How to sell single payer health care: It’s a great policy, but has a huge political drawback

Workers are not going to want to see employer-provided benefits disappear right as their taxes go up

The very public battle over Trumpcare — which seems like it may, fingers crossed, be collapsing due to the public rejecting the ejection of millions of people from the health care system — seems to have had the side benefit of increasing public interest in the idea of a single payer government-run health insurance system. Polling shows that anywhere from 33 percent to 44 percent to 58 percent of voters back the idea of single payer, and in blue states that theoretically have the tax base to pull off statewide system — such as New York or California — single payer likely could garner more support.

And yet one of the bluest of states, California, has once again failed to get a single payer bill off the ground, in no small part because it was, as David Dayen at the Intercept argued, “a shell bill that cannot become law without a ballot measure approved by voters.”

Dayen blames single payer proponents for not “committing to raising the millions of dollars that would be needed to overcome special interests and pass that initiative”and accuses them of “hiding the realities of California’s woeful political structure in favor of a morality play designed to advance careers and aggrandize power.”

When one looks at the players involved, it’s hard to deny Dayen’s accusation. But it’s also worth pointing out that single payer, as it’s currently constructed, faces a major political obstacle that even a lot of electoral hustle may not be able to overcome: People really do not want to see their taxes raised to pay for it. Proponents of single payer aren’t doing enough to address that objection.

The good news is that there are ways to address these voter concerns. The first step, however, is admitting that tax raises are a real problem.

Polling data shows this. The majority of California residents, 65 percent, say they want a single payer system, but that level of support drops to 42 percent if it will require a tax raise.

Proponents of single payer tend to counter this objection by pointing out that these taxes will replace spending on private health insurance and would reduce health care spending overall. That is true in a macroeconomic sense, but it fails to take into consideration that the majority of people below Medicare eligibility age get their health insurance through their employers.

The perception is going to be, like it or not, that single payer is shifting the responsibility for paying for health insurance off of employers and onto the shoulders of workers. People aren’t going to care about reduced health care costs if they think their bosses reap the bulk of the savings.

Why that gets so frequently overlooked, I have no idea. Otherwise, progressives seem to grasp that squeezing the workers while letting the bosses off the hook tends not to go down well with voters. The problem might be that there’s been a longing for single payer for so long in progressive circles that any objections are written off as neoliberal corporatist nonsense — a theory I suspect much of the response to this article will prove.

But if one accepts that this is a problem, then there’s all sorts of creative ways to address it. One way is to dispense with single payer bills and instead have states offer a Medicaid buy-in that employers can access, with the hopes that the lowered costs will allow Medicaid to eventually conquer the market. Or perhaps payroll taxes are structured so that employers pay a larger chunk, so workers don’t feel the pinch.

I say it’s time to get freaky with it. My proposal: Write the bill so that it requires employers to compensate their employees who lose their health care benefits with a raise in their paycheck. Then the plan could be marketed as “health care for all, plus a raise at work.” Higher taxes go down easier if you’re getting a raise to cover them.

The best part is that this could be a win/win situation. One of the bigger problems facing employers is that insurance premiums are rising while the value of what they get for it is not improving. Giving the money to employees directly in cash would actually be cheaper in the long run because employers would be escaping that inflation pressure. Employees see more money in their paychecks while the per-employee costs for the employer don’t rise as fast.

Ideally the raise would be one that’s equivalent to what the employer pays annually to the insurance company to cover that employee’s health care plan, but that could be negotiable depending on how much the employer will be on the hook for in higher payroll taxes. The details are less important here than sending the message to voters that single payer is not about shifting the health care burden away from employers to employees.

This is just one idea, of course. There may be — probably are! — other ways to deal with this political problem that make more sense economically. The main issue here is that the larger economic savings of single payer sound great in the abstract, but will be hard to sell if voters don’t feel that they personally are seeing those savings in their checking accounts. As long as single payer proponents fail to address that political problem, there’s very little chance of getting a single payer bill off the ground.

