Here’s why the improved economy means so little

The Thinker by Rodin

The stock market is reaching record highs again, which make us moneyed people woozy. I’m modestly including myself here although I’m not that well moneyed. But I am retired on a nice pension with plenty of assets to draw on should things go south. The Dow Jones Industrial Average passed 27,000 yesterday and closed for the week at 27,322. Not bad for an index that dropped to 6547 on March 6, 2009, a little over ten years ago.

Happy days are here again? It might help to wonder why the market indexes are so high. The most recent surges are almost surely due to the Fed’s strong hinting that it’s going to reduce interest rates soon. Maybe Donald Trump’s bullying is getting to the Fed, but much more likely the Fed has read the tealeaves and suspects a recession is getting started and is trying to prevent one. And it’s enough to calm Wall Street and make them think happy days will keep on coming.

You don’t have to look hard though to find worrying signs: tariffs are slowing trade, commodity prices are dropping, and the percentage of people in the workforce keeps dropping. This is artificially keeping the unemployment statistics low. Consumers are taking on the same levels of record debt they took on before the Great Recession and Republicans have managed to repeal many of the key safeguards put in place to keep it from happening again. Student loans passed the $1T mark, sucking money from these former students’ wallets that they can’t spend on actual goods and services like houses. Perhaps in response, mortgage rates are dropping again, which is actually not a good sign. Banks are trying to entice people to buy houses, so the lower the rates go the harder time they are having finding people who can afford to take out a mortgage.

Still, many of us including me have been expecting calamity and have been wondering why we have been proven wrong. There are a few positive signs. With unemployment low, workers can bargain for higher wages and it’s working, sort of. They are beating the cost of living by .5 to 1% annually. That doesn’t translate into a whole lot of money, but it beats the decades of wage stagnation we’ve been experiencing. This is hardly the end of wage stagnation, but it is at least a hopeful sign.

Donald Trump is wondering why he isn’t getting more traction on the economy. That’s actually his one bright spot, with a slim majority approving of his handling of it, while his overall approval ratings seem mired in the low 40s. 40% of Americans still cannot find $500 to draw from in an emergency. It could be they are all inept at financial management, which is what Republicans would like you to believe.

The real reasons are much simpler. Much of today’s work requires people with fewer valuable skills, which mean they can’t command as much in wages. That’s why they are working two or three jobs to pay the bills. Even this is not enough, which is the real reason they can’t find $500 and are living paycheck to paycheck.

But there’s one other important factor that is often overlooked. Certain things cost a lot more than they used to (housing is a prime example) and there are other things that cost dramatically more than they used to. The most likely reason you will get thrown into poverty is if you need more medical care than you can afford. The Affordable Care Act was a good first step, but it wasn’t nearly affordable enough, despite the subsidies. You still needed enough income to pay for the bronze plans. And since they came with high deductibles, they mostly only bought catastrophic protection. All those deductibles, copayments and coinsurance payments cost a heap of money and all of it needs to be in the form of disposable cash, which for the most part these people don’t have. They still can’t afford to be sick. Of course, a lot of states won’t offer health care under Medicaid to these people, which they probably could afford if it were offered because copays are minimal when they exist at all. Medical price inflation is still insane and there are fewer mechanisms to check it. The magic of the free market has proven largely illusory with health care costs.

It’s no wonder then that surveys show that for most voters it’s not how well the economy is doing that matters, but how well their economy is doing — and it’s not going that great. The good news is that there is work out there for pretty much anyone who wants it. The bad news is that without a lot of high-paying skills, at best you can barely get by on the wages you are earning. Voters have figured out that health insurance really matters, and it’s their number one concern now. Those who had Obamacare realized that at least for a while it cushioned financial shocks. But they also need health care because they can get sick and simply can’t afford to get well. There are people driving hundreds of miles to Canada regularly just to buy insulin at affordable prices.

While it’s true that Donald Trump is widely seen as unlikeable and unpresidential, what voters are really understanding is that government needs to actually govern, and so little of it is happening. A president can be thrown out after four years, which is likely to happen to Trump. But we need a Congress that compromises in the public interest and tackles real problems like immigration reform and the lack of affordable health insurance ten years after Obamacare.

It may be a long wait. The Supreme Court recently decided states were perfectly free to gerrymander based on political party. In short, it’s allowing states to stay in the business of incumbent protection, making it harder and harder for people to actually have a true republican form of government. With our courts now largely in conservative hands, it’s hard to see how this can change.

Which is why Bernie Sanders’ call for a political revolution makes a whole lot of sense. Achieving it without wholesale insurrection though looks incredibly improbable.

So what’s wrong with democratic socialism?

The Thinker by Rodin

We are told socialism is bad and un-American, but is capitalism really all that great? Consider how poor a job the free market is doing in providing affordable health care. Before the Affordable Care Act, insurance companies did their best to keep their insured pools as pristine as possible. They had no problems canceling people’s insurance when they judged they were too risky and often when they needed it the most.

In spite of the ACA, which Republicans and Trump are working hard to kill, premiums still are going up. Since this latest tinkering by Trump, they are going up a lot while kicking millions off health insurance. Premiums for 2019 will be announced shortly before the midterm elections and they are expected to rise twenty percent or more. This will likely result in lots of disgruntled voters. Right now, the cost and availability of health care is their number one concern. So I really don’t see why Democrats running on a “Medicare for All” platform should fear the wrath of voters. It’s much more likely they will be cheered on instead.

Ask any senior citizen if they want to give up their Medicare. Even the senior citizen gun nuts will give up their guns if the choice was between giving up guns or Medicare. Medicare is wildly popular, despite its issues. The rest of us simply wonder why if it’s good enough for old folks, we younger and healthier people can’t buy into it.

After all, Medicare takes all comers, at least if you meet the age and eligibility requirements. There are certainly aspects of the program that are annoying and baffling. I have been studying them as my Medicare eligibility looms in a few years. I’m not sure why parts B, C and D can’t come as a general benefit for one premium. I don’t understand why there has to be a donut hole if you use their drug program. In any event, universal health care is not that hard. Every major industrialized country except for ours has done it. Surprisingly, people in these countries are quite happy with their systems overall. So while we are creating Medicare for All, let’s improve the system too.

