As The Bullets Find Their Mark..

I will never understand the GOP obsession with repealing Obamacare.

I could certainly understand efforts to improve it, or even replace it with a different mechanism (not the smoke and mirrors sort of replacement that Trump yammered about but was unable to describe, but a different way to deliver actual healthcare).

It is hard for me to accept that there are people who genuinely believe poor folks aren’t entitled to medical care, that being unable to afford a doctor means you don’t deserve one. On the other hand, I recall that telling–and chilling– moment in a GOP debate when Ron Paul was asked what should be done with people who don’t have insurance, and the audience members yelled “let them die.”

So there’s that…

Even though Paul Ryan and his cronies couldn’t manage a complete repeal of the Affordable Care Act, they did manage to make it less workable. They didn’t kill it–they just made it more incoherent and costly.

According to Michael Hiltzik in the L.A. Times,

Those fiscal geniuses in the White House and Republican-controlled Congress have managed to do the impossible: Their sabotage of the Affordable Care Act will lead to 6.4 million fewer Americans with health insurance, while the federal bill for coverage rises by some $33 billion per year.

Also, by the way, premiums in the individual market will rise by an average of more than 18%.

These figures come from the Urban Institute, which on Monday released the first estimate of the impact of two GOP initiatives. The first is the elimination of the individual mandate, which is an offshoot of the GOP tax-cut measure signed by President Trump in December. The measure reduced the penalty for not carrying insurance to zero as of next Jan. 1.

The second is Trump’s plan to expand short-term insurance plans, which don’t comply with many of the ACA’s essential benefits requirements and allow insurers to reject or surcharge people with preexisting medical conditions or histories.

Both of these provisions siphon younger, healthier people out of the insurance pool–an entirely foreseeable (and indeed, widely foreseen) consequence. When the pool of insured individuals contains older, sicker participants not offset by as many young healthy ones, insurers must raise premiums.

Because government premium subsidies rise in tandem with premium increases, the cost of subsidies borne by the government will rise by $33.3 billion next year, or 9.3% — to $391.4 billion from $358.1 billion under existing law.

It isn’t only taxpayers who will get hosed by the changes Trump is so proud of. The article goes through a variety of ways in which people needing health insurance will get screwed over, and I encourage you to click through and read the whole analysis.

It’s hard to disagree with Hiltzik’s conclusion:

The damage estimate can’t be restricted to the immediate impact on individuals and families, the researchers observed. “As healthier enrollees exit for short-term plans, insurers will by necessity reexamine the profitability of remaining in the compliant markets. This may well lead to more insurer exits from the compliant markets in the next years, reducing choice for the people remaining and ultimately making the markets difficult to maintain.”

In other words, the Republican sabotage will continue to undermine health coverage in the U.S. The only alternative, it becomes clearer with every day, is some form of single-payer, Medicare-for-all coverage. That’s increasingly becoming part of Democratic Party orthodoxy, and it’s about time.

One more reason why we need a wave election in November.

Comments

It’s Going To Get Uglier

Last weekend, my husband and I attended the Phoenix Theatre’s presentation of Sweat, a prize-winning play based upon an episode of union-busting and outsourcing that took place some years ago in Reading, Pennsylvania. As with all Phoenix productions, the acting was superb, and the set evocative. But it was the play’s message that really resonated.

As workers in the local factories lost their jobs, social bonds frayed. Self-esteem suffered. Longstanding interracial friendships surrendered to suspicions that promotions had been awarded on the basis of “diversity” rather than merit. As with all powerful art, the play illuminated a human truth: in times of economic and/or social uncertainty–especially when  livelihoods are threatened– people turn on each other.

Political scientists have varying explanations for the election of Donald Trump, but those explanations all include, to varying degrees, economic insecurity and racial resentment. A significant number of Americans are struggling to put food on the table. Automation is threatening the jobs of many others. The pace of social and technological change can seem dizzying. And rather than working to tackle these and other problems, the President and his henchmen are telling us to blame the Other: immigrants, Muslims, minorities.

A recent headline from the Guardian tells us that anti-Semitic incidents soared in 2017.

Antisemitic incidents in the US surged 57% in 2017, the Anti-Defamation League said on Tuesday, the largest year-on-year increase since the Jewish civil rights group began collecting data in 1979.

Close to 2,000 cases of harassment, vandalism and physical assault were recorded,

Another report tells us that we are in danger of reversing the civil rights advances of the last fifty years.

Civil rights gains of the past half-century have stalled or in some areas gone into reverse, according to a report marking the 50th anniversary of the landmark Kerner Commission.

Child poverty has increased, schools have become resegregated and white supremacists are becoming emboldened and more violent, the study says…..

Fred Harris, the last surviving member of the Kerner Commission, told Tuesday’s conference at George Washington University: “We made progress on virtually every aspect of race and poverty for nearly a decade after the Kerner report and then that progress slowed, then stopped and in many ways was reversed, so that today racial and ethnic discrimination is again worsening. We are resegregating our cities and our schools, condemning millions of kids to inferior education and taking away their real possibility of getting out of poverty.”

