Tag Archives: GOP

The Unarguable Benefits of Universal Healthcare

As political posturing over the Affordable Care Act (aka “Obamacare”) continues, the fiscal and social benefits of expanded access to healthcare become steadily more obvious.

The journal Health Affairs recently reported an 8 percent increase per year in the number of early-stage colorectal cancer diagnoses since passage of the ACA. Extrapolated across the country, the researchers estimate the ACA led to approximately 8,400 additional early-stage colorectal cancer diagnoses among seniors between 2011 and 2013.

A 2015 study published in JAMA found that the ACA had increased the number of early-stage cervical cancer diagnoses in women aged 21 to 25.

Early diagnosis doesn’t just increase the likelihood of successful medical intervention; it significantly reduces healthcare costs. When cancer is caught earlier, it is cheaper to treat.

America’s healthcare costs have long been far higher–and our outcomes considerably worse-– than in countries with universal systems. The lobbying clout of Big Pharma and Big Insurance continue to make a cost-effective “Medicare for All” politically impossible, but even with its problems, the ACA has vastly increased the number of Americans who are insured while significantly slowing the rise of healthcare spending; last June, Fortune Magazine reported

The United States will save about $2.6 trillion on health care expenses over a five-year period compared to initial projections made right after the passage of the Affordable Care Act.

While health spending spiked briefly in 2014, evidence shows that it has once again slowed down and will help save Americans trillions between 2014 and 2019, according to a new study by the Urban Institute and Robert Wood Johnson Foundation.

Spending declines will happen across both private health insurance as well as Medicare and Medicaid. Centers for Medicare and Medicaid Services actuaries predicted that total Medicare spending between 2014 and 2019 would be $455 billion lower than the ACA baseline forecast. Projected Medicaid spending over the same time period is expected to be $1.05 billion lower than previous ACA estimates, while private insurance spending projections declined by $664 billion.

I simply do not understand the Republicans’ hysterical opposition to the ACA. Both health outcomes and cost controls have improved, and problems with the program can be fixed with relatively minimal tweaking. The program’s popularity has also improved. (According to survey research, approximately half of those who do remain unhappy with Obamacare complain that it doesn’t go far enough–they would prefer a single-payer system.)

It isn’t just the ACA. Paul Ryan and the GOP are threatening to dismantle both Medicaid and Medicare–programs with low overhead and proven effectiveness– and they are intent on defunding Planned Parenthood, which delivers critical medical services to millions of poor women.

It isn’t as though a free market system could work for healthcare. Market transactions require a willing buyer and a willing seller, both of whom are in possession of all information relevant to the transaction. Equal bargaining power doesn’t describe real-world doctor-patient relationships. In that real world, insurance companies have virtually total control over the options available to those fortunate enough to have coverage.

It seems inconceivable that Ryan, et al, simply do not see the multiple fiscal and social benefits of universal–or at least expanded–access to healthcare. So what accounts for their persistent hostility to programs that have proven their effectiveness? Why are they intent upon substituting block grants for Medicaid, turning Medicare into a “voucher” system, destroying Planned Parenthood and eviscerating the ACA?

If the answer to that question is what I think it is– slashing social programs that benefit millions of Americans will allow them to subsidize the insurance and pharmaceutical industries even more generously and deliver more tax cuts to their wealthy patrons–I wonder how they sleep at night.

Carrots and Sticks

Yesterday, a climate-change denier was confirmed to head the EPA. This comes as Trump and the Republicans gut environmental regulations, including those preventing coal companies from dumping toxic waste into our rivers and streams.

Nevertheless, hope springs eternal.

In the midst of the crazy that is the Trump Administration–in the face of Congressional Republicans’ stubborn denial of science and evidence in general and climate change in particular, three prominent conservatives-Martin S. Feldstein, Ted Halstead and N. Gregory Mankiw– have issued “A Conservative Case for Climate Action.” They explained their plan in an op-ed in the New York Times.

CRAZY as it may sound, this is the perfect time to enact a sensible policy to address the dangerous threat of climate change. Before you call us nuts, hear us out.

