Who Wants to Be the Last to Go Bankrupt Before Medicare for All Kicks In?

Pete Buttigieg (it's not actually that hard to pronounce) has been getting attention from a number of people I respect, and from some I don't.  Buttigieg is the mayor of South Bend, Indiana, a city I lived near for the first twenty or so years of my life and lived in for two of those years, so I'd heard of him before he decided to run for the American Presidency.  He came to my attention first because he's gay; getting elected to a traditionally Republican*, Roman Catholic city like South Bend is an impressive achievement for a gay man, even a married one, even a veteran.  It recently occurred to me that none of the right-wing Christian frothers I'm friends with on Facebook freaked out when he was first elected, even though some of them live in South Bend.  How'd he do it?

Recently a lefty tree-hugger friend of mine, an IU alumnus but now resident in the Bay Area, linked to Buttigieg's recent appearance on Stephen Colbert's Late Show.  My friend was highly impressed by Buttigieg's performance; I was more concerned that a homophobic "centrist" Obama toady like Colbert found Buttigieg acceptable.  Then Glenn Greenwald began praising him, which I take more seriously.  Greenwald is temperate in his praise:

There are specific policy views expressed by @PeteButtigieg I disagree with, but have been very impressed by him from the moment I began paying attention. I couldn't put my finger on why. Part of it was his heterodox thinking. But now I see the crux: he only speaks authentically...

As he links to Buttigieg's statement to South Bend's Muslims in the wake of the Christchuch massacre.  Fair enough, I guess, but this really just strengthened my doubts.  First, while he doesn't use the word, it seems that Greenwald is impressed by Buttigieg's charisma -- and he should know as well as I do the dangers of charismatic politicians.  There's an uncharacteristic lack of focus on Buttigieg's actual positions here ("I couldn't put my finger on why"), focusing on the claim that he "only speaks authentically".

To speak as authentically as I can, I'm not sure what that means.  Buttigieg's statement is fine, the kind of thing that any halfway experienced politician should be able to produce in his or her sleep.  That many such can't do so wide awake, with their staffs working on it at white heat, only means that the bar is pretty low.  (Compare this appalling screed by an Australian Senator to see how low the bar can go.)  Mayor Pete clears that bar, but it's not a sterling achievement.

Greenwald also wrote of Buttigieg's "heterodox thinking."  Heterodoxy is relative only to a respective orthodoxy, and I wonder which one Greenwald has in mind.  So I began looking for some of Buttigieg's specific policy positions, and found this interesting summary of his performance at a recent CNN town hall, reprinted in the Chicago Tribune from the Washington Post.  Notice that it's the work of Jennifer Rubin, a far right-wing writer, which makes her positive take on Buttigieg all the more disturbing.

He was asked about Venezuela. "Well, the situation in Venezuela is highly disturbing. And I think that the Maduro regime has lost its legitimacy," he explained. "That's why it's not just the U.S. but 50 countries that have declined to recognize the legitimacy of that regime."

He continued, "That being said, that doesn't mean we just carelessly threaten the use of military force, which is what it appeared the national security adviser was doing at one point, kind of hinting that troops might be sent to South America."

... "I don't mean to disagree that we need to support democratic outcomes in that country. And so to the extent that sanctions can be targeted and can be focused on trying to bring about new free and fair elections so that there can be self-determination by the Venezuelan people, that puts in a government that I think has that legitimacy, then we should do our part not through force but through the diplomatic tool kit in order to try to bring that outcome about."

Rubin gushes, "That might be the best answer on Venezuela I've heard from any Democratic candidate — maybe the best foreign policy answer, period."  Really?  It looks to me like the standard "centrist" answer to questions about US interference in Venezuela, and it's anything but "heterodox."  Buttigieg disavowed "carelessly threaten[ing] the use of military force" (maybe careful threats are okay?), which the other Dems would agree with, while endorsing the use of sanctions to starve the mass of Venezuelans into submission.  The kinds of sanctions that might target only government elites would probably also affect the wealthy, right-wing creoles of the opposition, and that would not go down well.

As far as "free and fair elections," Venezuela already has them, and that's why the US wants to overturn them: they produce outcomes we don't like.  Buttigieg says that "the Maduro regime has lost its legitimacy."  First, it never had any in the eyes of the US government, its lackey states, and its tame media; nor did Chavez' "regime," which the US began trying to replace with more corporate-friendly authoritarians from the time Chavez took office.  Second, the most recent election Maduro won was certified fair by international observers; presumably Buttigieg, like the rest of the US mainstream, chooses to forget that.  Finally, the US' designated hitter Juan Guaidó has no legitimacy whatsoever: he has won no election, has no mass base, and only has a platform because of US support.  He also says he's "not afraid of civil war" and hoped to incite US military intervention by staging provocations at the border with Colombia.  Whether Buttigieg likes it or not, that's the "self-determination" he's calling for and supporting.  This is not a minor issue either, because it indicates what Buttigieg's approach to other official enemies (such as North Korea, Iran, or Syria) would look like.

Next Rubin quotes Buttigieg's position on Medicare for all.  He praised the Affordable Care Act, which he said "made a great difference."

"That's why I believe we do need to move in the direction of a Medicare-for-all system. Now, I think anyone in politics who lets the words ‘Medicare-for-all’ escape their lips also has a responsibility to explain how we could actually get there, because as you know, from working on this day in and day out, it's not something you can just flip a switch and do.

"In my view, the best way to do that is through what you might call a Medicare-for-all-who-want-it setup. In other words, you take some flavor of Medicare, you make it available on the exchange as a kind of public option, and you invite people to buy into it. So if people like me are right that that's ultimately going to be more efficient over time and more cost-effective, then you will see that very naturally become a glide path ..."

