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Updated: 2017-06-21T04:44:08Z

 



Commander in Chief Trump Goes AWOL

2017-06-21T04:44:08Z

"The President shall be Commander in Chief of the Army and Navy of the United States." With that phrase, Article II, Section 2 of the Constitution of the United States ensures civilian control over--and accountability for--the American military. While the...

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"The President shall be Commander in Chief of the Army and Navy of the United States." With that phrase, Article II, Section 2 of the Constitution of the United States ensures civilian control over--and accountability for--the American military. While the power to declare war rests with Congress, responsibility for America's global vision, its foreign policy and national security objectives, the military strategies to achieve them, the operational plans they entail and, most solemn of all, putting the lives of servicemen and women in harm's way, rest with the president alone.

But what if the occupant of the White House fails to fulfill his constitutionally-mandated role as commander in chief? How would U.S. allies and enemies alike react to the strategic confusion and policy-making void left by the president's abdication of his or her most important job? What should the American people believe--what should their 1.5 million soldiers, sailors, airmen, and marines do--when the Pentagon's mission is a mystery?

Sadly, these questions are not hypothetical. As his decision this week to delegate Afghanistan strategy and force levels to the secretary of defense once again showed, commander in chief Donald Trump is absent without leave.

As the New York Times and the Washington Post reported this week, President Trump announced this week that when it comes to America's 16-year-old war in Afghanistan, the buck stops at the Pentagon.

President Trump's decision to delegate authority to the Pentagon to set troop levels in Afghanistan has raised concerns that a few thousand additional troops expected to deploy soon could be just the beginning of a new surge in the country after 15 years of war.

Defense Secretary Jim Mattis assured lawmakers Wednesday that a large increase in deployed forced will not happen, but some experts and former battlefield commanders warned the White House and Congress should be careful not to give the Pentagon a blank check.

Those experts are right to be worried.

Continue reading at Daily Kos.




Ask Your Senator if Trumpcara™ is Right for You

2017-06-20T01:00:50Z

Are you ashamed to be seen with your health care bill? Do you fear facing your own constituents? Are you plagued by feelings of dread and mild nausea at the thought of disappointing your seething supporters, angry activists and demanding... Are you ashamed to be seen with your health care bill? Do you fear facing your own constituents? Are you plagued by feelings of dread and mild nausea at the thought of disappointing your seething supporters, angry activists and demanding donors? If you answered "yes" to all these questions, you might be a Republican member of Congress suffering from moderate to severe Irritable Base Syndrome (IBS). That's where Trumpcara comes in. Brought to you by the good people of GOPLabs®, Trumpcara keeps your IBS at bay. With one simple vote, you calm the outbreak of red rage and make your pain and discomfort--and insurance for 23 million Americans--disappear! As for everyone else, ask your Senator if Trumpcara is right for you. Trumpcara (appallinghealthcareinamerica) legislation isn't recommended for anyone under the age of 65. Trumpcara can cause serious side effects, including: The loss of coverage for three million children under the age of 18, 6.4 million young adults ages 18 to 29, 8.2 million people ages 30 to 49 and 5.1 million older Americans in the reliably Republican 50 to 64-year-old age range. Between 21,000 and 50,000 needless deaths due to uninsurance very year. Mild to severe cashectomies and even financial ruin, as insufficient, age-based tax credits that grow too slowly make insurance premiums unaffordable for older, sicker and less affluent Americans. Conditions like "empty pocket disorder" and deductitis, as the end of the Affordable Care Act's cost-sharing reductions and essential health benefits along with new surcharges or disqualification to do preexisting conditions saddle families with massive new expenses. "Collateral closures" of rural hospitals and clinics as the gutting of Medicaid puts the onus for covering 51 million uninsured on cash-strapped states. Degenerative employer-provided insurance, as terminated Obamacare health care benefits bring back the worst excesses of the insurance industry including annual and lifetime caps on benefits. "Red state blowback," a tragically ironic affliction of voters in states carried by Donald Trump, states with higher percentages of people of preexisting conditions and fewer choices of insurers. Upward income redistribution caused by an $800 billion transfusion administered by the U.S. Treasury to the wealthiest people in America, a process doctors call "enrichening." Women should not handle copies of the legislative text. Nine out of 10 women who read the bill suffered from the immediate onset of severe depression due to the likely loss of coverage for contraception and maternity care. Women who are pregnant or considering becoming pregnant shouldn't take Trumpcara. In fact, in many states they won't be able to, as waivers from required "essential health benefits" will allow insurers to drop coverage for maternity care. So, if you're a GOP incumbent and want to make it to November 2018 without being primaried, take Trumpcara. It's not health care. And in the Senate, it's not even a bill. Trumpcara is trademark and GOPLabs is a registered trademarked of GOPLabs, Inc. [...]



