May 5, 2017--Winners & Losers

Though Republicans members of the House of Representatives did not pause to see what the non-partisan Congressional Budget Office would say about the consequences of the healthcare legislation they rushed to approve, the New York Times did an instant analysis of who won and who lost.

What the Times found should be no surprise and suggests why GOP House members were in such a hurray to vote--if any of them took the time to read the legislation (few did) they might have been embarrassed to be made aware of what was in the bill and what they were heartlessly voting for.

It also might have given them pause before, like needy children, they rushed to Big Daddy at the White House to have him praise them for their dastardly deed. And, yes, to have a Bud Lite together before heading back to their home districts for yet another ten day-vacation. They had after all had to work for their $174,000 salary for two whole weeks since their last "recess."

Here are the winners and losers--

Winners:

High-income earners--eliminates taxes for couple earning at least $250,000 a year.

Upper-middle-calss people without pre-existing health conditions.

Young middle-class people without pre-existing health conditions.

People who opt to go without insurance--the bill eliminates the individual Obamacare mandate.

Large employers--eliminates employer Obamacare mandates.

People who want less comprehensive coverage.

Losers:

Poor people.

Older adults in most states.

People with pre-existing health conditions in many states.

State governments because of cuts in Medicaid--including, little noticed, for special education.

Hospitals--because up to 24 million people will lose coverage and thus hospitals will have fewer patients. Millions will again seek care in high-cost emergency rooms.

Planned Parenthood which will not be allowed to receive any government funds for at least one year.

April 20, 2017--Tax Scam

I'm dense so it's taken me awhile to figure out why the Republicans so passionately want to
"repeal and replace" Obamacare. Actually, some of the most conservatives want only to do the repealing.

I got swept into believing some of the rhetoric. Obamacare is deeply flawed. True. It does not allow most people to keep their doctors, true; and it is not containing the rise in the cost of either medical care itself or healthcare insurance. Also true.

But, after a little time passed and the Republican talking points were countered, it became clear that the Paul Ryan American Health Care Act is not about healthcare but about taxes--a critical step toward his plan to cut and reform corporate and income taxes.

Here's the math--

In a March 22nd Forbes Magazine posting (not a socialist publication) it was reported that contained in the final version of the proposed bill, after all the deal making with the House of Representatives Freedom Caucus and White House, the nonpartisan Congressional Budget Office concluded that the plan would result in an $600 billion tax cut over the next decade, with at least $274 billion of the cuts going directly to the richest 2%.

Further, Medicaid would be cut, again over the decade, by $880 billion, making it more difficult for low-income taxpayers to secure insurance.

Though from a healthcare perspective it would be a crisis for low- and middle-income people--the CBO also estimated that these cuts would mean that 24 million would lose their current coverage--from a tax-cut perspective it would be a bounty. Again, with the top 5% benefiting the most from the GOP version of tax reform.

Obamacare does include two tax surcharges for high earners--

For couples filing jointly, if their adjusted gross income is $250,000 or higher there is a 0.9% Medicare surcharge and a 3.8% surcharge on net investment income, with the latter being income from certain types of dividends and capital gains.

The Ryan plan calls for the elimination of these two taxes for very high earners.

If this bill were to pass (and although it was set aside last month it is still a glimmer in Paul Ryan's eye and seems to have the support of the president, who feels the need to get at least something, anything done--even something this harsh and regressive) then Congress and the president could move on to what really interests them--massive tax cuts for the wealthy. Paid for largely, and here's the perversely brilliant part, by repealing the two Obamacare tax surcharges. Doing this would yield $1.48 trillion, which would "pay for" most of the additional tax cuts in a manner so as to make then seem "revenue neutral."

Again, this healthcare shell game is not about healthcare but tax cuts.

The claim, of course, is that cutting taxes for the wealthy is really about helping the middle class, because if you cut "job creators'" taxes they will invest in businesses that generate high-wage jobs.

The only problem with this claim is that it's untrue--the massive Reagan tax cuts and the even larger Bush tax cuts did not boost the economy or create jobs.  What was created were massive increases in the national debt--nearly tripling during Reagan's time and doubling under George W. Bush.

In contrast, the debt after Clinton's eight years increased by just 32% and during Obama's two terms, after inheriting a collapsed economy, it went up by 68%.

I am embarrassed to admit that it has taken me this long to finally figure out what is going on and what all the congressional healthcare machinations are about--tax cuts.

March 13, 2017--Ladies of Forest Trace: Not Resting

The Ladies are in a place of tranquility but they are not in repose.

I know this from my mother, who deserves to be at rest after more than 107 years of life. I discovered her state of agitation during a recent visit to Mt Lebanon Cemetery in Queens.

When I was a child we visited Mt. Lebanon regularly so that she could be with her parents and bring them news of the family and the world. We would sit together on the bench beside where her mother and father were and I would listen while she told them about Bertha's recovery from a stroke, Nina's trip to Israel, Eli's struggles with his creditors, Fanny's plans to move to Florida, news about Stalin, and how things were with my father.

