Wednesday, November 25, 2015
Saturday, November 21, 2015
Democratic Socialism: Let Us Finish What FDR and MLK Started
The following are the prepared remarks for a speech given by Sen. Bernie Sanders (I-Vt.) at Georgetown University on Thursday, November 19th, 2015.
In his inaugural remarks in January 1937, in the midst of the Great Depression, President Franklin Delano Roosevelt looked out at the nation and this is what he saw.
He saw tens of millions of its citizens denied the basic necessities of life.
He saw millions of families trying to live on incomes so meager that the pall of family disaster hung over them day by day.
He saw millions denied education, recreation, and the opportunity to better their lot and the lot of their children.
He saw millions lacking the means to buy the products they needed and by their poverty and lack of disposable income denying employment to many other millions.
He saw one-third of a nation ill-housed, ill-clad, ill-nourished.
And he acted. Against the ferocious opposition of the ruling class of his day, people he called economic royalists, Roosevelt implemented a series of programs that put millions of people back to work, took them out of poverty and restored their faith in government. He redefined the relationship of the federal government to the people of our country. He combatted cynicism, fear and despair. He reinvigorated democracy. He transformed the country.
And that is what we have to do today.
And, by the way, almost everything he proposed was called “socialist.” Social Security, which transformed life for the elderly in this country was “socialist.” The concept of the “minimum wage” was seen as a radical intrusion into the marketplace and was described as “socialist.” Unemployment insurance, abolishing child labor, the 40-hour work week, collective bargaining, strong banking regulations, deposit insurance, and job programs that put millions of people to work were all described, in one way or another, as “socialist.” Yet, these programs have become the fabric of our nation and the foundation of the middle class.
Thirty years later, in the 1960s, President Johnson passed Medicare and Medicaid to provide health care to millions of senior citizens and families with children, persons with disabilities and some of the most vulnerable people in this county. Once again these vitally important programs were derided by the right wing as socialist programs that were a threat to our American way of life.
That was then. Now is now.
Today, in 2015, despite the Wall Street crash of 2008, which drove this country into the worst economic downturn since the Depression, the American people are clearly better off economically than we were in 1937.
But, here is a very hard truth that we must acknowledge and address. Despite a huge increase in technology and productivity, despite major growth in the U.S. and global economy, tens of millions of American families continue to lack the basic necessities of life, while millions more struggle every day to provide a minimal standard of living for their families. The reality is that for the last 40 years the great middle class of this country has been in decline and faith in our political system is now extremely low.
The rich get much richer. Almost everyone else gets poorer. Super PACs funded by billionaires buy elections. Ordinary people don’t vote. We have an economic and political crisis in this country and the same old, same old establishment politics and economics will not effectively address it.
If we are serious about transforming our country, if we are serious about rebuilding the middle class, if we are serious about reinvigorating our democracy, we need to develop a political movement which, once again, is prepared to take on and defeat a ruling class whose greed is destroying our nation. The billionaire class cannot have it all. Our government belongs to all of us, and not just the one percent.
Hillary Is Already Triangulating Against Liberals
Her new attack on Bernie Sanders’ single-payer health care plan shows her indifference to progressive voters.
The Hillary Clinton presidential campaign has begun using an odd new line of attack against upstart Democratic primary rival Sen. Bernie Sanders: He’s too liberal on taxes and universal health insurance. Why is she doing this? After returning to the position in which she entered the race—as the near-certain nominee—she seems to be setting herself up for the general election. But it’s strange to see her now, after the previously shaky ship has been steadied, attacking a candidate whose supporters she’ll need in any general election campaign over an issue that his supporters care about very deeply.
Triangulating against Sanders (and, by proxy, the left wing of the Democratic Party) with conservative attacks does make some sense. For one, she is a Clinton, and this is what they do.
At issue is Sanders’ support for a single-payer universal health care system, which he and others brand as “Medicare for all.” A single-payer bill he introduced in 2013 would have levied a 2.2 percent tax on individuals making up to $200,000 or couples making up to $250,000, and progressively increased that rate to 5.2 percent for income beyond $600,000. It also would have tacked an extra 6.7 percent payroll tax on the employer side, at least some of which employers would likely pass on to workers.
The Clinton campaign is suddenly quite upset about that proposal and wants everyone to know. She has committed to the same (policy-constricting) pledge that President Obama took in 2008 and 2012, ruling out tax increases on individuals making less than $200,000 per year or joint filers making less than $250,000. This neatly positions her camp to say, by contrast, that the bug-eyed socialist Bernie Sanders wants to take all of your money.
