This Week in Health Care
Two big court decisions possibly affecting the future of the Affordable Care Act came down this week, within hours of each other, in the same city, reaching opposite conclusions. At issue is an admittedly badly phrased sentence in the law. Nobody who worked on writing the law says that sentence was intentionally vague--it was a screw-up, in the midst of writing a big piece of legislation under incredible pressure and scrutiny. It's possible that the conflicting decisions will mean the question has to be decided by the Supreme Court, but it's unlikely that it'll go that far, and if it does, unlikely that SCOTUS would rule against the law. As Ezra Klein writes, "The Supreme Court simply isn't going to rip insurance from tens of millions of people in order to teach Congress a lesson about grammar."
The effect of the ruling in Halbig v. Burwell would be to make people in states that refused to set up their own health insurance exchanges--states in which the federal government had to do it because the states wouldn't make the effort--pay the full cost of their insurance premiums, regardless of how poor those people are. A big point of the ACA was to provide subsidies for people who couldn't afford insurance and don't get it through employers, because as expensive as that might be, it's still cheaper than making them rely on ERs for medical care and then covering the costs when they become seriously ill or injured, not to mention the societal costs of lost productivity, unchecked spread of infectious diseases, etc.
The states Halbig would affect are, unsurprisingly, red states, most of them in the Deep South. The governors and legislatures in those states didn't like the idea of the federal government helping their citizens get health insurance. They wouldn't set up exchanges, and they wouldn't expand Medicaid. Already, those are the states where the residents are the most reliant on Social Security (and the states where the voters are most likely to reject the idea of the government getting involved in their lives, so go figure). They're also the states with the poorest populations, so they are, generally speaking, the unhealthiest states and the ones where the people can least afford health insurance on their own. For Halbig to prevail would be an example of America's right wing playing a cruel joke on some of its biggest supporters.
But the people who brought the suit don't care. Its chief architect is a Libertarian from the Cato Institute, and to the Libertarian right, the government simply doesn't belong in the business of making sure Americans don't go bankrupt because of medical bills, or suffer catastrophic illnesses from a lack of preventative care. In Cato's bleak, Ayn Randian vision, Americans should be on their own, regardless of the costs to society or the number of families crushed by financial devastation beyond their control.
Others of us disagree. Some of us recognize that the world is a big, complicated place. We don't know enough about the internal workings of automobiles to check out every mechanical and electronic aspect of each car we buy before making the down payment, nor do we individually have the power to make an auto company recall its products if they turn out to have fatal faults. We can't inspect the wiring of every TV set we purchase to make sure it won't explode or burn the house down. We don't know how to determine if the meat and eggs and vegetables we buy are free of listeria and e coli. We willingly pay government to do those things on behalf of us all.
Health insurance is the same thing. Without the ACA, the rise of health care spending was threatening to swamp the entire economy. Families were losing everything because of accident or illness. Insurance companies were putting profit ahead of service, jacking up premiums while denying claims whenever possible. The insurance business has always been regulated--those claiming the ACA amounts to a government takeover of the industry are lying through their teeth. The problem was that it wasn't well regulated. Insurance companies had too much power, and regular Americans had almost none. The ACA changed that, putting some of the power back into the hands of the collective us--the American public--and restraining the abilities of the insurance companies to jack up and deny in order to boost profitability.
We reject the idea that big corporations are necessarily always right, and we know with certainty that big corporations have their own interests and priorities that rarely extend to helping regular folks in need. Inserting the profit motive into the system by which people get medical care has always seemed counterproductive at best to us, but the framers of the ACA decided to boost the industry by providing it with millions of new customers, instead of making the more humane but more politically risky move of creating a truly public health care system. Given that reality, we're glad there are checks on the ability of the insurance companies to call all the shots. And we're glad to live in a country in which the government--our self-government, the people elected by us to represent us--cares enough about real Americans to set up regulatory frameworks that help ensure the safety of our food, our appliances, our infrastructure, and our family finances.
This Week in Veterans' Health Care
Remember back when Congress was all worked up about fixing the VA? As long as they don't actually have to do something, they're fine with it. But when called upon to do the jobs we pay them for? We get this. "Negotiations between the House and Senate over legislation reforming the Veterans Affairs Department melted down on Thursday, raising the probability that Congress will leave for the August recess without approving a bill."