Of course with our Congress awash in health care money, their real mission seems to be to keep these companies flush with profits. Which is why me and the majority of Americans could really use Medicare for All, which is basically democratic socialism at work. It’s socialist in the sense that the government creates and manages the system. It’s democratic in that we the people get to elect people who will enact such a system.

The private sector has proven not up to the task. That’s why Medicare was created in the first place. The private sector didn’t want anything to do with insuring old people. There was no profit in it so it was either put grandma in the poor house or create a government program to fix the issue. Now health care costs are getting so high for the rest of us that we simply can’t afford it even if we can find insurance.

Republicans don’t get that the government’s purpose is to do things the private sector can’t or won’t but which the public needs. If there were no needs like this, we wouldn’t need government. Private health insurance is a failure. Rather than lowering prices, it raises them for all while kicking millions off health care altogether. Competition between insurers with an even playing field was the basis of the ACA. It helped but it has not proven to be the solution. We need something a whole lot more socialistic.

So sign me up as a Democratic Socialist. There’s no Democratic Socialist party to join, but maybe there will be if the Democratic Party can’t get its act together on these pressing issues. Government exists to help all its citizens and to provide solutions where the free market can’t or won’t affordably or at all. I see this out here in western Massachusetts where I live. Cities out here have high speed Internet, but many in the hill towns don’t. Comcast and the like can’t be bothered. It’s not profitable. No wonder local governments are engaging in some democratic socialism by creating community networks, an effort I am helping lead in my city, and we already have Comcast. (We’ve figured that without Comcast, we could get 1 gigabit per second fiber to the home for a third less than Comcast charges. No wonder Comcast can afford to buy all those arenas.)

Ironically, many of the tenets of Democratic Socialism put Trump in the White House. During the campaign he promised much better health care than we have now for much less. He’s done nothing to implement this promise; in fact he has gone in a completely different direction. Many Obama voters voted for Trump because they thought he could break this gridlock by being different. Obviously they were crassly used, but the idea of having great health care while paying a lot less for it is sound, and is now the number one concern of voters.

Let’s bring in a whole new crew of Democratic Socialists to Congress in the midterms. Hopefully we can replace every Tea Partier elected in 2010 with a Democratic Socialist instead. Let’s let government govern again. Lyndon Johnson was the right leader in the 1960s to bring Medicare to fruition. Medicare for All can be done providing we elect leaders committing to doing the people’s business first.

Republicans continue to make the rich richer and the poor poorer

The Thinker by Rodin

It’s pretty hard to keep up with the inanities coming out of the mouth our “president”. As a Democrat he sure embarrasses me, but I often wonder why Republicans are not. If retiring Senator Bob Corker (R-TN) is correct, most Republicans in Congress are embarrassed by Trump, but can’t summon the political will to say so.

Trumps tweets and remarks get weirder and weirder. This is probably due to 50% ignorance and 50% cognitive decline. Still, it’s quite embarrassing. Yesterday, a day after his Secretary of Energy Rick Perry declared that Puerto Rico was a country, Trump told a convention of evangelicals that he has spoken with the “president” of the Virgin Islands. So two top administration officials including our “president” don’t understand that both Puerto Rico and the Virgin Islands are American territories. What’s next? Sending in the marines to take over these “countries”?

Yet on such capable shoulders we are entrusting our nation. The only thing seeming to restrain Trump from his worst impulses seems to be a few officials, principally Chief of Staff John Kelly, Defense Secretary Maddis and Secretary of State Tillerson. They are our firewall of sorts, although there is no guarantee they can restrain Trump. Reportedly they have a suicide pact: if one gets fired they all resign. In any event depending on one unflagging Chief of Staff to babysit Trump 24/7/365 doesn’t seem like a great plan. Trump might launch nuclear weapons against North Korea while Kelly is in the bathroom.

So what does all this have to do with the rich getting rich and the poor getting poorer? Nothing really. I am just venting. But in the boatload of stupid that has come out of Trump’s mouth and Twitter feed recently, there was this from his interview with Sean Hannity on Tuesday:

The country — we took it over and owed over 20 trillion. As you know the last eight years, they borrowed more than it did in the whole history of our country. So they borrowed more than $10 trillion, right? And yet, we picked up 5.2 trillion just in the stock market.

Possibly picked up the whole thing in terms of the first nine months, in terms of value. So you could say, in one sense, we’re really increasing values. And maybe in a sense we’re reducing debt. But we’re very honored by it. And we’re very, very happy with what’s happening on Wall Street.

Aside from the numbers themselves that are off, there is the amazing conclusion from Trump, a graduate of Wharton. Remember, Trump recently bragged that he could beat Rex Tillerson in any IQ test. Trump apparently thinks that gains in the stock market cancel out federal debt. This is surprising in itself, but apparently it only works if he is in office. It doesn’t apply to the Obama administration, which saw the longest sustained growth of the stock market in history. There is no doubt that the stock market is doing very well since he took office, but it’s not doing appreciably better than it did under Obama. Those of us with lots of stocks are just seeing our pile of wealth get larger and larger.

I certainly see it in our portfolio. We take $1900 a month out of it to supplement our retirement. Just our investments (almost all of it in retirement accounts) amounted to $795K on February 1, and is now valued at $857K. Add in our house and other assets are we are millionaires, if a net worth of about $1.41M means that much these days. Gains in the stock market though create wealth only for those who own stocks. Guess what? Many of those who voted for Trump don’t have much if anything invested in the stock market. That’s due in part because there is little money left over to invest in stocks. According to one study, in 2013 the top 1% alone owned 38% of the stock market. The top 10% owned 81.4% of stocks. That leaves 19% for the rest of us. I may be technically a millionaire but rest assured my assets are part of that 19%. In reality I am not even close to being rich, at least not by the standards of the top 10%. I sure don’t plan to buy a Tesla or fly on a private jet to Monaco.