Republicans Betray Their Gray-Haired Base with Trumpcare

2017-06-15T19:26:21Z

Ever since Donald Trump's shocking victory on Election Day, press, pundits, and pollsters have engaged in a furious debate about which voters propelled him to the White House. Was Trump's win the revenge of the "guns and bitter crowd" in...

Ever since Donald Trump's shocking victory on Election Day, press, pundits, and pollsters have engaged in a furious debate about which voters propelled him to the White House. Was Trump's win the revenge of the "guns and bitter crowd" in the Rust Belt, the white working-class voters whose racism, xenophobia and/or "economic anxiety" led them to pull the lever in 2016 for the reality TV star? Or was the Republican's core support throughout the primaries and the general election made up of more affluent and suburban backers? And as Trump's approval ratings continue to spiral downward to levels not seen since George W. Bush ambled out of the Oval Office, can he continue to count on an unshakeable "floor" of 35 to 40 percent support?

While these are all interesting questions, one thing is certain. Donald Trump, like Republicans nationwide over the past decade, has enjoyed the steadfast support of older voters. Since 2008, Americans (especially white Americans) over the age of 50 have reliably rallied behind GOP candidates. But under the American Health Care Act (AHCA) Majority Leader Mitch McConnell is now trying to sneak through the Senate, it will be the gray and the graying who suffer the most.

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To fully measure the magnitude of the coming Republican betrayal of older voters with the AHCA (a.k.a. Trumpcare), it helps to first appreciate their recent loyalty to the GOP. As the charts of exit poll data since 2008 above show, Americans over age 50 show up to vote and vote for Republicans. During presidential election years, voters ages 50 to 64 and over 64 combined have represented between 42 and 46 percent of the electorate. But in the 2010 and 2014 midterm balloting, their share reached a staggering 53 and 55 percent. While John McCain narrowly lost 50- to 64-year-olds by one point in 2008, Mitt Romney and Donald Trump had no difficulty winning voters over age 50 in 2012 and 2016.

The American Health Care Act is their reward for their loyalty. It's a loyalty expected by the GOP and (as we've learned) demanded by Donald Trump.

Continue reading at Daily Kos.




CBO: Conservative Bulls**t Obliterator

2017-06-05T03:18:02Z

This past two weeks have been big ones for some very big promises from Republicans in Washington. It didn't go well for them. Three weeks after House Republicans voted to pass a new version of their "American Health Care Act,"...

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This past two weeks have been big ones for some very big promises from Republicans in Washington. It didn't go well for them.

Three weeks after House Republicans voted to pass a new version of their "American Health Care Act," the nonpartisan Congressional Budget Office (CBO) weighed in on high-profile pledges from President Donald Trump and House Speaker Paul Ryan. While Trump guaranteed "insurance for everybody" that is "much less expensive and much better," Ryan insisted the revised AHCA "protects people with pre-existing conditions." Not content to rest there, HHS Secretary Tom Price boasted that Trumpcare's $880 billion in cuts to Medicaid will "absolutely not" result in millions losing coverage.

Meanwhile, the Trump administration also unveiled its fiscal year 2018 budget proposal. With its draconian spending cuts to the social safety net programs, the White House blueprint was proclaimed "dead on arrival" even by some Republicans. But more embarrassing to Donald Trump was its double-counting of $2 trillion in revenue for Uncle Sam magically generated by "sustained, 3 percent economic growth." As Treasury Secretary Steven Mnuchin declared a month ago, "the plan will pay for itself with growth."

Unfortunately for the White House and GOP leaders on Capitol Hill, the CBO demolished all of those Republican myths. Again. That's because whether the issue is health care, taxes, job numbers, or the impact of the President Obama's 2009 economic stimulus, the acronym "CBO" doesn't just stand for "Congressional Budget Office." It's also shorthand for "Conservative Bulls**t Obliterator."

As it turns out, in recent years that's been true even when Republicans have their hand-picked choice running the agency.

