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Off the Top of My Head

Joe Biden Gave a Fiery State of the Union Speech

by John Lawrence

Right out of the gate Joe Biden's voice was clear and strong. Nothing mealy mouthed here. I'm sure he had been practicing his enunciation and articulation. It helped that the volume on the microphone had been turned up. That strong, loud voice reassured me and others that Joe Biden was not too old for the job. It helped too that he could overpower his hecklers. It made me a little nervous when he started to cough. Oh no, I thought, what if he has a coughing fit! But he held it together and his voice didn't waver towards the end as I might have feared.

Now as for the speech itself. Overall it was good, but one thing he and his speechwriters should have taken more seriously is that less is more. He tried to cram in too many details which probably went right over the heads of the people he most needs to persuade. For instance, the fact that Medicare can now negotiate for prescription drugs does save the taxpayers money, but it takes a real wonk to appreciate that point. All most Americans care about is does it save them money when they go to buy drugs at the pharmacy. Joe tried to rush through a lot of details that would have better left out of the speech. He was most effective when he slowed down and made a major point and an applause line.  I think it was lost on most viewers especially the non-wonks that Joe Biden needs to persuade that he wants to extend the fact that Medicare can now negotiate drug prices to the negotiation of drug prices for everyone including those who are not on Medicare. These are big points, but the average American probably did not appreciate them. Again less is more. The part about shinkflation and capping credit card late fees at $8. was right on. This is the stuff most Americans can relate to - their petty pocket book issues.

I was happy that he went on about taxing billionaires and the wealthy and about how much money this would bring into the Treasury, but I wanted him to go further and say that he would use some of this money to give the middle class a tax break. The Republicans and especially Trump's big selling point is that he will give everyone a tax break! His base thinks that's great even though most of those tax breaks will go - like they have in the past - to the wealthy. Trump's base doesn't care as long as they get a paltry by comparison tax break. Biden should have taken that issue away from Republicans by emphasizing that, while he would tax the rich, he would give tax breaks to the middle class. He lost that opportunity by emphasizing how rich the Treasury would get by his taxing the rich. Who cares?

Finally, Biden was on top of his hecklers, the leader of whom was Marjorie Taylor Green. Biden should thank her for the opportunity to show he could fight back and take it to her. The hecklers were a godsend for Biden. I'm sure he was prepared. Now some Republicans are saying that Biden didn't respect decorum enough. Phooey! How much decorum does Trump respect? Zero. He calls people names. He breaks every rule of decorum in the books. Politics today is not what it was 50 years ago, even 10 years ago thanks mainly to Trump who has broken every rule in the book. I'm so glad that Biden was up to the situation and gave as good as he got thereby defeating the purpose of Marjorie Taylor Green which was to bully him and show he was weak. Biden took it to her, thank God.

Off the Top of My Head

Contrary to Larry Summers Biden's Relief Bill Will Not Cause Increased Inflation

by John Lawrence, February 8, 2021

Joe Biden's almost $2 trillion pandemic relief deal will not be inflationary despite Larry Summers' opinion. Inflation occurs when there is too much money sloshing around in the economy chasing too few goods, services and human resources. That is not the case here. First of all it will reemploy the unemployed. This is a presently unused resource. Secondly, it will suck up unused or unsold goods and services funding things that are currently unfunded like child care, and thirdly, it will serve to pay off debt and replenish savings. Any money going into savings or paying off debt is not inflationary. It's deflationary in the sense that the banks will lose money due to interest they won't collect if loans are paid off. The middle class that did have savings or credit in many cases has had to use those to survive the pandemic. That's why giving money to higher earning, but not wealthy, families is a good thing. To hear some people talk only money should be given to those who are desperate and living from paycheck to paycheck. Yes, those are the families most in need who should be given money first, but higher earning families who have depleted their savings or gone into debt need to be resuscitated also.

So here is what Larry Summers says about inflation:

"First, while there are enormous uncertainties, there is a chance that macroeconomic stimulus on a scale closer to World War II levels than normal recession levels will set off inflationary pressures of a kind we have not seen in a generation, with consequences for the value of the dollar and financial stability. This will be manageable if monetary and fiscal policy can be rapidly adjusted to address the problem. But given the commitments the Fed has made, administration officials’ dismissal of even the possibility of inflation, and the difficulties in mobilizing congressional support for tax increases or spending cuts, there is the risk of inflation expectations rising sharply."

Summers fails to take into account the deflationary effects of the relief bill. Money going to states and municipalities will actually be deflationary because much of it will be used to pay down debts and loans. Many state budgets are in horrible shape and employees such as police, librarians and firemen have been laid off. People paying back rents and mortgages will have a deflationary effect on the economy. People on the lower end of the economic spectrum who are living paycheck to paycheck will be able to get a little ahead and also save. This will not add a lot to inflation. Also money can always be withdrawn from the economy by taxing the rich, those who actually added to their wealth and income during the pandemic. This is the only reason that taxes might need to be raised because the US government has the ability to spend without raising taxes. The only reason to tax would be to fight inflation and those taxes can be targeted towards wealthier families and individuals. The Federal Reserve has not been able to achieve its target rate of 2% inflation recently despite maintaining almost zero percent interest rates. It wants more money sloshing around in the economy.

There are other ways to suck money out of the economy to offset inflation. Modern Monetary Theory (MMT) recommends Medicare for All which would result in much less money spent on health care while providing better health outcomes. This would be deflationary which would counteract any inflationary propensities of government deficit spending. Conventional economic thinking is that there is a tradeoff between unemployment and inflation. The more people unemployed there are, the more inflation is diminished. Therefore, full employment as defined by economists is not really employment where everyone is employed. It is that level of unemployment which just keeps inflation in check. However, according to "The Trade-off between Inflation and Unemployment in an MMT World: An Open Economy Perspective" by Emilio Carnevali and Matteo Deleidi, MMT it is contended that inflation "occurs when the system reaches the point of full utilization of its productive capacity, both in terms of capital utilization and in terms of availability of workers. At this point, the government should curb inflation forces cooling down the effective demand. This is another fundamental task of taxes." As long as there is unused capacity in human or production terms, increased employment will not be inflationary. So Larry summers need not worry that putting all those unemployed people back to work will lead to inflation.

Biden's putting a $15.00 an hour minimum wage in the relief bill is also what MMT advocates in relation to a Federal job guarantee. Real full employment at a minimum wage of $15.00 an hour does not need to be inflationary especially if it is in areas that don't compete with already employed workers. Biden's relief bill will have the effect of putting almost everyone to work with at least an hourly pay of $15.00 an hour. People who are living paycheck to paycheck and employed at $15.00 an hour are not going to contribute to inflation since their demands on the economy are those that can be easily accommodated by existing production and easily increased production. Deficit spending is not a problem. Former Chair of the Federal Reserve Alan Greenspan said, "The United States can pay any debt it has because we can always print money to do that. So there is zero probability of default." So the real limit on government spending is inflation which can be controlled by taxes on those sectors of the economy which are not easily upscaled to provide more supply.

There is much unused capacity in the current US economy both in human and material or physical terms. People should be put back to work with a minimum wage of $15.00 per hour. A follow-on bill that would address infrastructure rebuilding and a Green New Deal also needs to be done. Resources may have to be managed by government to control inflation, but the important thing is that work needs to be done in these areas and people need to be put back to work. Inflation can also be offset by the deflationary effect of withdrawing funds form a bloated defense sector.

Off the Top of My Head

Republicans' New Definition of Socialism: Any Government Program That Would Help Black People

by John Lawrence, February 2, 2021

Republicans are worried that the US will become a socialist country. The public sector will come to dominate the private sector. Well, the private sector has been helpless at solving the big outstanding problems: global warming and the pandemic. If the private sector could solve these problems, well, that would be great, but they're not capable of doing it. Therefore, government is left by default to deal with global warming and the pandemic as well as a host of other systemic problems like health care, poverty, economic inequality and racism. So what does capitalism stand for at this point: fossil fuel dependency and business as usual which means more and more income and wealth inequality. With capitalism there is no "we" there, only an accumulation of "I"s.

What Modern Monetary Theory (MMT) has shown is that the Republican accusation of Democrats - "tax and spend" - is a discredited misnomer because US government spending does not depend on taxation. In fact a Green New Deal and Medicare for All could all be accomplished without increasing taxes on anyone. That's because the US central bank aka the Federal Reserve can just create money with a few keystrokes on a computer the way it did to save the banking industry during the Great Recession when it gave the Big Banks several trillion dollars without any consequences whatsoever for deficit spending or increased taxes to pay for it. This facility should be used responsibly, however, just like the use of alcohol. Used irresponsibly this money creation facility could increase inflation.

So what is the responsible use of government spending? Obviously, during a pandemic and incipient global warming, it would be responsible for the government to spend money to solve these huge worldwide problems which not only affect the US, but affect the whole world. One of the lessons of this situation is that, if we want to contribute to the solution of global warming, we must become friends with the world's biggest GHG emitter which is China. China and the US are the world's first and second largest GHG emitters and the first and second largest economies. We can't afford not to be partners in the solution of this problem. China and US continued rivalry even amounting to a Cold War will guarantee that the earth is destroyed as a habitable living place for humans. So we have no other choice. Either we can continue our petty squabbles with China or we can cooperate with them to solve problems. We are truly all in this together. Either we hang together or we hang as nations separately.

The second lesson of MMT is that Medicare for All (M4A) could be part of the solution for global warming. If M4A were to be implemented, the US could have a much better health care system with better outcomes health wise at a far cheaper price. This has been shown in study after study. What's more M4A would be deflationary in financial terms. Deflation as well as inflation is bad for the economy. The fight against global warming would be inflationary because of the huge expenditures that must be made so it could offset the deflation caused by M4A. In fact we find in How to Pay for the Green New Deal, working paper 931 by Yeva Nersisyan and L. Randall Wray:

"To be clear, we do recognize that implementation of the GND will shift spending from the private sector to the government sector. However, unless there is an a priori reason to believe this would—by itself—be inflationary, we take the position that in the general case it makes no difference in terms of inflation whether the dollar spent to hire resources comes from the government or from the private sector, which is also the method used by Keynes. As Stephanie Kelton says, cash registers do not discriminate. Indeed, as we report below, there is strong evidence that at least in the healthcare sector a dollar of government spending buys more care than a dollar of private spending—so shifting toward government as the single payer would produce disinflationary pressure."

So while the US government can create as much money as it needs for a GND by means of the Federal Reserve's money creation powers without increasing taxes, the need to forestall inflation could be offset by M4A which would in addition provide a health care system with better outcomes for Americans at a lower price. The only reason then to raise taxes would be to diminish economic inequality which could be ameliorated by only taxing the rich.

Off the Top of My Head

Good-Bye Mitch McConnell: Democrats Win Control of Senate. Now They Need to Get Rid of Filibuster to Get Anything Done.

by John Lawrence, January 6, 2021

Nothing turned off GOP voters more than seeing their hero call for a $2000. payment to individuals while Mitch McConnell stood there on the Senate floor and said repeatedly, "Object. Object." Jon Offoss told his supporters that, if he were to be elected and Democrats controlled Congress, Biden had promised to implement the $2000 payments. That would be incentive enough for many Republican voters, especially the non-rich, to vote for a Democrat. Thank God, Democrats will control the Senate and the Roadblocker-in-Chief, will not get the chance to block all progressive Democratic legislation coming forward from the House in the next 4 years. Now there is one more potential roadblock that the Senate has the ability to do away with: the filibuster rule. Meanwhile, on the day Joe Biden is certified by the Congress, Trump, while completely neglecting the fact that yesterday the most people ever died from COVID, is holding another shit show and super spreader event in Washington so his supporters can get off on their collective anger that their hero wasn't reelected in a free and fair election. By the way I noticed in the excellent CNN film about Jimmy Carter (Rock and Roll President) that the Ku Klux Klan in white robes protested openly at one of his campaign events and one of them was carrying a sign, "America First." So that's where Trump got the idea for that slogan.

Even when Democrats gain control of the Senate, opposition party senators can filibuster the majority’s agenda. That means that any one Republican senator can filibuster any progressive piece of legislation that Joe Biden and House Democrats put forward including the Green New Deal, or more appropriately - the Biden New Deal, a public option for Obamacare which would allow anyone to choose Medicare, the elimination of part or all of student loan debt, $2000 COVID relief payments to most Americans and more, much more. The filibuster is not part of the Constitution; it is simply a rule of the Senate which can be changed by a majority vote. Eliminating the filibuster has been characterized as the so-called "nuclear option." Wikipedia notes:

"According to the Supreme Court's ruling in United States v. Ballin (1892), Senate rules can be changed by a simple majority vote. Nevertheless, under current Senate rules, a rule change could itself be filibustered, requiring two-thirds of senators who are present and voting to end debate. (This differs from the usual requirement for three-fifths of sworn senators.)

"Despite the two-thirds requirement described above being written into the Senate rules, any Senator may attempt to nullify a Senate rule, starting by making a point of order that the rule is unconstitutional or just that the meaning of the rule should not be followed. The presiding officer is generally expected to rule in favor of the rules of the Senate, but under rule XX, "every appeal therefrom shall be decided at once, and without debate" and therefore by a simple majority as there is no need for a vote on cloture.

"This happened in 2013, when Harry Reid of the Democratic Party raised a point of order that "the vote on cloture under rule XXII for all nominations other than for the Supreme Court of the United States is by majority vote". The presiding officer overruled the point of order, and Reid appealed the ruling. Mitch McConnell of the Republican Party raised a parliamentary inquiry on how many votes were required to appeal the chair's ruling in that instance. The presiding officer replied, "A majority of those Senators voting, a quorum being present, is required." Reid's appeal was sustained by a 52–48 vote, and the presiding officer then ruled that the Senate had established a precedent that cloture on nominations other than those for the Supreme Court requires only a simple majority. On April 6, 2017, that precedent was further changed by McConnell and the Republican majority, in a 52–48 vote, to include Supreme Court nominations."

Long story short. Democrats can eliminate the filibuster if they really want to. And they really need to do that because the Republican game plan will be to block all progressive legislation by means of the filibuster. Even without Mitch McConnell as chief roadblocker, Republicans will stymie Joe Biden and block all his initiatives. The result is that Biden's initiatives will go nowhere. It would be a total waste of Democratic power now that they have it. Republicans have shown no hesitancy to use their power to the full extent without any pretense of cooperating or compromising with Democrats. Now that Democrats have the power, they should use it starting with getting rid of the filibuster rule. Nobody knows more - from personal experience actually - than President Obama about how the filibuster rule can impede social progress. Republicans used it to effectively neuter Obama during his 8 year Presidency. Washington Post reported:

"Former President Barack Obama called on Thursday for eliminating the filibuster, joining a growing chorus of Democrats who portray the Senate’s signature procedural weapon as an obstacle to social progress that must be abolished if the party captures the Senate and White House.

"The appeal by Mr. Obama to do away with a tactic that Senate Republicans used to thwart him and the Democratic agenda for much of his eight years in office came during his eulogy in Atlanta for Representative John Lewis, the civil rights icon. The former president seized the moment to cast the filibuster as a vestige of a grim period in the United States when Southern lawmakers used it to impede voting rights and other advances for African-Americans."

“Once we pass the John Lewis Voting Rights Act, we should keep marching,” Mr. Obama said, referring to legislation Democrats are pushing on Capitol Hill in the face of opposition from Republicans. “And if all this takes eliminating the filibuster — another Jim Crow relic — in order to secure the God-given rights of every American, then that’s what we should do.”

So the writing is on the wall. Do we want this democracy to represent the interests of the majority of its people or only the upper 10%? Do we want to save the planet from global warming? If so the Republican call for "moderation" or "compromise" or "not being too radical" will not work. There is a limited time frame for us to act or the planet will soon - in our lifetimes and the lifetimes of our children - become uninhabitable for most people. We have failed to act on this in a timely manner. Now we must play catch up, and there is no time to waste. We have about 10 years to get global warming under control. Don't listen to people that say the Green New Deal is too radical. It's too radical only if we want to let the planet become virtually uninhabitable.

7 Ways 2020 Exposed America

by Robert Reich
Monday, January 4, 2021

If America learns nothing else from these dark times, here are 7 lessons it should take away from 2020:

1. Workers keep America going, not billionaires.

American workers have been forced to put their lives on the line to provide essential services even as their employers failed to provide them with adequate protective gear, hazard pay, or notice of when COVID had infected their workplaces. Meanwhile, America’s 651 billionaires – whose net worth has grown by over $1 trillion since the start of the pandemic – retreated to their mansions, yachts and estates.

Amazon CEO Jeff Bezos sheltered in his 165,000-acre West Texas ranch while Amazon’s warehouse workers toiled in close proximity to each other, often without adequate masks, gloves, or sanitizers. The company offered but then soon scrapped a $2 an hour hazard pay increase for warehouse workers, even as Bezos’ wealth jumped by a staggering $70 billion since March, putting his estimated net worth at roughly $186 billion as the year came to an end.

2. Systemic racism is literally killing Black and Latino Americans.

Black and Latino Americans account for almost 40 percent of coronavirus deaths so far, despite comprising less than a quarter of the population. As they’ve borne the brunt of this pandemic, they’ve been forced to fight for their humanity in another regard — taking to the streets across the country to protest decades of unjust police killings of their community members, only to be met with more police violence.

Among Native American communities, the coronavirus figures are even more horrifying. The Navajo Nation has had a higher per-capita infection rate than any state but can’t adequately care for the sick, thanks to years of federal underfunding and neglect of its healthcare system.

Decades of segregated housing, pollution, lack of access to medical care, and poverty have left communities of color vulnerable to the worst of this virus, and the worst of America.

3. If we can afford to bail out corporations and Wall Street, we sure as hell can afford to help people.

Senate Majority Leader Mitch McConnell continues to insist we can’t “afford” $2,000 COVID survival checks for Americans. But the latest coronavirus relief legislation doled out over $220 billion to powerful business interests that could instead have been used to help struggling working families.

Another way of looking at it: The total cost of providing those $2,000 checks ($465 billion) is less than half the amount America’s 651 billionaires added to their wealth during the pandemic ($1 trillion).

4. Health care must be made a right in America.

Even before the pandemic, an estimated 28 million Americans lacked health insurance. After it struck, an additional 15 million lost employer-provided coverage because they lost their jobs. Without insurance, a hospital stay to treat COVID-19 cost as much as $73,000. Remember this the next time you hear pundits saying Medicare for All is too radical.

5. Our social safety nets are woefully broken.

No other advanced nation was as unprepared for the pandemic as was the United States. Our unemployment insurance system is over 80 years old, designed for a different America. We’re one of the few countries in the world that doesn’t provide all workers some form of paid sick leave.

Other industrialized nations kept their unemployment rates low by guaranteeing paychecks during the pandemic. But Americans who filed for unemployment benefits often got nothing or received them weeks or months late. Under new legislation they get just $300 a week of extra benefits to tide them over.

