Republicans and Democrats, including more than one public forum.
Senate Democrats worked for months with a group of Senate Republicans to shape a bill that could find bipartisan support. (Republicans, sadly, were not working in good faith.)
The bill was introduced nearly a year before it would win final passage.
There was endless debate, and endless lies from the right, about what was in the bill. Experts weighed in. Insurance companies, hospital associations, doctors, other interest groups all participated in the long, rigorous debate.
Passage was arduous and difficult.
But the policy goal was clear: Make health care coverage more affordable for more Americans. Begin bending the cost curve of medical inflation to bring it closer to normal inflation. Preserve Medicare and expand Medicaid.
Watching Republicans thrash about trying to dismantle Obamacare — something they’ve been waiting nearly eight years to accomplish — is an entirely different experience.
They’ve attempted to push through bill after bill, all of them written in secret. No debate. No public hearings or other forums.
And, more importantly, no clear idea — beyond erasing the signature policy achievement of America’s first black president — of the policy goal they’re attempting to achieve.
The Republican “repeal and replace” bills wouldn’t have expanded access to health care. They would have restricted it. They wouldn’t have made health care coverage more affordable; they would have made it more expensive. They wouldn’t have preserved Medicare or expanded Medicaid.

The policy goal appeared to be to reduce health care spending in order to give tax breaks to the wealthy.

For the moment, thankfully, those efforts seem to have collapsed. The “repeal and we promise to come up with something better in the next two years than what we managed in the last eight years” gambit has also, apparently, failed — though, inexplicably, they are moving forward with trying to bring it to a vote.
I think the process used to pass Obamacare and the process attempted to repeal it are very illuminating about the state of America’s two parties.

One party wants to govern. It wants to make life better for Americans. It is willing to discuss policy ideas and goals and work on different ways to reach them.

The other party cares about power, and about winning. Once it gains power, it doesn’t seem to know what to do with it, beyond trying to cut taxes on the wealthy.

Democrats are far from perfect. They need a more coherent vision. They also sometimes seem to want power for power’s sake. But they can govern, and they want to govern. The Republican Party has no center, no guiding principle — which is how they ended up with Donald Trump as a leader.

I hope the Republican Party heals itself, but it may be too late. America may need a genuinely conservative party to start from scratch. The sooner the better.

The Republican Lie Machine

The Big Lies continue from the Republican Party.

In a Wall Street Journal commentary ironically titled “The Truth about Ryan and His Critics,” Rep. Tom Coburn lays out what should be a stunning series of lies and half-truths. They would be stunning, if such lies from GOP officials weren’t so routine these days.

“First, Paul Ryan didn’t force President Obama to abandon the budget recommendations of his own 2010 deficit commission, known as Bowles-Simpson,” Coburn wrote.

Well, no. But Ryan himself rejected the recommendations of the deficit commission, of which he was a member.

“Second, even though I served on the president’s debt commission and supported its recommendations, I recognize that we already have a debt commission. It’s called Congress. No one in Congress has done more to offer specific solutions to our fiscal challenges than Paul Ryan. He also has demonstrated the rarest and most important trait in politics—moral courage.”

Ryan’s budget wouldn’t achieve balance until 2040. He would add trillions upon trillions to the debt. Yes, he would cut spending, drastically, but not a penny of that would go to debt reduction. It all goes to pay for even more tax cuts for the wealthy, even while middle class taxpayers get hit with a tax increase. Don’t believe me? Maybe you’d believe Fox News:

A June study from the Joint Economic Committee — which is chaired by a Democrat — claims middle-class married couples could pay at least an extra $1,300 under Ryan’s plan, while those earning more than $1 million a year could see a nearly $290,000 cut.

According to an Aug. 1 study released by the Tax Policy Center, Romney’s tax plan would also include cuts that “predominantly favor upper-income taxpayers.”

It projected taxpayers making more than $1 million would see tax cuts averaging $175,000. Those making between $75,000 and $100,000 would see an average tax cut of $1,800. And those making under $30,000 would see an average increase of $130, according to the report.

Coburn goes on to write, “At any point in the past four years, President Obama could have called Republicans John Boehner, now House speaker, and Rep. Ryan, now House Budget Committee chairman, over to the White House and cut a budget deal.”

Ahem. Obama offered Boehner a budget deal, one so conservative that New York Times columnist David Brooks called it “the deal of the century.” More than two thirds of the debt reduction the deal achieved would have come from spending cuts, almost a mirror image of the three debt-reduction agreements signed by President Reagan. Boehner wanted to accept the deal, but radicals in his caucus – like Paul Ryan – rejected it. They would accept nothing that contained any tax increase whatsoever.