Continue reading at Daily Kos,




In Praise of Donald Trump

2017-05-22T21:42:38Z

From the moment Donald Trump won his surprising victory on Election Day, a new cottage industry sprung up to offer sympathetic profiles of the supposedly long-overlooked and long-suffering voters who rallied to him. The New York Times has been at... From the moment Donald Trump won his surprising victory on Election Day, a new cottage industry sprung up to offer sympathetic profiles of the supposedly long-overlooked and long-suffering voters who rallied to him. The New York Times has been at the forefront, delivering on-the-ground stories from Ohio, Pennsylvania and Michigan within days of the balloting. But as President Trump's ever-growing cascade of calamities drove down his approval rating to just above Ebola and just below Chlamydia, the Times responded with tales of his undeterred supporters for whom no sin could shake their faith in his ability to Make America Great Again. He is the enemy of their enemies; if liberals are angry, then Trump must be doing something right. The nation's paper of record wasn't content to rest there. As if to codify the right-wing stereotype of effete coastal elites out of touch with salt-of-the-earth "Heartland" Americans, the Times added climate change denier Bret Stephens to its growing stable of conservative columnists. Further concluding "it's not them, it's us," Michael Kinsley introduced a feature to "point out positive things Mr. Trump has said or done from the viewpoint of The New York Times and its readers." But by Week 3, Kinsley had to ask, "Is it possible there is nothing nice to say?" But if you and everyone you know passionately believe one thing while half the country believes the opposite, it may be time for a reality test. That is the purpose of this feature: not to persuade people that President Trump is any kind of good guy, but to ask whether it's possible that he has done or said anything good during his campaign and the first months of his presidency. Well, of course it's possible to say something nice about Donald Trump. You just have to know how to say it. For example, Donald Trump has helped us see the all too human side of our presidents. They are not supermen or gods, but flesh and blood mortals trying to do their very best for the nation. America's presidents aim high; they usually fall short. Trump is no exception. In a major address on August 18, 2016, candidate Trump made this pledge: Sometimes, in the heat of debate and speaking on a multitude of issues, you don't choose the right words or you say the wrong thing. I have done that, and I regret it, particularly where it may have caused personal pain. Too much is at stake for us to be consumed with these issues. But one thing I can promise you is this: I will always tell you the truth. [Emphasis mine.] As it turns out, according to Politifact Trump has always told the truth about 32 percent of time. That could happen to anyone who flew too high with borrowed wings, but just a little too close to the sun. Trump has shown that our presidents are sensitive, too. They don't just feel our pain, they feel their own, too. That's why the 45th President shared his personal life lessons this week with the graduates of the United States Coast Guard Academy. They, too, could overcome their lives of want and doubt to achieve great things: "Look at the way I have been treated lately, especially by the media. No politician in history, and I say this with great surety, has been treated worse or more unfairly. You can't let them get you down, you can't let the critics and the naysayers get in the way of your dreams." Our new guardsmen and women, many of whom doubtless overcame receiving $2 million from their parents, couldn't help but relate. And Trump had given them much to think about. Lincoln merely faced the secession of seven states by time he took his first oath of office. FDR only had to fight back against polio and charges that he was a "class traitor" bring socialism to[...]



How Trumpcare Ends Health Insurance As We Know It

2017-05-09T22:41:47Z

When the Supreme Court struck down the Affordable Care Act's mandatory expansion of Medicaid by the states back in 2012, observers quickly began focusing on who would "opt in" or "opt out." But from a purely budgetary standpoint, there was...

When the Supreme Court struck down the Affordable Care Act's mandatory expansion of Medicaid by the states back in 2012, observers quickly began focusing on who would "opt in" or "opt out." But from a purely budgetary standpoint, there was never any question that accepting federal dollars to fund 100 percent of that expansion and 90 percent thereafter was a no-brainer.

Studies from the Rand Corporation and others concluded that just saying yes to Medicaid expansion would add coverage for millions of previously uninsured, prevent thousands of needless deaths annually, help rescue financially-troubled hospitals in rural and poorer areas, and ultimately more than pay for itself as state costs for uncompensated care plummeted. (As the Kaiser Family Foundation and Kentucky Gov. Steve Beshear among others later reported, events transpired exactly as we foretold.) As Ezra Klein and Evan Soltas summed up the obvious opt-in case in June 2013:

So then, the math works out like this: States rejecting the expansion will spend much more, get much, much less, and leave millions of their residents uninsured. That's a lot of self-inflicted pain to make a political point.

Now, President Trump and Republicans in the House (if not the Senate) are pleased to perpetrate what might be the greatest act of political spite in modern American history. Replacing Obamacare with the latest incarnation of the so-called "American Health Care Act" (AHCA) wouldn't just leave 24 million more Americans uninsured, 14 million from Medicaid alone. Trumpcare would simply shift about $880 billion in funding for lower-income and elderly health care to giving tax breaks to the wealthiest Americans. With its smaller, slower-growing tax credits, penalties on those failing to maintain "continuous" coverage, comically under-funded "high-risk pools," and its green-light to insurers to charge older Americans much more than under Obamacare, Trumpcare guarantees poorer, sicker, and older people will pay higher premiums for insurance--if they can obtain it at all. And by letting states determine which--if any--of Obamacare's mandatory essential health benefits (EHB's) they will require, what Trumpcare calls "coverage" may no longer look like "insurance" in any meaningful sense of the word.

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Not, at least, according to the nonpartisan Congressional Budget Office. For the CBO, many Trumpcare plans won't count as insurance at all.

Continue reading at Daily Kos.




