October 23, 2018--Political Slut

Midterm election day is just two weeks from today. 

Two weeks at the end of a campaign can be a lifetime in voter mood swings. And, if you agree that this is the most consequential election of our lifetime, I hope you will consider how I am viewing it.

More than anything else voters need to restore some check and balance to the current political situation. James Madison was right--our system is designed to have divided government in order to prevent the emergence of a totalitarian leader. We face that prospect today. It is aided and abetted by the fact that the president and both houses of Congress are in the control of just one party.

Since the president is not on the ballot (except as a self-nationalizing surrogate), it is essential to flip at least one House. I think, forget the Senate. If anything, Republicans are likely to increase their majority there by at least two seats. Three or four incumbent Democratic senators are likely to lose and at most two states will switch from red to blue. Thus, the Senate will almost certainly remain in Mitch McConnell's gulag.

The House, though, is another matter. There, I am projecting, that as many as 35 Republicans will be defeated but only two or three Democrats. Enough to return the House to Democratic control.

But with Trump, the unusual often turns out to be the new usual. He has made this election about himself and has demonstrated the capacity to bring about electoral surprises. For example, two years ago by winning the presidency.

So, I say, when considering who to vote for forget totally issues that may be close to your heart. Become the same kind of political slut I am--obsessed about only one thing: winning.  

If you are passionate about gun control (I am) ignore the fact that the Democrat from your district running for the House is against what you consider to be meaningful gun control, hold your nose and vote for him or her anyway. (The Democratic House challenger here in Maine is featured in his TV ads as comfortable at a rifle range.)

If you are committed to single-payer healthcare--Medicare for all--(as I am) and if your Democratic candidate opposes this because he or she sees it as a budget-buster, for the moment forget that and vote for her or him.

And if you feel so strongly about preserving unfettered abortion rights that in all other circumstances it would be a litmus-test issue for you (I generally do feel this way), for the good of the larger cause, take a few deep breaths and pull the lever for the Democrat running in your district who supports some limitations on abortion--say, late term abortions--because unless he or she does take this position, to line up with the will of her or his potential constituents, the Republican will win and this will undermine the larger agenda--the desperate imperative to win back the House.

You get my point.

After we win, we can go back to debating issues. To do so now is a luxury we cannot afford. 

Also, during this final two weeks get involved. 

Make get-out-the-vote calls. Especially to Hispanic voters. Even if you are agoraphobic or have medical issues, you can do this from home in your pajamas. There is no excuse just to vote. Get directly to work. It is that important. 

There is no underestimating how empowered Trump and his people will feel and be if the Republicans retain control of all three branches of government (also, add the Supreme Court with its 5-4 conservative majority to this list). Unless some limitations are imposed on Trump's power by defeating him in at least the House (where serious investigations can take place as soon as January 1st) it will be a dangerous and depressing two or six more years.

Trump needs to be deflated. Right now. In two weeks.

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 16, 2017--In Line at Trader Joe's

There was a panicky run on food supplies and bottled water as the Blizzard of 2017 approached Manhattan. After Hurricane Sandy, no one wanted to take anything for granted. So Rona and I joined the hunt for things to stock our larder with in case there was two-feet of blowing snow and widespread power outages.

We had recently "discovered" Trader Joe's on 14th Street and, though we didn't think much of TJ's in Delray Beach, we gave the one in the city a try a couple of months ago and liked their selection and prices.

In truth, we especially liked their house brand of Belgian chocolate pudding. Two or three tubs of that could get us through another Sandy. With that who needs bottled water!

When about half a block away it looked like chaos at the entrance to Joe's. "I wonder what's going on," I said. "Maybe a sale?"

"I doubt that but I think it may be a line."

"Out onto the street? That doesn't seem possible. The way they line up people in the store itself who are ready to check out amazes me. Sometimes the lines, two of them, snake all the way from the fruit and vegetable area all the way along the refrigerated chests to the front of the store where there are 20, 25 cashiers. It moves pretty quickly, but a line out the door and halfway up the block, even in a pre-storm buying frenzy?"

"There is in fact in line and it looks like it would take an hour to get to a cashier. So, I'm thinking, I can get through a week--even if we're snowed in--without chocolate pudding."

"Really?" Rona said skeptically, knowing my guilty habits and obsessions better than anyone else.

"And notice, rather the the usual young crowd that shops here most of the people on line are decidedly middle-age."

"That is interesting. The prices in general are pretty good compared to what else is available around here from Agata & Valentina and Whole Foods. So that could be part of the explanation."

"I wonder how many are on line."

"Why don't we count them," Rona said.

As so we did. As unobtrusively as possible so as not to make anyone feel under surveillance. Anticipating the storm was producing enough anxiety.

About halfway to the checkout counters we decided to bail out. It was so crowded that threading our way parallel to those pushing their shopping baskets along was arduous and it began to feel as if we were spying on otherwise stressed-out people.

We stopped the count at 217. "Amazing," I said, and simlutaneously noticed they had already sold out of many things, including my nighttime treat.

A women, who looked to be about 60 overheard what we were saying, pushed her walker toward us and, with edginess, said, "What are we specimens or something?"

"No," I stammered, "We were only looking for my chocolate pudding and . . ."

"And staring at us as if we were on display."

