Tag Archives: medicare

Americans Expose Trump’s Quackery, Demand Affordable Health Care

Trump’s increasingly aggressive presidency has created widespread resistance in places not previously reached by American progressives and has enraged the Democratic party’s rank and file who are pushing their own representatives to ensure non-cooperation in Congress and impeachment as soon as possible.

But Trump’s supporters are unmoved and remain convinced he is carrying out his promises to shake up the establishment. They are just not concerned about the particulars of policy and cheer on his dysfunctional press conferences – which are performances especially for their benefit – and his characterization of the media as the “enemy.”

According to the Washington Post: “Those who journeyed to Trump’s Saturday evening event on Florida’s Space Coast said that since the election, they have unfriended some of their liberal relatives or friends on Facebook. They don’t understand why major media outlets don’t see the same successful administration they have been cheering on. … Many acknowledged that the president’s first month could have been smoother, especially with the rollout of the travel ban, but they said the media has overblown those hiccups — and they’re glad to see the president fight back.” Tony Lopez, 28, a car dealer who drove to the rally from Orlando, told the Post: “The media’s problem is that they keep wanting to make up stories so that he looks bad. It doesn’t work. He’s talking right through you guys.”

The danger for the American public in Trump’s presidency is both the empowerment of the security state to suppress immigrants and democratic rights, and his supporters’ unquestioning acceptance of Trump’s authoritarian rule with its alternative take on empirical reality. Trumpistas imagine him as a strongman who will sort out the Washington swamp in a way that will improve their lives. A Trump voter in Pennsylvania, Lee Snover, described him as enforcing “medicine for the American people,” a deeply troubling image evoking Mussolini’s blackshirts. But the Republican drive to cut social programs will hit these voters hard and bring them into opposition to Trump and his quack prescriptions for the body politic. The safety net is especially critical for Trump voters in states like Wisconsin, Iowa and Ohio that flipped to Trump in 2016, giving him a small majority from those who believed his promises of restoring jobs.

If there is one issue in particular that will divide moderate Republican voters from diehard Trumpistas it is the affordability of healthcare, not allegations of ties with Russia or Trump’s business interests. Republicans in Congress have made virtually no progress on their election pledges to repeal the Affordable Care Act. They are deeply divided between Tea Party radicals, who want to eliminate the law no matter what, and those who fear the reaction from constituents if Medicaid expansion under the ACA is removed. The Washington Post reported: “Republican senators who represent states that expanded Medicaid — including Bill Cassidy (La.), Rob Portman (Ohio) and Lisa Murkowski (Alaska) — huddled last week to discuss concerns that a House GOP repeal bill could leave millions of their constituents without insurance. While no consensus emerged, many lawmakers said they could not support an aggressive repeal bill that could harm so many of their constituents.”

Although Trump and his spokesmen dismiss the growing grass-roots protests over ACA repeal as the actions of “paid demonstrators” or “sore losers,” the New York Times points out that Democratic party organizers are struggling to keep up with the groundswell of activism “that has bubbled up from street protests and the small groups that have swelled into crowds outside local congressional offices. …  Some of the most creative activity is coming from people who are new to political activism. In Plymouth, Minn., Kelly Guncheon, a financial planner who described himself as an independent, has organized a ‘With Him or Without Him’ meeting for Representative Erik Paulsen, a Republican who has not scheduled any of his own. … Mr. Guncheon, like other new activists, said he was not looking to traditional political groups for guidance. ‘In this new culture, this new era, we have to figure out new ways to do things,’ he said. ‘There’s certainly no leadership at the head of the Democratic Party, or the state party’.”

Democratic representatives are also feeling the heat. In New Jersey, Josh Gottheimer faced an unexpected crowd of his constituents “concerned that the Democrat would not be an effective bulwark against the president, and others said they had become politically active for the first time since Trump’s election. …  ‘A lot of us are new to this type of activist movement. I’ve never done anything like this before,’ said Jennifer Russo, 44. Her advice to the congressman: ‘My stance is that now is not the time to be conciliatory’.”