6. The Electoral College must be abolished

Biden won 7 million more popular votes than Trump. But Biden’s margin in Arizona, Georgia, and Wisconsin totaled just 45,000. Had Trump won these three states instead, he would have gained 37 more electoral votes, tying Biden in the electoral college. Under the Constitution, this would have pushed the election to the House of Representatives, with each state delegation getting just one vote. Even though Democrats have a majority in the House, more state delegations have Republican majorities. Trump would have been reelected.

The gap between the popular and electoral college vote continues to widen. The Electoral College is an increasingly dangerous anachronism.

7. Government matters.

For decades, conservatives have told us that government is the problem and that we should let the free market run its course. Rubbish. If nothing else, 2020 has shown that the unfettered free market won’t save us. After 40 years of Reaganism, it’s never been clearer: Government is in fact necessary to protect the public.  

It’s tragic that it took a pandemic, near-record unemployment, millions of people taking to the streets, and a near-calamitous election for many to grasp how broken, racist, and backwards our system really is. Biggest lesson of all: It must be fixed.   

Paygo Exemptions in House Rules Will Help Pave Way for Green New Deal and Medicare for All, Progressives Say

Published on

Saturday, January 02, 2021

by

Common Dreams

"Paygo's the biggest scam of the decade, designed to legitimize the fear-mongering over artificial deficits. This is a big win by progressives."

by

Julia Conley, staff writer

 

 

66 Comments

Rep. Alexandria Ocasio-Cortez (D-N.Y.) speaks during a news conference outside of the Democratic National Headquarters in Washington, D.C. on Thursday, November 19, 2020. (Photo: Caroline Brehman/CQ-Roll Call, Inc via Getty Images)

Progressives on Saturday applauded House Democrats for including in the chamber's rules package for the incoming Congress two key exemptions from the "pay as you go" rule, also known as Paygo, which could cut down on roadblocks keeping lawmakers from passing far-reaching healthcare and climate action legislation. 

House Speaker Nancy Pelosi (D-Calif.) and House Rules Committee Chairman Jim McGovern (D-Mass.) unveiled an updated rules package which would exempt legislation "to prevent, prepare for, or respond to economic or public health consequences" of the Covid-19 pandemic or of the climate crisis, from being subjected to Paygo.

Paygo requires that any increase in spending by the federal government be matched by offsetting tax increases or budget cuts, and progressives including Rep. Alexandria Ocasio-Cortez (D-N.Y.) have called for the rule to be revoked in recent years while Pelosi and other Democrats have defended it. 

Ocasio-Cortez and her legislative goals were derided by critics after taking office in January 2019, as Pelosi adopted the Paygo rule for the 116th Congress. The New York congresswoman voted against the 2019 rules package. 

On Saturday, Ocasio-Cortez added the "demotion" of Paygo to the list of achievements by progressives in Congress in recent years. 

Breaking the federal government and corporate political press's "austerity mindset and rules, especially on climate, is a major tenet of the Green New Deal," Ocasio-Cortez tweeted.

The Intercept journalist Ryan Grim noted that the elimination of Paygo as a consideration for measures involving public health could eventually help Congress to pass Medicare for All as well as other measures to help Americans struggling with the effects of the coronavirus pandemic.

Lawmakers "could quite easily cite [the pandemic and the climate crisis] as the need for expanded public healthcare, which is specified in both subsections," Grim tweeted, adding that the rules change "easily covers a very sweeping set of policies." 

After decades of powerful House Democrats being "fervently committed" to Paygo, tweeted Claire Sandberg, former national organizing director for Sen. Bernie Sanders (I-Vt.), "it's welcome news that exemptions have now been created for two extremely broad policy areas."

Other progressives praised the proposed rules change, which must still be voted on in the Democrat-controlled House, on social media. 

"Amending Paygo opens the door to crucial legislation that meets the scale of our greatest challenges," tweeted Rep.-elect Marie Newman (D-Ill.).

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Off the Top of My Head

It's Almost Thanksgiving: Let's Talk Turkey

by John Lawrence, November 14, 2020

So what are Republicans saying about a Biden administration? That the progressive wing of the Democratic party will push him too far to the left. Well, what exact policies would be "too far to the left"? Defund the police? That's just a radical slogan that means about as much as "Lock her up." In other words it means nothing in terms of either Biden's agenda or progressives in the Democratic party. Reform the police - that would be more like where the Democratic party actually stands. As far as Medicare for All, Biden favors Medicare for All Who Want It. I guess there are those Republicans who so love their employer based health insurance that they are terrified by the possibility that it might be taken away from them and replaced with something better. So Biden's position is go ahead and keep it. He just wants to make it possible that those who do want it will be able to have it or a public option which amounts to the same thing.

So Republican concerns amount to whipping up a bunch of meaningless hysteria just like Trump has always done. It's his stock in trade. So what about the Green New Deal? Who could object to creating jobs to build infrastructure and combat global warming? Oh maybe it's that they fear their taxes will go up? There's actually no reason why anyone's taxes should go up based on the realities as they exist in the 21st century. The government has shown that any amount of money can be found and spent to bail out banks or to add to the debt to give people tax breaks. Trump's tax cuts added a trillion dollars to the debt. Quantitative easing and the money to bail out the big banks amounted to several trillion dollars and yet it has had no adverse effect on inflation or anything else. Modern Monetary Theory has shown that Deficits Don't Matter whether those deficits originate from bailing out the banks or a Green New Deal or Biden's Green Deal which is more or less the same. Expect Republicans to cry bloody murder any time government threatens to formulate a program to combat global warming or to create jobs for poor people or to raise wages for essential workers to $15. an hour.

Money spent constructively on infrastructure or other things will never cause inflation. What will cause inflation is money that is pissed away frivolously or unconstructively. Reorienting out priorities can and should be done even if deficit spending is required to do it. When the economy is rebalanced, it eventually will mean that the rich will have to pay their fair share of taxes in order to reduce inequality. That's the main thing that Republicans are afraid of - that eventually the rich will have to pay their fair share of taxes. In the meantime economic history since 2000 has demonstrated the fact that, if trillions of dollars were found to bail out the banks and give tax cuts to the rich, trillions of dollars can be found to repair and rebuild infrastructure and prevent the world from the disaster of global warming. Private enterprise has done nothing but accelerate global warming because private enterprise consists of the fossil fuel industry. Private enterprise profits from pollution that it doesn't have to compensate for. Therefore, it's up to government to balance out what private enterprise seems incapable of doing. That's not to say that private enterprise is unimportant. It does some things very well, some things that government does not do well. It's a matter of finding the correct balance between private enterprise and government enterprise.

Does any fossil fuel worker object to working in the renewable energy industry providing they are guaranteed a job in that industry? I don't think so. There's no one that loves fossil fuels per se or just because they are fossil fuels. They are not like Scrooge who just loves the look and feel of money. Are there people who so much like the look and feel of oil that they can't bear the thought of working in an industry that doesn't pollute the planet? There are new industries coming - a straw with the look and feel of a plastic straw that biodegrades and doesn't stay in the ocean for hundreds of years like the plastic straw does. These straws are being manufactured today. If government can assist in the ramping up of this private enterprise - Newlight Technologies - we will be all better off except for the plastic straw manufacturers which are using mainly robots to produce their straws so there are not that many jobs involved there.

Huntington Beach, California-based Newlight produces an ocean-degradable biopolymer called PHB using air and greenhouse gas. Newlight's methods are supported by more than a decade of research and development as well as an extensive patent portfolio. Newlight's Series F finance round coincides with the commissioning of a new commercial-scale production facility in California called Eagle 3 and the launch of branded products including a line of cutlery and drinking straws for the food-service industry. Newlight's foodware products deliver a unique level of material safety and certified sustainability, resulting in high-performance, ocean-degradable foodware that works for people and the planet. 

Government can provide an assist to private enterprise as long as that enterprise is headed in a new direction which doesn't pollute and which doesn't produce greenhouse gasses. Which is more important - hanging onto the familiar past or striking out in a new direction that saves the planet and makes it better for our grandchildren? Are we pioneers and adventurers like our ancestors or what?

Off the Top of My Head

Quantitative Easing = Printing Money

by John Lawrence

In her book, "Deficits Don't Matter," author Stephanie Kelton makes the case that we don't have to worry about deficit spending. That's when the US government spends more than it takes in in taxes. So in a sense taxes don't matter either at least as far as balanced budgets go. The US dollar is a sovereign currency. This means we don't have to ask anyone's permission to print money. The US dollar was taken off the gold standard in 1971 under President Nixon. It is a fiat currency meaning that it is not backed by anything other than the word of the US government. The US has experienced the phenomenon of printing money to bail out the banks in the Great Recession of 2008. As of September of this year, the Fed's balance sheet was $7.1 trillion. As of January 2008, the Fed's balance sheet was less than $1 trillion. That means that the Fed has printed money to the tune of over $6 trillion since 2008. Yet there has been no inflation in the US economy which is the danger a lot of economists had predicted from printing so much money.

The Federal Reserve bank can print US dollars just by a few keystrokes on a computer. Approximately $3.5 trillion was printed to bail out the banks during the Great Recession. Another $2.5 trillion has been printed so far to deal with the COVID pandemic. The question arises that, if the Fed can print money any time it wants, why can't there be Quantitative Easing (QE) for the people? In other words, if the Fed can bail out the banks, why can't it bail out the homeless, why can't it bail out the $4 trillion deficit in infrastructure spending, why can't it bail out the hungry and the poor? The answer is that it can do all those things, but this tool, QE, for that is what it is - a tool - should be used judiciously. It should be used to accomplish useful and necessary goals. It should not be used frivolously. It should be used in conjunction with other tools like tax policy. It should be used to promote a full employment economy and achieve socially useful goals.

Tax policy should be used to raise most of the money needed for government spending, and it should be used to redress the balance of the high amount of inequality in the American economy. Taxing the wealthy both in terms of income and wealth while giving tax breaks to the middle class and poor while implementing policies to help them build wealth is one of the major things US Federal tax policy should do. Additional money can be obtained by reducing the bloated military and military-industrial complex budget. If, however, there are additional goals that should be met like hastening the switch to renewable energy or a fuller safety net for the American people, then QE for the people should be implemented. The goal is to have a balanced and useful economy, one that promotes net zero carbon emissions, one that promotes sustainable development on other parts of the world, one that hastens the day when no child goes hungry or uneducated, one that reduces financial inequality.

It has already been demonstrated that deficits don't matter because the Great Recession of 2008 was quelled by the Fed's policy of printing money with no adverse effects on the economy. We have seen again the salubrious effects pf printing money or QE, if you want to call it that, during the COVID pandemic during which another $2.5 trillion has been printed so far. There is no reason why any country that has a sovereign currency like the US does cannot print money. Since the US dollar is the world's reserve currency, other countries and individuals are willing to buy up most if not all of US debt. But if they didn't buy up any of it, the Fed could still take it - or as much as necessary - on its balance sheet. In other words the fact that other countries are buying US debt means that the Fed doesn't have to print as much money. Any country with a sovereign currency can do the same even if their currency is not much in demand on world markets. Since the US dollar is used a lot in world trade, other countries need a supply of US dollars and are willing to buy US debt to get them.

There is no reason why any American should go hungry or be homeless or lack health care. Speaking of health care, Medicare for All would not eliminate private health care as some have suggested. Even with Medicare some doctors refuse to see patients because they don't like the reimbursement Medicare provides. There would be a private market for the wealthy who would just pay out of pocket to doctors who refused to accept Medicare patients. The wealthy don't even need health insurance. It could not be made illegal for such a market to exist. So even though everyone would have health care under a Medicare for All plan, the wealthy would still hire private and presumably better doctors at their own expense.

The policy of the Fed's buying US debt, which is equivalent to printing money, should be used wisely and the money not wasted.  QE for the people combined with the fact that deficits don't matter should lead to a more productive society providing that those additional tools and resources are used in a constructive way and not used to further militarize the society and the world. Any tool can be used for good or for ill. QE for the people could be used for a more healthy, beneficial and well balanced society for all people, could eliminate poverty in the US and the world, bring US infrastructure into the modern era and combat global warming and future pandemics.

Off the Top of My Head

Billionaires Get Bailed Out by Free Money From the Fed. A Green New Deal Has to be Funded by Increased Taxes? What's Wrong With This Picture? Socialism for the Rich. Capitalism for the Middle Class and Poor.

by John Lawrence, August30, 2020

The Federal Reserve has printed trillions of dollars to bail out Wall Street banks and billionaire Hedge Funds so they can continue to gamble in risky derivatives, interest rate swaps, collateral loan obligations, pooled mortgages, futures, options and other financial manipulations that do nothing except move money from one rich person's portfolio to another's. Meanwhile, those who advocate building and repairing crumbling bridges, dams, railroads, levees and airports and doing so by creating millions of good paying jobs are demonized by those who have received the free money - rich people and the politicians sucking at their teats. How ya gonna pay for it, they say. Y'all are going to have to raise taxes. Not necessarily if we use the same means and methods that the rich have used to balance their portfolios - the Fed printing trillions of dollars and then swallowing it in the Fed's black hole - no taxes necessary.

Modern Monetary Theory states that a nation can pay for goods, services, and financial assets without a need to collect money in the form of taxes or debt issuance in advance of such purchases. In short deficits don't matter which is based on observation of the real world in which the US adds at least another trillion to its national debt every year. The budget is never balanced nor need it be. The US can never be made to default because the Federal Reserve issues fiat money with debt being denominated in its own currency. Therefore, it can always print more money to pay its own debt. However, much of the US debt is held by foreign countries because the US dollar is the world's reserve currency. That means that most if not all financial transactions world wide are done in dollars. When the US treasury sells bonds, the Fed remains willing to buy them if the market does not provide buyers for all of them. So far this year during the pandemic, the Fed has seen to it that the richest Americans did not see any decreases in wealth. It did this by printing $3 trillion and basically giving it to the rich.

Between mid-March and mid-May, during the lockdown, the wealth of America’s 600-plus billionaires ballooned by $434 billion, according to a report by Americans for Tax Fairness, pushing the wealth of those 600 Americans to a combined $3.4 trillion. The Fed accomplished this by making sure asset prices, mainly the stock market, did not go down during the lockdown. The richest 10% of American households own 84% of the value of stocks, according to Federal Reserve data. When Fed Chairman Powell admitted that the Fed’s nearly $3 trillion in asset purchases caused asset prices (again the stock market) to increase, he said the goal was to “restore functioning markets,” which means markets where prices are rising, and markets where price discovery is not allowed to happen, and markets where investors are spared any losses.

So there we have the reason why the current pandemic caused depression did not result in the stock market tanking like it did in the infamous 1929 crash which led to the Great Depression. The Fed printed money and bought stocks. It's as simple as that. Yet the Fed resists doing the same thing for the middle class such as printing $3 trillion and spending it on a Green New Deal. Oh no, politicians whine, that would mean taxes would have to be raised. No they wouldn't if the Fed prints the money and spends it on infrastructure rather than buying stocks. The limitation on this money printing is only when the economy reaches full employment and/or inflation starts to rise. So far we're a long way from either of those events occurring.

The fact is that a Joe Biden Presidency could institute a program of Medicare for All and a Green New Deal and the forgiveness of student loan debt without increasing taxes. It would lead to huge deficits to be sure. Those deficits represent US Treasury bonds sold to the public. To the extent that the public doesn't want to purchase all of them, the Fed can step in, buy them up and disappear them on its balance sheet in just the same way it has propped up Wall Street after the Great Recession and the stock market presently during the Pandemic Recession. There is no reason why US policies should add huge amounts of wealth to the already rich while starving the country and most of its citizens of good paying jobs creating a green infrastructure. Both income and wealth taxes on the rich (but not on the poor or middle class) can then function to decrease economic inequality and mitigate the need for Fed money printing.

Off the Top of My Head

The Essential Economy Should Replace an Economy Based on Consumerism

by John Lawrence, July 7, 2020

The economy is never going back to what it was before the coronavirus pandemic. Brick and mortar stores were already failing. Now their fate is being sealed. J Crew, JCPenney, Brooks Brothers, Neiman Marcus, Chesapeake Oil, Gold's Gym, Hertz, Tuesday Morning, Diamond Offshore, Whiting Petroleum, Sur La Table, 24 Hour Fitness, GNC, Chuck E Cheese, Lucky Brand, Men's Wearhouse, Pier 1 - the list goes on and on. Many of these businesses were carrying huge amounts of debt even before the virus hit. This huge number of bankruptcies is going to slam the economy, and the economy will be restructured as a result. Brick and mortar stores will never be the same as more people are going online to order goods. More schools and businesses will also be going online and staying online. This is good as it will slow the greenhouse gas emissions from commuter vehicles.

The economy needs to be restructured even if we never had the pandemic. Maybe the pandemic is a blessing in disguise if it forces a restructuring which reduces the market for fossil fuels. There needs to be massive restructuring in this regard in the next 10 years if we are to have a prayer to escape runaway global warming. This restructuring will also allow the next President if it's Joe Biden to address economic inequality and uplift the lower half of family incomes. Joe Biden is calling for a $15.00 minimum wage with no exception for tipped workers. This is a step in the right direction. There needs to be massive hiring in fields which will rebuild American infrastructure in a way that uses renewable energy. Fossil fuel companies that are carrying huge amounts of debt should be left to go bankrupt instead of being propped up by interest free loans from the Federal Reserve.

Medicare for All needs to be implemented and updated to allow Medicare to negotiate drug prices. Both Medicare and Obamacare are currently prohibited by law from negotiating with drug companies to get lower drug prices. Whether Biden calls it Medicare for All or enhanced Obamacare, the health care system needs to be radically overhauled and updated so that the poor and middle class get the same level of care as the rich. This is all predicated on both Houses of Congress being controlled by Democrats. Otherwise, nothing will get done, and the US will continue to go down the path of degeneration.

The current American economy is predicated on 70% consumption. It is predicated on private enterprise and very limited government. The result is immense economic inequality and lack of investment in public health, which the pandemic has made evident, and also lack of investment in infrastructure. Instead, the only government investment has been in a ginormous military establishment which has been used in disastrous wars, the only result of which has been to create millions of refugees. It has done nothing to help the 40% of the world's population that does not even have access to clean water or proper sanitation. This situation has only been made worse by the current President whose only goal has been to make the world safe for white people. He has used economic sanctions with the result that the world has turned away from using the US dollar and turned toward China as an ally. Case in point: China has been helping Iran economically as the US policy of trying to trash Iran's economy has left it no alternative.

Instead of making America Great Again, Trump has absolutely trashed the nation including his response to the pandemic. While other countries have mounted a credible response, Trump has only further trashed the American economy by insisting that opening the economy was the only thing that mattered. "So I said to my people, slow down the testing, please." Exactly the wrong response. Trump said to his people (the Supreme Court) "Slow down the legal process, please." He got his wish there. His tax returns will not become public until after the election if ever. The Supreme Court said it has to go back to a lower court. From there it will probably go to a court of appeals and from there back to the Supreme Court in a neverending circular process that only rich people can afford. Lawyers will make a fortune though. That's why rich people get justice. Poor people can't afford it.