Harris, a former Democratic senator from Oklahoma and co-editor of the new report, added: “There are millions more poor people today than there were then. There’s greater child poverty; poverty’s harder to get out of. More poor people are in deep poverty than was true 50 years ago and income inequality is worse now and worsening.”

Last week, the Supreme Court heard a case that is very likely to eviscerate public-sector unions–the culmination of a decades-long, largely successful effort by the Koch brothers and their allies in the GOP to destroy workers’ ability to bargain. It is an effort that has gone hand-in-hand with their consistent and very effective attack on government programs that help needy Americans.

As Sweat vividly illustrated, poverty and powerlessness beget bigotry and social discord.

If voters don’t turn this country around in November, America will illustrate something else–Hobbes’ description of life outside society: solitary, poor, nasty, brutish, and short.

Comments

Why We Blame The Victim

The Guardian recently ran a fascinating column explaining the evolutionary purpose of that all-too-human tendency to blame the victim.

Rape and sexual assault survivors are asked about what they wore and how they fought back. Poor people who work three jobs and still can’t support a family are blamed for “laziness” and failure, despite facing an economy that is stacked against them.

Recent research suggests that this tendency is actually a somewhat weird side effect of our human desire for fairness–a hard-wired “just world” bias.

The “just-world bias” happens because our brains crave predictability, and as such, we tend to blame victims of unfairness rather than reject the comforting worldview suggesting that good will be rewarded and evil punished.

“There’s just this really powerful urge for people to want to think good things to happen to good people and where the misperception comes in is that there’s this implied opposite: if something bad has happened to you, you must have done something bad to deserve that bad thing,” says Sherry Hamby, a professor of psychology at Sewanee University.

It isn’t only human victims who are blamed for their own misfortune.

Case in point: In Indiana, local school districts rely upon state and federal tax dollars to operate. Since 2011, state per-pupil funding has been dramatically reduced. Those reductions initially cost Indianapolis Public Schools $9.4 million annually; the last three years, however, the annual loss has been $15.5 million. Federal funding has dropped by $14.2 million annually since 2010, and Indiana’s insane tax caps have cost the district an average of $16.8 million every year since 2011.

Meanwhile, expenses—especially teacher compensation and benefits, which represent the majority of the budget—have continued to rise.

So far, the district has met these punishing shortfalls without altering the academic programs that have led to recent, much-needed educational improvements. It has closed schools in order to save the expenses of operating underused facilities and it has sold off unused buildings and other properties. Where possible, it has leased facilities to third parties, to generate rental income. It has reduced its central office operations by $5.3 million annually. It has deferred maintenance on its remaining properties in order to protect instructional programs and refinanced debt when favorable interest rates made that feasible.

As I write in an upcoming column in the local business journal,

There’s nothing left to sell. At some point, deferring maintenance is no longer possible. Meanwhile, teachers need to be paid and provided with health-care benefits; and special education students must have their costly needs met.

The district is currently proposing to raise just over 65 million dollars a year for 8 years. Of that amount, 74% would go for compensation, 12% would go for supplies and services, 11% would go for transportation, and 3% for building maintenance. If the Referendum fails, teacher pay will be frozen, some transportation services eliminated, and educational programs cut back.

Predictably, opponents blame the district for poor management. But all school districts in Indiana—including IPS–are the victims of decisions made in the Indiana Statehouse, and to a lesser extent, in Congress. Among other indignities, Mike Pence and the legislature successfully diverted tax dollars from public schools to parochial ones. Indiana has the country’s largest voucher program, and Ball State researchers report that 98% of Hoosier children using vouchers attend religious schools. Taxpayers sent $146.1 million dollars to voucher schools last year; since 2011, the number is $520 million dollars.

None of those decisions were made by local school districts.

Blaming the numerous public school districts in Indiana that have been forced to propose Referenda is like accusing the victim of a robbery of being imprudent with the stolen money.

Comments

‘Job Creators’ and the Tax Bill

According to the Republicans pushing for its passage, the recent, massive overhaul of the tax code was a “middle-class” tax cut. Yes, they admitted that it bestowed largesse on the wealthy, and yes, they recognized that the benefits to corporate taxpayers dwarfed the pennies that the poor and middle-class will realize, but that, they assured us, was because the GOP is all about job creation. Give corporations tax “relief” (not that most of them had been paying at the going rate) and they would use those dollars to create jobs.

Right.

Opponents of the tax bill publicly doubted that corporate savings would be used to create jobs, or to raise pay levels. They predicted that the money would be used instead to buy back stock and “reward” management with bonuses. And they pointed out that the meager tax relief granted to the middle class will phase out, while the corporate cuts are permanent.

Once the bill passed–and the Koch Brothers had donated $500,000 to Paul Ryan (a contribution I’m sure was merely coincidental, despite coming a mere two weeks after the measure was approved)–there was an initial flurry of publicity suggesting that ordinary workers at several large companies had been given bonuses. (It later turned out that those payments went to far fewer workers than the original publicity had suggested.)

