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7/30/2012

LAME

My gout is acting up, so I guess I’m obsessed at the moment with the word “lame.”  Of course the New World dictionary defines it, suited to my present condition, as “crippled, disabled, esp. having an injured leg or foot that makes one limp.”  But, it’s another definition that gives me pause to reflect on the presumptive Republican candidate for President:  “weak, unconvincing, ineffectual, etc.”

Mitt is flying around right now trying to convince the world that he is not any of those things.  First, he goes to England, then Israel and then Poland.  He’s so ineffectual, that he can’t even get out of England without insulting our favored ally by implying that they aren’t quite ready for prime time Olympics, especially related to security.  Just what we need in a Commander-in-Chief: someone so ineffectual and unprepared for big-time diplomacy that he insults the citizenry, and a major government.  England was supposed to be something of a triumph for a former leader of the 2002 Olympics.  Bloody unlikely, as my English relatives might say!

Romney’s itinerary should make us all wonder if he has any intention of addressing any real foreign policy issues.  Oh yes, I know, Israel presents real foreign policy concerns, but what can Romney do about any of that, considering the fact that he holds no office, and is without power to negotiate.  He just wants to cozy up to Bebe Netanyahu and make it look as though he is a friend of Israel.  Unconvincing and ineffectual come to mind again, as he can do no more than declare his loyalty to Israel and Israel’s position in the Middle East, which he has now done. 

Basically, he has indicated that Israel should not be criticized for taking actions which protect its position and sovereignty.  In particular, he has made it quite plain that a Romney administration would support bellicose actions taken by Israel against Iran to prevent the construction of a nuclear weapon.  He has also indicated that Jerusalem should be considered the capital of Israel and that were he President, he would work with the Israeli government  to move the US Embassy from Tel Aviv to Jerusalem.  That would certainly lead to dire consequences as concerns the Palestinians, who claim part of that city for themselves.  His bellicose talk about Iran is not what is needed, and gives little hope that a Republican administration would try very hard to avoid a war with that country.

By these simple statements, Romney has indicated clearly that he has little understanding of the issues, but that he puts ideology in place of the primary tool of diplomacy.  Under the lame Mitt, we should expect another war, Palestinian animosity and rebellion, and a Middle East that is in turmoil of his administration’s own making.

And there’s the rub.  It is the other countries of the Middle East that must be convinced to, at the very least, be at peace with Israel, and to pursue whatever legitimate forms of government will provide a voice for the people of those countries in their quest for democratic change, and their desire for success and well-being.  Romney is simply in the wrong place.  He could have gone to Damascus if he really wanted to make a splash.  He could have added his admonition to that of the administration and said straight to Assad that it is time to step aside so that the tide of change can prevail. 

Why should Romney go there if Obama hasn’t?  Well, Obama has the creds he needs to get that message across.  He doesn’t have to go there, personally.  Obama has already demonstrated his strength and power in Libya, and Assad is not immune from that knowledge.  He has sent his foreign minister, the Secretary of State, to tell Assad to step down.  He has already demonstrated his resolve to bring to justice those who abuse the people of the Middle East and those of other countries, in bringing down Bin Laden and a growing number of his cadre of murderers.  Ours is not an ineffectual President when it comes to the Middle East.  Let us not fail to remember that President Obama has also led the way in putting Iran in a negative position, with countries turned against them, hard sanctions in place, and the UN and Arab nations strongly behind these attempts to keep Iran in line.  But Romney?  Well, here again the lame man of Bain is entirely ineffectual, not knowing what to do about Iran except perhaps to go to war. 

Let’s take a moment with that last thought: War.  Romney would have kept US troops in Iraq.  Romney wants the generals to decide if the war in Afghanistan should go on and on.  He doesn’t have a plan, nor an opinion, nor a position as regards what has torn this nation’s budget apart, along with tax cuts for the rich and the on-going expense of Bush’s war in Afghanistan.  He doesn’t even know whether a plan for withdrawal is appropriate.  Obama knows what he wants to do; has put plans in place for Iran, Iraq, Afghanistan, Libya, and now Syria. 

Romney, on top of all this in the Middle East, wants to get us into a trade war with China.  That’s terribly comforting.  On his first day in the Oval Office (God forbid), Romney will direct his Department of Commerce to assess countervailing duties on Chinese imports, just after he has his Department of the Treasury list China as a “currency manipulator”, which should scare the pants right off them!  Ineffectual -- you bet!.  Romney says: “We need a fresh and fearless approach to that trade relationship.”   One of his solutions is to keep counterfeit goods out of our country, and enforce intellectual property protections that we already have in place.  Strange that the best he can do is enforcement of protections “already in place.”  Too bad he has no original ideas of his own to offer. 

Well, on to Poland where he landed today.  Will he be able to get through this part of his trip without alienating some important group in that country?  I don’t know, but if he talks at all about his opposition to labor unions, watch out!  Come home soon Mr. Bain Brain; you’ve done enough damage overseas!  We need you to come forth with more of your troublesome domestic policy statements.  And, by the way, did you ever get to visit your off-shore financial accounts or any of the companies you helped move overseas?  We’re still waiting for those tax returns to be released so we can see just what you are hiding from the public. 

7/22/2012

Where Does All the Outrage Go?

