Trumpcare is dead, at least for now: But the health care fight will never end

McConnell-Ryan health plan collapses as conservatives bolt — but progressives have no victory to celebrate

It appears that the Republican effort to repeal and replace the Affordable Care Act is dead, at least for now. Donald Trump’s unrealistic, grandiose promise will go unfulfilled.

That didn’t work out. After weeks of prevarication and misdirection on the part of people like Vice President Mike Pence and Health and Human Services Secretary Tom Price, who went on TV last weekend and blatantly lied about the effects of the Senate health care bill, on Monday night two GOP senators, Mike Lee of Utah and Jerry Moran of Kansas, pulled the plug by saying they could not vote for it. Added to the previously announced no votes of Sens. Susan Collins and Rand Paul, Majority Leader Mitch McConnell is now at least two short. He has admitted that this bill will not pass.

We’ve been here before, of course. The first House bill was pulled and they came back and passed an even worse version. This may not end the way everyone seems to assume it will either.

Both Trump and McConnell acknowledged that the Senate’s BCRA is dead and signaled their support for a “full repeal plus two-year delay until they figure out what the hell is going on” plan. It is not impossible that they could put something else together.

After all, the reasons three of the four senators gave for their unwillingness to pass the bill is that it just wasn’t harsh enough. Repeal and replace with nothing would undoubtedly make them quite happy. That would leave the handful of Republican moderates in the Senate having to do something only Collins has so far been willing to do: take a stand for decency. Sens. Dean Heller of Nevada, Shelley Moore Capito of West Virginia, Rob Portman of Ohio, John Hoeven of North Dakota and Lisa Murkowski of Alaska have all said that they won’t vote to deny people health insurance. But there’s always a chance they can be appeased with the two-year delay and a fatuous promise to fix everything before then. Nobody should relax until it’s clear that this is all well and truly dead.

This repeal-and-delay plan was originally proposed back at the beginning of the year but faced a huge uproar, mostly from the health care industry, which cannot run its businesses with this kind of uncertainty about the financing, rules and regulations under which they must operate. A handful of senators balked at the time, including Bob Corker of Tennessee and Tom Cotton of Arkansas, who said, “I don’t think we can repeal Obamacare and say we’re going to get the answer two years from now.” Both Paul and Collins were against it too, as were many of the Republican governors who also have to plan their budgets.

But what really scared them off that time was public opinion. Only 20 percent of Americans were in favor of repeal-and-delay five months ago. It’s hard to imagine that after they’ve seen what kind of horrendous plans the Republicans tried to ram through the Congress they’ll be more favorably disposed today. According to a recent Gallup poll, Americans prefer Democrats to handle health care by 55 to 36 percent.

The Republican leadership exemplified by House Speaker Paul Ryan thought they had come up with a clever way to have their cake and eat it too. If they could repeal the Affordable Care Act and then take their big victory lap, that might satisfy their base that they were getting things done — after which they could pretend they were creating some kind of “new” health care system that would kick in gradually. The simple fact was that they had no idea how to cover the people who are currently covered under the ACA and they knew it. Their best hope was to ease people back into their previous anxiety and despair and blame Obamacare for it.

Donald Trump has said many times that he believes the best political move would be to keep Obamacare in place and help it fail, so he and his party could blame the Democrats. If Republicans can drag this out a couple of years and guilt Democratic lawmakers into signing on to some inadequate Band-aids in order to spare a few lives, that would really be sweet.

It will also be sweet for the Democrats when they run ads against every House Republican who voted for that AHCA atrocity under the assurance that they would “fix it in the Senate.” If the Democrats do manage to eke out a new House majority it will be the health care albatross that brings down the GOP. They can name him Donald.

But whether Republicans manage to push through repeal-and-delay or just drop it altogether, liberals and progressives need to reckon with the fact that this is not the end. There will never be an end.

Republicans have been trying to destroy the American safety net for decades. They’ve been hostile to Medicare and Medicaid since the day they were passed. They’ve been running against Social Security for 82 years. (They just tried to privatize it in 2005!) They will never stop attacking the ACA either.

This isn’t just about profits or ” free markets.” Consider that this Senate bill was opposed by all the so-called stakeholders: the insurance companies, the hospitals, doctors and even big business. It still has 48 out of 52 votes in the Senate. Conservatives simply do not believe that people have a right to health care. They see it as a commodity like any other, something which you should not have if you cannot pay for it.