Amanda Marcotte is a politics writer for Salon. She’s on Twitter @AmandaMarcotte

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.

Latest Republican health care tactic: A sneak attack on people with pre-existing conditions

In the fine print, GOP bill guts coverage of “essential health care benefits,” with devastating consequences

It’s becoming clear that Senate Majority Leader Mitch McConnell’s plan to decimate the American health care system is to tinker around the edges of his bill until, as Charles Pierce of Esquire argued, “you get a CBO score you can plausibly use to con the country, the elite political press, and the mind of Susan Collins into thinking you’re ‘moderating’ the bill.” McConnell is counting on the fact that the press is easily bored and always eager to move onto the next new thing — often meaning whatever President Trump has just said on Twitter — and all he needs is a week of such distractions to pass this stinker under the cover of darkness.

But don’t let the tinkering or assurances that the health care bill is somehow becoming more moderate fool you. Republicans still plan on passing a bill that will lay waste to the protections offered ordinary Americans in the Affordable Care Act, leaving people vulnerable to financial ruin or even death from illnesses or conditions that are covered under existing law.

One of the ways Republicans plan to do this is to gut the part of the Affordable Care Act that guarantees coverage of what are deemed “essential health care benefits.” That sounds like a minor bureaucratic adjustment, but in reality it’s a back-door way to deny coverage to people with pre-existing conditions, limit important and life-saving health services, and force people with expensive conditions to go bankrupt rather than rely on insurance to cover them.

The essential benefits that the Affordable Care Act delineated include 10 categories of care that every insurance plan has to cover. Some of these categories are straightforward things that most insurance plans, whether purchased on the individual market or provided by employers, already covered, such as hospitalization or doctor’s visits. But, as Timothy Jost, a professor at the Washington and Lee University School of Law and an expert on health care law, explained in an interview, prior to the passage of the Affordable Care Act many individually purchased plans skipped major categories of coverage.

“What they didn’t cover was maternity care, mental health and substance use disorder care — and often prescription drug coverage was quite limited,” Jost said. “The ACA also added habilitation care for special needs children.”

Under various versions of the Republican plan, states would be able to apply for waivers to exempt plans sold in their state from this mandated list of essential health care benefits. Republicans have repeatedly insisted that their bill bars discrimination against patients with pre-existing conditions. But as Jost explained, ending essential health care benefits creates a mechanism that allows insurance companies to deny coverage of those pre-existing conditions. You’d be allowed to buy insurance, but it might not pay for the things you really need it for.

“So you got a mental health problem, sorry, we’re happy to insure you, but we don’t cover mental health problems,” Jost said, describing the logic. “You’ve got cancer? We’re happy to insure you. We don’t cover any chemotherapy drugs or we don’t cover radiation therapy.”

Presumably, the reason Republicans want to cut essential health benefits is to lower premiums — which is why we get to hear Republican politicians making cracks about how men don’t need maternity care — but Jost said he believes the mandatory benefits “are really a very small part of the total cost of coverage.”

For instance, as Jost has argued on the Health Affairs blog, ending mandatory maternity coverage “might lower premiums by $8 to $14 per month,” but would force women who are giving birth to pay as much as $30,000 to $50,000 in out-of-pocket expenses.

Most of these effects would be felt by people who buy insurance on the individual market, or who work for small companies employers that offer less expensive plans with skimpier coverage. As Matthew Fiedler, a fellow with the Center for Health Policy in the Brookings Institution’s Economic Studies Program, explained, there’s a poison pill buried in the bill that would also affect people who work for large employers that offer more generous health insurance packages. Repealing mandatory essential health care benefits would mean reintroducing lifetime limits or annual coverage caps for many people on those plans. Which means that a lot of people who thought they had generous, comprehensive insurance plans could still face bankruptcy in the event of a serious illness or accident.