“Bernie Sanders has called for a roughly 9-percent tax hike on middle-class families just to cover his health-care plan,” a Clinton spokesman said Tuesday, via Politico. “Simple math dictates he'll need to tax workers even more to pay for the rest of his at least $18-20 trillion agenda. If you are truly concerned about raising incomes for middle-class families, the last thing you should do is cut their take-home pay right off the bat by raising their taxes.”
This is a truly messed-up thing for the leading Democratic presidential candidate, who claims to be a progressive stalwart, to be broadcasting.
A standard Democratic presidential nominee representing the center-left of the party might call a single-payer system politically impractical in order to argue against it. “If I were designing a system from scratch, I would probably go ahead with a single-payer system,” Sen. Barack Obama said during his 2008 presidential campaign, for example. He then explained why he wouldn’t pursue such a model: “People don’t have time to wait. They need relief now. So my attitude is let’s build up the system we got. Let’s make it more efficient. We may be over time—as we make the system more efficient and everybody’s covered—decide that there are other ways for us to provide care more effectively.” In the end that approach resulted in the Affordable Care Act, compromise legislation that greatly expanded coverage without really overhauling the country’s private health insurance model. But Obama didn’t really disown the idea of single-payer, which many progressives still prefer to the current system.
Clinton, however, is going much further by appropriating one of the right’s central talking points against government-funded universal health insurance: Think of the taxes! She’s not just saying that a single-payer system is a political nonstarter with conservatives. She’s reciting the actual conservative talking point that would make a single-payer system a political nonstarter.
There are fairly obvious policy counterpoints to that argument. She is well-aware of them and chooses to ignore them, because they would either blunt or negate her convenient political attack. Sure, under Sanders’ plan, the combination of the income and payroll taxes would add up to 8.9 percent (assuming employers pass on the full 6.7 percent payroll tax) on most earners. But people would not be paying for health insurance anymore, and a universal, public system would save money by eliminating all of the actuarial costs and profit expectations associated with the private insurance system.
Nurses Criticize Clinton Attack on Single Payer
WASHINGTON - National Nurses United, the largest U.S. organization of nurses, condemned the Hillary Clinton campaign today for its attack on Sen. Bernie Sanders’ proposal for healthcare for all, including its slanted use of data on the economics of Medicare for all.
“Any politician that refuses to finance guaranteed health care has abandoned my patients, and I will never abandon my patients. That’s why we support improved Medicare for all, and that’s why I support Bernie Sanders,” said NNU Co-President Jean Ross, RN.
“While the Affordable Care Act corrected some of the worst injustices in our insurance, profit-based healthcare system, the work of healthcare reform is far from done,” said Ross. “Today, 33 million Americans remain uninsured. Tens of millions more remain uninsured, facing bankruptcy due to unpayable medical bills or the choice of getting the care they need or paying for food or housing for their families.”
“The only fix for our broken system once and for all is the prescription Bernie Sanders has so eloquently presented – joining the rest of the world by expanding and updating Medicare to cover every one,” Ross said.
NNU also criticized Clinton for citing a rightwing report first published in the Wall Street Journal on the inflated cost of $15 trillion to implement a Medicare for all system. The Journal report claimed as its source research by University of Massachusetts Amherst economics professor Gerald Friedman.
But Friedman himself has criticized the Journal report, noting in a Huffington Post column that the “economic benefits from Senator Sander's proposal would create dynamic gains by freeing American businesses to compete without the burden of an inefficient and wasteful health insurance system.”
Those include a "productivity boost coming from a more efficient health care system and a healthier population, [that] would raise economic output and provide billions of dollars in additional tax revenues to offset some of the additional federal spending," said Friedman.
Friedman estimates nearly $10 trillion in savings while still reducing national health care spending by over $5 trillion. “With these net savings, the additional $14.7 trillion in federal spending brings savings to the private sector (and state and local governments) of over $19.7 trillion,” Friedman wrote.
Clinton is “ignoring the enormous savings that would come by assuring people could get proper care where and when they need it,” Ross added.
The country's largest private health insurer throws a 'tantrum' over lower profits
David Lazarus - LA Times
UnitedHealth Group, the country's largest private health insurer, has discovered that sick people tend to go to the doctor. And that means bills to pay. And that's bad for the company's bottom line.
