Republicans Voted to End Medicare

This, according to Politifact, is 2011's "Lie of the Year." Which is unfortunate because it's true.

Indeed, Politifact's Lie of the Year article seems to acknowledge as much in describing the object of Democratic scorn, the GOP's FY2012 budget proposal (associated with House Budget chairman Paul Ryan):

Introduced by U.S. Rep. Paul Ryan of Wisconsin, the plan kept Medicare intact for people 55 or older, but dramatically changed the program for everyone else by privatizing it and providing government subsidies.

If the difference between the situation for those subject to the GOP's plan and those who are exempted from it (i.e. those 55 or older) is that Medicare is "kept intact" for the latter, the point has been conceded. The clear implication, of course, is that Medicare is not kept intact for those young enough to be subject to the GOP's plan. And indeed it isn't.

So, despite Politifact's self-congratulatory and sanctimonious follow-up to the outcry over their mystifying choice in which they blame the ideologues of the "Echo Chamber Nation" for not recognizing how their "independently researched information" has "disrupted the status quo," the essential facts remain:

	Medicare	GOP (Ryan) Budget
Public health insurer (CMS) exists	✓	x
Gov't reimburses doctors and hospitals for medical services rendered to seniors	✓	x
Guaranteed benefit	✓	x
Seniors must look for private commercial insurance plan	x	✓

Medicare is a public health insurance plan that pays seniors' doctor and hospital bills. The fact that it reimburses providers directly is part of its great power. It can thus tell hospitals that if they want to receive reimbursements from it, the hospitals must provide emergency stabilizing care regardless of citizenship or ability to pay. It can subsidize graduate medical education by folding extra money directly into its reimbursements. It can jumpstart a health information technology revolution by offering bonuses to participating doctors and hospitals who start using electronic health records. It can provide incentives for providers to offer higher-value care and begin changing the ways they deliver that care.

Those things are all gone under the GOP's budget, which instead pushes future seniors to look for Anthem or Aetna or some other private plan if they want coverage. Not right away--which is the only point Politifact even tries to offer in its own defense. Because the proposal grandfathers in existing beneficiaries and people within 10 years of becoming eligible for Medicare, the program doesn't end overnight. It dwindles over time as, starting in 2022, no one is allowed to enroll in it and those grandfathered into it die off or are squeezed out of it by a shrinking provider network and rising premiums.

Yes, it's phased out instead of abruptly eliminated. But last I checked, phasing something out is still ending it. And as Politifact implicitly conceded, under the GOP's proposal Medicare is no longer intact for future generations. So I'm afraid it's true. In April 2011, the Republicans voted to end Medicare.

Times is Hard

Shocking and yet somehow utterly unsurprising.

'Dismal' prospects: 1 in 2 Americans are now poor or low income

WASHINGTON - Squeezed by rising living costs, a record number of Americans — nearly 1 in 2 — have fallen into poverty or are scraping by on earnings that classify them as low income.

The latest census data depict a middle class that's shrinking as unemployment stays high and the government's safety net frays. The new numbers follow years of stagnating wages for the middle class that have hurt millions of workers and families.

"Safety net programs such as food stamps and tax credits kept poverty from rising even higher in 2010, but for many low-income families with work-related and medical expenses, they are considered too 'rich' to qualify," said Sheldon Danziger, a University of Michigan public policy professor who specializes in poverty.

"The reality is that prospects for the poor and the near poor are dismal," he said. "If Congress and the states make further cuts, we can expect the number of poor and low-income families to rise for the next several years." [...]

About 97.3 million Americans fall into a low-income category, commonly defined as those earning between 100 and 199 percent of the poverty level, based on a new supplemental measure by the Census Bureau that is designed to provide a fuller picture of poverty. Together with the 49.1 million who fall below the poverty line and are counted as poor, they number 146.4 million, or 48 percent of the U.S. population. That's up by 4 million from 2009, the earliest numbers for the newly developed poverty measure.