Now, it turns out that the cynics were right all along. I know–you’re shocked.

After President Trump signed the Republican tax cut into law, companies put out cheery announcements that they were giving workers bonuses because of their expected windfalls from the tax reductions. The president and Republican lawmakers quickly held up these news releases as vindication for their argument that cutting the top federal corporate tax rate to 21 percent, from 35 percent, would boost workers’ incomes even as it added $1.5 trillion to the debt that future generations would have to pay off.

Now corporate announcements and analyst reports confirm what honest observers always said — this claim is pure fantasy. As executives tell investors what they intend to do with their tax savings and their spending plans are tabulated into neat charts and graphs, the reports jibe with what most experts said would happen: Companies are rewarding their stockholders.

Businesses are buying back shares, which creates demand for the stocks, boosts share prices and benefits investors. Some of the cash is going to increase dividends. And a chunk will go to acquiring other businesses, creating larger corporations that face less competition.

It isn’t just liberal pundits making these claims. Morgan Stanley analysts have estimated that 43 percent of the savings realized by corporations will be used for buybacks and dividends and another 19 percent will fund mergers and acquisitions. They calculate that  17 percent will go into capital investments, and a mere 13 percent will be used for bonuses and raises. CNBC reports that stock buy-backs are at a record pace.  Axios  has reported that nine pharmaceutical companies have announced $50 billion in buybacks since the tax law was passed.

The open question is whether voters whose paychecks are marginally fatter under the new withholding tables will believe they were the beneficiaries of this “reform,” and whether that belief will influence their votes in November.

As Lincoln said, you can fool some of the people some of the time….

Comments

Why Government Loses Public Trust–Indiana Version

Most of us would avoid patronizing a butcher shop where the butcher routinely put his thumb on the scale.  We would take our business elsewhere.

When our state government lies to us, however, most of us can’t simply move elsewhere. Worse, we may not even find out that we have been misled.

I don’t know how it is in other states, but here in Indiana, we are most likely to encounter biased information when the people running the state are religious zealots. Mike Pence was uninterested in the nitty-gritty of governing, but he was intensely focused on imposing his religious beliefs on Hoosiers–he saved his real enthusiasm for his anti-gay, anti-woman efforts.

I had a much better impression of current Governor Holcomb, who has seemed refreshingly free of the urge to sermonize and actually appears to be tending to the issues facing Indiana. But then I came across this report.

Indiana ranks as one of the worst states in the nation when it comes to its infant mortality rate. In his state of the state address earlier this month, Gov. Eric Holcomb (R) called attention to this crisis and announced the goal of improving the state’s status in the coming years. As part of that process, in November 2017 the Indiana State Department of Health (ISDH) launched a new mobile app for its existing statewide campaign aimed at improving Indiana’s infant mortality rate. The app, Liv, was developed with state funding and includes pregnancy and parenting guidance.

It also provides users with contact information for health and service providers, along with basic descriptions of what the users can expect from those providers. But the app’s resource list excludes evidence-based family planning clinics and centers, such as Planned Parenthood and All-Options Pregnancy Resource Center (PRC), while including crisis pregnancy centers (CPCs): fake clinics that do not provide medically sound reproductive health care and actively lie to people seeking services.

Public health research shows that access to comprehensive family planning programs and services can help reduce infant mortality. Nonetheless, continuing the legacy of former Indiana Gov. Mike Pence (R), this app—and ISDH’s larger infant mortality initiative—promotes ideology over evidence.

Infant mortality is the result of a combination of factors, including poverty and lack of prenatal care. But research shows that comprehensive contraception and family planning help reduce infant mortality rates.

For example, as research from the Guttmacher Institute shows, access to contraception gives women the tools to space their births: “By allowing women to time and space the number of children they want, contraception prevents unintended, often high-risk pregnancies—too close together, too often, too early or too late in life—that can lead to maternal and child death and injury.” Additionally, addressing unintended pregnancies by increasing access to contraception and family planning services also contributes to increased prenatal care provision by establishing connections between patients and providers.

When policymakers allow ideology to trump evidence, and erect barriers to access for family planning services, you get the results we have been seeing in Indiana. In 2011, only 68 percent of infants in the state were born to women who had received prenatal care in their first trimester–and nearly half of all pregnancies in Indiana are unintended.   

Using taxpayer dollars to direct vulnerable women to crisis pregnancy centers, while omitting information about high-quality health services available through Planned Parenthood, is worse than irresponsible. Crisis pregnancy centers are purveyors of dogma, not medically-accurate information. They have no place on a state-run registry.

Women using the app don’t have to go to Planned Parenthood. But they are entitled to know that it is an option. For state government to omit a medically-appropriate service from a directory it has created and disseminated while including a “service” that offers dishonest “counseling” is unforgivable.

It certainly isn’t the way to cultivate public trust.

Comments