The political system needs to be restructured so that the Senate can never again be captured  by one political party which then stymies any initiatives put forward by the other party. Democrats in the House can put forward progressive legislation, but, as long as Mitch McConnell is leader of the Senate, it will never see the light of day or be implemented. It becomes a joke. The result is that the political process is only spinning its wheels and has been for 40 years. Let's hope a Democratic President and a Congress in which both Houses are controlled by Democrats can implement, instead of just talking about, progressive policies starting in 2021.

Off the Top of My Head

Culture Wars: Neither Here Nor There

by John Lawrence, July 4, 2020

So they change a name of  a military base: is one black family any better off? Conservatives love it when the debate is confined to cultural stuff. It doesn't threaten their bank accounts one tiny little bit. But when you get down to anything substantive, anything concrete, like defunding the military-industrial complex and using the money for free public education from pre-school to college, well, wait a minute that's socialism. They already consider public education K-8th socialism. Well what about health care? When you start talking about free health care, or even reasonably priced health care, well that's socialism. Hey let's confine the discussion to whether or not we should allow confederate statues to exist. Taking one down does not make one black family any better off and doesn't threaten the white elite one bit. It doesn't cost them one dollar and it doesn't add one dollar to any black family's income.

So let's talk about concrete issues, ones that could really benefit the hoi polloi and take a few dollars out of wealthy peoples' pockets:

    1. Medicare for All

    2. A Financial Transactions Tax

    3. Forgiveness of student loan debt

    4. A Green New Deal that would create good paying jobs for millions of black, Native American and     Latinx people

    5. Raising the minimum wage to a living wage

    6. A wealth tax

    7. Defunding the military which is the police force of the world and increasing the budget of the Center for Disease Control and the World Health Organization

Instead of debating these concrete issues conservatives want to argue over symbols. That's where their mentality is at. Don't trample on my flag. Don't trample on my history. Don't burn my flag. None of these symbolic and cultural issues improve the life of any American. They just preserve the status quo and the economic inequality that is only getting worse and which will get worse at a faster rate due to the pandemic. In short the ones mired in these issues know that nothing really will change as long as they can keep the discussion at this level. And those who could profit by changing the system are too often persuaded by those who wouldn't just to argue about symbols. Eliminating all the statues of slaveholders will not change American history one bit and will not make one black person better off.

As long as they don't eliminate the military bases and reduce the inflow of money to the military, the big wigs would be happy to entertain changing the name of Fort Bragg to Fort Rosecrans. General Rosecrans whipped Bragg's ass in Tennesee. As Commander of the Army of the Cumberland, he fought against Confederate General Braxton Bragg at Stones River, and later outmaneuvered him in the brilliant Tullahoma Campaign, driving the Confederates from Middle Tennessee. So it's a logical change of name. But it won't do anything to improve the lives of blacks, native Americans or Latinx. All the government help given to whites like the GI bill after WW II effectively excluded blacks as did all the land given to whites by the Homestead Act. First slavery, then Jim Crow laws served to keep black wealth at a minimum even negative in many cases. Instead of gaining wealth as whites did, they were targeted to be debtors and kept there by PayDay loan operators charging exorbitant rates of interest. Native Americans were gypped out of their lands by Americans not honoring treaties and by outright theft. They were also killed by a pandemic the white man brought with him from Europe. Thus Montezuma's revenge and now maybe COBID will do the same thing to Trump's non-mask wearing base.

So Trump is getting his base excited about cultural issues. It's a total sideshow designed to keep the status quo intact and to let the rich keep on getting richer. The poor, especially blacks, need to be kept in their place. All the progressive legislation designed by Cory Booker to reform the police nationwide will never see the light of day as long as the Senate is controlled by Republicans. He might as well not waste his breath. It's meaningless and never has a chance in hell of passing the Senate and being enacted into law. So why don't the Democrats do something more productive instead of spinning their wheels with great ideas that will never see the light of day.

Off the Top of My Head

A House Built Upon Sand: the US Economy

by John Lawrence, June 26, 2020

The wise man built his house on rock, and it withstood the rains and the floods and the wind. The foolish man built his house on sand and it collapsed. An apt metaphor for the US economy in the midst of a pandemic that is only getting worse. Before the pandemic hit, it was a full employment economy in which half the people couldn't survive a $400. emergency. It was an economy built on consumerism. Consumerism was 70% of GDP. About half the economy was small business, but these jobs and this economic activity was vulnerable. Much of it was non-essential. It was bars (by the way you can drink at home); it was restaurants (by the way you can eat at home). It was travel and hospitality (by the way you can sleep at home if you're willing to make your own bed).

The essential parts of the economy continued to operate even when the pandemic hit. It isn't fair that minimum wage workers were more exposed to the coronavirus, but, be that as it may, with some exceptions these workers did not get sick in higher ratios than anyone else. If more of the jobs were essential, productive and less frivolous, there would have been fewer jobs lost and much less unemployment. The economic house was built on sand and when the pandemic hit, it collapsed. At the same time the fault line of black racism and inequality was fully exposed. It's as if the hurricane of the pandemic cut away the underbrush and exposed this situation for what it is thanks to #BlackLivesMatter.

The Homestead Act signed by President Abraham Lincoln which gave free land to white people allowed whites to build equity and wealth while blacks who were promised 40 acres and a mule after slavery were denied even that. They ended up in many cases working the same land as sharecroppers and living in worse poverty than when they were slaves. After World War II the G.I. Bill aimed to help American veterans adjust to civilian life by providing them with benefits including low-cost mortgages, low-interest loans and financial support. African Americans did not benefit nearly as much as White Americans. Historian Ira Katznelson argues that "the law was deliberately designed to accommodate Jim Crow". In the New York and northern New Jersey suburbs 67,000 mortgages were insured by the G.I. Bill, but fewer than 100 were taken out by non-whites.

Additionally, banks and mortgage agencies refused loans to blacks, making the G.I. Bill even less effective for blacks. Once they returned from the war, blacks faced discrimination and poverty, which represented a barrier to harnessing the benefits of the G.I. Bill. So whites were able to build wealth through home ownership while blacks were denied that opportunity. Wealth from home ownership is the difference between the middle class and the poor. Home ownership became the means for the intergenerational transfer of wealth for white people. Each generation of black people started out from zero. There was an intergenerational transfer of poverty instead.

Blacks who were able to get manufacturing jobs after the Second World War did fairly well, but those jobs have by and large fled the country. In the financial crisis of 2008, the Great Recession, blacks were screwed as well. While the Federal Reserve bailed out the banks and mortgage companies hundred cents on the dollar, blacks who needed help paying their mortgages did not get it and were foreclosed on. The government could have bailed them out instead, but it didn't.

So now the country is faced with not only a public health crisis but also an economic, financial and racial crisis which would be much less severe if those manufacturing jobs still existed. The economy is not coming back as it was constructed pre-pandemic. There is no way that small business based on 100% occupancy is going to survive based on 50% occupancy. Many of the businesses like professional sports, cruises and even churches are predicated on high occupancy. People will not be comfortable with high occupancy unless a vaccine is found for COBID, but finding a vaccine is not a foregone conclusion. There are some viruses for which a vaccine has never been found including HIV, malaria and tuberculosis.

It takes a lot of money to develop a vaccine, and that money has been lacking from US budgets. There are two obstacles to faster progress, said Dr. Gregory A. Poland, director of the vaccine research group at the Mayo Clinic. “One is scientific, and one is embarrassing,” he said. The embarrassing part is the lack of investment. It takes 10 years and more than $1 billion to develop a vaccine — a small fortune for a medical advance but a pittance for a weapons system. While defense research is driven by one mega-customer, the Pentagon, vaccine researchers face a confusing hodgepodge of potential backers. In short the US has spent its money on weapons of war instead of protecting its people from pandemics which are far more deadly than terrorist attacks. 405,000 Americans died in WW II. Over half that amount have already died in this pandemic, and it's getting worse due to American foolishness at the top levels.

There is a chance now for America to start out on a new path, and that path would be more or less what Bernie Sanders and other progressives have identified as their agenda: a Green New Deal would create good jobs for millions of unemployed Americans and it could give priority to black people so that they could get started on wealth building. Low cost housing loans and subsidies could give black people the same advantages they didn't get with the Homestead Act and the G.I. bill. At the same time a Green New Deal would be converting the country to renewable energy and rebuilding infrastructure, both of which are necessary if earth is to remain habitable for the human race. Medicare for All would only bring the US up to the level of most other civilized countries.

We have to reset our priorities, reduce the military-industrial complex and make peace and have cooperation with our so-called enemies. We can quibble about Russia's and China's internal affairs or we can cooperate with them as peers to forestall global warming and create a planet worth inhabiting. We can spend our money on war or we can spend it forestalling future pandemics. The solution to many of our myriad problems is clear, and it doesn't require a revolution necessarily. Reform is all that's necessary to implement Medicare for All. Reform is all that's necessary to implement a Green New Deal. But countries that do not do what's necessary and obvious to meet the needs of the people create a situation in which violence may ensue. It's no longer a question of capitalism vs socialism. Most countries of the earth including Russia and China are a combination of both. I started with a Biblical reference so I will end with one: "Blind guides! You strain your water so you won’t accidentally swallow a gnat, but you swallow a camel!" God bless the USA.

After Attacking Medicare for All as 'Unrealistic' During Primary, Biden Says Healthcare a 'Right for All' Amid Pandemic

Published on Thursday, June 25, 2020

by Common Dreams

"And the natural idea that follows from that is....?"

by Julia Conley, staff writer

 

Democratic presidential candidate Joe Biden gestures as he delivers remarks about healthcare on June 25, 2020 in Lancaster, Pennsylvania. (Photo by Jim Watson/AFP via Getty Images)

Presumptive Democratic presidential nominee Joe Biden left some progressives perplexed Thursday when he spoke at length about healthcare during a campaign stop in Lancaster, Pennsylvania—making a number of points that would suggest he supports Medicare for All, a proposal he denounced as "unrealistic" throughout the Democratic primary.

Washington Post reporter Jeff Stein noted that Biden mentioned the unemployment crisis that's grown out of the coronavirus pandemic in his speech, suggesting that the loss of employer-based health coverage has made a powerful case for the federal government to guarantee healthcare to all Americans.

Joe Biden notes in speech today that many people are losing their health insurance during the pandemic because it is tied to their employment

— Jeffrey Stein (@JStein_WaPo) June 25, 2020

"Families are reeling right now," the former vice president said, "losing their employers' plans in droves as their employers go out of business, or have to suspend business—they need lifelines now."

Thomas Kennedy, Florida state coordinator for the immigrant rights group United We Dream, suggested expanding the popular Medicare program to cover all Americans would be an effective lifeline for the 43 million people who could lose their employer-based health insurance during the pandemic, according to the Economic Policy Institute.

There is this thing called Medicare For All that would fix this. Biden should support it. https://t.co/kZtSFDKWqA

— Thomas Kennedy (@tomaskenn) June 25, 2020

However, Biden tied the crisis to his push for a public healthcare plan which would exist alongside the for-profit health insurance industry—not Medicare for All.

"We need a public option now more than ever, especially when 20 million people are unemployed," Biden said. "The public option will allow every American, regardless of their employment status, the choice to get a Medicare-like plan."

Biden is reportedly revamping some of the specifics of his healthcare plan in the coming weeks after forming a joint task force with former advisors to Sen. Bernie Sanders (I-Vt.), who continues to advocate for Medicare for All following his presidential run. 

In his speech, Biden said Americans would have to pay no more than 8.5% of their income on healthcare costs; under the Affordable Care Act, the current limit is 9.86%, and was lower in previous years. Deductibles and out-of-pocket costs on top of premiums would still exist under Biden's plan, and as written, roughly 10 million Americans would remain uninsured. 

During the primary, Biden derided Sanders' Medicare for All proposal—which a Yale University study in February showed would save over $450 billion in healthcare costs annually—as "unrealistic." In an interview with MSNBC in March, days before the coronavirus pandemic was declared a national public health emergency and millions were left jobless overnight, Biden suggested that even if Medicare for All legislation were to pass in both chambers of Congress during his potential presidency, he would not necessarily sign it into law, citing concerns over cost.  

Objections to Medicare for All over its potential costs have been particularly irksome to proponents of the single-payer solution, with study after study showing overall expenditures would be less while providing comprehensive coverage to everyone in the country.

On social media during his appearance in Pennsylvania—where a 2018 Morning Consult/Politico poll found a majority of voters supported Medicare for All—Biden suggested that Sanders was correct to demand that the federal government ensure every American have healthcare coverage, referring to healthcare as a "right for all."

Health care is a right for all — not a privilege for the few.

— Joe Biden (@JoeBiden) June 25, 2020

Medicare for All advocates implored Biden to commit to fighting to expand healthcare to all Americans—rather than just borrowing rhetoric from politicians who have pledged to do just that.

Health care is a right for all — not a privilege for the few.

— Joe Biden (@JoeBiden) June 25, 2020

"So what are you going to do about that?" asked Lauren Ashcraft, a democratic socialist who ran for Congress in New York's 12th district this year.

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Off the Top of My Head

Racist Economics

by John Lawrence, June 8, 2020

Is it racism when the schools in predominantly black neighborhoods are worse than schools in predominantly white neighborhoods? Schools in many parts of the country are funded with local property taxes. It stands to reason that property values in poor neighborhoods are less than property values in rich neighborhoods, and, therefore, property tax revenues and hence school funding is less. So the worse schools are found in poor "predominantly black" neighborhoods. A word you hear often these days is "predominantly". Nothing is totally black and white, but, when black people are affected in a way that is greater than their percentage of the population, one could say it is a "predominantly black" situation. When police arrest black people at a greater rate than they do white people, we could say that the police are a racist institution.

It has been said that the only mistake that the looters at the current protests made was that they didn't form a hedge fund first before they started looting. Martin Luther King said, “The black revolution is much more than a struggle for the rights of Negroes. It is forcing America to face all its interrelated flaws—racism, poverty, militarism, and materialism. It is exposing the evils that are rooted deeply in the whole structure of our society. It reveals systemic rather than superficial flaws and suggests that radical reconstruction of society itself is the real issue to be faced.” Republicans have breathed a sigh of relief that so far the Black Lives Matter movement has had little to say about poverty, economic inequality, militarism and materialism. Some though are getting to the heart of the problems in our society that affect us all but affect black people "disproportionately."

Writing in the New Yorker Keeanga-Yamahtta Taylor said:

The [1992] uprising in L.A. shared with the rebellions of the nineteen-sixties an igniting spark of police abuse, widespread violence, and the fury of the rebels. But, in the nineteen-sixties, the flush economy and the still-intact notion of the social contract meant that President Lyndon B. Johnson could attempt to drown the civil-rights movement and the Black Power radicalization with enormous social spending and government-program expansion, including the passage of the Housing and Urban Development Act of 1968, which produced the first government-backed, low-income homeownership opportunities directed at African-Americans.

By the late nineteen-eighties and early nineties, the economy was in recession and the social contract had been ripped to shreds. The rebellions of the nineteen-sixties and the enormous social spending intended to bring them under control were wielded by the right to generate a backlash against the expanded welfare state. Political conservatives argued that the market, not government intervention, could create efficiencies and innovation in the delivery of public services. This rhetoric was coupled with virulent racist characterizations of African-Americans, who relied disproportionately on welfare programs. Ronald Reagan mastered the art of color-blind racism in the post-civil-rights era with his invocations of “welfare queens.” Not only did these distortions pave the way for undermining the welfare state, they reinforced racist delusions about the state of black America that legitimized deprivation and marginalization.

The 1990s saw Democrats agreeing with Republicans that problems in the black community were largely caused by overly generous social programs. President Bill Clinton promised to "end welfare as we know it." Senator Joe Biden jumped right on board the push to reduce welfare programs by saying, "“the culture of welfare must be replaced with the culture of work. The culture of dependence must be replaced with the culture of self-sufficiency and personal responsibility. And the culture of permanence must no longer be a way of life.” Biden championed the 1994 “crime bill” that pledged to put a hundred thousand more police on the street, called for mandatory prison sentences for certain crimes, increased funding for policing and prisons, and expanded the use of the death penalty. By the 1980s Ronald Reagan decried "welfare queens."

Taylor continues:

So, though Biden desperately wants us to believe that he is a harbinger of change, his long record of public service says otherwise. He has claimed that Barack Obama’s selection of him as his running mate was a kind of absolution for Biden’s dealings in the Democrats’ race-baiting politics of the nineteen-nineties. But, from the excesses of the criminal-justice system and the absence of a welfare state to the inequality rooted in an unbridled, rapacious market economy, Biden has shaped much of the world that this generation has inherited and is revolting against.

More important, the ideas honed in the nineteen-eighties and nineties continue to beat at the center of Biden’s political agenda. His campaign advisers include Larry Summers, who, as Clinton’s Treasury Secretary, was an enthusiastic supporter of deregulation, and, as Obama’s chief economic adviser during the recession, endorsed the Wall Street bailout while allowing millions of Americans to default on their mortgages.

Biden was chiefly responsible for the 2005 bill that took away bankruptcy protection from student load debtors (presumably disproportionately black). Credit card companies, many of whom are headquartered in Biden's state of Delaware, have been major Biden campaign contributors. Biden was known as the Senator from MBNA. Biden should just turn over the Democratic nomination to Bernie Sanders who has been on the right side of issues which are now coming to the forefront in American life.

Taylor continues:

In 1968, King, in the weeks before he was assassinated, said, “In a sense, I guess you could say, we are engaged in the class struggle.” He was speaking to the costs of the programs that would be necessary to lift black people out of poverty and inequality, which were, in and of themselves, emblems of racist subjugation. Ending segregation in the South, then, was cheap compared with the huge costs necessary to end the kinds of discrimination that kept blacks locked out of the advantages of U.S. society, from well-paying jobs to well-resourced schools, good housing, and a comfortable retirement. The price of the ticket is quite steep, but, if we are to have a real conversation about how we change America, it must begin with an honest assessment of the scope of the deprivation involved. Racist and corrupt policing is the tip of the iceberg.

We have to make space for new politics, new ideas, new formations, and new people. The election of Biden may stop the misery of another Trump term, but it won’t stop the underlying issues that have brought about more than a hundred thousand COVID-19 deaths or continuous protests against police abuse and violence. Will the federal government intervene to stop the looming crisis of evictions that will disproportionately impact black women? Will it use its power and authority to punish police, and to empty prisons and jails, which not only bring about social death but are now also sites of rampant COVID-19 infection? Will it end the war on food stamps and allow African-Americans and other residents of this country to eat in the midst of the worst economic crisis since the Great Depression? Will it finance the health-care needs of tens of millions of African-Americans who have become susceptible to the worst effects of the coronavirus, and are dying as a result? Will it provide the resources to depleted public schools, allowing black children the opportunity to learn in peace? Will it redistribute the hundreds of billions of dollars necessary to rebuild devastated working-class communities? Will there be free day care and transportation?

