March 30, 2020--TRUMP Care

It is obvious that Trump hates everything associated with Barack Obama. Especially Obamacare.

Not because Trump has problems with what's included in the Affordable Care Act (Obamacare's actual name)--I am certain he has no clue about what's in it. But the one thing he does know is that it will always be thought of as Obamacare. 

Ironically, Republicans who hoped it would turn out to be a disaster mockingly labeled it "Obamacare" so the public would forever associate it with Obama's legacy.

Well, they will turn out to be right--the millions covered by Obamacare will always think of it as connected with Obama, the compassionate president who willed it into being.

On the subject of social and political policies named for people, think about the postwar Marshall Plan, named for Truman's secretary of state, George Marshall; think about the Fulbright Fellowship program named for its lead congressional sponsor, Arkansas senator William Fulbright; think about the Nixon Doctrine which articulated a strategy to contain the Soviet Union in Eastern Europe. And of course there is the granddaddy of all doctrines, the Monroe Doctrine, named for president James Monroe, who sought to limit European involvement in the Americas. 

And then there is the aforementioned Obamacare. Different than the generic Medicare and Medicaid. Both could have been named for President Lyndon Johnson--Johnson Care--who was able to get them approved by a reluctant Congress.

On the other hand, in New York City alone there are numerous buildings named for Trump--TRUMP Tower, TRUMP Parc, and TRUMP Plaza. I could go on. And on. 

On all of these properties in huge gilded letters, visible from miles away, we can see the TRUMP name blazoned on the facades. 

(An interesting sidebar--residents of many of these properties have successfully petitioned to have the TRUMP name removed.)

Further, Trump gets malicious pleasure coming up with nasty nicknames for those he opposes or dislikes.

So, among many others, we have Sleepy Joe Biden, Howdy Doody for Pete Buttigieg, and Pocahontas for Elizabeth Warren.

The latest nasty name is the "China Virus." Excoriated for this as racist, Trump has sort of backed off. But he knows his base loves this sort of xenophobia.

But before moving on, I have a suggestion--let's name the COVID-19 virus the TRUMP Virus. 

He's so obsessed with himself that he might actually like this.

July 26, 2019--Trump's F-You

How petty. How small minded. How mean spirited. How nasty. Only our president is capable of such behavior.

I'm talking about plastic straws. But, first, I need to supply a little context. 

That brings me to light bulbs.

You may remember that during the waning days of Barack Obama's presidency he issued an executive order which required that by 2020 traditional incandescent light bulbs were to be phased out. They use too much energy, generate too much heat; and thus, going forward, old-fashioned bulbs are to be replaced by low-energy, compact fluorescent ones. Forget that they do not give as much light as classic bulbs, the government still was to require us to switch over.  

I say "was to" since under Trump this will not be required. It's one more of his many attacks on anything Obama, anything that contributes to his legacy. 

If Obama was for it (say the nuclear deal with Iran) Trump is against it and will do all he can to take it down. 

In biggest picture terms at the top of Trump's cut list is Obamacare. It has been my view that if the Affordable Care Act had been named for someone else, say Harry Truman (he was the first president to call for federally subsidized national healthcare), my guess is that Trump would not have been obsessing for years about how to get rid of it. I doubt if he even knows who Truman is. He certainly doesn't know from "The buck stops here."

I'm OK with TrumanCare if that would assure ObamaCare's survival.

Now we have a flap about plastic drinking straws.

Liberal Seattle is the first city to ban non-compostable plastic straws and other cities are sure to follow. San Francisco, Washington DC,  and New York among them.

Plastic straws  are the seventh-most common trash item found washed up on beaches thanks to the massive number American use--about 500 million a day.

This alone is enough to engage Trump's imagination--anything these cities might do is by definition bad and needs to be undermined. He knows that his base sucks up these kinds of things. 

Forgive the pun.

His people say these kinds of federal moves are a restriction on their freedom. Like electric cars and seat belts.

Ever looking for a way to pander to his base and make a quick buck, soon after Trump heard about Seattle he began to sell Trump-embossed plastic straws on his "Trump Campaign Store" website.

Liberal paper straws don't work.

STAND WITH PRESIDENT TRUMP and buy your pack of Trump straws today.

Trump Straws - Pack of 10 $15.00

Please allow 12-14  business days.

Thus far he's raked in $200,000. At least he doesn't charge for shipping and handling.

May 4, 2017--Life Itself Is a Pre-Existing Condition

The current debate about healthcare among Republicans has come down to how the ultra-conservative Freedom Caucus and the so-called moderates disagree about how to deal with preexisting medical conditions--

As House of Representatives leadership scrounges around for votes to repeal and replace Obamacare, the debate focuses on how insurance should work for people who have health issues?

The moderates are concerned that tens of millions currently covered will lose their ability to purchase insurance since individual states can opt out of the requirement to offer coverage to Americans who have, say, cancer or heart disease or can charge many times what equivalent polices cost for individuals who do not have preconditions.

Though there would be some subsidies for low-income people these would be inadequate since the GOP version of healthcare insurance is in essence more free-market, for profit in structure than redistibutional. This means the legislation they are pushing is about two things--first, cutting government costs and, more important to Republicans, conservative or moderate, to repeal the taxes high earners are required to pay to help offset some of the overall cost of the Affordable Care Act.

This would mean that if you have a precondition you either have to come up with the cash to buy insurance or go without it. In a market-driven Darwinian world, c'est la vie.

Talking about this over breakfast yesterday, Rona said that everyone older than 50 has one or more preconditions just from having lived that long.