"Sorry to give you that impression," I said weakly, "We're just trying to stock up before . . ."

"So where's your basket, your cart with water and bread and other stuff?"

She had us there. I didn't know what to say. Rona was pulling on the sleeve of my coat.

"You live 'round here?" the woman said. "I can tell by your coat that you do." She pointed to Rona's furry white coat.

"Well, we . . ."

"Fancy people just as I suspected, looking down on the poor folks." She inched her shopping basket along, pushing it with her foot.

"I bought it, the coat, in K-Mart," Rona said almost inaudibly. "It was on sale."

"Speak up, will yuh," she hollered, tapping her ears, "I'm a little hard of hearing."  Rona didn't repeat what she had begun to say. "But, like I said, I'm from around here too." She hadn't mentioned that. "So it's my Manhattan too. I have rent control. Not everyone lives in fancy condos or coops." She was about to poke me in the chest so I recoiled as far as the overflowing aisles would allow.

"We're not that . . ." Rona said, "It's only that . . ."

"Only that you have money and I live on Social Security and Medicare."

"We . . . "

"I have to shop here while you two can go to Whole Foods or Dean & DeLucas and not have to stand out on the street in line, shivering for an hour just to save a few dollars."

"Is that how long you've been in line?"

"I'm exaggerating to make a point. But yes, at least half an hour on the street. But it's worth it. They take food stamps and don't give you attitude."

"We shop here a lot," I lied.

"There are these two Manhattans--yours and mine. I'm not a socialist mind you, though I voted for Bernie. I'm just pointing out the truth. I love living here. In my parents' old apartment. May they rest in peace. I go to a museum most every week. Just saw the new show at the Whitney."

"The Biannual," I said, "Was it any good?" I was glad to change the subject, "Half the time they're terrible. Too much about political correctness, not enough about the art."

"This time the art is very diverse but it's all pretty much of high quality. You should go. I have a pass so I don't have to pay but it shouldn't be a problem for you." Again she looked at Rona's coat.

"I think it costs at least 30 dollars. Not the coat, admission."

"That's a problem for you? If it is I don't see why you're living here. To go to the Whitney or the Met is the reason to be in the city." She again pushed her basket to close the gap in the line.

"We're trying to do more of that," I said.

"And while you're at it, look around at all your neighbors. New York is not just about money and museums. We don't bite." With that she chuckled and coughed at the same time.

14th Street Trader Joe's

March 29, 2016--Still Feeling the Bern

"Did you hear Bernie's speech this weekend?"

One of our very young friends was calling. It was clear she was excited.

"After winning the caucuses in Washington, Alaska, and Hawaii. He really trounced Hillary."

"He's good at caucuses but not so much so in primaries where people actually vote."

"You're always so pessimistic about him."

"I think I'm being realistic. I keep my eye on the delegate count. Like it or not, they will select the nominee. And by my calculation, and that of pretty much everyone else, Hillary should win easily."

"I'm never going to vote for her." I felt badly that what I said deflated her.

"If it comes to that--I mean Hillary versus Trump or Cruz or whomever, you'd think of voting for one of them."

"Never."

"So . . . ?"

"So, maybe I won't vote at all."

"That sounds defeatist to me. Not voting for Hillary is just like voting for Trump or whoever."

"Now you sound just like my parents."

"Well," I said, trying to lighten the mood, "Sometimes even parents get it right."

"I didn't call to get you to convince me to give up my ideals. I'm young and I want . . ."

"Touché. I hope you'll except my apologies. Listening to myself, I think you're right. That's what I was trying to do. Get you to be 'realistic,' to compromise."

"There's time for that."

"Yes, I did hear his speech. I haven't listened to a speech of his for quiet awhile and thought . . ."

"Because you already gave up on him?"

"Probably true. Probably true. With so much going on on the Republican side I admit I haven't paid much attention to the Democrats. So I . . ."

"Tuned out Bernie. For what it's worth, I excuse you for that. What's going on with the Republicans is more fun." She laughed, and I was glad to hear she was back to being her usualy enthusiastic self. "I don't know about you, but I thought he was amazing."

"I was impressed. Too bad . . ."

"There you go again being negative. Even if he doesn't have much chance of winning the nomination, didn't you feel that everything he said was true?"

"I did. But even if he somehow manages to get elected, I doubt he could get Congress to go along with Medicare for all much less free tuition at public colleges and universities."

Ignoring that, she said, "And weren't you impressed with what he had to say about minorities--he went down the full list, including Native Americans. No one else even mentions them much less as compassionately and honestly as Bernie."

"True. We could go over his speech point by point and probably agree with pretty much everything."

"Particularly what he said about what he said about women. As a woman, a young woman I was excited about that."

"Doesn't he say similar things as Hillary? About equal wages, abortion, childcare leave?"

"Yes, but I wasn't as impressed about the list of specific issues as how he spoke about the importance of both women and men working together on them. Not just women. If these are family issues, he was saying, that has to include men."

"I noticed that and I too was impressed."

"This is not the way Hillary speaks about the next things that have to happen to secure more rights for women. She makes it sound as if it's only a women's issue when in fact it's a women's and men's issue. I think this difference between Bernie and Hilary is one of the reasons so many young women are supporting him."

"I haven't heard anyone mention this. So good for you."

"I've got to run in a minute, but one more thing."