About that, the state of her own marriage, she would whisper so I needed to lean close and strain to hear what she was reporting. Though I could not catch most of the words, I could tell from their tone and her trembling that things were not going well.

"He never . . . He always . . . ," she said and then tearfully would switch to Yiddish to protect me from being swept into her unhappiness. But from this and how she placed her arm around me and drew me close into the protective nest of her body, I knew her pain was real. And that to her I represented a sense of purpose. She was happy I was there with her, with the family.

More than sixty years later I again needed to be close to her and so, though I sat alone on that now crumbling bench, listening to the wind, I tried to pick up her emanations, the comfort she provided, and, on that chilly pre-spring afternoon, her still flickering warmth.

"The girls are so upset," she began. I could hear the pain in her voice.

"Tell me Mom."

"About him."

"Who?"

"Thump, Donald Thump."

I didn't correct her wonderful malaprops, which frequently revealed more than literal truth.

"You've been hearing about him?" I wasn't sure how information was acquired and shared by the Ladies now that they were no longer . . .

"All the terrible things he's doing. With immigrants--wasn't his own father an immigrant?--with minorities, with women, with health. And we are so afraid about Korea and Russia. Especially Russia. We know Russia. Two of the Ladies are from there and I was born in Poland, near the border. Russian Cossacks raided our village, Tulowice, when I was a little girl. My mother hid me and my sisters and brother in the root cellar below the floor of our log cabin. The evil things they did which I cannot tell you about."

"You can tell me, Mom. You can tell me anything."

"You're still young and I don't want to upset you. You should be enjoying life."

Only someone who lived to 107 would consider me to be young. It was this kind of affirmation that I loved and which I greedily still needed.

"You should have your rest," I said, reversing her lifelong admonition to me.

"As your father said, 'There's plenty of time for rest. Later, there's time for rest.'"

"Yes he always did say that. As I grow older I understand it more and more."

"Ruth, who marched so we could vote, the women, is so upset that a majority voted for him--I can't say his name--so many women that I am sure Wolf on TV is saying that if it wasn't for the women voting for him we would have Hillary. Not that she's such a bargain. But almost anything would be better. Even Mike Expense, the Vice President, who we all are hoping will become president. This person, Expense, who doesn't believe in women's health and is too religious for any of our tastes we are wishing for."

"I am hoping for the same thing. Maybe if there's an impeachment or . . ."

"We're both dreaming. The Republicans in Congress, who we know did not support him will keep him in office because he will sign anything they approve--health care, taxes, regulations, pollution and who knows what else."

"It's a long list."

"But, one of the girls, Rose reminds us things have been worse."

"How? He's been in office only two months, though it feels like years, so how can things already be worse?"

"She means in the past. When we and Negroes couldn't vote. They couldn't drink water here in Florida. They had their own colored fountains. We didn't have the Pill but we had world wars. We had Depression but didn't have Xanax for that." She paused to let me know she meant that to be funny. So I wouldn't worry more than I do about her mental capacities.

"And you are old enough to remember the gas chambers. We had family who survived Auschwitz. Cousin Malkie and her family who lived with Aunt Tanna and Uncle Eli when they escaped and came to Brooklyn. You heard those stories when you were seven years old. I tried to protect you from them but you insisted you wanted to know about the world. Even at its most evil. So I let you sit with us at the kitchen table while Malkie and her son, whose name I forgot but whose haunted look I will always remember, told us about the nightmare."

"I remember that. I also wanted to see the tattoos on their arms. I didn't want to be shielded from the worst that life could bring. But I know you felt otherwise and wanted me to have nothing but a happy childhood. One time you told me that was in part because of all the children who were forced to suffer. You wanted me to live for myself but also when I was old enough to try to do things that would make less fortunate children's lives better."

Recalling that I began softly to cry.

"I bring this up," she said, "because I want to remind you that Rose is right. Too many things were worse in the past. Not quite as much so for those who were blessed to be born here or came to America as hopeful immigrants and refugees. We survived and over time many things did get to be better."

"You always say this," I said, knowing I had come to Mt. Lebanon in large part to have her remind and reassure me about that.

"Of course, things here could get worse but worse than Pearl Harbor? Worse than the Cold War? The Depression? The lynchings? I could say more but I know you have to rush away."

"I have a little more time," I said, feeling a bit better, though not yet assured or optimistic, "So tell me whatever else is on your mind and making you and the Ladies so restless."

"This isn't enough?"

"But I thought you brought up the War and women to remind me not to get too overwrought with what is happening?"

"That's my attention. But, yes, there is something else that is very disturbing to us."

"Please tell me."

"You know your history better than we do so I'm sure you have examples."

"Of what?"

"About what I am going to tell you."

"Sorry."

"And it's not all his fault. Though he is the beneficiary of it."

"You're starting to lose me."

"The hate." I waited but she didn't continue.

"The hate?"

