Wednesday, July 31, 2019

Bernie Sanders is the Pied Piper of Healthcare Hamlin | xpostfactoid

Bernie Sanders is the Pied Piper of Healthcare Hamlin | xpostfactoid: Bernie Sanders is determined to keep Democratic healthcare debate in utopian territory  SUBSCRIBE!
by Andrew Sprung

Political battles can be semantic, but important. Such is the case with Democrats wrestling with the meaning of Medicare for all.

This week Kamala Harris came out with a healthcare reform plan that seems designed to resolve her past flip-flops as to whether private insurance should be phased out entirely. In brief, she proposed a 10-year path to "Medicare for all" that includes Medicare Advantage -- private plans reimburses by the federal government and conforming to strict coverage rules. Employers could also offer "Medicare Advantage" plans.  Lots of question marks, but the intent to preserve the public/private hybrid of Medicare as we know it is clear.

Bernie's camp lit into the plan, claiming in effect that the his bill's title (Medicare for All) is politically trademarked. "“Call it anything you want, but you can’t call this plan Medicare for All," Sanders' campaign manager Faiz Shakir said in a statement. Pramila Jayapal, lead sponsor of the House version, tweeted, "as lead sponsor of #MedicareForAll, I find it misleading when my fellow Democrats use the #M4A name to describe proposals that are NOT #MedicareForAll."

That's a straight trademark play: we own the hashtag, we own the name. The subtext is that the
One True Path to Medicare for All is Sanders and Jayapal's Big Rock Candy Mountain in which a single government entity provides 100% coverage of everything for everyone, funded entirely by over $3 trillion per year in new taxes ($1.5 trillion according to Bernie).
Charles Gaba sensibly pointed out that some Democrats "have interpreted Medicare-for-all to simply mean expanding the current program to more people while keeping the existing limitations on covered services, as well as premiums, deductibles and co-pays." And, more provocatively,

even if you do use the existing program structure as your baseline, Harris’s plan is actually closer to the current definition of Medicare, because it would retain Medicare Advantage. This is no small thing, as more than 22 million people — a third of all Medicare enrollees — have Medicare Advantage plans. In fact, David Bowen, who worked for the late senator Ted Kennedy (D-Mass.), said Harris’s plan “closely resembles” the Medicare-for-all bill that Kennedy and Rep. John Dingell (D-Mich.) introduced in 2006. 
This is manifestly true. It doesn't mean that Harris's plan is better than Bernie's bill, or that either has the remotest chance of being passed or enacted in the foreseeable future, but it's a simple statement of fact: Harris's endgame more closely resembles enrollment of all Americans in Medicare as it currently exists than does Sanders'.

So what? Well, Sanders is a Pied Piper, luring a large subset of the Democratic base into a cave from whence democracy may never emerge. That is, he is piping a utopian solution -- complete transformation of the $3.5 trillion/year healthcare system within four years, financed by a doubling of U.S. tax revenue -- that threatens to foreclose on any realistic plan to expand access and control costs -- and may sour a good number of progressives on any candidate who proposes something doable, as Bernie fervor did in 2016.

The Sanders camp's attack on the Sanders plan also perpetuates Democrats' rhetorical avoidance of the largest obstacle to affordable healthcare for all: provider payment rates. That's evident in the second half of Fakir's response to the Harris plan. Referring to the preservation of Medicare Advantage:

“Folding to the interests of the health insurance industry is both bad policy and bad politics.”
Possibly true, but...Harris's plan would pay MA plans less than the cost of insuring their members under the public plan. In their denunciations of healthcare profiteering in the U.S., Sanders, Warren, and almost every Democrat alway focus on insurers and pharma and leave out hospitals and doctors' trade groups -- which have joined in coalition with insurers and the pharmaceutical industry to oppose single payer and any public option that pays Medicare rates (or something like them) to providers. Insurers could in fact live with the latter; they are more or less neutral as to provider payment rates, i.e., playing and profiting very happily in the Medicare Advantage and managed Medicaid markets, where their payment rates to providers are effectively constrained by the per-member rates the government pays to them. (Whether they can be better policed than at present when government is their payer is another question.)

Two takeaways from that. First, BernieBrand Medicare for All proponents are as loathe as anyone to verbally assault healthcare providers -- notwithstanding that, as Axios' Caitlin Owens notes, "hospital care is the largest driver of U.S. health prices."  Second, plans that effectively establish one payment schedule for healthcare providers but preserve a role for private insurance, such as the Medicare for America bill, have the potential to split the healthcare industry coalition currently united against major reform.