Republicans, though, are facing greater opposition from their own voters, who are finding Obamacare more attractive now the possibility of repeal is real. And the growing popularity of single-payer is reaching the Republican base. Pew Research found that the idea that government should be responsible for ensuring health coverage has risen strikingly among lower- and middle-income Republicans since last year, increasing 20 percentage points among those earning under $75,000 per year. Moreover, it is finding justification within the Christian ideology that many of them share. An emotional speech by a constituent of Republican representative Diane Black at a town hall meeting in Murfeesburo, Tennessee, is worth quoting in full:

“My name is Jessi Bohon and I’m in your district. It’s from my understanding the ACA mandate requires everybody to have insurance because the healthy people pull up the sick people, right? And as a Christian, my whole philosophy on life is pull up the unfortunate. So the individual mandate, that’s what it does. The healthy people pull up the sick. If we take those people and put them in high-risk insurance pools, they’re costlier and there’s less coverage for them. That’s the way it’s been in the past, and that’s the way it will be again. So we are effectively punishing our sickest people. And I want to know why not, instead of fix what’s wrong with Obamacare, make companies like Aetna that pulled out and lied to their consumers about why they pulled out, and said they pulled out because Obamacare was too expensive, but they really pulled out because of a merger. Why don’t we expand Medicaid and have everybody have insurance?”

CNN’s video of her speech went viral – but the news agency eliminated the last sentence about expanding Medicaid (see the full video here). The Atlantic magazine saw in it a political possibility: “Were they to take the plunge, Democratic candidates could run as challengers in upcoming elections on a third way of health reform: neither extending unpopular pieces of a program nor rolling back coverage, but giving everyone Medicare. And if the Democratic Party were to support universal health care, that might put pressure on Republicans, who wouldn’t want to lose voters who fear loss of coverage or doctors under a massive repeal.”

The left should not miss the implications of this political shift. While Democrats in Congress can do little against the Republican majority, their angry rank and file are in a position to insist on policies that will unite Americans across party lines and expose Trump as the quack he is.


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Filed under Affordable Care Act, Democratic Party, donald trump, health care, Obamacare, social justice, Uncategorized, white working class

Confounder in Chief Trump Cons America into Republican Repeal-and-Run of Obamacare

As the inauguration of Donald J. Trump as US president approaches, it’s still uncertain how exactly he is going to govern, since his actions before and after the election show his total disregard of accepted political norms.

He has surrounded himself with a billionaire cabinet whose members have political views that conflict with each other and himself; but this may in fact be how he intends to rule, elevating himself above clashing voices like a Mafia Godfather. The Washington Post comments: “A number of people have been given the highest level of White House jobs without a clear indication of who is in charge. By some accounts, Trump likes this sort of management chaos around him. But it is not conducive to policy creation.”

Trump specializes in creating political confusion while promoting his next “big reveal,” such as a “beautiful” health care plan with “insurance for all.” But regardless of these promises, the ultimate outcome of the chaos and corruption within his cabinet can only be the Republican agenda of dismantling state regulations and agencies on behalf of corporations and the plutocracy.

Healthcare is a concrete example of policy confusion that eventually defaults to the position of the Republican right. On the campaign trail, Trump vowed to repeal Obama’s Affordable Care Act but at the same time save Medicare and Medicaid. He repeated his promise last weekend, telling the Washington Post he would unveil a nearly finished plan that would guarantee “insurance for everybody.” This conflicted with Republican rhetoric that they would focus on lower costs to ensure “access” to insurance, rather than universal coverage.

But Wednesday, the day of the confirmation hearing for Tom Price, his nominee to lead Health and Human Services, Trump backtracked on the promise in two separate interviews. The Washington Post’s Greg Sargent comments: “While he reiterated that people without money will get coverage, he clarified that he’s considering a mechanism to do this: Medicaid block grants. … Progressives tend to oppose Medicaid block grants because they are all but certain to get cut, and because states would restrict eligibility requirements. … Thus, this idea – which seems likely to be at the center of the Trump/GOP replacement plan – would dilute the guarantee of coverage that Obamacare is striving to make universal. … Republicans just don’t believe health reform should guarantee coverage in the manner that the ACA does. … But the point is that Trump and his advisers are trying to obscure this. Trump does not want to be the guy who kicked millions off insurance. But it appears congressional Republicans philosophically cannot support anything that does not do this.”