I don't want to read too much into Obama's Osawatomie speech last week yet but it's a positive sign that maybe, just maybe, we'll see a strong Democrat on the campaign trail who isn't afraid to talk about frightening levels of inequality.

Now, this kind of inequality -- a level that we haven’t seen since the Great Depression -- hurts us all. When middle-class families can no longer afford to buy the goods and services that businesses are selling, when people are slipping out of the middle class, it drags down the entire economy from top to bottom. America was built on the idea of broad-based prosperity, of strong consumers all across the country. That’s why a CEO like Henry Ford made it his mission to pay his workers enough so that they could buy the cars he made. It’s also why a recent study showed that countries with less inequality tend to have stronger and steadier economic growth over the long run.

Inequality also distorts our democracy. It gives an outsized voice to the few who can afford high-priced lobbyists and unlimited campaign contributions, and it runs the risk of selling out our democracy to the highest bidder. (Applause.) It leaves everyone else rightly suspicious that the system in Washington is rigged against them, that our elected representatives aren’t looking out for the interests of most Americans.

But there’s an even more fundamental issue at stake. This kind of gaping inequality gives lie to the promise that’s at the very heart of America: that this is a place where you can make it if you try. We tell people -- we tell our kids -- that in this country, even if you’re born with nothing, work hard and you can get into the middle class. We tell them that your children will have a chance to do even better than you do. That’s why immigrants from around the world historically have flocked to our shores.

And yet, over the last few decades, the rungs on the ladder of opportunity have grown farther and farther apart, and the middle class has shrunk. You know, a few years after World War II, a child who was born into poverty had a slightly better than 50-50 chance of becoming middle class as an adult. By 1980, that chance had fallen to around 40 percent. And if the trend of rising inequality over the last few decades continues, it’s estimated that a child born today will only have a one-in-three chance of making it to the middle class -- 33 percent.

It’s heartbreaking enough that there are millions of working families in this country who are now forced to take their children to food banks for a decent meal. But the idea that those children might not have a chance to climb out of that situation and back into the middle class, no matter how hard they work? That’s inexcusable. It is wrong. (Applause.) It flies in the face of everything that we stand for. (Applause.)

Now, fortunately, that’s not a future that we have to accept, because there’s another view about how we build a strong middle class in this country -- a view that’s truer to our history, a vision that’s been embraced in the past by people of both parties for more than 200 years.

Late Night DS9

I'm working my way through Deep Space Nine and I just got to my favorite episode of the first season, Duet. The series itself picks up shortly after the end of a four decade occupation of one world by another. Duet probes some of the backstory and very clearly establishes the parallel with the Holocaust. The former occupiers, the Cardassians, are transparent analogs of the Nazis, having brutally pushed their victims, the Bajorans, into forced labor camps and engaged in a genocidal campaign against them.

This particular episode is about the apparent capture of a Cardassian war criminal, the former commander of a concentration labor camp during the occupation. As the episode title suggests, the episode revolves around the interaction of one of the series' main characters (a Bajoran woman who fought in the resistance against the occupiers) and the Cardassian prisoner. A great episode and the performance from the "Butcher of Gallitep" is especially fantastic.



Well worth watching, particularly for the payoff at the end, if you haven't seen it before.

The 2014 Myth

For some reason, smart people continue to repeat a misconception, and smart people continue to quote smart people repeating that misconception. The reason the health reform law's biggest pieces--the expansion of Medicaid and the launching of health insurance exchanges where people will be able to choose from a variety of private health insurance plans--don't go into effect until 2014, the misconception goes, is that a trick was played to make the numbers work out right. If only that trick hadn't been played, the law would already be fully in effect and in significantly less danger of being torpedoed after the next election.