By way of crude illustration, recall when libertarian godhead Rep. Ron Paul ran for president in 2008. CNN’s Wolf Blitzer asked him during a debate what an uninsured man who  became catastrophically ill and needed intensive care for six months should do. Paul replied, “What he should do is whatever he wants to do and assume responsibility for himself. That’s what freedom is all about, taking your own risk. This whole idea that you have to take care of everybody …” The audience then erupted into cheers, cutting off Paul’s sentence. Blitzer followed up by asking “Congressman, are you saying that society should just let him die?” Members of the audience clapped and shouted “Yeah!”

Or there was this remarkable moment from an Obamacare town hall in 2009:

The sainted Ronald Reagan made his name speaking out against “socialized medicine” for years, memorably warning that if the government passed Medicare, we were all “going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.”

Nobody who believes that human beings have a right to a government guarantee of health care, security in their old age and society’s support should they be unable to work should ever rest on their laurels. Those who don’t agree will never stop trying to take those things away.

Heather Digby Parton, also known as “Digby,” is a contributing writer to Salon. She was the winner of the 2014 Hillman Prize for Opinion and Analysis Journalism.

Francis Kielarowski’s key chain fob

Amazing. My grandfather’s key fob turned up for sale on eBay. A friend of my niece posted the ad on her Facebook page and I noticed it. Contacted the seller and identified myself as a relative and he sold it directly to me. I am the oldest son of the oldest son of Francis Kielarowski who came to the USA from Poland at the turn of the century. He bought the house on Fernleaf Street and my father was born and raised in that house; it was in the family until recently. My grandfather died when my dad was a teenager in the 1930s. I wonder where the fob has traveled over the years. I’m happy it came back to the family.

Apollo

The opioid epidemic in the US: A national health emergency

18 July 2017

The Washington Post recently published an extraordinary article on policies to address the spiraling drug epidemic in the United States. The article—“As opioid overdoses exact a higher price, communities ponder who should be saved”—did not feature calls for emergency health care or rehabilitation programs, but rather suggestions by some local officials that the state should just let drug addicts die.

The Post highlighted, among others, the proposal of Middletown, Ohio Council Member Daniel Picard that emergency responders should not use the drug naloxone to save overdose victims more than two times. The newspaper noted that the drug is often “the only thing separating whether an overdose victim goes to the hospital instead of the morgue,” and draws the conclusion that it is perfectly reasonable to adopt policies to ensure that many more go to the latter rather than the former.

That such fascistic measures—what might be called the “Duterte solution” to the drug epidemic in the US—are being treated as a rational and legitimate part of the political debate is an expression of the debased political psychology that dominates in the American ruling class. As far as the corporate and financial elite is concerned, if tens of thousands more people die from drug overdoses, this is not only acceptable, it is a positive good.

Such measures are being advanced amidst a national public health emergency on a scale not seen since the AIDS epidemic of the 1980s and ‘90s. In 2015, a shocking 52,000 people in the United States died from drug overdoses, including more than 30,000 from opioids alone. This compares to just under 42,000 deaths from AIDS at its peak in 1995. The figures for 2016, when finally totaled, are expected to show an increase of nearly 20 percent, rising to nearly 170 people every day of the year.

In the hardest hit regions, stories of morgues and funeral homes running at maximum capacity are commonplace. Twice already this year in Montgomery County, Ohio, the coroner’s office has been so overwhelmed with bodies that it was forced to rent extra refrigeration units.

Opioid-related deaths have jumped in states throughout the country, devastating rural areas and big cities, and affecting all races and ethnicities. In Maryland, the number of opioid-related deaths has nearly quadrupled since 2010. In Ohio, opioid related deaths jumped from 296 in 2003 to 2,590 in 2015, a 775 percent increase. In Florida in 2015, three opioids—heroin, fentanyl and oxycodone—were directly responsible for the deaths of 3,896 people.

The number of people directly impacted by the crisis—including family members, friends and colleagues, medical responders, social workers and many others—is in the millions. Many addicts have children who are forced into a resource-starved foster care system, or are left in the hands of family members who cannot provide for them. A recent study from University of Michigan estimates that one baby is born addicted to some sort of opiate every hour.

Thousands of workers who have dedicated their lives to jobs that treat drug addiction experience second-hand trauma from the hardships that come with combating the epidemic, with little to no resources. Hospital workers are forced to turn away withdrawing addicts from the emergency room without care; social workers have the task of telling children they cannot be reunited with their parents, or worse, that one or both of their parents have died; rehabilitation clinicians are expected to “cure” addicts with nothing more than additional drugs and a 12-twelve step program.

