Wednesday, September 25, 2013

Shutdowns and Obamacare

On my 9/1/2013 posting on this blog, I alerted us to steel ourselves for yet another melodrama coming out of Washington.  But this time it would be an old, repeated melodrama regarding the federal budget and the Affordable Care Act.  Once again we would be headed into reruns of past debates, leaving immediate pressing needs unattended.  Sure enough, as the Syria issue and the “do we bomb or not” question fades from the headlines, the spending “debate” is once again front and center – spurred by the need for a budget for the new fiscal year starting October 1, and hitting the debt limit shortly thereafter.

This time around, House Republicans have married their 1-note campaign against the legally-passed and Constitutionally-upheld “Obamacare” with their spending cut campaign.  They recently passed yet another Continuing Resolution (CR) to fund the federal government for less than three months, yet again abrogating their Constitutional responsibility to (timely) initiate and pass a budget to fund our government’s operations.  But this time they coupled that CR with a complete defunding of Obama’s health program – their 42nd meaningless and futile attempt to scrap Obamacare.  This latest maneuver will once again go nowhere, wasting everyone’s time while ducking a real spending plan that addresses our needs.

Since Obamacare seems to be “the end of America, our freedoms, and our economy as we know it,” perhaps we should once again look at some of its provisions to better understand its seeming inherent evil.  Some principal new requirements under this law include:

-Requiring that any preexisting medical conditions must be covered if a person seeks new medical insurance, ending the practice of those people who need medical care the most being blocked from coverage, or trapped in a job for fear of losing coverage on an existing illness;

-ending the practice of having ceilings (annual or lifetime) on one’s health care costs, which left supposedly insured people liable for the costs above these arbitrary ceilings;

-allowing young adults to stay on their parents’ policy until age 26, an important consideration for new graduates entering the workforce under a mountain of college debt;

-reducing the cost of prescription drugs under Medicare Part D coverage for seniors;

-requiring all taxpayers to have medical insurance, thereby expanding the pool of people covered and reducing premium charges to the individual, as well as to reduce the use of hospital emergency rooms as “free clinics” for the uninsured (the most expensive treatment, all underwritten by the insured population);

-leaving existing health insurance programs in place, so people who already have health insurance have to make NO CHANGE in their current insurance or medical providers;

-requiring that all companies with over 50 employees with individual employees working a minimum of 30 hours/week be provided with health insurance, thereby significantly reducing the number of uninsured people among the “working poor” population;

-providing new state-run insurance exchanges, with subsidies for low-income individuals, where people who have no coverage or whose employer does not offer an insurance option can buy health insurance;

-allowing states to significantly expand their Medicaid health programs for the poor, with funding predominately underwritten by the federal government;

-mandating a number of preventive screenings and medical services for seniors at no cost;

-setting a minimum percentage of premium dollars received by insurance companies that must be applied to the delivery of actual medical services, versus being passed on to stockholders as profit.

The actual Affordable Care Act refutes many of the lies said about it by self-serving politicians like Michelle Bachman, Sarah Palin, and countless other anti-Obama zealots.  Lies such as:

-the creation of “death panels” who will decide who lives or dies by determining who will get certain medical services and who will not.  If any such death panels exist, they exist in the insurance companies who decide – often arbitrarily and after-the-fact – what your policy covers and what it does not;

-Obamacare will bankrupt the country due to its supposedly high cost.  In point of fact, the non-partisan Congressional Budget Office projected long ago a DECLINE in health costs due to this same Obamacare;

-Obamacare will wreak havoc on small-business companies who cannot absorb this new insurance cost.  In fact, it is these same anti-Obamacare people who are also insisting that health insurance be an “employment benefit” instead of a basic right of citizenship – and many unscrupulous employers have long used any excuse possible to deny insurance coverage to their low-waged employees;

-that currently insured people will be forced to change their doctor, hospital or insurer of choice.  As noted above, it just ain’t so.

The radical right-wing has milked millions of dollars from the public by exploiting health fears among Americans, and has wasted millions of dollars trying to defeat any improvements in our health care system.  A system under which we pay more for our health care than any other country, yet show far less measureable quality of outcomes than many of those same countries.  For all our spending, millions of Americans, regardless of the severity of their medical needs, have no access to those very expensive health care services due to the costs involved.  To date, ZERO alternative proposals have been offered to improve health care access and outcomes, and to reduce these obscene costs.