"I'll give you a for-instance. When they talk about health there is so much resentment, so much hate for poor and elderly people who will have it taken away from them. They talk as if it's about how much it costs the government but what we really hear is how much the Republicans--and it is them--feel it is people's fault that they are poor and need help. They say they are making the wrong choices about how they spend their money--as if they had so much. Did we hear this correctly--sometimes communications to where we are are not so good--that someone in Congress, Jascha Heifetz, said that if people had enough money to have a telephone . . ."

"Jason Chaffetz, from Utah."

"I don't have my hearing aids with me. But that's him. He said if they have money for those phones they could give them up and use the money to buy health insurance."

"I did hear that. He really did say that."

"In the meantime if so many millions lose insurance how many will die from that? Who was it who talked about death panels? This is like that. Worse."

"Congresswoman Michele Bachmann."

"Who was also running for president. But all this meanness and resentment about struggling people--about children and old people--is very sad and tells us what these Washington people really think. They are so full of anger and resentment and this makes it acceptable for him to say the ugly things he has for years been saying. About Obama, about women, about Negroes, about Mexicans. And what's really worse when he talks this way is that many of the people who support him, who are filled with fear and hate, want to hear this. They give him encouragement and permission to say the ugliest things. They cheer loudest when he does."

"There has been hate and fear at other times in our history, that's true. About the Irish and Italian and Jewish immigrants. And obviously black people. You experienced that when you were a young girl and woman. People are this way when there are hard economic times. And when . . ."

"I'm sorry to interrupt but whatever was or has been is no excuse."

"I agree."

"About that, by now, we should know better."

To that I had nothing to say.

"We're all gone now," my mother whispered, "There is no room left here for anyone else. All the places are filled. Everyone from the family is here. And the Ladies are scattered like leaves. Ruth to her daughter in New Jersey. It's so cold there. Ruth was always shivering. And Rose next to her beloved father also in Queens. In Mt. Hebron. Adele, poor thing, is by herself. She lost all her family in Russia and never married. Never had children or grandchildren. I love her so much. How she made such a good life for herself. The first woman to become a school principal in Brooklyn."

"She was remarkable," I said.

"I could talk all day, but I know it must be getting dark and they close the gates soon. And you don't like to drive after the sun is down. You were such a good driver," I noted the past tense, "When you would take me to the doctor or out for Chinese, I felt so secure. And now . . ." Her words trailed off. Her breathing slowed. I didn't want her to strain herself.

It was time for me to go. I was feeling better. If not about the state of the world about her and how loved and safe she still made me feel.

"And remember, as I always say, be sure to wear your sweater."

It was as if I could see her smiling.

May 30, 2014--The Republicans Are Right

The title is not a pun about Republicans being to the right of the political spectrum. But rather about what they are advocating in regard to reforming the Veterans Administration healthcare system.

They are right about that and the Democrats are wrong in what they are proposing.

What was suspected--that corruption, greed, and incompetence at a number of VA hospitals have led to the maltreatment and even the death of many veterans--is now documented.

The acting inspector general of the Veterans Administration has completed his report and, among other findings, reported that more than 1,700 vets seeking appointments at the Phoenix VA alone were either ignored or never entered into the system. In spite of this, to generate bonuses for administrators, a second set of books was kept and submitted to Washington that showed them being treated within 30 days. In the meantime, many hundreds went untreated and scores died while waiting or ignored.

And, I suspect, as more is uncovered, we will see the same kind of malfeasance at other VA facilities as other administrators seeking bonuses cooked the books.

Putting aside for the moment why any government worker should be eligible for a bonus, why has it taken years to get to the bottom of this deadly scandal when alerts were filed by whistle-blowers from within the bloated system?

The head of the VA, General Eric Shinseki, should have been told about this in a timely way (and for all we know he was) and it should have been brought to the president's attention since for years since his first campaign he has been demanding better after-service care for wounded veterans (and, for all we know, he also was).

Minimally, Shinseki should be fired, a VA tsar should be appointed, someone with vast health-administration experience, and the system should be overhauled.

Serious consideration should also be given to the House Republicans' plan to privatize the VA hospitals and clinics. If that is too radical, minimally, as the GOP is proposing, any veteran who has had to wait for care for 30 days or more should be able to seek it through private medical providers at the VA's expense.

This is far better than the Democrats' approach--the Senate is preparing legislation to add 27 new healthcare facilities to the VA system to address the backlog of cases. Beyond the billions in additional cost, this is an unrealistic approach since it would take up to 10 years to get the hospitals built and functioning. For the nearly 8 million vets treated (or not treated) each year this is hardly a solution.

Each month a cousin who is a WW II veteran uses the VA for routine blood work since his out-of-pocket cost is just $15 per test, a third what it would cost if he went to his local hospital.

I asked him if he would prefer to go there if it could match the VA price. "Sure," he said, "It's much closer. And they do a good job."

This is true for most vets who require non-urgent testing and care. So why not give them an eligibility card to enable them to go to any hospital and have the VA cover the difference in cost? Sure this approach would have to be phased in over a number of years, but it would greatly simplify things, especially for service men and women who do not live close to VA treatment centers.

Over time we would no longer need a separate and unequal VA healthcare system. Veterans would get timelier and better care closer to home and taxpayers would save billions.

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.