"Sure."

"My feeling that you were pushing on me to be realistic, to compromise . . ."

"I already apologized for that."

"And I heard and appreciated that. But here's what I want to say about that--it's too soon for me to give up my ideals. Isn't that what young people are supposed to do--maintain their ideals? Weren't you like that when you were my age--not willing to give in? What with the antiwar and civil rights movements?"

"Fair points."

"And also, though I know it's unlikely, probably impossible for Bernie to win, if by some chance or fluke he manages to do so, I'd still want him to press Congress to raise Social Security benefits and make health care a right. And the rest of his agenda"

"But wouldn't he have to compromise to get anything done?"

"Not in advance the way I feel Obama tended to do. If we agree that everything Bernie said in his speech the other night is both true and right, to accomplish his goals, wouldn't it be smart for him to lay them all out in specifics and fight for them? Maybe he wouldn't win, but at least he'd get the discussion started and, who knows, maybe he'd get a few things done and set the agenda for the next decade or two."

"Go on."

"I know you like history."

"Yes."

"Isn't it true that Truman was the first president to call for universal health care, something even Nixon advocated, and then decades later Obamacare was approved and upheld? So who knows--maybe the things that Bernie wants to do could over time have the same results."

"Could be."

"Who was it who said that journeys of a thousand miles begin with a single step? Even revolutions."

I sensed she was smiling. Feeling good about herself.

"You know what?"

"What?"

"I love you. Very much."

December 11, 2015--Social Insecurity

There was a big envelope waiting in the mail from the Social Security Administration.

Rona looked at me seemingly concerned.

"Nothing to worry about," I said, "Must be my annual benefits letter. You know, the COLA amount for next year. The cost of living adjustment. How much more I'll be getting."

"Good, since we just got our COLA for the apartment. Maintenance is going up three percent beginning in January so it would be good if the Social Security increase will offset it."

Upstairs I opened the envelope. The letter was five pages long. "Let me get to the money shot," I said, thumbing through them. "Here it is. It says, 'We review Social Security benefits each year to make sure they keep up with the cost of living.'"

"That's good," Rona said, "That's what I was waiting to hear. To see how they are making sure we keep up with the cost of living."

"You're not going to like this then," I said, avoiding eye contact.

"What do you mean?"

"I mean it looks as if I'll be receiving less come January than I am now."

"That can't be," Rona said, snatching the letter out of my hands. "How much have you been getting?"

"Let me look." I thumbed through my checkbook. "$2,200 a month."

"And in January?"

"If I'm looking in the right place, "$2,186. Fourteen dollars a month less. That comes to . . . let me see . . . $168 a year."

"This is their version of helping you keep up with inflation?"

"I seem to remember hearing something a few months ago that the Social Security people determined there is no inflation and so there will be no COLA."

"In the meantime they came up with a negative COLA--they adjusted you down?"

"Unless they made a mistake, it looks that way."

"Let me talk to them," Rona snapped. There was a service number to call. "No surprise, the recording says there's a 35 minute wait time."

"There are about 50 million seniors receiving Social Security and probably half of them right now are calling because they got versions of the same letter. I wonder how many very old folks will die on line while waiting for someone to pick up."

"You're so cynical," Rona said. "But I bet I know what happened."

"What's that?"

"The only other thing listed is the deduction for Medicare. They say come January they'll deduct $202.30 a month. I'll bet that's more than this year. Do you know how much they currently withhold?"

"Not really," I confessed. "You know I don't pay that much attention to money matters. You do it for both of us. And in fact very well," I blew Rona a kiss.

She didn't respond.

In the meantime, on hold for half an hour, we listened to Social Security Muzak.

Impressively, someone picked up at the end of exactly 35 minutes. For some reason that made me feel optimistic that there had been a mistake in my calculation. How could they send me less while saying they review my benefits each year to make sure they are keeping up with inflation?

I needed to identify myself and provide authorization for Rona to ask about my account.

After doing that, Rona asked if there was an error. There wasn't. She then inquired if the new, reduced monthly benefit was in fact less than at present. It was confirmed.

"Why would that be?" As we suspected because they increased the Medicare deduction.

"How does that help us keep up with inflation?" Rona asked with a hint of attitude. It doesn't, she heard back.

"Let me see if I have this right--you determined there's no inflation and so there was no COLA." Correct. "But at the same time you're withholding $168 a year more, which is a form of increasing our cost of living--we have to come up with that amount." Silence.

"Right?" More silence.

"No wonder everyone is going crazy about the government," Rona said, "I know it not your fault, but really? This is the kind of letter you send? To people struggling to live on Social Security?" Again no response.

The SS representative had probably been fielding calls of this kind all day. Likely mainly from people less fortunate than we for whom $168 less a year will present real problems.

"More votes for Donald TRUMP," I said. "You know, Mad As Hell. Blah, blah, blah."

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."

May 8, 2015--Mike Huckabee

Mike Huckabee--or Mike Huckleberry as my mother refers to him--this week announced to no one's surprise that he is again running for president.

There is room in the Republican clown car for him since he is literally a lot smaller than he was in 2008, the last time he ran, thanks to lap-band surgery and the pressure to look slim on TV during the years he had a talk show on Fox News. He has little chance of winning the nomination but should see a bounce in his lecture fees and at the minimum during the campaign be good for a few laughs.