Coburn’s defense of Ryan’s Medicare plan is no less dishonest. To excuse Ryan’s radical plan, which would do nothing to lower health care costs but shift the burden more fully onto the shoulders of seniors, Coburn wrote: “Medicare Part A—the Hospital Insurance Trust Fund—could run out of money within five years. The massive amount of borrowing necessary to keep the safety net intact will trigger a debt crisis (higher interest rates, inflation, lower standards of living and higher unemployment) sooner rather than later.”

Actually, no. Thanks to changes in the Affordable Health Care Act, which Coburn derides as “fiscally flawed,” the Medicare Trust Fund is solvent through 2024. Only if Romney/Ryan get their way and undo the savings of Obamacare will Medicare be at risk of insolvency as soon as Cockburn warns.

That aside, if the problem is so urgent, then why does Ryan insist that the system won’t change for current retirees or anyone over 55. That means that any changes Ryan proposes won’t have any impact for at least a decade, which according to Coburn himself is too late – yet he complains about “the left’s election-year war on math.”

Paul Ryan’s budget isn’t a serious document. Anyone who claims it is, or claims that no one has “has done more to offer specific solutions to our fiscal challenges than Paul Ryan” is either misinformed or lying.

About that health care ruling…

As sporadically as I’ve been posting, I could not pass up the chance to gather some thoughts about the Supreme Court upholding the Affordable Care Act.

I need to spend more time with the opinion and the dissents, but a couple of things are clear: Chief Justice Roberts deliberately obfuscated the Commerce Clause argument in order to find the individual mandate exceeded that authority. He’s a smart man. He knows that the market being regulated is the health care market, not the health insurance market. He knows that inactivity in the health care market is not, and can never be, an individual decision. Any person, however young and healthy, can end up in intensive care at any moment. And except for a very few of the wealthiest Americans, no one can guarantee, absent health care insurance, that they can pay for their care.

Thus requiring every American to have some sort of insurance is a necessary and proper application of congressional authority in an area in which it has clear constitutional authority to regulate.

Roberts refused to admit that. He also, thankfully, refused to further tatter the Supreme Court’s reputation by overturning on such specious grounds the signature legislative achievement of a duly elected American president and Congress. So he plodded through a torturous line of reasoning, holding that the penalty could be construed as a tax. “The payment is not so high that there is really no choice but to buy health insurance; the payment is not limited to willful violations, as penalties for unlawful acts often are; and the payment is collected solely by the IRS through the normal means of taxation.” While he refused to acknowledge that Congress has the authority to compel the purchase of health insurance, he did grudgingly admit that it does have the authority to tax those who do not buy insurance.

The second thing that’s clear is that Republicans will continue to lie about a law they were determined to kill, not because they disagreed with the need for health care reform or the law’s approach to it (which, let us not forget, was modeled after the Massachusetts’ law championed by none other than Mitt Romney), but because they wanted to deny President Obama any victory, even a victory that benefited tens of millions of Americans. Romney continued to lie, calling the Affordable Care Act a job killer (even though the number of health care jobs has increased dramatically since it was passed and estimates are that the only impact it will have on employment is prompting some people to work less because they won’t have to work as hard or as long to afford health care). He said it increased the deficit, though it actually decreases it. He said it cuts Medicare, when actually it only cuts Medicare’s rate of growth. He said it does nothing to lower the cost of health care, even though everything in the bill is aimed at lowering the cost of health care — and even though health care costs have risen at their lowest levels in decades since the bill was passed.

Republican lies have been effective. Most Americans don’t like Obamacare, polls show. But polls also show that — except for the individual mandate, which is what makes Obamacare fiscally feasible — Americans love the individual components of Obamacare. They love that their children can remain on their insurance policies until age 26. They love that insurance companies will no longer be able to deny coverage to people with pre-existing conditions or put lifetime caps on coverage.

So Republicans will continue to lie, and they will continue to talk about repealing and replacing Obamacare. And they will continue to be extremely vague about what they would replace it with. Because their goal is not to do anything about the mess that is the American health care system. Their goal is the political defeat of President Obama, and affordable health care for all Americans is acceptable collateral damage in that fight.

