Daydreams of Elections Past

Let's go for two posts in one day; it's been dead around here lately.

Last night I finally watched Recount, HBO's 2008 film recounting (pardon the pun) the events in Florida in the 36 days following the 2000 presidential election. None of it was new to me, as I was already painfully familiar with the events of that historic 6 weeks. I just hadn't thought about them in years.

In some ways, watching the movie brought back some personal memories. Election Year 2000 is the moment I pinpoint as the time when I became politically aware. It was the first election in which I had a horse in the race and the first election in which I had determined which political party aligned with my understanding of the world. Recount opens with some real footage from Election Night 2000: Tim Russert with his whiteboard stressing the importance of Florida, Dan Rather and his barrage of bizarre but amazingly entertaining aphorisms, Tom Brokaw sheepishly walking back his network's early call of Florida for Al Gore.

I remember all of it. The exhilaration, watching the early coverage that night, of watching my preferred candidate (the first real political preference of my young life) seemingly headed for victory giving way to the excitement and confusion of that night. Florida goes for Gore, then Florida goes for Bush, then Florida is too close to call. Al Gore's concession call to George W. Bush, followed by his call to retract his concession (and the resulting popularization of "snippy"), and the cancellation of his late night concession speech. I can't recall for sure if my obsession with news coverage and my love affair with C-Span began that night but I suspect it may have. I was up all that night, glued to the coverage of that memorable night, not wanting to risk missing its resolution while I slept. Of course, as we know, there was no danger of that.

But watching the movie--as well as reading the comments in this post about the media coverage of Gore in 2000 over at The Monkey Cage--also reminded me of some of the 2000 campaign itself. The triviality of much of it, the relentless attempts to paint Gore as boring and, worse, some sort of pathological liar over willful distortions of his words (given the sheer volume of whoppers we're being subjected to this cycle about real policy issues of import, not dissections of the precise role one candidate played in securing support for the research that led to the development of the Internet, the more bitterly laughable it seems).

But even more than that, the remembrance of the palpable sense in some quarters that the country was on autopilot and who it put at the helm didn't matter. The false exuberance at the tail end of the Clinton years that lulled many into thinking peace and prosperity are easy. The conviction that, as Ralph Nader suggested, there wasn't "a dime's worth of difference" between Bush and Gore or the Republicans and Democrats.

I didn't believe that then and I don't believe it now.

But we don't get do-overs. We can't get back the lost decade that saw zero net job creation and declining median incomes and ended with us trying to claw our way out of the worst recession since the Great Depression. We can't get back the blood and treasure lost in the deserts of Iraq. We can't erase the torture conducted in our names. Nor can we forget the mistakes and failures of the Democrats in their minority role as the loyal opposition. We can't get back the lost opportunities.

But despite all this, watching Recount wasn't nearly as painful as I thought it might be (not that I didn't expect it to be entertaining and well-done, which it is). That was a long time ago and there's not much use in dwelling too much on what might've been. I find my mind wandering to Obama's '12 campaign theme: "Forward." We can't do 2000 over. But we can do 2012 and beyond right.

So I suppose the moral is: elections matter. Make sure you're registered to vote.

Courting Coruscant

I'm in a mildly reflective mood this afternoon, thinking on the great changes this country has seen since its founding. One window on these changes--the coming of the Industrial Revolution, the steady evolution of our work force (including the coming and going of unions), etc--is where people choose, or are compelled, to live. It should come as no surprise that since the founding days we've seen a massive shift from living in sparsely populated rural areas to the collecting of folks in close proximity to their neighbors in urbanized areas. The ideal in America shifted from the solitary plot of land to the small, fenced in enclosure mere steps from our neighbors (look to the right for the ideal American relationship and proximity to his neighbor in the late 20th century).

I took a look at Census data (and here for the most recent decades) to see just how much and how quickly that transition has happened:

Jefferson's veneration of the yeoman farmer in the vision of agrarian egalitarianism that came to characterize his philosophy took place in a nation that was more than 90% rural. Decades later, when the visceral, visual manifestation of Manifest Destiny, the driving of the Golden Spike into the ground, took place in a nation shifting its attention from war to industry, and when the first great waves of labor unrest swept through the land, the nation was still nearly three-quarters rural. When the American frontier officially closed and William Jennings Bryan took his brand of prairie populism up against the best financed, most Big Moneyed presidential campaign in history (up to that point and since), the nation was still more than 60% rural.