No person needs a semi-automatic gun.  Bar minors from possessing assault weapons.  No guns should be sold without background checks.  Guns should not be sold at gun shows.  Explosives should not be available to anyone without a commercial license for their use.  High-capacity ammunition magazines (more than 10-rounds) are not needed by ordinary citizens.   Make it a crime to distribute bomb-making information for criminal purposes.  Gun permits should be as difficult to obtain as are driver licenses; a user’s test should be involved.  These are all reasonable restrictions on the unadulterated freedoms that the NRA supports.  What the NRA advocates is anarchy, not freedom. 

The second amendment is not an excuse to be irrational and nonsensical.  Every right given to the people has attached to it, as a matter of common sense, some sort of restriction that exists in the end to protect those rights.  If rights have no restrictions accompanying them, there is the possibility of anarchy destroying the very rights that are available.  Thus, one cannot falsely yell “fire” in a crowded theater, for that act of speech  contains within it, not only the seeds of destruction of the right to free speech, but of life itself which is the ultimate right and responsibility of us all.  We cannot allow a right to free speech to override the right to life.  Dare we say it?  The right to own a gun is not as important as the protection and enhancement of life -- all life, not just life in the womb.

Little discussed, and perhaps little known, is the fact that Americans have regulated guns since our nation’s earliest days. According to an article in the Washington Post, even the founding fathers had strict laws that today’s National Rifle Association would never accept. James Madison, the author of the Second Amendment, and his generation restricted the possession of guns by political dissenters and racial minorities.  Through militia laws they also required people to appear at musters where their guns would be inspected by government officials and registered on public rolls.  To the founders, the Second Amendment was not a libertarian license for anyone to have any gun, anywhere he wanted. Instead, the founders balanced gun rights with the regulation they thought necessary for the public welfare.

So here we are again: at a tragic point in the life of our country, with the unrestricted sale of guns and explosives as a big part of that tragedy.  Columbine is not far away from Aurora, either in miles, or in tragedy.  Gabby Giffords and the persons who were killed in that incident come to mind; so does the Murrah Federal building incident and Timothy McVeigh.  Or, how about Virginia Tech or the much earlier Texas University shootings from the clock tower on that campus.  We could go on and on listing senseless tragedies that have occurred in this country, including assassinations and attempted assassinations, but that would be never-ending. 

We will hear outrage again that our country does not control its guns and explosives in any meaningful way.  We will hear again that we need more effective gun control.  We will hear people in pain.  We will hear of the waste that has been perpetrated by a mindless criminal-type.  We will hear complaints about the Mental Health system and the inability of law enforcement to track and share certain behaviors of people like the accused killer in Aurora.  The call for reforms will last about as long as it takes for the electioneering to heat up again. 

Then we will return inevitably to the same old situation that we have sheepishly accepted for years and years with absolutely no controls put forth, no restrictions, no common sense changes made by rational people.  The politicians who cow-tow to the NRA will look toward their own skins and court the support of the NRA and their cronies.  The Mental Health system will continue pretty much as it is.  The outrage will fade.  The public appearance of grief and mourning will stop and politicians will return to their meaningless agendas, meant to keep them in office for one more term, or to enhance their appeal to large lobbying or finance or manufacturing firms that will eventually hire them.

Where does all the outrage go?   We know it persists somewhere; mostly in groups that keep the drum-beat of gun-control going, like the Brady Campaign.  But, where does citizen outrage go?  Does it get buried?  Does it get subjugated to other concerns?  Does it get lost in daily life?  Does it get pulverized by NRA pro-gun publicity and lobbying?  Of course, all these things occur in the natural realm of living. 

Is there any way to keep the outrage alive?  Probably not in any facile way.  But, there is always the route that our democracy has built-in.  We must vote out-of-office the cowards who will not stand against the NRA, the pro-gun representatives who unquestionably support the NRA, and the fuzzy thinkers who take no stand one way or the other.  We cannot change things if we don’t change the legislators who block any progress on this issue.

And, that brings us around to a larger problem: where is the outrage when our elected representatives, and candidates for office, perpetrate foolish, potentially harmful, and  egregious policies and programs upon our children, our poor, our elderly and persons with disabilities, upon blue collar workers, upon women; but at the same time, put great energy into protecting the low tax rates, unfair subsidies, tax loopholes, and special tax breaks for the richest 1% and our biggest corporations.

Where is the outrage:

--when legislators want to repeal Health Care reforms that will be of great help to many citizens of all ages, but have no plans to keep or to improve any of the most popular provisions of the Affordable Care Act?

--when Paul Ryan, Mitt Romney, and the Republican Right present a Plan to do away with Medicare as we know it, and to substitute an inadequate voucher plan that will leave many parents as well as grandmothers and grandfathers in dire straits trying to afford the private plans that are available to them?

--when Big Oil continues to receive a 6 billion dollar subsidy from the federal government when it is already taking in numerous billions in profits?

--when Mitt Romney pays just 16% of his income in taxes while teachers and police officers, and other very middle class people, must pay between 20-25% of their income in federal income taxes?

--when 30+ states pass legislation to restrict voting (rather than broadening the franchise) which affects vulnerable populations (minorities, the elderly, persons with disabilities, the poor, students) who have more difficulty complying with the requirements of picture Ids with official expiration dates, etc.