In short we need good paying union jobs (Green New Deal) that will deal with the issue of climate change (Green New Deal), forgiveness of student loan debt (the least Biden can do since he was largely responsible for creating the situation), Medicare for All (since hospitals in black neighborhoods compare unfavorably with those in white neighborhoods), public housing (to end homelessness and guarantee everyone the right to have a roof over their head). If we want to solve the problem of institutional racism in this country, we need to address the fundamental problems of economic inequality. Where do we get the money? Not only by defunding the police which claim the lion's share of local budgets, but by demilitarizing the bloated military-industrial complex and taxing the rich at 1955 levels (91%). The Federal Reserve can always take a few more trillion on its balance sheet; it has taken trillions on its balance sheet already and given the money to the big banks. How about Quantitative Easing for the people? Economic inequality is a problem which affects black people disproportionately (there's that word again), but the solution of which will contribute to the benefit of white people as well.

Off the Top of My Head

Black Lives Matter: Police Reforms Benefit Whites as Well

by John Lawrence, June 7, 2020

No more "carotid restraints" or chokeholds is a police reform caused by the Black Lives Matter movement, but obviously it applies to whites as well. We don't know how many of the 237 times Minnesota police used chokeholds, blacks were targeted, but probably like all police violence it was disproportionate. Police reforms such as ending "no knock warrants" also obviously apply to whites as well as blacks. The point is that what black people are demanding in terms of police reform doesn't just affect black lives. It affect all lives.

So why stop with just police reform? How about prison reform.Though African Americans and Hispanics make up approximately 32% of the US population, they comprised 56% of all incarcerated people in 2015. African Americans are incarcerated at more than 5 times the rate of whites. The imprisonment rate for African American women is twice that of white women. Although only a small percentage are in prison for minor drug offenses, marijuana possession in small quantities should be made legal on a national basis. Many are in jail awaiting trial. Every day, 465,000 people are held in local jails even though they have not been convicted; legally, they are presumed innocent. Many are there because they cannot afford bail.

Let's not stop at prison reform. How about political reform? Mail-in ballots should be legalized and encouraged in every state. How many poor people can afford to take time off from work to go and vote? These people are probably disproportionately black, but it would help poor people who are white as well. Let's make the election of President be based on popular vote and not the electoral college. Let's do away with the filibuster which prevents legislation from being passed democratically. Let's limit the power of the leader of the Senate to even stop legislation from being introduced. Make it mandatory that legislation created in the House be debated and voted upon in the Senate. Let's outlaw lobbying which lets the richest and most powerful individuals and corporations determine the political agenda.

How about economic justice? That was basically Bernie Sanders' agenda. Let's eliminate poverty and homelessness in the US. Blacks are disproportionately poor and homeless, but there are plenty of poor and homeless whites as well. Instead of spending a trillion dollars a year on the military and military-industrial complex, instead of wasting money on fruitless wars, let's have a Green New Deal and rebuild American infrastructure while at the same time creating hundreds of thousands of good paying jobs. Let's cancel student loan debt which disproportionately affects blacks, but whites will benefit too. Let's have Medicare for All instead of an outrageously expensive health care system which is twice as expensive as any other country's while producing only half as good results.

You get the picture? All the reforms which could come from the Black Lives Matter movement will also bring those same reforms for whites, browns and any other colors. Let's protest to change the course of this whole country for all citizens. Then we have to help the rest of the world with a Green New Deal if we want to create a habitable planet for our children and grandchildren. Black people are leading the way for social justice, for political and economic justice, justice which will turn this country around and help turn this planet around. Let's keep on going.

Off the Top of My Head

What is Justice for George Floyd?

by John Lawrence, June 4, 2020

I just listened to the Reverend Al Sharpton's rousing eulogy for George Floyd. He said we want justice for George Floyd. All over the world people want justice for George Floyd. Even in bombed out Syria, an artist painted a wall honoring George Floyd. That's significant. It's not justice for George Floyd here in America. It's justice for George Floyd all over the world. That means justice for George in the Middle East, justice for George in Iran, justice for George Floyd in China, in Russia. So what would justice be? Reverend Al quoted Ecclesiastes, "For everything there is a season, a time for every activity under heaven. A time to be born and a time to die. A time to plant and a time to harvest. A time to kill and a time to heal." So what would this justice be?

For sure criminal justice system reform. Let's start with a national ban on carotid restraint, a national ban on the knee-to-neck restraint. Yes, but that's not enough. I feel that all this protest energy might just be dissipated unless there are concrete demands on the system. Where is Bernie Sanders when we need him now? He had concrete demands: a Green New Deal, Medicare for All, forgiveness of student loan debt. Most of the protesters both black and white are millenials, the most screwed generation in American history. But who among them would most benefit from these progressive demands? African Americans. They are the Americans who not only suffer from the criminal justice system and the law enforcement system, they are the ones who most suffer from poverty as it was made clear George Floyd's family did. Reforming the criminal justice system is not enough. Reforming the economic system is necessary to redress the grievances of first slavery, then Jim Crow and now the videotaped deaths of so many black people that generated the Black Lives Matter movement.

Black Lives Matter in terms of equal economic justice and millenial lives, both black and white, weighed down with student loan debt that can't be discharged in bankruptcy, matter as well. A country which supports a bloated military bureaucracy that consumes a trillion dollars a year while there is 20% unemployment represents a knee on all our necks. Justice for George Floyd has to extend to justice for all those innocent lives lost in Iraq, Afghanistan, Vietnam, Syria. Justice for George Floyd is justice for the 70 million people, half of them children, in refugee camps. Justice for George is justice for all the poverty stricken in favellas and barrios who can't socially distance. Justice for George Floyd is American acceptance of the United Nations 1948 Declaration of Human Rights which include economic as well as political rights.

Justice for George Floyd is justice for people all over the world: black, white and all shades in between. Justice for George Floyd is justice for people without regard to race, religion or national residence. Justice for George Floyd is electing leaders of our country who will make friends instead of enemies, who will convert swords into plowshares, who will create peace and justice in the world.

As Millions Stripped of Health Coverage Amid Covid-19, House Dems Unveil Bill for Emergency Expansion of Medicare and Medicaid

Published on Friday, May 01, 2020

by Common Dreams

"Our nation's for-profit, employment-based healthcare system did not make sense before Covid-19 struck, and it is proving dangerous and deadly during the crisis."

by Jessica Corbett, staff writer

 

40 Comments

Health workers greet people as they arrive in cars at a mobile Covid-19 testing site at the Westside Community Center in the Goldsboro neighborhood of Sanford, Florida on April 23, 2020. (Photo: Paul Hennessy/NurPhoto via Getty Images)

Just a day after the U.S. Labor Department announced that more than 30 million people have applied for unemployment benefits since mid-March, over 30 House Democrats came together to introduce legislation that would guarantee healthcare coverage to all Americans during the coronavirus pandemic.

In a statement announcing the Medicare Crisis Program Act, lead sponsors Reps. Pramila Jayapal (D-Wash.) and Joe Kennedy (D-Mass.) slammed the U.S. healthcare system and pointed out that an estimated 35 million people could end up uninsured due to the public health crisis.

"Our nation's for-profit, employment-based healthcare system did not make sense before Covid-19 struck, and it is proving dangerous and deadly during the crisis," declared Jayapal, co-chair of the Congressional Progressive Caucus and lead House sponsor another coronavirus-related healthcare bill unveiled with Sen. Bernie Sanders (I-Vt.) in April.

"Millions of Americans are losing their job and their health insurance at precisely the moment when we need everyone to be able to access care and treatment for illness," said Jayapal. "The Medicare Crisis Program Act would guarantee healthcare for millions of people struggling with the health and economic realities of the Covid-19 pandemic and protect Americans from outrageous out-of-pocket costs."

Millions of Americans are losing their jobs and their health insurance at precisely the moment when we need everyone to be able to access care. That’s why @RepJoeKennedy and I are introducing the #MedicareCrisisProgram to enroll unemployed Americans into Medicare.

— Rep. Pramila Jayapal (@RepJayapal) May 1, 2020

Millions of Americans are losing their jobs and their health insurance at precisely the moment when we need everyone to be able to access care. That’s why @RepJoeKennedy and I are introducing the #MedicareCrisisProgram to enroll unemployed Americans into Medicare.

— Rep. Pramila Jayapal (@RepJayapal) May 1, 2020

Jayapal and Kennedy's new bill would "dramatically expand" Medicare and Medicaid eligibility, cap out-of-pocket costs for Medicare enrollees, and require all public and private health insurers to fully cover care related to Covid-19—including for patients who display symptoms but test negative for the disease. Further, the legislation would bar healthcare providers from billing uninsured patients for Covid-19 care.

"A healthcare system more concerned with profits than patients was never equipped to confront a pandemic like Covid-19," said Kennedy. "Because of our nation's stubborn failure to guarantee universal healthcare, millions of people are now not only out of a job, but out of health care coverage as coronavirus ravages their communities."

"With the Medicare Crisis Program Act," he said, "we can begin to fill in the gaps of a fundamentally flawed healthcare system during this pandemic and chart a path towards Medicare For All when it ends."

The bill is backed by a number of high-profile progressives in the House, including all four members of the Squad and Reps. Barbara Lee (D-Calif.), Ro Khanna (D-Calif.), Debbie Dingell (D-Mich.), and Jan Schakowsky (D-Ill.). More than 60 local and national groups—such as Business for Medicare for All, Indivisible, Our Revolution, People's Action, and Social Security Works—have also endorsed the bill.

Robert Weissman, president of the consumer advocacy group Public Citizen, issued a lengthy statement in support of the legislation. He emphasized how Americans losing their jobs—and thus their employment-based health insurance—because of a pandemic serves as a harsh indictment of the country's current system and noted that even millions of Americans with insurance face cost-sharing demands for Covid-19 care.

"We would have none of these problems if we had a Medicare for All system, but for right now, we need an immediate solution. The Medicare Crisis Program Act is that solution."
—Robert Weissman, Public Citizen

"We would have none of these problems if we had a Medicare for All system, but for right now, we need an immediate solution. The Medicare Crisis Program Act is that solution," he said. "At the very least, everybody must be guaranteed healthcare amid a national health emergency, without fear of facing bankruptcy or unmanageable bills."

Drs. Justin Lowenthal and Meenakshi Bewtra, co-chairs of the Covid-19 response taskforce and members of the national board of directors of Doctors for America, said in a joint statement welcoming the legislation Friday that they "know firsthand that Covid-19 has not merely caused—but rather, exposed—the deep and critical problems that our patients face in affordability, equity, and accessibility of their healthcare."

"We applaud this proposal for ensuring coverage, affordability, and access to healthcare for all of our patients during the Covid crisis, while illustrating one of several viable approaches for moving toward universal healthcare in the future," the doctors said. "This crisis shows us that, as a nation, we are all in this together: We should all have access to [personal protective equipment] when caring for and serving others, and we should all have insurance coverage that does not disappear when you need it nor depend on your employment status during a pandemic."

Dr. Adam Gaffney, president of Physicians for a National Health Program (PNHP), another national network of doctors, also welcomed the new proposal—along with the Health Care Emergency Guarantee Act previously introduced by Jayapal and Sanders—in a statement Friday.

"To forestall medical and economic catastrophe, emergency action to cover the uninsured and underinsured through the federal Medicare program is needed now," said Gaffney, also a pulmonary and critical care physician at the Cambridge Health Alliance in Massachusetts. "Yet only single-payer reform will secure healthcare for all Americans in the years ahead."

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Off the Top of My Head

A Jobs Program for Inessential Workers
by John Lawrence, April 30, 2020

Turn inessential workers into essential workers by putting them to work building green infrastructure. This is essential work that is not getting done. Much of the previous inessential work they did is better left undone even in a recovery. It is still inessential. It'll always be inessential compared to what needs to be done in creating and building green infrastructure. Building out solar and wind renewable energy could employ thousands if not millions of people. Repairing roads, bridges, waterways, clean water systems, airports, railroads and all other infrastructure could employ millions. This is essential work that has remained undone despite the fact that the American Society of Civil Engineers has given the US a D rating for infrastructure. High speed rail needs to be built. The widespread adoption of electric cars has to be mandated, and construction of a national electric vehicle charging network to power them has to be built.

Unemployed people still need jobs. Mark Cuban said on CNN this morning that there should be a jobs program similar to that of the New Deal. He is exactly right although he didn't make the necessary connection about the essential work that's still being left undone and the inessential work that doesn't need to be done even in a recovery. Forget Cuban's sports and entertainment enterprises. I hate to tell you that they are basically inessential. What is essential is greatly expanding the public health undertakings of the Federal  government which has been totally behind the curve in this pandemic.

We must ask ourselves what is essential and not go back to a new normal in which all the inessential businesses of the past are brought back just in order to provide employment to the millions who have lost their jobs. The pre-pandemic economy was 70% consumerism. The economy post epidemic should be much less a consumerist economy and much more an investment economy. The four components of gross domestic product are personal consumption, business investment, government spending, and net exports. Of these government spending must be ramped up to provide the essential jobs in infrastructure building as well as in the areas that the pandemic has made clear are indeed essential: health care, education, transportation, agriculture.

Government spending must go up; personal consumption must go down. It's as simple as that. As for business investment, it's a lost cause as business will only do what's profitable for itself as has been made abundantly clear. Investment in fossil fuels and plastics which the big oil companies are making is only destructive to a green economy, not constructive. As far as exports are concerned, the dollar has already been weakened as much as it could possibly be by zero interest rates, so increased exports, although desirable, are not likely to happen any time soon.

Private enterprise knows only one thing in terms of the economy "reopening": get back to consumer spending. It ain't going to happen. People are still afraid of the virus. The pandemic is not over. They will use their money to pay off debts instead of going in debt to the hilt like they are used to. People will save their money instead of entertaining themselves to death. Why? Maybe they have learned their lesson that a high employment economy predicated on the fact that people will always have a job and always have a prepensity to consume is just a chimera. Rather than living paycheck to paycheck, I hope people will understand that there may come a rainy day, and they need to save for that. That lesson has really been brought home by the coronavirus pandemic.

The true heroes are essential workers not the military. The military itself was brought to its knees by COBID-19. There is a lesson there. It's more important to spend our collective money on preparing for the coming pandemic of global warming than on a bloated military. It is more important to house the homeless and guarantee the economic rights of shelter and health care to all Americans as in the 1948 UN Declaration of Human Rights. It is more important to help people all over the world escape from extreme poverty because poverty breeds health crises which then can spread all over the world. It's more important to make peace with our rivals rather than try to control them with military threats and sanctions.

May the next President (and I hope to heaven that it's not Donald Trump) see the light of a more rational, compassionate and humane world, one more concerned about the health and welfare of all the world's peoples. I hope Governor Cuomo's values of being tough, smart, disciplined and most importantly loving spread to every corner of US and world society, and we get on with essential business instead of the inessential business of amusing, entertaining and consuming ourselves to death.

Off the Top of My Head

How the World Could Change When the Current Crisis is Over

by John Lawrence, April 26, 2020

Perhaps we will rethink what is essential and what is inessential. Here's my list of what is essential: 1) Health care; 2) Food; 3) Water; 4) Sanitation (Waste water and trash collection); 5) Education; 6) Transportation; 7) Electricity; 8) The Internet; 9) Grocery stores. 10) Elder care.11) Police, Fire and Paramedic services. Here are some things that are considered inessential now: 1) Spectator sports; 2) Spectator music events; 3) Parades; 4) Conventions; 5) Bars; 6) Restaurants; 7) Barber and beauty parlors; 8) Tattoo parlors; 9) Political campaign events; 10) Large parties like wedding receptions.

Everyone can come up with their own list of what they consider to be essential and what they consider to be inessential. In my opinion the least essential of inessential services are tattoo artists. There are a lot of products and services in our mass consumer culture which are also frivolous and have nothing to do with what is essential or beneficial to human well being.. It seems that the most essential workers are the least paid while the least essential are well paid indeed. Is advertising really essential? You can look up everything you might want or need online using google or amazon. Why do you have to have some irrelevant product or service pounded into you by TV advertising? It's a historical relic. I record most programs so that I can fast forward through the commercials. If I watch a live program, I put it on pause while I do something else for awhile, and then I fast forward through the commercials. In my opinion everything advertised on TV, especially pharmaceuticals, is inessential. They should be prescribed by a doctor. It's the doctor's business to know which pharmaceuticals you need, not yours.

Are hedge funds essential? Is jewelry essential? Are the products of the wedding-industrial complex essential? Many people are having weddings during the pandemic without paying the tens of thousands of dollars that current weddings fashioned by the wedding-industrial complex demand. There are many frivolous consumer items which advertising insists that people need that they don't really need, that are completely inessential. Some are nice to have, but inessential, and some are downright destructive to peoples' health and welfare.

The most essential activity at this time in history is saving the planet from global warming. Production of renewable energy alternatives is absolutely essential. The provision of green infrastructure is absolutely essential. Fossil fuels need to be left in the ground. Getting rid of plastics which pollute the oceans and other waste products that aren't biodegradable is absolutely essential. Rethinking payscales for essential workers like agricultural workers and grocery store workers is essential. If these are the most essential workers, they should be paid more. The same goes for doctors, nurses, certified nursing assistants, the CNAs who do most of the caregiving at nursing homes. CNAs make little more than minimum wage and yet they are exposed to the coronavirus. What this means is that so much that is really essential now is either being ignored or very little money is being allocated to it while huge amounts of money are being allocated to fruitless and frivolous activities.

The most fruitless activity is war and the provoking of war. The trillion dollar annual budget of the military-industrial complex has been shown to be fruitless and meaningless when the real war is against a virus. Unhealthy conditions in poverty stricken areas of the world including refugee camps can breed disease which affects the whole world including "privileged" people in the more advanced nations. Poverty and disease need to be eradicated in all parts of the world. The military cannot do that. Oh, they can be repurposed a little bit to help out with a pandemic, but they can not really do the job that needs to be done. In particular they are vulnerable to the pandemic themselves and all of the weapons of war cannot protect them. The real war needs to be against poverty and disease which are the breeders of war and pandemics. The real war needs to be against global warming. The real essential workers are construction workers who need to be constructing advanced green infrastructure.

What is clear is that real essential workers need to be paid more which argues for a lessening of economic inequality. So much of the wealth is held by people who are absolutely inessential to the health, welfare and betterment of people all around the world. A Green New Deal needs to be prioritized. Wealth needs to be taxed to pay for it. New York state needs to tax Wall Street to make up for its budget deficit. Priorities, priorities. The helping professionals and care workers need to be given more respect and money. Taxing inessential workers like hedge fund managers is what needs to pay for it.