She meant it as a quip since it is not literally true; but, when we went down the list of our family and friends to see how many have one or more preconditions, we found that this is true for almost everyone we know.

Including the two of us! If we had to, neither one of us would be able to secure much less pay for health insurance.

From TermLife's Website below is a very partial list of preconditions that would be disqualifying if Obamacare were replaced by what is apparently about to be approved by Republicans in the House of Representatives.

At least a third of Americans have preexisting conditions that would not allow them to buy insurance or it would be beyond their means to afford if we move back to a market approach.

Everyone has stories about people being denied coverage. Here are two from Wednesday's New York Times--

Larisa Thomason, of New Market, Ala., remembers how her husband got a letter from Humana informing him that his policy would not cover cancer care because a colonoscopy had turned up several benign polyps.

Also, an insurer in Washington refused to cover any treatment to Alice Thompson's reproductive system because a doctor had written in her remedial record that she should have a hysterectomy to eliminate powerful menstrual periods.

This is a glimpse of the future of health care if Republicans in Congress and the White House have their way.

ACID REFLUX (GERD)

ADDISON’S DISEASE

ALCOHOL ABUSE AND RECOVERY

AMYOTROPHIC LATERAL SCLEROSIS (ALS)

ANEMIA

ANEURYSM

ANGINA PECTORIS

ANGIOPLASTY

ANOREXIA

ANXIETY

AORTIC ANEURYSM

ARRHYTHMIA

ARTHRITIS

ASTHMA

ATRIAL FIBRILLATION

ATRIAL FLUTTER

ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)

AUTISM

B

BARIATRIC SURGERY

BASAL CELL CARCINOMA

BERGER’S DISEASE

BENIGN PROSTATIC HYPERTORPHY

BIPOLAR DISORDER

BLOOD CLOT

BLOOD PRESSURE

BRADYARRHYTHMIAS

BREAST CANCER

BRONCHIECTASIS

BRONCHITIS (CHRONIC)

BULIMIA

BUNDLE BRANCH BLOCK

C

CANCER

CARDIOVASCULAR DISEASE

CELIAC DISEASE

CEREBRAL ANEURYSM

CEREBRAL EMBOLISM

CEREBRAL PALSY

CEREBRAL THROMBOSIS

CHARCOT MARIE TOOTH DISEASE

CHOLESTEROL

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

CHOLITIS (ULCERATIVE)

CLAUDICATION

COLON CANCER

COLON POLYPS

CONGESTIVE HEART FAILURE (CHF)

CORONARY BYPASS 

CROHN’S DISEASE

March 10, 2017--Skip the Betty Ford Idea

A good friend, Lynne Roth, sent me these musings which are riffs from a series of my recent blogs. I love her sensibility and thought you might like to listen in--
Honestly, I have been sparing you by not sharing my views. I have even refrained from checking your blog first thing every day.  It is difficult.

As for rehab--skip the Betty Ford idea you and your partner in love have your own retreat in Delray Beach, the rehab capital of the country. Another perk is you do not require searching for a halfway house. 

Last night on The Last Word, Lawrence O'Donnell read a letter allegedly written by Trump's grandfather, begging not to be deported from a European country

Yesterday Dr. Carson spoke to the captive audience he now lords over. He struck a nerve when I heard him refer to slaves, upon the backs of whom this nation's lopsided economy was built, as immigrants!  As if they had a choice. Then he back-peddled more than once and said we needed to look up the definition of "immigrants." I was not the only person who took offense.

A visual of three cabinet members holding the new Executive Order on immigration was broadcast. The body language spoke volumes.

Like you, I have rationed my intake of the news but have failed. Playing bridge with a group of people, refraining from discussions of politics helps but is not long lasting.

Frustrated, I am still awaiting for citizens to use the correct term  Affordable Care Act and drop the "Obama."  The new version will soon be labeled as unaffordable and cause a few Republicans to find new jobs.

Anyone in government or the legal business knows if someone is worried about wiretapping or surveillance you have the premises swept. Parinoid attorneys I worked for had it performed frequently on a daily basis.

Your reference to geese is on point. Many folks know geese are as fierce and intimidating as ferocious dogs.  I speak from experience having been chased as a child while visiting a farm.  My father warned me, but it was too late. I was five years old and the same size as the snowy white monster waddling across the lawn. The simmering sounds of a few quacks errupted into terrifying screams from my throat as I turned and ran for safety. My short legs were reliable and I clamored up a fence, ripping my dress as the goose chomped and tore a hole in the edge of the skirt.

My second encounter was in the Dominican Republic. I drove into the parking lot of a road side stand to refill some propane tanks. A young man bounded out to my car and carried off the two tanks. He invited me to shop for fresh vegetables and eggs. We practiced our language skills as I casually gathered some eggs.  The eggs varied in color and size.  Simultaneously, as I asked about and picked up a goose egg, a gaggle of geese appeared.  I needed no warning! I left my eggs and vegetables  and jumped in the car. The gentleman placed the full tanks in the car trunk and came to collect payment.  He grinned and said, "You're a smart lady, not everyone knows geese are the best watch dogs. Many men have tried to steal from me but my geese are good workers."

When I learned the long tradition of daily briefing journalists was winnowing into a gaggle I hoped the geese would be as aggressive as those I have encountered. This tradition of maintaining democracy should not be forfeited for good ratings.

Our nation is paying a terrible price to educate an uncouth illiterate thug on the law, diplomacy, and the art of faking forgiveness. 