--when once a person earns $110,100, they no longer have to pay Social Security taxes, meaning that once again, our representatives are ignoring or avoiding the obvious path to social security solvency:  raising the income that is eligible for FICA tax; instead they continue to protect the rich from having to share meaningfully in social security payments

--when the Supreme Court can vote 5-4 to allow corporations to be considered as individual persons so that they (the Conservative Justices) could apply free speech rights to their political contributions so that elections could be seriously affected and skewed by the rich.  In addition, the reporting of 3rd party contributions was declared to be unnecessary, so that the names of donors through third party sources (Super PACs) did not have to reveal their identities or the amounts they contributed.

--when Senate Republicans use a procedure that was meant only for occasional use -- the filibuster -- 97 times this session to block critical legislation like jobs and infrastructure repair legislation, and disclosure of donors to Super PACs, and many more critical bills, such as sending money to states to hire teachers and emergency first responders.
This procedure forces a cloture vote (to stop debate) of 60 votes, a vote total that is not supported by the Constitution, and which is allowed only under the provision for Congress to set its own rules.  Where is the outrage against a Congress that destroys the very method -- majority vote -- by which legislation should be passed or defeated?  A headline in the Washington Post emphasizes the increase in filibuster use: “The filibuster has gone from affecting 8 percent of big bills in the 1950s to 70 percent in the 2000s.”
 
--when TV, radio and print ads distort and defame, and lie about another candidate, policy or program, or piece of legislation.  Is falsehood what we believe will advance our civilization or enhance our form of government?  What happened to the old admonitions of parents and elders that lying is destructive to ourselves and others?  Where is the outrage when ads or claims are proven to be false or very misleading, and they go on and on, repeated over and over until they are accepted as factual -- “Obamacare will destroy our health care system” is one of those false statements that comes in many forms.  If the net result is the ultimate repeal of that legislation, millions upon millions of people will be adversely affected.  Where is the outrage over false advertising or resume enhancement or covering-up of harmful effects such as in the tobacco and pharmaceutical industries?  Have we become inured to lying, cheating, stealing and scamming? 

Perhaps I need to stop here and let you, dear reader, ponder your own examples of outrageous items that seem to have been buried or ignored. 

For my part, I simply re-direct your thoughts to the latest gun tragedy that will, for a time, provoke sympathy, fear, uneasiness, focus on family, and moral and personal outrage that such a thing could happen in our society, as it should.  I share just such feelings and sentiments for those harmed by this outrageous tragedy.  As a father and grandfather, I pray for those caught in this terrible event.

But, our outrage will fade even though such things continue to happen.  In fact, many such things are happening -- to a greater or lesser degree (think of unprovoked war as in Iraq. or abuse of young children, or the diminution of public education or even the outrageous methods of selling automobiles to unaware consumers). 

Where does the outrage go?  It goes into the cubbyhole in which we store matters with which we cannot, or will not, deal.  It goes into the portion of life called “daily routine” by which we tend to lose sight of other matters.  It falls by the wayside of indifference through which many people avoid the un-pleasantries of life.  They say “I don’t care” by which, too often, they mean “I can’t care” or “it’s too painful to bear” or “I don’t want to give my time, energy or money to anything but my own little world.” 

Outrage fades under the inevitable onslaught of the demands of our lives, in spite of the fact that our lives, that we so often circumscribe and protect, could be enhanced by outrage that demands the best, rather than the least, of our leaders, our government agencies, our industries, our institutions, and even of ourselves. 

Outrage is not a negative force.  It is a driving force toward re-creation, reform and re-vitalization.  Is that perhaps why we let it fade: do we, in the end, fear its effects?  Are we intimidated by the relentless pursuit of change for the better and the best?  On the other hand, there are many who have devoted their lives to the betterment of this society, even making the ultimate sacrifice of their lives (Martin Luther King, Jr. comes to mind).  So why, with such examples to guide us, do we let outrage fade and fail to produce needed reforms?  I don’t know for sure…do you?

7/17/2012

Survival of the Fittest: Social Darwinism

“Survival of the Fittest” is one part of Darwin’s Origin of the Species.  The concept is basically that of “Natural Selection;” “Survival of the Fittest“ being an alternate description of that theory.  According to Wikipedia, “Darwin meant it as a metaphor for ‘better adapted for immediate, local environment‘, not the common inference of ‘in the best physical shape‘.”  Further, “the phrase ‘survival of the fittest’ is not generally used by modern biologists as the term does not accurately convey the meaning of natural selection, the term biologists use and prefer...  Fitness does not refer to whether an individual is "physically fit" – bigger, faster or stronger – or "better" in any subjective sense.  

“An interpretation of the phrase ‘survival of the fittest’ to mean ‘only the fittest organisms will prevail’ (a view sometimes derided as ‘Social Darwinism‘) is not consistent with the actual theory of evolution. Any individual organism which succeeds in reproducing itself is ‘fit’ and will contribute to survival of its species, not just the ‘physically fittest’ ones, though some of the population will be better adapted to the circumstances than others.”

It has often been claimed that the biological theory of “survival of the fittest” was “borrowed” or interpreted by late 19th century capitalists as an ethical precept “that sanctioned cut-throat economic competition,” at times leading to justification for racism, war and most especially of Laissez-faire economics.  It is important not to blame all this on Charles Darwin, as these ideas predate him and even contradict his theories.  Some have argued that “survival of the fittest” provides justification for behavior that allows the strong to set standards of justice and competition and success to the detriment of the weak.  Some even claimed that this idea implied treating the weak badly.  The term "social Darwinism," referring to capitalist ideologies, was introduced as a term of abuse by Richard Hofstadter’s Social Darwinism in American Thought published in 1944.