In regard to that, he started off with a few zingers--

First, to differentiate himself from all other GOP candidates, while calling for cutting or eliminating almost everything else, he offered strong support for retaining Social Security and Medicare pretty much as they are. Chiding other Republicans--specifically those many no-shows in the Senate who, on the public payroll, are running for the presidency--Huckabee called for cuts in their own fat government pensions and health care benefits instead of those of more vulnerable citizens.

This was a smart move for him, considering his likely 65+ year-old base of supporters, and fits right in with the Populist passion to take regular swipes at anything having to do with government.

But beyond this, he is such a fiscal conservative (a GOP requirement) that he advocated the elimination of much of the rest of the federal government. Supporting the military--another imperative--aside. For that he wants to spend more and presumably use our troops more aggressively than he claims they are at present. Do I hear in Iran?

From his perspective I get eliminating the Department of Education--the federal role in education has for decades been a Republican whipping boy, with claims that it exists only to promulgate socialist, secular propaganda in our public schools. Of course, neither Huckabee nor any of the others tell us what they would do about various forms of student financial aid (the largest part of the DOE budget) that even Republican critics use to help them and their children pay for college.

OK so we'll figure out how to make that work. Probably through privatization--give those programs back to the banks. Who cares if it would cost billions more than at present. If the private sector is in charge, to conservatives by definition that's better than the government playing a role.

And of course, top of the list of federal agencies to be eliminated is the loathsome IRS. Even poor Rick Perry last time around was able to remember that was one to the three programs he would eliminate--he needed help with the other two. Perhaps soon he'll tell us which they are since he too is about to grab a seat in the clown car.

Without the IRS why would anyone feel compelled to pay taxes? Talk about America becoming just like Greece where hardly anyone does.

But, of course, that would be a good thing--no tax money means no federal government. Sure, Huckabee and his colleagues would have to figure out how to pay for the military and border security. Their two favorite federal programs.

Maybe we'll privatize the military. Turn it into a for-profit operation. For example, let Boeing or United Airlines run the Air Force, GM or Ford the Army, and Carnival Cruise Lines the Navy. Issue stocks and bonds to support it and peg dividends to how many wars we can drum up and  . . .

And then we could hire Blackwater to take over border security. Look how good a job they did in Iraq where the Bush administration had them provide security for American operatives. No matter a host of them were recently convicted of murdering Iraqi allies.

Do we want the CIA, FBI, NSA? If so, is it possible to privatize them? We could contract with Facebook and Google to do the electronic surveillance. For marketing purposes, by collecting big data about each of us, they are already doing a version of that.

Do we want an FDA to offer assurance that our medications work and are safe? Not if we have to spend tax money to do so. But since we do want to avoid the undue side effects of new medications (the current scary ones are enough) we could turn the FDA functions over to Pfizer and Novartis. They'd jump at the chance to fast track the approval of their own new products.

Our crumbling federal highways and bridges? Sell them to Abu Dhabi. They already have experience running the parking meter concession in Chicago so maybe we should ask them to repave our interstates.

The Government Printing Office and Mint? Turn them over to Citibank. In the early days of the United States banks offered their own currency so this would be a strict-constructionist way to manage our money 2015-style. And while we're at it, get rid of the Federal Reserve. With Citibank controlling the money supply, who needs them?

Federal Prisons? Many states have already privatized theirs so why not the U.S. government.

The airports? A perfect role for JetBlue.

The postal service? A no-brainer--FedEx is already handling a substantial portion of our packages and is venturing successfully into mail service. So let's turn the rest over to them.

And of course we should sell the national parks to Disney. That's an easy one. Grand Canyon Land. Yosemite World. Love it! Now if Disney would only add a water slide at Old Faithful and . . .

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?

July 3, 2014--Barefoot and Pregnant

I recently read Sean Wilentz's Age of Reagan.

It's a reasonably balanced view of how Reagan emerged on the national political stage in 1964 during Barry Goldwater's quest for the presidency and how, when Reagan was elected president, his administration became a vehicle for the proliferation of neo-conservative thought and action, with players who then and later influenced domestic and foreign policy. He managed to keep the pre-empters isolated, those who wanted to aggress against the collapsing Soviet Union, but allowed supply-siders to take control of economic policy.

Trickle-down became the belief system that guided tax and spending policy and, though it didn't work (the federal debt tripled and the gap between the rich and working poor began to widen dramatically), it continues to dominate, even control current conservative thinking.

Wilentz does a good job of describing the basic Republican strategy, fully on display during the Reagan eight years, to undo the policies of the New Deal, Fair Deal, and Great Society.

With the significant exception of welfare reform, they never had the votes (as now) to overturn or dramatically transform safety-net programs such as Medicare and Medicaid, Social Security, unemployment insurance, aid to education, federally-subsidized college loans, low-income housing, food stamps, and the like, nor could they get the Supreme Court to declare these unconstitutional. But they did figure out an effective long-term strategy to reduce and even eliminate them--asphyxiate them by cutting off their fiscal oxygen supply.

By refusing to go along with full appropriations, not agreeing to spend the money required to sustain these policies, over decades they have managed to chip away at the size and reach of many of these signature progressive programs.