While Nixon drank and spoke to his demons, Nancy consulted the stars and Hillary channeled Eleanor Roosevelt, Roy Cohn is whispering in Donald's ear (as he did in Joe McCarthy's) reassuring him a job well done while his dogs lay bleeding in the west wing, exhausted from the mandatory battles, hoping one of the messages leaked to various agencies will reach the ears of some brave citizens able to end this nightmare.

The rockets are being fired at our bases in Japan. 

When the daily Trump news is interrupted by breaking news and now a word from our President,  who will appear and tell us we are at war?  But don't worry, "trust me."

Where are our leaders?

Roy Cohn & Donald Trump

January 13, 2017--A Fine Bromance

On an unseasonably warm day I was out on the terrace helping Rona secure some of her trees and plants for when the worst of winter will arrive.

When my part of the work was done, I collapsed on the bed and turned on MSBC to see if the world still existed.

At the bottom of the screen there was a shot of the White House State Dining Room. A graphic indicated they were waiting for the President and Vice President to arrive for a brief ceremony to honor Joe Biden's remarkable political career.

They were running late but I sensed it might be worth waiting. Maybe Biden would unleash a few valedictory Bidenisms. Like when he was caught on an open mic nearly eight years ago at another formal ceremony, Obama's signing the Affordable Care Act. Biden hugged Obama and whispered for all the world to hear, "This is a big fucking deal." It turned out to be just that.

Yesterday's was a wonderful occasion. The president struck the perfect balance between honoring Biden for his nearly 50 years of service and as is traditional in male-male bromances (and they clearly have an intense one) there was lots of affectionate joshing, including a smattering from the opus of the best Bidenisms. The "big deal" one very much featured with the f-word deleted (many grandchildren were present) but clearly hanging in the air.

When it was Biden's turn he didn't disappoint. He told stories from his life, a life of love and death and then more love and yet more death. But much of what he had to say was about Obama. All heartfelt and full of tears for what had been and what might have been.

"You have a heart as big as your head," Biden said, "And with it you entered my heart." It felt like a defining moment in both of their lives. These unlikely brothers. Not their political lives but their larger lives of family and commitment and integrity and resilient optimism even though, for Biden particularly, his life could have easily been one of cynicism and loss.

As it ended, I couldn't help but think about what was underway literally in other rooms beyond the true emotion and simple beauty of that White House ceremony.

The news channels could not wait to get back to it. One could feel that, as if there were digital emanations from the TV screen reaching out to pull us back into another version of reality, of what the media have opted to present as most important--the "unsubstantiated" CIA document, leaked by BuzzFeed, that alleges, in regard to Russia, that Donald Trump participated in many financial and personal indiscretions.

The reputable news outlets have known about this since August but did not write about it because they could not verify any of the accusations. But all the while, and this is what the networks and and papers such as the New York Times do when there is the hint of a scandal--as with Monica Lewinsky--pretending to be above matters of these kind, they cover the coverage.

That way they do not have to get down in the muck but instead write about what other sources that thrive in that muck are leaking. Journalistic ju jitsu at its most hypocritical. Having it both ways, the elite media remain clean while reporting about the reporting about the dirt.

In the current case that involves revealing, "unverifiably," that once when in Russia Trump asked to stay in the same suite in the same hotel that earlier had accommodated the Obamas and then hired Russian prostitutes to preform "golden showers" on the Obama bed.

Sad to say, though not verified, I'm almost inclined to believe this. This is where America is at. Where I am at. This is to where Donald Trump has helped to bring us.

And, I also thought, what will things be like, what will our country be like when the Obamas and Bidens are no longer in the White House and the Trumps next Friday arrive to check in.

                                       

August 22, 2016--Don't Know Much About Algebra

For many, college resumes today. Including for the daughter of our friend Sarah who is a freshman at the University of Maine, Augusta.

She's splendid. This past summer, between high school graduation and her first day at UMA, she was one of three incoming students to be selected to spend the summer in Costa Rica, living with a local family and working as a medical assistant in a hospital in San Jose.

The college was so impressed by what they were hearing about her that they upped her scholarship by a few hundred dollars and asked her to take the lead in beginning a student EMS program at the campus in Augusta.

This should be a sweet time for Alexa, but it is turning into a time of trial.

First, she, as all students, is required to have medical insurance. For middle--middle-class kids this should be no problem--they would be covered by their parents' policy.

The problem is that Sarah is a single mom, works three part-time jobs, and has no employer-provided coverage. In the aggregate, her jobs yield slightly more in income than would qualify her for the subsides provided by the Affordable Care Act, Obamacare.

"The least expensive policy I could get that would also cover Alexa is $385 a month."

"Wow," Rona sad, "That's more than $4,500 annually."

"To be precise, $4,620. With a $5,000 a year deductible. They call that affordable?" Sarah sputtered, "Give me a break. And I voted for him two times. Obama. Why, I'll never know. But I'm a liberal. I suppose that's why. So now what am I going to do about Alexa? Get another job? I'm already working seven days a week."

"What are you going to do?" I asked.

"Good question. See if I can borrow some money from my mother. Not that she has much. Or maybe Alexa will take out a student loan. I hate for her to have to do that. Saddle her with tens of thousands in debt when there probably won't be that many good jobs when she graduates."

"Sad but probably true," I said, "But she sounds special and will probably do just fine."

"It's all about the probablies."

To shift the subject somewhat to something more positive, Rona said, "I'll bet she's excited. She's off to such a good start even though she is just starting."

"She is excited, but good kid that she is the money issues are getting in the way of her feeling positive about beginning college. She's talking about taking a year off, deferring her admission and working to save up enough money to help out with all the costs."