Ah, the "public option."  Again, that's hardly a "heterodox" position, any more than his gradualist "move in the direction."  Medicare itself was "something you can just flip a switch and do," both in the US and Canada.  Yes, it will take planning, but my impression is that the politicians who are spearheading the drive to Medicare for All are working on the planning and the details.  But it's not really hard to explain "how we could actually get there," since we could learn a great deal from Canada's implementation, not to mention the fact that we already have Medicare in this country for people 65 and older.  It's extremely popular with voters, as is the idea of a national single-payer system.  The basic infrastructure is already in place; it would not be a radical move to expand it.  I'd have a bit more respect for Buttigieg's gradualism if he balanced it by noting how much money and energy we waste on, say, the military.  Instead he went on to say:

"You know, we as a country pay out of our health care dollar less on patient care and more on bureaucracy than almost any other country in the developed world. And so it's very clear that we've got to do some unglamorous technical work. Actually, some of the benefits of automation could come in this sense. You think about how many hands have to touch a prior authorization sometimes. And the right answer to that should be zero, but we're not there yet. So we've got to do that, that kind of unfashionable technical work within (the Centers for Medicare and Medicaid Services) to make the system more efficient."

This is extremely misleading.  He may not have meant it that way, but in context Buttigieg gave the impression that the "bureaucracy" that runs up the costs of healthcare in the US is located within "the Centers for Medicare and Medicaid Services," so we need "to make the system more efficient."  I have no doubt that the Medicare administration has room for improvement, but it's hardly obscure that the wasteful bureaucracy that runs up costs so that too "many hands have to touch a prior authorization sometimes" belongs to the private insurance companies that Buttigieg wants to preserve until the Messiah comes.  A smart technocrat, as he presents himself to be, must know that. Again, there's nothing heterodox here, it's just centrist boilerplate.

I'm going to skip his remarks on impeachment, which are more safe on-one-hand/on-the-other hand stuff, perfectly compatible with the Democratic establishment.  Speaking of Buttigieg as smart technocrat, though:

"As to what Gov. (Mitt) Romney was talking about, look, we do need to work to make government more efficient. One of the things we did when I came in, in South Bend as mayor was — kind of a banned phrase around the county city building was 'We do it this way because we've always done it this way.'"

"We subjected everything we do to rigorous analysis, because at the city level, I don't get to print money. We legally have to balance the general fund budget. And if I want to do more, we just have to figure out a way to do what we're doing more efficiently or else we'll have to do less of something else. And sometimes that's the right answer, too.

"So I think that on-the-ground knowledge of how to get something done that I maybe began to get in the business community, but really put to work in public service at the local level, will be useful at a time when, frankly, in federal budgeting we're being told we can get something for nothing. And things that are completely unaffordable, like the tax cuts for the wealthiest, are being passed off as though they're worth just as much as things that if we ever do deficit spending would be a better use of it, like investing in infrastructure and education and the things that we know have a payback and will pay for themselves in the long run."

"We've always done it this way" is of course a stumbling block in private enterprise too, regularly attacked in books on management.  Wherever Buttigieg got his "on-the-ground knowledge of how to get something done," it wasn't "in the business community."  Beyond that, these remarks are standard centrist prattle about running government like a business, you can't get something for nothing, we have to balance the budget.  Many arguments can be made against these slogans, but the key point is that they are not heterodox, not bold path-breaking authentic proposals that no one has had the guts or imagination or passion to advance before.  Far from it: they're routine parts of every election cycle as far back as I can remember.

Maybe Buttigieg is better than these remarks indicate, but again, he made them on his own, in a showcase where he evidently felt free to say what he thinks.  Contrary to Glenn Greenwald, I don't see a lot of exciting authentic substance here.  When my Bay-Area friend was upset by my skepticism toward this shiny new guy, I made it clear that I don't think he's totally evil, he might amount to something someday, but I really think he should at least run for a legislative office, state or federal, before aiming at the Oval Office. Much of the excitement I see over Buttigieg, like the excitement I see over Robert "Beto" O'Rourke, whom he resembles, is based on his presentation, his aging-elfin cuteness, his undeniable intelligence rather than his positions, which I think are ground for concern rather than celebration.  O'Rourke has been compared to Obama in his vacuousness, but thanks to his political history O'Rourke's unsavory record is there for scrutiny for those who care.  But many don't care: they'd rather daydream at their desks, practicing writing their married name in their notebooks (guys, Mayor Pete already has a husband).

Which brings up what is by now a familiar paradox: smart liberals who denounce Joe and Jane Sixpack for focusing on personalities rather than issues, generally have very little interest in issues but swoon over personalities.  If a candidate has no personality or a repellent one, no problem -- they'll work very hard to persuade themselves that he's really the most charismatic candidate ever!  Pete Buttigieg doesn't have that problem, he's evidently an engaging person.  Speaking seven languages, I admit, is a refreshing change from the monolingual Trump and Obama.  If you like a candidate, invite him to dinner, ask her out for coffee, paper your room with posters, but that is no reason to overlook his policies, let alone a reason to vote for him.  It bothers me, because it's so reminiscent of the rise of Barack Obama over a decade ago, to see this pattern repeating itself among people who really are smart enough to know better.

*CORRECTION: I've learned since I wrote this that South Bend's mayors have been Democrats for decades.

Only Nixon Could Go to China

It was really just a tactical rhetorical move, I know, but I was slightly surprised by Roy Edroso's decision yesterday to speak ill of the Only President We've Got:

I realize that, as circumscribed as he's been, Obama has accomplished some good things for the country. The trouble is, they're mostly half-measures. Take Obamacare. We only have this shaky Rube Goldberg system because the insurers and the AMA had to get paid off or national healthcare would never fly -- Senators and Congressmen have to get their contributions from somewhere, y'know! Single payer has been and remains the choice of the American people, but in the name of prudence and moderation we have instead a system nobody's entirely happy with, and because they're not happy Republicans get to exploit it while scheming to bring back their preferred Pay or Die healthcare system.

Okay, maybe not ill but less than the adulation that is mandatory for the faithful.  I mean, how can Edroso undermine POTUS like this?  If Barack is defeated by Ann Coulter in 2016, we'll know who to thank.

Edroso's mild critique followed on praise of Obama for criticizing Republicans who wanted to block Syrian refugees from our shores.

Naturally I am very pleased to see this, not only because Obama is usually much too nice to these assholes, but also and mainly because it's a refreshingly strong defense of common sense in the normally common-sense-free War on Whatever. When was the last time you heard any other top-tier elected official call bullshit like this?