So instead of just railing against something called “Obamacare,” passing nonsensical Congressional resolutions to overturn it, and forcing the shutdown of government to try to eliminate this law, I pose these questions on behalf of the American people: which of the features listed above would you eliminate from the Public benefit, and why?  If there are just certain parts of the Act you oppose, why don’t you introduce targeted legislation to alter those, versus canceling ALL provisions?  Which of these features are so odious that they are worth shutting down virtually all government services to the public?  What concrete features and steps would you offer in replacement of this Act – instead of spouting the usual rhetorical platitudes praising “American free enterprise” and decrying non-existent “socialized medicine” in lieu of real solutions?

Just being “against” is no strategy to “promote the general welfare” promised by the Constitution.  As a consequence, we are sailing into the very dangerous – yet avoidable – waters of funding and governance turbulence on a ship captained by fools.

© 2013   Randy Bell
 

Monday, September 9, 2013

The Syrian Dilemma

Syria is one of those topics that reminds me how fortunate I am to not be the President of the United States.  (A good fortune for many others, I am sure!)  Because this issue starts out as a very bad premise to begin with, and good answers rarely flow from such a bad premise.  There are numerous valid viewpoints that can be argued, each with great validity.  And the tentacles that reach out from Syria, the many dominoes waiting to fall, are just as numerous.  Ultimately, there will be no “right” thing to do; there will only be, at best, the “most appropriate” things to do (or not do).

It may be helpful, just to try to get our arms around this crisis, to break out the subject of Syria into four major subtopics for discussion:

AMERICA AT WAR: Americans are sick of being at war.  Sick of the maiming and killing of so many of our young people.  Sick of all the tax dollars being sucked into these wars and diverted from other badly needed efforts here at home.  And (thankfully) increasingly tired of being the world’s policeman, the place where everyone looks to for leadership and answers, while also being the target of so much anger and resentment in spite of all our sacrifices and “noble efforts.”

The world is rife with tensions, and we are tired of being pulled into seemingly every one of these conflicts.  So in spite of the numbers being killed in Syria, in spite of the humanitarian crush, in spite of the atrocities of petty dictators, most Americans want to pick and choose our involvements far more selectively than in the past.  There is today simply no appetite to fight yet another battle in another far-away ungovernable outpost.  The disastrous ghost of Iraq’s non-existent WMDs looms large.

THE SYRIAN REVOLUTION: Americans are justifiably proud of their biggest gift to the history of civilization: the governance of a major country by a democratic/representative form of government.  We feel it is our duty to spread that concept of democracy across the globe.  Given our own successful revolution needed to establish that freedom and governance, we automatically side with “people’s rebellions” against an autocratic rule.  The “Spirit of 1776” infuses our sympathies.

But this is not 1776.  And Syria (and e.g. Egypt, Iraq, and Libya) is not Colonial America, with an established history of local participatory rule from which to build a democracy.  Democracy is hard, given mankind’s prevailing history, and not everyone is prepared to handle it.  When a violently suppressed or minority people successfully rebels, the swing of the social pendulum can be quite extreme.  Revenge, not democracy, is often the order of the day.  That order can be quite violent itself, whether one speaks of the French Revolution of 1789, or of modern-day Egypt.

Syria is another Afghanistan.  A cruel and despotic government lording over a collection of individual tribes, sects, villages, factions, religious/cultural differences.  Each splinter has its own leaders, its own agenda, its own desired outcomes – which may or may not include democracy for all versus just a new despotic group controlling all others.  Syrian rebels are not Washington’s Continental Army; Syria is a guerilla war with no battle lines and no umbrella war structure.  Regardless of what America might do, there is no guarantee that a post-Assad government will be any better.  We can supply major quantities of humanitarian aid to Syrian communities and their border countries. We can try to help the various rebel factions find “right leaders” and supply the good guys with arms.  But this is not a rebellion we can take on, regardless of the injustices occurring.  We must learn a necessary humility that, even for a “superpower,” some things are simply beyond America’s range and abilities.  The killing will continue in Syria.  There are now in place too many agendas, too many killed already, and far too many motivations for revenge.  Syria will go to the last solder or rebel fighter standing, which may be still years from now.