So UnitedHealth said Thursday that because of the "continuing deterioration" of its profits from Obamacare, it may quit offering coverage through the system by 2017.
In its next breath, UnitedHealth stressed that it "remains a strong supporter of sustainable efforts to ensure access to affordable, quality care for all Americans."
But, well, business is business. The company's concerned that it might not see the same $1.6 billion in profit that it pocketed in the third quarter.
Supporters of healthcare reform will view UnitedHealth's warning as further proof that for-profit companies shouldn't be making money off the sick. Critics will see evidence of Obamacare's failed promise of fixing a broken healthcare system.
They're both right. The bigger issue, however, is what we're going to do about it.
"We should be worried," said Dana Goldman, director of the USC Schaeffer Center for Health Policy and Economics. "The long-term sustainability of the Affordable Care Act requires a functioning market with lots of players.
"If this is what the largest insurer is thinking, other insurers are probably thinking the same," he said. "If the number of players shrinks, it will be a less functional market."
Gerald Friedman, a healthcare economist at the University of Massachusetts Amherst, said no one should be surprised by a major health insurer threatening to take its ball and go home.
"They're a for-profit company," he said. "That's capitalism."
True. UnitedHealth's chief executive, Stephen J. Hemsley, has a fiduciary duty to deliver consistently solid results to the company's shareholders. There's a reason he received total compensation valued at more than $66 million last year.
The problem, as Friedman and others said, is that many of the first people to sign up for Obamacare coverage were those with preexisting medical conditions who had been denied coverage in the past. They wasted no time seeking treatment.
"UnitedHealth is still making a lot of money, just not as much as they thought," Friedman said. "So they need to signal their shareholders that they take this seriously."
Will the company really quit the individual insurance market? Most experts I spoke with said this would be unlikely.
"They're probably just sending a message," said Timothy McBride, a healthcare economist at Washington University in St. Louis. "They may be saying that to stay, they want to see higher premiums."
If so, people buying insurance on Obamacare exchanges can look forward to paying more for coverage and being able to afford only policies with huge deductibles.
That would be good for insurers and bad for patients, and it would represent yet another roadblock to creating a system that guarantees everyone access to affordable medical care.
What to do? That's where things get tough — as the long, bumpy road to passage of the Affordable Care Act in 2010 made clear. With about $3 trillion in annual healthcare spending at stake, this is a pot stirred by lots and lots of chefs.
USC's Goldman had one suggestion: Rather than having people sign up for coverage under Obamacare on a yearly basis, extend contracts to two or three years. This would help even out insurers' returns by raising the likelihood of fewer claims once immediate health issues have been addressed.
Stuart Altman, a professor of national health policy at Brandeis University, said perhaps the sickest Americans should be broken off into a separate high-risk pool and receive coverage from the government. "In the individual market, the risks are just too great," he said.
This would shield private insurers from the biggest claims. But it would stick taxpayers with the cost.
Friedman at the University of Massachusetts said a partial step toward addressing that problem would be lowing the eligibility age for Medicare, thus spreading the risk among millions of program beneficiaries.
But why stop there? Nearly every expert I spoke with said the only cost-effective way of covering an entire population is to do what the rest of the developed world does — offer a single-payer system that can serve as the foundation of people's insurance options.
"If you think that healthcare is a right, single payer becomes the most direct solution," said Frank A. Sloan, a professor of health policy and economics at Duke University.
"Unfortunately," he said, "the American people have been told this is socialized medicine, and we don't like socialism."
It's not socialized medicine. Nobody's talking about government-controlled medical care. Single-payer insurance is simply a way of managing risk and providing stable financing of treatment.
It's also a smart way of relieving corporations of the burden of insuring employees, which would improve their global competitiveness.
Asked about the chances of a single-payer system in this country, most of the experts said, "Not in my lifetime." The political and the ideological barriers are just too high.
Instead we have UnitedHealth throwing what Princeton University economist Uwe Reinhardt called "a tantrum" when confronted with the possibility of not cleaning up at the Obamacare craps table.
"Of all the conceivable ways to finance healthcare," he told me, "Americans have found the dumbest way to do it."
That, it appears, won't change any time soon.
UnitedHealth Group Losing Big Money and Threatening to Leave the Obamacare Exchanges--Because the Obamacare Insurance Business Model Does Not Work
by Robert Laszewski
It's official. The Obamacare insurance company business model does not work.