Better late than never, I suppose.  As I've said before, it would have been better to anticipate the Republican hysteria before Obama was even elected, instead of whining that no one could have foreseen that the Right would be so mean.  But you'd have to be mighty gullible to think that Obama really will follow through when he talks tough.  I don't deny that he faces a vicious, obstructionist opposition -- "art of the possible and all that," as Edroso says -- but it seems to me that in such a case it's better not to make threats or promises you can't keep.  In Obama's case, I doubt he even intends to do so.  These remarks are meant to excite his fans, who will spread them all over the social media and pump their fists and hoot derisively like the Bandur-log they are.

I decided to look at the comments to see if any of his regulars would attack Edroso as a turncoat stealth Republican and Trump-lover.   So far (I'm not up to wading through all 350-plus comments), no.  What there was was funnier.  The first comment is from the blogger Susan of Texas, whose Hunting of the Snark is even more specialized than alicublog: most of her posts for the past several months have been devoted to jeering at Megan McArdle.  Here's Susan of Texas's opening volley:

When somebody starts talking about reality and common sense, run for the hills. They're about to do something stupid and they want you to tell them that they are being smart.

Okay, I agree with this too.  But Ms. Texas seems to have missed Edroso's invocation of common sense in his post.  Did she mean that he was about to do something stupid and wanted his readers to tell him that he was being smart?  Of course not: she was attacking the centrist writer Kevin Drum for expressing his commonsense concern about letting thousands of Ayrabs into our country.  Several other commenters defended Drum, and I quit scrolling through the comments when one of them accused Drum's critics of "purity of rhetoric."  It's entertaining to see conventional liberal-Democrat invective turned back on its usual deployers, though.

For what it's worth, Ms. Texas herself has been known to call on the name of Common Sense in her critiques of the Right ("Stupid people think they are following their ideology to its logical conclusion. They ignore common sense, logic, reason, and empathy because they they have an ax to grind."  So has Barack Obama.  So does just about everybody, including sophisticated moral philosophers who ought to know better.  It's almost always a sign that someone is arguing in bad faith.

And what's wrong with talking about "reality"?  That used to be popular among Democratic loyalists as it is on the Right.  Am I the only person who remembers liberals casting themselves and their positions as "reality-based"?  The very Republicans supposedly conceded that they were, by contrast, "faith-based."  But since then, Democrats gained Hope, and they're clinging to it fiercely, until you pry it from their cold, dead fingers.

I'll Show You the Life of the Mind

The initial right-wing and corporate-media reaction to the Congressional Budget Office's forecast that the Affordable Care Act would enable many workers to work fewer hours without forfeiting health insurance coverage was, of course, that Obamacare was a job-killer.  This had to be corrected, but now the Right is trying to show its wisdom by jeering at people who don't want to work sixty- or eighty-hour weeks just to have health coverage, and who might want to spend more time with their families or even engage in other activities, such as the arts or entrepreneurship.

Roy Edroso put up a post today, appropriately mocking right-bloggers who are obsessed with the mental image of lazy proles writing poetry instead of standing behind a counter at McDonalds or "hold[ing] an entry-level office job [thus] foregoing not only the drab cubicle but also the corner office that might have been hers 25 years of diligence later."  Oh, my goodness!  A corner office, who could ask for anything more?

As usual, Edroso and his commenters are shooting fish in a barrel, though some of the poetry parodies in the comments are amusing.  A few people had something of their own to say, like this commenter:

This is evidence of how conservatives have not only changed American politics, but also change American sensibilities. We used to look at our neighbor with the union job, high wages, and guaranteed pension and say, "Gee, why can't I have that?" And then work to attain those. Now, we look at that same neighbor and say, "Goddamnit! I don't have those things, and neither should he!" And how we work to impoverish everyone.

Well, true enough, though as so often when people are playing Ain't It Awful, a historical perspective is lacking.  Back in the Sixties we saw the same thing: people who'd worked hard for decades in jobs they hated, were furious that a few people were Turning On, Tuning In, Dropping Out, and choosing lives they enjoyed, or hoped to enjoy. Sometimes the critics came near to saying it explicitly: why should they be happy when I'm miserable? So I suspect that the "sensibility" this commenter observed is not so new after all, nor a unique product of the age of Reagan.

There was also handwringing in those days about the perils of leisure: people would get into all kinds of trouble if they were kept busy constantly on the job. Noam Chomsky discussed that issue in "Psychology and Ideology," his great takedown of B. F. Skinner and Richard Herrnstein, which can be read in For Reasons of State.  The business strategy of the Seventies was a very conscious reaction to the relative affluence of the Fifties and Sixties.  It wasn't so much dropped-out hippies whom the elites feared as college graduates who, instead of devoting themselves to the creation of profit for their betters, were living cheaply, becoming radical journalists and writers, even public defenders, doctors in free clinics and the like.  Ellen Willis wrote in Don't Think, Smile! about how cheap rents and the proliferation of independent print media in the Sixties and Seventies made it possible for people to live in urban environments, thinking and questioning and organizing, without devoting all their energies to making a living.

The fear of the lower orders having leisure and Getting Ideas is, of course, much older than that.  David F. Noble has written (in Progress without People and Forces of Production) about the elites' (and wannabes') desire simply to eliminate the mass of humanity and replace them with machines.  That working people might be living soft lives, as opposed to their rulers and betters, was always offensive; it would lead to unruliness and chaos, and must be nipped in the bud -- as it always was.  But there have always been people lower in the hierarchy who were happy to stamp on the fingers of the people below them.  As Katha Pollitt suggested a couple of years ago in a comparison of the German nanny state with the American one, "a critical mass of white Americans would rather not have something than see black and Latino Americans get it too."  She was probably right, too: most important social programs, including Social Security at first, were limited to whites because whites didn't want blacks to get such benefits.  I've quoted her line to some white racists I know, and they confirmed it.  If whites are more selfish than they used to be in that regard, it may be because blacks and other nonwhites can't be excluded (at least openly) from any new social programs.  Which puts that "critical mass of white Americans" right into Pollitt's dilemma: they really would rather do without than share government benefits with The Colored.

Would You Buy a Used Health Care System from This Man?

I'm still seeing rebuttals of the complaints about the Affordable Care Act, and I'm disturbed by the kinds of arguments they're using.  This is a paraphrase, but I think it accurately represents the gist of what I'm seeing.