"A lot of young people are doing that. Look at Obama's daughter, Malia, isn't she taking a year off?"

"With all due respect, we're not talking about the same thing. His daughter . . . "

"Touché," I said, "Sorry."

"Not a problem," Sarah assured me, "I know you're trying to be empathetic. But there's one more thing. Something really outrageous."

"What's that?" Rona asked.

"Textbooks."

"They're still using textbooks?" I said. "I would think with the Internet they would be more and more obsolete."

"Not as long as they can make money selling them."

"I know they can be ridiculously expensive."

"Take a guess," Sarah said, "She needs one for Biology and another for her required arts elective, the History of Music."

"When I used to teach, they could be as much as $50 dollars each," I said.

Sarah smiled and gestured that they cost more than that.

"Seventy-five dollars?" Rona guessed.

"I'll save you the trouble,"Sarah said, "You're not even close. It's three hundred for the music text and . . ."

"You've got to be kidding," Rona interrupted.

"I wish I was. And, even more outrageous, the biology book is $400."

"So just two books run $700. I'm staggered. How corrupt this feels."

"That's the right word for it, 'corrupt.' Is it any wonder that people in America are angry? I mean modest hard-working people."

"No surprise at all, I said, "We're fortunate to be financially secure and don't have kids in college but what you're saying makes me furious."

"This helps explain some of the Trump people," Sarah said. "Not the crazies or the bigots, but, frankly, people like me. I'm working my butt off; have no child support from Alexa's father; I'm a feminist--in the way I live, not just in the way I talk--and I'm not a fascist. As I said, I'm pretty progressive. But things have gotten to the ridiculous stage and out of frustration, if Trump wasn't such a jerk--and worse--I can't tell you I wouldn't be thinking about voting for him."

"I think I understand that," Rona said.

"Things need radical change and I'm feeling that voting for Hillary, who I can't stand, would not be voting for someone who'll make things better. She's cut from the same cloth as all the other professional politicians. More concerned about themselves. Don't really get me and people like me. They mouth the words but it's just words to get us to vote for them. Trust them. I did that eight years ago and then again four years later. But what did Obama do that was good for people like me? Including with his famous Obamacare. Again, for people like me, it turns out to be a scam."

"Well . . ." I started to say.

"I know, I may be overstating things. But have you ever worked seven days a week? I'm not meaning to give you a hard time, but I've been doing that now, all on my feet, for more than three years."

"Well . . ." I started to say.

June 29, 2015--Jiggery-Pokery

In his, even for him intemperate rant against the Supreme Court's historic 6-3 decision to uphold the constitutionality of the Affordable Care Act (ACA), associate justice Anton Scalia went further than usual in a descent that went beyond the judicial to the very personal.

More than saying that he fervently disagrees with his colleagues' legal logic, he accused them of participating in a deceitful and dishonest act, even applying the archaic Scottish slur jiggery-pokery to impeach their honor and integrity.

In the old days, which he so reveres, he might have been called out to a duel on the field of honor by one of the other justices. But alas, we will have to endure more of him and more of this because the court, under chief justice Roberts, is going rogue on him.

As the intellectual leader of the court's conservatives, the alleged strict constructionists or texturalists,  for decades dominating the other three to four justices who have placidly gone along with his views of the Constitution (with Kennedy occasionally being a swing vote, agreeing with the four automatic liberals), Scalia now finds himself at times in the minority, especially when the court hands down its most significant decisions, like last week's rulings on Obamacare, same-sex marriage, and the Fair Housing Act. (Do not overlook the importance of the latter.)

Scalia might have been more enraged than ever by Roberts' majority opinion in Burwell (the ACA appeal) where he subtly and without attribution quoted Scalia to himself to support the core of the argument he articulated for the five concurring justices.

It is all about context, as Scalia claimed in cases last year when he employed the same contextual argument--it is all about what the Congress truly intended. In the ACA case, Roberts wrote last week, if one looks at the 900-plus page context of the ACA--as Scalia would have us do in selective instances such as this one for laws he viscerally despises--it is clear that Congress intended the uncovered to be able to obtain affordable health care insurance.

Being quoted this way to justify something he violently opposes clearly got under Scalia's skin and motivated him to deliver his dissent from the bench, a highly unusual occurrence that underscored his fury.

But, again, Scalia's intemperance is less about the Obamacare vote than his sense that the court and American society on key social issues are moving on and he is more and more being left in the retrograde past--multiple meanings intended.

He will learn forcefully now that this is the Roberts' Court, not the Scalia.

June 26, 2015--Obamacare!

With the Supreme Court decision announced yesterday that the Affordable Care Act (ACA) is constitutional, in addition to all the lives that will be bettered and saved as a result, there is one jolly political irony for those of us who consider it a pretty good piece of social legislation and feel that Barack Obama deserves to leave office in two-and-a-half years with his reputation, all right--his legacy, enhanced.

Here's the irony--

From literally the day Obama was elected in November 2008, many activist Republicans saw his election somehow to be illegitimate and have done everything they can to bring him down and delegitimatize him and his accomplishments--again, his legacy.

This is not to say that he has been a "great" or even a "near-great" president (if he secures a sound deal with Iran regarding their nuclear weapons program his stature will rise further) or that he deserved the Nobel Peace Prize in 2009, but all things considered--the economy, the roiled world with its out-of-control nationalisms and terrorism--he has done a rather good job. The economy is decidedly better than the one he inherited and he did end in an admittedly bumpy way the two wars that George W. Bush started and led into chaos.

