Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts

Tuesday, June 2, 2020

LET THE DEBATE BEGIN: HOW MUCH ‘‘SOCIALISM’’ IN AMERICA?


Some conservatives have complained
about the measures Congress enacted aimed at helping Americans get through the coronavirus dislocation. They label the measures “socialist,” “un-American”,
and at odds with
capitalism.  They say
we must get business as usual going or risk having these adjustments become permanent.


The country faces questions about the
appropriate level of government involvement in the economy and other aspects of life. Cries of “socialism” are not new when the government tries helping non-corporate middle America and the poor.
The
1936 Republican presidential nominee, Kansas Governor Alf Landon, attacked Social  Security as “socialism” (Franklin Roosevelt won the Electoral College, 523-8).

New York Governor Al Smith, the 1928 Democratic presidential nominee, wrote that year, “The cry of socialism has been patented by the powerful interests that desire to put a damper on progressive legislation. Is this cry of socialism anything new?... I have heard it raised by reactionary elements and the Republican Party … for over a quarter-century.”   

Many Americans who never thought
they’d seek or accept government assistance found themselves doing just that under the unprecedented circumstances the pandemic wrought. The pandemic exposed flaws in our healthcare and food supply systems. What happens when the
pandemic
ends? Is the kind of government assistance provided in connection with the pandemic an outlier or are significant policy changes on the horizon?

Will the nation remedy these weaknesses in our health care system
with new measures addressing some of the systemic shortcomings that made the coronavirus situation worse? Or, will the “socialism” objections prevail and keep the status quo in place?

Harry Truman’s 1945 health care
proposal was defeated in large measure by the American Medical Association’s labeling of the legislation as “socialized medicine.”  Things have changed. A recent Reuters/Ipsos poll showed over 70 percent of respondents favoring universal health care.

That Old Definitional Issue
When opponents leveled charges that Franklin Roosevelt’s New Deal programs
were “socialism,” he said in his 1936 State of the Union Address that the proper role of government was “the adjustment of burdens, the help of the needy, and the protection of the people’s property.”

This year, Democratic presidential candidates Bernie Sanders and Elizabeth Warren presented safety net programs aimed at assuring more Americans better access to health care,
child care, and other services. They proposed Medicare-for-All, a federal guarantee of health insurance mandated for everyone that would replace private health insurance. Other candidates, including presumptive Democratic nominee Joe Biden, also proposed expanded health insurance plans, though not Medicare-for-All.

In light of the virus experience, must we adopt measures that seem like “socialism?” The pandemic exposed three particular shortcomings in the health care system. First, many Americans don’t have insurance
coverage, meaning they couldn’t get adequate treatment if infected. Second, the lack of health care puts some groups at greater risk. Louisiana, for example, became an
early coronavirus “hot spot” because so many of its low-income citizens, most of the people of color, had limited access to health care before the virus hit. They suffered from medical conditions – hypertension, diabetes, obesity - that made death more likely upon contracting the virus. Finally,
health care workers faced massive shortages of equipment and supplies.

Theodore Roosevelt, the 26th president, responding to charges he was a capitalism obstructionist and opponent of individualism, wrote, “Ruin faces us ... if we permit ourselves to be misled into refusing to exert the common power of the community where only collectively action can do what individualism has left undone or can remedy the wrongs done by an unrestricted and ill-regulated individualism.”

What Will Americans Accept? What do they Want?
Post pandemic life in America probably will look different than life before March
2020.  Until we get a coronavirus vaccine, limits on large gatherings and close personal contact will likely remain necessary. Many won’t like that (sports fans?), but they’ll probably accept it in exchange for re-starting the economy. But what about political changes?  How much government will Americans accept or desire?

Democrats flipped the House of Representatives in 2018, relying on health care as a way of attracting suburban women and people of color. The pandemic assures the push for improved health coverage will play a central role in the 2020 campaign and in the next session of Congress. Once the emergency ends, will Republican resistance to expanded health insurance fade? We don’t know.
Many Democrats will seek a larger
federal investment in the health care system. That means lots of money for assembling and maintaining government stockpiles of medical equipment. Will anybody suggest rolling back the Trump tax cuts for financing such investment? Is doing such a thing “socialism?” 
What about unemployment insurance?  That’s mostly funded by taxes on employers. In light of the record number of unemployment claims, will
political and business leaders agree on a different way of funding that system? Would using general revenue and assessing higher taxes for that purpose make sense? Debating the issue seems reasonable now.

The Most Vulnerable
Many of these questions center on what America does about issues faced for the first time by middle-class people. How much “socialism” will they accept or want? That’s a political question on
which the spotlight will fall in the months ahead. Another issue, however, lurks beneath the surface. America has a population for whom the issues raised by the pandemic were not new. They live with them every day and have for a long time.

For this group, health insurance often doesn’t exist. Visits to doctors don’t happen except in the direst emergencies. Trips to food banks occur regularly, something middle-class people recently experienced for the first time. These most at-risk Americans need a voice in the political debate about “socialism.” Over the next few months, in this space, we intend to give it to them.      