Republicans Chanted Goodbye After Democrats' 1993 Vote for Clinton Tax Increase

2017-05-07T22:48:45Z

It only takes about 31 seconds of this week's health care coverage to show why people hate what passes for mainstream media reporting. After Democrats sang "goodbye" to 217 Republicans who voted to take health insurance away from 24 million... It only takes about 31 seconds of this week's health care coverage to show why people hate what passes for mainstream media reporting. After Democrats sang "goodbye" to 217 Republicans who voted to take health insurance away from 24 million Americans and strip essential protections from millions more, conventional wisdom regurgitators like Katie Couric and CNN's Chris Cillizza were shocked--SHOCKED--by the performance. While Couric asked "was it appropriate for Dems to chant 'nah nah' on the House floor," Cillizza headed to the fainting couch with a piece titled, "31 seconds of the healthcare vote that shows why people hate politics." Of course, long before Cillizza proclaimed, "And the DC political class wonders why people hate them," Republicans were shattering all norms of decorum on Capitol Hill. Before South Carolina Rep. Joe Wilson shouted "you lie" at President Obama and GOP legislators displayed "Kill the Bill" signs outside the second floor of the Capitol Hill during the Obamacare battle, House Republicans chanted "Goodbye, Marjorie" to the woman who cast the deciding vote to pass the 1993 Clinton tax cut plan. As you might recall, Republicans predicted economic and political disaster for that budget. Instead, it ushered in an era of 22 million new jobs and the longest economic expansion since World War II. Twenty-four years before the New York Times reported "Democrats Taunt Republicans with 'Hey, Hey, Goodbye' During Health Vote," the nation's paper of record described "cheers and jeers" for Rep. Marjorie Margolies-Mezvinsky's tie-breaking vote for President Clinton's upper-income tax hikes. Before she became famous as Chelsea Clinton's mother-in-law, Ms. Margolies-Mezvinsky put her party before political pragmatism in her traditionally Republican district: The first-term Congresswoman had come out against the plan, having won election last November in her Main Line district, a group of mythically prosperous Philadelphia suburbs where winning candidates usually wear striped ties, by only 1,373 votes. A former television newscaster in Washington, she was one of the surprises of 1992, and thousands of her constituents will now be paying higher taxes next year as she seeks re-election... At the last moment the whips gave her the word that she was needed, and she walked down the aisle. One Democrat after another hugged her, patted her on the back and touched her as if she were Joan of Arc. As she finally voted aye, her Democratic colleagues cheered as the Republicans jeered, "Goodbye Marjorie." As turned out, the Republicans were right about Marjorie's fate. She lost in the 1994 midterms, along with 53 other House Democrats. But on the fates of Bill Clinton and the U.S. economy, the GOP had it all wrong. As Republicans continue their campaign to gut the American health care system, that history is worth revisiting. If Barack Obama's experience with record-setting Republican obstructionism was shocking, Bill Clinton's was unprecedented at the time. . When Clinton's 1993 economic program scraped by without capturing the support of even one GOP lawmaker, the New York Times remarked: Historians believe that no other important legislation, at least since World War II, has been enacted without at least one vote in either house from each major party. Inheriting massive budget deficits and stubborn unemployment from Bush the Elder, Clinton's $496 billion program was nonetheless opposed by every single member of the GOP, as well as defectors from his own party. As the Times recounted, it took a tie-breaking vote from Vice President Al Gore to earn victory: An identical version of the $496 billion d[...]



Trump's Tax Plan is a Laffer

2017-05-03T04:30:16Z

Long before it mastered the mass production of "fake news," the Republican Party propagated its Ur-lie that "tax cuts pay for themselves." Almost from the moment that Arthur Laffer first sketched his now-famous curve on a napkin in 1974, right-wing...

Long before it mastered the mass production of "fake news," the Republican Party propagated its Ur-lie that "tax cuts pay for themselves." Almost from the moment that Arthur Laffer first sketched his now-famous curve on a napkin in 1974, right-wing pundits, politicians, and propagandists have declared as an article of faith the belief that tax cuts incentivize so much economic growth that revenues to Uncle Sam will be at least as high as they would have been without the reduction in rates.

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Unfortunately for the American people, four decades of supply-side snake oil have produced only mushrooming national debt and record-high income inequality. Far from paying for themselves, the Reagan and Bush tax cuts delivered a windfall only for the wealthy while unleashing oceans of red ink from the United States Treasury. (Of course, the other objective of draining Washington's coffers in order to add to the bulging bank accounts of the rich was to get government "down to the size where we can drown it in the bathtub.") It's no wonder that by 2015 even Keith Hall, the man hand-picked by the Republican majority on Capitol Hill to head the nonpartisan Congressional Budget Office (CBO), acknowledged the obvious:

"No, the evidence is that tax cuts do not pay for themselves. And our models that we're doing, our macroeconomic effects, show that."

Nevertheless, last week Treasury Secretary Steve Mnuchin unveiled the Trump administration's tax plan by proclaiming the fiscal equivalent of saying the sun rises in the west and sets in the east. Six days after first announcing "the plan will pay for itself with growth," Mnuchin told the White House press corps:

"This will pay for itself with growth and with the reduction of different deductions and closing loopholes."