It's the basic jujitsu approach to legislating--do as little as possible, better, do nothing and in the process watch programs such as Head Start wither.

A few are sacrosanct and have widespread support even among anti-government Tea Party Republicans--cut government to the bone, they chant, but take your hands off my Medicare and Social Security. Both actually forms of socialism!

Tea Party folks may say this, but the Republicans they keep reelecting to Congress continue to vote to make Social Security either discretionary or investable in the stock market and have voted repeatedly for the so-called Ryan budget, which would end Medicare as we have come to know and depend on it.

Democrats have no equivalent long-term plan to preserve and expand policies that reflect their core values and, as a result, the handwriting is on the wall. Even if they manage to keep electing Democrats to the White House this policy erosion will continue.

Beyond congressional tactics, for the moment conservatives have firm control of the Supreme Court and the national federal judiciary and there they are doing a version of the same thing--taking seemingly small regressive steps that have enormous long-term consequences. The recent Hobby Lobby decision is a case in point.

It exempts two small family-owned companies from having to comply with the Obamacare requirement that their health care insurance cover the cost of contraceptives. But legal scholars worry that this is just a foot in the door to other forms of restriction. Few are yet thinking of rolling back the right to buy and use contraceptives--pre-Griswold v. Connecticut days--but one never knows. There are more than a few Republican and Tea Party leaders who would ban all forms of contraception and like to see women again barefoot and pregnant.

May 23, 2014--The VA Mess

It's déjà vu again.

For my entire adult life I have heard stories about the Veterans Administration healthcare system. Mainly horror stories.

About how bureaucratic it is and thus difficult for our veterans to get timely, high-quality treatment. And now we are learning how delays and suffocating administrative procedures may have led to the deaths of score of veterans in Phoenix and elsewhere.

When Barack Obama first ran for office in 2008, he made fixing the VA system his highest priority so our troops could get the treatment they deserve. His promise came at a time when there were reports about the disgraceful quality of care and conditions at Walter Reed Hospital, walking distance from the White House.

Obama pledged to clean up the mess and bring the VA up to "21st century standards." He even designated his wife Michelle to make the care of veterans her priority.

So where are we five years later?

Business as usual. Maybe, business worse than usual.

And the mess cannot be attributed to George W. Bush. The full blame rests with the current occupant in the White House.

What has Michelle Obama been up to in regard to veterans' care? Mainly periodic hospital visits between planting a vegetable garden in the White House lawn and jumping rope with inner-city kids. I know this is overstated, but not by much.

Like almost everyone, I am mad as hell about this.

The president cannot honor those killed and shed tears at the bedside of the grievously wounded, hypocritically, for political reasons, calling them as often as possible "heroes," while presiding passively over this ongoing disgrace.

Obama's head of the VA, General Eric Shinseki may have been a good general (though not everyone would agree) but he was  not qualified to head the Veterans Administration. What job did he ever have to prepare him for such a huge and complicated assignment? He was selected mainly because he publicly disagreed with President Bush's approach to the war in Iraq and fit an Asian Cabinet demographic to which Obama was eager to pander.

In the VA system there are 151 hospitals and 820 outpatient clinics that serve 6.5 million people a year. The annual budget is more than $57 billion. To run that is a very big job, it's a highest-priority assignment, and who do we have running it?  Someone whose major responsibility previously was serving four years as Army Chief of Staff.

If fixing the VA was such a high priority, was there no head of a major healthcare system, Humana, HCA, or the Mayo Clinic, who could have been recruited to take on the assignment?

Sadly, Shinseki's appointment was typical of the kind of people Obama named to Cabinet-level positions--minimally-competenet lightweights such as Tim Geithner who would not challenge or threaten Obama's leadership.

Name one Cabinet appointment with a truly distinguished track record in public or private life who went on the serve with true distinction? Or on the White House staff for that matter. Even Hillary Clinton's record is at best mixed.

So, where do we go from here?

First, fire Shinseki. Do not ask him to reign, summarily dismiss him. That would be a first for Obama and send a message of concern and seriousness.

And then about the larger problem--restructuring the VA healthcare system itself--there are two good approaches.

Privatize the VA hospitals and clinics. Get rid of the ineffective bureaucracy and sell the whole thing to HCA or Mayo and in this way eliminate of the Civil Service deadwood.

Equally important, and not mutually exclusive, make all veterans eligible for Medicare. No matter that they are not all 65. Pretty much everyone with Medicare likes it so why not extend this cost-effective, high quality healthcare system to all those Americans who did so much to serve our country?

Tinkering at the margins of this massive problem will not solve it. Doing something radical and smart is the better approach. Our brave men and women deserve no less.

May 13, 2014--Minimum Age

"Do you think at the military commissaries on our bases in Afghanistan, when soldiers return from patrol and ask for a beer, if they look younger than 21, they get carded?"

"What made you think of that?" I asked Rona.

"For some reason I've been thinking about age restrictions."

"Not just drinking?"

"In general."

"Specifically, I doubt that our troops get carded even though you can engage in combat well before you're twenty-one."

"That's my point. How setting minimum ages for things is often inconsistent and even hypocritical."

"I do remember back in the late 60s and 1970s when the 26th Amendment was passed to lower the voting age from 21 to 18, it was said to be unfair to draft 18 year-olds to fight and get killed in Vietnam but not allow them to vote."

