Because Donald Trump tends to do three or four outrageous things a day, it’s hard to isolate his remarks about John McCain. If his favorable numbers went up or down in the aftermath of those remarks, it could be because of something else. Still, several pundits were quick to pronounce Trump’s candidacy dead when he mocked McCain for getting captured, and others suggested that he’d peaked in popularity.
The picture is nuanced, but it doesn’t support these prognostications. While Trump saw a dip in his favorables and a spike in his unfavorables, the bottom line is that he’s doing better than ever.
Former Florida Governor Jeb Bush’s favorable ratings this week are similar to those of Trump, though fewer Republicans rate Bush unfavorably.
But there is clearly a core group of registered voters who identify as Republicans that has coalesced around Trump’s tough talk and proposals. He is even more clearly in first place than he was two weeks ago when Republicans are asked to choose among the current candidates. Two weeks ago, in the Economist/YouGov Poll, 27% of registered voters who identified as Republicans chose Trump as their first or second choice for the nomination. This week, 28% say he is their first choice, and another 10% rank him second.
That’s actually a considerable boost. I said that I doubted that the McCain comments would hurt him, and I said that I doubted that thinking about Trump in terms of the second or third choices of poll respondents would explain as much as it should. Here we see Trump suffering from dropping popularity and still doing much better as a second choice. That’s not what people would predict if this were really about Trump.
But it’s not about Trump. It’s about the modern GOP. Trump is only the honey trap that collects massive inchoate discontent that has grown to the point of outright nihilism. Seriousness has been completely jettisoned. Trump can fall down dead tomorrow and the Republicans will have the exact same voters with the exact same lack of regard for science, common sense, or any American institution, whether it be the president, Congress, the Supreme Court, the media, the RNC, the Republican leadership, or our academic institutions.
That’s why people can simultaneously like Trump less and support him more.
This isn’t that complex, but it is tough medicine to swallow. Pundits do not want to believe the truth about what’s happened to the right in this country, but it’s the most dangerous development we’ve seen in a long time, and it’s the biggest story of this campaign.
Trump kind of is like Father Coughlin before him – was an adamant FDR and New Deal supporter, and pro-labor and anti-bankers (because he said most of them were Jewish) eventually became an Anti-Semitic supporter of Fascism, and Hitler and Mussolini.
Trump started off as a wealthy supporter of Democrats, and, in the past decade, has devolved into some boastful angry xenophobic megalomaniacal loon.
Ok, he was always 4 out of the 5 – he’s just added rabid xenophobia to his prior lunacy.
And some Plutocratic Fascism, too.
Coughlin was immensely popular in the 30’s. Until he went way too far, and lost his popular radio show.
What was the margin of error in the ” This week, 28% say he is their first choice, and another 10% rank him second” because that number of “good Germans” who are angry is approaching 10 million voters. That’s still far from the 70-75 million that it is going to take to elect a President next year, but a serious problem of legitimacy thereafter.
I’m not so sure that it’s a matter of the pundits’ failure to see or the occupational risk of telling a truth that their bosses want to hide. The dismisaal of Ed Schultz from MSNBC for his loud opposition of the TPP is instructive in this respect. He was stepping on one of Comcast’s potential future income streams (unlimited intellectual property rights); it was not about ideology so much. But an owner exercising censorship in that way, although expected, is striking. It really is the subtext behind Brooks, Friedman and a lot of the others.
This post helps explain why I can be a little dogmatic here on the Frog Pond about what I experience as false equivalences from some of the commenters.
These commenters’ anger over Obama’s drone policy and claim that his military policies are just a continuation of W. Bush’s pales in comparison to, for example, Scott Walker’s stated willingness to start a military war with Iran in the very first day of his Presidency, and Walker’s inference in that statement that any candidate who is not willing to go to war with Iran on the first day of their Presidency is not fit for the office.
Commenters who complain that Obama was not a fighter for single payer health insurance (even though he did not campaign on that plan) and grouse about their perceptions of the ways the ACA should have been better fail to account for supposed “centrist” Jeb! Bush’s statement this week that Medicare needs to be phased out because it is financially unsustainable, a radical and dangerous view common among Republicans which stands in ignorance of the fact that the best projections of future Medicare cost growth have changed remarkably strongly for the better since the ACA was implemented.
This is true of subject after subject after subject. Obama is not running a conservative or moderate Presidency, and the reliance on evading facts by commenters who claim he is following conservative policy goals are very irritating to me. Hillary is not my first choice as a Democratic Party POTUS nominee at the moment, but if she wins the election she will not be a conservative President, and it now appears that she will be a solidly liberal President.
The reason this issue takes up much of my interest here is that the corrosion of thought that comes from these nasty false equivalencies leads to encouraging others to take the destructive action to not care who wins the next election because there aren’t any differences between the candidates anyway. That’s a damaging and despicable lie. This doesn’t come from blind partisanship; it comes from my ability to decipher factual information and bring it into my decision-making.
I agree. Personally I think there’s a pretty important difference between invading and occupying a foreign country based on a bunch of lies and not invading and occupying a foreign country based on a bunch of lies.
nicely said.
How about not invading and occupying a foreign country but arming other countries to do that for you and helping them along with drone strikes and God knows what else based on a bunch of lies?
Does that count?
AG
I agree with you that the Obama policies you list are counterproductive, wasteful and immoral.