Under the ACA, Fiedler explained, “Insurers can’t put lifetime or annual limits on types of care that are considered essential health benefits. But they can put lifetime or annual limits on things that aren’t essential health benefits. What that means is that when the definition of essential health benefits changes, that can substantially change the scope of the protection against annual or lifetime limits.”

Even if you live in a state that sticks with the old Affordable Care Act definition of essential health benefits, you may not be protected if you work for a large employer, defined as any company or entity with 50 or more employees. That’s because, according to Fielder, a large employer can choose any state’s definition of “essential health benefits.” It doesn’t have to stick to the state where it does most of its business, or where its employees actually live.

“Employers could choose a state that had implemented a very lax definition of essential health benefits and thereby have fairly broad latitude to impose these kinds of limits,” he explained.

So a worker in a state like California or Massachusetts, which is likely to continue to protect essential health care benefits, might find that her employer has instead chosen define essential health care benefits under the terms set by Texas or Mississippi. So while that person’s policy might still cover cancer treatments or maternity care or mental health services, she might find out that in practice her insurance company will not cover nearly as much of the cost as it would have under the ACA.

Because of the ban on lifetime and annual limits, the cap on out-of-pocket spending for patients, and the ban on discrimination based on pre-existing conditions, the Affordable Care Act was able to cut the number of personal bankruptcy filings in the United States by half between 2010 and 2016. By drafting a way for states to opt out of the essential health care benefits mandate, the Republican bill will potentially allow insurance companies to dump those costs back onto the consumer. The number of medical-related bankruptcies could well soar back to pre-Obama levels — if Mitch McConnell can find a moment when we stop paying attention and ram this bill through the Senate.

Amanda Marcotte is a politics writer for Salon. She’s on Twitter @AmandaMarcotte

Understanding Republican Cruelty

The Senate majority leader, Mitch McConnell, is having a hard time selling his health insurance plan.Credit Eric Thayer for The New York Times

The basics of Republican health legislation, which haven’t changed much in different iterations of Trumpcare, are easy to describe: Take health insurance away from tens of millions, make it much worse and far more expensive for millions more, and use the money thus saved to cut taxes on the wealthy.

Donald Trump may not get this — reporting by The Times and others, combined with his own tweets, suggests that he has no idea what’s in his party’s legislation. But everyone in Congress understands what it’s all about.

The puzzle — and it is a puzzle, even for those who have long since concluded that something is terribly wrong with the modern G.O.P. — is why the party is pushing this harsh, morally indefensible agenda.

Think about it. Losing health coverage is a nightmare, especially if you’re older, have health problems and/or lack the financial resources to cope if illness strikes. And since Americans with those characteristics are precisely the people this legislation effectively targets, tens of millions would soon find themselves living this nightmare.

Meanwhile, taxes that fall mainly on a tiny, wealthy minority would be reduced or eliminated. These cuts would be big in dollar terms, but because the rich are already so rich, the savings would make very little difference to their lives.

More than 40 percent of the Senate bill’s tax cuts would go to people with annual incomes over $1 million — but even these lucky few would see their after-tax income rise only by a barely noticeable 2 percent.

So it’s vast suffering — including, according to the best estimates, around 200,000 preventable deaths — imposed on many of our fellow citizens in order to give a handful of wealthy people what amounts to some extra pocket change. And the public hates the idea: Polling shows overwhelming popular opposition, even though many voters don’t realize just how cruel the bill really is. For example, only a minority of voters are aware of the plan to make savage cuts to Medicaid.

In fact, my guess is that the bill has low approval even among those who would get a significant tax cut. Warren Buffett has denounced the Senate bill as the “Relief for the Rich Act,” and he’s surely not the only billionaire who feels that way.

Which brings me back to my question: Why would anyone want to do this?

I won’t pretend to have a full answer, but I think there are two big drivers — actually, two big lies — behind Republican cruelty on health care and beyond.