In the confirmation hearings, Price himself twisted and turned to avoid answering a question from Elizabeth Warren if Medicare or Medicaid would be cut. Asked point-blank if dollars would not be cut, he replied: “We should put forward the resources to take care of the patient.” Earlier, he repeated the Republican line that individuals should have the opportunity to “gain access” to coverage, as opposed to “insurance for everybody.”

Trump’s role in this scenario is to create public uncertainty about what his administration is actually going to do about healthcare, a smokescreen for what Republican legislators like Price are preparing. This is a big deal because the deindustrialization of America has eliminated most unionized jobs with health benefits. The Republican rush to repeal the Affordable Care Act and remove coverage from up to 32 million Americans will affect many Trump voters who believed his promises of a better healthcare plan. But since the Republican strategy is to repeal the funding for Obamacare before a new plan takes effect – described by Elizabeth Warren on Sunday as “repeal and run” – it will be politically impossible to restore the taxes that will pay for any of the things he or his spokespeople have promised.

Many people who voted for Trump believed he would stop short of removing the coverage they were already receiving under the ACA. Greg Sargent reports a CNN feature about “people who live in Eastern Kentucky coal country and backed Trump because he promised to bring back coal jobs. Now, however, they worry that a provision in the ACA that makes it easier for longtime coal miners with black lung disease to get disability benefits could get eliminated along with the law. That provision shifted the burden of proving that the disability was directly caused by work in the mines away from the victim” and placed it on the owners.

Sargent argues that “while Trump did repeatedly vow repeal, these voters were absolutely right to conclude that he would not leave them without the sort of federal protections they enjoy under Obamacare. That’s because Trump did, in fact, clearly signal to them that this would not happen. … Yes, Trump said endlessly that he’d do away with the ACA instantly. Yes, his own replacement plan would leave millions without coverage. But here’s the rub: Trump also went to great lengths to portray himself as ideologically different from most other Republicans on fundamental questions about the proper role of governmental intervention to help poor and sick people without sufficient access to medical care. … Trump also repeatedly vowed not to touch Medicare, explicitly holding this up as proof he is not ideologically aligned with Paul Ryan on the safety net.”

Now the reality of Trump’s plans is not only causing extreme emotional distress but also imperiling the health of people currently covered by the law. Although under-reported, Bernie Sanders’ “Our Revolution” organized a day of action against ACA repeal on Sunday. At least 40 rallies took place in different cities, the highest profile one in Macomb County just outside of Detroit, Michigan, drew up to 10,000 in below-freezing weather to hear Sanders call for the defense of the ACA and the creation of a Medicare-for-all, single-payer system. Some in the crowd were Trump supporters now scared of losing their coverage. Elizabeth Warren spoke to 6,000 people at the historic Faneuil Hall in Boston – the rally was intended to be inside the hall, but had to be moved outside because of the size of the crowd.

In Price’s confirmation hearing, Democratic Senator Patty Murray told him: “My constituents are coming up to me with tears in their eyes, wondering what the future holds for their health care given the chaos Republican efforts could cause.” And in local meetings, Republican legislators are confronting angry constituents demanding answers on Obamacare repeal. The Houston Chronicle reported that far-right Ways and Means chair Rep. Kevin Brady, a vocal critic of the law, encountered 50 people at a meeting where he expected them to share “experiences with rising costs and loss of coverage and choice.” Instead they grilled him about his support for repeal without a replacement. “Don’t lie!” shouted Emily Hoppel, a 39-year-old with her 2-year-old son perched on her hip, when Brady moved from one goal of dismantling ACA to another of defunding Planned Parenthood, which he said used taxpayer money for abortion. “The Hyde Amendment,” she sputtered, incredulously, as Brady continued to talk over her. In Grand Rapids, Michigan, Rep. Justin Amash was repeatedly interrupted by constituents concerned about the repeal of the Act during a packed town hall meeting. After Amash referred to the healthcare law as “Obamacare,” a number of audience members interrupted to insist that he call it the “Affordable Care Act” instead.

The left needs to cut through the smoke-and-mirrors rhetoric that Trump, the Confounder in Chief, uses to dominate the media and work to build support for Sanders’ and Warren’s defense of the ACA, together with other movements of mass resistance to corporate hegemony. This means developing an organized opposition to the Democratic leadership which failed to mobilize the party’s voters in the 2016 election.