The conservative reaction to Obamacare has been completely at odds with the actual content of the bill. They foam at the mouth about how it’s a socialist takeover of one-fifth of the American economy — even though it is an extremely moderate (even conservative) free market-based approach to reform filled with measures that Republicans not only once embraced, but ones that conservatives developed, including the much-maligned individual mandate.

Americans need to ignore the political bluster and focus on what the law actually does, and the benefits it will actually provide. Then they need to ask why one party is so hell bent on taking those benefits away and mischaracterizing the legislation that provides them.

It is not about liberty, because Obamacare detracts from no person’s liberty. It is not about policy, because Obamacare is filled with policies that conservatives agreed with. It is about partisan politics and the lust to regain power, by any means necessary.

Such lust should not be rewarded in November.




Women can’t be well-off without a man ‘in possession of a good fortune’?

James Taranto, the right-wing newspaper columnist and author of the daily “Best of the Web,” always struck me as a bit sexist, what with his constant references (borrowed from Limbaugh) to, for instance, a “blogress” when discussing a female blogger or “reporter-ette”. But the last item in today’s Best of the Web takes the cake. Discussing research that found an inverse correlation between obesity rates and the value of one’s home among women, but not men, Taranto concludes that researchers missed the obvious: Rich men apparently like hot (presumably thin) wives.

For each $238,000 drop in property value, the report found, obesity rates went up 80 percent among women. Taranto quotes various theories about why the effect would be more pronounced among women: Women are more influenced by the home environment; higher-priced homes tend to be in more walkable neighborhoods or closer to grocery stores; obesity in women is more related to financial insecurity.

All that overlooks what to Taranto seems obvious:

No one seems to have thought of the most obvious explanation. As Jane Austenobserved: “It is a truth universally acknowledged, that a single man in possession of a good fortune must be in want of a wife.” Imagine a man in possession of a good enough fortune to buy a snazzy house in Seattle. Now think about what his wife would look like.

I guess in Taranto’s world, the only women who live in nice houses are those married to men who were already “in possession of a good fortune.” Perhaps Taranto has already forgotten Cindy McCain who certainly did not need John McCain to afford too many snazzy houses to count. I guess the thought of a woman earning her own good fortune is just beyond Taranto’s ken.

The Supreme Court, the mandate and … broccoli

By all indications, the second day of oral arguments on the constitutionality of ObamaCare did not go well. This surprised many legal experts, who assumed that Supreme Court justices would follow well-established precedent and approve the individual mandate. Of course, they still may.

What stood out to me, though, in reading the coverage of the arguments was Justice Scalia’s insipid line of questioning, which didn’t rise above the level of commentary you’d expect to find on the Sean Hannity or Rush Limbaugh shows. How bad was it? Scalia actually parroted one of the most intellectually dishonest talking points against the mandate: broccoli.

Scalia: “Could you define the market – everybody has to buy food sooner or later, so you define the market as food, therefore, everybody is in the market; therefore, you can make people buy broccoli.”

That might work on talk radio when you’re blabbing to a bunch of sympathetic listeners. But Americans deserve better from justices sitting on their highest court.

Donald Verrilli, the Obama administration lawyer who everyone agrees was far from at the top of his game, managed to counter Scalia, but in a halting and convoluted way: “No, that’s quite different. That’s quite different. The food market, while it shares that trait that everybody’s in it, it is not a market in which your participation is often unpredictable and often involuntary. It is not a market in which you often don’t know before you go in what you need, and it is not a market in which, if you go in and — and seek to obtain a product or service, you will get it even if you can’t pay for it,” Verrilli said.

Health care spending makes up one-sixth of the U.S. economy. There is absolutely no doubt that Congress has the Commerce Clause authority to regulate the health care market. No individual can choose not to be part of that market. You can hope you won’t need health care services. You can pray you won’t need them. You can work out regularly and eat right and be young and healthy. But that bus you accidentally walk in front of … or the cancer that catches up to you … or any other number of unforeseeable circumstances can force you into the market at any time whatsoever.

Billions of dollars are currently spent by hospitals, states and the federal government to pay for the care of people who wished they could have stayed out of the health care market.

It is thus a perfectly necessary and proper part of the response to the systemic problems in our health care system to require everyone to prepare for their eventual need to enter that market by either purchasing insurance, and by providing subsidies for those who can’t afford it.

If you think that in anyway is comparable to forcing Americans to buy broccoli, you should not be wearing the robes of a Supreme Court justice.

PolitiFact’s ‘Lie of the Year’ is actually true

Here’s a head-slapper: PolitiFact, the ordinarily respected and Pulitzer Prize-winning fact-checking organization, picked a true statement as its “Lie of the Year.”