Off the Top of My Head

Bernie, Where Are Ya Now, Buddy?

by John Lawrence, April 21, 2020

Can I take back my vote for Joe Biden? Now that I've lost my job and my employer based health insurance, I don't have a job, and I don't have health insurance. Medicare for All has never sounded so good. This is the situation for so many in this age of pandemic. Fortunately, it doesn't apply to me. I already have Medicare. Fortunately, for the rich, the poor who could profit the most from Medicare for All don't vote in anywhere the same numbers as do the rich. That's why voting by mail is something Republicans don't want. It means more poor people would be voting.

Does anybody care that Medicare for All is a "socialist" program advocated by a "socialist." They only have a similar system in every other developed country and most underdeveloped ones as well. Now that unemployed people have more time off, they will have ample time to think about Medicare for All vs the health care system they have (or don't have) now. Maybe they will come to the conclusion that Medicare for All is really in their best interests despite all the propaganda about it being "socialist." Bernie tried to tell us that health care was a human right not just a right for employed people. It would seem like a better deal now that "we are all in it together" except that we're not really despite all the sugary sentiment. If we were all in it together, people would be as concerned about their unemployed neighbor's health care as they are about their own especially if a sick neighbor is likely to spread the sickness to you which certainly is the case with a very contagious coronavirus.

Bernie's website says:

Today, more than 30 million Americans still don’t have health insurance and even more are underinsured. Even for those with insurance, costs are so high that medical bills are the number one cause of bankruptcy in the United States. Incredibly, we spend significantly more of our national GDP on this inadequate health care system—far more per person than any other major country. And despite doing so, Americans have worse health outcomes and a higher infant mortality rate than countries that spend much less on health care. Our people deserve better.

30 million? More like 130 million with a pandemic taking out its vengeance on the American people and in fact the world's people. In an op-ed in the New York Times, Bernie said the coronavirus outbreak has exposed the “absurdity and cruelty of our employer-based, private health insurance system” as “tens of millions of Americans” lose their jobs, incomes and healthcare as a result of the pandemic.Our neighbor to the north takes care of every Canadian citizen. All they have to do is present their health care card to any doctor's office or hospital and they are taken care of, no questions asked and never getting a bill. Some people have questioned the 'waiting times'. They haven't been to an emergency room in the US lately even with health insurance. First you have to wait a couple hours in the waiting room before you're even taken back to a stall in the emergency room. Then, if you need to be admitted to the hospital, you have to wait in the stall for several hours until a room is available. All this time, as much as a day if you're lucky, you're not given anything to eat or drink.

Rich people are afraid that if Medicare for All becomes the law of the land, they will just get the same level of service as the hoi polloi. They needn't worry. Even with Medicare for All they could pay a lot more and get a gold plated policy. This is the arrangement they have in the Netherlands. The rich can always pay more and get treated better, but with Medicare for All everyone is guaranteed adequate medical services at about half the price they are paying now with co-pays, premiums, deductibles and every other way the health care system in America has invented to fleece you. No wonder so many Americans go bankrupt. The health care system is the leading cause of bankruptcy in America.

The American diet consists of junk food, heavily advertised on TV, but guaranteed to give you diabetes and obesity if consumed over a lifetime. All those juicy hamburgers, fries and pizza and a lack of enticing pictures of fruits and vegetables means that you will need insulin and cholesterol medicine at some point. You will end up taking a bunch of pills every day for underlying heart disease and a ton of other diet caused maladies. Then you will pay through the nose to pharmaceutical corporations for the privilege of consuming them. Medicare for All would eliminate the travesty that pharmaceutical companies are perpetrating on the American people.

Wendell Potter was formerly in charge of public relations with Humana until his conscience got the better of him.. His job was to make sure that Americans would not be favorably persuaded by Medicare for All. He wrote: "The industry knows from years of focus group message testing that terms like “socialized medicine” and “government-run health care” scare many Americans and that many of us respond favorably to terms like “choice” and “competition.” Based on this knowledge, there were several big lies I helped craft — and that are still in circulation today."

Today those Democratic candidates that wanted a Medicare for All Who Want It option have been shown to be dead wrong. They said “If you like your employer-based plan, you can keep it." Well today many of those that liked their employer-based plan are not liking it so much especially those who are unemployed and without a plan.

Exposing 'Folly of Tying Health Coverage to Jobs,' New Study Estimates 7.3 Million More Uninsured in US by June

Published on

Tuesday, April 07, 2020

by

Common Dreams

Employer-based health insurance during the current coronavirus outbreak, said one researcher behind the study, "is like an umbrella that melts in the rain."

 

by

Jon Queally, staff writer

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Medical workers take in patients at a special coronavirus intake area at Maimonides Medical Center on April 07, 2020 in the Borough Park neighborhood of the Brooklyn borough of New York City. Hospitals in New York City, which has been especially hard hit by the coronavirus, are facing shortages of beds, ventilators and protective equipment for medical staff. (Photo: Spencer Platt/Getty Images)

A new study out Tuesday estimates that worker layoffs unleashed by the coronavirus pandemic in the United States have already caused more than 1.5 million people to lose their employer-provided health insurance in recent weeks, with another 5.7 million likely to become uninsured by the end of June.With a total of 7.3million newly uninsured Americans by this summer, the new research—titled "Intersecting U.S. Epidemics: COVID-19 and Lack of Health Insurance"—reveals the devastating consequences of a health system so heavily reliant on employer-based insurance, especially in the face of an unprecedented public health emergency like the current outbreak.

"Millions of Americans are newly vulnerable to financial catastrophe, as we face an epidemic of life-threatening illness," said study co-author Dr. Steffie Woolhandler, a primary care doctor, distinguished professor at Hunter College and lecturer at Harvard Medical School. "The COVID-19 epidemic highlights the folly of tying health coverage to jobs. Our health care system saddles people with medical bills when they're least able to afford them because they've been laid off or are too sick to work. Health insurance in the U.S. is like an umbrella that melts in the rain."

"The COVID-19 epidemic highlights the folly of tying health coverage to jobs. Our health care system saddles people with medical bills when they're least able to afford them because they've been laid off or are too sick to work."
—Dr. Steffie WoolhandleThe study was published in The Annals of Internal Medicine,the official journal of the American College of Physicians, the largest U.S. medical specialty society in the U.S. with 159,000 members. Woolhandler and her co-author Dr. David Himmelstein, an internist and distinguished professor at CUNY's Hunter College and lecturer at Harvard Medical School, looked at state-by-state unemployment data to determine estimates about the number of people now out of work who relied on their employer for insurance. According to their report:

We estimated the likely effects of current job losses on the number of uninsured persons by using data from the U.S. Census Bureau's March 2019 Current Population Survey on health insurance coverage rates among persons who lost or left a job. The uninsurance rate among unemployed persons who had lost or left a job was 26.3% versus 10.7% among those with jobs. Applying the 15.6–percentage point difference to the 9.955 million who filed new unemployment claims last week, we estimate that 1.553 million newly unemployed persons will lose health coverage. This figure excludes family members who will become uninsured because a breadwinner lost coverage and self-employed persons who may lose coverage because their businesses were shuttered, but are ineligible for unemployment benefits. If, as the Federal Reserve economist projects, an additional 47.05 million people become unemployed, 7.3 million workers (along with several million family members) are likely to join the ranks of the U.S. uninsured population.

Himmelstein and Woolhandler further argue that their new research "exposes the imprudence of tying health insurance to employment, and the need for more thoroughgoing reform. "

"In this emergency, Congress should make all of the uninsured automatically eligible for Medicare."
—Dr. David Himmelstein

"A trickle of families facing the dual disaster of job loss and health insurance loss can remain under Washington's radar," they continued. "However, the current tsunami of job and coverage losses along with a heightened risk for severe illness demands action."

Dr. Himmelstein said states are too overwhelmed by the catastrophe now unfolding to adequately address the current situation—especially as things get worse, not better in the coming weeks and months—and called for the federal goverment and Congress to step in.

"The states can't do it because tax revenues are plunging, and they're required to balance their budgets," Himmelstein warned. "Congress and the President have provided free testing for coronavirus, but no new coverage for those who need treatment. In this emergency, Congress should make all of the uninsured automatically eligible for Medicare."

New @AnnalsofIM study from PNHP co-founders Drs. @swoolhandler and David Himmelstein estimates 7.3M Americans will lose health coverage by June 30, because of the #COVID19 pandemic. https://t.co/FwGG4ef8NA pic.twitter.com/tTuJjiIwuK

— Physicians for a National Health Program (@PNHP) April 7, 2020

The call for lawmakers to immediately open Medicare enrollment has been issued by other progressive voices as well. As Common Dreams reported earlier Tuesday, Public Citizen and others have said opening the program to the recently unemployed is the easiest and quickest way to provide coverage to those who need it.

"With millions of people losing their jobs because of a pandemic, it's both crazy and immoral for them to be stripped of health insurance," said Robert Weissman, president of Public Citizen. "If we had a Medicare for All system, this kind of problem wouldn't occur. But we can't wait to win Medicare for All. The solution to this immediate problem is to enroll all unemployed people in Medicare."

While expanding Medicare for the out-of-work and uninsured would be a short-term way to stem the pain for millions, advocates for Medicare for All—including Himmelstein and Woolhandler—say that the coronavirus may finally be the catastrophe that wakes the nation up to the need for a permanent solution to its healthcare woes and the unsustainable and inhumane design of the current for-profit system.

"A decade ago," the two researchers concluded in their report, "Victor Fuchs forecasted that 'National health insurance will probably come to the United States after a major change in the political climate—the kind of change that often accompanies a war, a depression, or large-scale civil unrest.' Such a major change may be upon us."

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Off the Top of My Head

In the Age of Pandemic Has War Become a Luxury?

by John Lawrence, April 12, 2020

Saudi Arabia and Yemen have declared a cease fire. Sailors are becoming infected on aircraft carriers. War planning requires groupings of military people. So has war become a luxury we can no longer afford? Are we really "all in this together"? Does the pandemic require cooperation among all nations since the pandemic doesn't respect national borders? Will the pandemic, when it's over, have changed the way human beings conduct their affairs in the world or will we get back to business as usual. If the pandemic engenders cooperation instead of rivalry among the nations of the world, does this mean that we will all be socialists or communists? Does it even matter?

If the pandemic makes us realize that war is a useless exercise with few benefits, will the US military-industrial complex be defunded. Will the money then go to health care workers, to Peace Corps and AmeriCorps workers who will attempt to bring clean water and modern sanitary systems to developing countries? Will there be a push to create more sanitary conditions in the world so that pandemics don't get started? Plagues and pandemics before have motivated people to build modern sanitary systems in places like London and New York in the 19th century where urban populations in close proximity created the conditions of cholera and bubonic plague. Is homelessness a social situation we can no longer afford?

Will the meaning of 'essential services' become normalized in the economy post corinavirus? What then will be considered essential and what could we live without? As long as there is no vaccine for coronavirus, new cases will continue to crop up even after the economy has "reopened." The flu epidemic of 1918 lasted 10 months and had several spikes. We can expect more spikes in the current pandemic until there are widespread vaccinations available. So what is essential? Sports events? Cruises? Rock concerts? Movie theaters? Now with Netflix and Amazon prime we can watch movies at home. Any movie we want to see. I'm catching up on all the great movies I've missed over the years. Last night I watched "To Catch a Thief" with Cary Grant and Grace Kelly. Free on Amazon Prime. The fidelity  both video and audio was excellent on my smart TV. I have no need to go to a movie theater where I can't control the volume. Hint: they are too loud.

Perhaps now we can grasp the concept that cooperation among peoples and nations is more important than manufactured rivalries over some nation's form of government. Perhaps now we can grasp the concept that diplomacy is more important, getting along is more important and winning isn't everything. Maybe now public health and human rights can be seen as more important than having everyone pull themselves up only by their own bootstraps. Maybe we can get on with the business of cooperating to combat the real enemy - climate change and even future pandemics. Maybe we will bring the US infrastructure into the modern world with a Green New Deal. Maybe we can finally grow up and have a consensus about what is really important, what really matters. Maybe doctors, nurses, caregivers, and social workers will come to be seen as more important that Wall Street brokers, the Peace Corps and AmeriCorps as more important than the War Corps. As Governor Cuomo says, "Love will conquer all." Happy Easter.

Sanders and Jayapal Put Forth Bill to Provide No-Cost 'Health Care for All During Pandemic'

Published on Friday, April 10, 2020

by Common Dreams

"We have got to work together to make sure that anyone in America who is sick—regardless of their income or immigration status—can seek the medical treatment they need during this national emergency."

by Jake Johnson, staff writer

 

37 Comments

Medical workers take in patients at a special coronavirus intake area at Maimonides Medical Center on April 6, 2020 in New York City. (Photo: Spencer Platt/Getty Images)

As the number of Americans without health insurance continues to rise rapidly due to ongoing mass layoffs across the nation, Sen. Bernie Sanders and Rep. Pramila Jayapal on Friday introduced emergency legislation that would empower Medicare to cover all healthcare costs for the uninsured and all out-of-pocket expenses for those with insurance for the duration of the coronavirus crisis.

"Our broken healthcare system is failing to protect millions of Americans from the coronavirus pandemic," Jayapal, a Washington Democrat and co-chair of the Congressional Progressive Caucus, said in a statement. "Now more than ever, we need to take bold action to prevent more Americans from getting sick or dying."

"With an estimated 35 million Americans in danger of losing their employer-provided health insurance over the coming weeks and months, this legislation is needed now more than ever."
—Sen. Bernie Sanders

If passed, the Health Care Emergency Guarantee Act (pdf) would take effect immediately and remain in place until the Secretary of Health and Human Services certifies to Congress that a Food and Drug Administration-approved coronavirus vaccine is widely available to the U.S. public.

The legislation to "provide health for all during the pandemic," according to a summary (pdf) released by Sanders' office, would "fully cover the cost of medically necessary healthcare, including prescription drugs," for the tens of millions of Americans currently without health insurance.

An analysis by Health Management Associates earlier this month warned that the total number of uninsured Americans could rise to 40 million within the next several months if U.S. job losses continue at the current rate.

For Americans with either public or private insurance, "Medicare will cover the copays, deductibles, and other cost-sharing for all medically necessary healthcare, including for prescription drugs," the summary of the bill states.

"When individuals go to the hospital or doctor, they will provide their insurance information as usual," the summary explains. "The provider will use this information to bill Medicare—either for the out-of-pocket costs if the individual has another type of insurance, or for all of the care if the individual is uninsured. The patient will not be charged anything."

"An interesting play. Give people a taste of Medicare for All during this emergency while continuing to advocate for the real thing."
—Anand Giridharadas, TIME

Additionally, the legislation would ban surprise billing and prevent private insurance companies from limiting coverage or hiking co-pays and deductibles until a COVID-19 vaccine is available.

"During this unprecedented crisis, no one in America should delay seeking medical care because of the cost," Sanders said in a statement. "If this pandemic has taught us anything, it is that we are only as safe as the least-insured among us."

"We have got to work together to make sure that anyone in America who is sick—regardless of their income or immigration status—can seek the medical treatment they need during this national emergency," Sanders added. "With an estimated 35 million Americans in danger of losing their employer-provided health insurance over the coming weeks and months, this legislation is needed now more than ever."

Sanders and Jayapal are two of the leading advocates of Medicare for All in Congress, and the Health Care Emergency Guarantee Act represents a short-term solution as they work to build support for a national single-payer plan.

"An interesting play," TIME editor-at-large Anand Giridharadas tweeted in response to the new bill. "Give people a taste of Medicare for All during this emergency while continuing to advocate for the real thing."

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Off the Top of My Head

What About the 150 Million Workers Who Love Their Employer Provided Health Care?

by John Lawrence, April 5, 2020

This is what you heard Pete Buttagieg and Amy Klubuchar say in response to Bernie's Medicare for All proposal. Well, what are they saying now that a lot of those 150 million have lost their jobs AND their health care? You get employer provided health care as long as you're employed. Once you're not, forget it. All of a sudden Medicare for All looks a lot better. The coronavirus pandemic and resulting economic collapse could cause a staggering 35 million people in the US to lose their employer-sponsored health insurance over the next several months, with lower-income Americans bearing the brunt of the damage. Now is the time to get behind Bernie Sanders' Medicare for All initiative. Is it really about more "choice" vs a Medicare for All system. How many of those with employer based health care really love their health insurance now that they can lose it any day when their employer decides to lay them off. And besides they are still paying a ridiculous amount for premiums, co-pays, deductibles and out of network expenses despite the fact that their employer is paying part of the premiums.

With one system that is not employer based everyone is covered pandemic or no pandemic. "Good-quality health care should not be tied to your job," tweeted Sen. Bernie Sanders. "At a minimum, the government must ensure health care for all, without cost, for the duration of this crisis." The pandemic has really brought out the flaws in the employer based system. Joe Biden still doesn't like Medicare for All. “What we should be doing is having the Affordable Care Act, add the public option for those who want it, meaning Medicare if that’s what they want rather than keep their own health insurance policies,” he said. Probably most would opt for the public option now especially those who have lost their employer based health care. However, a new poll shows that support for Medicare for All is surging. The survey, conducted by Morning Consult and Politico from March 27 to 29, showed that 55 percent of voters back the Vermont senator's proposal for a single-payer universal health care system. That's the highest level seen by Morning Consult since June 2019, and nearly equal to the record high of 56 percent support reported back in January 2019. "Our health care system should be about protecting lives, not making huge profits for corporations," Sanders tweeted.

Trump is still trying to get rid of Obamacare. Some experts have said that the best solution for those that have lost their health insurance is to open back up the enrollment period for Obamacare, but Trump will not have any of that. Instead he says that those who require hospital treatment because of COVID-19 will not have to pay. He has restarted a lawsuit against Obamacare arguing in court that it is unconstitutional. “The one lasting effect of the repeal and replace debate is that the ACA is actually more popular than ever. That will make it harder to talk about repealing and replacing it,” said Larry Levitt, senior vice president for health reform at the Kaiser Family Foundation. “The repeal and replace debate in 2017 did the one thing that seemed impossible: which was to make the ACA popular.”

Medicare for Each of Us in the Age of the Coronavirus

Published on

Friday, April 03, 2020

by

Common Dreams

The U.S. public—and increasingly the business community—are becoming acutely aware of the rising costs and inadequacies of our current for-profit system, particularly as the current epidemic unfolds. There is no other choice but Medicare for All.

 

by 

Peter S. Arno, Philip Caper

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 4 Comments

"The corporatization of medical care," writes the authors, "may be the single most distinguishing characteristic of the modern US health care system and the one that has had the most profound impact on it since the early 1980s." (Photo: Fatemeh Bahrami/Anadolu Agency via Getty Images)

Over the past two weeks, the explosive growth of the coronavirus pandemic has forced nearly 10 million Americans to file for unemployment benefits. Along with their jobs, many have lost their health insurance, if they had any to begin with. Aside from possibly spelling disaster for these newly unemployed workers and their families, this situation puts both the public health and economic wellbeing of our country at great risk. A clearer rationale for universal, affordable, lifetime health coverage as exemplified under a Medicare For All framework would be hard to find.