To make money in the stock market though you need to invest regularly over many decades and hold onto the assets. And that’s only possible if you have money left over to invest in the first place. It also means that you also need a relatively secure job, so that you are not raiding your nest egg in lean times. You also need it just to get through recessions and downturns with your investments able to wait out the hard times. If you don’t have all these factors in your favor you probably won’t be investing much in stocks and if you do it will be periodic retirement investments during relatively flush times.

So the surging stock market is really creating wealth principally for the rich who already have plenty of it, exacerbating income inequality. At best its effect for the rest of us is indirect, perhaps by keeping unemployment low thus maybe pushing up wages a bit, or by stimulating investment in the economy. Nothing about the stock market’s rise though fundamentally changes things for the middle class, poor and working class.

Indeed, Republicans seem intent to make things worse. Just yesterday Trump ordered an end to Obamacare subsidies for the working class. This will have the effect of pricing almost all of them out of the health insurance market. This will make healthcare more expensive, increase the probability of bankruptcy due to medical debt and make their financial situation more precarious. In short, they are likely to be pushed down the ladder again. The major reason these classes saw any gains recently was from having affordable health care, which helped protect their assets.

Having tasted real health insurance, these voters are likely to be furious when they vote next November, particularly as the rich will keep getting richer. While the stock market may continue to surge until then, these changes will directly affect the financial stability of the middle and lower classes. It’s likely that when these voters realize they have been shafted once again that Republicans will pay a huge political price.

Ted Cruz is worried about a blowout if Republicans don’t deliver on tax cuts and repealing Obamacare. As he will discover next November these are the factors likely to cause the blowout.

At the health care inflection point

The Thinker by Rodin

Back in January I mentioned a mindful eating course I was enrolled in. A full discussion of the course is probably for another time if I think it warrants a blog post. (I’ve become pickier about what I blog about, as I post less frequently and am trying hard to make my posts more relevant and topical.) One of the interesting takeaways from the course though was to learn to trust your body.

It turns out this is a really hard thing to do, particularly here in America. For most of us spend lives trying to respond to conformance requests coming mostly from outside ourselves. It’s constant and incessant. In the area of eating, you get endless “shoulds” and guilt-laden advice about what to eat, when, how much and using which techniques. These techniques rarely work in the long term because they are not natural to us, which is why so many of us are overweight and obese. Trusting to your own inner wisdom shouldn’t be hard, but it is hard because we simply don’t know how.

Of course it’s much more than food. We spend much of our lives being inauthentic to ourselves. We pray to gods we don’t really believe in. We chase after status symbols thinking we’ll be better or happier when we possess that McMansion or that BMW. We take advice from popular people in our class or some loudmouth on the TV or talk radio thinking they are actually wiser than we are. More topically, we vote for people who don’t have our best interest at heart, ending up more unhappy and miserable as a result.

We do this at least in part because we’ve learned that to get along you got to go along. We want to belong and since most of us don’t have local tribes anymore, we join our virtual tribes instead. They are often led by people looking to screw us over, if not monetarily then at least mentally. Facing the reality of our bad choices is hard. If we were to face them, we would often realize we were played for a fool. So rather than face them we continue to work against our own self-interest.

Logically most of those who voted Republican or for Trump should be regretting their choices. Many of them are but of course even Trump has a dependable group who will stick with him no matter how much he sticks it to them. As I noted recently, ninety percent of Republicans voted for Trump, despite knowing full well what he was about: a bankrupt-prone, pussy-grabbing businessman with zero common sense and a racist streak a mile wide.

It seems though that many who voted for Republicans are waking up. We see this not in a pressing desire to vote for a Democrat, but in polls showing waning enthusiasm for their fellow Republicans. There are other polls that show even majorities of Republicans disapproving of their party’s actions. Both the House and Senate health care “reform” bills are widely despised, even among Republicans.

Trump ran partly on a platform of reforming health care. It would be easy to reform he told us, and you would get better coverage for less. Whereas the sad reality is that Trump really has no idea what’s in the bills he has been promoting, other than he heard the House bill was “mean” so he instructed the Senate not to make their bill “mean”.

Trump is not being mendacious; he is simply unable to absorb detail. But if the Congressional Budget Office is to be believed, either 22 or 23 million people will be uninsured within ten years if either of these bills become law, with 14 million losing health insurance within the first year and likely a majority of them will be Republicans. Those with insurance will pay a lot more, both in higher premiums and higher deductibles. Technically these don’t amount to higher taxes since this money is not going to the government. If it did, it might buy something useful. It will feel like a tax hike however as your standard of living rapidly erodes.

If either of these bills becomes law, it will be a disaster. It certainly will be for those losing health insurance. The reality however will be much more brutal. Health care spending is a huge part of our economy. It will close hospitals, mostly in rural areas. Without insurance people won’t see doctors, so doctors will bill fewer hours and make less money. The cost of emergency care will be foisted on those still with insurance, raising the cost of insurance even higher. It will have a huge cascading effect of not only people dying prematurely and in misery, but in creating huge amounts of medical debt and lost health care jobs. It will careen like a locomotive off its tracks and wreck much of our economy. It won’t affect just the healthcare industry, but all those businesses that depend on health care employees and health care spending, which is most of the economy.

All this is to give huge tax cuts to the 1% who don’t need the money. Arguably the taxes these rich people pay pay for themselves in sustained economic growth, which is keeping stock prices and their portfolio rising.

Some lessons for me:

  • Our current healthcare system must be fundamentally changed if it is to survive at all. The current system works poorly, but it works a whole lot better than it will if either of these bills pass.
  • It’s really in everyone’s best interest to reform our health care system, as it is unsustainable. If there is any industry too big to fail, it’s not on Wall Street but our health care system. It feeds off patients. And patients need insurance to see doctors because only the top 1% can pay for their own healthcare.
  • Obamacare is dying, but not for the reasons people think. It’s dying because it tried to work using a system of private insurance. It’s the private health care system that no longer works as it puts profits first, not people.
  • Expanded Medicaid is demonstrating to new generations that socialized medicine does work. Ask most of Mitch McConnell’s constituents, who are on the program. Only to them it’s something called KyNect.
  • Like it or not we are at a health care inflection point. We must solve this fundamental issue in the only way it can be solved: through comprehensive national legislation that addresses its critical defects. Obamacare does not need amending. And it needs to be replaced with something that is the complete opposite of what both bills in Congress purport to call “health care”.
  • My life, and yours, depends on us rising to the occasion.