In reality, it won't even be close.

Continue reading at Daily Kos.




Only Trump Can Save ISIS Now

2017-04-28T03:12:54Z

The end is nigh for the Islamic State in Iraq and Syria. To be sure, ISIS affiliates in Libya, Yemen, Afghanistan and elsewhere will remain dangerous. And its fighters and sympathizers will continue to launch terror attacks in Europe and... The end is nigh for the Islamic State in Iraq and Syria. To be sure, ISIS affiliates in Libya, Yemen, Afghanistan and elsewhere will remain dangerous. And its fighters and sympathizers will continue to launch terror attacks in Europe and the United States for years to come. But the writing is on the wall for the supposed caliphate itself. In Iraq, Kurdish fighters, government forces and allied Shiite militias have nearly retaken Mosul and have ejected the Sunni extremist forces from most of the territory they occupied in 2014. Across the border in Syria, Kurdish forces and anti-Assad rebels backed by the United States have the ISIS "capital" of Raqqa nearly surrounded. With its oil revenues plummeting, its finances in tatters, and the influx of new foreign fighters reduced by as much as 90 percent over the past year, nothing can save ISIS now. Well, almost nothing. That's because President Donald Trump could yet snatch defeat from the jaws of victory. His ham-handed Muslim ban has already provided a propaganda windfall for ISIS, while alienating American allies on the ground in the region. Trump's incendiary rhetoric towards Iran, expanded military operations in Yemen and possible further U.S. strikes against the Assad regime in Damascus are occurring even as American troops find themselves on the same side as Tehran-backed militias in Iraq. Meanwhile, the Trump administration's apparent unwillingness to cross the Erdogan government in Turkey over American support for Kurdish forces for the final push on Raqqa means more U.S. servicemen and women will be fighting and dying instead. That Donald Trump would be the beneficiary of the Obama administration's progress against ISIS was clear within days of his assuming the presidency. As Andrew Exum, who served in the Pentagon's Middle East shop in 2015 and 2016 put it in mid-February, "Donald Trump will defeat ISIS and it will be mostly due to the work of his predecessor." The dysfunction at the highest levels of the American government right now obscures a dramatic reality: Donald Trump is going to defeat the Islamic State, and Americans need to be fine with that. Even the grudging Exum certainly had little problem with giving credit where it isn't due because "defeating the Islamic State is a national good that should be bigger than politics." Reflecting on the dire situation in early 2015, he wrote that "if we could figure out a way to apply pressure to the group from multiple directions and cut off its key supply routes, that would create real dilemmas for them. And so that's what we did." Two years later, Exum concluded: One by one, cities and towns under the control of the Islamic State started falling. Because we were fighting with local partners, it was messier than if we had done it ourselves. The destruction to Ramadi and Fallujah, in particular, was breathtaking. And it took longer than it would have taken if U.S. forces had been in the lead. But it was also a lot less expensive, and only five U.S. servicemen were killed in the process --compared with almost 5,000 over the course of the earlier war in Iraq. And the success of the campaign was going to be more sustainable than that of our earlier efforts, we told ourselves, because Iraqis and Syrians were owning the fight--at tremendous human cost, I must add--and thus owning the victory. This was the war President Trump inherited from President Obama. The fall of the Islamic State is going to happen on this president's watch despite the staggering dysfunction Exum fretted about. Candidate Trump, after all, didn't merely promise to "bomb t[...]



Eight Years After Bogus Tea Party Rallies, Tax Marches Target Trump Returns

2017-04-28T02:01:56Z

On Saturday, April 15, thousands of Americans will take part in Tax Day Tax Marches in cities and towns across the country. Their objective? To pressure President Donald Trump to release his hidden tax returns. The concerns are certainly legitimate....

On Saturday, April 15, thousands of Americans will take part in Tax Day Tax Marches in cities and towns across the country. Their objective? To pressure President Donald Trump to release his hidden tax returns. The concerns are certainly legitimate. After all, Trump isn't merely the first occupant of the Oval Office in over 40 years to refuse to do so. The Donald also pledged he would publish his returns, just as he promised his tax cut windfall for the wealthy would "cost me a fortune." Americans deserve to know, as Richard Nixon explained his disclosure of his own returns, "if their President is a crook." And even if President Trump isn't a crook, the nation more than ever needs to do know who he is doing business with and whether he's getting paid in rubles.

The contrast with the Tax Day Tea Parties on April 15, 2009, could not be more stark. On that day, thousands of people took to the streets chanting "Taxed Enough Already" despite having just received the largest two-year tax cut in modern American history, all courtesy of President Obama and Democrats in Congress.

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Eight years ago, thousands of the furious faithful rallied at those Tax Day Tea Parties lovingly promoted by Fox News and bankrolled by the right-wing sugar daddies including the Koch brothers and DickArmey's FreedomWorks. In addition to carrying signs like "Sieg Heil Herr Obama" and "No Taxation without Representation," many displayed buttons, hats, and posters announcing "T.E.A." or "Taxed Enough Already." As future House Speaker John Boehner summed up their complaint:

"Across our nation, thousands of Americans are participating in taxpayer tea parties today for one simple reason: overtaxed families and small businesses have had enough."