Keep in mind, then, that “Social Darwinism is generally understood to use the concepts of struggle for existence and survival of the fittest to justify social policies which make no distinction between those able to support themselves and those unable to support themselves.”  Those who advocate this view  don’t want to help the poor or the unemployed or others who have fallen on hard times or circumstances because, they say, this encourages life-long dependence and laziness.  Many such views stress competition between individuals and struggle between national or racial groups.  If the ultimate success in competition is to absorb or destroy rivals and emerge at the top of the heap, able to dictate wages and prices, then Social Darwinism is at the heart of modern-day capitalism.

And so we come to modern-day politics, most especially in the United States.  Strangely enough, some modern-day politicians have a view of policies and programs that belongs in another era.  Some would like us to return to the world of the 1920s when Wall Street was unfettered, the rich grew even richer while everyone else sank into debt, and the doors of entry to citizenship were closed to immigrants.  Many would like to take this society even further back: to the late 19th century when there was no federal income tax, antitrust laws, the Federal Reserve, or the Pure Food and Drug Act, and, of course, environmental concerns and the EPA (founded in 1906 under the Progressive Republican, Teddy Roosevelt). These Radical Regressives would be completely satisfied with a small federal government having little clout or power, with no Federal Reserve or IRS and with states being able to determine many policies and programs like taxes, health care, worker safety and hours.  It was a time when so-called Robber Barons -- titans of industries like railroads, finance, coal and oil -- lived like old-time aristocrats and ran the country.  At the same time it was a time of wrenching squalor for many people.  Free Enterprise was an over-arching concern, but many Americans (racially, ethically or income-based) did not enjoy much freedom. 

Perhaps a few photos from those times would tend to help you get the picture of what it was like.

                                                                                  image        Pollutionimage           Crowded living                  

image    Slums

 

image      Homelessness

 

These late 19th century problems and concerns were addressed minimally by government, mainly by private organizations which began to grow and take action, like the Salvation Army, American Red Cross, YMCA, settlement houses, etc.  Because government was small and inefficient (as well as inexperienced) in attacking social needs, the private organizations were stretched to their limits by the conditions of the people and the environment. 

This is the world that Regressives prefer.  They want government to drop all their social programs, all environmental regulations, all entitlements so that children, and the sick, the disabled and the elderly and women can be under the care of anyone but government.  In fact, their principles include the belief that government should do very little (or nothing) to help those in need because that interferes with natural selection of the strong over the weak.  They want to undo reform of health care insurance and delivery without replacing the losses, so that we can return to the days of a life expectancy that was unacceptable.  This foolishness of getting government out of our lives is fraught with danger, and with an end result that looks like the pictures you have just seen.  You want a banana republic?  Just vote Republican and you will get your wish.

image

On the other side of the coin, it is important to understand that alongside these conditions existed what was known as the Gilded Age.  It was a great time for the rich. During the 1870s and 1880s, the U.S. economy rose at the fastest rate in its history, with real wages, wealth, GDP, and capital formation all increasing rapidly.  For example, between 1865 and 1898, the output of coal increased by 800% and miles of railway track by 567%.  Large national networks for transportation and communication were created. The corporation became the dominant form of business organization, and a managerial revolution transformed business operations. By the beginning of the 20th century, per capita income and industrial production in the United States led the world.

The businessmen of the Second Industrial Revolution created industrial towns and cities in the Northeast with new factories, and hired an ethnically diverse industrial working class, many of them new immigrants from Europe. The super-rich industrialists and financiers such as John D. Rockefeller, Andrew Carnegie, Andrew W. Mellon, Henry Flagler, J.P. Morgan, Cornelius Vanderbilt, and the prominent Astor family, were sometimes labeled “robber barons” by those who perceived them as underhanded in the ways they achieved great wealth.  Many of these captains of industry, in addition to building the still fledgling American economy, participated in great acts of philanthropy (referred to by Andrew Carnegie as the "Gospel of Wealth") and used private money to endow thousands of colleges, hospitals, museums, academies, schools, opera houses, public libraries, symphony orchestras, and charities.  Rockefeller for example, donated over $500 million to various charities, slightly over half his entire net worth.
 
Still, while these men donated much to their communities, there existed a rapaciousness in business that exploited workers, especially women and children, and which kept the working class in a place that was not always happy or pleasant.  Their ultimate goals were to make as much profit as possible and to control as much of their milieu as they possibly could.  Often their philanthropy was inspired by more than a “protestant ethic”.  It was informed by a motive of manipulation.  What town in those days would fight against cruel and inhumane practices of the robber barons, if those same men were about to build that town’s first hospital?  Money, as it does today, equates to control, and the barons of industry knew how to control the politicians and the masses.

Our situation today is not so different.  Except today, we have a strong central government that often stands between the working classes and the big industrialists and their greed.  A strong central government is necessary not only for the nurture of the weak, but for the protection and furthering of the aspirations of a broad middle class that exists in this country mainly because government stepped in to “level the playing field”; to control the rapaciousness and the manipulation of power that capitalism sought in the Gilded Age and beyond. 

The Gilded Age has returned, in many senses.  We live today in a society where the richest 1% are seeking to gain control of all aspects of that society.  America has long prided itself on being a fair society, where everyone has an equal chance of getting ahead, but the statistics suggest otherwise: the chances of a poor citizen, or even a middle-class citizen, making it to the top in America are smaller than in many countries of Europe. The cards are stacked against them.