A: The President said I could keep the health insurance policy I already have if I want to, but I just got a letter canceling it.  I'll have to pay a lot more for a replacement.

B: But your policy was crap insurance, so you shouldn't want to keep it.  The President is offering you something better, something you'll like much more, even if it costs you a little extra; but it will probably cost you less.

Notice that I'm not saying anything about the accuracy of certain claims here, either that A will have to pay more for a new policy, or B's assertion that the new policy won't cost much more, or will cost even less.  Those are important questions, to be sure.  It's hard to know what to make of the anecdotes the corporate media are pushing about people who say their individual policies have been canceled and the only policies they can find to replace them will cost much more.  As I wrote yesterday, some of those stories have been debunked, even by right-wing Fox News.  It'll take time to find out how true and representative these stories are, just as it will take time to evaluate the claims of Obama's apologists that people whose policies are canceled will be able to replace them for less, or for not much more money.

Meanwhile, though, I think it can fairly be said that B's rebuttal is a crooked salesman's defense: you don't really want what I promised to sell you, and what I'm substituting is much better, for only a little more than I said you would pay.  Even if it's true that the substituted product is better, and costs the same or less or only a little more than what the customer ordered, it's not what the customer ordered.  And that matters.

For those who want to know, this is not about me.  I'm on a group insurance plan through my former employer, and so far it appears that my policy hasn't been canceled.  In this post I'm evaluating claims other people are making about their situations.  I'm skeptical of the stories people are making about their options now that their policies have been canceled, but the fact remains that Obama lied when he said they'd be able to keep their policies.  The answers he and his apologists are giving to these complaints are dishonest, since they dodge the main issue.  And I doubt that they really know what kinds of experience people are mostly having on the exchanges, any more than I do.

Today Roy Edroso wrote an imagined and hopefully satirical version of the complaints of those who have had their policies canceled.  It's easy to dismiss the ignorance and frequent stupidity of the Republican base (as opposed to the elites who are our government's real base), but as I've argued before, the fact that the Republicans are stupid doesn't mean Democrats and especially Obama apologists like Edroso are smart.  Obama supporters are just as determined not to face reality about their guy as Republicans are about their side, just as prone to misrepresent Obama's critics from the left as the Right is to misrepresent Obama.  When Edroso dishonestly attacked Glenn Greenwald for pointing out that Ron Paul was right about a few things, he got his ass handed back to him on a platter, and could only whine that it was unfair that Greenwald was right, but only Edroso's own partisan blinders made him misread him.  But that was long ago, almost two years!  And Edroso continues to work his own side of the street, finding and delineating and giggling at the Stoopid of the American Right. Which is just fine -- it just shouldn't be mistaken for a serious discussion of the American political scene.

Something else emerges again in Edroso's post and the comments below it: the contempt for the Opponent.  Now, suppose that what I think (no less than Edroso and the ACA's other defenders) is true, that the people who've come forward to complain about Obamacare are stupid and lazy, and that if they really looked on their state exchanges they could find policies as good as or better than the ones that were canceled, without having to pay (very much more).  I wouldn't take this for granted, because of course what Obama and his posse say should not be taken as true, simply because they said it.  But again, suppose this time they're right.  Since we're talking about people who have individual policies and who therefore must have done some shopping to get them, they should be capable of watching out for their own interests to replace them.  (Not least because they tend to present themselves as canny, self-reliant individuals who don't need government handouts aside from the many government handouts they do get.)  But the same is going to be at least as true of the uninsured who'll be shopping on those same exchanges.  The Republicans dismiss the uninsured as stupid, feckless, lazy parasites who think that the world owes them a living; the Democrats dismiss those whose policies have been canceled as stupid, lazy, bigoted assholes who want the country run to suit them and only them.  Even if both sides are correct, access to health care should not be dependent on a person's intelligence.  Especially if, as the ACA defenders like to claim, health care is a human right.  That means that even people they (or I) don't respect have that same right.  If the Right are daunted by the complexity of the ACA website and the exchanges, surely so are the uninsured.  The process of signing up must be made as easy as possible for both groups.

Here's an analogy: I often help friends of mine with problems they have with Facebook and their e-mail, which they mostly access on their smartphones.  Usually I helped them set up those accounts to start with, so when they have trouble they tell me that they've been locked out of Facebook, they don't know why.  So I sit down with them and ask them to show me what happens when they try to log in.  Every time it turns out to be something trivial: they have tried to log in with the wrong e-mail account, or the wrong password, or they've gotten one character wrong in their password, or tried to write their e-mail address with spaces instead of periods between the names, and so on.  They haven't been blocked by Facebook at all; they just have trouble with the pickiness of computer systems.  Are they stupid?  No.  (The computers are.)  Ignorant?  Yes.  Am I a genius?  No.  I just have lots more experience with computers than they do.  So I get them sorted out -- until the next time.

The same is going to be true of people who are having trouble, for whatever reason, with the ACA.  It's likely that the software they had to navigate when they first got their policies was different than what they must deal with now, even if it were to get the same policies they've lost. The kind of people who are deriding them online are somewhat more computer-savvy, more at ease with filling out forms either virtual or paper, and so on.  But all that has to be taken into account when designing websites for services like this.  It can't be designed solely for smart, literate, computer-facile intellectuals and tech geeks; it has be designed for the doofuses, because doofuses are people too, whether they're poor uninsured Democrats or well-to-do Tea Party Republicans.  Is it really necessary to say that?  Evidently it is, and that's why I find most dispiriting about American political discourse today, even or especially by people who are nominally on my side.  Even if they are smarter than what they like to call the Reichtards and Rethugs, they're not as smart as they like to think.

P.S. I should admit that I'm feeling some personal anger, or at least pique, about all this.  I was one of the people who assured others that they would be able to keep their present policies under the ACA.  One of the others I assured was one of the people I mentioned above, who got a cancellation letter. As far as their original concerns went, I was half right: they believed that everybody would lose their existing policies and have to submit to Obama's brute will.  (Rather like those people who believe that when same-sex marriage is legal, all heterosexual marriages will be dissolved and everybody will have to gay-marry.)  It looks like people like me, on group policies, who constitute 80 percent of the American insured, will get to keep the insurance we already have.