First, the evils of the G.O.P. plan are the flip side of the virtues of Obamacare. Because Republicans spent almost the entire Obama administration railing against the imaginary horrors of the Affordable Care Act — death panels! — repealing Obamacare was bound to be their first priority.

Once the prospect of repeal became real, however, Republicans had to face the fact that Obamacare, far from being the failure they portrayed, has done what it was supposed to do: It used higher taxes on the rich to pay for a vast expansion of health coverage. Correspondingly, trying to reverse the A.C.A. means taking away health care from people who desperately need it in order to cut taxes on the rich.

So one way to understand this ugly health plan is that Republicans, through their political opportunism and dishonesty, boxed themselves into a position that makes them seem cruel and immoral — because they are.

Yet that’s surely not the whole story, because Obamacare isn’t the only social insurance program that does great good yet faces incessant right-wing attack. Food stamps, unemployment insurance, disability benefits all get the same treatment. Why?

As with Obamacare, this story began with a politically convenient lie — the pretense, going all the way back to Ronald Reagan, that social safety net programs just reward lazy people who don’t want to work. And we all know which people in particular were supposed to be on the take.

Now, this was never true, and in an era of rising inequality and declining traditional industries, some of the biggest beneficiaries of these safety net programs are members of the Trump-supporting white working class. But the modern G.O.P. basically consists of career apparatchiks who live in an intellectual bubble, and those Reagan-era stereotypes still dominate their picture of struggling Americans.

Or to put it another way, Republicans start from a sort of baseline of cruelty toward the less fortunate, of hostility toward anything that protects families against catastrophe.

In this sense there’s nothing new about their health plan. What it does — punish the poor and working class, cut taxes on the rich — is what every major G.O.P. policy proposal does. The only difference is that this time it’s all out in the open.

So what will happen to this monstrous bill? I have no idea. Whether it passes or not, however, remember this moment. For this is what modern Republicans do; this is who they are.

The Democrats’ fraudulent opposition to Trumpcare

By Kate Randall
21 June 2017

Senate Republicans are working feverishly to pass their version of a bill to “repeal and replace” the Affordable Care Act (ACA), having set themselves an arbitrary deadline of securing its passage before the July 4 congressional recess. Early last month, House Republicans passed the American Health Care Act (AHCA), celebrating in the White House Rose Garden with President Trump, who said of the bill, “It’s a great plan, and I believe it’s going to get better.”

A group of 13 Republicans senators is working behind closed doors on the Senate version of the legislation. Senate Majority Leader Mitch McConnell plans to push the legislation—which concerns one-sixth of the US economy, and which will affect the health and lives of tens of millions of Americans—with no committee hearings, no public mark-up (drafting and editing) of the bill, and only limited debate.

It is no secret that the clandestine nature of the Senate “working group’s” negotiations is due to the AHCA’s wide unpopularity, with a recent poll showing that only 20 percent of Americans approve of it while 57 percent disapprove. The broad opposition is due to its draconian features, particularly the gutting of Medicaid, the social insurance program for the poor jointly funded by the federal government and the states. The AHCA would effectively end Medicaid as a guaranteed benefit based on need by placing a per-capita cap on overall spending.

The AHCA would slash $824 billion from Medicaid and would end the ACA’s expansion of Medicaid to low-income adults, causing 14 million newly insured people to lose their benefits over a decade. All told, the Congressional Budget Office estimates that 23 million people would become uninsured in 10 years under the AHCA. At the same time, the bill would slash taxes for corporations and wealthy individuals, while boosting the already multibillion-dollar profits of the health care industry.

McConnell has an additional reason for secrecy, since any divisions within the Republican caucus threaten passage of the bill, and concessions made to far-right senators like Ted Cruz and Rand Paul could provoke opposition from a group of “moderates” from states with large Medicaid populations, and vice versa.

Under the “reconciliation” process chosen for the health care legislation, the Republican leadership can push through the bill despite holding only a narrow 52-48 majority, providing they lose no more than two Republicans, with Vice President Mike Pence casting a tie-breaking vote.