The richest want it all, and then some:

--to control wages and benefits by attacking unions and destroying them (Reagan and the Air Controllers; Wisconsin and the loss of collective bargaining; reduction of union membership from a high percentage of workers to a mere 11.9% now)


--to control the levying of taxes, so the tax burden falls less and less upon the richest 1-2% and more and more upon the middle and working classes (through either a reduction in high end taxes, or a flat tax that automatically favors the richest).

--to undo decades of regulation of industry -- especially finance, Oil, food production, and electronics -- so that they may be unfettered in their conduct of certain business practices 
(the promised doing away with environmental and working-place regulations; the repeal of Barney-Frank law, the Romney promise to overturn all regulations that interfere with the conduct of business)

--to change the educational system in this country from public to private so that only the privileged are well-educated, and all others must struggle for a semblance of higher education (elimination of the Department of Education, the reduction of Pell grants and Stafford loans, the replacement of public schools by charter schools, the prevention of the re-furbishing of public schools in poor neighborhoods)

--to control the levers of power -- from statehouses and legislatures to Congress to the Presidency and even to the Supreme Court.  This is a concerted effort to control, through money, manipulation and inside access, the politicians who represent the vast array of voters.  It involves lobbying, campaign finance, and the manipulation of politicians into sometimes doing nothing to prevent destruction or perversion of our system of representative democracy (the examples extend from barons of industry being called in to  Executive offices or congressional offices to help write legislation or regulations, to lobbyists manipulating representatives with promises of campaign funding, to a Supreme Court decision (in Citizens United) that essentially legalizes the intrusion of corporate entities into the electoral process in such a way (through Super-PACs) that an election can be manipulated by the sheer amounts of cash poured into negative advertising and character assassination (think Koch brothers, Sheldon Adelson, and others).  This is sheer bribery made legal by a Supreme Court in the name of free speech.  But this is not free speech, it is destructive speech meant to destroy the very foundation which protects and defends free speech.  You can’t legally yell “fire” in a movie house, but you can destroy a candidate for public office through lies, innuendo and misconstrued wording in a television ad.  All you need is a few million in contributions.

This is the insane situation we find ourselves in today.  Through money, manipulation of politicians, and destruction of a social contract that has served us well for decades, we are embarked on a course that will lead us into ruin.

Think about it.  The average voter, at an educational level of say an 8th grader, is being led down a path over which they have little control, and even less knowledge or understanding.

So it is, that millions of voters are prepared to vote for Romney for President (or for other Radical Republicans for Congress) in spite of the fact that Romney has now pledged himself to repeal the very health care provisions in the Affordable Health Care act that are designed to help those voters.

So it is, that millions of working class males will vote for a man who has destroyed jobs and doesn’t support unions in their quest for fair wages, health insurance for their families, and an adequate pension for their retirement. 

So it is, that millions of elderly folk, many of whom have always voted Republican, do not realize or acknowledge that this is not the party they have known, nor the party of their forebears; this is a party that wants to destroy the very programs on which they have based their lives since turning 65: namely social security, Medicare and Medicaid.  They don’t seem to understand that this Republican party is not their friend, but their mortal enemy, bent on throwing them back to work, assuring them that any ill-health will become their Waterloo, ripping apart the safety net that keeps them going from day-to-day, and reducing any chance of long-term care that is something they don’t have to worry about. 

So it is, that millions of independents will vote for a man who will allow polluters to raise the level of carcinogens released into the environment, who wants to subsidize the richest among us to the detriment of those who have less, who wants to eliminate any chance they may have had to help their grown children less than age 26 to transition gently into a good paying job while on their health care; who wants to get into a tariff war with China, who wants to continue spending our tax dollars to subsidize big oil, who wants to diminish re-training of workers, reduce Pell grants, and devastate the labor unions.

The Gilded Age was above all, an age of ostentation, crassness, political corruption, squalor, and shoddy ethics.  The term refers to the gilding of a cheaper metal with a thin layer of gold, with a hint of the "golden age" of a nation's glory.  The Radical Republicans of our day seem to be well-suited to produce the cheap and glossy gilding of an austere existence making it appear to many to be a “golden egg” instead of a broken  system. Our democratic system, developed for the benefit of the many, is in danger of being converted into something that works only for the few who can afford to pay to play.

7/08/2012

MEDICARE for ALL?

As long as we’re talking about Health Care and the Affordable Care Act, let’s be honest.  The Affordable Care Act was a valiant effort, but it falls short of what we so desperately need in this country: adequate health care coverage for everyone!  We remain the only major nation that does not provide health care for every man, woman and child as a right of citizenship, and it’s time we did the sensible thing by establishing a single-payer system.  Wikipedia offers a definition of such a system: “Single-payer health insurance collects all medical fees, and then pays for all services, through a "single" government (or government-related) source, typically extended to all citizens and legal residents.”

Why does the ACA fall short?

1)    Because it still allows private insurance companies to dictate too many outcomes: premiums, benefits, levels of coverage, etc.  Why do you think that since the passage of the ACA, premium costs have gone up dramatically?  Because those same private companies are trying to make huge profits before many of the provisions of the law kick-in in 2014 and beyond.