But I've noticed some dissembling with the numbers by ACA defenders now, when they dismiss the complaints about canceled policies.  I've seen some saying that only about 5% of the population will face cancellations.  But when you consider that the people most affected by cancellations appear to be people with individual policies, who constitute about 14% of the population, you're talking about a plurality or even a majority of that group.  And in a country with 300 million people, 5 or 10 percent of the population is 15 to 30 million people -- not a negligible number.  Ironically, Atlantic writer Garance Franke-Ruta posted a piece today about the "squeaky-wheel problem in Obamacare coverage":

It's all well and good to argue that only a small fraction of Americans will see premium increases in the individual market, but most of those who are seeing them—and who also are subsidy-ineligible under Obamacare—are from the middle to upper-income part of the middle class. More than 40 percent of people in the individual market are there because they are self-employed or running a small business. They're entrepreneurial and independent-spirited by nature, and when they squeak, they make a lot of noise.

By contrast, I'll be shocked if we see nearly as much attention devoted to the personal stories of the tens of thousands of low-income people now getting insurance through Obamacare's Medicaid expansion. Instead, we get experts tut-tutting over whether the planned expansion that's intended to cover an additional 9 million near-poor people over the next year is going to be a burden on the states.

She has a point here.  I agree, the corporate media will be much less interested in stories about the low-income people getting insurance than in petit bourgeois white Republicans whose individual policies are canceled. They also aren't very interested in "those who are being denied Medicaid coverage because they happen to live in states where officials have decided not to participate in the expansion."  It's like predicting that the sun will rise tomorrow.  But all those stories should be told.  The irony is that Franke-Ruta was a member of the AIDS activist group ACT-UP, who knew a lot about squeaky wheels getting the oil.  (You can see her in the great documentary How to Survive a Plague.)  Since then she's become a fairly shameless Obamabot, whom I read mainly for her representation of that position.  The number of Americans with HIV/AIDS in the late Eighties and early Nineties was even smaller than those who will be affected by the cancellation of their individual policies, but they didn't think that meant their problems were of no consequence -- very much the opposite.  And while the right-wing Republicans are easy to despise (I, too, dislike them), they are still people and they have a right to make noise when their interests are affected, no less than poor uninsured people do.

That's the thing about government.  I can't remember who said that you have to remember that every person sees him or herself as the center of the universe, with interests that matter to him or her more than anyone else.  No one is dispensable to him or herself.  If a government ignores the interests of enough people, it will lose its legitimacy, and our government has been doing just that for the past several decades.  In a matter like health care, you can't take away from one group while giving to another: rather you must add the other group, so that the number of people protected increases.  I feel the same impulse to dismiss the worries of the aging white Right that so many liberals do, but even leaving ordinary basic humanity out of it, dismissing them is bad politics.  We've had enough bad politics, haven't we?

Our Pitiful Helpless Savior

One of my right-wing acquaintances (RWA3 for future reference), someone I knew from high school, posted to Facebook today that her and her husband's insurance policy had been canceled because of Obamacare.  This is a person I don't trust to tell the truth; she has established a pattern of dishonesty even about matters that pertain to her, let alone to others.  She and her husband were among the right-wing Republicans who responded to Obama's election in 2008 by demanding (to the wind, of course) that because they had voted against Obama, he should do what they wanted him to do.  But another high school friend, whom I trust more, said that his and his wife's policy had been canceled too.

There have been a number of reports of this happening because the Affordable Care Act raises standards for basic coverage, and the policies they had no longer were adequate.  According to an article quoted by a FAIR blogger,

The law requires policies sold in the individual market to cover 10 “essential” benefits, such as prescription drugs, mental health treatment and maternity care. In addition, insurers cannot reject people with medical problems or charge them higher prices. The policies must also cap consumers’ annual expenses at levels lower than many plans sold before the new rules. 

There's some dispute about exactly how many policies are going to be canceled.  But I don't see any reason to doubt that Obama's insistent promise, that whose who like the policies they have would be able to keep them, is false, and has been false since 2010.  While Fox News picked holes in one Florida woman's story about the high cost of the replacement plan she'll have to get (via), the fact remains that her original policy was canceled and she will have to pay more for a new one.  For her own good, of course.

In comments under RWA3's complaint, my liberal law professor friend, who also attended my high school, mounted a brave but dishonest defense of the ACA and Obama.  I considered joining in, but then it occurred to me that I could think of no reason why I should defend Obama, or the ACA.  The website debacle, Obama's misrepresentations of what the law would require, his blocking even of discussion of a public option let alone a single-payer alternative in favor of a deal brokered with Big Pharma and the insurance industry -- all these are reasons why the President should be allowed to fend for himself, even if he hadn't done plenty of other terrible things.

Periodically over the past year I've received form letters from the Obama organization, imploring me to reassure the President that I've got his back.  I don't, of course.  Though I've criticized Obama many times over the past five years, I've wasted time defending the man against right-wing misrepresentations, simply because I think truth and rationality are important.    But why bother?  Truth and rationality are no more important to him, or to his lackeys and apologists, than they are to the Right.  Maybe the ACA will work out in the long run, but its incompetent management by the Obama administration so far is a bad sign.  Obama's approval ratings have dropped to a new low according to an NBC/WSJ poll (though once again, so have approval ratings of the Republicans).  Does Obama think he can do whatever he wants, simply because his enemies are hated even more than he is?  No matter.  If anything, he seems determined to torpedo his second term.  Let him fall, brought down by his own arrogance and incompetence.

Fly, You Fools!

Oy, what a day.  Here's a quickie: Ian Welsh posted a good piece today on the government shutdown and the Affordable Care Act.  He declared:

Straight up the individual mandate is a transfer of  money from the working poor and the young and healthy to insurance companies and older sicker individuals. It forces people who can’t afford an extra expense every month (and if you have never lived paycheck to paycheck you should shut your mouth, you have no idea what it’s like) to buy something they can’t afford: to choose between food or rent or insurance.