The drug epidemic is a public health crisis of incredible magnitude, and yet nowhere in the political establishment is there serious discussion on the measures needed to combat it—or who is responsible.

The underlying assumption in articles like the one in the Post is that drug abuse is a moral failing, and that those addicted deserve to face the consequence of their actions. This is a convenient explanation for those who wish to wash their hands of a problem that threatens their pocketbooks.

The drug epidemic, however, is not an individual failing but a symptom of a diseased social system. It is the product of definite actions taken by the ruling class and its political representatives, Democratic and Republican.

There are of course the pharmaceutical companies, which have for years have been given a free hand to aggressively market some of the most addictive opioids, making huge profits in the process. These drugs were recklessly misbranded as “abuse resistant” throughout the 1990s and early 2000s, despite overwhelming evidence to the contrary. Prescriptions for opioids such as Percocet, Oxycontin and Vicodin skyrocketed from 76 million in 1991 to nearly 259 million in 2012, enough to supply each American adult with a bottle of pills, and some with two.

The same pharmaceutical companies continue to profit from the crisis that they helped foster. One of the reasons that cities face growing costs for using naloxone is that some companies marketing varieties of the drug have hiked up the price by as much as 500 percent.

More fundamentally, the drug epidemic is a symptom of the devastation produced by nearly forty years of social counterrevolution. Whatever the specific circumstances behind each individual tragedy, the crisis is the product of the unrelenting attack on social programs, wages, education and health care, combined with deindustrialization that has wiped out hundreds of thousands of jobs and produced levels of social inequality not seen since the 1920s.

Obama concluded his two terms in office declaring that “things have never been better” in the United States—a proclamation that applied to the ruling elite he served, but not to the great mass of the population. Now, under the Trump administration, the political establishment is engaged in a great “debate” over the future of health care, currently centered on just how much and in what way to destroy Medicaid, which funds at least eighty percent of drug abuse services.

The outcome of the new health care bill, whatever its form, will be nothing short of social murder. In this sense, Picard, the local Ohio official, is merely channeling the general outlook of the ruling class, for which the reduction in life expectancy is a basic strategic aim.

A health emergency on the scale of the drug epidemic requires an emergency response. The Socialist Equality Party insists that billions of dollars must be allocated to fund rehabilitation centers, using the most advanced scientific methods and procedures. The health care system must be equipped with detox centers and connected to institutions to help with long-term recovery. All social workers in the field must receive a decent wage and the counseling and support needed. Children must be given the highest level of care while their parents recover.

Such elementary measures and more must be connected to the reconstruction of society to ensure that everyone has the right to a high-paying job, health care, education and quality housing. Only in this way can the underlying causes of drug addiction be addressed.

None of these measures is possible without a frontal attack on wealth of the corporate and financial elite and its stranglehold on the entire economic and political system. As tens of thousands die, the ruling class conspires to spend trillions on war and conjure up new ways to amass ever greater fortunes.

The disease of which the drug epidemic is a symptom is the capitalist system. It can be cured only through the mobilization of the entire working class in the fight for socialism.

Genevieve Leigh

http://www.wsws.org/en/articles/2017/07/18/pers-j18.html

Trump rejects his poll numbers as fake news — but even his voters are starting to notice the scam

Even voters who bought into Trump’s reputation as tough-talking deal-maker are starting to glimpse the truth

Stressed and agitated about all the “fake news” about Russia and his son’s legal predicament, not to mention the ongoing train-wreck of his legislative agenda, Donald Trump decided to spend the weekend watching and tweeting about the U.S. Women’s Open tournament at his New Jersey golf club. It had to make him feel a little better, since the profits from these golf properties go into his own pocket.

According to this report from McClatchy’s Anita Kumar, Trump is unique in that respect even as a business owner, much less a president of the United States — who would normally be assumed to be too busy to make personal appearances for publicity at his profit-making businesses virtually every week.

Trump’s Twitter feed indicated he was having a nice time, at least until the Washington Post unveiled its new poll numbers:

The ABC/Washington Post Poll, even though almost 40% is not bad at this time, was just about the most inaccurate poll around election time

That was a nice try, but the poll showed that Trump is actually at a 36 percentapproval rating, which is the lowest rating of any president at this point in his presidency since Harry Truman. He is down six points from his 100-day mark; his disapproval rating is at 58 percent, with 48 percent “strongly disapproving” — levels never reached by Bill Clinton or Barack Obama and only reached in George W. Bush’s second term. He can tweet that it’s not bad all he wants, but it’s bad.

