Month: October 2012

Will this strong support for Medicaid last under ruthless Grand Bargaineering?

by digby

This is the strongest statement of support for Medicaid I’ve seen from the administration and it’s a very effective message:

Kevin Drum posted this earlier today which shows just how high the stakes really are:

Romney wants radical changes here too, promising to “block grant” Medicaid if he’s elected. This means the program would be turned over entirely to the states. The federal government would continue to provide a share of funding, but that funding would go straight into state coffers, and states could decide how to spend it. So the question is: Once released from federal regulations, what would states do with their Medicaid money?

Romney’s plan represents a massive change in our commitment to providing decent medical care for those who can least afford it.

Some states would probably try some genuinely interesting experiments, though it’s unlikely we’ll ever discover any magic bullets for reining in health care costs on a state level. But lots of states, especially poor states in the South, don’t have much interest in experimenting. They just want to slash eligibility for Medicaid. Given the freedom to do it, they’d adopt what Ed Kilgore calls the “Mississippi model,” cutting off coverage for a family of three earning anything over $8,200. For all the talk of fresh thinking and new solutions, what they really want to do is simple: They want to stop providing medical care for poor people.

But that’s not all. In this case, there’s more than just differences in ideology at work. Unlike Medicare, which he’s willing to fund at about the same rate as Obama, Romney doesn’t want to spend as much on Medicaid as Obama does. In fact, he wants to take a chainsaw to it. Aaron Carroll and Austin Frakt took a look at the Romney and Obama plans in the Journal of the American Medical Association this week, and the chart above shows their conclusions. On Medicare, the two candidates want to spend roughly similar amounts of money. On Medicaid, Romney wants to spend way, way less. And not just on poor people. As Jon Cohn points out, cuts of this size will have a huge impact on “dual eligibles,” elderly patients who rely on Medicaid to pay their nursing home bills. This is not a minor point of technocratic disagreement. It represents a massive change in our commitment to providing decent medical care for those who can least afford it. Medicaid, much more than Medicare, demonstrates what’s really at stake in November’s election.

I’m assuming that because Obama is making such a strong commitment in this campaign, he’s not going to acquiesce to demands to cut Medicaid or block grant it in any deficit reduction negotiations. But I’m not entirely sanguine. Recall this from the New York Times in the summer of 2011:

Before the talks led by Vice President Joseph R. Biden Jr. broke off 12 days ago, negotiators said, they had reached substantial agreement on many cuts in the growth of Medicare, which provides care to people 65 and older, and Medicaid, which covers lower-income people. Those proposals are still on the table when Congress reconvenes this week, aides said, and are serious options that Democrats could accept in exchange for Republican concessions that raise revenues.

Up until now, Medicaid has very much been part of Grand Bargain deficit negotiations and it’s hard to see how they get to their magic numbers if they take it off the table. The devil is in the details, of course, but it’s something to keep an eye on.

And just as an aside, during the health care debate, one of the most painful aspects of it to watch was progressives being morally obligated to vote for a plan that expanded Medicaid so substantially to the working poor — all while knowing without a doubt that the funding for the program itself would be constantly under assault and almost surely whittled away over time. Certainly, I didn’t expect the Obama administration to offer to do it and was quite surprised when they put it on the table, but when you look at that graph above, it’s quite clear that any GOP administration with enough Democratic helpmates in the congress will cut it severely one way or the other. I expect it’s true that the Republicans will end up reluctantly accepting the guts of Obamacare — the exchanges and the basic coverage requirements — but this population is going to be at the mercy of politics for a very long time to come.

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The essential secret ballot

by digby

Chris Hayes discussed this In These Times investigation of a Koch Brothers email to 50,000 employees scaremongering the socialist takeover and urging them to vote Republican on his show this week-end:

Visit NBCNews.com for breaking news, world news, and news about the economy

Dear co-worker,

While we are typically told before each Presidential election that it is important and historic, I believe the upcoming election will determine what kind of America future generations will inherit. If we elect candidates who want to spend hundreds of billions in borrowed money on costly new subsidies for a few favored cronies, put unprecedented regulatory burdens on businesses, prevent or delay important new construction projects and excessively hinder free trade, then many of our more than 50,000 U.S. employees and contractors may suffer the consequences. … It is essential that we are all informed and educated voters. Our future depends on it.

This is why we have a secret ballot, folks. There’s always been pressure from people in power to force those in their employ or otherwise answerable to them to vote according to their instructions. The biggest problem with this is the fact that while they are allowed to proselytize in favor of their own issues and candidates, they also have the freedom to restrict their employees from doing the same. They can fire you for it — there’s no such thing as free speech in the corporation.