Are the Obama defense policies quite a bit less wasteful and immoral than those pursued by W. Bush? The evidence is there to show that they are. Do Obama’s current successful efforts to use diplomacy to pull us away from a military attack on Iran while achieving a crucial outcome in service of the goal of halting nuclear weapon proliferation turn us toward a productive set of Defense and State policies? Yes, they do.
What Obama is trying to pull off re. Iran is a direct attack on the (to use your construct) PermaGov powers. I’d think you might have taken a moment to recognize what Obama/Kerry/Moniz et al. are about to achieve here, and respect them for the efforts.
Among the things that critics fail to credit Obama for is that he successfully negotiated cuts in Defense spending through the budget sequester.
Count for what? You should try climbing down from your pedestal some time so you can hear what some of us are actually saying. My point is that even if the only goddamn thing you care about is the goddamn drone strikes, there is a vast and important difference between Barack Obama and George W. Bush. I did not say, nor do I believe, that Barack Obama is Jesus, an incarnation of Vishnu, Frederick Douglass reincarnated, or the Kwisatz Haderach.
See, here’s the problem with the grandstand of philosophical detachment. Someone is going to be elected president of the United States next year. Supposing that candidate A is going to blow up 10,000 people, and candidate B is going to blow up 500,000 people, what is your responsibility as a citizen? (And no, that is not a reason to support that neoconfederate fuckhead that you’re always wanking over. He would get God knows how many people killed by ignoring the climate crisis.)
Think about Pontius Pilate, too. He said, “I wash my hands of this.” Is it really that easy?
agree with what you write and also become impatient with (polite term) what you describe. one reaction, of course, is Davis X’s rejoinders (he’s our version of TPM’s Ghost of Eustace Tilley as someone pointed out)
btw, Obama has more in the pipeline, Kerry working on climate
http://www.rtcc.org/2015/07/23/the-week-climate-change-diplomacy-went-into-overdrive/
Kerry is impressive
[link from Carne Ross’s twitter feed which I highly recommend
https://twitter.com/carneross
Bullshit.
Kerry threw the 2004 election, just as did Gore in 2000.
“Impressive!!!???”
Impressively in service to the PermaGov.
Still working for them 11 years later.
A trusted front man.
Nothing more.
AG
Here’s Arthur, just sitting on the biggest political story in the last 100 years…
They both caved in to a court-ordered OK on uninvestigated vote fraud. They could have fought. They didn’t. Why? “For the good of the country.” End result? 8 years of BushCo. How “good” was the country after CheneyBush finished diddling with it? End of story.
WTFU.
AG
The fact that Republicans have now turned so far Right that they are now fascists or reactionaries does not alter the fact that Obama has run a conservative administration by twentieth century standards. The dial has gone so far Right that Nixon and Dirksen are being called Liberal by some. They were not and Obama is not. Unless you count the clowns that claim is a socialist or communist.
Only a person completely unwilling to be objective would claim that the operations of Obama’s Cabinet Departments have been generally run in service to conservative policy goals. Multiple Departments have taken sufficiently aggressive actions to draw rejections from the Judicial branch, as well as much resistance from many Americans. And there’s the dance that Obama has done with the military-industrial complex which has resulted in him keeping the U.S. from engaging military invasions in multiple countries. Fuck, look what’s happening right now with the Iran nuclear deal! Unhappiness with actions and leadership choices in Commerce, Justice, and perhaps other Departments do not do away with the overall set of actions pursued by this President and his Cabinet.
Now let’s discuss the signature legislation of Obama’s Presidency.
We went the entire 20th century with President after President and Congress after Congress taking greater or lesser interest in passing major health care reform. None of those Presidents or Congresses were able to pass comprehensive reforms, even as the American health care system became more expensive and less accessible to the average American, year after year after year.
Obama and his first Congress successfully passed comprehensive health care reform over the most vicious, unfair opposition we have seen in response to any legislative effort in our lifetimes. Despite the perspective-free criticism from some on the Left, the ACA as originally passed was an extremely progressive Law which disproportionately benefits low-income and middle-income Americans. It remains an extremely progressive Law, despite its benefit to the pharmaceutical and health insurance industries.
A radically conservative Supreme Court has made the Law less progressive by allowing the Stupid States to reject expanded Medicaid eligibility. The SCOTUS judges nominated by Obama and Bill Clinton, another President hated by many on the Left, all stated in their opinions that the ACA provision which essentially made Medicaid eligibility expansion mandatory was constitutional.
I’m sorry, the claim that “Obama has run a conservative administration by twentieth century standards” should not be based on feelings. Factually, it just doesn’t hold up.
Factually, it does hold up. You pick and choose certain items to support your contention and even those aren’t more than center by 20th century standards. Hello: SaltI and opening China was Nixon. INF – Reagan. StartI GHWB.
Then you conveniently omit the decidedly right of center stuff.
You are free to label the Obama administration was the most liberal ever, but that doesn’t change the facts.
what items of Obama admin would you point to as evidence of a conservative admin?