The PolitiFact “honor” went to the Democratic argument that Republicans voted to “end Medicare” when they voted for Rep. Paul Ryan’s budget plan that would, yep, end Medicare.

Oh, sure, there would still be a program called Medicare. It just would bear no resemblance to the program that’s been providing health care coverage for seniors for nearly 50 years.

Today, we have a single-payer program that covers most health care costs. The Ryan plan would end that program and replace it with a voucher system that, by design, will eventually cover only about a third of senior’s health care costs.

Here is PolitiFact’s justification:

• They ignored the fact that the Ryan plan would not affect people currently in Medicare — or even the people 55 to 65 who would join the program in the next 10 years.

• They used harsh terms such as “end” and “kill” when the program would still exist, although in a privatized system.

• They used pictures and video of elderly people who clearly were too old to be affected by the Ryan plan. The DCCC video that aired four days after the vote featured an elderly man who had to take a job as a stripper to pay his medical bills.

So, the fact that Democrats didn’t focus on the fact that Ryan would leave the current system in place for today’s seniors makes the claim that would end Medicare a lie? The use of “harsh” terms that  accurately portray the effect of ending a single-payer plan and replacing it with a private, voucher system that would intentionally leave tomorrow’s seniors without adequate coverage is damning why? Perhaps if they had time-stamped the images of elderly people hurt by the plan to make it clear they were talking about the future impact, it would be ok?

This is a charade. As Paul Krugman suggested, this is probably a lame attempt at “balance”:

[T]he people at Politifact are terrified of being considered partisan if they acknowledge the clear fact that there’s a lot more lying on one side of the political divide than on the other. So they’ve bent over backwards to appear “balanced” — and in the process made themselves useless and irrelevant.

Sadly, PolitiFact isn’t alone. FactCheck included the same truth in its “Whoppers of the Year” report. I don’t quite see the difference between the Democratic statement – Republicans voted to end Medicare – and what FactCheck describes as the “truth”: “The budget plan that Republicans pushed through the House in 2011 would have radically changed Medicare in the future — for workers now under age 55.” That radical change would end the current Medicare system and replace it with something completely different, and completely inadequate to cover senior’s health care costs. The fact that current seniors are, ahem, grandfathered in, doesn’t change the essential truth of the Democratic line of attack.

This is one of the incredible frustrations with the so-called “liberal media.” In its attempts at balance, it too often ends up obscuring the truth.

What the Tea Party is, and why it must be stopped

Watch this from the Tea Party Express debate and see Tea Partiers cheering the notion of letting a 30-year-old sick person die because he didn’t plan ahead and buy insurance for an unexpected illness.

These people are inhumane and un-American. Their views must not prevail.

One chart; one profound truth

Despite the severity of consequences of the current debt ceiling debate, I was reminded tonight yet again of how ludicrous the debate we’re having is. We’re talking about trillions of dollars in spending cuts, but for the most part those cuts will not do a single thing to contain the long-term debt crisis.

A single chart, courtesy Yuval Levin via Matt Yglesias, makes the problem clear:

For the most part, Republicans and Democrats have been arguing about the blue line. To the extent they’ve been arguing about the far more important red line, Democrats have been resisting Republican plans to deal with the red line by pushing the federal share of rising health care costs onto seniors and poor people.

What all this energy should have been expended on is trying to figure out a way to change the trajectory of that line, and that can only be done – at least responsibly and morally – by slowing health care inflation for the entire nation. The moderate health care reform that Obama barely managed to pass – and that Republicans continue to try to kill – might set up the preconditions necessary to begin that job. But much more needs to be done.

This is the debate America ought to be having. Instead, Democrats are trying to figure out how to keep the Republicans from trashing the global economy intentionally.

Does anyone in Washington wonder why the country hates them?

Samuelson’s odd defense of ending Medicare

Washington Post columnist Robert Samuelson had a curious piece in today’s paper. It appeared to be a defense of Rep. Paul Ryan’s radical plan to end Medicare’s current single-payer system and replace it with a voucher program for private insurance. But in defending Ryan’s plan, Samuelson admits that no one knows if it would work, and that if it doesn’t, health care costs would not only not be lowered, they’d go up a third more than under the current system and out-of-pocket expenses for seniors would more than double.