    And, right there is the rub: private companies putting profits before people or before quality.  Is that what we really want?  Or do we want to take the profit-motive out of the picture and rely on the non-profit public sector to reduce costs, increase coverage, and push effective outcomes for all, including preventive care?

2)    A whole new structure of state Exchanges where many people can go to get their health care coverage.  But why, pray tell, do we want to put in place a whole new structure when we already have structures in place that are working: the VA system and the Medicare system.  Think about it: in order to placate and enhance the private insurers, we are willing to go to the extreme of establishing Exchanges so that the private companies can still sell their over-priced packages and their under-financed coverage.   

3)    A built-in penalty for all those who can afford it, but decide not to purchase coverage.  This is a needless invention to achieve universal coverage when we could have such a system through payroll deduction or direct payment to the Revenue Service for the self-employed, charging everyone a Medicare tax that goes toward universal health insurance coverage.  It’s already in place and working, but will need attention to achieve universal coverage and near universal participation.  Have you noticed?

4)    Although some reform of Medicaid is involved, the ACA does not solve the problem of its major costs, nor its inadequate reimbursement schedule.  Medicare for all would necessitate incorporating Medicaid’s most important provisions so that we could eliminate health care for the poor as a separate system.

MEDICARE for All.  It’s not rocket-science, folks, but a matter of adjusting an existing system to meet the needs of a larger constituency.  Here’s what National Nurses United has to say:

“The Affordable Care Act still leaves some 27 million people without health coverage, does little to constrain rising out of pocket health care costs, or to stop the all too routine denials of needed medical care by insurance companies because they don’t want to pay for it.”  NNU co-president Jean Ross, RN echoes: “The continuing fiscal crisis at all levels of government and the anemic economic recovery remind us that rising healthcare costs and shifting costs to workers burden our society, cause (many) of these fiscal problems, and limit the opportunities for working people. Only real cost control through a national health program can solve this crisis. Improved  Medicare meets that challenge.”
Adds NNU co-president Karen Higgins, RN: ‘Medicare is far more effective than the broken private system in controlling costs and waste that goes to insurance paperwork and profits, and it is universally popular, even among those who bitterly opposed the Obama law.  Let’s open it up to everyone, no one should have to wait to be 65 to be guaranteed healthcare.”

Let us be clear upfront that single-payer systems do differ.  “The term "single-payer" only describes the funding mechanism—referring to health care financed by a single public body from a single fund—and does not specify the type of delivery, or for whom doctors work.”  So, while the fund holder is usually the state, some forms of single-payer use a mixed public-private system, and that is what some critics do not realize.  Some single-payer systems do contract for healthcare services from private organizations (as is the case in Canada).  Thus, advocating for a single-payer system does not automatically mean a system in which doctors and nurses work for the state!

So, what are the basics?  Here are just ten of them.

1)    Universal coverage guaranteed.
2)    Administrative costs dramatically lowered
3)    A system under scrutiny by the peoples’ representatives
4)    Care begins at birth and continues through a lifetime
5)    As with Medicare now, you can appeal decisions
6)    Paper-work is minimal for the patient and for the doctor
7)    No co-pays, such as a co-pay for doctor or specialist office visit.
No deductibles. And no coinsurance, such as bills from a hospital
8)    Small and large companies won't have to spend money managing the employee benefit of health insurance. That one factor means that the cost of operations for business units in the United States will be more competitive with businesses in other countries
9)    The natural result of no major medical bills is that patients will not over-mortgage or lose their homes; along with not needing to declare bankruptcy because of excessive medical bills
10)    Improved Medicare for all will cover all medically necessary care. Examples: primary care; inpatient; outpatient; emergency; prescription drugs; equipment; midwives; long term care; palliative; podiatric; mental health; dentistry; hearing, vision; chiropractic; substance abuse treatment as per H.R. 676.

Many Americans living abroad have begun to wonder why the USA is still worried about preserving the multiple private payer system that currently dominates our country.  Here are a few testimonials (in brief) from some of those Americans, as found on www.medicareforall.org.

— “(Our family) … can’t understand a developed country without universal coverage — Everyone is insured … (about) $67 a month. (Americans in The Netherlands)
That’s it. This includes doctor’s visits, medications, physiotherapy, even things like visits to a nutritionist or a problem overseas.
— Linda, April 2009.

Exceptional Care. (Americans in France)
In 25 years, our family has only had two major emergencies and in both cases, the medical care was exceptional and cost us nothing.
— Christine, July 2009

Excellent Care at Low or No Cost. (American in Australia)
Wife’s mother had terminal cancer and received excellent care with no worry “that her treatment would bankrupt us. … I … made use of their national health care system numerous times … (with the care being) of the highest quality at no cost …”
— Isaac, March 2008

Excellent Care; No Bills. (Americans in Germany)
” … (my mother’s multiple) eye surgeries … all paid for (in) Germany … (My mother in later years) received excellent care at the university hospital (for 3 weeks) and … we did not have to pay any bills ….”
… and, from another American in Germany: “(no) limit as to how long they would pay for it as long as the doctors said that the therapy was required.”
— Natalie, June 2008