Off the top of my head, bailouts, Dodd-Frank and the lax/slow implementation, covert military/CIA ops, TPP, didn’t let the Bush tax cuts expire, off-shore drilling, charter schools (Arne Duncan is a disaster for anyone that values public education) and most of the PPACA. Expanding the community health care clinics was sort of liberal — non-profit but privately owned. Expanding Medicaid (building on the existing Medicaid system) is liberal but the funding for it screws up the original model which it didn’t touch. Expanding the national physician health corps is liberal, but also adds to what already existed.
please explain more fully – which bailouts and why? [GM?] Dodd-Frank not enough? you’re assuming the covert opps are from Obama, so you disagree with Tarheel’s assessment?
and which offshore drilling? TarheelDem pointed out several years back that Obama proposed then offshore drilling where tourist industry would be most affected, presumably because those states will fight against it.
I think your case is weak, but willing to read more details.
If we don’t have an agreed upon working definition of conservative and liberal/progressive, a debate about this or that legislation or issue is a waste of my time.
You asked for a list and I gave you a list. To declare that my “case is weak” but you’re willing to listen if I supply details while you haven’t offered anything in support your conclusion that they are liberal is like a patronizing male attitude that I’m all too familiar with. “Marie, you think X and I think Y; so, you need to write up a thirty page report on why X is right. And if it’s good enough, I might agree with you. Otherwise, Y is correct and I don’t need no stinking information or analysis to support it.” (Sometimes I did the work and sometimes I told them to fuck off. And they were always wrong.)
Five Years Later, Dodd-Frank is on the Chopping Block
Glass-Steagall worked and it took the GOP and Clinton and his Wall St. buds over sixty years to get rid of it. Dood-Frank is so weak that implementing provisions of it has been slow. Will it last even six years?
Sometimes it’s not even a question of how liberal or conservative legislation is, but how fundamental and robust it is for the common good. When banksters can steal billions that isn’t good for the pocketbooks of all of us and it erodes the societal level of honesty. Narrow income/wealth inequality is a common good for a society and the opposites is harmful.
Senator Warren, hardly one to lay false claims on the subject of financial regulations reform, is seen here stating that the Dodd-Frank reforms are important and valuable ones, and that they are protecting Americans. She has also said that the reforms should have been stronger, and I share her worries about regulatory capture, but it’s beyond parody to claim that Dodd-Frank is in pursuit of conservative policy goals. You might want to tell Wall Street and the banks that; they’re screaming that the reforms are The Worst Liberal Things Ever.
Re. Taibbi’s piece, I think that some of his critiques are poorly measured and substantiated in this piece, and we can see that some of his predictions re. D-F policy repeals have failed to materialize. It’s remarkably unfair of Taibbi to take Judicial decisions which declared some parts of the Law invalid and somehow lay those rotten decisions at the feet of Congress. If anything, those Judicial decisions suggest that the Legislative and Executive branches were exceedingly aggressive in their construction of the Law.
For more see Matt Taibbi 2012
Didn’t say “most liberal ever.” Have been refuting your claim that his Administration is “conservative by 20th Century standards.” But when my discussion is taking place with someone who believes that Dodd-Frank in its overall regulatory scheme expresses conservative policy goals, I realize that maintaining reasonable judgments in our discussion may be difficult, because that’s an unreasonable judgment.
As discussed elsewhere on this thread, Obama lacked the Congressional majorities it would have taken to pass the breadth of regulatory schemes achieved by FDR in response to the Great Depression. The Great Depression was also much worse, with unemployment rates more than twice as high as they were at their peak a few months after Obama took office. Then there was the preposterously radical obstruction offered by the filibustering Senate GOP and the subsequent GOP House majorities. All of these facts gave Obama much less room to maneuver.
And I’ve just got to address the claim that the stimulus was botched on many levels. Yes, economists can offer critiques that the stimulus was not as large or structured as well as might have been optimal. I’ll point out two things: one, “optimal” was not on the table due to Republican obstruction. Criticisms of Obama’s negotiating strategy can be reasonable, but the idea that Obama was pushing for policy goals “conservative by 20th Century standards” is absurd. He negotiated with Congress the passage of the single largest Federal fiscal stimulus in the history of the U.S.
Two, the recovery of the job market, the most important task to be accomplished by the stimulus, took place quite quickly in comparison to the agonizingly slow recovery we had under FDR, partly because the bottom of the Great Depression was so much lower. When Obama took office, we were in real freefall, however, losing over 750,000 jobs a month. Less than a year later, we had our first month with job gains, which has now taken place for 64 straight months, and the unemployment rate has been cut to less than half of what it was at its peak. These facts stand in the way of claims that the stimulus was ineffective.
My disagreement comes at the point that policy becomes so captive of politics when there is not a visible reason for it being so that what we wind up with is bad policy and worst politics.
People in fact understand how single payer works better than they do Obamacare–even now. The hurdle on single-payer is convincing people that it can be paid for. The reality is that as a policy it does in fact reduce the cost of health care by disintermediating a whole lot of corporations and makework jobs. That jobs issue most like was what scared the Obama team from pursuing single-payer. Maybe sometime we’ll get a candid opinion. But makework jobs aren’t a real substitute for jobs that contribute meaningfully over the long term to the economy. That temporary disappearance of makework jobs (all connected with billing and collections that disappear with single payer and with the overhead of health insurance companies – CEOs, marketing, legal departments, and so on) would have by now resulted in some other jobs as employers no longer had the expense of employer-based health care policies.