In other words, Ryan’s plan could well lead to a million personal catastrophes. Or maybe not. Though Samuelson’s description of how the plan might possibly lower costs seems pretty far-fetched to me:

Beginning in 2022, new (not existing) Medicare beneficiaries would receive a voucher, valued initially at about $8,000. The theory is simple. Suddenly empowered, Medicare beneficiaries would shop for lowest-cost, highest-quality insurance plans providing a required package of benefits. The health-care delivery system would be forced to restructure by reducing costs and improving quality. Doctors, hospitals and clinics would form networks; there would be more “coordination” of care, helped by more investment in information technology; better use of deductibles and co-payments would reduce unnecessary trips to doctors’ offices or clinics.

Suddenly “empowered”? That’s what Samuelson calls being given a voucher that will be nothing close to sufficient to buy private coverage? How many consumers can cut through the complexity of insurance offerings to figure out which is actually the lowest cost and highest quality? Even with the limited options offered to most people through their employers, it can be difficult to select the right plan. And, of course, Samuelson assumes, as Ryan does, that there will be lots of insurance companies eager to serve the oldest, sickliest segment of the American population – especially when they supposedly won’t be permitted to reject those with pre-existing conditions or try to cherry pick only the healthiest.

Samuelson fails to mention that, while no one has a clue if Ryan’s plan would work as advertised, more than 100 health care experts and economists believe President Obama’s approach – which Samuelson writes off as “tinkering” – would “slow the rapid projected increases in health care costs in the federal budget and to improve the delivery of health care. Increases in Medicare, Medicaid and the private sector could be slowed by giving providers greater incentives to adopt more cost-effective treatments and prevention interventions.”

Samuelson is right that uncontrolled increases in health spending represent an enormous threat to the United States, both the government and its citizens. But his confidence in Ryan’s “empowerment” methods seems grossly misplaced.

Fact-checking the fact-checkers

I don’t know why, but when it comes to entitlement questions, ordinarily reliable fact-checking organizations can’t seem to get it right. For instance, PolitiFact gave a DCCC ad their worst rating – Pants on Fire – for saying that Rep. Paul Ryan’s plan to change Medicare from a single-payer plan to a voucher system for purchasing private insurance would “end Medicare.” But Ryan’s radical plan – overwhelmingly passed by House Republicans – would end Medicare in everything but name, replacing it with a system that would shift ever-rising health care costs onto the backs of seniors.

As The Washington Monthly’s Steve Benen put it:

Medicare is a single-payer health care system offering guaranteed benefits to seniors. The House Republican budget plan intends to do away with the existing system and replace it with something very different — a privatized voucher plan. It would still be called “Medicare,” but it wouldn’t be Medicare.

Then yesterday, The Associated Press came out with another fact-check item accusing Democrats of distorting the Republican Medicare plan.

Here’s what the AP said:

THE FACTS: First, the Ryan plan explicitly forbids insurance companies from denying coverage to anyone who qualifies for Medicare, including those who have pre-existing illnesses. Second, it does not merely send money to the elderly and leave them to their own devices in arranging for medical care.

The plan calls for Medicare to stay the same for people 55 and older. But starting in 2022, new beneficiaries would get their health insurance from competing private insurers instead of from the government. The government would offer subsidies to pay for the coverage and set standards that insurers must follow. One condition, says the plan, is that participating insurers “agree to offer insurance to all Medicare beneficiaries, to avoid cherry-picking and ensure that Medicare’s sickest and highest-cost beneficiaries receive coverage.”

Nor would the government merely send “X amount of dollars” to the elderly and let them figure out whether they can afford coverage. The subsidies would go to the plan selected by the beneficiary. The nonpartisan Congressional Budget Office, in analyzing the plan, said it would not let insurers charge more to sick people. Premiums would be the same for everyone of the same age.

The “facts” actually do nothing to refute the Democratic message on what Republicans want to do to Medicare. Sure, plans that participate in this will have to offer insurance to all Medicare-eligible beneficiaries, but as far as I know, Ryan won’t force any insurance companies to participate. And it’s an open question whether there will be a clamoring to get into the health care market serving America’s oldest, sickest segment of population. And it makes no difference at all if the vouchers are given to Medicare recipients or to the plans they select. The fact remains, as AP admits, that the vouchers won’t be sufficient to cover the cost of care: “By 2030, a typical 65-year-old would be paying two-thirds of his or her health costs.”

The facts are this, and Democrats are getting them exactly right: This is a radical plan that would end Medicare as we know it and replace it with an untested system that will do little or nothing to actually slow the increase in health care costs but will those costs onto the Americans who can least afford them.