But no matter how much they try to pressure their employees to vote their own way, they will never be know who followed their orders and who didn’t. And that’s because some people long ago who truly valued liberty and understood what it meant, also understood that you cannot trust those in authority not to use their power for their own purposes. They knew that Democracy simply cannot exist without the secret ballot.

*In case you are wondering about the “No on Prop 39” ad at the beginning of the Chris Hayes segment, Credo’s Progressive California voter guide is urging a yes vote. Here’s the LA Times editorial board explanation for why they are urging yes as well.

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The deficit tango: 20 years of New Dem windmill tilting

by digby

Steve Benen reports that we’re going to be treated to a week’s worth of Romney-Ryan blathering nonstop about deficits. Fell the magic. He also points out that the current deficit is 200 billion less than was projected, and has been reduced by 800 billion since Obama took office. He adds:

To add a little historical context to this, over the last four decades, only two presidents have reduced the deficit this much, this quickly: Bill Clinton and Barack Obama.

I have two points to make about this. The first is that Bill Clinton and his DLC allies insisted on deficit reduction (while “ending welfare as we know it”) ostensibly in order to build credibility for the Democratic Party on economics. They would prove that you could be a responsible fiscal steward while “putting people first” through new technocratic reforms and “reinventing government.” And they’d show that you could deliver all the same services by harnessing the power of the markets and the private sector for the public good and all the Republican arguments would be vanquished in one fell swoop. And politically, once the nation saw that the Democrats were the grown-ups who really cared about debt, they could never again be called tax and spenders. At the time it was commonly believed that the only task left was to wipe off the stain of Vietnam and Gulf War I appeasement to leave conservatism in the dust once and for all.

How’s that plan working out?

Now, there’s every probability that this was always just about money and pleasing our corporate overlords among many of the 80s Democratic politicians who “outgrew” their earlier idealism and settled comfortably into the Reagan era. But there was also an ideological and political calculation, the latter being the most important in my opinion. The sense that liberalism had hit a wall and needed to be “re-tooled” was strong during that period and the necessity of running from the embarrassing hippie recent past was rife within the Democratic Party in the Reagan years. So, they gave it the good old college try.

But a funny thing happened. It turned out the Republicans and the political press weren’t going to cooperate in the make-over and would continue to portray them as the crazy tax-n-spend hippie freaks they used to be no matter how hard they tried to yuppify themselves. So here we are, with the Democrats still trying as hard they can to be Very Serious and never getting any credit for it. Go figure.

But in the case of Obama vs Clinton on this, I do have to point out one tiny difference. Clinton’s deficit reduction came about during an historic boom while Obama’s deficit reduction came about during an epic slump. I don’t think I have to explain why this matters, but I’ll just let Krugman do it just in case:

Let’s look at estimates of the cyclically adjusted budget deficit from the IMF’s Fiscal Monitor, measured as a percentage of potential GDP. I don’t think you want to take these numbers as gospel — for Britain, at least, there’s a very good case that the IMF is greatly understating potential output and hence overstating the structural deficit, and I suspect that this is true to a lesser extent for the US. But in any case the point is that even cheap-money countries facing no pressure either from the market or from external forces to engage in immediate austerity are nonetheless engaged in sharp fiscal contraction:

This is taking place in an environment in which the private sector is still deleveraging ferociously from the debt binge of the previous decade; so we’re creating a situation in which both the private sector and the public sector are trying to slash spending relative to income. And whaddya know, the world economy is sputtering.

The truly amazing thing is that this calamitous error is not, for the most part, the result of special interests, or an unwillingness to make hard choices. On the contrary, it’s being driven by Very Serious People who pride themselves on their willingness to make hard choices (which, naturally, involve inflicting pain on other people). In fact, I’d argue that the desire to make hard choices, or at least to be seen as doing so, is the reason the VSPs chose to ignore the extensive and, we now know, completely accurate warnings from some economists of what would happen if they gave in to their austerity obsession.

I can’t get inside these administration people’s heads, but if I had to guess they’re still at least partially driven by the quixotic belief that they’ll buy credibility with deficit reduction. At some point you’d think they’d figure out that it isn’t helping them politically — and judging by the chart above, I have the sneaking suspicion that we’re about to see the results of a real life demonstration of just how bad the policy is on the merits.

Bragging about being the better deficit reducers may seem like a winner. But to me, it just shows how feckless the Democrats really are. They keep doing the Republicans’ dirty work for them and getting blamed for the bad results. No matter how hard they try, Mean Villagers just won’t give them any credit.