My opposition to the use of drones (and also weapons like StuxNet) has a similar politics/policy principle. The sorts of policies you have to put into place to provide “due process” at least on American targets of drones extends the power of the President from the de facto power to declare war (which has been the product of nuclear weapons) to the de facto power to arbitrarily assassinate anyone in the world. And neither of those de facto powers really have checks and balances (as our entry into Vietnam and Libya show with respect to war). They depend exclusively on the trustworthiness of the President. To a great extent, President Obama has shown that sort of trustworthiness despite the fact that those who implement those policies have done some pretty boneheaded things. Among the most egregious with respect to assassination (but not drones) is the false flag operation, or was it just a story, involving poliio vaccinations in Pakistan. The fact that set back polio eradication in Pakistan is one of the most boneheaded things the US national security operations have done (except maybe attacking our own members of Congress with anthrax, but we await the evidence on that one and that happened in the Bush administration.) Arbitrary assassinations seem not to have shortened any war nor is there real evidence that they kept the US safe; they did have the unfortunate collateral damage of killing many women and children even when often the principal target was missed. The President now has these consequences on his conscience (one hopes). It was a poor policy that tried to rescue the poorer policy (war to deal with international terrorist organizations) and continued the slide from al Quaeda as a training camp to ISIL/ISIS/Daesh as a proto-state. It is likely that a better policy in 2008 for dealing with terrorism and shutting down the two wars the US was in could have prevented the dissolution of Syria and the rise of ISIL/ISIS/Daesh. Politics throughout the Obama administration (especially the internal politics and Congressional allies of the military) prevented sound policy. Had sound policy there been implemented, we might possible have the peace and prosperity that produce winning politics. (Interesting that no one can envision peace and prosperity any more.)
What is politically expedient in the short term is often self-defeating in the long term. Five years of folks with experience with a real single-payer system would likely be good politics for any Democrat anywhere. Which is why the Republicans set out on a scorched earth policy of obstruction.
Getting involved in additional wars in Libya and Syria and succumbing to the siren song of neo-cons on Iran’s nuclear program and on Ukraine has prolonged the international mess and created a more destabilizing situation; now Turkey is bombing the Kurds (our allies) who have been holding some of the border crossings to ISIS closed and also bombing cities and towns that ISIS is holding, which strengthen ISIS’s grip.
Policy and politics interact.
There major differences of degree between what Republicans claim they will do and what President Obama has in fact done. There are less major differences in degree between the Bush and Obama administrations compared to the clown car. There are nonetheless substantial differences in degree Obama’s commitment to get US combat troops out of Afghanistan and Iraq and Bush’s eagerness to be a war president. But there are not dramatic differences in kind because Obama has not tried to dramatically rein in the national security establishment from creating new dangers in the process of trying to deal with old ones.
Indeed the only difference in kind so far is saying yes to the Syrian-Soviet offer to remove chemical weapons from Syria and seeing through the agreement with Iran. And only the latter seemed to agree with President Obama’s view of where his foreign policy should go. And the long overdue normalization of relations with Cuba. There are 18 months left; maybe we will see more.
False equivalence is much to superficial a charge for the real policy differences between people who voted for Obama and the way they view his performance.
With Obamacare in place, the transition to single payer should not be that hard. It won’t happen until Democrats own the presidency and both branches of Congress with votes to spare. There will also have to be a grass roots moving demanding they take up the issue since politicians tend to be wusses.
However, once those conditions are in place, adding a Medicare buy-in option (or a public option by another name or mechanism) won’t scare anyone but the insurance companies. It doesn’t threaten the status quo for ordinary Americans the way Obamacare did.
Actually it makes it harder. Obamacare greatly reduces the urgency by covering millions more policy ANd it strengthen the insurance companies who are now consolidating and accumulating more political power.
Remember the Heritage Institute conceived Obamacare as an alternative to forestall single payer.
I am seeing people who had good workplace insurance now turning crappy turning away from government. This is because employers and insurance companies (mostly wrongly) tell their employees/clients “Obamacare made us do this.” It’s a convenient deflection from anger over dropping coverage and raising rates.
They thought that “good workplace insurance” was free. So, while they demanded (or were told that they needed or could have) more medical care, they didn’t pay attention to 1) the rising cost of medical care 2) employers reducing other benefits to pay for the increased cost of health insurance.
Back around 1980, my (white collar) employer gave us a choice of either an indemnity health insurance plan (choose your own doctor and hospital) or Kaiser. I as the only one in my work group that went with Kaiser. Others sniffed at the very idea of going to a clinic. My bi-weekly share for the insurance was approximately $2. They paid four or five times that much. Kaiser medical appointment and prescription co-pay was $1. They did complain when they received a large co-pay bill, but felt “choosing their own great doctor” was worth it. As it they possessed any doctor assessment skill.
As medical costs began to skyrocket, Kaiser’s did as well. Otherwise, they wouldn’t have been able to retain physicians. A decade or so later, all those snooty co-workers were shifting to Kaiser because they couldn’t afford the indemnity policies, but that stretched the Kaiser infrastructure and new, more upscale building was done to accommodate all those middle class white people. Kaiser was great when it served working class people. It’s still good but is pricey.
Kaiser is the cheapest policy available to feds that’s not like a high deductible HSA.
Also the reason I don’t have Kaiser is because I don’t want to be taken to an out of network doctor in the event of emergency and then get bankrupted. If I could be guaranteed to get access to in-network hospitals I’d probably get Kaiser. So I pay the extra $500 a year for BCBS fee-for-service.