UnitedHealth Group just announced they expect to lose $700 million in the Obamacare exchanges and are seriously considering withdrawing from the program in the coming year.
This morning, the Wall Street Journal reported just about everybody else is losing their shirts in Obamacare as well:
Several other big publicly traded insurers also flagged problems with their exchange business in their third-quarter earnings Anthem Inc. said enrollment is less than expected, though it is making a profit Aetna Inc. said it expects to lose money on its exchange business this year, but hopes to improve the result in 2016. Humana Inc. and Cigna Corp. also flagged challenges...Every health plan I talk to tells me that they don't expect their Obamacare business to be profitable even in 2016 after their big rate increases. That does not bode well for the rate increases we can expect to be announced in the middle of next year's elections.
There are signs that broad pattern has continued--and in some cases worsened--this year. A Goldman Sachs Group Inc. analysis of state filings for 30 not-for-profit Blue Cross and Blue Shield insurers found that their overall company wide results were "barely break-even" for the first half of 2015.
Goldman analysts projected the group would post an aggregate loss for the full year--the first since the late 1980s. The analysis said the health-law exchanges appeared to be a "key driver" for the faltering corporate results, and the medical-loss ratio for the Blue insurers' individual business was 99% in the first half of 2015--up from 91% at that point in 2014, and 82% for the first six months of 2013.
And, then there are the insolvencies of 12 of the 23 original Obamacare co-op insurance companies--the canaries in the Obamacare coal mine--with almost all of the rest of the survivors losing lots of money.
Why is this happening?
Because nowhere near enough healthy people are signing up to pay for the sick.
Critics say high deductibles make insurance ‘unaffordable’
COLUMBUS, Ohio — When President Obama’s landmark health care law ushered in a slew of new insurance options in 2013, the Andersons could not wait to sign up.
Roger Anderson, 54, a formerly uninsured construction worker, has a bad back and a bad heart. He and his wife are still paying for his earlier heart surgery and feared another crisis could ruin them.
“This law was going to give people a chance,” said Cassaundra Anderson, 44, a freelance proof reader.
But in April, when Roger Anderson fell while hiking and hurt his shoulder, he discovered, to his dismay, that simply being insured was not enough. The Andersons’ mid-tier plan, which costs them $875 a month, requires them to meet a $7,000 deductible before insurance payments kick in.
“We can’t afford the Affordable Care Act, quite honestly,” said Cassaundra Anderson, whose family canvassed for Obama in their neighborhood, a Republican stronghold outside Cincinnati. “The intention is great, but there is so much wrong. . . . I’m mad.”
The Andersons’ experience echoes that of hundreds of thousands of newly insured Americans facing sticker shock over out-of-pocket costs. Although the law survived two Supreme Court challenges, it could still be on the line in the 2016 presidential election, posing a significant political barrier to Democrats in this critical battleground state, which includes both conservative rural sections of Appalachia and diverse cities.
The problem experienced by the Andersons is particularly acute in Ohio, which has the fourth-largest number of people enrolled in high-deductible insurance plans in the country, after Texas, Illinois, and Pennsylvania, according to America’s Health Insurance Plans, the industry’s trade association based in Washington.
Now that the law’s major provisions are in place, the outcry over cost has prompted Hillary Clinton, the Democratic front-runner, to call for changes to Obama’s signature domestic achievement.
“This will be an issue at least one more time in the 2016 election. It could absolutely still hurt Democrats,” said Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health. “Polls about the Affordable Care Act have a considerable amount of middle-income people who say either the program has done nothing for them or actually hurt them.”
Governor John Kasich, like other Republicans running for the party’s presidential nomination, blames rising insurance costs on Obama’s 2010 health reform law and has called for its repeal. Clinton defends the Affordable Care Act on the campaign trail but is pledging to lower out-of-pocket costs including deductibles and making affordable health care a “basic human right.” Senator Bernie Sanders, a self-described socialist challenging Clinton for the Democratic nomination, says Obama’s health law does not go far enough and advocates for a “Medicare-for-all” single-payer system instead.
The percentage of Ohioans who view the law unfavorably is higher than in the nation as a whole, especially among independents and Democrats, according to new data from the annual Ohio Health Issues Poll. Nearly half of Ohioans do not like the law, compared with the 42 percent national figure reported by the Kaiser Family Foundation in October.