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HPV Vaccines: Another Social Conservative Myth Implodes

by David Atkins

Remember how conservatives fretted that giving teen girls HPV vaccines would lead to increases in risky sexual behavior and somehow end society as we know it? Like almost everything social conservatives say, that was all basically bullshit:

Since public health officials began recommending in 2006 that young women be routinely vaccinated against HPV, many parents have hesitated over fears that doing so might give their children license to have sex. But research published on Monday in the journal Pediatrics may help ease those fears.

Looking at a sample of nearly 1,400 girls, the researchers found no evidence that those who were vaccinated beginning around age 11 went on to engage in more sexual activity than girls who were not vaccinated.

“We’re hopeful that once physicians see this, it will give them evidence that they can give to parents,” said Robert A. Bednarczyk, the lead author of the report and a clinical investigator with the Kaiser Permanente Center for Health Research Southeast, in Atlanta. “Hopefully when parents see this, it’ll be reassuring to them and we can start to overcome this barrier.”

Not likely. The sort of people who have these “concerns” are the sort of people who don’t believe in evolution and think tax cuts magically pay for themselves. A scientific study isn’t exactly going to dispel their ignorance.

But the rest of us can mock them all the same, even as we drag them kicking and screaming into modernity–a modernity that hopefully has a lot less cervical cancer in it, even for them and their children.

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Without irony, a Republican politician whines about rewarding mediocrity

by digby

Another smug GOP candidate claims that a whole lot of his fellow Americans are lazy, no-good losers who are addicted to Real Americans’ money. This one’s from Washington State 01:

KOSTER: Reform isn’t just taxing the rich, the very people by the way who create jobs. Our economic system has been the envy of the world for generations, but it seems to get more convoluted and more onerous every year. Under this administration it has become a system that punishes those who dare to dream, those who dare to invest, those who dare to work hard or succeed. It seems to reward the mediocrity — dare I say it, slothfulness and laziness — of those who choose not to do those things. Furthermore, it creates a dependency on government programs, even an addiction I would say, by virtue of the sense of entitlement that it creates. I can tell you, those people aren’t the 99 percent.

These are, by the way, the same idiots who are out there complaining every day about the president not creating enough jobs. So which is it? Are there a ton of great jobs that these lazy, slothful welfare queens refuse to take? Or are there no jobs out there and all these government addicted losers should just starve? What’s supposed to happen here?

I’ve been hearing some version of this garbage my whole life. But I have never seen so many right wing jackasses willing to stand up in public and basically say “fuck you” to so many of their fellow Americans at a time of economic hardship. And that they do it while blubbering like spoiled three year olds because the president once called a rich guy a “fat cat” and whining about how he waging “class warfare” is so astonishing I think they must be having a mental breakdown.

Unfortunately, this crude formulation is quite potent for a lot of people. I’ve been hearing from quite a few “civilians” (none of whom are millionaires, by the way) that they are petrified that their taxes are going up and they resent Obama for saying they “didn’t build that.” These are people who never built a thing in their lives, but they’ have some image in their minds that they are Galtian heroes. This stuff works.

And I’m afraid it makes me very cynical about the basic decency of my fellow countrymen.

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The Masters of the Universe threaten the whole enchilada

by digby

Over the past four years or so I’ve been fairly astonished as the willingness of the Masters of the Universe to kill the golden goose. I mean, you don’t have to be an economic genius or a professional historian to see that it’s generally been a bad idea for the wealthy to become so greedy that they create an unstable, unequal society and a stagnant economic system run by inbred bluebloods. But they seem intent upon doing just that.

Chrystia Freeland writes today about one historical parallel:

IN the early 14th century, Venice was one of the richest cities in Europe. At the heart of its economy was the colleganza, a basic form of joint-stock company created to finance a single trade expedition. The brilliance of the colleganza was that it opened the economy to new entrants, allowing risk-taking entrepreneurs to share in the financial upside with the established businessmen who financed their merchant voyages.

Venice’s elites were the chief beneficiaries. Like all open economies, theirs was turbulent. Today, we think of social mobility as a good thing. But if you are on top, mobility also means competition. In 1315, when the Venetian city-state was at the height of its economic powers, the upper class acted to lock in its privileges, putting a formal stop to social mobility with the publication of the Libro d’Oro, or Book of Gold, an official register of the nobility. If you weren’t on it, you couldn’t join the ruling oligarchy.