Unless it’s changed, Kaiser does have a provision for out-of-network emergency care. However, each of the regions are independent; so, they will vary. My comments refer mostly to NorCal. Later when I had SoCal it wasn’t the priciest option but nothing like that price and value NorCal had been fifteen years earlier. Currently in the NorCal region, if they can afford it, consumers continue to switch. More interesting is that private practice physicians have been throwing in the towel on being a subsidiary of insurance companies and have joined the Kaiser physician group.
Just checked Northern California’s comparison. Kaiser is more expensive there than my current plan.
NoCal Kaiser (high-self): $341.90/month
My area Kaiser (high-self): $168.85/month
BCBS is the same because it’s a nation-wide plan at $197.23/month
“Remember the Heritage Institute conceived Obamacare as an alternative to forestall single payer.” This claim is infuriatingly wrong, and the main problem with this factual claim is included within the sentence.
http://www.heritage.org/research/lecture/assuring-affordable-health-care-for-all-americans
As seen at the link, the Heritage Institution did wish to create minor regulatory changes of the health insurance industry, and changes in the tax code to finance its recommended list of reforms. But there’s a long, long list of progressive policies which made it into the ACA which go missing in this summary, and a whole bunch of conservative hobby horses advocated for in the Heritage recommendations which would not work in practice and were excluded from the ACA.
What of the broad expansion of Medicaid? This is a form of a government-run single payer program for low-income Americans’ the ACA broadened the income eligibility requirements and did away with the assets test. Not a word referencing any Medicaid expansion in the linked document; this is not surprising, since you are correct that Heritage wanted to pull down government involvement in the health care marketplace, not expand it. Instead, Heritage wanted to subject low-income Americans to an individual mandate to buy private health insurance. And I’m no tax expert, but the tax breaks listed look to me like they would fall fall short of the substantial tax subsidies offered to those buying private health insurance on the ACA-created marketplaces, particularly for those on the lower side of the income range for the marketplaces.
And, of course, because the Heritage plan fails to expand Medicaid eligibility, the individual mandate to purchase private health insurance would have almost certainly been at debilitating expense to those with low incomes. Either that, or these poor people would have been forced to buy junk insurance which would have stuck them with almost all significant health care costs when they used services. Oh, yeah, the ACA has outlawed these sham plans for everyone buying insurance on the individual or business exchanges. The ACA also prevents any American from paying the more obscene out-of-pocket costs of the past that the Heritage plan would have failed to regulate out of existence:
http://groupservicesinc.com/blog/aca-copayment-deductible-limits
Does the Heritage recommended plan include guaranteed issue and prevention of rescission? No.
Does it restrict the medical loss ratio so that privite health insurers are forced to spend more money on health services and less money on marketing and other non-health services? No.
http://healthjournalism.org/blog/2014/07/aca-rules-force-health-insurers-to-increase-spending-on-car
e-delivery/
Does it create the ACA’s regulations of health care providers, particularly acute care hospitals, which heavily incentivize these providers to change their care practices to stop wasteful health care services prevalent under the old fee-for-service model, a model which the ACA is transitioning us out of? No.
OTOH, does the Heritage plan, in its design, encourage employers to drop health insurance coverage for their employees? Yes, it does, unlike the ACA, which places tax break incentives and a common health insurance marketplace for small businesses, incentivizing them to maintain this employer benefit, not eliminate it.
Does the Heritage plan exclude Federally run risk pools to deal with what even Heritage admits would be a problem in their plan for unhealthy and/or low-income Americans to gain affordable health insurance? Yes, it suggests States should run their own risk pools and lose the savings and improved regulatory control which would come with a nationwide risk pool.
Does the Heritage plan substantially privatize Medicaid while simultaneously unburden the States from the strict regulations of their Medicaid programs? Yes, it does.
Does the Heritage plan substantially privatize Medicare while simultaneously increasing out-of-pocket expenses for those who choose to stay in the standard Medicare program? Yes, it does.
I could go on. These are hardly the only differences between Heritage’s shit sandwich and the ACA’s success in helping many tens of millions of Americans gain health insurance and improved health care access, while simultaneously reducing the rate of increases in total health care expenditures in the U.S. This last result has been particularly crucial, as it is the main driver of significant improvements in future viability of the Medicare system, and reductions in projected overall Federal budget deficits.
No Law is perfect; no President or Congress is perfect. The challenges the ACA faces and the weaknesses in the Law are made more difficult to solve by the terrific partisanship in Washington and the Stupid States. I would claim the ACA’s challenges are made even more difficult to solve by the wholesale swallowing of unmitigated horseshit by too many Americans on our side of the aisle.
When one very large group of Americans is saying OBUMMERCARE IS WORSE THAN SLAVERY AND THE HOLOCAUST and another very large group of Americans is saying THE ACA IS NOT GOOD AND ENRICHES RICH INDUSTRIES, the details of the Law’s policies and the great real-world ACA outcomes which have been realized are lost. Those wanting single payer are beyond foolish when they criticize the ACA, particularly when they disseminate false and misleading information to do so. THAT’s the Heritage Foundation’s real plan, to get liberals and progressives to do the work necessary to tear down the ACA.
Where I think the “not a dime’s worth of difference” argument takes its energy in is the ways that the Republican and Democratic establishments cover for each other and protect an establishment agenda. The effort to widen the Democratic map since Obama was elected has been sabotaged by those who considered Obama’s health care plan a step too far. And by those who saw Democratic victories threatening their cozy relationships with a set of lobbyists. The Tea Party radicals in the Republican Party have the same gripes with their establishment.
