Tag Archives: Health Care

Compulsive Lying & the Republican Party

A Republican operative wrote a recent book about the party titled It Was All a Lie. I haven’t read the book, but that’s certainly an exemplary instance of “getting the headline right.”

Dishonesty almost seems like it’s an out-of-control compulsion for the Republican Party at this point, and this seems worth noting even if it may only be a footnote to the larger picture.

In the larger sense, the Republican Party committed itself to dishonesty decades ago, when a critical mass of influential figures decided that winning over majority support to their priorities was no longer a realistic prospect. David Frum has written that “If conservatives become convinced that they cannot win democratically, they will not abandon conservatism. They will reject democracy.” As democracy existed and was rather broadly popular, however, Republicans’ agenda first obliged them to reject honesty about said agenda.

They did that, and have reached a point where they have rigged so many systems of power in their favor that they have done little except abuse power for a dozen years, without any evident corrective which could force them to stop. Yet they continue attempting to sustain frauds which are almost like trying to conceal something behind a plate-glass wall.

Read More →

Living atop a powder keg

“The weather was indeed fine, but thinking men and women were aware that Europe lived on a powder keg, and had for years.” James Stokesbury wrote this about summer 1914, in the opening paragraphs of A Short History of World War I, which I have read over and over.

I think about this lately, as well as a few words about the eve of another even larger convulsion: commenting about their respective countries in The Wind Rises, Castorp speaks very plainly to Jiro: “Japan is going to blow up. Germany will also blow up.”

For all that I go on about this theme, it feels like one thing to perceive such a course and quite another to process it and adapt one’s thinking accordingly. I may be making some progress. It seems more immediately real that America is living on a powder keg, which we should expect to blow up.

Read More →

Medicare for All vs Solidarity for Some

Just over four years ago I was writing about the contortions which many Democrats were twisting themselves into, over policies including Medicare for All, seemingly in order to pretend that their feelings toward individual candidates were policy-driven.

Plus ça change, plus c’est la même chose.

Short version, Bernie Sanders is back running for president again; in the intervening four years his advocacy of Medicare for All has been joined by a small number of top-ranked Democrats, including even one of the other leading candidates for president, Senator Elizabeth Warren; Sanders’s campaign has vigorously framed Medicare for All as a wedge issue to justify disdain for and distrust of Warren, anyway, without any remotely credible basis in policy disagreement.

Read More →

2010s: a bad decade

Thinking back on 2010-19 this decade has simply been brutal.

Personally it has been rich with experiences, change, and growth (if not with monetary wealth). I’m not ungrateful for that. But all of that has occurred against a near constant background of political, sociocultural and ecological sabotage.

I have watched it all and chronicled much of it in one space or another, and most of the time the trend has been pretty clear. For all that the 2010 elections were catastrophic in many ways, I think I had a valid point when I proposed several weeks after them that the fundamental reality of committed Republican obstructionism in Congress had already been a reality for two years by then.

Having reflected for a while, I conclude that this proved to be the most significant thing to happen in the 2010s, certainly for America: at the beginning of the decade one party in a firmly established two-party political system committed itself completely to sabotage, and at the end of the decade no corrective mechanism has intervened.

Read More →

Messaging around Medicare for all

On healthcare, I’m pretty convinced that some kind of single-payer system is by far the optimal policy. I’m less convinced about the politics than are many single-payer proponents. But I’m certainly onboard with efforts to build support.

Amid signs that this is happening, the emerging Republican argument is essentially that “Medicare is awesome… and America just can’t afford that for everyone, so, senior voters, better that others go without so you can keep what you have all to yourself.” In a sense it is a less obviously ridiculous, but more obviously selfish, update of the 2010 “keep the government’s hands off my Medicare” message.

The other day, a suggested response occurred to me: “OK Republican, whom do you want to leave without healthcare? Please be specific.”

Because this seems like the weakness in the “Medicare for all would mean Medicare for none” message: it’s based on activating a fear that America can’t afford for everyone to have healthcare. Doing this has implications.

The implication of a “can’t afford M4A” message is that there just isn’t enough healthcare to go around. Republicans using this message should have to specify whom they think should go without, then.

Read More →

Post-Election Thoughts Nov. 2018

The Economist examined the question of whether or not America is “ungovernable” nearly nine years ago. At the time they concluded no, and blamed Barack Obama. By four years ago, their tut-tutting confidence had slipped a bit. I have documented that slide before.

