Yesterday, the resident Clown Circus also known as the republican party plowed new ground. Representative Nunes, majority party chairman of the House Intelligence Committee–do the words house and intelligence really belong in the same sentence?–advanced the crazy ball at least 50 yards. After being given information from the security community in his role as chairman of the Committee he immediately dashed over to the White House, without sharing this information with anyone else on the committee, to divulge it to the White House. Now ordinarily this would be startling but given the fact that the White House and even the president is a target of the investigation he is heading it ventures into the realm of the unbelievable. One must conclude that Nunes thought the White House needed a heads up, either to protect itself from stepping in it again or to figure out someway in advance to spin whatever he told them. If this doesn't demonstrate the need to have some sort of bipartisan select committee look into these matters nothing will.
Meanwhile the Republican-controlled House can't pass the repeal and replacement of the ACA because of disagreement within the party. You may recall that the twit meister on the campaign promised more affordable and better healthcare for all. The debate among the Republicans appears to be whether they have succeeded enough in providing less comprehensive healthcare for those that are not shut out entirely. The wonderful Freedom Caucus wants to make sure that the costs are lower. There's solution appears to be to give our citizens the right to" choose" to receive less Health care, eliminating things like preventative healthcare and god knows what else. They also have some cockamamie idea that Insurance companies will provide individualized policies so that each citizen only ensures himself against those episodes of Health problems most likely to be experienced by that person. Plus, I suppose, if there is no history of heart disease in one's family they can eliminate that coverage. Similarly, if there appears to be no genetic disposition towards cancer I suppose that could be illuminated. What the cost would be in creating and administering these plans by insurance companies as not been a topic of discussion. As of the science of genetics increases our knowledge, once imposes a greater precision in designing cafeteria style Health plans. We should extend this concept so that for instance one only needs to pay for road maintenance in one's own neighborhood and well-traveled routes. God for bid that we agree that important problems be addressed collectively. It's every man for himself as much as possible.
If the Republicans really wanted to reduce the cost and provide greater choice, they would allow citizens citizens to choose the public option which we clearly decrease the cost of healthcare two individuals and the country as a whole. One wonders why the Democrats are not pointing that out to them.
Thursday, March 23, 2017
Wednesday, March 22, 2017
Shell game
I have been for the last 10 days in Amsterdam and Paris. There was not a lot of discussion about Donald Trump as each of those countries has political problems of its own. The Netherlands did not elect their version of Donald Trump.It is yet to be seen whether Marie Le Pens will prevail in France. I was able to keep up with the continuing antics of Donald Trump and his ability to demonstrate that he is a lying incompetent. One wishes the ability to know what Angela Merkel for instance thinks how about this buffoon.
In the area near the Eiffel Tower there are a considerable number of conmen enticing tourists with the pea under the three cup game. They always have shills who will win the game enticing the gullible to play. Sort of like Kellyann Conway trying to convince the American public that Trump is on the up and up. Metaphorically, this Parisian con game is not much different than the current Republican healthcare proposals. Somehow, under the Health savings accounts and imaginary competition among Insurance companies will be found the pea of better cheaper healthcare. Why the major healthcare companies and insurance companies are going to race across state lines to compete when they are quite clearly oligopolistally interdependent is a mystery to me. I suppose the most dismal aspect of all this is that the, to use Trumps term," so called" Freedom Caucus thinks the government is being far too generous. At some point, many of Trump's supporters are going to learn they have been given the freedom to go without healthcare and nothing in exchange.