The three are forthright about the fact that Republican congressional opposition prevented Obama from addressing climate change as vigorously as he wanted; he was only able to enact a handful of measures through Executive Orders, and those are likely to be reversed by Trump, who (they say with delicious understatement) “seems much less concerned about the risks of climate change, and more worried about how excessive regulation impedes economic growth and depresses living standards.”

They note that

an ideal climate policy would reduce carbon emissions, limit regulatory intrusion, promote economic growth, help working-class Americans and prove durable when the political winds change.

Hard to argue with any of those goals.

After listing a number of other notable Republicans who participated in authoring their proposal, they proceed to outline it.

Our plan is built on four pillars.

First, the federal government would impose a gradually increasing tax on carbon dioxide emissions. It might begin at $40 per ton and increase steadily. This tax would send a powerful signal to businesses and consumers to reduce their carbon footprints.

Second, the proceeds would be returned to the American people on an equal basis via quarterly dividend checks. With a carbon tax of $40 per ton, a family of four would receive about $2,000 in the first year. As the tax rate rose over time to further reduce emissions, so would the dividend payments.

Third, American companies exporting to countries without comparable carbon pricing would receive rebates on the carbon taxes they’ve paid on those products, while imports from such countries would face fees on the carbon content of their products. This would protect American competitiveness and punish free-riding by other nations, encouraging them to adopt their own carbon pricing.

Finally, regulations made unnecessary by the carbon tax would be eliminated, including an outright repeal of the Clean Power Plan.

The authors assert that a carbon dividends program starting at $40 per ton would achieve nearly twice the emissions reductions of all Obama-era climate regulations combined. They also report that, if all four elements are put in place at the same time, the plan would be sufficient, all by itself, to meet America’s commitment under the Paris climate agreement.

Environmentalists should like the long-overdue commitment to carbon pricing. Growth advocates should embrace the reduced regulation and increased policy certainty, which would encourage long-term investments, especially in clean technologies. Libertarians should applaud a plan premised on getting the incentives right and government out of the way. Populists should welcome the distributive impact.

The appeal of this plan is obvious: as the authors note, simply repealing Obama’s measures would be immensely unpopular; unlike Congressional “deniers,” most Americans accept the reality of climate change and support measures to address it.

Recent polls show that 64 percent of Americans are concerned about climate change, 71 percent want America to remain in the Paris agreement, and an even larger share favor clean energy. If the Republican Party fails to exercise leadership on our climate challenge, they risk a return to heavy-handed regulation when Democrats return to power.

If the goal is to reduce carbon emissions–and that is the goal among people who accept the reality of climate change–Republicans and Democrats who share that goal should embrace any proposal that will demonstrably achieve it.

If carrots will do what sticks cannot, I’m all for carrots.

Why Good Republicans Should Vote Democratic in 2018

When I left the GOP in 2000, John Keeler, an eminently thoughtful and civil legislator, asked me what I thought it would take to keep people like me–not just reliable Republican voters, but active  and involved party workers–from leaving. I responded that I would have remained a Republican had the party continued to be the party I’d originally joined–my version of a refrain that I have often heard in the years since, “I didn’t leave the GOP, it left me.”

When I run into people I worked with in the Hudnut Administration, or on campaign committees supporting Republicans like Bill Hudnut and Dick Lugar, the conversation often turns to bewildered “what the hell happened” commiserations. My students (who appear to have overwhelming animus for today’s GOP and its priorities) find it hard to believe that the party wasn’t always a refuge for anti-woman, anti-minority, anti-immigrant, anti-science, anti-government know-nothings.

One consequence of Trump’s election has been a vast increase in political activism by previously unengaged citizens of all ages. And that participation–not to mention demographic data showing a rapidly graying GOP and a young, diverse and growing Democratic party that did not bode well for the future electoral prospects of the Grand Old Party even before Trump– is not a good sign for Republicans.

Right now, the GOP is dominated by a relatively small group of white, elderly political and religious fundamentalists. If it weren’t for highly successful gerrymandering and the Electoral College, the GOP would already have been consigned to permanent minority status.

That wouldn’t be good for America. America needs two responsible, adult parties.