Even as late as the Great War, which saw future president Harry Truman leave behind his plow for the lure of an overseas adventure, the country was still split roughly 50-50 between urban and rural living. By the time our cities burned in the midst of the massive social unrest of the 1960s, the nation was over 70% urbanized. Today we're over the 80% mark.

Where do we go from here? Do these trends reflect changing economic and social realities or shape them (or both)? How do these changes affect our politics and our polity today (e.g. public awareness of and reaction to the fact that the U.S. is now experiencing the largest drought in a half century, or the unusual inability of the current Congress to pass the Farm Bill). No answers, just questions from me this Sunday afternoon.

TDM: Romney on Pre-existing Conditions

Starting with a relevant FDR clip is a sure sign of a good segment. And this one turned out to be very entertaining.

Visit NBCNews.com for breaking news, world news, and news about the economy

Seven Memorable, Readily Available DNC Moments

After a thoroughly enjoyable three-day Democratic convention, it's time to put up a few notable moments chosen because 1) they're worth watching, and 2) they're currently available as short clips on YouTube. There are many more notable moments but not notable enough to be clipped off and uploaded to YouTube yet, it seems.

If you didn't watch much of the convention here are, in no particular order, a few clips worth watching.

1) Gabby Giffords leading the Pledge of Allegiance.

In an emotional moment, the former Congresswoman who was shot in the head last year came out to lead the convention in the Pledge. The reaction of the crowd and her obvious joy make this one very enjoyable.



2) John Lewis reminiscing about his incredible past.

He gave the campaign slogan (and frequent thematic device at the convention) "Forward" deeper meaning with powerful reflections on the past and how far we've come.



3) Obama on foreign policy.

In 2008, Obama (though then a member of the Senate Committee on Foreign Relations) was the relative neophyte on foreign policy, a subject that was at least theoretically one of John McCain's strengths. The student is now the master. In this clip from Thursday night, he points out his administration's remarkable foreign policy successes and gets in a few jabs and the complete lack of foreign policy experience on the Romney-Ryan ticket. Given that Romney completed neglected to mention our troops currently in harm's way or Afghanistan in his own acceptance speech, this bit stands in sharp contrast to his speech last week.



4) John Kerry (currently Chairman of the Senate Committee on Foreign Relations) making the foreign policy case for Obama.

Kerry gave a surprisingly entertaining speech to push the foreign policy argument, working in both self-deprecating humor ("talk about being for it before you were against it," he said with a half-smile as he attacked Romney's ever-shifting opinions on Afghanistan) and even a reference to Rocky IV! But at a convention where, to put it mildly, Osama bin Laden's death did not pass without notice, Kerry had probably the line of the convention about bin Laden:



5) Clinton makes the economic argument for Obama.

In an extraordinarily policy-oriented and delightfully engaging (even folksy) speech that's rightly been described as a tour de force, Bill Clinton forcefully rebutted Republican criticisms and made the case for a second Obama term. In this short clip, he succinctly lays out the Republican and Democratic arguments and, with a playful grin, recycles a famous line from the Republicans' patron saint.



6) Ted Strickland gets rowdy.

In a speech some felt was too loud or too populist, Ted Strickland reminds us what the auto bailout meant for Ohio. An earnest speech from an earnest Rust Belter and I don't think he could've delivered his final line any better. Plus the strange little chuckle he does occasionally is pretty entertaining.



7) Barack Obama's closing argument.

I'll have more to say about his speech sometime this weekend. But in this short clip, he ends his acceptance speech and officially begins the fall campaign.

The Seven Lean Years

Throughout the presidential campaign, Mitt Romney has had an oddly reactive approach to putting out policy proposals, seemingly flying by the seat of his pants and offering almost spur-of-the-moment, invariably ill-thought out policy ideas and usually defining himself by what he's not (i.e. Obama). Who can forget his tax plan, developed during the Republican primaries, which turns out to raise the tax burden on the middle class (whoops!)? He's done it again now that Paul Ryan is his running mate.

He seems to have impulsively decided to move up the date at which the Medicare trust fund becomes insolvent.

As Rick Perry might say: oops.

But first some perfunctory background. Broadly speaking, Medicare pays for hospitals services, services from doctors (e.g. like your family doc), and prescription drugs. In table form:

Medicare Component	Pays For	Financed Primarily Through	Finances Go Into...
Part A	Hospital services	Payroll taxes	Hospital Insurance (HI) trust fund
Part B	Physician Services	General revenue/Monthly premiums from beneficiaries	Supplementary Medical Insurance (SMI) trust fund
Part D	Prescription drugs	General revenue/Monthly premiums on beneficiares	Supplementary Medical Insurance (SMI) trust fund

(Part C is the privatized portion of Medicare--Medicare Advantage--that generally combines these three benefits in a single private health insurance plan for the 23% or so of Medicare beneficiaries who choose to go that route: and at only ~114% of the price of traditional Medicare!)