The political shift, which had begun nearly two decades earlier, was so striking a change that the Venetians gave it a name: La Serrata, or the closure. It wasn’t long before the political Serrata became an economic one, too. Under the control of the oligarchs, Venice gradually cut off commercial opportunities for new entrants. Eventually, the colleganza was banned. The reigning elites were acting in their immediate self-interest, but in the longer term, La Serrata was the beginning of the end for them, and for Venetian prosperity more generally. By 1500, Venice’s population was smaller than it had been in 1330. In the 17th and 18th centuries, as the rest of Europe grew, the city continued to shrink.

Freeland’s whole article is worth reading. She discusses the similarities between the Venetians and the current economic elite, pointing out that the modern version is quite a bit subtler if just as effective at closing off entry to the game.And she concludes with this:

It is no accident that in America today the gap between the very rich and everyone else is wider than at any time since the Gilded Age. Now, as then, the titans are seeking an even greater political voice to match their economic power. Now, as then, the inevitable danger is that they will confuse their own self-interest with the common good. The irony of the political rise of the plutocrats is that, like Venice’s oligarchs, they threaten the system that created them.

The growing awareness that the 1% is threatening the whole system is welcome. Assuming democracy remains operative, perhaps that’s the necessary first step to correcting the problem.

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Polarization: ain’t that America?


by digby

When people start hand wringing over the fact that we are suddenly a polarized country, I always wonder what cave they’ve been living in. With some rare exceptions, it was ever thus.  At least I’ve always thought so.

Michael Lind wrote about this recently for Salon:

Now that they dominate the Republican party, Southern conservatives are using it to carry out the same strategies that they promoted during the generations when they controlled the Democratic Party, from the days of Andrew Jackson and Martin van Buren to the Civil Rights Revolution of the 1950s and 1960s. From the nineteenth century to the twenty-first, the oligarchs of the American South have sought to defend the Southern system, what used to be known as the Southern Way of Life.

Notwithstanding slavery, segregation and today’s covert racism, the Southern system has always been based on economics, not race. Its rulers have always seen the comparative advantage of the South as arising from the South’s character as a low-wage, low-tax, low-regulation site in the U.S. and world economy. The Southern strategy of attracting foreign investment from New York, London and other centers of capital depends on having a local Southern work force that is forced to work at low wages by the absence of bargaining power.

Anything that increases the bargaining power of Southern workers vs. Southern employers must be opposed, in the interest of the South’s regional economic development model. Unions, federal wage and workplace regulations, and a generous, national welfare state all increase the bargaining power of Southern workers, by reducing their economic desperation. Anti-union right-to-work laws, state control of wages and workplace regulations, and an inadequate welfare state all make Southern workers more helpless, pliant and dependent on the mercy of their employers. A weak welfare state also maximizes the dependence of ordinary Southerners on the tax-favored clerical allies of the local Southern ruling class, the Protestant megachurches, whose own lucrative business model is to perform welfare functions that are performed by public agencies elsewhere, like child care.

Obviously, not all Southerners agree with this. There are many staunch southern liberals as well as Hispanics and African Americans who are almost all hardcore Democrats. And the northern and Western states are full of conservatives, including the effete “intellectuals” like Paul Ryan. But what he’s talking about here is the South as the political epicenter of America’s unique philosophical conservatism and the long, long history of its struggle with the more liberal “Northern” culture for supremacy in our political life.

Now, I happen to believe these All-American conservatives would like to extend their belief system to the whole country. Merely preserving the South’s unique way of life is hardly their goal. Indeed, I think the avatars of American conservatism in other parts of the country are a good guide in that respect:

The maps don’t tell the whole story, but you have to admit they are interesting:

Slave states – Free states

Union vs Confederacy

2008 electoral map

2008 electoral map by population

Demographic changes may eventually mark the end of this.  But this divide been amazingly enduring. Despite civil war and strange bedfellow political alliances along the way, it still manages to revert back to this equilibrium. These are two distinct political cultures that have been fighting this out since the beginning. It’s America.

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Paul Ryan, phony altruist (What would Ayn say?)

by digby

Michael Shaw at BagNewNotes catches the media enabling yet another Paul Ryan lie — they allowed him to stage a photo-op of him and his wife “cleaning” dishes that were already clean at a soup kitchen. A couple of them noted the phoniness, but for the most part, they just published the staged photos:

Looking at the pictures published by CBS, AP, NBC and the NYT, it appears as if Paul Ryan rolled up his sleeves and helped clean up after a meal served at an Ohio soup kitchen. That’s in contrast, though, to the WAPO post which indicates Ryan not only arrived after all the homeless diners had left, but also after the kitchen was cleaned up. Although cautiously worded, the WAPO story indicates that Ryan, with his family present and donning aprons, took already clean dishes, then soaped them up and washed them for the cameras as if he was really contributing.