Senate Democrats profess outrage over the closed-door nature of the Republicans’ deliberations. They staged a talk-a-thon on the Senate floor Monday night, stalling chamber proceedings through a series of parliamentary maneuvers. A few senators live-streamed their “search” for the elusive legislation, driving around the capital. All of these stunts amount to so much hot air. The Democrats are incapable of mounting a true opposition to the Republicans’ vicious assault on the health care of ordinary Americans because they share their class objectives.

Numerous media commentaries have pointed to the Democrats’ “powerless” position to oppose the Republicans’ plan, due to the Republicans’ 52-48 Senate majority. This is only valid in terms of parliamentary arithmetic: the vast majority of the American people oppose the House bill and will oppose the Senate bill once they learn its provisions. But the Democratic Party is unwilling and unable to mobilize this popular opposition.

Every Senate Democrat, including so-called independent and self-professed “democratic socialist” Bernie Sanders, portrays Obamacare as a progressive social reform, or at least a “step in the right direction,” concealing the reactionary and anti-working-class character of the Affordable Care Act.

Obamacare was aimed from the start at cutting costs for the government and corporations while rationing health care for the vast majority. In that sense, the Republicans have invented nothing new. Whatever version of “Trumpcare” eventually passes the Senate will only take the tendencies already present in Obamacare and make them worse: imposing more and more of the cost of health care on individual workers and their families.

The logic of this process, under both Democrats and Republicans, is the development of an openly two-class health care system: the best health care money can buy for the super-rich and a privileged upper-middle-class layer; and for the vast majority of the population, a cut-rate system, starved for funds and personnel, offering inadequate and overpriced care, if any at all.

In response to Trump and the Republicans’ howls that the ACA is “failing” and “imploding”—through rising premiums and deductibles and dwindling networks of insurers—the Democrats beg for a seat at the table to “fix” Obamacare. This is a euphemism for making further concessions to the demands of the insurance companies and other corporate interests by further restricting subsidies for low-income purchasers of insurance plans, cutting business taxes and implementing other regressive measures.

Any health care overhaul hatched in Washington will be based on the for-profit health care system, enriching the insurance companies, drug companies, hospital chains and medical device companies and the CEOs that run them.

Looking beyond the Democrats’ bluster, working people need to actually take stock of what is at stake in the Republicans’ plan. The most fundamental attack is the gutting of Medicaid, one of the last social reforms wrested from the ruling elite through working-class struggle. While limited in nature, Medicaid guaranteed the right to health insurance and medical services for the poor and for children and disabled people, and provided funding for nursing care for the elderly based on need. Medicaid emerged as part of the “Great Society” and “War on Poverty” under the Johnson administration, alongside landmark legislation such as the Civil Rights Act and the Food Stamp Act, both in 1964, and the Voting Rights Act of 1965.

The assault on health care exemplified by the Republicans’ reactionary legislation is of a piece with the ruling elite’s attack on all the social rights of the working class—the right to a job, education, decent housing, a secure retirement, access to the arts and culture, and a healthy and safe environment.

Congressional Democrats have chosen to oppose the Trump administration not over the destruction of social conditions, but over Trump’s alleged “softness” toward Russia. They are working in alliance with the dominant factions of the intelligence apparatus to whip up a war fever against Russia in an attempt to condition the public for an escalation of the wars in the Middle East as well as a military confrontation with Iran and nuclear-armed Russia. Incapable of opposing the most reactionary presidency in US history on anything resembling a progressive or democratic basis, they have positioned themselves to the right of Trump on issues of imperialist foreign policy.

Whatever form it takes, the health care legislation that the Republicans are able to pass through Congress and place on the president’s desk to sign will be one of the most reactionary pieces of legislation in modern history. The ruling elite sees the attack on Medicaid as the first shot in their war on Medicare and Social Security and wants to see all of these social programs privatized or ended outright. In the final analysis, both big-business parties agree that health care must be limited to what is compatible with the profit interests of corporate America.