In the area near the Eiffel Tower there are a considerable number of conmen enticing tourists with the pea under the three cup game. They always have shills who will win the game enticing the gullible to play. Sort of like Kellyann Conway trying to convince the American public that Trump is on the up and up. Metaphorically, this Parisian con game is not much different than the current Republican healthcare proposals. Somehow, under the Health savings accounts and imaginary competition among Insurance companies will be found the pea of better cheaper healthcare. Why the major healthcare companies and insurance companies are going to race across state lines to compete when they are quite clearly oligopolistally interdependent is a mystery to me. I suppose the most dismal aspect of all this is that the, to use Trumps term," so called" Freedom Caucus thinks the government is being far too generous. At some point, many of Trump's supporters are going to learn they have been given the freedom to go without healthcare and nothing in exchange.
Wednesday, March 8, 2017
Markets and choice
The Republicans have now unveiled the skeleton of their Health plan. It is clear that the guiding principle is not providing decent health care for all of our citizens in the most efficient manner. The guiding principle is conservative political ideology that overrides all other considerations. They continue to promote the fantasy that markets with less or no governmental oversight or participation provide the best solution. They have been saying this from the time that Ronald Reagan said that Medicare would destroy the American healthcare system.
For markets to function efficiently conditions must be met. Knowledge on the part of all participants must be symmetrical, users must be rational maximizer's in the markets cannot be highly concentrated. These are minimal requirements and the market for health care, and for that matter health insurance, do not have these characteristics. The market for health insurance is highly concentrated and is at the least oligopolistic. There is no reason for large insurers to compete. Opening markets across state lines only creates an allusion of more competition. There can be competition at the provider level at least in highly populated areas but the republican proposals do nothing to promote this. The insurance funding model is a dinosaur and only adds an unnecessary additional expense to the healthcare system.
The Republican" Choice "is similarly an illusion. Too many of our citizens cannot" Choose" good healthcare because they will not be able to afford it. The question that the Republicans refuse to address is a simple one." Do we as a country and a society want to commit to providing a reasonable level of healthcare, including preventative healthcare, for all of our citizens"? The Republican answer is only if they can afford it. If the Republicans wanted our citizens to have a real choice, they would allow those citizens to have the choice between the Republican plans or a participation in what is essentially Medicare by way of the public option. All our citizens would be given the choice between the grim reality of the Republican political ideological approach to healthcare or more Government participation. To prevent this option from being gamed, individuals would have a limited amount of time to choose the public option instead of waiting until they were older and sicker.
As imperfect as it was, the affordable care act accomplish two things. It got rid of the uninsurable's and recognized the need for greater governmental subsidies. The republicans have spent the last six years sabotaging that act by among other things refusing to fund the provisions that would compensate insurance companies for insuring those with preexisting conditions and refusing Medicare expansion at the state level. The Republicans now claim the affordable care act can't work after spending six years doing everything in their power to make that true. The Republicans now want to take a giant step backward. They will disadvantage those who need help the most purely for the promotion of political ideology. A measure of the morality of a political and economic system is how it treats those most vulnerable and unable to fend for themselves. On this basis, what the Republicans are proposing is despicable.
For markets to function efficiently conditions must be met. Knowledge on the part of all participants must be symmetrical, users must be rational maximizer's in the markets cannot be highly concentrated. These are minimal requirements and the market for health care, and for that matter health insurance, do not have these characteristics. The market for health insurance is highly concentrated and is at the least oligopolistic. There is no reason for large insurers to compete. Opening markets across state lines only creates an allusion of more competition. There can be competition at the provider level at least in highly populated areas but the republican proposals do nothing to promote this. The insurance funding model is a dinosaur and only adds an unnecessary additional expense to the healthcare system.
The Republican" Choice "is similarly an illusion. Too many of our citizens cannot" Choose" good healthcare because they will not be able to afford it. The question that the Republicans refuse to address is a simple one." Do we as a country and a society want to commit to providing a reasonable level of healthcare, including preventative healthcare, for all of our citizens"? The Republican answer is only if they can afford it. If the Republicans wanted our citizens to have a real choice, they would allow those citizens to have the choice between the Republican plans or a participation in what is essentially Medicare by way of the public option. All our citizens would be given the choice between the grim reality of the Republican political ideological approach to healthcare or more Government participation. To prevent this option from being gamed, individuals would have a limited amount of time to choose the public option instead of waiting until they were older and sicker.