More broadly, I seriously doubt that a Democratic president elected in 2021 with at best a bare Senate majority is going to have the bandwidth to do more immediately on the healthcare front than  a) end balance-billing, which effectively undermines everyone's insurance; b) patch the ACA, boosting subsidies, enlarging subsidy eligibility, and possibly adding a public option; and c) pass effective legislation to control drug prices. That would in fact constitute a ton of accomplishment. But you'd never know it while listening to Democratic candidates blather about single payer purity.

P.S. A reminder from the Kaiser Family Foundation that while Bernie & co. think they own the brand, they don't:

based on a poll fielded in early 2019, 55% of the public think that they and their families would be able to keep their current health insurance under Medicare-for-all; 54% think they would continue to pay health insurance premiums and 69% think they would continue to pay deductibles and copays for covered health services.

Monday, July 29, 2019

Balkinization: Can Congress Investigate Whether the President Has Conflicts of Interest, is Compromised by Russia, or Has Violated the Law?

Balkinization: Can Congress Investigate Whether the President Has Conflicts of Interest, is Compromised by Russia, or Has Violated the Law?
by Marty Lederman - Georgetown Law
July 29, 2019
The answer to the question in my title is obvious, isn't it?:  Of course Congress can do so.  According to Donald Trump and his (personal) attorneys, however, the correct answer is “no.”  And in a series of pending cases involving challenges to congressional efforts to obtain the President’s financial and tax records, they’re urging the courts to hold that Congress’s oversight and regulatory authorities simply don't extend to investigating the wrongdoing, foreign influence over, and possible conflicts of interest of, the President of the United States.

It’s hard to exaggerate just how profound a challenge this is to our longstanding system of checks and balances.  Yet these cases, and Trump's arguments in them, have mostly flown under the radar: They haven't received much attention in the press or among legal observers.  Perhaps that's as it should be:  After all, if the arguments are as extreme as I'm suggesting, maybe there's nothing much to worry about.  The Trump team is deadly serious, however; the Department of Justice might come to its aid; and it’s possible Trump’s lawyers will find a receptive audience among at least some Supreme Court Justices.  Therefore I thought it might be worthwhile to unpack those arguments a bit in this post.

Background on Congress's Oversight Authority and "Informing" Function

Thursday, July 25, 2019

Wednesday, July 24, 2019

Adam Schiff examines Robert Mueller

This is how it is done.

Monday, July 22, 2019


Tuesday, July 16, 2019

Geort Cobway in go back where you came from

Monday, July 15, 2019

Saturday, July 13, 2019

Busing...Nicole Hannah Jones

Thursday, July 11, 2019

The Douglass Plan | Pete For America

Image result for levittown new york
The Douglass Plan | Pete For America: A Comprehensive Investment in the Empowerment of Black America
"After the accumulated weight of slavery and Jim Crow, America cannot simply replace centuries of racism with non-racist policy; it must intentionally mitigate the gaps that those centuries of policy created."  Pete Buttigieg

It's not just slavery. In 1949 our parents signed lease-purchase agreements in Levittown, NY that contained a promise to sell only to Caucasians.  Levittown is 98% white today.  Black and Latin people were denied the home equity that fueled our prosperity.  - gwc

p.s. - want to know more?  See Richard Rothstein's The Color of Law for the story of the white suburbs

His Kampf

 hours ago
His Kampf.

Donald J. Trump
July 11, 2019
The White House will be hosting a very big and very important Social Media Summit today. Would I have become President without Social Media? Yes (probably)! At its conclusion, we will all go to the beautiful Rose Garden for a News Conference on the Census and Citizenship.
A big subject today at the White House Social Media Summit will be the tremendous dishonesty, bias, discrimination and suppression practiced by certain companies. We will not let them get away with it much longer. The Fake News Media will also be there, but for a limited period..

....years, or maybe 10 or 14 (just kidding), they will quickly go out of business for lack of credibility, or approval, from the public. That’s why they will all be Endorsing me at some point, one way or the other. Could you imagine having Sleepy Joe Biden, or ,..
...or a very nervous and skinny version of Pocahontas (1000/24th), as your President, rather than what you have now, so great looking and smart, a true Stable Genius! Sorry to say that even Social Media would be driven out of business along with, and finally, the Fake News Media!

Robert Mueller Missed the Crime: Trump’s Campaign Coordinated With Russia - Jed Shugerman

Robert Mueller Missed the Crime: Trump’s Campaign Coordinated With Russia: The special counsel will testify before Congress next week. He needs to answer for historic legal and factual errors.
by Jed Shugerman (Fordham Law)

Wednesday, July 10, 2019

5th Circuit appears ready to strike down ACA.

Nancy Pelosi is VERY smart ~ Kevin Drum

Saturday, July 6, 2019

The busing myth. Sherilyn Ifill ~ LDF Slate

Thursday, July 4, 2019

China includes IP in its SAT