Absolutely Superlative Care; Zero Cost. (Americans in Scotland)
“… correctly diagnosed the disease (in Scotland, after suffering for years in the U.S.). Since then, she has been hospitalized for a month, given two very expensive courses of IVIG treatment, and had her thymus removed in major, open chest surgery. Recently, we flew back to New York to consult with perhaps the world expert on Myasthenia. … he declared that the doctors in Scotland were doing all the right things. He then asked how much this cost. He had a bit of a hard time understanding that the cost was exactly zero. … I spent about two months paying various bills associated with that one visit to his office. Is the system in the UK perfect? Of course not. Did they provide superlative care for our daughter? Absolutely.
— John, August 2009 (question marks added)

So what can we expect from this system of improved Medicare for All?  According to the MedicareforAll.org website, we can look forward to the following:

“Based on the cost per person results of other free-market countries and based on our system being the best, we will cut costs by 60%. We will eliminate unnecessary administrative functions; negotiate drug and equipment costs. The results of cost-cutting include these: no premiums, co-pays, deductibles, or major medical bills, such as those that result from coinsurance.
Businesses, states, counties, cities and school boards will no longer be burdened with the topic of managing health insurance as an offered benefit ... and no longer be burdened by an excessive cost of providing it to employees.
Health care with dignity: no hardships, fund-raisers or applications to charities.”

Sign-up on www.medicareforall.org to further this reform of our health care system!

7/02/2012

Health Care Re-Visited

In light of the positive ruling by the Supreme Court legitimizing the universal mandate contained in the Affordable Care Act under the taxation power of the Congress, it makes some sense to re-visit some earlier points made on this Blog.

Right-wing radical Republicans in Congress (as well as co-opted candidate Mitt Romney) are trying hard to characterize the Affordable Care Act as a failure, and as “government controlled”, and even as “socialism.”  As a matter of fact, it is less of a government-controlled system then is their own health care insurance, which is organized, managed, and overseen by the Office of Personnel Management (OPM).  To go a step further, the extra health care benefits available to members of Congress include clinical care on-site operated by naval personnel, and access to taxpayer-subsidized surgical/hospital care at Walter Reed Army Medical Center in Washington DC, and the National Naval Medical Center in Bethesda, Maryland. (Senate Minority Leader Mitch McConnell had heart surgery there in 2003). So, while they take full advantage of their own government-organized and taxpayer-subsidized health plans, they rail against anyone else having a similar opportunity.  Hypocrites all.

Under the Affordable Care Act provisions, the government does not provide medical services, nor does it control from where you get your health insurance.  You are free under this Act to continue choosing from a number of private insurance companies for your coverage.  The Act does have a provision for state-based Health Exchanges through which individuals and small businesses with up to 100 employees, could purchase qualified coverage, but these Exchanges can be administered by either a state agency or a non-profit organization; presumably, the states can make that choice.  States can also opt in 2017 to set up Regional Exchanges or allow other state Exchanges to operate within a given state.  In addition, the OPM will contract with private insurers to offer at least two multi-state plans in each Exchange.  Going a step further, the Act allows for the creation of non-profit, member-run health insurance companies in all 50 states and DC to offer qualified health plans.  So, while some aspects of the PPACA may be government-assisted, it is far from being government-run, or a takeover of health care by the government.

Are there some requirements in the Act that would involve government implementation and management?  Of course; but that doesn’t make it “socialism” or “government-run.”  There is a federal requirement that everyone be covered, backed up by certain penalties for those who fail to comply.  That  provision has now been addressed by the Supreme Court and found to be constitutional under the taxation power given to the Congress.  Some restrictions are placed on what can be offered by insurers and what cannot be included.  But, in my opinion, this is no different than many pieces of  legislation that require certain actions, programs, restrictions and innovations that result in changes in administration or management in the public and/or private sector.  One example:  the ADA - the Americans with Disabilities Act.

But congressional Republicans and Mitt Romney continue to claim that Obamacare is a government takeover of health care.  Just what has been taken over, since private corporations still provide health care insurance and health care delivery?   They never tell you what has been taken over, because they don’t want you to know that they actually support government control when it is in their own interest as federal employees. The truth is that private companies, that have long controlled our health care, are being reigned-in by the government and the Republican shills for those companies, from whom they get a lot of monetary support, are not happy about it.

For many decades, private health care insurance conglomerates have been the ones standing between a patient and his/her doctor  by excluding pre-existing conditions from coverage, by placing lifetime caps on those with acute illnesses, by lack of support for preventive care and by dropping coverage when a serious illness shows up.  Now none of these is allowed.  That is not government takeover; it is government protection for consumers.  Obamacare actually builds on and improves the nation’s private health care system.

So, let’s take another look at the PPACA, and see what it has actually done for consumers, or will be doing for them, in a positive way:

- allows adult children up to age 26 to be on their parents’ healthcare insurance; has already extended insurance coverage to perhaps 3 million young adults under age 26, some of whom had other plans before they switched, so this figure does not represent just new sign-ups

- prohibits insurers from citing pre-existing conditions for denial of coverage; from placing lifetime caps on coverage, or dropping persons with newly acquired illnesses or conditions;

- provides portability between employers;

- expands Medicaid to all non-Medicare eligible individuals under age 65 (children, pregnant women, parents and adults without dependent children) with incomes up to 133% of the federal poverty level; all newly eligible adults will be guaranteed a benchmark benefit package that meets the essential health benefits available through the Exchanges; (will perhaps cover up to 17 million of the 31 million that are currently uncovered, but this may change based on the part of the SCOTUS ruling that struck down a penalty on states that disallows all Medicaid funding if a state opts out of this provision);