"Or buy and smoke cigarettes."

"Also true."

"There's even some fringy thinking that says since young people mature more quickly today than in the past that the voting age should be lowered further."

"I've heard that. Would they allow 15 year-olds to vote?"

"Maybe. But the larger point when it comes to voting may not be about age at all."

"Meaning?"

"I'm not advocating," Rona said, "that we go back to the time when only men who were property owners could vote or . . ."

"Even if that 'property' was slaves?"

"Touché. Or maybe asking people to take a test to see if they have even a minimum understanding of the issues." I raised my hand to interrupt. Rona waved me off. "I know how tests of this kind in the past were used to block black people from voting. So that's off the table too."

"So then what's on the table?"

"I was reading recently about an NBC/Wall Street Journal poll that underscored how people of different ages feel about issues. Which is not surprising. Younger people are more libertarian when it comes to cultural issues such as same-sex marriage and legalizing marijuana while older people have much stronger views about health care. They, for example, though they're on Medicare--which is a version of socialized medicine--are overwhelmingly opposed to Obamacare."

"For me that says it all--how older folks, who have great coverage paid for totally by taxes are so opposed to others having a version of the same thing. How selfish and self-centered can you get?"

"Which makes me wonder," Rona said, "though I know what I'm about to say makes little practical or constitutional sense, that if we think it's fair to set minimum ages for things maybe we should also set maximum ages for other things. For example, most companies have manditory retirement policies. And maybe we shouldn't allow 95 year-olds to drive."

"I could see that making sense. Maybe a relicensure test should be required after age 85. But if you're going where I think you're going, well . . ."

"Where might that be?"

"Setting a maximum age for voting."

Rona rocked back in her chair and just smiled.

April 9, 2014--Republicans Are "For Nothing"

When Frank Rich is booked to appear on the Rachel Maddow Show I try to tune in. I like the way he sees through the hypocrisy that passes for political discourse and though he is an unashamed progressive is not above giving Democrats corrective grief when he sees them pandering or posturing. Which is often.

The other night he joined Rachel to mark what they claimed was the end of the Obamacare debate. With up to 10 million newly signed up to be covered through health insurance exchanges or enrolled in Medicare, plus millions more young people covered by their parents' policies, they proclaimed there will be less political advantage to Republicans to keep bringing it up.

It's a done deal, they said, and as the benefits really begin to phase in and even people who were reluctant to be forced to buy insurance or be subsidized to do so see how good a heath care delivery system it is, they will become as fervent in their support of it as people were who hated the idea of Medicare ("socialized medicine") but now will defend it to the death. Or minimally, to the ballot box.

As evidence of this, Rich and Maddow cited the latest version of the Ryan budget which calls for the full repeal of the Affordable Care Act. They mocked him for being both politically tone deaf (again, it's a done deal) and for not having an alternative to propose. They showed clips of him making the rounds of the Sunday talk shows fumbling when asked what he was proposing as a substitute to the tens of millions who would be denied coverage or would see their coverage severely restricted since he and his colleagues also want to turn Medicare into a version of a voucher system.

Ryan said, "We're working on alternative proposals." He didn't mention that his budget is the third or fourth in an annual series of Ryan budgets, each not much different than the others, and that coming up with a viable alternative proposal should not have be taking this long to develop.

This shows, Frank Rich said, that Ryan and his fellow Republicans are against everything, that they are, as he put it, "for nothing."

For a moment this did not feel to me like much of an exaggeration. Republicans are clearly not for Obamacare; they are clearly not for Medicare or Medicaid as it currently exists; they are not for food stamps; they are not for environmental protection; they are not for financial systems regulation; they are not for taxes; they are not for . . .

Listening to Rich and Maddow make this list, it sounded as if the GOP is indeed for nothing. (Though they are for increasing defense spending.)

But on further thought this seemed simplistic. Even unfair. Disagree with them as you will, most Republicans are in fact for something. Actually, many things.

Being against Obamacare and Medicare and especially Medicaid is being for less government participation in healthcare.

Being against raising the minimum wage is being for letting the market determine workers' wages.

Being against extending long-term unemployment insurance is being for a Darwinian economy.

Being against regulations is being for allowing markets to self-correct.

Being against taxes is being for trickle-down economics.

You get the point. They achieve their goals but doing as little as possible. Being for something by seemingly being for nothing.

In sum, Republicans are not for nothing. Quite the opposite.

January 29, 2014--Uncle Eli's Tongue Factory

While the Obama administration is thinking about publishing a list of individual doctors who are off the charts in the amount they bill Medicare as a way of exposing them to public scrutiny and potential prosecution if there is evidence of over-billing, Health Management Associates in Naples, Florida is already publishing data of its own about doctors affiliated with its South Florida chain of hospitals.

In Naples, according to a report in the New York Times, scorecards are posted for all attending physician to keep track of how many over 65-year-old patients they admit to the hospital each day.

Doctors hitting the target to admit at least half of the Medicare and Medicaid patients who entered via the emergency room are color-coded green; the doctors who were close to that 50 percent target are coded yellow; and those not admitting enough to the hospital are red-lighted.