This seems sensible to me.  But I immediately asked myself why the Republicans who've shut down the government (once again) over the ACA don't use sensible, accurate arguments against it, or against Obama.  Instead they rely on lies.  Which doesn't mean I believe the Democrats either.  Sometimes, though, I try too hard to walk a mile -- well, a few steps -- in my right-wing friends' shoes, and see things their way.  It doesn't work very well.

That's it for now.  Plus Hello Gandalf -- just because I can.

Why Johnny Can't Blink

But for the time being, the administration has blinked.

Oh, noes!  They've never done that before!  Well, hardly ever.  Well, usually.  Only politically naive professional leftists would have expected the President to do anything else.

Also from The Atlantic today, Republicans are indignant that Democrats are concern-trolling them, which the Republicans would never do, especially now that the party is "down-and-out" and the Democrats are "triumphant." A lot of conspiracy-theory mongering in there too, which is amusing when you consider how respectable politicians and pundits despise conspiracy theories floated by their opponents.  I guess there just isn't enough going on right now for people really to worry about.

Free Advice, Five Cents (The Doctor Is In)

At first I wasn't sure I was reading this sign correctly, it was so obviously and blatantly off the mark.  But it does seem that the person brandishing it is an Obama devotee, who supports the Affordable Care Act because she believes that it provides "free HEALTHCARE."  It doesn't do anything of the kind, in fact.  It doesn't actually provide any kind of healthcare, since it is about health insurance.  As such, the law has its virtues, but it's far from fixing the mess our health care system is in.

Even more ironic, Obama himself is opposed to free healthcare and to its advocates, who he thinks want to turn America into communist Canuckistan.  People who advocated a single-payer system, also known as Medicare for All, were shut out of the Congressional debate; a "public option" for people who couldn't afford commercial insurance was one of the first provisions Obama ditched during negotiations.  What sick bastard would want to provide free healthcare?  Certainly not Obama.

It also seems to me that "free healthcare" isn't a great slogan in the first place.  Nothing is free, and certainly not health care, which is more expensive in the US than in most of the developed world.  A state-run health care system like Britain's would be cheaper, more effective, and more efficient, but it wouldn't be free.  The question is, or ought to be, how people are going to pay for it.  The Right loves to harp on this point, and throwing "free" around simply plays into their hands by giving them an easy diversion from the real issues.  Of course they're right about the cluelessness of liberals, but that doesn't mean they're any smarter.

Meritocracy in Action, Episode 5487

Yesterday I wrote that "people who make large amounts of money in business or finance often think, and are thought by some, to know how the government should be run, or even just the economy.  Aside from the huge business and fiscal disasters over which such people have presided, their public statements since the re-election of Barack Obama should have disabused most people that they're not even qualified to decide their own salaries: they routinely think they're worth a lot more than they are."

New examples keep turning up.  The other day, Whole Foods CEO John Mackey made headlines when he claimed that the Affordable Care Act was "like fascism," marking himself out as a blustering fool.  So of course he quickly attempted to rewrite the record, digging himself in even deeper, as public figures from Todd Akin to Barack Obama usually do when they try to make it all better.

Mackey conceded that the word "fascist" wasn't the most felicitous choice: "it's got so much baggage attached to it ... Of course, I was just using the standard dictionary definition."  It's hard to see how the ACA fits with the dictionary definition of fascism; maybe Mackey took "Obamacare" literally and thought that Obama just wrote the law himself and signed it without going through Congress?  There are all kinds of objections that have been made by rational people to the ACA, but it is not an example of a strong autocratic government led by a dictatorial leader, etc.

"We no longer have free-enterprise capitalism in health care," he said. "The government is directing it. So we need a new word for it."

Mackey defined it later on HuffPost Live. "I think I'm going to use the phrase government-controlled health care. That's where we're evolving to right now," he said.

 Of course this is raving, pure and simple.  Arguably we haven't had "free-enterprise capitalism" in health care since the insurance companies took it over a few decades ago.  Almost no doctors are independent small-business owners anymore, as many were when I was a kid; most now work for the HMOs.  Corporate capitalism is not free-enterprise capitalism, and the American health care system is not 'directed' by the government, it's directed by giant corporate entities.  Which, as been pointed out at tiresome length in the past few years, is why our health care system is so wasteful, inefficient, and overpriced, with poorer outcomes than other industrialized nations.

The very limited regulation of the insurance companies mandated by the ACA isn't "government-controlled healthcare", anymore than food inspection is "government-controlled food production."  If you're going to talk about government 'direction' of health care in the US, you could talk about state licensing of medical practitioners, or federal oversight of drug safety, or Medicare.  I think most Americans would agree that if Medicare is fascism, fascism isn't so bad after all, and we could use a good deal more of it.

Of course our neighbor to the north has what Mackey would probably also call "government-controlled healthcare", but few would call Canada fascist because of it.  England's National Health Service goes even further in that direction, but again, it isn't fascist.  (Mackey previously compared the ACA to socialism in a 2009 Wall Street Journal op-ed, according to the HuffPost article I've linked here.  But you can't blame a man for evolving; he was so much younger and less mature then.)  Most developed countries have government involvement in the health care system to keep costs down and manage outcomes, for that matter.  Our corporate-controlled system is the main reason why Americans' health is so much worse than citizens of other First World countries.  And don't forget, President Obama and his core supporters find it hilarious or outrageous that anyone should think Canada's system might be a good example for us.

Richard Dawkins has railed against clergy and theologians being allowed to participate in public discussions.  They couldn't be any worse, and often aren't, than our corporate elites.  Which doesn't mean I want business types to be silenced; better they should be allowed to remind us, as often as necessary, how dumb they really are.

Don't Let Me Be Misunderstood

As I'm sure everyone has noticed, after the elections there was a flurry of pronouncements by several corporate bigwigs, more in anger than in sorrow, that they were just going to have cut costs some more because of Obamacare.  Probably the most notorious was Papa John's CEO John Schnatter, but there were others.

Papa John's CEO John Schnatter says that Obamacare will result in a $0.11 to $0.14 price increase per pizza, or $0.15 to $0.20 cents per order, Pizza Marketplace, a trade publication, reports ...

“We're not supportive of Obamacare, like most businesses in our industry,” Schnatter was quoted as saying in Politico. “But our business model and unit economics are about as ideal as you can get for a food company to absorb Obamacare." 