Republicans fall into their own health care trap

The Thinker by Rodin

House Speaker Paul Ryan’s laughably named American Health Care Act bill went down in defeat yesterday. It was abruptly withdrawn before yet another planned vote Friday afternoon. Millions of Americans, particularly those who stood to lose under the law, breathed a sigh of relief. I was not surprised by its defeat. It was inevitable.

Without complete Republican control of government, it was an impossible needle to thread. Republicans don’t have total control in the Senate, although they do have a majority of its members. Thus the only way to “kill” Obamacare was to gravely wound it. It would have to be done using the Senate’s budget reconciliation process, which would leave in place the structure of the Affordable Care Act so as to avoid a filibuster. Consequently a House bill (where all financial legislation must emerge) must have met the constraints of this Senate rule to have a chance of passage. In essence that was what killed it.

House Democrats would not vote for it, which left Ryan to persuade all but twenty-two Republicans to vote for something that would meet the Senate’s budget reconciliation criteria. For members of the Freedom Caucus in the House then a vote for the bill would amount to a tacit endorsement of the ACA, the exact thing they ran against to win their seats. Attempts to make the bill more punitive were not enough because the ACA’s basic structure would still be in place. It was doomed.

Why it was doomed though is interesting and part of a larger story about the challenges of governing and points to a fatal flaw in the Republicans’ governing structure. It was doomed because the Republican Party, like all parties, is full of factions. These factions could not come together and find consensus. It was the same problem that drove former Speaker John Boehner into an early retirement. It’s okay to be true to your principles as long as you know doing so won’t affect anything. Republicans could to this during the Obama Administration, passing more than fifty votes to wholly repeal the ACA. These were acts of symbolism and statement, not actual legislating. When you control Congress but you still can’t move legislation for the same reasons, these principled but unmoving factions become self-defeating.

If they compromised, the Freedom Caucus effectively continued the health care legislation they so revile, albeit in a crippled form. Yet by not compromising they undermine their own cause. It’s like being in a battle and wounding your opponent instead of killing him. In their eyes, the only option is to kill. They ran not on a “no Obama” platform but a “never Obama” platform. This left them no place to go toward, at least not without embracing hypocrisy.

Much has been written about the polarization of Congress on both sides of the aisle. Right now with Republicans controlling Congress this polarization affects the whole Republican agenda. The only legislation that can go forward will be bills that have general Republican consensus and can survive Senate filibusters or can be narrowly written to pass the Senate’s budget reconciliation rules. Republicans are going to find more success in these areas like tax cuts. Where factions inside a party don’t agree and won’t compromise, progress is impossible.

What fascinated me was how big the explosion was yesterday. It tarred the whole Republican brand. It showed that Trump’s claims of being a master negotiator were simply bluster. He could not deliver on this promise that he said would be easy. It proved that Paul Ryan couldn’t govern using the normal legislative process. His only hope was to draft something in secret and try to rush it through the House. It was a very long pass indeed. Given a lack of an offensive coordinator it’s no surprise that he didn’t have a player in the far end of the field to catch the ball.

The Affordable Care Act, as imperfect as it was, was at least a process of a lot of open discussion and back and forth negotiating. Republicans were offered a seat at the table but refused to sit down, leaving it to Democrats to write the bill. Even that turned out to be long and tortuous and resulted in many of the flaws that affect the ACA today, principally the lack of a public option. But at least Democrats were able to get the ball somewhat down the field. In doing so Americans got a taste of what affordable health insurance was like. The nearly visceral reaction to Ryan’s bill, approved by only 17% of Americans based on a recent Quinnipiac poll, demonstrates that what was proposed was deeply reviled.

Withdrawing the bill was a bad option but the best available. Had it gone to a vote a whole lot more House and Senate seats would be in jeopardy in 2018. As it is though it left a bad taste in Americans’ mouths. It demonstrated that Republicans largely have forgotten how to govern and this is a problem they own by empowering the far right to gain the majority. Trump was elected based on his so-called “talent” to get things done. Expect few things to change in government in the years ahead and that due to this disillusionment and being in charge that Republicans will be paying a heavy price.

Slowly boiling the frog

The Thinker by Rodin

Yesterday House Speaker Paul Ryan finally released a bill to replace the Affordable Care Act, i.e. Obamacare. The bill came out of the Capitol basement, literally, where it was under lock and key. Wonks are still sorting through the bill, which hasn’t been scored by the Congressional Budget Office. The plan is not to repeal Obamacare, but to effectively put it out in the desert and wait for it to die a natural death. The expectation is that if done this way Republicans won’t get blamed for its demise. Perhaps slowly and over time as subsidies are lessened, health insurance companies drop out and both revenue and cost containment parts of Obamacare go away no one will notice that Republicans actually killed it.

Meanwhile, it’s important to ram it through as quickly as possible before legislators have a chance to consider its implications, the big ones being the impact on their reelections. Reading the early tealeaves suggests this bill is more likely to die than survive. A majority of the Tea Party members are against it as they see it as a continuation of Obamacare. Meanwhile, at last count four Republican senators suggest that they will vote against it, meaning that if it gets to the Senate as a reconciliation bill (where a simple majority rules) the votes won’t be there to enact it. Curiously these senators are from states that chose to accept the Medicaid expansion in Obamacare. They are keenly aware that many of those voting for them have found they like their Obamacare Medicaid, even if they didn’t like it enough to vote for Hillary Clinton for president.

So like past similar attempts to take away benefits citizens have come to expect, the strategy seems to be to use smoke and mirrors to obscure what it really going on. The idea is to boil the frog slowly. You don’t want the frog to jump out so make sure to turn up the heat shortly after Election Day. So keep the Medicaid part of the ACA and kill it by stealth. Cap enrollment after three years. Also make it hard for those on Medicaid who find decent employment to reapply if their luck takes a turn for the worse. Then cap the amount of money states will get. Since there is nothing in the legislation to restrain costs other than the hope that Health Savings Accounts will make consumers shop around more, effectively states will end up covering fewer people, which means the ranks of the uninsured will grow again. This is exactly as God has intended, in the eyes of Republicans.