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Filed under Affordable Care Act, Bernie Sanders, donald trump, Elizabeth Warren, Medicare, Obama, Obamacare, Stand Your Ground law, Uncategorized

Is Screwing Seniors OK? NYT Reports that Democrats Flirt with Privatizing Medicare

Buried among its articles about Black Friday shopping, the New York Times published an article headlined “Support Builds for a Plan to Rein In Medicare Costs.” In case readers should get the idea that a breakthrough has been reached which would actually reduce the cost of providing needed services, the article begins: “Though it reached no agreement, the special Congressional committee on deficit reduction built a case for major structural changes in Medicare that would limit the government’s open-ended financial commitment to the program … Members of both parties told the panel that Medicare should offer a fixed amount of money to each beneficiary to buy coverage from competing private plans, whose costs and benefits would be tightly regulated by the government.”

Sarah Kliff commented on the NYT story in the Washington Post: “In some ways, you can read this as a big shift: Democrats have long been skeptical of allotting seniors a fixed-level of spending for Medicare. It could leave some seniors short of covering medical expenses, they have worried. The Medicare market could suffer, as all the healthy seniors gravitated towards less costly options, leaving the sick with increasingly costly options.”

That’s right. A trial balloon is being floated here to test a new narrative on controlling health care costs. Should the government cap the amount of money allocated to each senior to buy Medicare (so-called “premium support”), which mostly ends up in the pockets of the insurance and drug companies, or should the high profits of these companies be brought under control by using the government’s buying power to stop them creaming off the money intended to go to health care providers?

It looks as though congressional Democrats have offered to accept the premium support method of reducing actual benefits in exchange for the minimum amount of tax increase on the rich to make it politically palatable. They are also reinforcing the false premise that competition among private-sector companies creates a more efficient system than government control.

The NYT article makes no mention of the successful Republican filibuster which ended Donald Berwick’s recess appointment as administrator of Medicare and Medicaid. According to Talking Points Memo, “The irony is that Berwick is best known, and widely respected, for his academic work on making the U.S. health care system more efficient — i.e. how to save people, businesses, and the government money, and simultaneously improve patient care. … Berwick, like most liberals and Democrats, is of the school of thought that the system can be made much more efficient before it becomes necessary to roll back increasingly expensive government programs like Medicare and Medicaid. …  That’s why conservatives rejected Berwick’s nomination. He wanted to prove that the government does a better job financing health care — at least for the poor and elderly — than private insurance companies. The implication, if he’d succeeded, would have devastated the right’s campaign against the centerpiece of the Great Society. That’s why he had to go.”

But even more onerous than the Republican all-out attack on Medicare, is the congressional Democrats’ capitulation to the ideology of market capitalism that truly threatens the achievements of the Great Society. Is the NYT facilitating this capitulation?


Filed under health care, marxism, Medicare, monetary economies, Obama, political analysis

No to austerity and centrism

E.J. Dionne’s column in the Washington Post today critically compares moderation with centrism. While moderation seeks to achieve a balance between the needs of business and the duties of government, he says, centrism charts a middle ground between political positions. However, the extreme rightward turn of the Republican party has made centrists “fear saying outright that by any past standards — or by the standards of any other democracy — the views of this new right wing are very, very extreme and entirely impractical.

“Centrists worry that saying this might make them look ‘leftist’ or ‘partisan.’ Instead, the center bends. It concocts deficit plans that include too little new tax revenue. It accepts cuts in programs that would have seemed radical and draconian even a couple of years ago. It pretends this crisis is caused equally by conservatives and liberals when it is perfectly clear that there would be no crisis at all if the right hadn’t glommed onto the debt ceiling as the (totally inappropriate) vehicle for its anti-government dreams. …”

It couldn’t be clearer that this is a critique of Obama. But Dionne hedges it by describing him as a moderate who has lost his way, and blames his political advisers. “Obama’s advisers are said to be obsessed with the political center, but such a focus leads to a reactive politics that won’t motivate the hope crowd that elected him in the first place. Neither will it alter a discourse whose terms were set during most of this debt fight by the right.”