Schnatter has thrown his weight behind Republican presidential candidate Mitt Romney this election season, even hosting a campaign fundraiser at his Louisville-area mansion in May. "Don’t you love this country?" Romney, who attended, asked during the event. "What a home this is, what grounds these are, the pool, the golf course."

Not too surprisingly, Schnatter backtracked almost immediately, and claimed he'd been misquoted and misunderstood.  Poor baby.  (It's hard for me to believe that a damn pizza-industry publication would misquote or misunderstand one of its own, but maybe some Communists infiltrated it.)

Today I stumbled on an interesting article, also from an industry source, which reported that

The brand perception of Papa John's, Applebee's and Denny's took a beating after high-ranking representatives of the companies said Obamacare would force them to stop building restaurants, cut worker hours and raise prices.

As the article reports, correlation doesn't equal cause, so it isn't certain that the lowered approval of these brands was a reaction to the announcements.  But it's noteworthy that people like Schnatter found it prudent to repudiate their earlier remarks, even to pretend that they hadn't made them, even before data like this turned up.  But there's something else that I take from this story.

Not all the Obamacare warnings came from the top dogs: some came from franchise owners who ran numerous restaurants, and some came from individual restaurant owners in the franchises.  We hear a lot about the practical common sense of those great job creators, the small businesspeople of America, no less than we do about the wisdom of the great entrepreneurs.  But I think that stories like this should make us all skeptical about what we hear on that score.  Schnatter, for example, claimed that Papa John's would have to raise pizza prices by 11 to 14 cents apiece to make up for increased costs entailed by providing insurance to their employees.  Those numbers have been disputed, but who knows?  Some will call me just a reflexive hater of rich people, but that's not true; I only reflexively hate rich people who are stupid, vicious, and dishonest. 

Just from a shareholder's point of view, there'd be good reason to have doubts about a CEO who took advantage of his prominence to run to the media and make Scrooge-like pronouncements that made the company look bad.  Papa John's stocks took a dive right after he vented, which probably had something to do with his recantation.  (I took that information from the same Forbes article I just linked to -- again, a business-friendly source, not the Daily Worker.)  I suspect that Schnatter pulled the 11 to 14-cent numbers out of his ass, just because he felt like throwing a tantrum over Obama's survival and the very idea of having to provide health insurance to his employees.  Which is his right in a free society, just as the reactions he got were everybody else's right.  It's nice to be reminded, though, that it wasn't just the little people, the mob, who were put off by the hysteria of Schnatter and his ilk; even the real America, the 1 percent, turned against him.

Still, the next time you hear someone babbling about the wisdom of entrepreneurs, their competence, their practical common sense, remember that you're hearing about people like John Schnatter, and he's evidently not unrepresentative of the breed. Rich guys all over America are stamping their expensively-shod feet and screaming like two-year-olds at Obama's socialist agenda.  At the very least, this is imprudent of them, since he is all that stands between them and the pitchforks.  (O faithful servant! no matter how much they abuse him, still he offers himself as a human shield, again and again.  I trust he has his reward in the life to come, by which I mean after January 20, 2017.)

Speaking of Obama, he's still making it clear whose side he's on.  The other day he told the Business Roundtable:

We’ve seen some movement over the last several days among some Republicans. I think there’s a recognition that maybe they can accept some rate increases as long as it’s combined with serious entitlement reform and additional spending cuts. And if we can get the leadership on the Republican side to take that framework, to acknowledge that reality, then the numbers actually aren’t that far apart. Another way of putting this is, we can probably solve this in about a week; it’s not that tough.

The key word for my purpose here is "entitlement."  Several of my liberal friends have been throwing tantrums of their own over that word as used by Republicans, typically having hissyfits over words rather than what they refer to.  (This, for instance.)  But they're less attentive to their god-king's use of the word.  Bear in mind that part of what Obama means by "serious entitlement reform" is cutting Social Security benefits for new retirees by raising the age of eligibility -- again -- as part of his program to cut the deficit, though Social Security has nothing to do with the deficit.  The reason for making such cuts is to appease people -- mostly, but not all, Republicans -- who want to get rid of Social Security, Medicare, and other social programs for other, Scroogier reasons.

Long Briefs 3: ObamaDoesn'tCare

Closely related to the Supreme Court's ruling on strip searches is its consideration of the Affordable Care Act. It's been entertaining, though entirely predictable, to watch supporters of Obama and the ACA fulminating against activist courts disregarding the Will of the People as Republicans have solemnly affirmed the salutary and necessary role the Supreme Court plays as a defender of liberty. This is a reversal of their usual positions, of course, but only to be expected since neither side has any principles, only partisanship.

It didn't help the Democrats when the President put his foot into it and squished it around. At a press conference last week he declared, "Ultimately, I am confident that the Supreme Court will not take what would be an unprecedented, extraordinary step of overturning a law that was passed by a strong majority of a democratically elected Congress."

Bear in mind that Obama's fans love to point out that he's a Constitutional scholar! He's so smart! He knows his stuff better than the stoopid Tea Party! So it's hard to understand how a Constitutional scholar could say something so amazingly stupid. Damage control ensued, especially when a 5th District federal appeals judge in Texas ordered a lawyer arguing another health insurance case to submit "a letter stating what is the position of the attorney general and the Department of Justice in regard to the recent statements by the president, stating specifically and in detail, in reference to those statements, what the authority is of the federal courts in this regard in terms of judicial review." Attorney General Eric Holder complied, essentially conceding that judicial review is neither unprecedented nor extraordinary.

I'm not concerned that Obama is trying to interfere with or even threaten the Supreme Court, as many of his partisan critics have claimed. My objection is that he was wrong, and since he can hardly be accused of ignorance about the Constitution and the role of the Supreme Court, he was either lying or stupid. (Or both -- I am not bound by your narrow Western binaries.) As the Washington Post reported,

But the White House was forced to defend the assertion that overturning the health-care law would be unprecedented. According to the Congressional Research Service, the court through 2010 had ruled 165 times that laws passed by Congress were unconstitutional.