You can tell what Republicans really care about by what goes away almost instantly. To start, all those taxes on higher earners that effectively subsidized health insurance for those of more modest means. This has the effect of depleting the Medicare Trust Fund much sooner. This should not surprise anyone because if there is one thing Republicans always agree on is that people should carry their own weight, even when it’s impossible.

Just today Rep. Jason Chaffetz (R-UT) opined that the poors should stop spending money on $700 iPhones and use it for health insurance instead, even though $700 won’t even begin to pay the annual deductibles for the discount basic health insurance plans. Clueless Republicans like Chaffetz prefer to live in La La Land, you know where you will shop around for medical discounts even though when you usually need health care, it requires urgency. It’s hard to shop around for a discount emergency room when you are bleeding to death, unless you prefer to bleed to death while trying. This appears to be what Republicans really want. If you can’t afford insurance then naturally you shouldn’t get any.

Don’t fret too much. Obamacare isn’t dead yet but it’s already bleeding profusely from inattention. It is lying on the sidewalk and is having trouble staggering to its feet. So it’s dying a slow death, mostly due to lack of consensus on how to fix it. That’s because only the Democrats want to fix it. The Affordable Care Act was launched with the expectation that its flaws would be fixed by a future Congress working (here’s the funny part) in the best interest of the American people. What it really did was give uninsured people a taste of what it feels like to be insured. What they discovered is what the rest of us discovered: it’s great, except for the paying for it part, which is hard even with subsidies.

Real insurance is basically risk mitigation. I pay homeowner’s insurance but it’s likely I’ll never get back in benefits what I pay in premiums. If my house burns down though I won’t regret paying those premiums. Health insurance works similarly but not identically. It works better when everyone participates and it works best with intelligent government oversight. Effectively the young subsidize the old because they require fewer services. Take away the mandate to have insurance as the bill allows and the pool gets older and sicker. Unsurprisingly, rates go up.

Health insurance though also requires redistribution of wealth. So the young don’t entirely subsidize the old and the sick, most require subsidies of their own to afford the insurance. The rich have the money so it’s logical that they should provide the subsidies. When the rich don’t subsidize the insurance pool anymore, it raises costs for all left in the insurance pool. Given the rules of supply and demand costs will go up and as they do fewer will be able to afford insurance at all.

There is no way to stick this Republican square peg of a bill into the round hole of health insurance because it does not recognize the way health care actually works. In fact it actively works to undercut it. All of this is fine with Republicans. Like block grants to states without accountability that shrinks every year, the goal is to make the existing system more dysfunctional every year with little oversight and no accountability.

The irony is that most Republicans really aren’t hostile to the idea of health insurance for everyone. They just refuse to have it based in part on the transfer of some wealth from the rich to the poor. If before the system collapses altogether we add a trillion dollars in new deficits, those deficits don’t matter. The money that does matter is the amounts in their bank accounts.

As for the rest of us, we’ll be bleeding on the sidewalk too.

Four weeks in, a Trump update

The Thinker by Rodin

At four weeks into the Trump Administration things are about as bleak as I expected them to be. And yet there are signs of hope. The Trump Administration so far has proven staggeringly inept. Moreover, the protests arising to his administration are passionate, largely organic and growing in intensity.

Trump’s stubbornness and dogged determination to prefer loyalists to insiders has had the predictable result of causing confusion and chaos, which amounts to little of his agenda getting worked on. You might say his ship of state is still in dry dock. A number of cabinet nominees have been approved. One was rejected, and one approved only due to an unprecedented vote in the Senate by his vice president. His administration is clearly divided given the crazy number of leaks coming out of the place. One of my guilty pleasures is reading the @RoguePOTUSStaff Twitter feed. Is this really one or more people inside the White House close to Trump? There is no way to know for sure but comparing the posts with events just some hours later, it has the whiff of being the real deal.

The more outrageous our president becomes, the more ineffectual and hated he becomes too. It’s proving to be his Achilles Heel. In some ways the best way to get rid of Trump is to let Trump be Trump. I’d hand him an anvil but he doesn’t seem to need one. This approach works provided he does not do something that seriously jeopardizes our national security while he is in office. Unfortunately, it’s hard to tell if he is or has, but it’s clear our intelligence agencies are leery about conveying too much to Trump, particularly their sources and methods. This reportedly has Trump irate and his CIA director proclaiming they are not doing this. Given that Trump said during the campaign that his campaign was in touch with the Russian government and that he approved of their hacking of the DNC, it’s completely reasonable to think he may be facilitating espionage, which is a crime BTW.

Just the other day six staffers were escorted out of the White House for failing to clear a background investigation. Trump would definitely fail one but none is required if you win the presidency. Meanwhile, Trump thinks that making war with the press is a good thing, when it simply makes the press dig in their heels more. It doesn’t take much press digging with leaks sprouting all over the place. These leaks paint a picture of an administration that is deeply dysfunctional and riven with political intrigue. Anyhow, to make himself feel better Trump scheduled a campaign event tonight in Florida. “Campaign event?” you might reasonably ask. Yes. He filed for the 2020 nomination the same day he was sworn in. I guess you can see where his priorities lie.

All this has congressional Republicans pretty miffed but for the moment they are largely sitting on their hands. They have been chomping at the bit to exercise power again but instead they are busy on other things, like endless hearings for nominated officials. That makes it hard to do things like repeal Obamacare. Meanwhile, protesters are busy making their feelings about the ACA and other things known to their legislators, going all Tea Party-ish, just in a leftward direction this time. Legislators are fleeing public events so they don’t have to deal with their anger. To the extent they meet with people it’s only with people they know are on their side. The ruckus though is enough to give some legislators pause, particularly many in the House who are forced to run for reelection every two years. Their tightly gerrymandered districts don’t look as safe anymore. Midterm elections usually favor the party out of power, although with so many Senate seats in Democratic hands up in 2018 the dynamics might not work out in the Senate. But clearly there is visceral anger on the left and for a change it’s pretty effective. It’s making some rethink the idea of repealing Obamacare, at least without a “replace” option that Republicans seem unable to create.