Now, there was a big problem with this claim at the heart of the Tea Party movement: it simply wasn't true.

Continue reading at Daily Kos.




The Three Iron Laws of Universal Health Care

2017-04-11T21:28:34Z

Economics, the textbooks say, is the study of the allocation of scarce resources. The economics of health care is certainly no exception. Given the competing and often contradictory demands across its ecosystem of patients, employers, physicians, drug stores, pharmaceutical firms,...

Economics, the textbooks say, is the study of the allocation of scarce resources. The economics of health care is certainly no exception. Given the competing and often contradictory demands across its ecosystem of patients, employers, physicians, drug stores, pharmaceutical firms, device manufacturers, clinics, hospitals, insurers, and government, the economics of health care might more accurately be described as the allocation of pain. In the face of the infinite "wants" for healthy citizens, financially secure families, well-compensated practitioners, and strong profits for private companies of all stripes, societies must choose how and why to distribute discomfort and dissatisfaction to some or all of the constituents.

But that "why" isn't so much a question of the "dismal science" as one of national values. And in the United States, virtually alone among major modern economies since World War II, the paramount, if often unstated, value has been an especially narrow notion of "freedom." Freedom, that is, to choose which if any insurance to offer or purchase. Freedom to charge whatever prices the "market"--and insurers--will bear for doctors' visits, tests, procedures, surgeries, prescription drugs, hospital stays, and even insurance itself. But by 2010--with 50 million uninsured, 25 million underinsured, 60 percent of bankruptcies due to medical costs, one in five people deferring needed care, and thousands without coverage needlessly dying every year--Americans had learned that freedom of choice often only meant the freedom to go without. To put it another way, the U.S. health care system had long allocated most of the pain to its consumers.

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With President Obama's signature on the Patient Protection and Affordable Care Act on March 23, 2010, the United States began to elevate another objective for its health care system: Near-universal coverage. And by and large, the ACA has worked as designed, enabling as many people as possible to obtain health care at a "reasonable" cost to themselves and the government. (Some 12.7 million taxpayers were exempted from Obamacare's individual mandate in 2016, while another 6.5 million paid $3 billion in penalties for not obtaining insurance coverage.) With 25 million newly covered, America's uninsured rate has dropped to a historic low as family finances and income inequality have improved.

Nevertheless, Republicans, who have never accepted universal coverage as the objective for American health care reform, are continuing in their perpetual quest to "repeal and replace" Obamacare. Democrats, concerned about rising premiums, high deductibles, and limited choice of insurers in some regions are offering proposals to "improve and extend" the ACA. But if the "why" of reform is to ensure health care for every citizen and legal resident of the United States, there's no great mystery as to how to achieve it. Decades of global experience and recent American history provide three inescapable lessons to show the way.

Continue reading at Daily Kos.




Trump's Litmus Test for GOP Tax Plan? It Must "Cost Me a Fortune"

2017-03-29T19:09:54Z

With the Republican drive to repeal and replace Obamacare halted (at least, for now), President Trump and GOP leaders are moving on to their next quest: tax reform. On this issue, press secretary Sean Spicer declared, Trump will be "driving... With the Republican drive to repeal and replace Obamacare halted (at least, for now), President Trump and GOP leaders are moving on to their next quest: tax reform. On this issue, press secretary Sean Spicer declared, Trump will be "driving the train" because "this is a huge priority for him, something that he feels very passionately about." Trump has never been shy about what that passion means for any tax plan he's going to sign into law. It must be a "phenomenal" bill that calls for "lowering the overall tax burden of American businesses, big league." Any Republican tax code overhaul must "growth that will be tremendous" because "we are looking at a 3% but we think it could be 5 [percent] or even 6 [percent]." Just as important, Trump and his Treasury Secretary Steven Mnuchin declared, "The rich will pay their fair share" because "there will be no absolute tax cut for the upper class." And on that last point, he made clear during the campaign, his litmus test will be Donald Trump himself: "It reduces or eliminates most of the deductions and loopholes available to special interests and to the very rich. In other words, it's going to cost me a fortune -- which is actually true -- while preserving charitable giving and mortgage interest deductions, very importantly." [Emphasis mine.] Now, there are only a couple of problems with Donald Trump's pledge. For starters, as we'll see below, it's virtually impossible that Trump's tax plan will increase his payments to the U.S. Treasury. Instead, the President and his family will almost certainly be the beneficiaries of a massive windfall. Regardless, to prove his case, Trump would have to do something else: release his tax returns. After all, Donald Trump has yet to demonstrate that he currently pays Uncle Sam anything at all. While his leaked 2005 return revealed that he paid $38 million to Uncle Sam on $150 million in income, almost all of that assessment was the result of his paying the Alternative Minimum Tax (AMT), a provision he has promised to eliminate. And as the New York Times discovered in October, thanks to tax code advantages for real estate investors like himself Trump may have owed no federal taxes for almost two decades: The 1995 tax records, never before disclosed, reveal the extraordinary tax benefits that Mr. Trump, the Republican presidential nominee, derived from the financial wreckage he left behind in the early 1990s through mismanagement of three Atlantic City casinos, his ill-fated foray into the airline business and his ill-timed purchase of the Plaza Hotel in Manhattan. Tax experts hired by The Times to analyze Mr. Trump's 1995 records said that tax rules especially advantageous to wealthy filers would have allowed Mr. Trump to use his $916 million loss to cancel out an equivalent amount of taxable income over an 18-year period. As Matthew Yglesias explained in Vox, "You don't need 'genius' to pull off Trump's tax avoidance -- you just need to be rich." Rich, that is, and in the real estate business. The key, as tax expert David Cay Johnston documented, is the manipulation of "net operating losses" on top of the "already liberal tax breaks Congress gives big real-estate owners." Trump dumped the real costs of all this on investors who saw gold in his brand name, but who lost everything even as he was paid tens of millions of tax-free dollars... NOLs are incredibly valuable. These tax losses can be used to offset salaries, business profits, and income from, say, a television show or makin[...]