- extends funding for the Children’s Health Insurance Program through 2015 and keeps current income eligibility levels through 2019; beginning in 2015, states will receive a 23 percentage point increase in the CHIP match rate up to a cap of 100%; CHIP-eligible children who are unable to enroll in the program due to enrollment caps will be eligible for tax credits in the State Exchanges;

Very briefly and quickly, let us look at some more positives that will occur in the near future:

- will provide refundable and advance premium credits to eligible individuals and families to purchase insurance plans through the State Exchanges with savings of up to $2,300 for those families
- will require Exchanges to maintain a call center for customer service, and to use a single form for application that can be filed in person, by mail or online;
- will create a temporary insurance program for employers providing health insurance coverage to retirees over age 55 but not eligible for Medicare
- will create an essential health benefits package which is the minimum that must be offered by all health care plans;
- will establish a temporary national high-risk pool to provide coverage to individuals with pre-existing conditions along with subsidized premiums.

Finally, let us deal with the latest charge from Republicans, especially Mitt Romney, that this Act will raise taxes for everyone.  Wrong.

It will impose a penalty/tax on those who opt to stay uncovered by a qualifying  insurance plan, beginning in 2014.  But, that group of people will be relatively small compared to the numbers who are now uncovered and who will opt for coverage, or the numbers of people who have their own plans and will continue to do so.  In reality, that penalty would affect only 1 percent of Americans and keep their medical costs from shifting to the rest of us; and, it’s the same policy Mitt Romney put in place in Massachusetts.  Trying to make this penalty on free riders into a general tax increase is ludicrous.  Obamacare is actually the largest-ever middle-class health care tax cut.

There are other taxes involved, but they too are targeted and not general in nature:
--increasing the tax on distributions from health savings accounts that are not used for qualified medical expenses;
--increasing the threshold for an itemized deduction for un-reimbursed medical expenses from 7.5%  to 10% of adjusted gross income but with a waiver for those over age 65 during tax years 2013 through 2016
--imposing an excise tax on insurers of employer-sponsored health plans that exceed certain higher thresholds;
--eliminating the tax deduction for employers who receive Medicare Part D retiree drug subsidy payments (effective Jan. 1, 2013).
--an excise tax of 2.3% on the sale of any taxable medical device;
--imposing a tax of 10% on the amount paid for indoor tanning services

None of these taxes are general taxes on the population.  They are limited in scope. It is important to understand that, on the contrary, Obamacare includes the largest middle-class tax cut for health care in history. According to the independent Congressional Budget Office, 19 million people will receive tax credits worth an average of about $4,800 each to help them afford health care, putting health insurance within reach for millions of American families.  Analysts predict that premium growth should slow after 2014 because of the law, predicting $2,000 in family savings by 2019, and the Congressional Budget Office projected savings of 14 to 20 percent through exchanges and new rules in the market.
 
So, let us concentrate now on what would be lost if Republicans were to rescind this legislation.  The CBO has weighed in on this in a letter, dated  May 26, 2011, written to Congressman Henry Waxman, ranking member of the Committee on Energy and Commerce, in which there is some discussion of the consequences of repealing this legislation.  Here are some of the CBO points for your consideration:

1)  would result in a significant loss of revenues, particularly from certain fees and taxes that would be collected by the IRS: e.g. 40% excise tax on insurance plans above certain thresholds for persons with incomes above 250k, and certain insurance industry and pharmaceutical industry fees
2)  would significantly alter the effects of many provisions of the ACT, including changes to Medicare and Medicaid; tax credits, and cost-sharing subsidies designed to increase the number of Americans with health insurance
3)  could prevent CMS from modifying Medicare payment rates on an annual basis and signing contracts with private insurers that offer Medicare Advantage and Part D (prescription drug) plans; the possible result - no Medicare Advantage plans and no more Part D plans for Medicare beneficiaries!
4)  preclude the Secretary of HHS from implementing recommendations of the Independent Payment Advisory Board aimed at limiting Medicare costs
5)  prevent federal government from setting up insurance exchanges if states chose not to; and grants to states for setting up exchanges and subsidies for cost sharing would not be available, putting states in a further bind as to health care support
6)  prevent CMS from assessing and collecting its share of higher rebates from pharmaceutical companies for drugs dispensed to Medicaid beneficiaries
7)  payment to doctors would be affected because the calculation of annual rates by CMS would be affected and rates would remain at current levels, and Medicare spending would increase in 2012 and 2013
8) mandated demonstrations and pilot projects designed to improve efficiency and quality of care would increase spending in some cases
9) in the absence of mandates for insurance coverage, the number of families and individuals covered would be lower than under current law
10) CMS would probably be prevented from providing assistance and guidance to states as to their Medicaid and CHIP programs
11) provisions to reduce waste fraud and abuse would be undercut, as would provisions to improve quality of care to enrollees

The Patient Protection and Affordable Care Act of 2010 is not the failure that many conservative Republicans would have you believe.  There are many, many provisions that will not only reform our health insurance provisions, but that will go a long way toward reforming our health care delivery system into one in which quality is primary and preventive care and wellness are of the utmost  importance.  Those who want to destroy the most important health care legislation since establishment of Medicare under Lyndon Johnson, are simply deluded.  It is time to praise this major accomplishment of the Obama administration, and to seek to implement those positive aspects that are pending between now and 2019.  “Obamacares” is indeed an apt title for this major piece of important legislation.