Still, it’s a period of high danger for the country. We have a new EPA administrator who wants to get rid of pollution laws and his agency and a new Secretary of Education who never attended a public school and who is so controversial she has to travel with U.S. marshals. And that’s just on the domestic side. No one can read the foreign policy tealeaves. Trump doesn’t want Israel to build more settlements but doesn’t want a two-state solution with Palestine. He’s been working the phone with China although he called them our biggest enemy. Oh wait, that’s the press. It’s so hard to keep up with it all. And most surprisingly, it’s apparently okay have ad hoc meetings on dealing with a North Korean missile test in his resort’s dining room at Mar-a-Lago.

Despite high profile appointments, a lot of these lofty goals will simply not be realized as long as Democrats retain forty-one seats in the Senate. That means the EPA and the Department of Education won’t be abolished, or really any other agency for that matter. These agencies can certainly be reorganized to be much less effective but they won’t be going away. Appropriation bills are the vulnerable spot since in the Senate they are not subject to filibuster. We can hope that the dynamics of dysfunction continue so that Republicans spend much of their energy fighting with each other instead of the country.

I doubt Trump will see out the end of his term. It seems likelier to me now than it did that if necessary Republicans in Congress will find ways to bring Trump down, particularly if it looks like he will be toxic to the party’s chances in 2018. There are plenty of paths to Trump’s impeachment and removal and doubtless more will surface. With only 39% of Americans approving of Trump, it may begin sooner than we think.

Letting freedom (and common sense) reign

The Thinker by Rodin

It was just a year ago that I blogged about the Supreme Court’s Hobby Lobby v. Sebelius decision. While not entirely unexpected due to its earlier disastrous Citizens United decision, this decision, which let a “closely held corporation” opt out of the birth control provisions of the Affordable Care Act, still felt like a kick in the groin to us progressives. June can be a very frightening month in the United States since it’s when the court’s most controversial opinions get released.

For 2015 though progressives have much to cheer about, and it’s the conservatives that are furious. This is principally because of two cases decided in the last two days that had seismic impact.

In case you just climbed out of a cave, these were King v. Burwell and Obergefell v. Hobson. In the former, a majority of the court said the Affordable Care Act could not be gutted because of the ambiguity of one section of the law that talked about state health care exchanges. In the latter, a closely divided court decided that no state could prohibit two people of any sex or gender from marrying, and that every state had to recognize same sex marriages issued in other states. In short, gay marriage was instantly legal everywhere in the United States.

If you are a progressive, this makes for a very good week indeed, but it gets even better. Almost ignored was Texas Department of Housing and Community Affairs v. The Inclusive Communities Project, Inc. The ruling said that even if a housing developer did not knowingly engage in housing bias, it could still be subject to a civil suit for such bias. Apparently, ignorance of the law by housing developers is no get out of a civil suit free card, even though the plaintiffs were hoping it was.

So while the court’s decisions last June were mostly a fright show for us progressives, this year it is mostly a fright show for conservatives. It caps an excellent week for President Obama, who also resurrected his Trans-Pacific Partnership proposal by getting Congress to agree to special rules to enact it with an up or down vote with no amendments by either chamber. For progressives though this was the sour political note of the week. The TPP, or actually the TPA, sort of rose from the dead after we thought we had put a stake through its heart two weeks ago in the House.

Include into the melee the nine people brutally murdered by Dylann Roof last Wednesday at Charleston, South Carolina’s historically black Emanuel AME church in what but only a few of the craziest conservatives agree was a racist act of domestic terrorism. The tragic and horrifying event though had a special power in a way that its perpetrator did not intend. Just a few months after the 150th anniversary of the end of the Civil War, the South seems to suddenly want to actually end it, just in spirit this time. The Confederate flag, even in the South, is no longer cool. Once South Carolina governor Nikki Haley spoke in favor of the removal of the Confederate flag from its special flag post at the state’s capitol, Republican politicians were practically jumping on top of each other trying to agree that Confederate flags everywhere needed to go to museums and stay there. States across the South are anxiously revisiting their previous pride about the Confederate States of America.

Despite Republicans controlling a majority of the state houses and governorships and the U.S. congress, their agenda is being beaten back. It’s not supposed to be this way and in fact in many ways it’s not happening. It’s largely not happening with their increasingly onerous restrictions on abortion rights, or voting rights, or on many other issues. But on some of the issues that animate them the most, like gay marriage and Obamacare, they got bitch-slapped something bad this week. They are furious but largely impotent. If you see someone foaming at the mouth these last few days, it’s probably a Republican.

Whereas progressives like me are kind of stunned by it all, but particularly on the court’s ruling on gay marriage. It’s not its decision that surprised me, but I am stunned by how quickly the nation and the courts evolved on the issue. I wrote in this post back in 2008 that I expected it would take a few more decades for gay marriage to be legal in all fifty states. In the court’s 5-4 decision today, it’s now legal in every state, just seven years later! To put this in perspective, it was just 11 years ago that Massachusetts became the first state to legalize gay marriage. This is a stunningly fast change. Justice Kennedy, writing for the majority in Obergefell v. Hobson, was almost poetic in his writing:

No union is more profound than marriage, for it embodies the highest ideals of love, fidelity, devotion, sacrifice, and family. In forming a marital union, two people become something greater than once they were. As some of the petitioners in these cases demonstrate, marriage embodies a love that may endure even past death. It would misunderstand these men and women to say they disrespect the idea of marriage. Their plea is that they do respect it, respect it so deeply that they seek to find its fulfillment for themselves. Their hope is not to be condemned to live in loneliness, excluded from one of civilization’s oldest institutions. They ask for equal dignity in the eyes of the law. The Constitution grants them that right.