But still GOP leaders and most of their followers wake up every day thinking about what they can do to undo everything Obama had a hand in accomplishing. Nothing more fervently than the ACA which the House of Representatives under John Boehner's fractured leadership voted to repeal literally dozens of times. There was a time during 2010 after the GOP seized control of the House that they did so every week for months.

Even Jeb Bush yesterday, with all the courage of a marshmallow, vowed to repeal it the day he is sworn into office in January 2017

As a sneering epithet to stigmatize the ACA, Republicans labeled it Obamacare. They couldn't say it enough. It was supposed to remind Americans that this abominable piece of legislation was the result of "his" efforts, the best evidence that he was a European-style socialist.

The name stuck. And isn't it amusing that this healthcare law, which is already providing life-saving coverage for up to 17 million previously uninsured Americans, many of them poor, and now twice has been upheld by a radically divided Supreme Court, will likely remain a permanent part of our social safety net alongside Social Security and more appropriately Medicare and Medicaid?

No other law that I can think of is named for a president. Social Security isn't called Roosevelt-Security, Medicare is not referred to as Johnsoncare, nor is the Voting Right Act named for LBJ. Welfare reform is not Clintonfare. Yes, we have the Monroe and Truman Doctrines but they were promulgated by an executive order, not something hatched with their leadership and then considered and passed by Congress.

Obamacare will be the way the Affordable Care Act will forever be known. So three-cheers for it and Obama.

As Joe Biden was heard to say on an open mike back in Match 2010 when it was passed, "This is a big f---ing deal."

January 8, 2015--Poor You

According to a recent story in the New York Times, many of the very same Harvard professors who were in such demand as advisors to the Obama administration as it fashioned the legislation that launched the Affordable Care Act (Obamacare) are now whining that because of it they have to pay a little more for the health care coverage that Harvard provides faculty and staff.

Outraged by this turn of events, the Faculty of Arts and Science voted overwhelmingly to oppose those changes in Harvard policy that would have them, for example, pay an annual deductible of $250 for individuals and $750 for families. This for what everyone acknowledges is platium-level or Cadillac coverage.

Some say this is punishing the sick since for many members of the faculty and they dependents, as for the rest of us, costs really begin to accrue when one is in fact sick or in need of extensive testing and even hospitalization.

In the Times piece there is scant recognition, whatever the professors feel about having to dip a bit deeper into their wallets, of how unbelievable privileged they still are in contrast to almost every other American affected by the health care system they helped devise.

What insensitivity. What obliviousness. What hypocrisy.

To see what kind of a financial burden the new guidelines represent for Harvard faculty, I checked to see what average annual salaries are for professors.

According to the Harvard Crimson, in 2012, on average assistant professors earned $109,800 a year; associate professors $124,900; and full professors $198,400. Not noted is the fact that most faculty at places such as Harvard typically earn at least the equivalent of an additional one-quarter of their annual salaries as consultants.

And, the new Harvard health care guidelines indicate that anyone--faculty or staff--earning $90,000 or less per year (almost everyone else) will be assisted to pay their copays and deductibles.

As an NYU full professor friend, who acknowledges he is doing very well, used to say about similar circumstances, "Poor you."

September 8, 2014--Two Cheers for Obamacare

I've been wondering why we've been hearing relatively little recently from Republicans about Obamacare. It had been thought that in the run up to the November midterm elections the GOP would be all over it, savaging it as an assault on both our freedom and the federal budget. It was to be their political trump card. The route to majority control of both houses.

Could it be that there is now relative silence because Obamacare is actually . . . working.

Many millions have signed up, and with the exception of some anecdotal horror stories the vast majority with health care coverage for the first time are happy with it; and, perhaps most surprising, in spite of all the scary stories about how the Affordable Care Act would bust the budget, it has in fact not only been cost effective but has already been contributing to deep cuts in the federal deficit.

Just as Obama said it would.

So then two cheers for Obamacare. It is too soon to offer three because, though the nonpartisan Congressional Budget Office's projections show significant downward trends in overall Medicare costs (the result in part of aspects of the ACA law) and thus dramatic deficit reductions over the decade, we still do not know how many more will sign up, how much subsidy they will require, and the nature of the care these new enrollees will require.

The CBO, adjusting for inflation, recently reported that the average amount spent annually per Medicare recipient declined from $12,000 each in 2011 to $11,200 this year and will be reduced further to $11,000 per Medicare enrollee by 2017. Technically, this is called "negative excess cost growth."

All told, the CBO is projecting that, as a result, over the next ten years the federal deficit will be reduced by $715 billion. Nearly three-quarters of a trillion dollars.

To be fair, this good news is not fully the result of the ACA. This downward trend is also a consequence of "young" Baby Boomers becoming eligible for Medicare for the first time and the apparent, not entirely understood, reduction in costly tests, treatments, and drug use. All good things as our health care system has grown bloated with over-testing and the over-selling of unneeded treatments and medications.

This $714 billion in savings dwarfs all deficit reduction plans being discussed, including Paul Ryan's draconian budget.

Wouldn't it be good if we could stop playing demagogic games with the budget and health care and get on to the real problems we face--how to create more jobs, improve the treatment of veterans, fix our crumbling infrastructure, improve public education, and tackle the inequality crisis.

Why am I not optimistic?

December 20, 2013--At the Risk of Being Snide . . .

There's a new New York Times/CBS News poll about Obamacare.

No surprise, there is widespread skepticism about the whole thing--from the law itself (though most polled confessed they didn't yet understand what's in it) to the enrollment process.