As imperfect as it was, the affordable care act accomplish two things. It got rid of the uninsurable's and recognized the need for greater governmental subsidies. The republicans have spent the last six years sabotaging that act by among other things refusing to fund the provisions that would compensate insurance companies for insuring those with preexisting conditions and refusing Medicare expansion at the state level. The Republicans now claim the affordable care act can't work after spending six years doing everything in their power to make that true. The Republicans now want to take a giant step backward. They will disadvantage those who need help the most purely for the promotion of political ideology. A measure of the morality of a political and economic system is how it treats those most vulnerable and unable to fend for themselves. On this basis, what the Republicans are proposing is despicable.
Tuesday, March 7, 2017
Democrats–Time to go to work
The Republicans are unveiling their ACA replacement. It bears no similarity to the extravagant promises made by Donald Trump. Remember he promised better, less expensive healthcare for everyone.
First point. This plan does not offer healthcare. It offers" access" to health insurance. The Republicans are talking about free markets and choice. The choice part is a total illusion. There will be a so-called choice between plans which have higher deductibles and less coverage and those which provide actual health care at a much higher cost. The cost of an insurance based Health coverage is the cost paid to the insurer plus the deductible. Thus, a plan with a $10,000 deductible w ill cost $10,000 dollars plus whatever is paid to the insurance company. Also, add in the cost of uncovered healthcare under the plan. Free markets are illusory when it comes to healthcare. It's not like buying a TV set. When one needs health care, it is not a discretionary purchase.Many people are going to be thrown back on the emergency ward Health care model.
Second point. Those on the Medicaid and who need Federal subsidies will find themselves disadvantaged. Medicaid block grants to states will put recipients at the mercy of whatever the state to size to do. The Federal subsidies being proposed will severely disadvantage all the those except those who are nearing Medicare as they are based on age rather than need.
Third point. The cost of healthcare is largely experienced at the provider level. The Republican plan as thus far explained does nothing to address this. As it is Insurance based, it also retains of the 15% excess administrative cost over the administrative cost of Medicaid and Medicare.
Finally, this proposal will not only provide nothing new but also takes away much-needed benefits from all those unemployed or marginally employed workers from West Virginia through Pennsylvania Ohio Wisconsin and Michigan who voted for Trump. This is where the Democrats need to expand their time and energy. The Democrats need a persistent and relentless campaign of telling these people they have been lied to. That needs to begin now. And, the Democrats need to be offering their own solution which must include the public option. They need to also harp on the notion that the United States among all of the advanced Western democracies is the only one that does not provide healthcare for all its citizens.
First point. This plan does not offer healthcare. It offers" access" to health insurance. The Republicans are talking about free markets and choice. The choice part is a total illusion. There will be a so-called choice between plans which have higher deductibles and less coverage and those which provide actual health care at a much higher cost. The cost of an insurance based Health coverage is the cost paid to the insurer plus the deductible. Thus, a plan with a $10,000 deductible w ill cost $10,000 dollars plus whatever is paid to the insurance company. Also, add in the cost of uncovered healthcare under the plan. Free markets are illusory when it comes to healthcare. It's not like buying a TV set. When one needs health care, it is not a discretionary purchase.Many people are going to be thrown back on the emergency ward Health care model.
Second point. Those on the Medicaid and who need Federal subsidies will find themselves disadvantaged. Medicaid block grants to states will put recipients at the mercy of whatever the state to size to do. The Federal subsidies being proposed will severely disadvantage all the those except those who are nearing Medicare as they are based on age rather than need.
Third point. The cost of healthcare is largely experienced at the provider level. The Republican plan as thus far explained does nothing to address this. As it is Insurance based, it also retains of the 15% excess administrative cost over the administrative cost of Medicaid and Medicare.