As the table should make clear, there are two trust funds to think about: one funded primarily by payroll taxes that covers hospital services and another funded primarily by general tax revenue (with another significant component coming from insurance premiums on seniors enrolled in Medicare) that pays for doctors' services and prescription drugs. This excellent Kaiser Family Foundation primer on Medicare financing identifies a difference between these two trust funds that's worth noting:

A key difference in the structure of the HI and SMI Trust Funds affects their financial status. In the case of the HI Trust Fund, dedicated revenue may be greater or less than expenditures in any given year, so that in some years HI expenditures may exceed income, while in other years, reserve funds may be generated. By contrast, SMI Trust Fund financing does not produce excess revenue or shortfalls due to the way it is structured, with premiums and general revenue contributions adjusted each year in order to cover projected expenditures for that year. When excess HI Trust Fund revenue is collected, the excess amounts are loaned to the federal government and used to pay for other federal obligations. Interest on the loans is credited to the Trust Fund as income.

So theoretically there is some money collected in the HI trust fund for spending on Medicare hospital services. Or rather, that money was loaned out to the rest of the government at interest to help pay for other things but it can be reclaimed when needed. But now that Medicare is paying out more than it takes in, at some point the money in that trust fund--or owed to it--will be exhausted. At that point, Medicare won't be able to fully pay for its obligations to cover hospital services, though it can still pay out whatever the Medicare payroll tax is bringing in. But the coming insolvency of the HI trust fund is a serious concern, particularly since the shortfall the trust fund experiences will just continue to grow with time.

In 2009, before health reform (or the Affordable Care Act or ACA or Obamacare--whatever the kids are calling it these days) passed, the Medicare Trustees forecast that the HI trust fund would be exhausted in 2016/2017. Then the ACA passed and the next year that number receded to 2029. The continuing stumbling of the economy put a little damper on that and for the next two years (including this year), the Trustees' report put the date of insolvency at 2024.

The point is that the ACA pushed the HI trust fund's insolvency date back from being a few years from now to being in the middle of the next decade. The catalyst for this change is the controversial savings (or cuts, as the GOP prefers to put it) that got so much airtime and ad time during the midterm elections two years ago. These Medicare savings showed up primarily in three forms:

1. As I intimated above, the privatized portion of Medicare (known as Medicare Advantage) costs more per enrollee than traditional public Medicare. The reason is essentially that the process by which the federal government's payments to these private insurers on behalf of Medicare beneficiaries are determined is currently rigged in the private insurers' favor, allowing them to pick up outsized federal subsidies. The ACA dials these back, reducing the government subsidy to these private insurers over time to largely bring them in line with traditional Medicare.

2. Traditional (public) Medicare pays for hospital services according to a fee schedule. The ACA, assuming certain "productivity improvements," requires that those reimbursements increase more slowly over the next decade than they were otherwise scheduled to. These assumptions aren't baseless, as the ACA also contains some mechanisms to help hospitals (and other providers) achieve them. But it's going to be a challenge to make it all work.

3. A hodgepodge of other savings/cuts (though not to physicians; their payments are governed by a different law). For instance, Medicare pays certain hospitals extra to cover some of the costs of the uninsured; the theory is if there are less uninsured people under the ACA, those payments can start going down.

Together those savings push back the date of the HI trust fund's insolvency by several years because the trust fund is paying out less over the next decade thanks to them.

When House GOP Budget Chairman Paul Ryan (now Mitt Romney's running mate) was putting forth his budget proposals this year and last, he sought to include a plan to transform Medicare into a voucher program. The merits of that plan aside, people tend not to like change, particularly when they've been expecting or experiencing something else. The bigger the change you're proposing, the more important it becomes to make the change's implementation minimally disruptive. So Ryan delayed implementation of his proposed Medicare reforms for a decade, stipulating that they wouldn't start until 2022. That allowed Ryan to claim that no one currently receiving benefits would be affected by the changes, nor would anyone 55 or older, i.e. folks within 10 years of Medicare eligibility. It was only folks who were 11 years away from hitting Medicare eligibility at 65, the 54-year-olds and younger, who would be given a voucher.