What jumps out for me is that 53 percent who are currently uninsured disapprove of the law and, while about half of those said that they are thinking about getting health insurance, at least a third say they do not plan to do so.

Here's what's confusing to me--

These folks for the most part have no idea what's in the law; and, although they do not have insurance, many will not make the effort to learn what the Affordable Care Act can do for them and thus still say they will continue to remain uninsured?

For them I have a couple of questions--

Do they have a better idea as to what would work for them? If not Obamacare, what?

Then, if they do not have a credible alternative and intend to remain uninsured, who do they expect to take care of them and pay for them if they become seriously ill or are critically injured in an accident?

I'm not inclined to want to.

In the past when coverage was unaffordable for low-income Americans, when people couldn't get coverage if they had preexisting conditions, when there were lifetime caps on coverage, I was all right with the rest of us picking up the cost of emergency room care for the uninsured.

If we as a people couldn't figure out a better way to take care of our most vulnerable citizens, then we had to do something--even something as crude and expensive as making ER care universally accessible. But now, I'm not so sure.

I am tempted to say that you either get insurance on your own (with generous subsidies for the working poor) or you're on your own.

December 9, 2013--The Rollout

I've been having a back and forth with a friend about the rollout of Obamacare.

She is being extra-critical, feeling that the botched launch of the Website is emblematic of Obama's botched presidency. "He's great at articulating big ideas but when it comes to actually getting the work done, he either has no interest, is inept, or a combination of both."

I haven't been disagreeing with her--I too am quite disappointed with the president about whom I initially had great hopes. But I've been saying that Obamacare is not about the website but about Obamacare itself.

If in a year or two 30 to 40 million people who do not now have health insurance are by then covered and are satisfied, healthier, and the cost of care overall continues to decline, who will even remember the website fiasco?

"But, I fear," she says, "that conservatives will continue to claim that the federal government is incapable of carrying out big projects. They will say it's only private industry that is capable of doing large-scale things."

"If they say that," I've been asserting, "they will be ignoring much of the history of the last 150 years when the federal government took the lead in the construction of the transcontinental railroad, electrified all of America (especially remote, rural America), built the interstate highway system, constructed huge dams, mobilized to win the Second World War, and launched Social Security and Medicare. All of these massive undertakings were criticized in their day by some of the same kind of small-government  conservatives we're seeing today--saying they were unconstitutional, socialistic, would never work, and were going to bankrupt us to boot. Sound familiar?"

"Yes," my friend has been acknowledging, "Though all of this got done, that was then and what we are seeing is now. I feel we have lost our way since the Manhattan Project and the TVA. Maybe even more recently after successes with Medicare and Medicaid. There may very well be truth to the claim that now it is only private enterprise that can get the job done."

"You mean like the folks who brought us the Edsel, New Coke, and the collapse of the Big Three auto companies? These failures were all the result of private industry hubris."

At best, in spite of my efforts to marshall history to provide some context for what we see today, my friend remains skeptical, even pessimistic. "We're things at these earlier times as bitterly partisan, with both side only interested in winning?"

"That to. The things they said about Lincoln, Wilson, Teddy Roosevelt and FDR were pretty ugly. The attacks weren't magnified as much as they are today since they didn't have 24/7 so-called news networks, but still things back then could be vicious. And yet they found ways to accomplish some big things."

"You could be right. Some times having a historical perspective helps."

"We could talk about Jefferson and Jackson and . . ."

"For the moment," my friend at last laughed, "let's stick with the Roosevelts. There's only so much history I can deal with in the morning."

November 13, 2013--Hillary in 2013

If anyone has been wondering if Hillary will run for president in 2016, yesterday there was clear evidence that she is already running in 2013.

From her principal surrogate--husband Bill.

Just the other morning, as Barack Obama's approval rating plummeted well below 50 percent and his disapproval poll numbers soared about 50 percent, Rona and I wondered how Hillary will run against her ultimate Republican opponent and the president she served as Secretary of State.

With Obama on the political ropes--largely because of the disastrous rollout of Obamacare--how will she distance herself from him? It will not work for her to campaign offering four-more years of what we now have.

Bill gave us our first public glimpse of her presidential campaign strategy.

Recall that when she was on ropes of her own after the early primaries in 2008--the upstart Obama was doing so well that it looked as if she was no longer the inevitable nominee--Bill was unleashed in South Carolina to get her back on track.

There he unabashedly played the race card, reminding South Carolinians, after Obama's victory, about how Jessie Jackson had won the Democratic primary there in 1984 and 88 and look what happened to him. The conflating of the decidedly black Jackson with the post-racial half-white Obama was considered by many well below the belt, even for the Clintons who take no prisoners.

Yesterday Bill was back in campaign mode suggesting very publicly that Obama should seek to change the Affordable Care Act to allow people "to keep their current health insurance, just as he promised" when Obamacare was controversially working its way through Congress.

Don't be surprised if Bill Clinton soon tries to put the blame on Barack Obama for the murder of our ambassador in Benghazi, Libya.

October 18, 2013--The Not-So-Grand Bargain

Didn't everyone know it would end this way?

The congressional adolescents would have their week or two of cable airtime where they would be permitted to have politically-motivated temper tantrums and then the adults would take over, send them to their rooms, and make a deal.

In this case the deal was to surrender unconditionally to the Democrats and especially President Obama since the focus of the Tea Party's fury was and remains the Affordable Care Act.

The deal is a pathetic one--to negotiate a long-term budget by mid-December and then in early January, since there will likely be no such deal, begin the process again of threatening to shut down the government and then in February begin to rally around the idea to not raise the debt ceiling.