Trumpcare in Red and Blue

2017-03-29T18:56:51Z

ive days after the presidential election, I wrote a concession message to Trump voters congratulating them for what they had won. To those Trump promised would get "sick of winning," I predicted, "You've won his 'big and beautiful' Obamacare replacement...

ive days after the presidential election, I wrote a concession message to Trump voters congratulating them for what they had won. To those Trump promised would get "sick of winning," I predicted, "You've won his 'big and beautiful' Obamacare replacement plan that will take away health insurance from 22 million Americans." If the president-elect and his GOP allies in Congress got their way, I suggested, "millions of people across America will have the opportunity for financial ruin and even needless death, and maybe both." And thanks to President Trump, "you could be one of them, especially if you live in a red state like Arkansas or Kentucky where Obamacare had the biggest impact in dramatically reducing the ranks of the uninsured."

Now that Congressional Republicans are facing a growing backlash as they struggle to pass their ever-changing American Health Care Act, I won't say I told you so. Instead, I will simply state that events have transpired exactly as I foretold.

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As it turned out, Paul Ryan's hand-picked director of the nonpartisan Congressional Budget Office (CBO) didn't merely reject the GOP myth that Obamacare was in a "death spiral." Much to the chagrin of President Trump, House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell, the CBO forecast 24 million Americans would lose health insurance under the GOP plan over the next decade. Premiums would rise for both older and lower-income people. Under the AHCA, deductibles and out-of-pocket costs would invariably jump for all beneficiaries as increasingly inadequate tax credits force the older and sicker out of the market altogether. Adding insult to injury, Trumpcare's massive cuts to Medicaid spending will be used to fund an $880 billion tax cut windfall for the wealthy. The ultimate irony of the GOP's supposed replacement for the Affordable Care Act is that Trump voters will disproportionately lose their health coverage while blue state millionaires cash their checks from the United States Treasury.

Of course, that perverse outcome was known long before Republicans first began chanting "repeal and replace" seven years ago this week. That's because now, as it has been since what became Obamacare was first debated, the defining irony of GOP opposition to it has been this:

Health care is worst where Republicans poll best.

A trip back to 2009 shows why.

Continue reading at Daily Kos.




CBO: GOP Health Care "Plans" May Not Count as "Insurance"