The WashPo's usually great Sarak Kliff quotes the usually impressive Paul Starr:

Paul Starr makes a smart point in his recent Washington Post op-ed on the health reform law. The law’s unpopularity, he argues, has a lot to do with the fact that it had to be constrained to get a good score from the Congressional Budget Office:

Primarily to ensure that the Congressional Budget Office would “score” the legislation as reducing the deficit, Obama agreed to delay implementation of the major provisions of the law until January 2014, nearly four years after the bill passed. And contrary to his position during the 2008 campaign, the president also agreed to an individual mandate — again, partly to keep down the program’s cost — even though the mandate predictably became the law’s most unpopular provision and the focus of legal and political challenges.

These concessions have had opposite effects on the emotional commitments in the two parties. While opposition to the mandate has become a rallying point for Republicans, the long delay in implementing reforms has left many Democrats discouraged and uncertain about the law’s benefits. The four-year timetable also undercuts any possible political gain from the reforms; the president will have little to show by the 2012 election and little chance of clearing up the confusion and anxieties about the law.

The reality is that those big pieces of the reform law are tough. They're being built state-by-state and are subject to myriad local political hurdles, not least because the Republicans did especially well at the state level in the 2010 elections. But even putting aside the political constraints, the technical and policy feats needed to make this work are substantial. Even in those states that want to make this work and are moving full steam ahead to implement the law, the challenges are very real and the dangers of missing the 2014 deadline loom.

That's part of the reason the federal government is bending over backwards to be as collaborative and flexible as possible. For example, the law provides that states that don't set up their own health insurance exchanges get one set up and operated by the federal government. But through the rulemaking process, the folks at the Department of Health and Human Services are proposing a few more shades of gray--varying degrees of federal control to help states stand up their own exchanges by leaning on federal support for certain key features. States can then conceivably retain autonomy over their exchanges, yet not shoulder the technical and operational burdens of making an exchange work all by themselves.

The point here is that the suggestion that health reform could already be implemented under some scenario is simply wishful thinking. This is hard, uncharted territory: minus pieces of the Massachusetts experiment, no one has ever done anything like this. That's why it's going to work. But states were always going to need time to make it happen.

And guns. Lots of guns.

Conspiracy!

As Stanek and Andrew are probably well aware of by now, I work in an office with some pretty hardcore Republicans - every day they listen to Glenn Beck and Rush Limbaugh on the radio, complain about the liberals and certain minorities in the city, etc. etc. Usually I just tune it out and concentrate on my work (I have a handy pair of headphones and an iPhone with a lot of Beatles music on it which has been instrumental in preventing migraines), and they have always been more than pleasant towards me personally so I can't really complain. But a few days ago they mentioned something to me that struck me as overwhelmingly ridiculous. According to them, the conservative radio shows that they listen to have been stressing that businesses are ready to hire again and are sitting on "piles of money", however they want to see how the next presidential election turns out because they're scared that President Obama might win again.

This helped put into words a suspicion I've always had about the Republican party. Maybe my theory is nothing new (Stanek can probably answer that better than I can and I find it hard to believe that nobody has connected the dots here), but considering that business owners and corporate executives are almost exclusively Republican, aren't they essentially holding the economy hostage to support their preferred political party? If what these conservative radio shows are arguing is true, and I don't know if it is or even that they actually said it (and I'm sure as hell not going to re-listen to their shows to find out), then the economy is supposedly getting better but business owners are holding it back because Obama is president. This creates a pretty interesting self-fulfilling prophecy among conservatives who think Democrats are bad for the economy. How can economic strength ever be used to gauge the effectiveness of a Democratic president when businesses are willing to cripple the economy until a Republican is elected? And I know what conservatives would say in response: "Democrats are innately bad for business so employers are just protecting themselves." But all that does is bypass the issue and fuel the self-fulfilling prophecy to carry on.

Again, I have no idea how true this is or if Rush or Glenn Beck even made this argument. However, it still makes me wonder about businesses manipulating the economy for political reasons in general. And as I said before I don't expect this to be all that revolutionary of an idea, but I am interested in what you guys think or know. At least it makes me more confident that President Obama is doing a better job than people seem to think.