Finally, this proposal will not only provide nothing new but also takes away much-needed benefits from all those unemployed or marginally employed workers from West Virginia through Pennsylvania Ohio Wisconsin and Michigan who voted for Trump. This is where the Democrats need to expand their time and energy. The Democrats need a persistent and relentless campaign of telling these people they have been lied to. That needs to begin now. And, the Democrats need to be offering their own solution which must include the public option. They need to also harp on the notion that the United States among all of the advanced Western democracies is the only one that does not provide healthcare for all its citizens.
Monday, March 6, 2017
Shame on you Republicans
Saturday, after the startling demonstration that he could actually read a script, Donald Trump reverted to type. He apparently went on a temper tantrum against his staff for their failure to explain or cover-up the stupid things he says and does. He then started twitting making what appeared to be totally baseless allegations against President Obama and of course reiterated why he was a much more successful star of the apprentice than Arnold Schwarzenegger.
He thus once again demonstrated what we have come to know about him: he is petty, he is thin-skinned, he will lie about anything if he thinks he can get away with it, and he cannot focus on difficult problems as was fully documented by the ghostwriter of his Art of the Deal Book. He is thus not only an incompetent loose cannon but someone who can be played by a competent leader from some other country, and there are plenty of such competent leaders.
Let's remember how he got here. He launched his political career by claiming Pres. Obama was not a legitimate Americn President because he was not born in the US. He then jumped feet first into the campaign by announcing that all Mexican immigrants were rapists and murderers, or at least most of them. Then, on the primary debate stage he insulted and vilified his opponents as well as women and of all things Sen. John McCain because he was a POW and thus not a winner. This from person who was an obvious draft dodger during the Vietnamese war. At that point you would've thought that the RNC would have said, you are not fit to be a Republican nominee for president. But what did they actually do? Rhinoceros proboscis, the head of the RNC made a pilgrimage to Trump tower, groveled before him and asked him to sign a pledge of loyalty. Apparently nothing was too strong to stomach if he could be helpful to the Republican Party and the elections. Well he was, or maybe he only helped himself. Time will tell. What is clear is that the republican party process is swallowing whatever good taste and pride they may have to keep his base for the 2018 elections and in hopes he will help them pass the Congressional agenda, even though he seems to have the profound differences of opinion. About the best they can muster for his latest outrageous statements about Pres. Obama is something along the lines of," Gee, there doesn't seem to be any support for that but we shall see."
About the only thing that could happen to make this guy more grotesque is if he started sporting a man bun.
He thus once again demonstrated what we have come to know about him: he is petty, he is thin-skinned, he will lie about anything if he thinks he can get away with it, and he cannot focus on difficult problems as was fully documented by the ghostwriter of his Art of the Deal Book. He is thus not only an incompetent loose cannon but someone who can be played by a competent leader from some other country, and there are plenty of such competent leaders.
Let's remember how he got here. He launched his political career by claiming Pres. Obama was not a legitimate Americn President because he was not born in the US. He then jumped feet first into the campaign by announcing that all Mexican immigrants were rapists and murderers, or at least most of them. Then, on the primary debate stage he insulted and vilified his opponents as well as women and of all things Sen. John McCain because he was a POW and thus not a winner. This from person who was an obvious draft dodger during the Vietnamese war. At that point you would've thought that the RNC would have said, you are not fit to be a Republican nominee for president. But what did they actually do? Rhinoceros proboscis, the head of the RNC made a pilgrimage to Trump tower, groveled before him and asked him to sign a pledge of loyalty. Apparently nothing was too strong to stomach if he could be helpful to the Republican Party and the elections. Well he was, or maybe he only helped himself. Time will tell. What is clear is that the republican party process is swallowing whatever good taste and pride they may have to keep his base for the 2018 elections and in hopes he will help them pass the Congressional agenda, even though he seems to have the profound differences of opinion. About the best they can muster for his latest outrageous statements about Pres. Obama is something along the lines of," Gee, there doesn't seem to be any support for that but we shall see."