2017-03-24T18:40:35Z

There is total chaos in the House of Representatives today as Speaker Paul Ryan rushes to jam through a version--any version--of his so-called American Health Care Act. The timing and the ever-changing content of the bill have little to do... There is total chaos in the House of Representatives today as Speaker Paul Ryan rushes to jam through a version--any version--of his so-called American Health Care Act. The timing and the ever-changing content of the bill have little to do with health care for the American people and everything to do with political spite. Ryan wants to pass a bill by midnight Thursday in order to humiliate President Obama on the 7th anniversary of his signing of the Affordable Care Act. But in their mad scramble to take health insurance away from 24 million people over the next decade (at last count), Speaker Ryan, President Trump and their GOP allies may have made yet another mistake. By gutting Obamacare's list of "essential health benefits" to win over the extremists of the House Freedom Caucus, Ryan's GOP health care "plans" may no longer meet the nonpartisan Congressional Budget Office definition of "insurance." As Vox and The Hill among others have reported, Republicans are trying to reduce premiums by eliminating the ACA's list of 10 mandated benefits insurers must provide. These provisions regarding prescription drug coverage, hospitalization, out-patient treatment, mental health care, pregnancy and maternity care and much more not only set a baseline for insurance offerings under Obamacare, but also help spread the risk for insurers across a much larger pool of policyholders. And that, CBO warned Obamacare repealers in December, is a big problem as far as the agency is concerned: CBO and the staff of the Joint Committee on Taxation (JCT) anticipate that insurers would respond to such legislation by offering new types of insurance products in the nongroup market, which are likely to differ from existing products in their depth and extent of health insurance benefits. If there were no clear definition of what type of insurance product people could use their tax credit to purchase, some of those insurance products would probably not provide enough financial protection against high medical costs to meet the broad definition of coverage that CBO and JCT have typically used in the past--that is, a comprehensive major medical policy that, at a minimum, covers high-cost medical events and various services, including those provided by physicians and hospitals... If there were no clear definition of what type of insurance product people could use their tax credit to purchase, everyone who received the tax credit would have access to some limited set of health care services, at a minimum, but not everyone would have insurance coverage that offered financial protection against a high-cost or catastrophic medical event; CBO and JCT would not count those people with limited health benefits as having coverage. For their part, CBO and the Joint Committee on Taxation (JCT) warned of the challenges they "would face in estimating the number of people who would purchase coverage in the nongroup market, and the scope of that coverage, under such proposals." Larry Leavitt of the Kaiser Family Foundation helped explain why. Under the new GOP rules, insurers would doubtless create new plans under which premiums would come down. But on the flip side, he wrote, insurance plans could become very skimpy, because insurers would be wary of offering generous plans and attracting only sick, costly people who were willing to pay more for them. "With no benefit requirements, insurance policies could get quite skimpy. No insurer wants to be the one most [...]



When Paul Ryan Gave the Game Away on Health Care Rationing

2017-03-20T23:59:59Z

House Speaker Paul Ryan has just experienced two weeks from hell. On Monday, the nonpartisan Congressional Budget Office (CBO) led by his hand-picked director mauled Ryan's so-called "replacement" for the Affordable Care Act. CBO forecast that over the next decade... House Speaker Paul Ryan has just experienced two weeks from hell. On Monday, the nonpartisan Congressional Budget Office (CBO) led by his hand-picked director mauled Ryan's so-called "replacement" for the Affordable Care Act. CBO forecast that over the next decade the "American Health Care Act" will cost 24 million Americans their insurance. The bill, which slashes $880 billion in Medicaid funding even as it delivers a massive tax cut windfall of the same size to the richest Americans, only lowers projected deficits because it continues Obamacare's $1.1 trillion in Medicare savings, something Ryan for years decried as a "raid on Medicare." Even the claim that Ryancare eventually "lowers premiums" is only made possible by forcing the older, sicker and less wealthy from the ranks of the insured altogether. Topping it all off, Congress' budget scorekeeper eviscerated Ryan's go-to talking point that Obamacare is "collapsing." But it wasn't just the severe beating administered by the CBO (also known as the "Conservative Bullshit Obliterator") that left Speaker Ryan politically weakened. Ryan's carefully crafted reputation as a "serious thinker" and "policy wonk" was battered, too, by side-splitting statements that ranged from the comically pathetic to the desperately dissembling. After all, the notion that "the people who are healthy pay for the people who are sick" isn't "the fatal conceit of Obamacare," but instead the very basis of health insurance. Withdrawing coverage from tens of millions doesn't give those people "access" to health care, give them "choice" or enhance their "freedom," but only guarantees the exact opposite. And ushering millions to the brink of financial ruin and thousands annually to needless deaths isn't "an act of mercy." If he succeeds, at worst Paul Ryan's will be an act of murder. At best, Ryan is engaged in brutal exercise in cold-hearted rationing of health care. As he has been all along. In February 2010, Paul Ryan gave the game away. At a time when over 50 million people lacked coverage, Ryan's fatal conceit then as now was to pretend that private insurers weren't the gatekeepers standing between them and their health care. "Rationing happens today! The question is who will do it? The government? Or you, your doctor and your family?" You read that right. A month before President Obama signed the Affordable Care Act, insurers were discriminating against millions of people with pre-existing conditions, using the vile practice of "rescission" to drop coverage for hundreds of thousands more when they got sick, and bankrupting families with wholly inadequate caps on annual and lifetime benefits. Meanwhile, thanks to the worst U.S. economic calamity since the Great Depression, employers were shedding insurance coverage, raiding deductibles and shifting costs to their workers. Nevertheless, Paul Ryan began pushing the same doomed formula--insufficient and too-slow growing subsidies, underfunded block grants and toothless consumer protections--that led to his beclowning this week. The context for Paul Ryan's first major foray into health care policy was his proposal to privatize Medicare, the government insurance system for 60 million American seniors. But as he soon learned, the politics of his voucher scheme were even worse than the math. In April 2009, twenty-four months before all but four House Republicans voted for Ryan's plan to ration Me[...]