The working class must fight for its own class interests. The crisis in health care requires a socialist solution, which takes as its point of departure the needs of working people and society as a whole, not the wealth and profits of a tiny minority.

The establishment of a system of universal, free health care for all requires placing the entire health care system—the private insurers, pharmaceuticals, giant health care chains—under public ownership, managed democratically to serve human needs, not profit. Such a fight requires the mobilization of the working class as a revolutionary force, independent of and opposed to both the Democratic and Republican parties.

http://www.wsws.org/en/articles/2017/06/21/medi-j21.html

Will the Democrats ever stand for something?

If Democratic Party leaders want to be an alternative to the Republicans, they sure have a funny way of showing it, writes Elizabeth Schulte.

Clockwise from top left: Nancy Pelosi, Hillary Clinton and Chuck Schumer

Clockwise from top left: Nancy Pelosi, Hillary Clinton and Chuck Schumer

HILLARY CLINTON resurfaced last month from her long post-election hibernation with a message: “I’m back to being an active citizen–and part of the resistance.”

And just so everybody knows, if it hadn’t been for Russian hackers and FBI Director James Comey bringing up her e-mails, “I’d be your president,” she told CNN’s Christiane Amanpour.

Considering the crisis of the Trump administration right now, the Democrats’ claims about Russian meddling in the election look more believable than before. But as for this losing the election for Clinton, it’s a lot more complicated than that.

And as for Hillary Clinton being part of a “resistance,” well…come on now.

All the Russian meddling in the world wouldn’t change the fact that core supporters of the Democratic Party didn’t turn out for Clinton because she represented everything they didn’t like about Washington politics–a devoted servant of Corporate America and the political establishment’s status quo.

So even though she won the popular vote by nearly 3 million, Clinton let Donald Trump, the anti-immigrant, misogynist, Islamophobic billionaire, get close enough to steal an Electoral College victory because the Democrats offered so little for voters to turn out for.

– – – – – – – – – – – – – – – –

DESPITE THIS, the Democratic Party–which ought to be in a good position to challenge a politician as unpopular as Trump–is still debating what it should do next. Some party leaders are concluding this isn’t time to lead, but time to start compromising on key issues.

Issues like abortion.

In April, the Democratic National Committee (DNC) threw its support behind Omaha mayoral candidate Heath Mello, a self-described “pro-life” Democrat.

After a storm of criticism from pro-choice forces, including NARAL Pro-Choice America, DNC Chair Tom Perez–who appeared on a stage with Mello alongside Vermont Sen. Bernie Sanders–was forced to publicly reaffirm the party’s support for women’s right to choose.

But some Democrats didn’t get the memo.

House Minority Leader Nancy Pelosi made sure instead to emphasize that, yes, the party welcomes anti-choice Democrats. “It’s kind of fading as an issue,” Pelosi told the Washington Post. “It really is.” Pelosi advised Democrats to concentrate more on the issues that affect “working families.”

Of course, abortion isn’t a fading issue–the Republicans have made sure of that by successfully restricting women’s access to abortion services in dozens of states.

Furthermore, characterizing reproductive rights as an issue that “working families” don’t care about–in a country where one in three women have an abortion, many likely in “working families”–is out of step with reality.

Support for abortion rights is one of the main issues that at least rhetorically distinguished the Democrats from the Republicans, and now at a time when it’s so important to take a side, party leaders are discussing whether it might alienate voters they want to attract.

“You know what?” Pelosi said to the Post. “That’s why Donald Trump is president of the United States–the evangelicals and the Catholics, anti-marriage equality, anti-choice. That’s how he got to be president. Everything was trumped, literally and figuratively, by that.”

– – – – – – – – – – – – – – – –

SO UNDERLYING this dispute about whether abortion is a Democratic issue is another discussion about what the party has to do to win over the audience of people who were attracted by Trump’s populist campaign rhetoric in 2016. Leading party figures are opting to downplay so-called “social” issues, like abortion, racism or LGBTQ rights, in favor of “economic” issues.