Obama himself agreed with some of those decisions, including 2008’s Boumediene v. Bush, in which the court ruled 5-4 that the Military Commissions Act’s suspension of the right of habeas corpus for Guantanamo Bay detainees was unconstitutional.

And Wednesday, the administration was in court in Boston explaining why it thinks the Defense of Marriage Act is unconstitutional, although it was passed by bipartisan majorities and signed by a Democratic president.

Damage control ensued, of course. Obama's press secretary Jay "Carney said Obama was 'referring to the fact that it would be unprecedented in the modern era of the Supreme Court, since the New Deal era, for the Supreme Court to overturn legislation' on a 'matter of national economic importance' — not that it would be unprecedented for the court to rule that a law was unconstitutional. 'That’s what the Supreme Court is there to do,' Carney said."

That may very well be what the Great Communicator and eloquent Not-Bush orator President Obama meant; but it's not what he said. (Not surprisingly, his apologists have followed the party line and ignored what he said in favor of his excuses.) What he said was so wrong-headed that even his Harvard mentor Lawrence Tribe called him out on it.

“Presidents should generally refrain from commenting on pending cases during the process of judicial deliberation,” said Harvard Law professor Laurence Tribe, a close Obama ally. “Even if such comments won’t affect the justices a bit, they can contribute to an atmosphere of public cynicism that I know this president laments.”

Since we ordinary middle-class Americans can only sit at home while our Shield Against the Cossacks is watching out for our interests in the Oval Office, it's especially worrisome (and it contributes to that "atmosphere of public cynicism") that our advocate is so bad at his job. From his inability (or disinclination) to bargain effectively with the Republicans on his stimulus program, allowing them to put in counterproductive tax cuts, to caving in (or selling out) to the health insurance industry on the public option, to reassuring Wall Street bankers that he was on their side against the public that wanted their heads on a pike, to putting Social Security and Medicare on the chopping block during the budget negotiations, to ... well, this little incident, President Obama has made many of us feel less safe against Republican depredations.

Teacher, Educate Thyself!

There's a good post (or so it looks to me, I have no legal background) by bmaz at Emptywheel on the coming oral arguments before the Supreme Court on the Patient Protection and Affordable Care Act, aka "Obamacare." Among other things, consider the irony of the Right seeking an activist Supreme Court to overturn a law they don't like. As the post concludes, "One thing IS certain, when the dust has settled, one side will say the Supremes are beautiful minds, and the other will say they are craven activist tyrants."

There's one aside in the piece that stuck in my attention, though, and merits comment. (Also chastisement.) bmaz considers an analogy, posed by an opponent of ACA, between the individual mandate (requiring everyone to purchase health insurance) and a hypothetical federal mandate to keep everyone in school until the age of 18. What do you think of that, ya libs? asks the right-wing critic. "Anyone think the government should win?"

I'd say no, but I'm not a Supreme Court Justice. And maybe, in terms of law and precedents, they should. bmaz replies (emphasis added by moi):

Actually David, yeah I wouldn’t have a real problem with that. As a sage friend related to me this morning, there is a direct correlation between a nation’s ability to compete in a world market and the level of education provided to it’s citizens. Citizens with less, or poorer, education harm the entire nation – it’s welfare, it’s defense, its very liberties and it’s ability to defend itself against threats and enemies, foreign and domestic. I think that is exactly right; if you accept the individual mandate is constitutionally agreeable, it would be hard to see how you could disagree with an “education mandate”.

bmaz may know a lot about the law, but not about educational issues, or apparently economic competitiveness. (Notice, by the bye, how the apostrophes take over the next sentence, though that's trivial; it's just amusing.) Actually, there is no direct correlation between a nation's ability to compete in the world market and the level of education provided to its citizens. bmaz's sage friend's dictum set off alarm bells in my head, and I looked up some of the late Gerald Bracey's remarks on this subject -- it was what you might call a pet peeve of his.

In 2007 Bracey discussed a World Economic Forum report on global competitiveness which covered twelve factors in ranking nations. The WEF ranked the US #1 at that time (admittedly before the worldwide collapse of 2008), though our rankings varied widely in the twelve factors. In number 4, Health and Primary Education, we ranked 34th in the world; in number 5, Higher Education and Training, we ranked 5th. Interestingly, given what I've been hearing lately, we ranked number 1 in both Labor Market Efficiency and Innovation. Even if we don't have a federal mandate on education, it's not hurting us much.

Bracey also pointed out:

First, though, we have to take a look at the concept of competitiveness. Many people take it as a zero-sum game: If you win, I lose. Not so. The computer chip was invented in the U.S. Many other nations benefited. If some young medical student in Nigeria invents a cure for AIDS, the world, not just Nigeria, will win.

Which is a reminder that harping on competitiveness, internationally or locally, is basically a dumb idea. (I've written about that before. See also this post by Bracey.) Bracey had other useful things to say on the subject five years earlier.

But there is a broader, more objective means of looking for any relationship. The Third International Mathematics and Science Study (TIMSS) provides test scores for 41 nations, including the United States. Thirty-eight of those countries are ranked on the World Economic Forum’s CCI. It’s a simple statistical matter to correlate the test scores with the CCI.

There is little correlation. The United States is 29th in mathematics, but second in competitiveness. Korea is third in mathematics, but 27th in competitiveness. And so forth. If the two lists had matched, place for place, that would produce a perfect correlation of +1.0. But because some countries are high on competitiveness and low on test scores (and vice versa), the actual correlation is +.23. In the world of statistics, this is considered quite small.

So, direct correlation? It doesn't look like it. Sage Friend isn't so sage after all.

There are other reasons to doubt the wisdom of a federal educational mandate, apart from its legality or constitutionality. And it's not only the Right that opposes ACA's individual mandate for health insurance. As bmaz concedes,

This is about far more than Obama’s questionably cobbled together ACA law; the law is inane in how it soaks Americans to benefit craven insurance companies. Either way, sooner or later, healthcare as constructed and/or mandated by the ACA will die a painful death, but will continue to decimate American families for years, irrespective of the ruling by the Supreme Court on its nominal constitutionality. At some point, single payer, such as “Medicare For All” is inevitable.

So, while emptywheel is a very informative and intelligent blog, its writers do have their blind spots. I wish bmaz would ditch the schoolyard homophobia too.