In this article we outline the need for a universal health plan, its historical context, and the obstacles raised by the medical-industrial complex that must be overcome.

There is a large elephant in the room in the national discussion of Medicare for All: the transformation of the US health care system’s core mission from the prevention, diagnosis, and treatment of illness—and the promotion of healing—to an approach dominated by large, publicly traded corporate entities dedicated to growing profitability and share price, that is, the business of medicine.

The problem is not that these corporate entities are doing something they shouldn’t. They are simply doing too much of what they were created to do—generate wealth for their owners. Unlike any other wealthy country, we let them do it. The dilemma of the US health care system is due not to a failure of capitalism or corporatism per se, but a failure to implement a public policy that adequately constrains their excesses. 

"How is it that we spend more on health care than any other nation, yet have arrived at such a sorry state of affairs?"

Since the late 1970s, US public policy regarding health care has trended toward an increasing dependence on for-pofit corporations and their accompanying reliance on the tools of the marketplace—such as competition, consolidation, marketing, and consumer choice—to expand access and assure quality in the provision of medical care.

This commercialized, commodified, and corporatized model is driving the US public’s demand for fundamental reform and has elevated the issue of health care to the top of the political agenda in the current presidential election campaign.

Costs have risen relentlessly, and the quality of and access to care for many Americans has deteriorated. The cultural changes accompanying these trends have affected every segment of the US health care system, including those that remain nominally not-for-profit. Excessive focus on health care as a business has had a destructive effect on both patients and caregivers, leading to increasing difficulties for many patients in accessing care and to anger, frustration, and burnout for many caregivers, especially those attempting to provide critical primary care.

As a result, the ranks of primary care providers have eroded, and that erosion continues. One of the major reasons for burnout in this group is the clash between its members’ professional ethics (put the patient first and “first do no harm”) and the profit-oriented demands of their corporate employers. Applying Band-Aids can’t cure the underlying causes of disease in medicine or public policy. Ignoring the underlying pathology in public policy, as in clinical medicine, is destined to fail.

Many of the symptoms of our dysfunctional health care system are not in dispute:

• We pay more than twice as much per person on total health care spending and on prescription drugs in comparison to other developed countries. This spending totals nearly 18 percent of our economy
• Between 2008 and 2018, premiums for employer-sponsored insurance plans increased 55 percent, twice as fast as workers’ earnings (26 percent). Over the same time period, the average health insurance deductible for covered workers increased by 212 percent
• An average employer-sponsored family health insurance policy now exceeds $28,000 per year, with employers paying about $16,000 and employees paying about $12,000
• Almost half (45 percent) of US adults ages 19 to 64, or more than 88 million people, were inadequately insured over the past year (either they were uninsured, had a gap in coverage, or were underinsured; that is, they had insurance all year but their out-of-pocket costs were so high that they frequently did not receive the care they needed).
• Compared to other developed countries, the US ranks near the bottom on a variety of health indicators including infant mortality, life expectancy, and preventable mortality.

We must therefore ask: How is it that we spend more on health care than any other nation, yet have arrived at such a sorry state of affairs?  

"The theology of the market and the strongly held—but mistaken—belief that the problems of US health care can be solved if only the market could be perfected have effectively obstructed the development of a rational, efficient, and humane national health care policy."The answer is that only in the United States has corporatism engulfed so much of medical care and come so close to dominating the doctor-patient relationship. Publicly traded, profit-driven entities—under constant pressure from Wall Street—control the financing and delivery of medical care in the US to an extent seen nowhere else in the world. For instance, seven investor-owned publicly traded health insurers now control almost a trillion dollars ($913 billion) of total national health care spending and cover half the US population. In 2019, their revenue increased by 31 percent, while their profits grew by 66 percent.

The corporatization of medical care may be the single most distinguishing characteristic of the modern US health care system and the one that has had the most profound impact on it since the early 1980s. The theology of the market and the strongly held—but mistaken—belief that the problems of US health care can be solved if only the market could be perfected have effectively obstructed the development of a rational, efficient, and humane national health care policy. 

There are three main reasons to pursue a public policy that embraces genuine health care reform:

1. Saving lives: To simplify our complex and confusing health care system while providing universal affordable health care coverage;
2. Affordability: To rein in the relentless rise in health care costs that are cannibalizing private and public budgets; and
3. Improving quality: To eliminate profitability and share price as the dominant and all-consuming mission of the entities that provide health care services and products when that mission influences clinical decision making. Profitability should be the servant of any health care system’s mission, not its master as seems to be increasingly the case in the US.

What Is The Best Approach To Reform? 

It is not an exaggeration to say that no reform other than publicly financed, single-payer universal health care will solve the problems of our health care system. This is true whether we are talking about a public option, a Medicare option, Medicare buy-in, Medicare extra, or any other half-measure. The main reason is because of the savings that are inherent only in a truly universal single-payer plan. Specifically, the administrative and bureaucratic savings gained by eliminating private insurers are the largest potential source of savings in a universal single-payer framework, yet all the “option” reforms listed above leave largely intact the tangle of wasteful, inefficient, and costly private commercial health insurers. The second largest source of savings comes through reducing the cost of prescription drugs by using the negotiating leverage of the federal government to bring down prices, as is done in most other developed countries. The ability, will, and policy tools (such as global budgeting) to restrain these and other costs in a single-payer framework are the key to reining in the relentless rise in health care expenditures and providing universal coverage. 

"The real struggle for a universal single-payer system in the US is not technical or economic but almost entirely political."The various “option” reform proposals will not simplify our confusing health care system nor will they lead to universal coverage. None have adequate means to restrain health care costs. So why go down this road? Is it too difficult for the US to guarantee everyone access to affordable care when every other developed country in the world has done so?

The stated reason put forth in favor of these mixed option approaches is that Americans want “choice.” But choice of what? We know with certainty from former insurance company executives such as Wendell Potter that the false “choice” meme polls well with the US public and was used to undermine the Clinton reform efforts more than 25 years ago. It is being widely used today to manipulate public opinion. 

But choice in our current system is largely an illusion. In 2019, 67.8 million workers across the country separated from their job at some point during the year—either through layoffs, terminations, or switching jobs. This labor turnover data leaves little doubt that people with employer-sponsored insurance are losing their insurance constantly, as are their spouses and children. And even for those who stay at the same job, insurance coverage often changes. In 2019, more than half of all firms offering health benefits reported shopping for a new health plan and, among those, nearly 20 percent actually changed insurance carriers. Trading off choice of doctors or hospitals for choice of insurance companies is a bad bargain.

The other major objection to a universal single-payer program is cost. Yet, public financing for health care is not a matter of raising new money for health care but of reducing total health care outlays and distributing payments more equitably and efficiently. Nearly every credible study concludes that a single-payer universal framework, with all its increased benefits, would be less costly than the status quo, more effective in restraining future cost increases, and more popular with the public—as 50 years of experience with Medicare has demonstrated. 

The status quo generates hundreds of billions of dollars in surplus and profits to private stakeholders, who need only spend a small portion (millions of dollars) to influence legislators, manipulate public opinion, distort the facts, and obfuscate the issues with multiple competing reform efforts. 

Conclusion

The real struggle for a universal single-payer system in the US is not technical or economic but almost entirely political. Retaining the status quo (for example, the Affordable Care Act) is the least disruptive course for the existing medical-industrial complex, and therefore the politically easiest route. Unfortunately, the status quo is disruptive to the lives of most Americans and the least effective route in attacking the underlying pathology of the US health care system—corporatism run amok. Following that route will do little more than kick the can down the road, which will require repeatedly revisiting the deficiencies in our health care system outlined above until we get it right. 

The US public and increasingly the business community are becoming acutely aware of the rising costs and inadequacies of our current system, particularly as the current epidemic unfolds. It is the growing social movement, which rejects the false and misleading narratives, that will lead us to a universal single-payer system—truly the most effective way to reform our health care system for the benefit of the American people.

Peter S. Arno, PhD. is an economist and senior fellow and director of health policy research at the Political Economy Research Institute at the University of Massachusetts–Amherst and a senior fellow at the National Academy of Social Insurance.

Philip Caper  is a physician and founding member of the National Academy of Social Insurance and currently serves on the Board of Maine AllCare.

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Off the Top of My Head

#President Cuomo

by John Lawrence, April 3, 2020

Governor Andrew Cuomo of New York is one of the competent, masterful people on the scene of mitigation of the coronavirus in contrast to the bumbling incompetence of President Trump. Trump has demonstrated over and over again that he doesn't know what he's doing. He has to be reigned in by people like Dr. Anthony Fauci. He is given to ridiculous pronouncements and prognostications. Why is his approval rating going up? Cuomo on the other hand is on top of the situation, compassionate, thorough and totally dedicated. Trump is a dillettante compared to him, a know nothing. New Yorkers are lucky to have such a knowledgable, proficient and intelligent person for their Governor.

Meanwhile, the Democratic race between Joe Biden and Bernie Sanders has almost been forgotten. They should be getting more media attention than they are getting. As usual Trump is getting all the media attention whether it be good or bad. The truth is that Trump and other Republicans have messed the Federal government up almost beyond recognition. Their mission has been to "drown the government in a bathtub" as Grover Norquist so famously said. Especially everything except the military and the military-industrial complex. So every humanitarian aspect of government from health to welfare has been systematically reduced. In fact they would like to eliminate entirely the Department of Health and Human Services.

Now they're recommending that we wear masks when we go to the grocery store. Where do you get them? Amazon can deliver them somewhere between May 21 and June 21. A lot of help that will do. New York City is running out of ventilators. People will die who might have lived. Of course the poor have been affected more than the rich. This is always the way it is in any crisis. That's why Trump is not overly concerned. When the rich start dying in larger numbers, then Trump will be more concerned especially if his family or donors are affected. It's always the vulnerable who bear the brunt.

Republicans have been successful in cultivating the loyalty of the southern tribe even though a good percentage of southerners are not well served by Republican policies. But gerrymandering and winner take all politics effectively negates any power that minorities might have in this country. White southerners are happy with this situation because they don't want minorities to have any power that would take power away from them. So naturally they are Trump supporters. He is the Great White Hope.

The alternative is to have a government that supports human beings at all economic, ethnic and racial levels. A government that supports people instead of policies which drive economic inequality and creates a few exorbitantly rich people while leaving everyone else in a precarious economic state. If there was ever a time to make a case for Medicare for All, it's now. So why isn't Bernie Sanders all over the TV making that case. It's not his fault, surely. The media is making a ton of money off this crisis. They haven't diminished the number of commercials they're running. In fact they have even more commercials because they know more eyeballs are on the news channels like CNN. So they're making a ton of money off this crisis.

Off the Top of My Head

It's Not Just Zantac: American Pharmaceutical Corporations are Importing Tainted Drug Ingredients from China

by John Lawrence

Tainted blood pressure medications have been traced back to Chinese manufacturers Zhejiang Huahai Pharmaceutical Co. Ltd. and Zhejiang Tianyu Pharmaceutical Co. Ltd. along with Hetero Labs Limited in India. Those companies then sold ingredients to generic drugmakers. I wrote 3 days ago: " FDA inspectors are unable or unwilling to provide appropriate oversight of Chinese manufacturing. In contrast to the robust testing required for approval for new prescription drugs, the FDA only requires that generic manufacturers prove that patients will absorb drugs at the same rate as the brand-name medications they copy." China and India Now Manufacture About 80% of the Drugs Consumed in the U.S. Funny all the articles on the banning of Zantac don't mention the fact that most US pharmaceuticals are manufactured outside the US where US inspection authorities can't get to them.

Even Fox News was worried. They reported:

"I have no doubt that they would consider weaponizing their dominance of the pharmaceuticals market if they felt that that would give them an advantage over us strategically," retired Brig. Gen. John Adams told Fox News. Adams is also president of Guardian Six, a defense research consulting firm.

In a worst-case scenario, experts warn, China could withhold supply of medicines like important antibiotics, or degrade the quality of our medicines -- even put lethal contaminants in them. Even when it comes to treating anthrax, China is the largest exporter of the building block to make ciprofloxacin, an anthrax antidote.

The more probable threat from China, however, is that it could make America's prescription drugs more expensive.

"In five to 10 years, when China has a complete chokehold over the United States and its supply of medicine, it's gonna be telling us how much to pay for our medicine," Gibson told Fox News. "We will lose control over how much we pay. We will be the price taker, not the price setter. And that's devastating."

We've already lost control over how much we pay thanks to the rapacity of the profit seeking American pharmaceutical corporations. Of course what the Fox News article misses is that its not China that is making huge profits. It's the American pharmaceutical companies which take advantage of cheap Chinese labor, then jack up the price on the imported drugs in order to make huge profits. That's why they don't make them here. Their profits wouldn't be as large if they did, and evidently, the American government doesn't really care about the situation or they would ban the import of drugs from other countries so they would have to make them here.

That's why we need Medicare for All and strict government oversight of pharmaceutical corporations.

'Abolish For-Profit Health Insurance': Analysis Warns Companies Could Hike Premiums by 40% Amid Pandemic

Published on Monday, March 30, 2020

by Common Dreams

"Corporate-run health insurance isn't about saving lives. It's about making as much money as possible. With Medicare for All we can finally put an end to this international disgrace," said Sen. Bernie Sanders.

by Jake Johnson, staff writer

 

26 Comments

Staff and volunteers with Project C.U.R.E hold a drive outside the United Center to collect donations of Personal Protective Equipment (PPE) from the community which will be used to supply hospitals and clinics that are experiencing shortages due to the COVID-19 pandemic on March 29, 2020 in Chicago, Illinois. (Photo: Scott Olson/Getty Images)

A new analysis warning that U.S. health insurance companies could hike already exorbitant premiums by 40 percent or more next year amid the coronavirus pandemic was received by Medicare for All advocates as further confirmation that America's healthcare system—driven first and foremost by the profit motive—is ill-equipped to provide necessary care for all, particularly in a time of nationwide crisis.

The research conducted by Covered California, the state insurance marketplace created under the Affordable Care Act, found (pdf) that "if carriers must recoup 2020 costs, price for the same level of costs next year, and protect their solvency, 2021 premium increases to individuals and employers from COVID-19 alone could range from 4 percent to more than 40 percent."

"They're doing healthcare to make money, not to take care of people."
—Dr. Judd Hollander, Thomas Jefferson University

The health and economic impacts of the coronavirus outbreak are "potentially staggering," the analysis states, and could result in even more "consumers and employers no longer being able to afford coverage, leading to employer groups dropping coverage or individuals deciding to go uninsured."

More than 80 million people in the U.S. are currently uninsured or underinsured, according to the Kaiser Family Foundation, and millions more are losing their employer-provided insurance as the jobless rate spikes due to the coronavirus crisis.

"The impact of COVID-19 will be significant, and... absent federal action, consumers, employers, and our entire healthcare system may be facing unforeseen costs that could exceed $251 billion," Peter V. Lee, executive director of Covered California said in a statement. "Consumers will feel these costs through higher out-of-pocket expenses and premiums, as well as the potential of employers dropping coverage or shifting more costs to employees."

"These increased costs could mean that many of the 170 million Americans in the commercial market may lose their coverage and go without needed care as we battle a global health crisis," Lee added. "These are not 'insurer' costs—these are costs directly borne by individual Americans."

Abolish for-profit health insurance. https://t.co/c95gYxyc1T

— Public Citizen (@Public_Citizen) March 29, 2020

Sen. Bernie Sanders (I-Vt.), whose Medicare for All proposal would virtually eliminate private insurance in the U.S., tweeted in response to the Covered California study that "America's for-profit insurance industry is not compatible with healthcare as a human right."

"Now is not the time for greed," said Sanders, a 2020 Democratic presidential candidate. "Now is the time for Medicare for All."

Corporate-run health insurance isn't about saving lives. It's about making as much money as possible. With Medicare for All we can finally put an end to this international disgrace. https://t.co/sZrb6FcUPz

— Bernie Sanders (@BernieSanders) March 29, 2020

The new research comes as the coronavirus crisis continues to expose systemic flaws in America's fragmented and dysfunctional healthcare system. The Guardian reported last Thursday that as the virus has spread rapidly across the U.S., "private health insurance companies have lagged behind: making incremental changes to plans even as health providers seek to change course."

"They're doing healthcare to make money, not to take care of people," Dr. Judd Hollander, emergency medicine physician and associate dean at Thomas Jefferson University in Philadelphia, told The Guardian.

Last week, a 17-year-old boy in Los Angeles County died from complications believed to have been caused by COVID-19 after he was denied treatment at an urgent care center. The reason: he was uninsured.

"He didn't have insurance, so they did not treat him," said R. Rex Parris, the mayor of Lancaster, California.

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Off the Top of My Head

During WW II, Cars and Gas Were Rationed. Would the American People Accept Such Sacrifices in the War on Global Warming?

by John Lawrence, March 10, 2020

Evidently not. Despite warnings that we have less than 10 years to do something before there is runaway global warming, nothing much has been done. Yet the coronavirus has set the world's consciousness on fire in just a few short weeks. Why hasn't global warming gotten the world so up in arms? During WW II everybody had a job; everybody worked, yet there were government mandated limits on consumption. All kinds of things were rationed especially cars and gas. Yet economic activity expanded due to ramping up the war effort. Today the economy is going into a tailspin because large crowds have been proscribed. All the money that has been added to GDP by music events and professional athletics has gone bye-bye. This is not necessarily a bad thing because people might be better off staying home and reading a good book rather than being out at a sporting event. I know. I know this is a very unpopular opinion.

The point is that, during WW II people had the basic necessities, and everyone was employed. They just couldn't have the icing on the cake until after the war when rationing was lifted. Then the economy boomed. Perhaps there is a lesson here for how to mobilize a society to get a handle on global warming.  In the few short weeks that government spokesmen have decried cruise ship and airplane travel, green house gas emissions (GHGs) have actually decreased. If the government proscribed these and other activities such as automobile travel (think gas rationing), GHGs would decrease even more rapidly. Then, if the government went on an investment spree in terms of renewable energy the way it did on planes and battleships during WWII, there would be full employment. People would just be limited temporarily until this war is won in how they could actually spend their money just like in WWII.

Then after a totally green economy is achieved fueled by green renewable energy, the barriers on spending money would be lifted. Could this even work? Some authors don't think so. William Greider writes in "Secrets of the Temple":

World War II was a model of the possible. In theory, if a national consensus of purpose developed, if people would accept temporary limits on their economic choices as well as regulatory controls on wages and prices, the nation could literally rebuild itself, almost overnight. With the right choices, America could practically double the productive capacity of its economy and advance innovation and dramatically multiply new wealth and incomes. These economic choices, however, were really political questions: who would take the sacrifices and who would take the rewards? Whose consumption would be restrained and whose production would be encouraged. All this consigned extraordinary powers to government, perhaps tolerable only in war. No one, including the most ardent Keynesian planners, has ever figured out how to recreate a comparable combination of creative sacrifices in peacetime or how to sell it to a free society.