But it’s not just Obama, it’s the whole Democratic leadership. Talking Points Memo noted a statement made by Pelosi on Monday night which made the same argument. “If you look closely at Pelosi’s austerity-lauding you’ll see the types of pressures being brought to bear. Her full phrase was: ‘It is clear we must enter an age of austerity; to reduce the deficit through shared sacrifice.’ The last two words are important: ‘shared sacrifice.’ They were echoed in President Obama’s Monday night address when he suggested raising taxes on the rich, asking ‘millionaires and billionaires… to share in the sacrifice everyone else has to make.’ … However, this tax-the-rich suggestion has gone nowhere in the subsequent debate. Indeed, of the bills lined up in the House and Senate right now, neither of them goes anywhere near a tax increase. The language of austerity has so far benefited the Republican position, which is all cuts and no taxes.”

The bills being considered in Congress and the Senate are virtually identical in their austerity cuts: the only difference is that the Republican bill calls for a two-stage debt increase which requires another vote on the limit in six months time.  TPM explains: “There are two reasons for this Rube Goldberg approach. One is simply to embarrass the President and force Democrats to take votes that can be turned into 30-second ads this election season. The other, though, is to achieve deep cuts in Medicare and Medicaid under the threat of default.”

The Democrats are in the process of making themselves the instrument of the corporate drive to cut welfare spending, something billionaire right-wingers have been advocating since Reagan but which up till now has been regarded as unthinkable. The Democratic leadership is making a grave strategical error in taking this centrist position so as to appeal to independent voters; as cuts begin to bite, the independents will swing rapidly to oppose them.

Whatever form of austerity bill passes, the losers will be the U.S. public. Up until now, they have not been heard from. But, if Social Security and Medicare is cut, the social contract will be broken: people’s lives will be disrupted, they will no longer be able to maintain the balancing act necessary to sustain their situation, and they will inevitably get drawn into political struggle.

The social contract is both an agreement between the government and the governed about their rights and responsibilities, and a recognition of the mutual dependence of generations. As Lyndon Johnson said to Bill Moyers in 1965 when discussing how to persuade Congress to extend Social Security and launch Medicare, “We’ve just got to say that, by God, you can’t treat grandma this way. She’s entitled to it and we promised it to her.”

In the case of Social Security, the legitimacy of the social system was based on an implied understanding that if you worked hard, paid your mortgage and taxes, the state would provide an assurance of at least a minimum base of security in old age. This understanding reflected a post Second World War equilibrium between corporations and labor, where employers offered comparatively high wages to build up domestic spending and fund their future profits in exchange for labor never questioning fundamental management decisions. However, this agreement eventually allowed corporations to relocate production to low-wage and non-union locations so that U.S. workers became socially dispensable.

A classic study of workers’ attitudes notes how an individualistic ideology leads many workers to blame themselves for their situation even though they know the system is stacked against them. “To speak of American workers as having been ‘bought off’ by the system or adopting the same conservative values as middle-class suburban managers and professionals is to miss all the complexity of their silence and to have no way of accounting for the intensity of pent-up feeling that pours out when working people do challenge higher authority.” [Sennett and Cobb, The Hidden Injuries of Class, 1991, qtd in Domhoff, Who Rules America, 5th Ed., New York, 2006:114]

One indication of what the release of this pent-up feeling might look like is given by Wisconsin. What struck veteran advocate for social programs Frances Fox Piven about the protests was the “extraordinary solidarity” between different groups of workers, between young and old, teachers and school students. It drew in college students, trade unionists, homeless advocates, and many others in a quietly determined opposition to Walker’s attacks on state workers’ collective bargaining rights. As recall elections loom large, right-wing groups are pouring in  money to try to influence the vote. But what will decide the outcome is active participation by politically-committed citizens, and that is what is happening there (although unreported in the national media).

Unlike Europe where workers tend to be ideologically tied to Social Democracy, and see only conservatives as the alternative, Americans are more pragmatic about their allegiance. There is the strong possibility of offering an alternative to conservative Democrats who acquiesce to austerity programs through the 2012 election process. If the right can transform the Republican party through selecting their candidates in the primaries, then the left can transform the Democrats. Wisconsin Clubs in the Democratic Party which support candidates committed to reversing Republican policies can change the political landscape considerably.

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Filed under health care, marxism, Obama, political analysis, populism, state unions, Tea Party movement, US policy, Wisconsin