DIPLOMATIC RESOLUTION: I read of many calls for a “negotiated resolution” rather than American armed intervention, and calls for international diplomatic efforts to squeeze Assad from power.  It leaves me wondering what people think has been going on over the past several years.  Countries have collectively frozen Assad’s assets and instituted economic boycotts and embargoes of goods to his army.  Peace talks have been called for on numerous occasions.  But negotiations require willing and vested partners.

Assad has shown that he is every bit as strong and brutal as his predecessor father.  He looked at the “Arab Spring” revolutions and decided early on to do no negotiations, to slam the door on his protestors.  To stay exactly in his power position and go nowhere else.  And he has partners willing to keep him in power by blocking real international actions: Russia, who provides Syria with arms, trade goods, and funding, while also allowing Vladimir Putin to assert his ego and “stand up to America”; China, who never supports outside intervention in countries’ “internal affairs” lest that same intervention be directed to China’s dictators themselves (e.g. with Tibet); Iran, which is consistently looking to extend its influence across the Middle East.  So keep talking – yes.  Keep maneuvering – yes.  But expect little united action or meaningful negotiation.

CHEMICAL WEAPONS: The Assad regime’s undeniable use of chemical weapons on multiple occasions is an issue totally separate from the Revolution itself.  Chemical weapons, like nuclear weapons, are horrible things capable of mass killing.  Which is why all nations agreed to ban their use after mustard gas killings in World War I.  What has prevented their use over these past 100 years is the understanding that these chemical weapons, like their nuclear counterparts, are too terrible to use, as any such use would invite a reciprocal and escalating attack.  The minute we give implicit sanction to their use, a most dangerous door opens with potentially unimaginable results.  Even Syria’s allies Russia and Iran are squeamish on this war machine escalation, especially as Iran was the victim of Iraq’s use of such weapons during their 1980s war.  So on this issue, the international community must speak up and act.  Regardless of what individual may have actually sent out the order, the community must punish, and severely so, to assure any future Assad, or rogue general, or terrorist that this kind of weaponry is untenable.  (Remember the deadly sarin attack in the Tokyo subway system in 1995 that killed 12 and injured over 5,500?  This is not just a theoretical discussion.)

Complete a thorough United Nations investigation to its scientific conclusion – yes.  Build an action coalition if possible – yes.  But go it alone if necessary to say to others “This time you have gone too far, and you will not go there again” – also yes.  Chemical weapons in the subways of New York City are beyond a nightmare.

In spite of our desire to believe in, and bring out, the inherent good of people, there are simply some people who are willing to do very bad things.  There are some fights we need to pass over and let individuals find their own pathway out.  But there are some fights that can wind up on our own doorstep; those are fights we must stop.  The Syrian Revolution must find its own pathway out, however long and difficult that may be.  A political establishment willing to unleash the horror of chemical war must be stopped – for everyone’s future.

©2013  Randy Bell
 

Sunday, September 1, 2013

We Have Seen This Movie Before

The second week of September, Congress will reconvene after its annual 5-week August vacation.  Frankly, I cannot think of any group of salaried employees less deserving of a vacation of any length.  So far, this collection of politicians has passed just over 20 bills, on track to be the lowest productive Congress ever.  And of those 20, most all are token statements, of minimally consequential impact.  (“Let’s show our non-partisanship by agreeing to name a bridge in St. Louis after Stan Musial!”)

The important social issues of the day have been ignored or are in process of being swept aside.  Reforms in gun ownership are dead, even though 90% of Americans wanted some kind of action.  So it is clear that the opinions of the American public have been closed out of the discussions.  (Which only leaves you to ponder and speculate about who our congresspersons are listening to.)  Immigration reform, in another overweight bill that passed the Senate amid much hullabaloo, is now heading to its funeral service already planned in the House.  Restoration of some Voting Rights Act provisions struck down by the Supreme Court will not even get seriously introduced for consideration.