We got a not-so-grand bargain but need a real one that controls spending and adds more revenue to the budget mix.

We need to see the Medicare and Social Security cost curves bend downward as Baby Boomers cascade toward retirement and put bankrupting pressure on those two programs.

If we do this seriously, next time around it will be the liberals doing the screaming.

In the process, we will find out if President Obama has starch in his shorts and is willing to take on his own party and constituency or was his tough stance this time around just about preserving his eponymous program--Obamacare?

October 4, 2013--Rite Aid

On Wednesday, while in Camden in 80 degree weather, we stopped at the Rite Aid pharmacy to buy a bottle of water. Forget for the moment that 18 ounces was $1.95 and Rona couldn't resist making a point about what must be the profit on selling "free" water.

What was most interesting was the chat I had with a Rite Aid staffer who was set up with a computer at a desk near the prescription counter.

He was with a customer but we caught each other's eye and I mouthed, "Obamacare?"

He nodded and when the person with whom he was talking got up--seemingly quite happy--I stepped closer and we chatted about what he was doing and how it was going. Counseling people, he said, about the Obamacare options available to them in Maine and how the public he was encountering was reacting to what they were learning about it from him. Very positively he reported.

He told me that at every Rite Aid around the country, not just in communitarian Maine, there were people like him who had been trained to help uninsured people think about what might be best for them.

I told him I was not waiting to have him describe the options to me, that I am on Medicare and have Aetna in addition, but since there was no one waiting he seemed eager to chat.

"They come in here having gotten most of their information about the Affordable Care Act from listening to fear-mongers such as Glenn Beck, Michael Savage, and Mark Levin on the radio in the middle of the night and, as you might imagine, are very worried about what having to purchase insurance will mean for them and their families and how much it will cost them to sign up."

"I can only imagine," I said, "Though to me it's far from perfect, I support Obamacare; but feel he hasn't done as good a job describing it, selling it, as people such as Rush Limbaugh have done to denigrate it and instill fear in unsuspecting listeners."

"Pretty much everything they tell me that they 'know' about Obamacare is wrong. For example, there is still the belief out there that if you sign up for it you and your family members will be under the control of death panels and if you currently have coverage you will not be able to keep it but will be required to join a plan endorsed personally by Obama."

"What about cost issues? Are people worried about how much it will cost them?"

"Initially, pretty much universally yes. But when I sit them done and run the numbers--based on their family income--considering incomes here are in general not that high, they discover that it will likely cost them a manageable amount to select a health care plan."

"Can you be specific?"

"Sure. For a couple making less than about $62,000 a year (and that would be almost everyone here) with the tax credits available, on average it could cost them about $100 a month. Which almost any working couple can afford. For a family of four, tax credits kick in up to about $94,000 of annual income; and the cost for the plan selected--and there's a range of them--would run from a couple of hundred dollars a month to $1,000 or so for those opting for the low-deductable, so-called 'platinum' one. On the other hand, if a family of four makes less than $32,000 a year, the cost of the basic plan will be about zero. Like for those of you on Medicare. The government subsidies will cover pretty much the entire cost. Which, to say the least, is a good and big deal."

"Do they know about how with Obamacare there are no lifetime caps on how much will be covered and how, no matter one's preexisting conditions, coverage can't be denied?"

"Some have heard about that but most haven't. And when I tell them about that--almost everyone I've spoken with thus far does in fact have a preexisting condition--they think I'm not telling the truth. That I'm a shill for Obama."

"So Mark Levin and company have been ironically successful in spreading misinformation . . ."

"And lies," he said. "That's what this computer's for," he tapped the screen, "I show them the truth in black and white, so to speak."

"How's business? I mean, how many people have you seen?"

"Between yesterday and thus far today maybe a couple dozen. But here's the most interesting part."

"What's that."

"Already today I'm seeing people who had friends or relatives who I spoke with yesterday coming here now based on what their friends learned. It's too early to generalize, but word of mouth seems quite positive."

A couple of middle-aged people had joined the line behind me so I turned to leave.

"They're not positive about me," he laughed, "but about Obamacare."

"I wonder if this will find its way to the media or will they continue to insist on covering the negative?"

"That would be a first," he said, winking and waving as I left.

September 25, 2013--GOPcare

Forty-two times Republicans in the House of Representatives have voted to repeal or defund Obamacare.

Most recently the end of last week when they did so as part of a budget package to make the entire federal budget contingent upon eliminating it. Effectively, they said, if you want the Affordable Care Act, there will be no government--no Social Security, no Medicare, no national parks, no aid to education, no airport security, no oversight of drugs and medicines, and even (their favorite federal program) no military.

And then they went home for their 6th or 7th vacation of the year.

Additionally, they left a marker back in Washington, saying that unless Obamacare is ended by the end of October they will not vote to raise the debt ceiling. They will not vote to pay for federal programs that they themselves already enacted into law.

Effectively, they are, with this, drawing a legislative red line which asserts that unless the Democrats and the president go along with this they will allow the United States for the first time in history to default on our financial obligations--if you have T-Bills, they will not pay you the interest you thought was guaranteed; and the U.S. dollar will no longer serve as the world's reserve currency because we will have welched on our international debts and obligations.

All because of Obamacare. All because the GOP leadership has caved in to the Tea Party crazies who are really anarchists seeking to eliminate most of our government, seeing nearly all of it profligate and evil.

While spending much of the past two years futilely voting against Obamacare, the Republicans have not put forth a credible alternative health care plan of their own. One to cover the 44 million Americans who who have no coverage, or would have none if Obamacare were to be rolled back--mainly dependent children and lower-income workers whose employers do not provide medical insurance or do not have the $5,000 to $10,000 a year to buy their own insurance.

