Showing posts with label Medicare. Show all posts
Showing posts with label Medicare. 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.      

Friday, February 21, 2020

BEFORE NEVADA AND SOUTH CAROLINA: BILLIONS, BAGGAGE, CHROMOSOMES, AND GENES


The week since the New Hampshire primary has made clear the peril for the Democratic Party in the 2020 campaign. Despite facing a just-impeached president with historically low approval ratings and an endless list of bad acts proving his unfitness for office, many justifiably fear seeing him re-elected. The complex and simple reasons behind this implicate some of America’s most enduring biases.

Coming out of the botched Iowa caucuses and the New Hampshire
primary, Vermont Senator Bernie Sanders became the narrow front runner.  In Iowa, he tied former South Bend, Indiana  Mayor Pete Buttigieg. Sanders won New Hampshire by two points over Buttigieg and a few more over surging Minnesota Senator Amy Klobuchar

Sanders leads in polls heading into the February 22 Nevada caucuses. He has the money and infrastructure for sustaining that advantage. In South Carolina, which votes February 29, he’s moved into second behind teetering former Vice President Joe Biden. If Sanders wins Nevada, then finishes a strong second in South Carolina (or wins), he could have put himself into position for taking the nomination.

Or would he? Sanders didn’t break 30% percent in Iowa or New Hampshire. It’s not clear he can in Nevada or South Carolina, even with victories. Given the nature of his appeal and national polling, which shows his support at around 25%, it isn’t likely Sanders will crack 30% many places unless the field winnows. That brings us to…

Billions
Former New York Mayor and multi-billionaire Michael Bloomberg has risen
to double digits in national polls and gotten on the debate stage by spending almost $400 million on advertising and staff, much of it in Super Tuesday states that vote March 3 (he’s not
on the ballot in Nevada or South Carolina).
He’s come under increasing scrutiny as he’s
risen. Bloomberg’s record offers targets like his racist stop-and-frisk policy in New York and sexist comments like
suggesting women spend
time in libraries instead of shopping if they want professional respect.

Whether Bloomberg’s billions immunize
him against negative impact from his past policies and statements became the subject of intense commentary as he rose in the polls. In the age of Trump who, of course, has made worse statements and promoted policies more damaging to women and people of color, some Democrats simply ignore
Bloomberg’s impolitic record. They recognize he’s with them on issues like climate change and guns and love the campaign infrastructure his money can buy for the general election. Which brings us to…
 
Baggage
The 2020 campaign has made clear almost all the contenders, including Bloomberg, bring arguably disqualifying baggage. That’s apparent for candidates who remain and some who’ve dropped out. 
California Senator Kamala Harris, who is African-American, never caught on with
Kamala Harris
black voters, partly because of suspicions about her
prosecutorial record. Former Massachusetts Governor Deval Patrick,
Deval Patrick
aside from starting too late, got tainted by his association with Wall Street. New Jersey Senator Corey Booker suffered from the same problem. Alleged connections with Russia dogged Hawaii Representative Tulsi Gabbard
Cory Booker
(she’s suing Hillary Clinton over a charge that she was a “Russian asset”).

Of the remaining viable candidates, Bloomberg’s mayoral record could undo him. Klobuchar now must answer for prosecutorial decisions she made in Minnesota. Opposition research fuels politics now and no perfect candidate exists.
Caption - NY Times 2/11/2020
Which brings us to…

Chromosomes
With the turmoil in the race – Biden
falling apart,  the weakness of Sanders as a front runner, Bloomberg’s baggage – it might seem Klobuchar or Massachusetts Senator Elizabeth Warren would have emerged as a consensus candidate. It’s true both have individual challenges. Warren stumbled over-explaining the cost of Medicare for all and Klobuchar lacks money and name recognition in some places.
The New York Times endorsed both. Each has a stellar record, though they offer different strengths and experiences. Both brim with intelligence and decency. Neither appears to have been touched by scandal.

Warren finished third in Iowa and, even worse,  fourth in her neighboring New
Hampshire. Klobuchar was fifth in Iowa, her neighboring state, and third in New Hampshire. What’s the problem?
They’re women! The specter of Hillary Clinton’s 2016 defeat looms over both. With many Democratic voters worried more about “electability” than policies and ideology, we fear both Warren and Klobuchar have been disadvantaged by the concern – rational or not – that a
woman can’t beat President Donald Trump. We aren’t endorsing that idea. But we suspect it’s out there, even though Clinton won nearly three million more votes than Trump. Which brings us to…

Genes
Most Americans now believe homosexuality isn’t a choice. They
believe people are born gay or lesbian as others are born straight. The notion people decide they’ll become gay has been out of favor for a while. If being gay is one of those immutable characteristics of life like race – something none of us can change about ourselves – no justification exists for denying gay and lesbian people rights and opportunities. We wouldn’t see one even if being gay were a choice. 

Buttigieg is the first serious openly gay presidential candidate. Many reasons exist for not supporting him – his tone-
Buttigieg & spouse Chasten
deaf handling of racial issues in his city, his inexperience, maybe even his campaign fundraising tactics. His sexual orientation isn’t a reason for opposing him.

We sense, however, that’s happening. We see the same dynamic as with the female candidates. Democratic voters otherwise attracted to Buttigieg shy away out of fear America won’t elect a gay president. Recent signals from right-wing commentator Rush Limbaugh suggesting Buttigieg’s sexual orientation is fair game heighten that concern.

So that’s the state of the Democratic race as Nevada and South Carolina vote. It’s not a pretty picture for Democrats, which means it’s not a pretty picture for an America desperately in need of ridding itself of Trump and the autocratic state he’s creating.