About the only thing that could happen to make this guy more grotesque is if he started sporting a man bun.
Friday, March 3, 2017
Democrats – Steal the march
I am sure that the democrats are giddy with pleasure over the consternation the Jeff Sessions affair is causing the administration. And they should keep the pressure on. But they need to understand that this sort of thing is not going to win them elections. They need to remember why Trump won and why Bernie Sanders was so popular in their party. As one of their sages once said ," it's the economy stupid."
The Republicans in Congress are apparently working diligently on their economic plan which they are keeping secret from most of their members and certainly any Democrats. The Democrats need to be preparing to respond not only with criticism but with their own plan. If they want to get back on track, they need to concentrate on the geographic region from West Virginia through the Midwest to Wisconsin and on those disaffected workers who voted for Trump. They need to devise something with a snappy title such as the Midwestern Revitalization Plan. There is free money out there arising from the repatriation of overseas profits at a low tax rate but which creates a significant pool of funds. The Democrats should have a plan that would direct well those receipts to revitalize this Midwestern belt. How might that work? It could be used to subsidize, Most importantly, the creation of small businesses throughout the area that either produce components for things like robots, Solar panels, windmills, electrical grids and the like. Another component would be subsidizing apprenticeship programs to create workers better skill to do these jobs as well as become plumbers electricians carpenters and a host of other jobs. An example of how some of these things could occur as exemplified by M TU, a subsidiary of a German company that opened a company in South Carolina.
They developed an apprenticeship program which became subsidized by the state, to train the type of workers they needed. Other types of programs that the government could create would be to essentially clean up the Midwest. For instance, out of work whole miners in West Virginia, and coal mining is not coming back because there's no demand, could be hired to clean up the mess that the coal companies I have made. West Virginia in his natural state is quite beautiful and could develop a robust tourist industry along with new small businesses, perhaps building components for the Virginia shipbuilding industry. The main point is, the Democrat should create a shadow administration and draft their own legislation. Another component of this that would allow small businesses to be created is amending the affordable care act to enact the public option. That would give access to good health care at a reasonable cost for these new businesses. Because the administrative costs of Medicare are about 5% as opposed to 20% for insurance based health programs, there is another immediate savings. Finally, Tom Perez should arrange for Joseph Stiglitz to become the economic adviser to the shadow government. He would be invaluable in promoting plans creating aaggregate demand as well as exposing the flaws in the republican plan which are essentially the same old trickle-down plans that don't work with the new border adjustment, VAT component.
As Dr. Seuss once wisely said," the time has come, the time is now". Nail your thesis to the Wittenberg Church door.
The Republicans in Congress are apparently working diligently on their economic plan which they are keeping secret from most of their members and certainly any Democrats. The Democrats need to be preparing to respond not only with criticism but with their own plan. If they want to get back on track, they need to concentrate on the geographic region from West Virginia through the Midwest to Wisconsin and on those disaffected workers who voted for Trump. They need to devise something with a snappy title such as the Midwestern Revitalization Plan. There is free money out there arising from the repatriation of overseas profits at a low tax rate but which creates a significant pool of funds. The Democrats should have a plan that would direct well those receipts to revitalize this Midwestern belt. How might that work? It could be used to subsidize, Most importantly, the creation of small businesses throughout the area that either produce components for things like robots, Solar panels, windmills, electrical grids and the like. Another component would be subsidizing apprenticeship programs to create workers better skill to do these jobs as well as become plumbers electricians carpenters and a host of other jobs. An example of how some of these things could occur as exemplified by M TU, a subsidiary of a German company that opened a company in South Carolina.