Another cycle of presidential and midterm elections has now passed. I don’t know what The Economist may have to say at the moment; I don’t read the site regularly now that it’s tightly paywalled.

I, however, am left with a stronger than ever sense that America is ungovernable, at any rate in the sense of a capacity to organize at large scale and lead a substantive program of reform.

What is the point of any of the shouting, struggling, attempted organizing and counter-organizing, etc., etc.? I realize that things take time, but what has been the point of anything during the past 20 years in American politics?

In the 1990s, I can perceive the entrenchment of a neoliberal program, in broad terms. I may not approve of it, but I can at least identify a possible program of reform which (starting some time earlier) was still viable across multiple elections.

Since then…?

Read More →

2016 Year in Review

My experience of this year mostly lends itself to sorting into two, very different, categories: political, and other.

Except that politics isn’t really something separable from other areas of life, however much one may wish or believe that to be so.

Once again, I confront election results that are not only distasteful, but could very realistically make me a healthcare refugee in the foreseeable future. I’m self-employed, I have an expensive preexisting condition, I’m ineligible for Medicaid and a long way from Medicare (both of which will also come under fire anyway). If a Republican federal government junks the Affordable Care Act (and rules out substitutes which feature either redistribution or heavy-handed regulation, which are the only real ways to make private health insurers cover someone like me), I’ll have to look for other governments that might be more helpful. Which, right now, probably won’t include Ohio.

Meanwhile, even in my own life this year, “political” bled substantially into “other,” although this was admittedly voluntary to a great degree.

I really feel that, looking back, I actively “volunteered” for very few of the political activities in which I found myself immersed in 2016. But if I was recruited over and over, I rarely said “no,” and perhaps after a time that amounts to volunteering.

Oh, Lakewood politics, you’re crazy but maybe that makes us a match.

Read More →

America goes bonkers, contd.

Recently I wrote up a post about Bernie Sanders, Hillary Clinton and the Overton window, but I have since decided to throw it all out. In a way, further reflection has convinced me that the whole Overton window concept may not even be useful any longer, as my earlier post was in fact implying, even if I hadn’t realized it. At this point I think a single “window” of what’s possible in American politics, at the national level, is not even accurate as a simplified model. It feels like a relevant update would now involve something out of a nightmarish video game, with multiple holes opening, closing, changing size, etc., simultaneously without any reference to one another.

Obviously Republican America has ceased giving any heed to any universal idea of what’s practical, or of anything else. I mean, what is there to say? The latest word from those pundits still attempting to make meaningful observations is that the GOP establishment is, now, preparing to embrace Donald Trump for president because they find him less offensively deranged than his leading rival. I’m not even sure what part of that sentence it would make sense to emphasize; it’s all surreal.

In the meantime, some kind of much more modest but still dumbfounding suspension of reason seems to be creeping through Democratic America. I’m certainly not unbiased, but here’s what I’m seeing. A growing number of putative liberal voices are

Read More →

2015 Year in Review

One year ago, I expected that “keep doing my thing and try to make ends meet” would predominate in 2015, and that forecast wasn’t wrong. In day-to-day existence, that definitely characterized most of this year. But there were exceptions, and in looking back on the whole year… those exceptions loom remarkably large.

Unlike 2014, it feels like the “events” of 2015 are such as to support a “top stories” list. Probably something like this:

Save Lakewood Hospital. After 36 years without any real involvement in local politics, anywhere I’ve lived, I dove straight into the deep end and have spent almost 12 months, now, involved in an impossible soap opera controversy that is still a long way from ending. For much of the year, a logo that I designed over a weekend was on signs on just about every street in Lakewood. Last month I got up and spoke to city council; strangers have stopped me in public to thank me and ask my opinion. Just about every day of “Christmas vacation” I replied to at least some correspondence about this campaign. Etc., etc., etc. The experience as a whole has been fascinating, energizing, demoralizing, rewarding, and maddening.

Japan! I spent a week in Tokyo. It was actually a bit like my experience with Save Lakewood Hospital—fascinating, energizing, demoralizing, rewarding, and maddening—but more compressed, more expensive, less worrying and way more fun. (Aside from flying across the Pacific. Blecch.)

Authorship continued, and actually turned a profit! In 2015, I attended another author fair, spoke at Lakewood Library, mostly finished my research on a third book and got an early draft nearly complete, and craziest of all I showed a modest profit for the year. I’m still a long way from an all-time profit, thanks to spending a bunch on publishing Brilliant Deduction, but if that’s viewed as a sunk cost I made a real profit for the first time, this year.