And that, dear reader is the crux of the matter. How do you sell the necessary war time effort to combat global warming to a free society? Sure the coronavirus has had the salutary effect of decreasing cruise ship and airplane travel with the concomitant decrease in GHG emissions. At the same time the stock market has gone into a tailspin. If the same kind of effort were made in behalf of global warming, we could expect the stock market to go into the mother of all tailspins. Is it worth it or should we consign future generations to the fate of runaway global warming and an uninhabitable planet?

Abraham Maslow wrote a book, "Towards a Psychology of Being" in which he identified a pyramid of needs starting with D-needs. D-needs are the basic needs of food, air, water, housing and clothing. You might throw in medical care.Then, as you ascend the pyramid, higher order needs are revealed once the lower order needs are met. At the top he identified B-needs or self-actualization which might mean developing all your latent higher order capacities such as becoming a great musician. What seems to me to have happened though is that society has intervened in this process to impose superfluous needs on people. Let's call them S-needs. These needs have to do with all the materialistic consumption that a commercial society imposes or tries to impose on people through advertising so that Maslow's higher order needs are really short-circuited. That's why I say that staying home and reading a good book might be more beneficial in and of itself than attending  a professional sporting event in addition to protecting one from the coronavirus.

What an enlightened society would do to combat global warming is exactly what America did during WW II. D-needs were well satisfied due to a full employment society in which certain kinds of consumption were discouraged while making sure that everyone was fed, clothed, housed and had adequate medical treatment. Could in Greider's words a " national consensus of purpose develop" in which people felt it was more important to delay certain kinds of consumption in order to develop the green infrastructure needed to get global warming under control? The world needs America's leadership on this because America is largely responsible for the GHGs already in the atmosphere, and, if America will not have a sense of urgency, why should any other nation which is just starting to develop a consumer culture?

'Give Us an Hour on MSNBC': Sanders Says He Would Love to Debate Medicare for All vs. For-Profit System With Joe Biden

Published on Thursday, March 05, 2020

by Common Dreams

"We're spending twice as much per capita on healthcare as the people of any other country and yet 27 million are uninsured, 30,000 people die, half a million people go bankrupt every year because of medical-related debt, and we spend far and away the highest prices in the world for prescription drugs. You want to defend that system?" Sanders said. "Let's do it."

by Jon Queally, staff writer

 

104 Comments

Sen. Bernie Sanders (I-Vt.) gestures as former Vice President Joe Biden listens during the Democratic presidential primary debate at Loyola Marymount University on December 19, 2019 in Los Angeles, California. (Photo: Justin Sullivan/Getty Images)

Sen. Bernie Sanders on Wednesday night said he would "love to debate Joe Biden on this issue"—the difference between a Medicare for All plan that dozens of studies show would cover all people for less overall cost and the for-profit status quo that leaves an estimated 28 million Americans uninsured and tens of millions more underinsured, vulnerable to bankruptcies, or lacking care due to financial reasons.

"It's time to say it: Medicare for All is now the mainstream, popular, nationwide consensus position for the Democratic Party in 2020. Voters are sick and tired of awful deductibles, surprise bills, stifling networks, and begging strangers for help with medical bills on GoFundMe." —Wendell Potter, Medicare for All Now

"Medicare for All is wildly popular with working class and lower income people who understand that we have a dysfunctional health care system," Sanders said in an interview with MSNBC's Rachel Maddow.

"We are spending twice as much—and by the way—I would love to debate Joe Biden on this issue, give us an hour on MSNBC," Sanders said, "where we can talk about how anyone can defend this system in which we're spending twice as much per capita on healthcare as the people of any other country and yet 27 million are uninsured, 30,000 people die, half a million people go bankrupt every year because of medical-related debt, and we spend far and away the highest prices in the world for prescription drugs. You want to defend that system? Let's do it."

Watch:

"Medicare for All is wildly popular with working class and lower income people who understand that we have a dysfunctional health care system...I would love to debate Joe Biden on this issue, give us an hour on MSNBC... You want to defend that system? Let's do it." #Maddow pic.twitter.com/uvju5mdKDB

— People for Bernie (@People4Bernie) March 5, 2020

While Sanders won the biggest-delegate state of California on Super Tuesday—along with victories in Colorado, Utah, and Vermont—Biden swept the other ten states leaving him with a slight lead in the national count for Democratic delegates in the party's primary. Strikingly, in every single one of the primary races held so far that had entrance or exit polls on the question, Medicare for All has shown to be more popular with Democratic primary voters compared to those defending the for-profit system.

Wendell Potter, a former health insurance executive turned whistleblower who now runs the group Medicare for All Now, said the primary polling should be considered a "watershed moment" in public opinion:

A watershed moment in America: 16 states have voted in the Dem primary & been asked in exit/entrance polls about healthcare, and all 16 show majority support for replacing private health insurance with single-payer healthcare. As a former insurance exec my reaction is: wow. (1/5) https://t.co/alqPboYgJl

— Wendell Potter (@wendellpotter) March 4, 2020

"It's time to say it," Potter continued, "Medicare for All is now the mainstream, popular, nationwide consensus position for the Democratic Party in 2020. Voters are sick and tired of awful deductibles, surprise bills, stifling networks, and begging strangers for help with medical bills on GoFundMe."

"To my great shame," he added, "I spent years helping the private insurance industry trick the American people into thinking the for-profit healthcare system benefits them, when the very opposite is true. I've never been more glad to see my own legacy erased. It's a new era in America."

As study after study after study after study has shown, Medicare for All would cost the American people less money overall while providing comprehensive, free at point of service coverage to all—even as Biden continues to fearmonger over the pricetag.

Sanders has made Medicare for All a cornerstone of his 2020 campaign while Biden has attacked the progressive solution to the nation's healthcare woes by using GOP and insurance industry talking points and misleading mathematics to denounce it.

As Biden has repeatedly attacked the ten-year estimated cost of Medicare for All by saying it would cost $35 trillion, what he repeatedly leaves out is that, as Los Angeles Times columnist David Lazarus points out this week, citing figures from the Centers for Medicare and Medicaid Services, total spending under the status quo for-profit system "over the subsequent 10 years likely will reach a staggering $60 trillion — at least." As Lazarus writes:

That's the cost of doing nothing. It's what opponents of healthcare reform are saying is our best option.

And that, of course, is insane.

"We've gotten ourselves into a big hole by letting expenditures get out of hand," said Vivian Ho, a healthcare economist at Rice University. "It's happening right before our eyes, and we're not doing anything about it."

On Thursday morning, a new study by researcher Josh Bivens at the Economic Policy Institute found that a Medicare for All system "would bolster the labor market, strengthen economic security for millions of U.S. households, and would likely boost the number of jobs in the U.S. labor market."

Medicare for All, according to the study, would:

• Provide a potential boost to wages and salaries by allowing employers to redirect healthcare spending to workers' wages.
• Increase job quality by ensuring that every job would come bundled with a guarantee of health care.
• Lessen the income loss, stress, and economic shock of unemployment and job transitions by eliminating the loss of health care that accompanies job-loss
• Support self-employment and small business development—which is low in the United States relative to other rich Organisation for Economic Co-operation and Development (OECD) countries—by eliminating the daunting cost of health care from startup costs.
• Inject new dynamism into the overall economy by reducing "job lock," by allowing workers to go where their skills and preferences lie, not just to workplaces with affordable health plans.

"A fundamental health reform like Medicare for All would be an unambiguously good policy for the labor market, for the economy overall, and for U.S. workers," Bivens said in a statement. "Besides the obvious benefits of expanding health care to millions of uninsured and underinsured Americans, Medicare for All could raise wages, boost productivity, and help small business owners."

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Off the Top of My Head

The Changes Needed in the Composition of GDP

by John Lawrence

The four components of GDP are personal consumption, business investment, government spending, and net exports. Right now personal consumption is 70% of GDP in the US. Business investment is 18%. Most businesses are buying back their stock rather than investing in manufacturing or R&D. Government spending is 17%. More than 60% is military spending. Net exports were -5% since imports (18%) were greater than exports (13%). This represents an oil based economy heavy on fossil fuel pollution. What needs to happen to fend off global warming is a reduction in personal consumption especially in those aspects that are high in greenhouse gas (GHG) emissions such as automobile, airplane and cruise ship travel. Government needs to increase its spending in areas of infrastructure rebuilding and spending on renewable energy systems while reducing military spending which is highly GHG contributing as well.

Businesses need to be encouraged to manufacture here in the US instead of importing everything from China and elsewhere because cargo ships are highly polluting. Businesses which help solve the climate change dilemma need to be encouraged while high polluters need to be reined in. We need to become more like Europe where personal consumption is only 54% of GDP. In Europe government spending is 46.5% of GDP. Of this spending on defense amounted to 1.2 % of GDP in 2018. Contrast this with the 60% that the US spends on defense, and you see the difference between a highly militarized nation that has no money to spend on infrastructure much less a Green New Deal and a group of countries that spends more of its money on the welfare of its citizens. Trump has been agitating to get European countries to spend 2% on defense. This would still mean that the US would be spending 30 times as much.

If Bernie Sanders wins the election for President of the US, we can expect radical changes in the current composition of GDP. Certain items of personal consumption need to be reduced, namely combustion engine car travel. The infrastructure for electric automobiles needs to be built out. Government subsidies need to be given to electric car purchasers. Mass transit needs to be built out and encouraged. Military expenditures need to be reduced both to promote peace in the world and so that the money can be freed up for more constructive purposes. Coal fired electric power generating plants need to be replaced with renewable energy electric power generating plants. Frivolous personal consumption needs to be discouraged while consumption based on human needs for all people should be encouraged especially affordable housing, nutritious non-industrialized food production which is affordable for all and universal health care like Europe has.

In short we need to become more like Europe with a reduced military empire and an increased build out of green infrastructure based on renewable energy. Bernie Sanders represents this kind of change for America - a government which invests in its people and takes radical steps to mitigate global warming.

Off the Top of My Head

Bernie Socks It To Them

by John Lawrence, February 25, 2020

The critics have piled on Bernie about how he's going to pay for his proposals for Medicare for All, a Green New Deal, forgiving student loan debt and free college tuition. Now Bernie has come out with a detailed plan about how to do it. The obvious answer is how do other countries do it? Most other advanced countries have free universal health care and free college tuition. They take it for granted. I had some passengers from Calgary, Alberta whom I asked 'how do you like the Canadian health care system?'. He replied, "It's free." I said, "Yeah, but don't you have to pay for it in your taxes?" He said, "I guess so." So he wasn't really concerned that he was paying taxes through the nose to pay for "free" health care. He didn't even know what percentage of his taxes went to health care. I suspect that once the tax structure changes here so that rich people pay more and poor people pay less that everything will be like that too.

It will cost $2.2 trillion to make public colleges, universities and trade schools tuition-free and to cancel all student debt over the next decade. It is fully paid for by a modest tax on Wall Street speculation that will raise an estimated $2.4 trillion over ten years. A Financial Transaction Tax has been talked about for years. Bernie is the only one bold enough to actually make it part of his campaign platform. It needs to be done. The financialization of the economy is what led to the 2008 economic debacle in which the banks were bailed out by the American people to the tune of trillions of dollars. So now even though it's years later, let them pay to bail out the American people. It's a good thing.

Bernie’s bill to expand Social Security will increase benefits for low-income senior citizens and people with disabilities by more than $1,300 a year. It is fully paid for by making the wealthiest 1.8 percent of Americans – those with incomes over $250,000 a year – pay the same rate into Social Security as working families. I like that a lot. Right now even though I'm still working and paying into social security, I'm receiving less than $700. a month in social security. Another $1300. a month would bring my social security up to $2000. a month. Why it's even enough to rent an apartment!

Bernie’s proposal to guarantee housing as a human right and to eliminate homelessness will cost $2.5 trillion over the next decade. It is fully paid for by a wealth tax on the top one-tenth of one percent – those who have a net worth of at least $32 million. (Bernie’s wealth tax will raise a total of $4.35 trillion.) A wealth tax on the rich! I love it. Eliminating homelessness and finally implementing the 1948 UN Declaration of Human Rights - priceless! It's time the millionaires and billionaires paid to eliminate poverty in this country. The wealth tax will also pay for universal child care and pre-school. By the way maybe the Congress should get on board and finally ratify the 1948 Declaration.

The Green New Deal will transform this country and be the first step in saving the planet from ultimate destruction. It needs to be extended to the rest of the world eventually as well. We need to cooperate with other countries to implement it and share renewable energy technology. This means joining China's Belt and Road initiative in terms of making sure everything under development is based on renewable energy and is non-polluting. It goes without saying that the US should rejoin the Paris Accords on climate change, but extend it even further.

All in all Bernie's plans are a wonderful and refreshing change of pace for the US of A and the rest of the world. If they come to pass, i will be proud of my country again for implementing both humanitarian policies and policies which will save the earth from a global warming catastrophe.

Off the Top of My Head

“These billionaires, the top 1%, they’re probably crapping their pants.”

by John Lawrence, February 23, 2020

Thanks to the internet and Google, I couldn't locate who is responsible for that quote. However, Bernie Sanders' campaign for President of the United States is not only a campaign, but it's also a community organizing event at the same time. He is organizing the community of voters that will turn out for him. In that sense it is a political revolution. It's all about turning out the vote. Whoever turns out the most voters in their behalf will win the election. The establishment, both Democratic and Republican, doesn't want Bernie Sanders to win. In particular the Democratic party is set up in such a way as to rig the nominating process. Bernie will probably not have enough delegates to win on the first ballot.

So the Democratic party has invented this way that they can eliminate any candidate who is not mainstream enough to their tastes. It's called superdelegates. According to Wikipedia:

In American politics, a “superdelegate” is an unpledged delegate to the Democratic National Convention who is seated automatically and chooses for themselves for whom they vote. These Democratic Party superdelegates (who make up slightly under 15% of all convention delegates) include elected officials, party activists and officials.

Democratic superdelegates are free to support any candidate for the presidential nomination. This contrasts with pledged delegates who are selected based on the party primaries and caucuses in each U.S. state, in which voters choose among candidates for the party's presidential nomination. On August 25, 2018, the Democratic National Committee agreed to reduce the influence of superdelegates by generally preventing them from voting on the first ballot at the Democratic National Convention, allowing their votes only in a contested nomination.

Bernie may not have the 1991 pledged delegates to win on the first ballot although he will probably have the most pledged delegates by then. That means that Democratic National Committee (DNC) party officials who constitute the 764 superdelegates will be eligible to vote on the second ballot. Also the pledged delegates are unpledged on the second ballot. This whole process adds to the confusion of who will win the Democratic nomination as there are two wings of the Democratic party - the progressive wing led by Bernie Sanders and Elizabeth Warren and the moderate wing comprisng Joe Biden, Amy Klobuchar, Pete Buttigieg and now Mike Bloomberg. Will these wings combine pledged votes so they can stand behind the nomination of one candidate? Or can they according to DNC rules?

What no one wants (except perhaps Republicans) is a slugfest at the Democratic National Convention. A brokered convention is one where party elites will probably dictate whom the nominee will be. These are the superdelegates who can vote on the second ballot. It seems clear they don't want Bernie Sanders. But if Bernie goes into the convention with a substantial plurality, a substantial lead over the other contestants, will the Democratic party elite have the nerve to take the nomination away from him? And will then the whole progressive wing of the Democratic party stay home on election day, or, worse yet, turn out and vote for Trump?

It seems clear that the voters want change in America. That's why they voted for Trump who was a disrupter on the right of the political spectrum. Bernie is also a disrupter, but on the Left. It seems clear to me that the people don't want the same ol same ol as represented by the Democratic party's moderates like Joe Biden. They want radical change. There must be radical change just on the issue of climate change alone or else planet earth is destined to be a not very habitable home for human beings and other animals. Cockroaches will probably survive, and maybe someday they will evolve into more intelligent beings. That will be the outcome if Trump is reelected.

Off the Top of My Head

He had to Destroy Social Security in Order to Save It

by John Lawrence, February 19, 2020

Just as in Vietnam when a commander said, "It became necessary to destroy the town in order to save it", Trump and conservative Republican budget hawks are saying the same thing about social security and Medicare. "The president promised that unlike other Republicans, he wouldn't touch Social Security, Medicaid and Medicare. He's already broken that promise and gone after Medicare. Now it looks like Social Security is in the president's crosshairs as well," Schumer said at the outset of a press conference to discuss the Senate impeachment trial. Trump casually made his remarks at a World Economic Forum in Davos, Switzerland, a gathering of the world's financial elite.

Republicans wouldn't consider cutting the bloated military budget in order to reduce the deficit. Their whole thing is to go after social programs. They can't stand the fact that some old poor person might not have to end up on the street because a government program saved her. The last President to actually balance the budget was Democrat Bill Clinton. Republicans have only driven it skyward with their tax cuts for the rich (and to be fair pennies for the poor) and huge increases in military appropriations. "Even as this important trial continues, Americans should hear that the president is casually talking about cutting their Social Security at a Swiss ski resort with the global financial elite," Schumer added.

There is supposed to be a reserve of funds in the Social Security Trust Fund. In practice the government uses these reserves to fund other programs like the military. At the end of 2014, the Trust Fund contained (or alternatively, was owed) $2.79 trillion, up $25 billion from 2013. This is called intergovernmental debt, in other words money the government owes itself. This debt can be eliminated at any time by  a vote of Congress. In fact that is exactly what Republicans seek to do. Then they can use all government funds for the military. In their minds it's more important to fund the military than it is to keep old people off the streets.

Old people are finding that, despite the fact they are still working and paying into social security, their monthly social security checks from the government are actually going down. How can this happen, you ask? In 2018 I wrote this:

"In 2016 I received a monthly social security benefit of $735.90. My Medicare monthly premium was $104.90. So the amount that the Social Security Administration deposited in my checking account each month was $631. Now despite the fact that I'm still working and paid $430. self employment tax in 2017, which should have given me an increase in my monthly social security check because the amount you get depends on the total amount paid in and I'm still paying in, the amount deposited in my account each month has gone down to $618. How could this be possible, you might ask? The answer is simple. I was given a paltry $1 a month increase in social security based on the fact that I paid $430 into it so the government made $418 off me in self employment tax for 2017. However, my monthly Medicare premium went up to $134. So my Medicare premiums are going up much more than the paltry amounts the government thinks I should get because I'm still working and paying in to social security. In short I'm getting ripped off as an elderly person who still works."

Those vaunted COLAs are not even keeping up with the cost of living. Certainly not with the cost of renting an apartment. Bernie's plan is the following: "Our plan: make health care a right to all. Stop giving tax breaks to billionaires. Protect and expand Social Security, Medicare and Medicaid. Transition to sustainable energy and leave behind a livable planet for our children." Let's get behind it. He's right, you know. Stop the military onslaught which is all about the protection of oil. Keep fossil fuels in the ground. Fund green infrastructure with the Green New Deal. Is that socialism. Who cares? It's all about saving the planet for future generations.