No, all of these issues (along with others) are going to be pushed aside in the coming months for yet another repeat argument over government spending – which itself is a disguise for a more basic attack on the purpose of government itself.  On October 1st, the current fiscal year ends, having been propped up by endless “continuing resolutions” to keep the government level-funded through the year.  (Of course, “level” now reflects the drastic, indiscriminate cuts of sequestration from last spring that were supposedly never intended to happen.)  So now what we will spend in FY 2014 will be the focus of the next big argument.

Shortly thereafter, we will once again bump up against our national debt ceiling limit.  And we will have yet another insane Congressional argument over whether we should pay our debts or not – debts incurred to fund Congress’ own spending decisions already made.  It assumes that we spent our money, then realized we spent more than we can afford, so we just default and go bankrupt as a “solution.”  But in the government’s case, its default would become a world-wide default and economic meltdown well beyond the 2008 Great Recession.  It is the ultimate fiscal mismanagement.  And the mis-managers are the same ones now asking us to trust their judgment to fix it all.  Speaker John Boehner has promised a “whale of a fight” over raising the limit.  It is a fight that should not even be fought in the first place.

Tax reform?  Badly needed.  A major key towards economic growth.  But the question of “fair share” has been completely perverted by a Tax Code that favors certain groups over others, or gives direct benefit to individuals with sufficient purchasing power of influence.  But there is not a chance in hell that tax reform will rise to any level of serious conversation or action.

Within all of this nonsensical discussion, yet another old issue will resurface: the Affordable Care Act (aka “Obamacare”).  Republican opposition to health care reform was defeated in the Senate, in the House, and to people’s ultimate surprise, in the Supreme Court.  Public polls show increasing support for the Act as more of its provisions are implemented.  Yet the opposition, not to be deterred by reality, refuses to move on and continues to fight over what has already been decided.  The Republican dominated House has now voted over 40 TIMES to repeal this legislation – all to no productive end whatsoever.  More token, symbolic, and meaningless gestures except to raise funds for political campaign treasuries.

Meanwhile we watch some sleazy CEOs using Obamacare as the cover story for other lousy decision-making.  Employee working schedules of highly profitable companies are being reduced to keep employees below the 30-hour threshold for health coverage.  Similarly, hiring is being limited to stay below the 50-employee threshold.  The CEO of Papa John's Pizza argued that providing health care to its employees to meet the Affordable Care specifications would “raise prices on all pizza products”; follow-up research by independent economists concluded that this increase would amount to 1-2 cents per slice.  Trust me, I would be perfectly happy to pay even a whole nickel more to help provide health care to already low-paid employees.  Fortunately, some socially responsible CEOs are getting on with “the new normal.”  Starbucks will continue providing health coverage for employees with as few as 20 hours/week.  Even Wal-Mart has announced additional low-cost insurance options, including coverage for domestic partners/same sex couples – although it still needs to expand the pool of employees covered.

Yes, the biggest flaw of the ACA is that it still replies on one’s employee status as the source and eligibility for health insurance.  I support those employers who object to paying this added and uncompetitive cost.  But such complaints need to be redirected towards achieving a wholly different, and non-employer based, funding base.  Until that time, health care will remain the private insurance company / employer-provided / Congress-endorsed social contract for providing health care.

The bigger issue in all of this is the tiredness of these discussions.  Spending budgets; debt ceilings; Obamacare; shutting down the government.  These are all old news.  Legislation and constitutionality has long been decided.  Budget deficits have been consistently shrinking each of the last several  years.  The economy is growing, albeit slowly and without the proper government support needed.  The American character used to be to fight the good fight over areas of disagreement.  But once the decision was made, accept it and move on to the next issues.  But this Congress is stuck in a time warp, stomping their feet over their losses like petulant children in the school playground.

It is time to move on.  Time to deal with today’s ignored issues, not re-hassling the past.  Even as we try to remain vigilant against further political radicalism and division, the American people are increasingly tuning out listening to these clanging political voices.  And with good cause.

We’ve seen this movie before.  We’ve read this book before and know how it ends.  It is time for a new script, one that will likely require a new set of actors.

©2013  Randy Bell