P.S. - This is the 200th post at the Speakeasy! Grab a beer and celebrate.

The Path to Power, Perry-style

Celebrated ideas man Rick Perry attempted to bounce back from his "oops" moment this week with the release of a bold--non-999--plan. From the man who brought you the optional flat tax comes the plan to "Uproot and Overhaul Washington." What caught my eye were his suggestions for "fundamental reform of the legislative branch." Specifically two items:

Part-Time Citizen Congress:

[...]

The U.S. does not need a full-time Congress that is more focused on increasing its perks instead of reducing spending. America needs a part-time, Citizen Congress – populated with those who choose to serve not for profit, or for the promise of a high-paying lobbyist job, but for the good of their communities, states, and the nation. Even with a 50 percent pay-cut, Congressional members would still make a significantly higher income than the average American.11 [...]

Slash Spending for Congressional Staff:
According to the Congressional Research Service, Congress employed more than 15,000 staffers as of 2009.13 In the Senate, the number of staff assigned to senators’ personal offices has more than doubled since 1977; the number of so-called “leadership staff” more than quadrupled over the same time period.14 As the number of staffers grows, so does congressional involvement in nearly every aspect of the American economy.

Why those two in particular? Because they strike me as being an enormous executive power grab.

I can't claim to be well-versed in Texas politics but the word on the street seems to be that Perry inherited a relatively weak office from his illustrious predecessor and found ways to strengthen it, centralizing power through heretofore untapped channels:

For most of history, Texas has been considered a “weak governor” state. That changed under Perry’s leadership. His lengthy tenure as governor has allowed him to appoint political allies in every single state agency, effectively establishing a Cabinet-style government and giving him vastly more power than any of his predecessors.

And now it seems the governor is setting his sights on accomplishing a similar feat in Washington, D.C.; disconcerting perhaps when you realize we already have a pretty strong federal executive. Aside from the obvious ramifications for executive power of slashing Congressional pay and sending Congress home, the gutting of their staffs is particularly significant. To see why, we need only look back at the overhaul of the modern bureaucratic state that occurred in the first half of the last century, particularly under FDR. With the balance of bureaucratic expertise (and raw numbers of staff) tipping heavily in the White House's favor, Congress found itself at a distinct disadvantage.

"Congressional procedure," Life magazine was to note in 1945, is largely "the same as it was in 1789." As for the Senate's basic committee and staff structure, that had been established in 1890. During the intervening decades, government had grown enormously--in 1946 the national budget was three hundred times the size it had been in 1890--but the staffs of the Senate committees had grown hardly at all. To oversee that budget, the Senate Appropriations Committee staff consisted of eight persons, exactly one more than had been on that staff decades earlier. Not only were they ridiculously small, the staffs of Senate committees had little of the technical expertise necessary to understand a government which had become infinitely more complicated and technical. The salaries of congressional staff members were so low that Capitol Hill could not attract men and women of the caliber that were flocking to the executive branch.

A study done in 1942 concluded that only four of the seventy-six congressional committees had "expert staffs prepared professionally even to cross-examine experts of the executive branch." As for senators' personal staff, as late as 1941, a senator would be entitled to hire only six employees, and only one at a salary--$3,000--which might attract someone with qualifications above those of a clerk. So little importance was attached to staff that many senators didn't hire even the six to which they were entitled, and an astonishingly high proportion of the approximately 500 employees on senators' personal staffs and the 144 on the staff of the Senate committees were senators' relatives. The Founding Fathers envisioned Congress as a check on the executive. Congress couldn't make even a pretense of analyzing the measures the executive submitted for its approval.