Because there have been so many allegations made about the Romney/Ryan campaign and truth telling, my question is: did Ryan in fact stage his involvement in the clean up of the meal, and to what extent did the press collude with the campaign to make it appear so?

Whereas several outlets published photos of Ryan getting “hands on,” not all indicated the potential misrepresentation. Take the shot above by NBC reporter Alex Moe, for example, who published this photo to Instagram. The caption of her post is technically accurate: “Paul Ryan washes dished at soup kitchen outside Youngstown, OH.” For those who know no better, however, it gives no sense Ryan was washing clean dishes.

Here’s Ryan pretending to care about poor people:

Shaw’s criticism of the press here is right on. They all should have noted that Ryan staged this little scene. But in my mind, it’s even more pertinent because Ryan’s Randian philosophy which holds that altruism is immoral.

Recall that Ryan said as recently as 2009:

“Ayn Rand, more than anyone else, did a fantastic job of explaining the morality of capitalism, the morality of individualism. And this to me is what matters the most: it is not enough to say that President Obama’s taxes are too big or that the health care plan does not work, or this or that policy reason. It is the morality of what is occurring right now; and how it offends the morality of individuals working for their own free will, to produce, to achieve, to succeed that is under attack.”

In case you are wondering what Rand actually said about morality in this respect:

Capitalism and altruism are incompatible; they are philosophical opposites; they cannot co-exist in the same man or in the same society. Today, the conflict has reached its ultimate climax; the choice is clear-cut: either a new morality of rational self-interest, with its consequences of freedom, justice, progress and man’s happiness on earth—or the primordial morality of altruism, with its consequences of slavery, brute force, stagnant terror and sacrificial furnaces.

Or how about that strapping fictional hero John Galt?

A morality that holds need as a claim, holds emptiness—non-existence—as its standard of value; it rewards an absence, a defect: weakness, inability, incompetence, suffering, disease, disaster, the lack, the fault, the flaw—the zero.

Parasites, 47%, “takers”, they’re all — nothing.

Ryan must have had a epiphany sometime in 2012, because these days he’s telling anyone who asks that Rand is ridiculous:

I grew up reading Ayn Rand and it taught me quite a bit about who I am and what my value systems are and what my beliefs are.

Her philosophy is kind of a ridiculous — one of opinion of objectivism, I’m a devout Catholic. How can you be — you know, believe in that stuff?

Go back and read John Galt’s tedious speech (if you can bear it) and you will see how much Ryan’s “takers vs makers” echoes the points within it.

This is why it sickens me to see him have the utter gall to stage pictures of him and his wife pretending to clean dishes for poor people. It’s exactly the opposite of what this con-artist who celebrates selfishness stated he believed in just a couple of years ago. In fact, Ryan is far worse than your average Republican who believes in “faith-based” charity and other means to help poor people, even if they demand fealty to their belief system in order to get it. Paul Ryan believes that helping poor people at all is immoral. These pictures are the ultimate pretense.

If you’d like to see him out of politics completely, you can give a little something to his congressional opponent Rob Zerban here. If you’d like to enter a drawing to win a B-52’s platinum award at the same time, you can do it here.

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The essence of the VP debate

by digby

“Uhm no, Irish is I come over there and smack that dumb look off your face.” 

The guy doing Ryan has the voice so perfect it’s eerie.

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Quotes of the day: libertarian edition

by digby

These are both from an interesting post at Corey Robin’s place about the libertarian experiment going on in Honduras after the American backed coup, (also known as Back to the Future Part II) It sounded very familiar to me and then I remembered: Iraq. They also set out to create a free market paradise there, you’ll recall, by sending Heritage Foundation interns over to create new private institutions from he ground up. How’d that work out?

Anyway, the post he cites from Greg Grandin features two quotes from noted libertarian sources who are down there working on the project. The first is Milton Friedman’s grandson Patri:

“Democracy is the current industry standard political system, but unfortunately it is ill-suited for a libertarian state.”

and renowned libertarian Peter Thiel, founder of Paypall and bankroller of FB and another supporter of the Honduran scheme, who wrote:

“Most importantly, I no longer believe that freedom and democracy are compatible.”

This is a subject Robin has gotten into before and was greeted with howls of dissent from many of those who consider themselves libertarians. But it’s true. When push comes to shove, markets must rule, not people.

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