This warped view of who workers are–the workforce is disproportionately female, people of color and LGBTQ people–and what their concerns include reveals how out-of-touch Democrats are with the people who vote for them. It’s also the case that even by these wrongheaded standards, the Democrats’ populist economic rhetoric is no better in practice for working people than Trump’s.

The fight over health care is an excellent example. In May, House Republicans went after the Obama administration’s Affordable Care Act (ACA), voting for a plan that would eliminate some of the few positive aspects of Obamacare, such as the expansion of Medicaid and a guarantee of coverage for people with pre-existing conditions.

And what was the reaction from Democrats? Something close to rapture. The party that claims to stand for working people stood by and watched as Republicans shredded the ACA in the hopes that this would fatally damage the Republicans with voters.

While most human beings reacted with shock and outrage, Democratic leaders celebrated the fact that the Republicans’ nightmare might help them win a victory in 2018 congressional elections. Democratic strategist Caitlin Legacki summed up the strategy to the New York Times: “Our best shot at stopping the Republicans has always been to let them cannibalize themselves, and this proved that.”

Meanwhile, as Democrats cheered on the Republicans’ passage of Trumpcare, real people with real health care needs face the daily threat of not being able to afford to get well.

Trumpcare is highly unpopular–only 17 percent of the population said it supports repealing and replacing Obamacare with the Republican plan, according to a Quinnipiac Poll. But there is growing frustration with Obamacare, too.

Obama’s health care plan may have included some important reforms, but it also kept in place the worst aspects of for-profit health care, and the result was that insurance became even more expensive for workers.

When Trump and the Republicans threatened to make health care even more inaccessible, they gave Obamacare and the Democrats a lifeline, at least as far as public opinion is concerned. In this context, many people felt they had no choice but to defend the lesser-poison status quo of Obamacare.

Democratic politicians are making similar political calculations when it comes to protecting immigrants under attack from Trump’s new amped-up deportation regime.

In April, as state lawmakers debated making California a “sanctuary state” to stand up to Attorney General Jeff Sessions’ threat to cut off federal funding to states that didn’t cooperate with ICE and immigration enforcement, some Democrats were cautioning against going too far.

“It may feel good to take certain actions, but that could result in real hurt on the ground,” Los Angeles Mayor Eric Garcetti told the New York Times. “My responsibility is to make sure that I bring resources back to my city that come from tax dollars we send to Washington.”

“The civil rights movement was not won by calling Bull Connor a racist,” Garcetti said. “He was a racist. But it was won by saying we should be at that lunch counter.”

Garcetti is forgetting the most important thing that happened at those lunch counters: protest.

– – – – – – – – – – – – – – – –

IF GARCETTI’S strategy of concede and retreat sounds familiar, that’s because it is. The Democrats used the same strategy during Election 2016–when they nominated Hillary Clinton, the status quo candidate with a history of serving wealth and power, as the candidate they were sure would win easily against Trump.

The party behind Clinton’s “campaign of militant complacency,” as author Thomas Frank put it, never even considered that the people who actually vote might be dissatisfied with the status quo she embraced.

In other words, at a time when many people are looking for more radical solutions, the mainstream Democrats are offering something that’s even further to the right of what already exists. And since they won’t actually stand for something, they continue to fall back on the fact that Trump and the Republicans are just worse.

This reality will lead even the best activists–people who care about changing the world a thousand times more than Nancy Pelosi–to conclude that the most important thing we have to do in the next year is get more Democrats into office, no matter what the compromise.

Thus, Bernie Sanders, who himself is staunchly pro-choice, reached the same conclusion as Pelosi that not every Democrat has to be pro-choice to get his support.

The Democratic Socialists of America unfortunately succumbed to this pressure too when it issued a statement in response to Sanders’ support for Heath Mello in Omaha that refused to take a stand and instead advised its members to “trust our grassroots.”