The 14th amendment to the U.S. constitution was the legal rationalization for the decision. It is also known as the “equal protection” amendment. Its citing was not a surprise, but using it as a justification was poetic as well. Here’s why: the 14th amendment was passed after the Civil War to protect the rights of blacks who were no longer slaves. The amendment can be thought of as the “equal means equal” amendment. The Supreme Court simply stated that its ruling was constitutional because otherwise gay, lesbian and transgendered individuals would be denied privileges available to others, which is both the intent and spirit of the 14th amendment. Progressives can feel giddy because had there been no Civil War it’s unlikely that this amendment would have been introduced at all, so it’s quite possible this ruling would never have been enacted. There probably would have been no constitutional rationalization for this decision otherwise, and conservatives would have won the day. In short, you can tie the court’s ruling on gay marriage as a very belated response to the insurrection of the southern states and the apartheid principles that Dylann Roof perpetrated last week.

In the case of King v. Burwell, the Supremes essentially undercut the premise of the self-proclaimed constitutional conservatives on the court. Constitutional conservatives believe that every law must be judged against the original intent of the constitution and it means exactly what it says and nothing more. No less that Chief Justice Roberts, who wrote the majority opinion, explicitly undercut that rationalization. He wrote:

The combination of no tax credits and an ineffective coverage requirement could well push a State’s individual insurance market into a death spiral. It is implausible that Congress meant the Act to operate in this manner. Congress made the guaranteed issue and community rating requirements applicable in every State in the Nation, but those requirements only work when combined with the coverage requirement and tax credits. It thus stands to reason that Congress meant for those provisions to apply in every State as well.

Roberts and a majority of the court affirmed, as it has hundreds of times throughout its history, that when a portion of a law erroneously works against its clear intent, then the intent of law is what prevails. It was a ruling that faithfully reflected the will of Congress when the ACA was written, and a majority of the court thus held to the fidelity of the law.

For us progressives, this has been a week of largely good news. It is good news that gays, lesbians and the transgendered have the same marriage rights as heterosexuals. Equal now really means equal. We see it as an expansion of freedom. Strangely, conservatives only want to expand freedoms for those who look and act a lot like they do. Anything else is the overreaching hand of big government at work. Similarly, in the case of the interpretation of the Affordable Care Act, conservatives think that every law should be interpreted literally, whereas the Supreme Court reaffirmed that its rulings should be faithful to the law’s clear intent. These rulings were victories for common sense and for the spirit of the law and constitution.

What goes around though will come around. These court decisions seem to ping between favoring liberal and conservative wings, usually based on Justice Kennedy’s interpretations of the law and the constitution. So it wouldn’t surprise me if in a year from now I will be railing against the court again for their ill-informed judgments. For now though it’s pop the champagne time. Obergefell v. Hobson in particular is a landmark opinion of a scope and breadth rarely seen these days, and whose impact will be strongly felt for decades to come.

The point of the Affordable Care Act

The Thinker by Rodin

Sometimes you want to cheer and shake your fist at the same time. That was my reaction to this Washington Post article that curiously arrived on my birthday, Saturday, when I turned 57:

Nine days into the new year, the 41-year-old call-center worker headed to the health clinic on Highway 15. She saw a doctor about her chronic stomach ulcers, had her blood drawn for tests and collected referrals for all the specialists she had been told she needed but could never afford.

Health insurance finally came last month to Breathitt County, Kentucky and a lady named Mary Combs. Previously, like many of the people in this part of Appalachia, she saw a doctor irregularly if ever. She could not afford health insurance or even to see a doctor most of the time. She could occasionally afford to see a doctor at the local clinic, which at least had a sliding scale of payment based on her meager income. But even twenty dollars came hard to her and many of those who form the working poor of this country. Seeing specialists was simply out of the question. She was uninsured and in the eyes of many, principally Republicans, she did not deserve health insurance. Let them be miserable. C’est la vie.

Of course because she was working, albeit at starvation wages, she made too “much” money to qualify for Medicaid. At least that was the case until the Affordable Care Act finally caught up with her, which made it possible for her to enroll in Kentucky’s version of Medicaid, thanks to a healthy subsidy from the federal government. Mary Combs, like many of the people documented in this article, finally could do something to heal herself. Finally, at last, government gave a damn.

So many people like Mary Combs live in a world of hurt, always a paycheck or less away from losing all they have, and rarely with enough cash to see a doctor, even one with a sliding payment fee. Life for them is mostly suffering, something that is largely endured. Sometimes it ends abruptly and prematurely with a stroke, but often it means slow declines and frequent hospitalization for bills they cannot pay, but which simply adds to their indebtedness and drive overall health care costs higher. Often they come home from the hospital without a job. It left them when they couldn’t show up for their shift for a week. The hurdles just to stay alive simply grow higher every day for people like Mary Combs.

However, now she can afford to see a doctor, and specialists, and maybe start treating one of her many medical conditions. She can do so without going bankrupt, and by avoiding the hospital perhaps without losing her job as well. She had a chance not just to live, but to get better and maybe eke out some modest enjoyment from life again. It’s still a very long road and with her chronic conditions the odds are still against her. But she is getting some relief: psychological as well as medical.

Elsewhere in the article:

“Yeah, sometimes his face will get real red like he’s going to blow up?” Terri said. “Then he gets sick.”

“Okay,” Freeman said, pressing a stethoscope to his chest. “Big breaths.”

“Sometimes my heart hurts,” her new patient said as she listened to his stomach. “All I know is when you get 30, you start falling apart.”

No, at fifty you start falling apart. You don’t start falling apart at thirty unless you simply cannot afford to get treated and your job and environment stress you like a professional football player. At thirty you should be able to go three years without a physical. You should not have crushed discs in your back, suffer from sleep apnea and have already filed for bankruptcy. But if you live in Appalachia like John Wagers profiled in the article, and repair heaters for a living and never had health insurance before, then maybe you do fall apart at age thirty. This is what happened to our ancestors a few centuries back when medicine was more black art than science and most people never escaped a poverty they were born into.