I don’t see a Democratic majority in Congress unless there is a huge grassroots rebellion in the Democratic Party that moves it in a more progressive direction. And I don’t see Bernie doing or attempting to do that yet. And Hillary is the quintessential definition of Democratic establishment. The failure of the Mark Penn campaign in 2008 likely saved Democrats from extinction.
I don’t see those conditions being in place in my lifetime and possibly not in my children’s lifetime.
A Medicare buy-in option does not deliver the savings that full Medicare single payer does. It just does the compromise that Max Baucus, Kent Conrad and Ben Nelson scuttled in 2009.
Of course, the situation economically could turn so desperate that even Republican grassroots will demand single payer or public health service. But that doesn’t seem likely at the moment.
The transition is not technically hard. It is not hard for the public to adjust to. It is only hard to get passed through a Congress that is radically corrupt.
I don’t see a Democratic majority in Congress unless there is a huge grassroots rebellion in the Democratic Party that moves it in a more progressive direction. And I don’t see Bernie doing or attempting to do that yet.
Agree. Meant to include a note on this in my Sanders’ diary. There isn’t much more that he can do at this time other than to keep pushing from the top line. The grassroots is barely beginning to organize, and may only be dimly aware that the task is larger than electing Sanders. Dean and Pelosi were successful in 2006 and 2008, but that success was fragile. Why? I would submit that more Democrats isn’t good enough.
TarheelDem, do you really believe it is unlikely that there will be Democratic Party Congressional majorities in your lifetime and possibly not in your children’s lifetime? Politics is quite a bit less predictable than that. You’re broadly taking Karl Rove’s prediction of decades-long Republican domination of Federal politics as your own. Tying your cart to Rove-like predictions, with its attendant propagandistic purposes, seems an unwise decision which is unlike you.
A transition to single payer is easy in communities where the health care delivery system isn’t stratified by cost.
That isn’t the norm. Even in Vermont which is why Sanders insisted on expanding low cost community health care clinics. Say a CHCC charges $100 for service X. Whereas the private practice physician charges $150. And insurers cover 80% of the cost for either one and the patient co-pay is 20%. For a low income individual, $20 instead of $30 is significant enough that they’ll use the CHCC. So, what happens under single payer?
Is the reimbursement rate the same for X regardless of provider? Do all providers get $80, $120, or somewhere in between? What if that private practice physician currently charges private insurance patients $180 to compensate for her Medicare patients that are only billed $100 and a handful of Medicaid patients for which she only receives $60. But to continue her practice, she must average $150 gross and $120 net for all her patients.
How will the highest cost (usually perceived as having the best facilities and providers) hospitals manage a huge influx of patients that can now get the perception of more for the same price? (Public hospitals were severely, financially impacted with the Clinton era “reform” that permitted Medicare patients to use private facilities. Led to a building boom in private hospitals — not because they made a profit from Medicare but because it covered costs of surplus capacity that could be opened and closed depending on the private insurance patient loads.)
Your comments here seem pretty accurate and perceptive. Glad to see an acknowledgement that an installation of single payer nationwide would face significant policy challenges. I’d like to see a citation of your claim that the reforms which gave Medicare beneficiaries greater access to private Hospitals took place during the Clinton Administration. My remembrance is that most of those reforms took place in the ’80’s, but I’m interested in what you might provide here.
I’d just add that it is possible for public or private hospitals to make a profit on seniors with Medicare Advantage plans. Private hospitals aggressively market themselves to those customers, which has acted to increase the wide divide in reimbursements between private and public hospitals, a divide made much more severe by the tremendous consolidation of ownership and operation of private hospitals.
Sorry — my reference notes are in my old computer that’s waiting to be repaired. The change was in Medicaid and it’s history is convoluted, but I’ll stand by my statement as to when it negatively impacted revenues of public health facilities.
Some sort of compromise after Reagan failed to convert Medicaid to a block grant program. “Freedom of choice” is code for privatization.
The Clinton health reform task force was enamored with “managed care.” For those of us that had experience with a true HMO such as Kaiser we were initially supportive. [While private, Kaiser was initially much like socialized health care for working class people. Cost efficient and for very little more in cost, not as bare bones or stark as underfunded public health care facilities at that time.) But PPOs and insurance company HMO are nothing like Kaiser. I had one claims clerk laugh at me because the date of my medical service fell into some two week black hole and I was out of luck. I did exactly what they hoped I’d do to avoid the aggravation of an endless run around. I paid the freaking bill myself.
1115 waivers can be used in service of progressive and well-run policy reforms; the States decide what policies they want waived. There’s nothing inherent in these waivers, or in managed care generally, that pushes them to be in service to conservative goals. The unfortunate political realities of the ’80’s and ’90’s in many States saw to it that they were often used to hurt affordable health care access.
Obama’s HHS has been willing to deny waiver requests from many States whose policy proposals failed to show evidence that they would meet Medicaid standards for access to quality care for the targeted low-income population.
You asked and I answered.
Plenty of provisions have merit for good, but can just as easily be used for ill or produce negative longer term outcomes. Usually because the goals/objectives aren’t fully though through. I’m not interested in debating whether or not 1115 waivers are inherently good or bad, because that wasn’t my freaking point.