Here is the choice faced by “real” Republicans– the ones who still believe in facts and evidence, in compromise and bipartisanship, in working toward the public good–those who recognize that the last election was not a fight between candidates with contending policy preferences , but an atypical and dangerous departure from democratic norms.

Those Republicans can continue to vote, however reluctantly, for any candidate with an “R” beside the name, and (assuming the country survives Trump/Pence) watch with dismay as the radical cult that is now the GOP dwindles into inconsequence. Or those rational, good-government Republicans can take the party back, and grow it by returning it to its roots in the socially tolerant and fiscally conservative “big tent” politics that have been displaced by the zealots, alt-right bigots and assorted “true believers.”

In order to do that, however–in order to reassert control by the adults–the current iteration of the GOP has to be defeated. If the party is to be resurrected, its faithful voters in those bright-red gerrymandered “safe” districts are the only ones who can do it. They have to declare “enough,” and the only way to do that is by voting Democratic in 2018 and then picking up the pieces, restoring sanity and–quite possibly–saving the two-party system.

If the Trump/Pence/Bannon administration continues on its current course, if enough reasonable Republicans are sufficiently embarrassed and repelled by Mitch McConnell’s appalling behavior in the Senate and by the GOP’s “lunatic caucus” in the House, it might actually happen. (But then, I’ve always been an optimist….)

The 60s Redux?

I had an interesting inquiry from a friend the other day. He wanted to know how I thought the upcoming few years would compare with the turmoil of the late 1960s–and whether I thought American divisions are as deep now as they were then.

As those of you who are regular readers of this blog may recall, when Trump “won” the election, my first prediction was that we were going to see a replay of the 60s, but on steroids. So yes–as I said in response to my friend’s inquiry– I think the country’s divisions are every bit as deep as they were then.

But I also think those divisions are different in kind; I think they run along different lines of demarcation.

When I was doing research for my book “God and Country,” I learned about a phenomenon called paradigm shift—times in human history where social/experiential/intellectual change is so profound that people on either side of the shift can no longer communicate with each other. The phrase was coined by Thomas Kuhn, a physicist and philosopher who, as a student, read Aristotle and realized he didn’t understand him. Kuhn concluded that neither he nor Aristotle was stupid (!), but that the nature of the realities they inhabited had changed so dramatically that they no longer spoke the same scientific language.

Kuhn concluded that competing paradigms are frequently incommensurable; that is, they are competing and irreconcilable accounts of reality. Today, I think urban and rural Americans, and educated and uneducated Americans (to grossly and unfairly oversimplify the categories) live in those incommensurable different realities.

Election data strongly suggests that a significant percentage of Trump voters harbored sexist and racial resentments. When your world is changing, when technology is confusing and new norms are disorienting and your formerly privileged status is no longer so privileged, it is comforting to have someone to blame for that bewildering new reality. Trump obligingly provided those people with scapegoats: Muslims, African-Americans, women, Mexicans, Jews.

Meanwhile, educated people in urbanized environments, people occupying the new paradigms, comfortable with diverse populations and new technologies, have increasingly embraced that paradigm’s more cosmopolitan and inclusive worldviews.

So — yes, the divisions are certainly as deep as they were in the 60s. On the other hand, while history may “cycle,” it doesn’t actually repeat itself.

The wild card, as I see it, is that Trump is so obviously deranged and dangerous he makes Nixon look normal. Nixon was a much more conventional bad actor, and he did know how government worked, did understand foreign relations. He even championed policies that today’s rightwing would consider unacceptably liberal; he established the EPA, wanted national healthcare, went to China…

Trump is a very different kettle of fish. Moreover, he is pursuing all sorts of “policies” (if you can call his ego tantrums “policies”) that enrage multiple different constituencies. America has never seen anything like Trump, and my guess is that only hard-core neo-Nazis and other White Supremacists are going to stick with him for very long. Furthermore, Nixon did actually win the popular vote, albeit by a very small margin, while Trump started in a three-million vote hole that would have been even deeper but for GOP vote suppression.

Bottom line, in the 60s, not only were the “sides” more equally balanced, the so-called “country club Republicans” were firmly in the anti-flower-child camp. Today, those Republicans– Chamber of Commerce business people, responsible conservatives, mainstream Christians, officials from prior Republican administrations–are appalled by Trump, not by those who oppose him.