By not voting in favor of a plan of their own the GOP is rendering a death sentence to hundreds of thousands of Americans who will die prematurely without preventative or on-going care.

I know for these radical Republicans the death penalty is one of their favorite governmental programs; but at least executing people comes after someone commits a heinous crime and is tried and convicted.

To kill people (and that in fact is what we're talking about) because they cannot afford to pay for an operation or cancer-fighting medications is not so different from condemning someone to death through the courts.

One difference--we usually put people in the gas chamber one at a time. Denying people the medical help they need and deserve is nothing short of mass murder.

August 30, 2013--Cruzcare

I'm slow so it took me some time to understand why Republicans can't stand the Affordable Care Act, better known as Obamcare.

During the past two years John Boehner has had the House of Representatives vote to overturn it 40 times. Literally, 40 times. It was passed each time in lockstep partisan fashion but has never been taken up in the Democrat-controlled Senate.

But every Republican who can't say no to an invitation to be on TV and, more significant, every Republican who sees himself (thus far there are no women) as the GOP nominee to run against Hillary in 2016, is basing his campaign primarily on the promise to get rid of Obamacare.

Never mind that it is based on Republican ideas and practices, from Romneycare in Massachusetts, when he was governor, to the healthcare recommendations of the conservative Heritage Foundation.

But when Obama endorsed these policies in his own version of expanding healthcare for the uninsured, everyone on the right who was for it suddenly was against it.

And now during their August recess town meetings back in their home districts, in the embrace of their apoplectic Republican base, the talk by congressmen and presidential aspirants is almost exclusively about this abomination--Obamacare. They can barely get the word out without becoming physically nauseous.

The opposition is so viscerally agitated that one has to wonder about the source of this aversion.

Thus my belated insight--it's because the Affordable Care Act is popularly named Obamacare. After him!

Forget for the moment that it is the very same Republicans who can't look him in the eye and are made physically uncomfortable when in the same room with him who labelled it such, thinking that in itself would doom it--who would want to see a doctor and have that intimate experience tainted by an overt association with him? This in itself, it was thought by conservative political strategists, would be enough for the masses to rise up and demand it be overturned.

But now that even Tea Party folks are seeing their parents' and grandparents' medications paid for by Obamacare (the donut-hole is closing), their adult children covered by their existing insurance policies, and more and more states agreeing to participate, their strategy is backfiring.

Like Medicare, which at first was passionately opposed by the same right-wing elements but quickly became one of our most popular safety-net programs, how awful would it be if the ACA followed the same trajectory and forever was named for Obama?

There's nothing equivalent for Franklin Roosevelt. The Civilian Conservation Corps could have been called the Roosevelt Conservation Corps, we could have had the Kennedy Peace Corps, and the Johnson Voting Rights Act, or the Reagan Tax Cuts--well, we did have them and look where that got us: trillions in debt.

Yes, there is the Monroe Doctrine and the Bush Doctrine. And there is the Hoover Dam, the JFK and Reagan Airports, and the Eisenhower Interstate Highway System.

But to have a substantial portion of our basic healthcare coverage named for the Kenyan-American president is too, too much.

Canadian-born Texas Senator Ted Cruz, the reincarnated Joe McCarthy lookalike, who has been in the Senate for just a few months and is already running for president, is basing his entire campaign on opposition to Obamacare. Just as Michele Bachmann did the last time around.

Maybe if we can solve the name thing the issue would go away. If Cruz manages to get nominated (unlikely) and elected (get your passports updated)--calling it Cruzcare would detach it from Obama and the millions covered could feel confident that they would not be thrown off the books and left to fend for themselves.

July 18, 2013--Affordable Health Care in NY

There was a report in yesterday's New York Times about the rollout in early 2014 of the Affordable Care Act in New York State.

One might expect that since New York is about the highest-cost state in the United States the cost of mandatory insurance to New Yorkers would be in line with what one needs to come up with to buy a one-bedroom apartment in Manhattan. In other words, a ridiculous fortune.

But in spite of all the alarmist ranting about how Obamacare is socialized medicine and that people will have their health care rationed with end-of-life decisions taken aways from patients and their families and be assigned to government "death panels," when all is said and done, tens of millions will for the first time have health insurance, hundreds of thousands of lives will be better and even saved, and the cost, it appears, if administered correctly, will go down. Actually plummet.

In New York, for example, because of the competition engendered by having various health care insurers compete for new clients, to quote state regulators, because of the on-line purchasing exchanges, the rates they have approved for insurers are "at least 50 percent lower on average than those currently available in New York."

For those now paying $1,000 or more a month, as early as October, they will be able to purchase comparable insurance for as little as $300 a month. If one cannot afford that, with federal subsidies, the cost will be even lower.

I suspect that politically we will see a situation similar to the mid-1960s when Medicare was rolled out. It was condemned by organized medicine (the AMA in the lead) as socialized medicine and this was echoed and worse by most Republicans. But now, even Tea Party members though wanting to eliminate much of what government provides, make an exception for Medicare.

When I have at times confronted some who have nothing good to say about any government program, pointing out to them that Medicare is a government program, and in fact is socialized medicine, still they say, poking a finger in my chest, "Don't you touch my Medicare."

Five years from now people will be saying the same thing about the Affordable Care Act--though it is far from socialized medicine (it is after all based on a Republican model), they will be poking fingers in chests and warning, "Don't you touch my Obamacare."