This Week in Uniform
Check out this brief profile of US Air Force Staff Sergeant Jesus Yanez, who since 1993 has served in the Marines, Navy, Army, and Air Force (along the way earning associate's, bachelor's and master's degrees). He says the Air Force has the best food.
This Week in Poverty
Former vice presidential candidate Rep. Paul Ryan (R/WI) has released a long-promised anti-poverty plan. We're pleased to see a prominent Republican recognize the problem of poverty in America (since the days of Jack Kemp, there have been precious few serious voices on the right addressing it). And interestingly, Ryan's plan is in many ways a complete contradiction of the budget plan he offers up every year, including just a few months ago.
Looking for ways to fight poverty is a good thing. Ryan's plan, however, is not. He misunderstands the problem; therefore, what he proposes isn't really a solution. Some of his ideas hold promise, some are demeaning to the dignity of human beings, some are just wrongheaded.
He wants poor families to work with a "provider"--presumably a government official or someone contracted by the government--to come up with a plan of action that will lead them out of poverty. Those families have to sign a "contract" with the provider, in which they agree to certain benchmarks. There are incentives for beating those benchmarks, and sanctions (Ryan's word) for failing them.
The assumptions Ryan has to make for that plan to work are numerous and nonsensical. Most poor people don't choose to be poor. Their problem isn't that they can't figure out a path forward, it's that there are no jobs they can get that will take them down that path. Asking them to sign a contract (presumably without a lawyer--often a bad idea) that requires them to meet certain employment and wage criteria that are entirely outside their control, and threatening sanctions if they can't somehow measure up, is absurd. And if those sanctions are financial, they could push the poor ever deeper into poverty. There's nothing wrong with work requirements for receiving assistance--if the jobs are there. If they're not, that's another story.
Ryan also wants the federal government to hand the states all the antipoverty dollars it would normally spend, as block grants (a favorite idea on the right). There are various problems with this idea, too, beginning with the obvious point that some states are already better at fighting poverty than others, and some are far, far worse. A federal government can look at the issue with a more global eye than an individual state can, and there's no guarantee that the states where assistance is most needed won't continue to funnel that money into ineffective programs. Then there's the fact that a single federal program--like the SNAP program that issues food stamps--can be a model of efficiency. SNAP worked exactly as it was supposed to during the Great Recession. In general, federal antipoverty programs have done a very good job at reducing poverty. That system could always use some tweaking, but it's far from broken. How is it more efficient or effective to create 50 agencies to do what one does now?
There are things to like in Ryan's plan. Unfortunately, the larger takeaway is that Ryan is trying to impose "solutions" to the wrong problem. He's not addressing the systemic deprivation that keeps people poor--lack of educational opportunity, lack of employment opportunity, even nutrition/health issues--and instead works from the assumption that the poor are too dumb to figure out that what they need are opportunities they don't have and can't get.
Side Note: Here's the most conservative approach to eliminating poverty: send everybody a check.
This Week in Georgia
Georgia has been a reliably red state for years, but parts of it are shading toward purple these days. Not its 10th congressional district, though, which is virtually a lock for whoever the Republican candidate happens to be. In this year's election, that means Georgia will send a crazy person to Washington. The winner of this week's primary was Jody Hice. Mother Jones describes Hice's views thusly:
"In a 2012 book, that candidate—pastor and talk radio host Jody Hice—alleges the gay community has a secret plot to recruit and sodomize children. In It's Now or Never: A Call to Reclaim America, Hice also asserts that supporters of abortion rights are worse than Hitler and compares gay relationships to bestiality and incest. He proposes that Muslims be stripped of their First Amendment rights."
"In Hice's view, the United States took a turn for the worse after the Civil War, when President Abraham Lincoln stripped away the hallowed rights of states. He says 'the technical reasons for the War are still being debated,' but he mentions that the war—by undermining states rights—essentially ruined the original idea of America."
This man will probably be a member of Congress. Weep for America.