Having affordable health insurance is something I have taken for granted. I can spend most of my life out of pain. I can enjoy most days. I can look forward (I hope) to an active and happy retirement. Now perhaps can the John Wagers and Mary Combs of the country too. Maybe as their health improves they will be able to compete for better paying jobs, because they are healthier and can be productive but also maybe because the minimum wage is raised, as us Democrats want to do. Maybe they will be able to attend a community college when they are healthy and have a few more dollars in their pockets. Just maybe they will get a real chance at the American dream, which needlessly denied them by tactics like only allowing those who can afford it to see a doctor.

The Affordable Care Act is hardly perfect, but it is a start. It warms my heart that in our fractured way we are finally moving people like John Wagers and Mary Combs out of misery and into health. They are being treated like human beings now instead of someone in a lower caste. It’s why elections matter and it’s why I am a Democrat and progressive.

Spock in charge

The Thinker by Rodin

In case you haven’t noticed in the last five years, we seem to have a Vulcan in the Oval Office. Spock is in charge.

Obama as Mr. Spock
Obama as Mr. Spock

Oh, I know what some of you are thinking: we have an atheist/Muslim, Kenyan-born unnatural American in the White House instead. All that stuff about Barack Obama being born in Hawaii is faked, and even if it isn’t, Hawaii was barely a state in 1961, so he’s still not a naturally born American, and thus is not qualified to be president! The good news is that if Obama really is Mr. Spock, well, then we do have an imposter for a president, since anyone with knowledge of Star Trek canon knows that Spock is a Vulcan from the planet Vulcan.

Not so fast! There is the minor matter of Spock’s mother Amanda, who happened to be human, which means Spock is a product of a mixed-species marriage. Curiously, Obama is a product of a mixed-race marriage. It’s unclear from Star Trek canon whether Spock’s mother Amanda was born in the United States, and it’s also very unclear whether in the 23rd century world of Star Trek there is a United States. It sort of sounded like in Gene Roddenberry’s imagination we had evolved past nation-states. However, Spock’s mother Amanda was white and spoke English with a flawless American accent. If she had a son on Vulcan and was a member of a 23rd century United States, why, Spock would be no less eligible for the presidency than Senator Ted Cruz (R-TX) is for being born in Calgary, Canada to American parents. Hmm.

So I am going with this assumption, because President Obama is so much in mind and temperament like a Vulcan in general, but Spock in particular, that I figure Spock is real. He figured out a way to transport himself back to our time, got a little plastic surgery on his ears and otherwise inserted himself seamlessly into our national consciousness around 2004 when Obama made that famous speech at the Democratic National Convention. I mean, Obama is a dead ringer for Spock anyhow: tall, thin, highly logical and low key. I don’t know where the Barack Obama before that speech is, but I figure he is deep in a holding cell somewhere out of the way, probably in Guantanamo. Maybe he will be released after Spock finishes his term in 2017.

Some rabid Christians believe in the antichrist, and many suggest that Obama is the antichrist. If the opposite of religious is secular, then Obama seems to qualify. It is true that he belonged to a predominantly black church in Chicago, but since assuming the presidency he and church have been strangers at best. He had not joined any of the local churches. His attendance is sporadic at best. Vulcans don’t need no stinkin’ churches. They are entirely logical and that certainly describes our president.

Obama, more than any president I can recall, is a relentlessly pragmatic politician, which means that he is driven by logic, not emotion, just like a Vulcan. It is borne out in so many ways, but most importantly to Americans perhaps in Obamacare. It was an imperfect law at best but the main thing was that it could get through Congress, although it just barely made it out of Congress. When it arrived it quickly showed imperfections. However, its imperfections were not as important as the fact that Obama and Democrats in Congress had at least moved this political football down the field, an accomplishment that eluded many past presidents and congresses. Obamacare was certainly not the best health care legislation, but it was doable. It was the logical choice as opposed to doing what so many others had done: nothing.

I find Obama/Spock’s pragmatism welcome. I see it not just in the Affordable Care Act, but in lots of other actions Obama/Spock has taken. The Iraq and Afghanistan Wars were good examples. Mr. Spock would look at these wars and say, “There is no way to win these wars. We need to get out quietly, set up some fig leaf governments that suggest that we care about the inevitable mess we’ll leave behind, but basically just go. We can’t afford them anymore.” And so we did. For the most part, even the Republicans who started these wars aren’t complaining. They have moved on to other issues that excite their base, like cutting spending in general.

The Hindus recognize the god Shiva, whose job is basically to destroy things. This is because life is about change. If it didn’t change, it wouldn’t be life. Curiously, Republicans who claim to not want things to change seem to be channeling Shiva, eager to destroy pretty much all the social legislation of the 20th century. Obama/Spock seems to be trying to cope with change, to build on what has worked in the past to make for a better tomorrow, making him in some ways conservative. The Affordable Care Act demonstrates this principle at work: build a health care system on top of our existing private health insurance market to minimize the shock of change. It’s highly logical in the context of where we are today, which is why Obama/Spock supported it.

Obama himself has repeatedly spoken about his intent on playing a “long game”. He tries to ignore the ups and downs of the moment and keep his eye on the far end of the field where the goal line is. Whatever it takes to move that ball down the field is fine with him. As quarterback though Obama prefers to rush instead of pass. He may start out with a pass, as he did with the Affordable Care Act, but once it proved politically impossible to get a single payer system through Congress he found it less risky to rush instead. He got his first down, which was the Affordable Care Act. Some other quarterback will get to the goal line: a single payer system. Obamacare makes this conversation possible in the future. Without it, it could not happen at all.

Obama is obviously not a perfect president, so the Spock analogy is imperfect as well. But I find his relentless pragmatism quite refreshing. At times it gets him in trouble, such as in national security matters with electronic eavesdropping and the use of drones to kill terrorists. Spock though would fearlessly make these choices. “The needs of the many outweigh the needs of the one,” he has said in various TV shows and movies. Disconnects like these can happen when you elect left-brain presidents. What is logical is not always what makes the most political sense, and it can come back and bite you from time to time. Overall though, I prefer a left-brain president to a right-brain one.

We face terrible problems from overpopulation to climate change. No Messiah is going to come down from the skies to solve these for us. We made this mess, and only we can clean it up. We need clear thinkers and people of practical action to pull it off, if we can pull it off at all. The odds are very long.

So I for one am glad that Spock is in charge.