Monday, August 26, 2019

A LITTLE HELP FROM YOUR FRIENDS (PART I)


OUR ADVICE FOR ELIZABETH WARREN, JULIAN CASTRO, AND KAMALA HARRIS

Recently we offered the field of 2020 Democratic candidates some general advice. We first urged that they stop attacking President Obama. Given his 95% approval rating among democrats, little good can come from assailing his time in office.  We urged that the candidates simplify their healthcare plans and fire at  Donald Trump,  while avoiding personal attacks on each other. We promised advice for individual candidates “later.” That time has arrived.

The debate in Houston September 12-13 will feature a smaller field because of tougher democratic party donor and polling criteria. How many candidates make the stage remains uncertain, but expect something like 13, not 20 as in Miami and Detroit, meaning the debate might require one day, not two.
We don’t know who’ll remain viable when voting starts next February, so we won’t try advising everybody. We've taken a  "top
four plus two” approach. Joe Biden, Elizabeth Warren, Bernie Sanders, and Kamala Harris lead in almost every poll we’ve seen. We’re still in the campaign’s early stage, we projected two other candidates we think could have a shot. Somebody we didn’t pick (Cory Booker? Amy
Klobuchar
?) still might catch fire. For reasons we’ll discuss, our might-get-it-going candidates are the two Texans, Julian Castro and Beto O’Rourke. We start with Warren, Castro, and Harris and will follow up with Biden, O’Rourke, and Sanders.
 
Elizabeth Warren
Frankly, we don’t see much we can tell you. Since getting past that DNA test mistake at the beginning, you’ve run a nearly flawless campaign. You’ve become legendary for detailed policy proposals (“I’ve got a plan for that!”) and turned in two excellent debate performances. You’ve eschewed big donors yet raised plenty of money. One CNN commentator called you “the best athlete on the field.” Still, we have a few suggestions.

First, you must work harder at combatting the notion you’re a pointy-headed elitist Harvard professor who isn’t a regular person. You can accomplish that by talking more about your personal narrative in addition to those policy
proposals. You’re from Oklahoma, for crying out loud! You grew up with the everyday problems real people, especially women, face – paying for an education, taking care of children while pursuing a career, making ends meet on a limited salary. We suspect many people don’t know any of that. 


Second, we suggest you show some flexibility in your plans, especially health care.  If you get nominated all your proposals will face intense examination.  Make clear your broad health care goals, but spend less time on mechanics.  We hope you can indicate a willingess to adjust your plans if someone else has a better idea. 


Third, you must disabuse the nation of the idea you're a socialist.  Polls show many of your policy proposals, like the wealth tax, enjoy broad public support.  The media, in its perpetual horserace focus, lumps you with self-described Democratic Socialist Bernie Sanders. Senator, as we've written, you have some very capitalist ideas.  Socialism means governmental control of the means of production. You haven't advocated that, and you should take every opportunity you can for reminding people of that. 

Julian Castro
We identifiedy you as a possible party crasher because you performed well in both debates and your records suggests you have the right stuff for being President.  Unlike many of your
rivals, who've only been legislators, you have administrative experienc as housing secretary and as Mayor of San Antonio. So, what advice do we have for you? 

First, you must show you're more than a one-trick pony.  Immigration has been your debate
calling card, but you talk more about other things.  Your website offers interesting proposals on education, the economy, and policing.  Since you made the Houste debate state, talk more about those.

Second, when discusssing immigration, you can't come across as attacking President
Obama.  You sounded like that in Detroit when you went after Biden on deportations.  There's plenty you can challenge about Trump's immigration policies without an apparent assault on Barack Obama.  Though we understand your qualms about his deportation policies, you can't become President without the Obama coalition.
 
Kamala Harris
We find you the most frustrating candidate in the race. We’re attracted by the idea of a progressive woman of color as the
Democratic nominee. We have little difficulty with your 
policy positions though, even more than Senator Warren, you should simplify your health care approach because it’s too complex. Our biggest concern with you lies in your communication style. That could have more to do with you not getting nominated than any issue.

Despite being in the U.S. Senate only three years, you’ve forged a reputation as a tough inquisitor of Trump nominees. You effectively
utilized your prosecutorial
experience in making both Supreme Court pick Brett Kavanaugh and Attorney General designee Bill Barr squirm. In the Miami debate, you
employed those skills in a well-timed
attack on Biden over school integration, an attack he flubbed. This gave you a boost in the polls and had pundits talking about how you’d proved you can stand on the debate stage against Trump.

All well and good, but you should stop being a prosecutor 24/7. We’ve seen that style in interviews and other appearances and it doesn’t work. You come off at times as “snarky” and unpleasant. That style may work in California, but it will fail in the heartland. As trial lawyers, we learned there comes a time
for leaving the cross-examination persona in the courtroom. Your poll numbers dropped after both debates as the glow of your performances faded. You must understand interaction with voters and media in a presidential campaign occurs outside a court or congressional committee hearing room.

NEXT: Biden, O’Rourke, Sanders