This Week in Unintended Consequences
Everybody's concerned about the young refugees flowing across our southern border. Different variations on that concern collide--some people, often church groups, want to take care of the children who've made the thousand-mile journey across Mexico, fleeing the out-of-control violence in the so-called Northern Triangle of Guatemala, Honduras, and El Salvador. Others want to block them at the border or send them back to their points of origin, however deadly that might prove to be.
Those most anxious to send them back are typically those on the far right, where distaste for anyone brown-skinned is not only rampant but often an electoral advantage. What they may not understand and will probably never admit to is that one of their other pet issues is largely responsible for the flood.
The problem in those countries is gang warfare, and its deadly overflow. And those gangs are, increasingly, armed with guns bought "legally" in the US (or, in some cases, slightly illegally, but most of the bulk purchases heading into the Northern Triangle are legal. Transport to those countries and sale in those countries, however, is not legal nearly as often). The pro-gun death advocacy groups keep fighting to make it harder for American officials to regulate or even fully know just how many American guns are going south, but we know it's a lot.
So the NRA and its allies are fueling the violence in the Northern Triangle, through their efforts to keep gun sales almost entire unregulated in this country. American-made guns are successfully slaughtering human beings not only here at home, but in other nations as well. Then, when parents want to make their children safe by sending them north, the same folks writing checks to the NRA are trying to turn them away at the border, never understanding their role in the bloodshed.
Side Note 1: Now that we're well into President Obama's sixth year, we have to wonder at what point the NRA will stop claiming that he's out to grab your guns. Probably about the same time they admitted that President Clinton wasn't going to--which is to say, never, even though he served two terms without grabbing anybody's guns. Instead of admitting that they're consistently dishonest, they'll just transfer their bogus threat to the next Democratic presidential candidate and start the scare tactics all over again.
Side Note 2: Texas Governor Rick Perry (R) has ordered 1,000 National Guard troops to the border to intercept unarmed children who are already turning themselves in to authorities as soon as they cross (and the numbers of which have already dropped significantly). One wonders what exactly the mission of the Guard troops is supposed to be. Texas taxpayers might want their governor to explain why he's spending an estimated $12 million of their tax dollars every month on this. What doesn't require wondering about is Perry's motivation--he wants to run for president again. Last time, his humanity toward undocumented people sank him in the Republican primaries, so these time Perry's going full-bore after the hatin' vote.
Side Note 3: It didn't take scammers long to start targeting the families of those immigrant children.
Side Note 4: How bad is Sen. Ted Cruz (R/TX) at graphs? This bad.
This Week in Regulatory Reform
From the early days of our nation up until the early 1930s, our economy followed a boom-and-bust pattern that was often devastating to families and the country's financial situation as a whole. When the Great Depression hit, people realized that the boom-and-bust was largely due to the games played by unregulated banks and other financial institutions, and to the severe economic inequality those institutions helped promulgate. Common-sense regulations were put into place, and they broke the destructive cycle we had endured for so long, allowing the nation its longest run of continued prosperity.
Then came President Reagan, who in the 1980s started the dismantling of those regulations (spurring the nearly immediate crisis of the S&L disaster). The deregulation picked up steam in the 1990s and beyond. In 2008, we learned what the (entirely predictable) result was. Freed from the rules that constrained them, financial institutions created all kinds of new financial products, many intended to trick ordinary people, others intended to disguise what they were doing even to institutions they wanted to sell to. And then it all came crashing down, nearly wrecking the country's economy for good.
We've recovered most of the lost ground, and by some measures are doing better than we were in 2007, before the crash. Determined not to keep making the same mistakes, Congress passed some regulatory reform to put back in place rules that had been tossed by the wayside. The Dodd-Frank reforms are four years old this week, and though many of them have yet to be fully enacted, they've already had significant positive impact. Along with the Volcker Rule, they'll help keep the economy safe from the pirates who would again blow it up in the quest for short-term profits.
We need to resist conservative cries to deregulate, and remember there are plenty of occasions when regulations are not only good but necessary. The financial industry needs rules, and those rules need to be enforced. When they're not, bad things happen. Really, really bad things. And those things hurt us all.
This Week in Presidential Fortitude
Remember how tough President Reagan was when the Soviets shot down a Korean Airlines flight 007 passenger jet? And how weak President Obama's response to the Malaysian Airlines incident has been, by comparison? If so, maybe you need a history refresher.