Since the HMA hospitals, reflecting national changes in the way medicine is practiced, employ more and more doctors rather than just granting them attending status, pressure on these salaried doctors to increase income (and their own bonuses) by admitting more patients who have good insurance is increasing. So much so that at a HMA Naples hospital a Medicaid-elegible child was admitted with a diagnosis of having "fever" when her actual temperature was normal, 98.7; and an 18-year-old with a minor knee laceration was admitted though the wound could easily have been treated in the ER and the patient sent right home.

These are not isolated cases but rather examples of routine business.

These hospitals, like most in the nation, are technically "not-for-profit," but beyond that IRS designation, they are very much in the business of making as much money as possible so as to be able to pay doctors top dollars and hospital administrators seven-figure salaries.

It is thus no wonder that the money-driven healthcare system in the U.S. is by far the most costly in the world and for "average" people far from the best.

With thousands of lobbyists keeping the pressure on politicians not to change anything, very little does change. Big Pharma, the AMA, health care unions, medical equipment companies, hospital associations all join hands in assuring that their bottom lines, not patient care and cost-containment, are paramount. And thus far they have pretty much had their way.

Occasional exposés and law suits as the one being launched against Health Management Associates are rare and only chip away at the problem.

But there is a simple way to keep an eye on quality of service and billing practices.

Years ago, an uncle of mine owned a meat processing plant in the South Bronx. While trying to "find" myself I went to work for him and spent long days unloading truckloads of hams, pork butts, and beef tongues.

The Department of Agriculture required that the meat be inspected and, if it passed, labelled as such--USDA Inspected.

So in Uncle Eli's plant, on site, there were two full-time federal inspectors. They wandered around at will in their long white coats, randomly selecting a rack of curing tongues for careful analysis. They were incorruptible, permitted to work at any single establishment for only a month or two so as to inure them from being approached for bribes. And, in order to contain costs to the government, Uncle Eli was required to reimburse the Department of Agriculture for their salaries and benefits.

It worked rather well and this approach to safety and quality control could easily be extrapolated to all hospitals that are allowed to bill Medicare and Medicaid.

These hospitals, like Paramount Meats, should be required to have a team of on-site inspectors who they would pay for and who would keep an independent eye on services and billings. If, for example, they discovered a red light-green light system designed to defraud taxpayers (which that in fact does), they would have the power to intervene and, if necessary, report abuses to the Medicare-Medicaid Administration which in turn could refer cases to the Department of Justice.

This would lead to a significant decline in medical scams and reduce costs to those of us--really all of us--who through our taxes are paying the cost of abuse and fraud.

Doctors, then, could again be held to the Hippocratic injunction to "do no harm."

December 27, 2013--GOP Quandary

Republican don't know what to do. Up to now they have been all-in in opposing Obamacare. It is, they have been obsessively claiming, an evil intrusion of big government in people's lives fostered on us by an evil, illegitimate president; and they have passed nearly 50 bills in the House of Representatives in efforts to repeal it.

Of course that has been a futile effort--with the Senate in Democratic hands and the evil one still ensconced in the White House, that strategy was going nowhere. But they pursued it to make a political point--if you want to get rid of it and him, vote GOP in 2014 and 2016.

Now matters are even worse--it exists and people are signing up. Perhaps not in the numbers Obama and the Democrats had hoped for, but as of last count at least 2.0 million have; and as of January 1st they will have health coverage for the first times thanks to, sorry, Obamacare.

The GOP doesn't know what to do next. Especially if millions more sign up and, like those on Medicare, they come to like it. Flaws and all.

Wisconsin Senator Ron Johnson got it right. He said, "It's no longer just a piece of paper that you can repeal and it goes away. There's something there. We have to recognize that reality. We have to deal with the people that are currently covered under Obamacare."

Translation of "we have to deal with the people that are currently covered under Obamacare"--

"We have to figure out some way, some scam, to get them to vote for us. Or say hello to President Hillary. How does that sound to you?"

Equally flummoxed, the ever-effervescent Lindsay Graham moaned, "The hardest problem for us is what to do next. Should we just get out of the way and point out horror stories? Should we come up with a mini Contract With America on health care, or just say generally if you give us Congress, the House, and the Senate in 2014, here's what we'll do with you on multiple issues including health care?"

Translation--

"Listen up, I'm fighting for my political life here. I'm up for reelection next year and they're running a Tea Party flunky against me in the primary, saying I'm too liberal. So what if I have a man-crush on John McCain and spend all my time traveling around the world with him? If trashing Obamacare isn't enough to get me reelected, we'd better come up with something good. Maybe like Obama is fooling around with Jill Biden."

The Republicans didn't ask for my advice, but I have a suggestion for them anyway that would show them to be ideologically consistent (not just typical hypocritical Washington politicians) and would fit right in there with their hatred of big-governement Obamacare--

Go after something that really is socialistic--Medicare.

Besides their favorite federal program--the military--Medicare is the biggest government program of all time. Like Obamacare it too has the Feds requiring tens of millions to get their health care though the government. But unlike Obamacare it doesn't require people to buy insurance through for-profit insurance companies. It's socialized medicine pure and simple.

So Republicans should forthwith pull up their socks, forget about Obamacare, and go after the most evil program. Paul Ryan in his budget (which, recall, all House Republicans voted for as did all but one or two GOP senators) pretty much calls for Medicare's elimination. It would turn it into a voucher program and save trillions since the vouchers wouldn't provide enough money for millions of middle class people currently covered to go into the market place to replace it.