But trusting the grassroots means taking a stand for its political concerns.

It goes without saying that Hillary Clinton isn’t part of any “resistance.” There is, however, a resistance being built. It had its beginnings before the 2016 election, but having Donald Trump in the White House has led more people to think about that we need to get ourselves organized.

Many people will look to the Democratic Party to take the lead in the anti-Trump opposition, but the Democrats haven’t yet, and show no signs at all of doing so. We have to take part in grassroots organizing that stands up to the attacks of both Republicans and Democrats–and that offers an alternative to the status quo Washington politics we’re expected to accept.

 

https://socialistworker.org/2017/06/01/will-the-democrats-ever-stand-for-something

Paul Krugman: Under Trumpcare, millions will lose coverage, many will die

 — and the GOP will try to blame it on liberals

A moral disaster is under way

Paul Krugman: Under Trumpcare, millions will lose coverage, many will die — and the GOP will try to blame it on liberals
(Credit: Getty/Mark Wilson)

AlterNet

“Every word,” Paul Krugman writes in Monday’s column, of the disastrous American Healthcare Act, “is a lie, including ‘a,’ ‘and’ and ‘the’.”

Sure, politicians aren’t exactly revered for their truth-telling abilities, and Congress has passed cruel and unjust laws, even lied about exactly how cruel and unjust, but rarely has there been a law like Trumpcare, which Krugman calls “a miserably designed law, full of unintended consequences… a moral disaster, snatching health care from tens of millions mainly to give the very wealthy a near-trillion-dollar tax cut.”

Instead of spending the last seven years coming up with a credible replacement for Obamacare, Republicans used that time to craft a series of lies. They claimed Obamacare was rushed through without debate (there were multiple committee hearings, markups and a CBO score, all of which the AHCA was missing). They claimed “Deductibles were too high…so were premiums. They promised to bring these costs down, to provide, as Donald Trump insisted he would, coverage that was ‘much less expensive and much better.’”

They also promised to keep the parts of the law everyone liked (conveniently without admitting that these provisions were due to Obamacare in the first place): no one would lose Medicaid or be denied coverage for pre-existing conditions.

In a feat of doublespeak not even Orwell could have seen coming, Krugman reveals the opposite of all of those points is true:

Deductibles will rise, not fall, as insurers are set free to offer lower-quality coverage. Premiums may fall for a handful of young, healthy, affluent people, but will rise and in many cases soar for those who are older (because age spreads will rise), sicker (because protection against discrimination based on medical history will be taken away), and poorer (because subsidies will go down).

And about those pre-existing conditions? Let’s hope you’ve never had so much as a cold, because for many Americans, coverage will either be unavailable entirely or so prohibitively expensive, it might as well not exist. Despite Trump’s frequent campaign promises, Medicaid too will be cut. But who cares about the working poor when there are tax cuts for the rich to be had?

After all, as Krugman reminds us, “according to independent estimates of an earlier version of Trumpcare — people with incomes over $1 million would save an average of more than $50,000 a year.” We must never lose sight of the fact that “there is a powerful faction within the G.O.P. for whom cutting taxes on the rich is more or less the only thing that matters.”

Perhaps the worst part of this whole charade is that the people who trusted Trump the most, the white working class that the mainstream media fetishizes, are the ones who stand to lose the most. And when it goes wrong, when the base loses its benefits and people can’t go to the doctor and are in danger of dying, the GOP will find a way to blame it on liberals.

Krugman leaves us with a warning, one that those who think this will be an easy win for 2018 would do well to heed: “What just happened on health care shouldn’t be treated as just another case of cynical political deal making. This was a Freedom is Slavery, Ignorance is Strength moment. And it may be the shape of things to come.”

 

 

http://www.salon.com/2017/05/08/paul-krugman-under-trumpcare-millions-will-lose-coverage-many-will-die-and-the-gop-will-try-to-blame-it-on-liberals_partner/?source=newsletter