This Week in Clueless
Rep. Kevin McCarthy is the new House Majority Whip, having taken over from Eric Cantor (R/VA) when Cantor failed to win his primary. McCarthy is known as a political guy, not a policy guy, which might, one charitably assumes, explain his cluelessness this week. Criticizing the president's trip to California. McCarthy said, "[A]s the drought worsens, he uses hardship in California to push his climate change agenda and fails to take action to pull back harmful regulations or implement a pending proposal to bring more water to the Central Valley."
Ummm, Rep. McCarthy? You might try opening a junior high earth science textbook sometime. Climate change and California's awful drought are not two separate issues. For a weightier take, there's a paper in Geophysical Research Letters specifically explaining the link between climate change and the California drought.
It's not regulations that are causing the drought, Congressman. It's a warming planet. Deal with it.
Side Note: Here are four of the lesser known consequences of climate change, including sewage in your drinking water and parasites in your brain.
This Week in Intellectual Property Theft
Sen. Rand Paul (R/KY) has shown a career-long pattern of plagiarism, and his "explanations" and subsequent "solution" demonstrate that he doesn't really understand why that's a problem. Since we here at TWiA headquarters have made a life's work of creating intellectual property, we see it as a huge problem, an indication of a dishonesty that goes to the man's core, and an intellectual vapidity that won't let him comprehend what he's done. But politically, is it a problem? It doesn't seem to be. He's still discussed as a possible 2016 presidential contender (and what that says about the country, much less the field of potential candidates, is sad indeed).
So will it be a political problem for Sen. John Walsh (D/MT) that he's been outed as a plagiarist, too? Probably. Democrats, after all, are held to a higher standard by voters than Republicans are [just ask former Governor Eliot Spitzer (D/NY) and current Sen. David Vitter (R/LA)]. Walsh could have been an important player in the Senate. A conservative Democrat from a reddish/purplish state, Walsh is currently the only Iraq/Afghanistan War veteran in the Senate. As adjutant general in the Montana National Guard, Walsh commanded troops in combat, experience that ought to be worth something in Washington.
We think plagiarism should be a more serious matter than it is in politics, if for no other reason than what it reveals about the offender (also because ownership of one's own work should be taken seriously--don't pirate books, movies, or music!). As much as we like having John Walsh in the Senate, we think this should be a disqualifier, as it should be for Sen. Paul. We'll have to see if Montana's voters agree.
This Week in Sad Delusions
What's the half-life right-wing disinformation? According to the latest poll, 23% of Americans still don't believe that President Obama is an American citizen. 17% still aren't sure.
This Week in Income Tax Mythology
Raising income taxes on the rich kills jobs and the economy, right? Isn't that what conservatives have insisted for decades?
Not so much. And we don't have to rely on historical data (though the same results apply). We have contemporary data from various states that have recently moved one way or the other, and it's pretty telling. Kansas: Cut taxes. Facing extreme budget shortfall, terrible job growth. California: Raised taxes. Better job growth than the national average. Wisconsin: Cut taxes. Pathetic job growth and a lagging economy. Minnesota: Raised taxes. Better than average job growth, thriving economy.
Across the country, in the higher tax states, the economy has recovered and then some, and everybody--including the very wealthy--benefits. The point, as always? You lift an economy from the middle, not from the top.
This Week in Arizona
Arizona is one of the worst states in which to be a child--we rank 46 out of 50 (which is one up from last year--go us?). Too many of our kids live in poverty, too many are in foster care, and not enough are in preschool. Having a legislature focused on cutting taxes, and therefore education and infrastructure and just about every social service there is doesn't help. Here's the full national report.
This Week in How You Can Help
The children crossing our border don't need soldiers with guns. They need care and compassion and safe shelter, while their families are located and permanent arrangements are made for them. The United States Conference of Catholic Bishops has put together a helpful resource kit (thanks to TWiA special Vatican correspondent Marcy Rockwell for the tip), and Kids in Need of Defense (KIND) is doing great work, and with a few bucks from some of us they could do more.
This Week in Bears
What happens when you let a bear test a bear-proof trashcan?