This would work, no?

October 19, 2013--Ladies of Forest Trace: Immaculate Generation

Approaching 106, there are days when my mother has less vitality. At those times, our conversations are brief as she struggles to take in the oxygen she needs. We talk only about the weather in Florida and New York and what we plan to have for dinner. If she hears we are cooking and eating at home she is happy that we are taking care of ourselves and not "wasting money eating out."

So I was pleased to find her in good form the other day when I made my daily call.

One of the ladies of Forest Trace, she told me, was having trouble with her eyes. "Gussie, poor thing, not only has to walk with a walker but now when she goes down for dinner she can't see where she is going and bumps into everything."

"Maybe she needs an aide," I suggested, "Like yours who would help her find her way and do whatever else she needs help with."

"I tell her that, but she is very proud and doesn't want to admit she needs any help."

"I understand that."

"There's nothing to understand. She's a danger to herself not to mention people in worse shape who she keeps crashing into. If she was driving a car, God forbid, they'd take away her license."

"You're probably right."

"But that's not the worst of it."

"What is?"

"I told you about her condition."

"To tell you the truth I don't remember. There are so many conditions to keep track of."

"Immaculate Generation."

"Immaculate what?"

"Generation. Generation. That's what she has."

"You mean, Macular Degeneration. Her eye problem."

"Whatever."

"What about it? How far advanced is it?"

"Plenty advanced. That's why she's running people over."

"I suppose she's too old to do much about it."

"That to. But her doctor is terrible."

"In what way?"

"He doesn't have time for her."

"He won't make an appointment to see her?"

"Not that. He makes the appointment, but when she goes she's in and out in five minutes."

"If there isn't anything they can do--"

"Still is this a way to treat people who are going blind?"

"I suppose not. What would you have the doctor do."

"You know Gussie's not shy."

"That I know from direct experience," I chuckled, recalling having dinner with her a few times. She has opinions about everything--generally sound ones--and isn't reluctant to share them. At full volume. My mother says she talks so loud because she can't hear and refuses to get hearing aids.

"So she complained to the doctor, telling him he shouldn't be running his office like a factory. Though Gussie knows there is nothing to do for her condition, she wants to feel the doctor knows who she is and cares about her. That he has time to at least talk with her. After the life she lived, she should be entitled to that. A little talking to. A little being paid attention to."

"That is not unreasonable to expect."

"But her doctor tells her he has no choice."

"No choice?"

"That with Medicare cuts he can't afford to stay in practice if he spends more time with patients. 'I couldn't pay my rent or my office staff,' Gussie quotes him, 'if I practiced the way I want. The way I used to.'"

"I've heard that from others," I said. "From doctor friends who are frustrated with the state of health care these days."

"Do you think Obamacares will make things any better?"

"I'm not sure it will for Gussie, but for millions of others, absolutely."

"They're making such a big deal on TV about the computer."

"You mean the Obamacare website?"

"I think so, though I don't know from computer webs."

"No need to worry about that."

"It's the least of my worries. I have plenty of other things to worry about. About why I take so many naps, why I--"

"I take naps too," I cut in before she went down her whole list. "It is not unusual for older people to take naps. And you are nearly 106."

"I never took a nap until I turned 100. I'm wasting my time sleeping the day away. You know what your father used to say about sleeping?"

"Yes, 'There's plenty of time to sleep when you're . . ." I couldn't utter the word to my ancient mother.

"Dead. Dead is what he said. I know what that is. You don't need to sugar coat me. I want to live. I'm fine. But I'm ready for whatever awaits me. That too."

"Anything else about Obamacare?" I was looking to change the subject, "By the way, I love that you call it Obamacares.

"Because he does. Care. And it will turn out to be wonderful. The same kind of people said the same kind of things about Medicare when that came out. How it wouldn't work. How doctors wouldn't take Medicare patients. How people would not be able to keep their doctors. How we wouldn't be able to afford it."

"True. Though I do worry about the cost going forward."

"There's plenty of money for other things like bombs so we shouldn't be so worried."

"Also true," I said.

"But now, ask anyone here what they think about Medicare and they will tell you, 'Don't touch my Medicare.' Even people from that Tea Party who want to get rid of the government. I tell them, 'What do you think the Medicare you love so much is? I'll tell you what--a government program. Socialized medicine.' That one they like. Food stamps, no. Welfare, no. But Medicare because it's for them, and they think it's free, they don't want you to touch."

"I hear the same thing. Don't expect people to be consistent when it comes to their self interest."

"They have what they want and now they want to deny the same thing to others. Like Obamacares."

"I agree with that. Among other things their attacking it feels so selfish."

I could hear her breathing becoming labored. "But you'll see--I won't be here to see it but please God you will be--two years from now everybody will be happy. All of this will be forgotten. Millions more will be healthier. Especially children. And like with Medicare no one will want to change anything. Including the Tea Party. If they are still around. Which I doubt. I see the beginning of the end for them. Which is another good thing."

"Don't overtax yourself," I said, concerned about her breathing.

"I'm not like this every day any more so when I am I want to get things off my mind."

"I'm for that. But I don't want you to overdo it."

"Poor Gussie," she said and hung up.

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."

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.

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."