The critical unanswered questions are, first, whether several decades of persistent assaults on our constitutional and electoral institutions (gerrymandering, vote suppression, abuse of the filibuster, etc.) has weakened them so badly that a minority of lunatic Republicans can continue to keep control of the federal government despite the fact that majorities of Americans disapprove and are finally engaging politically; and second, if our time-honored checks and balances do fail, what happens then?

Comparisons to the 60s only take you so far. We’re in uncharted waters….

Meanwhile, Back at the Constitutional Crisis….

Checks and balances. Impartial justice. The rule of law. These are considered to be bedrocks of American government–or at least, they have been. Yet a full-throated attack on those principles has been inexplicably downplayed if not ignored by the media: the inexcusable refusal of Republicans in the Senate to fill vacancies on the federal bench.

This effort to subvert a co-equal branch of the United States government did not begin with Senate Republicans’ unprecedented refusal to “advise and consent” to President Obama’s nominee to replace Justice Antonin Scalia. For the past several years, the Senate GOP has stubbornly resisted acting on most of Obama’s judicial nominees.

Note that this refusal is entirely unconnected to the bona fides of the individuals nominated. The Senate has declined to confirm them because they are Obama’s nominees.

According to the Federal Bar Association, vacancies in the district courts, where most federal judicial work gets done, are reaching crisis proportions: 65 seats on the federal district court bench and at least 90 vacancies throughout the Article III courts. That’s more than 10 percent of the federal judiciary.

When court dockets are slowed to a crawl, when there simply aren’t enough judges to move litigation at a reasonable pace, people with legal grievances are the ones who bear the consequences. They face unpalatable choices: they can settle for less than they are entitled to or wait an extra couple of years for their day in court.

When neanderthal Tea Party types throw tantrums and completely shut down government, everyone notices–and the polls reflect widespread disapproval. Refusing to fill positions that are needed if government is to function properly is far less public, so it doesn’t engender the same level of public opprobrium, but the result—while slower—is the same.

Recent vows by Senators Cruz and McCain to block Supreme Court nominees through an entire Clinton Presidency, and reports that Senate Republicans are already meeting to plan how they will block her nominees should remove any doubt about the motivation for the GOP’s behavior.

In North Carolina, Senator Richard Burr was recorded stating that if Clinton is elected, he will do everything possible to “make sure that four years from now, we’re still going to have an opening on the Supreme Court.”  Here in Indiana, GOP Senate candidate Todd Young has enthusiastically thrown his lot in with those promising to block Merrick Garland, or anyone else nominated by Obama–or, presumably, Clinton. His website has featured a prominent “petition” encouraging signatories to “stand with Todd” against filling the vacancy.

This is what it has come to: Candidates for the United States Senate are asking Americans for their votes; in return, they promise to throw sand in the gears of the government they are being elected to manage.

Vote for me, and I’ll work to dismantle our Constitutional system!

Todd Young, a candidate for the United States Senate, is proudly telling voters that when the interests of the nation—their interests—come into conflict with the prospects of his political party, he will ignore his obligations to them and to the Constitution if doing so will benefit his party.

We are getting used to politicians placing partisanship over country, but the predictability of this behavior doesn’t make it any less reprehensible.

Our local sorry excuse for a newspaper reported Todd Young’s position on the courts as  “he will work for judges in the mold of Justice Scalia.” It didn’t reference his “petition” or contain any indication that anyone had bothered to ask him about his pledge to deny confirmation to qualified jurists simply because the other party nominated them.

The lack of media attention to this intentional crippling of the federal court system, an issue that affects all Americans, is frustrating. Why isn’t every candidate for U.S. Senate being asked “If elected, will you do your job? Will you provide your honest advice and consent to nominees for the federal bench? And if not, why not?”

I for one would like to hear Todd Young’s response.

Addendum: If you are as frustrated as I am about what has passed for reporting during this election, the ACLU is hosting a discussion tonight, at 5:30, at Emmis Broadcasting. The title is “Election 2016 & the Media: A Free Press or a Free-for-All?” Details are here.