But there's a problem here. If the HI trust fund is exhausted in 2016--assuming the ACA is repealed--then how does Ryan wait until 2022 to implement any kind of Medicare reforms? The answer is that he can't. So in writing his budgets, he retained the ACA's Medicare savings (while calling for the repeal of the rest of the health reform law). The fact that Ryan tacitly endorsed them and virtually every federally elected Republican--in the House and Senate--voted for them didn't stop Ryan's party from shamelessly continuing to attack the President for his Medicare "cuts." (Now that he's in the national spotlight, Ryan has recently been called upon to explain why the cuts that his running mate routinely denounces were included in his budgets. His rather lame answer: "First of all, those are in the baseline, he [Obama] put those cuts in...It gets a little wonky but it was already in the baseline. We would never have done it in the first place.")

But running on Obama's Medicare cuts at the same time he was demonizing them on the campaign trail proved too much even for Multiple Choice Mitt. After being unable to describe any difference between his plan for Medicare and Ryan's (the plans are, after all, virtually the same), by mid-week Romney had found a major difference between his approach and his running mate's: “My campaign has made it very clear: The president’s cuts of $716 billion to Medicare — those cuts are to be restored if I become president and Paul Ryan becomes vice president,” Romney said on “CBS This Morning.”

Nice! Jettison Ryan's baggage by not following his lead in adopting Obama's Medicare savings/cuts. Why did Ryan even embrace those in the first place? Oh, right...

It turns out this creates a problem for Mitt. He too has pledged that under his Medicare plan "Nothing changes for current seniors or those nearing retirement," meaning that none of his reforms begin until 2023 (i.e. the year in which a current 54-year-old would hit 65 and become eligible for Medicare). But by "restoring" Obama's savings/cuts, Romney moves the date of the HI trust fund's insolvency up to 2016 from 2024. Whereas Ryan had retained the hated cuts to keep the trust fund solvent until his reforms could kick in in the early 2020s, Romney is explicitly saying he won't do that.

Meaning that the trust fund will be exhausted in 2016, but Romney's reforms (a voucherization of Mediare similar to Ryan's proposal) won't kick in until 2023.

That makes for seven lean years in which Medicare can't meet the entirety of its hospital care obligations to current beneficiaries. Indeed, the magnitude of the shortfall and thus the degree to which current beneficiaries' services are cut into grows each year. Again, ignoring the merits of Romney's proposed reforms, under his plan there will be a seven year gap between the HI trust found becoming insolvent and any reforms beginning.

To date he hasn't explained how Medicare beneficiaries are supposed to get by during their seven lean years and what, if anything, his administration is prepared to do to fix the problem. The Obama campaign seems to have noticed, mentioning at 1:38 of their latest video explaining Romney and Obama's differences on Medicare that "If Mitt Romney and Paul Ryan are elected, Medicare will be bankrupt by the end of their first term."



Good of them to reference it but this strikes me as a huge issue requiring more attention: Mitt Romney is pledging to accelerate Medicare's spending, depleting the HI trust fund more quickly, to the point that it will be exhausted within four years. And he's also promising not to reform Medicare in any way for a decade. That's huge. And I doubt it was intentional. More likely, it was an unintended (and unforeseen) consequence of Romney's constant ill-thought-out Not-Obamaism. But now is the time for the Obama camp to make him pay for it.

Obama derangement

This is an actual tweet from Iowa's GOP Senator Chuck Grassley, apoplectic that Obama stopped by to speak at the Iowa State Fair today:

Who does PresO think he is. He comes to StateFair the SecretService shut down all small business vendors depriving them of income wo compsat

— ChuckGrassley (@ChuckGrassley) August 14, 2012

Well, shit, it wasn't Portman

I'm genuinely surprised. Portman was the obvious "don't rock the boat" pick with a potential marginal upside in Ohio. But that choice is appropriate for a campaign that's more or less in a dead heat with its opponent.

Apparently Romney concluded that thus far he's been on track to lose. Granted, he hasn't had a good week since the first half of June, he's the first candidate in recent memory to have a higher unfavorable rating than favorable, and three polls that came out at the end of last week showed him down between 7 and 9 points.

But I still wasn't expecting a risky choice like Paul Ryan, the GOP Budget Chairman best known for his draconian budget that would replace Medicare with a voucher for private health insurance. This strikes me a sign of mild panic (or at least resignation) in the Romney camp. Which surprises me.

Sorry Rob, maybe next time.