During the decades since 1890, when the Senate had authorized a staff of three persons for its Foreign Relations Committee, the United States had become a global power, with interests in a hundred foreign countries. In 1939, the staff of the Senate Foreign Relations Committee was still three: one full-time clerk who took dictation, typed and ran the stenotype machine, and two part-time clerks. As one observer put it, "There could be no adversary relationship between the two branches of government [in foreign relations] because most of the professional work had to be done in the Department of State." Anyone seeking an explanation of the Senate's willingness to allow the rise of the executive agreement, which freed it from the details of foreign policy, need look no further: the Senate simply had no staff adequate to handle the details of foreign policy. The adversary relationship--the relationship that had lain at the heart of the Framers' concept of the American government they thought they were creating--had become impossible in virtually all areas; even Senate Parliamentarian Floyd Riddick had to admit that "with occasional exceptions, Congress did little more than look into, slightly amend or block bills upon which it was called to act."

Unable to analyze legislation, Congress was equally unable to create it.

This was perhaps the most significant alteration in the power of the House and the Senate. The Framers of the Constitution had given Congress great power to make laws, vesting in it "all legislative powers," and during the early, simpler days of the Republic, Congress had jealously guarded that power; as late as 1908, the Senate had erupted in anger when the Secretary of the Interior presumed to send it a bill already drafted in final form. But by the 1930s, with government so much more complicated, bill-drafting had become a science. Knowledge of that science was in extremely short supply on Capitol Hill. There were plenty of legislative technicians with the necessary expertise at the great law firms in New York. There were plenty at the White House, and in the executive departments--the legislative section of the Agriculture Department alone had six hundred employees. In 1939, the Legislative Drafting Service that helped both houses of Congress consisted of eight employees. And of all the scores of major statutes passed during the New Deal, approximately two per year were created by Congress--because, as Tommy Corcoran explained, Congress simply lacked the "technical equipment to draft a big, modern statute."

--Master of the Senate, Robert Caro

Does Perry really want to revert to a time when the legislative branch was so emasculated it didn't have the expertise to even ask executive branch officials to explain themselves?

He seems so stupid but, if only by accident, there's something Johnsonian about him. Stupid like a fox!


P.S. If you haven't read any of Caro's multi-part series (including Master of the Senate) chronicling the rise of Lyndon Johnson, do it. Just do it.



(The Passage of Power is coming in May. I'm going to fucking hyperventilate.)

Pendulum Swings

So far it seems to be a night in which overreaches on the part of overzealous newly-elected Republicans have been repudiated. Issue 2 in Ohio, the anti-union legislation, has gone down in flames. Same day voter registration here in Maine was restored by the people tonight, after the Republican legislature and Governor eliminated it. Even in ruby-red Mississippi a movement to define personhood as beginning at conception seems to have been handily defeated.

One more example to make the point. Way back in January I posted Dis-integration about the demise of Wake County North Carolina's successful effort to integrate schools along socio-economic lines. Flashback:

IN RALEIGH, N.C. The sprawling Wake County School District has long been a rarity. Some of its best, most diverse schools are in the poorest sections of this capital city. And its suburban schools, rather than being exclusive enclaves, include children whose parents cannot afford a house in the neighborhood.

But over the past year, a new majority-Republican school board backed by national tea party conservatives has set the district on a strikingly different course. Pledging to "say no to the social engineers!" it has abolished the policy behind one of the nation's most celebrated integration efforts.

Remember?

And tonight: Democrats complete sweep of Wake school seats

RALEIGH, N.C. (AP) — A Democratic-aligned candidate retained his seat on the Wake County school board Tuesday, completing a sweep of the seats up for grabs this year.

Incumbent Kevin Hill beat challenger Heather Losurdo by nearly 1,000 votes Tuesday. The result means Democrats will have a 5-4 majority on the board governing North Carolina's largest school district.

It could also mean a change in direction for the board that decided last year to scrap a decade-old busing plan aimed at making sure schools didn't become too heavily identified as either poor or rich.

So it looks like working people, women, kids, and everyone entitled to political franchise are the big winners tonight. Smile, Teej.

Back swings the pendulum. Here's hoping that it gains momentum over the next 12 months.