And it has to be mentioned that for all the right’s yammering about the election polls being wrong, they actually weren’t. The national average on the day before the election showed Hillary Clinton winning by a 3.5 percent margin, and she won the national popular vote by about 2 percent — easily within the margin of error. People were shocked on election night because they just couldn’t believe that he’d pulled off a weird inside straight in the electoral college, not because the polls had been rigged against him, which seems to be an article of faith among his faithful followers.

In any case, this poll shows that Trump is slipping badly with independent voters, 38 percent of whom approved of his leadership back in April. Only 32 percent are behind him now. Democrats aren’t even worth counting at 11 percent. Yes, Republicans are still in his corner for the most part: Eighty-four percent approved of him in April and 82 percent approve now. Experts suggest that a president is in real trouble when approval among his own party dips below 80 percent, and that hasn’t happened yet.

One of the most astonishing results in the poll regards the Russia scandal. Six in 10 Americans believe the Russian government tried to influence the election while 31 percent don’t think it happened and 9 percent are unsure. Sixty percent of the public believe it happened, and 67 percent of those people think the Trump campaign was complicit.

But here’s the weird number:

The number of Republicans and Republican-leaning independents who think that the Russians sought to influence the election, and that the Trump team intentionally helped them, has fallen from 18 percent in April to 9 percent now, indicating even stiffer GOP resistance to the idea. Among leaned Democrats it’s gone from 60 to 64 percent, not a significant shift.

The more Republicans hear about it, the less they believe it happened. And we aren’t just talking about Trump true believers. This is all Republicans, even ones who held their noses to voted for him. Considering the information we have, it would be fair to say “we don’t know what really happen,ed” but for Republicans to think there’s less evidence today than there was three months ago is bizarre.

Still, a majority of Americans (52 to 37 percent) think Trump is interfering in the investigation and 63 percent think Donald Trump Jr.’s meeting with someone he believed was from the Russian government, in hopes of collecting dirt on Hillary Clinton, was inappropriate. So there’s that.

While the Russia scandal may inform people’s views of Trump’s leadership, it’s his own behavior on the world stage that has 48 percent of the country believing that U.S. global leadership is weaker since Trump was inaugurated. Only 27 percent think it’s gotten stronger. That was supposed to be his big selling point — his unique talent for making deals with foreign leaders. But only a little over one-third trust Trump in any negotiations with foreign countries.

Fifty-five percent say that Trump is not making much progress on his goals, which is probably a relief to most of them, particularly when it comes to health care. That GOP bill continues to be about as popular as E. coli: Only 24 percent support it. More troubling for Trump and the GOP is that they’ve lost older voters and white women without college degrees on this issue. Older voters vote in midterm elections, and women without college degrees make up a large portion of the population that will be affected by the possible loss of health care. They might just vote in larger than usual numbers too.

A new NBC/Wall Street Journal poll will be released later this week, but they teased their results with one interesting observation: Trump’s base may finally be eroding a bit. They sampled voters in counties that either flipped from Obama in 2012 to Trump in 2016 or where Trump did much better than Mitt Romney, and found that Trump’s support is slipping.

In those counties where Trump did much better than Romney, he beat Hillary Clinton by a combined 65 to 29 percent. Today he’s down to 56 percent approval. In the counties that flipped to Trump from Obama, the president’s approval rating is just 44 percent. He won those overall with 51 percent last November.

All of these numbers are dismal for the president. The big question is the reasoning behind it. Gallup has some answers. It’s not so much that people disagree on issues, which isn’t all that surprising since Trump is all over the map on those. Sixty-five percent of people who disapprove of his performance in office say it’s because of his character, personality and competency, specifically criticizing his bad temperament, arrogance, obnoxiousness, lack of experience, selfishness, racism and sexism, lack of knowledge, wishy-washiness and use of social media.

Certainly one can assume that Democrats, at least, are hostile to Trump’s stands on issues as well, but because of his bad character and incompetence they don’t feel that anything he says on the issues one way or the other is trustworthy. That’s his problem: Donald Trump is demonstrating his unfitness for the job, right out there for everyone to see, every single day.

Heather Digby Parton, also known as “Digby,” is a contributing writer to Salon. She was the winner of the 2014 Hillman Prize for Opinion and Analysis Journalism.