I went to Baltimore, for three hours. Related to the aforementioned research, I made a round-trip visit to Johns Hopkins University in right around 16.5 hours. (From Lakewood, Ohio.) This wasn’t actually… awesome, aside from verging on awesomely stupid, but 1) it makes for a story, 2) I did find material to justify the trip, thankfully, and 3) it’s nice to know that I can still pull off a stunt like that.

Politically, despair was mixed with multiple instances of hope, and even near euphoria. There was bad in 2015, oh my yes. From the dismal election outcome here in Lakewood all the way up to not-so-grand geopolitics. Yet… who can forget those incredible days in June, when the Supreme Court gave marriage equality the green light and basically pulled the plug on “undo Obamacare” hopes. Who can forget “PURE APPLESAUCE!,” ever? Then there have been the ongoing follies of the Republican party, from March’s fiasco in Indiana to what one pundit seriously predicted would be “the best field in a generation” of presidential candidates… bwa ha hah. Just weeks ago, even as Lakewood city council was disgracing itself, real leaders met in Paris to negotiate the future of the entire biosphere and actually didn’t produce a complete disgrace, for once.

Read More →

What next for the Democratic Party?

Let’s indulge hope, just for a moment, and play pretend. Let’s imagine possibilities, precisely because we’re pessimists and expect that even an illusion of encouraging circumstances is usually short lived, and so one might as well daydream when one gets the chance.

Along these lines, then, let’s ask what liberals/Democrats should do next?

The prompting for this bit of whimsy is, obviously, the Affordable Care Act’s most recent Houdini Act. Plus a couple of recent articles that more directly considered the idea that the Democratic Party might be about due for a new project.

This is, on a basic level, not actually all that fanciful. It does seem possible that the years-long effort to implement and defend the Affordable Care Act is, at least, ready to shift from war-of-survival to maintenance-program. I think it isn’t completely delusional to suggest, as Vox has, that Republicans are just running out of ideas to disembowel the ACA with one stroke. More importantly, perhaps, I suspect that they may also just be running out of steam a little bit. At some level. Certainly the fact that, by the time the Supreme Court finally ruled on King v Burwell, many many elected Republicans were actually quietly relieved that they didn’t have to deal with the consequences of a “victory” suggests that they may be ready to redirect resources to some other issue.

So perhaps the Democratic Party ought to be thinking the same thing. Significantly, and strange as it is to suggest, “Obamacare” arguably completes the several-decades-long project of safety net programs. Compared with e.g. a European welfare state, America’s redistributive social programs are still a net, indeed, i.e. full of holes. But as a skeleton, an outline, they do seem basically complete: old-age pensions, unemployment insurance, disability payments, and, finally, a program that at least aspires toward universal health care access (however short it falls at present). There is no longer any obvious, complete void to demand patching over as priority one.

At the same time, I might add, it looks (from my point of admitted privilege) like social equality is making reasonable progress. Racism, sexism, homophobia etc. still certainly exist, but the space in which it’s okay to be noticed practicing these -isms seems to get narrower every year. Maybe, as I will speculate with some other issues as well, progress from the bottom up is now self-sustaining here without top-down pressure. Perhaps.

All of this suggests both an opportunity and a challenge. A once-in-a-generation chance to think big and dream of something more than just building a floor is kind of exciting, in theory. At the same time, however, a description I read a few years back of legislative reform in America having “limited bandwidth” has only seemed more and more apt with time. It seems likely that Democrats will mark eight years in the White House with precisely one major legislative achievement to show for them (health care reform). It seems just about as likely that accomplishing even that much in the next decade will be a tall order. Yet that’s all the more reason to prioritize. Chance is always a factor, but for the most part this generation shouldn’t expect much further in the way of big, national progressive reform without a sustained, focused campaign for it. Plus, a party ought to have some national agenda to run on in a national election, however dim that agenda’s prospects, right?

So: what to place first in that low-bandwidth download queue? (Note: as this is primarily a look at what should be done, even if there is limited support, it won’t be constrained by present congressional malapportionment, etc., because what do several more years of locked-in gerrymandering matter when it may take 10, 15 or more years to build your case for action anyway? That said, I am going to “score” each issue and will examine political prospects therein, briefly.) Read More →