They developed an apprenticeship program which became subsidized by the state, to train the type of workers they needed. Other types of programs that the government could create would be to essentially clean up the Midwest. For instance, out of work whole miners in West Virginia, and coal mining is not coming back because there's no demand, could be hired to clean up the mess that the coal companies I have made. West Virginia in his natural state is quite beautiful and could develop a robust tourist industry along with new small businesses, perhaps building components for the Virginia shipbuilding industry. The main point is, the Democrat should create a shadow administration and draft their own legislation. Another component of this that would allow small businesses to be created is amending the affordable care act to enact the public option. That would give access to good health care at a reasonable cost for these new businesses. Because the administrative costs of Medicare are about 5% as opposed to 20% for insurance based health programs, there is another immediate savings. Finally, Tom Perez should arrange for Joseph Stiglitz to become the economic adviser to the shadow government. He would be invaluable in promoting plans creating aaggregate demand as well as exposing the flaws in the republican plan which are essentially the same old trickle-down plans that don't work with the new border adjustment, VAT component.
As Dr. Seuss once wisely said," the time has come, the time is now". Nail your thesis to the Wittenberg Church door.
Wednesday, March 1, 2017
Dr. Jekyll shows up
So, last night what appeared to be a reasonable human being showed up and gave a speech. He has been getting a lot of positive reinforcement so maybe we will see more of that tone and style.
The speech was about goals with some guidance as to strategies. No one expected much more and such a speech was not unreasonable at this time. However, one can draw some conclusions, tentative though they may be. First, it is clear that those of us who have enough and even more than enough are going to end up with more. Second, various tax cuts and schemes, notably the border adjustment, will flow more money to the top. The border adjustment concept and execution, which in design and implementation is quite complex and includes expected currency exchange adjustments, will essentially do the job of a tariff. That is, foreign countries will pay more of our tax bill and we collectively will pay less.
The more and better and cheaper republican health plan will not provide more and will not be better. It might be cheaper because people will be forced to look for far less coverage. The keyword is" access". In other words, if you can afford it it will be out there. The tax credit component will favor the older. People with pre-existing conditions will doubtless be put in a special risk pool. That will require either massive Federal subsidies or exclusion from coverage. All in all it will be a massive step backwards towards people either getting federal subsidies because their healthcare is part of their employment package but not taxed , with the rest getting less healthcare and probably at a higher cost. Medicaid will be shoved down to the states without adequate funding with expected results. I suppose this is a guess on my part but I wouldn't mind betting on it.
One of the more chilling things about what is going on with the Republicans is that Grover Norquist seems to be nearly ecstatic. That generally means that those people who need Government help the most will get less and those who have no need for it will get more
The speech was about goals with some guidance as to strategies. No one expected much more and such a speech was not unreasonable at this time. However, one can draw some conclusions, tentative though they may be. First, it is clear that those of us who have enough and even more than enough are going to end up with more. Second, various tax cuts and schemes, notably the border adjustment, will flow more money to the top. The border adjustment concept and execution, which in design and implementation is quite complex and includes expected currency exchange adjustments, will essentially do the job of a tariff. That is, foreign countries will pay more of our tax bill and we collectively will pay less.
The more and better and cheaper republican health plan will not provide more and will not be better. It might be cheaper because people will be forced to look for far less coverage. The keyword is" access". In other words, if you can afford it it will be out there. The tax credit component will favor the older. People with pre-existing conditions will doubtless be put in a special risk pool. That will require either massive Federal subsidies or exclusion from coverage. All in all it will be a massive step backwards towards people either getting federal subsidies because their healthcare is part of their employment package but not taxed , with the rest getting less healthcare and probably at a higher cost. Medicaid will be shoved down to the states without adequate funding with expected results. I suppose this is a guess on my part but I wouldn't mind betting on it.
One of the more chilling things about what is going on with the Republicans is that Grover Norquist seems to be nearly ecstatic. That generally means that those people who need Government help the most will get less and those who have no need for it will get more
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