Did those Medicaid waivers for managed care reduce aggregate health care costs in this country? Somehow it went from just over 12% of GDP in 1990 to near 18% by 2010. What they did do is shrink the public health care delivery sector and expand the private health care delivery and health insurance sector. If you think that’s a great outcome, fine. But don’t pontificate that it’s a liberal or progressive outcome because it’s not.
I really don’t understand this – the contrast of Obama admin vs Republican admin is Obamacare vs. nothing, not Obamacare vs single payor. actually if he’d waited on the healthcare issue, as some wanted him to do, we would have had nothing. My take on Obama is that foundationally he’s committed to actions based on laws, not because he’s a nice guy. If the laws weren’t changed (e.g. Patriot Act) he wouldn’t rein in the national security establishment – the point is to change the law. these last months of his administration he does seem to be doing things somewhat differently due to Republican dedication to negating everything he does.
Diplomacy vs. Lone Ranger war mongering – ia is a difference in kind, that has affected many trouble spots around the world not just Syrian chem weapons and Iran in the readiness to go for military options.
Climate change, alternative energy, and consumer protection – these are all areas where Republican means doing nothing, or making the problems worse. it’s a difference in kind.
But makework jobs aren’t a real substitute for jobs that contribute meaningfully over the long term to the economy.
Easy to overlook that direct government makework jobs can contribute meaningfully. 12 WPA projects that still exist. How much did this nation gain from the (popular) short lived CCC?
Those were hardly makework jobs despite the characterization of them in the 1930s. One of the prettiest pieces of stonework in a small town in South Carolina is on the County Department of Agriculture. It was built during the New Deal. All of that in fact is infrastructure work.
Makework are most line supervision jobs, a lot of staff jobs, and almost anything that has to do with adding multiple levels of intermediation.
Most of the so-called makework CETA jobs were of the same character, but because CETA was framed as a public-private program, the corruption in CETA contracts was big enough that it served the Reagan administration to bring down the program through blockgranting it.
The CCC built the Blue Ridge Parkway and segments of both the Skyline Drive and Appalachian Trail, most state parks that were constructed during the period and a few national parks. More infrastructure.
In real time it was “makework.” That there remain tangible legacies to that “makework” is a bonus. How do we assign a value to the planting of 3 billion trees? That too was a bonus.
The primary value was that it gave people jobs. How well would they have been prepared to work when jobs began to emerge if they’d spent several years doing nothing but picking their toes? Intermittently relieved by drugs. They may not have been great jobs, but neither were the factory and military jobs that came soon after. If one learns how to work at a young enough age, work in and of itself has positive psychic value for individuals.
…and in the process made a few bucks to maintain themselves. Don’t think my Dad would have made it to parenthood with being in the CCC.
OH Lord!!!
Yes, Tarheel!!! So on the money!!!
Don’t hold your breath. If you do you’ll turn blue and then they’ll rush you the the hospital and disintermediate you of as much money as they can manage to get away with.
Bet on it.
Once more once, as Count Basie said:
Right on target.
Of course the PermaGov “liberal” drones will scream bloody centrist murder at this statement, but there it is for all with the eyes to see. It wasn’t the RatPublicans alone who “prevented sound policy.” Obama and his handlers themselves have invented ways to get around “sound policy” by way of executive privilege in order to further prosecute the Blood For Oil wars by any means possible and necessary,
You see all of this shit so clearly from your vantage point in North Carolina!!!??? Maybe we all oughta move there.
Buyer’s remorse.
Not felt by the real“buyers” of the current presidency, methinks. You know…the people who bought Obama’s electoral success?
For them? An investment worth making.
Bet on it.
For us?
Not so much.
So it goes.
Thanks, Tarheel.
For your clarity of mind.
Later…
AG
I’m happy to see some grappling with the fact that politics act as impediments to what we would view as better policies. In a couple of instances, it would be preferable if that grappling was more substantial here. For example:
“What is politically expedient in the short term is often self-defeating in the long term. Five years of folks with experience with a real single-payer system would likely be good politics for any Democrat anywhere.”
I agree that the second sentence is likely, but I would point out that this predicted good politics outcome would be far from assured. So many confusing changes would be brought to consumers and brought to them quickly. At the same time, all the oxes which would be gored by the elimination of the private health insurance marketplace would assure that any single payer plan would see the ACA’s unhinged opposition turned up to 11.
There’s also a presumption in your presentation that it is corruption and only corruption that was or is in the way of passing a Federal single payer (in fact, you level that exact claim in another post here), but this fails to acknowledge a quite crucial aspect of the politics-getting-in-the-way-of-good-policy problem:
A majority of Americans oppose the establishment of a single payer program. We simply haven’t won the political argument yet, much as that pains you and me.
So, looking at the political problems which were most substantial during the small window of time we had 60 members in the Senate Democratic Caucus seated to overcome the universal opposition by the GOP:
You can say that Ben Nelson’s past as a private health insurance CEO made him too corrupt to pass single payer or a stronger ACA. You can claim that Joe Lieberman’s own business ties, and Blanche Lincoln’s political campaign contributions, and Max Baucus’ purchase by Big Pharma and the health care monoliths, and other Senators’ corrupt conflicts, made them too corrupt to pass single payer or a stronger ACA. But were the voters in Nebraska, Conneticut, Arkansas, Montana and elsewhere calling out those conflicts and bombarding their Senators with constituent contacts, demanding that they pass Medicare for All or a stronger ACA?
Much the opposite, correct?
If we want better outcomes, we need to overcome all the substantial barriers in our way and win the political argument with the American people. That’s the path to better policies. Citizens United and naked racism are far from the only problems here.
difference in kind is Obama’s interest in diplomacy vs previous admins’ (and national security establishments’) commitment to proxy wars. and diplomacy of a particular sort i.e international partners on specifically (fairly narrowly?) defined issues
It is the biggest story of the campaign, and it’s the biggest reason I still haven’t thrown my support to Bernie even though I am more aligned with his positions. Because, Hillary to me seems more capable of delivering an absolute beat-down of what’s left of the Republican voting base so that the GOP has to give up the game and start adapting to the new reality.
I was watching some youtube’s of the 2012 election and the pundits were talking how it was imperative that the GOP embrace a platform more inclusive of Latinos, and they’ve gone the opposite direction. It can’t be rewarded with a close election. The Dems need to break 400 EV’s and win back the Senate to send the message that needs to be sent.
No doubt she is more likely to capture the White House and Congress. But what will she do when she gets them?
I think she will be, effect and policy wise, Obama 2.0. Obama hasn’t been perfect by any means, but he’s advanced the country forward in many respects. If Scalia and Thomas and Kennedy could just retire in the next 4 years under a Clinton admin, the country will be better off for a generation.
That would be bad enough, but I think she will be Clinton 2.0 by looking at those hanging around her campaign.
Trump destroys the Republican party as a national party if he is the candidate in 2016.
No, there aren’t enough dumb people who will elect him President, full stop.
He might go third party and play the role of Thurmond, Wallace, and Nader.
Even better.
I don’t think this is about the Party. I think it’s about Trump gaming the system. The GOP said that only the top tier candidates get to participate in the debates, based on their popularity. Trump knows how to make sure he’s part of that by amping up his views to the media. If the GOP had to decide today who was going to be in the debates, they would have to include Trump. If he can keep it up until they do cull the herd, then he gets to be taken ‘seriously’ as a candidate.
A talking point more and more Rep’s are using this week heralds Bernie Sanders. It’s made me wonder whether they’re beginning to understand that not only can they not stop Trump but that he’s bringing more and more of their base out, that might vote, and then he’s also doing a good job of training the weaker voiced base that there’s room for them on his wagon. His actual policies may not be as off kilter as his mouth from the actual party.
The most interesting part of this is that the Rep Party is completely out to sea trying to figure out what Trump’s going to do to the Party and what they should do.
If Obama is conservative then FDR was a right wing nut and LBJ was as well.
At one pint in his presidency, including those that caucused with the Dems, FDR had 80 of 96 seats in the senate and 334 seats in the house. Those aren’t just large majorities, that’s Repubs practically not being in congress. And he also didn’t face filibusters on everything.
With that, FDR did NOTHING on health care. People bitch about the ACA and no public option. Well FDR gave us no option at all.
With social security, agricultural workers and domestic workers got nothing, meaning blacks and Latinos got nothing. It failed to cover any government employees, or the self employed, or clergy. or railroad workers, nor did it give ant benefits to the self employed, nor survivors and their dependents. It also had no cost of living adjustment and the benefits itself were crappy.
In addition, he firebombed Tokyo, put Japanese Americans in internment camps, re embraced austerity throwing us into a recession. And it is little remembered that the very first thing he signed in office was the “Economy Act”, a piece of conservative legislation that slashed salaries of all government employees.
When it comes to LBJ, his majorities included a 68-32 majority in the Senate and a 295-140 majority in the House. And with that, the supposedly tough LBJ took a total pass on national single payer and instead passed two VERY watered down programs.
A program for the old in Medicare which in it’s original form didn’t even cover the cost of one’s medicine, nor any home health services, or disabilities. And Medicaid, which originally did not even cover adults. Just poor children and their primary care givers.
And that was it, a program for the old that didn’t cover basics like medicine, a program for just poor kids, and NOTHING for anyone in the middle.
And we also lucked out with LBJs wonderful leadership in Vietnam.
Decades from now no one will be defining Obama by “the stimulus being too small, not having a public option, taking too long to repeal don’t ask don’t tell”. or drones.
No, what history will say is that Obama is the President that stopped a depression, rescued an entire auto industry, created a consumer financial protection Bureau, passed health care reform, student loan reform, credit card reform, repealed don’t ask don’t tell, ushered in an era of marriage equality took out Bin Laden, took out Gadaffi, ended the Iraq war, ended the Afghanistan war, banned torture, decimated Al Qaeda, and disarmed Syria and Iran of their WMD without a shot being fired, opened diplomatic relations with Cuba and signed the “New Start” treaty with Russia. And oh yeah, pot is legal in several states and spreading.
Like I said, if the above is the record of a conservative, then FDR and LBJ are pure right wing.
In the future please try to hold the black presidents to same standard as the white ones, because this double standard is just tiring already.
A goodly number of those Democrats in the FDR and LBJ administration were the same Dixiecrats who hang out in the Republican Tea Party.
Decades from now, Obama’s most significant achievements are likely to be seen to be in foreign policy, for which he pre-emptively received a Nobel Peace Prize.
The ACA will be seen as the titanic domestic policy achievement it is. That will lead Obama’s legacy, once the hot winds of swirling bullshit clear and the solid results of ACA policies are realized and accepted, both for individual Americans and our Federal budget.
Thank you