Off the Top of My Head

Bernie Sanders Best Candidate to Defeat Trump

by John Lawrence, February 16, 2020

There is a tug of war going on between Bernie and the so-called moderates. What the pundits don't understand is that the swing voters in the coming election don't just want somebody that can beat Trump. They want something different. That's why they voted for Trump in the first place. If the Democrats offer up a moderate, unexciting candidate, Trump will be reelected. Trump was a wild card; that's why people voted for him. They are still in the same mood. They want something different - not a party line Democrat.

Sure Trump has a base; the Democrats have a base, but this next election will be about who has the best ideas, not just turning out the base. Ideas are exciting especially when there are as many things that need to be dealt with as this country has. Certain issues have reached crisis proportions, namely, global warming, infrastructure, unending wars and health care. What young and swing voters don't want is a moderate of either party, and they will embrace a radical of either party. Those who voted for Trump in 2016 will turn around and vote for Bernie in 2020. By now Trump has pretty much worn out his welcome among a lot of people.

David Lazarus of the LA Times says that Bernie has done a lousy job of selling Medicare for All. He says $32 trillion for Medicare for All is a bargain.

[Democrats are] adept at highlighting the myriad problems with our healthcare system — the high costs, the millions uninsured, the financial devastation of getting sick.

But when it comes to solutions, most of the Democratic presidential candidates offer vague policy proposals and sidestep pointed questions about how much healthcare reform would cost.

This is simply foolish. On both counts — policy and price — the Dems have a winning political issue. ...

Gerald Kominski, a professor of health policy and management at UCLA, tells me the problem with communicating these ideas is that the scope of the problem is so large, and the underlying components so complex, many people can’t get their heads around such difficult policy matters.

“This easily slips into Nerd Land,” he said.

But once you clear away all the policy brush, Kominski observed, there’s a fairly simple message to be conveyed about Medicare for all or any other single-payer system.

“Most families would be better off,” he said.

There it is.

Yes, this is all very complicated. And, yes, there would be nothing easy about transforming the U.S. healthcare system into one more in line with our economic peers.

But let’s emphasize Kominski’s point: Most families would be better off.

That’s the case Democrats should be making, again and again, to the American people.

So what's so complicated about that? That's what a great communicator has to do. Make the case in the simplest terms. Bernie has made the case that there would be no premiums, no deductibles and no co-pays. He just needs to emphasize that the cost per person would be half of what it is now in line with costs per person in other advanced countries, and that there would be a sliding scale tax wise so that the rich would pay proportionately more while the middle class would pay proportionately less and the poor would pay nothing at all.

So rather than letting other candidates attack by mentioning an astronomical cost for Bernie's plan, he has to come back at them with the facts that for most people the cost would be less. He and Elizabeth Warren have to double down on the wealth tax and making corporations and the wealthy pay their fair share of taxes instead of getting tax subsidies.

Republicans will go nuts over Bernie being a "socialist", but most young people don't care about that label any more. They care about tangible things like free college tuition and the forgiveness of student loan debt which affects even people in their 60s.

Young people also don't want to inherit a dying planet. Better to siphon off the wealth of those who won't be around to see it and, therefore, don't care if the planet dies after they're gone. They will be like the rats leaving the sinking ship leaving the young to go down with it. But the young who will suffer sure do care about the planetary crisis that will be handed to them by their elders, and they will vote accordingly.

Medicare for All 'Is What Patients Need': New Harvard Study Shows Even Those With Private Insurance Can't Afford Care

Published on Monday, January 27, 2020

by Common Dreams

"When so many people can't get the care they need even when they have insurance coverage, it says that insurance is not doing what it is supposed to do: ensure that healthcare is affordable when you need it."

by Jake Johnson, staff writer

 

6 Comments

Vicki Ibarra opens a late medical bill for her son at her home on Saturday, February 2, 2019 in Fresno, California. (Photo: Jabin Botsford/The Washington Post via Getty Images)

The for-profit U.S. healthcare system is so broken that a growing number of people who are fortunate enough to have private insurance coverage are still unable to afford doctor visits and other essential services due to soaring costs—leaving a larger number of Americans with unmet medical needs today than there were two decades ago.

That's a central finding of a new study by Harvard University researchers published Monday in the peer-reviewed journal JAMA Internal Medicine, examining 20 years of government data between 1998 and 2017.

The study found that despite a major expansion of insurance coverage in the U.S. during that period—most significantly through the 2010 Affordable Care Act (ACA)—"most measures of unmet need for physician services have shown no improvement, and financial access to physician services has decreased." The study's authors noted that the rise of "narrow networks, high-deductible plans, and higher co-pays" has contributed to the growth of unmet medical needs in the U.S. since the 1990s.

"Our findings call into question the value of private health insurance today."
—Dr. Laura Hawks, Harvard

Dr. Laura Hawks, a Harvard research fellow and lead author of the study, said the research poses fundamental questions about the viability of the private health insurance system at a time when presidential candidates, members of Congress, physicians, nurses, and much of the U.S. public support a transition to a single-payer system like Medicare for All.

"Our findings call into question the value of private health insurance today," Hawks, a primary care physician, said in a statement. "When so many people can't get the care they need even when they have insurance coverage, it says that insurance is not doing what it is supposed to do: ensure that healthcare is affordable when you need it."

The study found that, overall, the share of adults aged 18-64 who were unable to afford to see a doctor rose by nearly a third—from 11% to nearly 16%—between 1998 and 2017. Among adults with health insurance, there was a 60 percent increase—7% to nearly 12%—in inability to afford a doctor visit.

"Inability to see a physician because of cost also became more frequent among most clinical risk groups, especially those with coverage," the study found. "In 2017, the proportion of persons with cardiovascular disease who were unable to afford a physician visit was 25.6%, 5.9 percentage points... higher than in 1998."

"A single-payer reform like Medicare for All that eliminates financial barriers to care is what patients need."
—Dr. David Himmelstein, City University of New York's Hunter College

Compared to other wealthy nations, the U.S. healthcare system has left significantly more of its population unable to meet medical needs due to prohibitive costs, according to the analysis.

"The current level of unmet health needs in the U.S. that we found far exceed those of similar countries," the study's authors wrote. "In Canada, only 1% of adults 45 years old or older with a chronic disease reported a cost-related unmet health need—compared with 18.7% of adults with a chronic medical condition in our U.S. sample."

Dr. Steffie Woolhandler, a study co-author and co-founder of Physicians for a National Health Program (PNHP), said in a statement that the findings demonstrate the dire need for a healthcare system that is both "universal—covering everyone—and comprehensive—paying in full for all medically necessary care."

Another study co-author and PNHP co-founder, Dr. David Himmelstein, said a single-payer system like Medicare for All would meet those standards by providing comprehensive coverage to everyone—including the 30 million people currently without insurance—and eliminating premiums, co-pays, and deductibles.

"Some aspects of healthcare are improving, but death rates are actually rising and we are mostly moving backwards on the health and healthcare of working-age adults," said Himmelstein. "A single-payer reform like Medicare for All that eliminates financial barriers to care is what patients need."

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In Historic Shift, Second Largest Physicians Group in US Has New Prescription: It's Medicare for All

Published on Monday, January 20, 2020

by Common Dreams

"Major changes are needed," declares the 159,000-member American College of Physicians, "to a system that costs too much, leaves too many behind, and delivers too little."

by Jon Queally, staff writer

 

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More than 2,000 physicians announced an open letter to the American public, prescribing single-payer Medicare for All, in a full-page ad in the New York Times that will run in the print edition on Tuesday, January 21, 2020. On Monday, in a separate but related move, the American College of Physicians (ACP), a national organization representing 159,000 internists, officially endorsed single-payer Medicare for All reform. The ACP is the largest medical specialty society and second-largest physician group in the country after the American Medical Association (AMA). (Photo: PNHP)

The fight for Medicare for All received a two-handed boost from tens of thousands of doctors on Monday when the American College of Physicians—in a move described as a "seachange for the medical professions"—officially endorsed a single-payer system as among only one of two possible ways to improve the nation's healthcare woes.

Representing 159,000 doctors of internal medicine nationwide, the ACP is the largest medical specialty society and second-largest physician group in the country overall after the American Medical Association (AMA).

"All over this country, a growing number of doctors are sick and tired of the enormous waste and bureaucracy that exists in our cruel and dysfunctional healthcare system."
—Sen. Bernie Sanders (I-Vt.)

The ACP delivered its case in a 43-page position paper—titled "Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care"—published in the Annals of Internal Medicine on Monday. According to the paper:

Although the United States leads the world in health care spending, it fares far worse than its peers on coverage and most dimensions of value. Cost and coverage are intertwined. Many Americans cannot affford health insurance, and even those with insurance face substantial cost-related barriers to care. Employer-sponsored insurance is less prevalent and more expensive than in the past, and in response, deductibles have grown and benefits have been cut. The long-term solvency of U.S. public insurance programs is a perennial concern. The United States spends far more on healthcare administration than peer countries. Administrative barriers divert time from patient care and frustrate patients, clinicians, and policymakers. Major changes are needed to a system that costs too much, leaves too many behind, and delivers too little.

Sen. Bernie Sanders (I-Vt.), a leading candidate for the 2020 Democratic presidential nomination and the author of the The Medical for All Act of 2019 now in the U.S. Senate, welcomed the development.

"I am delighted that the American College of Physicians has come out in support of a Medicare for All, single-payer healthcare system," Sanders said in a statement emailed to Common Dreams.

"All over this country, a growing number of doctors are sick and tired of the enormous waste and bureaucracy that exists in our cruel and dysfunctional healthcare system," Sanders added. "They are sick and tired of spending time filling out reams of paperwork and arguing with insurance companies. Medicare for All will give doctors the freedom to focus on making their patients healthy, not making health insurance executives wealthy." 

"Major changes are needed to a system that costs too much, leaves too many behind, and delivers too little."
—The American College of Physicians (ACP)

The ACP's detailed review of the current for-profit system—even with some of the improvements resulting from the Affordable Care Act (ACA)—found that "too many Americans are uninsured or underinsured" and that current spending is "high and unsustainable"—especially as other developed nations show their ability to achieve better or similar outcomes for less while offering universal, government-guaranteed coverage to all.

While it did not say that Medicare for All was the only way to achieve a more equitable, accessible, and sustainable healthcare system, the ACP laid out four key recommendations for achieving universal coverage in the United States. They are:

1. The American College of Physicians recommends that the United States transition to a system that achieves universal coverage with essential benefits and lower administrative costs.

2. Coverage should not be dependent on a person's place of residence, employment, health status, or income.

3. Coverage should ensure sufficient access to clinicians, hospitals, and other sources of care.

4. Two options could achieve these objectives: a single-payer financing approach, or a publicly financed coverage option to be offered along with regulated private insurance.

While acknowledging that a transition to Medicare for All could be "highly disruptive" to the healthcare system, the ACP said "single-payer financing approach could achieve [its] vision of a system where everyone will have coverage for and access to the care they need, at a cost they and the country can afford. It also could achieve our vision of a system where spending will have been redirected from health care administration to funding coverage, research, public health, and interventions to address social determinants of health."

Medicare for All, the paper continued, could also "achieve other key policy objectives, including portability, lower administrative costs and complexity, lower premiums and cost sharing, lower overall health care system costs, better access to care, and better health outcomes, depending on how it is designed and implemented."

"As physicians, we see daily the harm that our fragmented, private-insurance based system does to our patients." —Dr. Adam Gaffney, PNHP

While the ACP in its backing of a single-payer approach also co-endorsed the more incremental step of creating a federally-administered "public option" as a pathway to universal coverage, Drs. Steffie Woolhandler and David Himmelstein, co-founders of Physician for a National Health Program (PNHP), argue the latter would be an inferior avenue if the aim is to cover everyone while reducing overall costs.

According to an op-ed by Woolhandler and Himmelstein, also published in the Annals alongside the ACP's new position paper, "Achieving universal coverage would be costlier under the "public choice" model the ACP co-endorses along with single payer."

Unlike a public-private mix of coverage that the public option would represent, the pair write, a single-payer Medicare for All  would allow hospitals and doctors to "save billions on billing-related costs" each year, and those savings could be re-purposed "to expand care" to millions for less cost than the status quo.

In a separate but related move to the ACP's announcement, more than two thousand physicians on Monday announced an open letter to the American public, prescribing single-payer Medicare for All, in a full-page ad in The New York Times that will run in the print edition on Tuesday, January 21, 2020.

Among the doctors "prescribing" Medicare for All as the only serious solution to the nation's healthcare crisis, said PNHP—which helped organize the effort—"are towering figures in American medicine" and include Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine; Dr. Bernard Lown, developer of the defibrillator; Dr. Paul Farmer, infectious disease expert and founder of Partners in Health; and Dr. Mary Bassett, former New York City Health Commissioner.

The full text of the open letter follows:

We are doctors from across the spectrum of our profession. We serve patients rich and poor, in hospitals and clinics, private offices and public agencies.

We witness daily the inhumanity and irrationality of the current health care system. America funds health care more generously than any other nation, and our hospitals and medical workforce are second to none. Yet despite an abundance of medical resources, care is too often meager.

For the thirty million who remain uninsured and millions more whose insurance is inadequate to their needs, life-saving treatment is often out of reach, deepening health disparities. Oppressive costs and the fear of financial ruin amplify the suffering of illness. Meanwhile, doctors and nurses struggle to provide good care in a bad system. We waste countless hours complying with arcane billing requirements and, along with our patients, imploring insurers to fulfill their promises of coverage.

It is time to transform the way we pay for care — to embrace improved Medicare for All.

Medicare for All would curb soaring drug prices and dismantle the wasteful bureaucracy of private insurance companies, freeing up hundreds of billions of dollars to expand and improve care — while ensuring free choice of doctor and hospital.

Vested interests who profit from the current broken system raise false alarms of dislocation and disruption to incite fear of change. They are wrong. Improved Medicare for All would bring welcome relief to patients, lower costs for families and communities, and allow doctors and nurses to focus on what matters most: caring for our patients.

"As physicians, we see daily the harm that our fragmented, private-insurance based system does to our patients," noted Dr. Adam Gaffney, president of PNHP and a pulmonary and critical care physician at Harvard Medical School and the Cambridge Health Alliance. "Patients go without the care they need, and physicians squander time and resources on wasteful billing and clerical tasks. Medicare for All would be a much better way — for patients and doctors both." 

As physicians, the signatories of the letter said, the answer is obvious: "we prescribe Medicare for All."

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Off the Top of My Head

Trump Will Run on the Economy

by John Lawrence, January 20, 2020

What's not to like about the economy? Lowest unemployment in 19 years. The stock market is through the roof. Low income workers have made the biggest gains in wages. According to the Wall Street Journal: "The lowest-paid Americans saw weekly earnings grow more than 5% in the second quarter from a year earlier, more than the national median gain of 1.7% for all workers, according to a quarterly survey of households produced by the Labor Department. Workers with less than a high-school diploma saw their wages grow almost 6%, and younger workers’ pay grew almost 3%." So is trickle down really working?

The Fed stands by to give more money to the rich if the economy shows a sign of faltering. The Big Banks are too big to fail. Unlimited prosperity, right? Except all this economic growth is adding to rather than subtracting from global warming.  More people are traveling while jets are spewing more jet fuel effluent into the atmosphere. The automobile industry has a huge investment in fossil fuel cars. Every year more carbon dioxide goes into the atmosphere as oil still predominates in world markets. The American as well as the Chinese consumer economy is providing more middle class goodies each year which are tossed away creating more and more waste. Plastics are piling up in the oceans. More and more weedkillers are used to grow crops whose residues end up in human blood streams. Feed lot animals are fed a diet of antibiotics to make them grow quicker so they can be slaughtered sooner. This creates the situation in which they are not really useful for overcoming human diseases any more. The American way of life, which the whole world aspires to, is polluting the planet and despoiling the atmosphere, but it keeps the economy churning. Entrepreneurs are thinking up even more ways to sell us useless products and vapid entertainment.

The economy is predicated on waste, inefficiency and destructive weapons production including nuclear weapons. More and more money goes into the military-industrial complex to develop more and more expensive planes and battleships which are so complex they don't work half the time. But we are promised a computer fix after they alter a few lines of code. And all those people making a living off the military-industrial complex waste would be out of a job if peace broke out. All those people involved in the labyrinthine insurance industry would be out of a job if Bernie's Medicare for All came to fruition. The economy thrives on inefficiency and waste. If things were done rationally, so many people would be out of a job that the economy would grind to a halt.

Wall Street is not about to change its policy of promoting companies which seek maximum short term profits instead of sustainable growth that benefits all stakeholders including Mother Earth who in the final analysis is the most consequential stakeholder. But Americans and humans in general don't want to tighten their belts in order to save the planet. They would rather have short term profits and growth particularly if it can be tailored to fit into their lifespans. After their death all hell can break loose, but they won't be here to experience it. They had a good life at the expense of future generations. Ta ta, future babies. Trump will win because people care more about their present life than they do about the future generations of life on earth. Besides all those people in the military-industrial complex, which in the larger sense includes anyone who has ever been in the military, will vote for Trump because association with the military, whether pecuniary or not, represents masculine pride, virility and vanity. Ayn Rand would approve.

Off the Top of My Head

The Solution to High Drug Prices

by John Lawrence, January 1, 2020

The U.S. Department of Health and Human Services (HHS) protects the health of all Americans and provides essential human services so why not have them develop, control and sell needed pharmaceuticals to the American public doing away with the private pharmaceutical corporations which have been gouging the American public and raising drug prices by ungodly percentages? What good is Medicare for All if Medicare has to buy drugs from private corporations?

Trump’s original spending proposal for fiscal year 2019, released last month, included major cuts to not just to the National Institute of Health (NIH), but the National Science Foundation as well. It is those two publicly funded entities — not Big Pharma — that support the bulk of the country’s basic research into diseases and pathways to new treatments.

That’s why the cuts were especially unwelcome in the executive suites of drug and biotech companies. Their business models depend on Washington subsidizing expensive, high-risk basic research, mostly through the vast laboratory network funded by the NIH.

Since the National Institute of Health does the research to develop drugs and not the pharmaceutical corporations themselves, why does the American public have to buy drugs from Big Pharma? Why instead can't we buy the drugs directly from HHS or NIH? If we want to cut out the middle man and bring drug prices down, let's have a public option for buying drugs.

But the NIH doesn’t get to use the profits from these drugs to fund more research, the way it might under a model based on developing needed drugs and curing the sick, as opposed to serving Wall Street. Instead, publicly funded labs conduct years of basic research to get to a breakthrough, which is then snatched up, tweaked, and patented (privatized) by companies who turn around and reap billions with 1,000-times-cost mark-ups on drugs developed with taxpayer money.

Those companies then spend the profits on executive bonuses and share buybacks, and lavish mass marketing campaigns to increase sales of amphetamines, benzos, opioids, and dick pills.

So Medicare for All? How about public sale of drugs developed by publicly funded research? Why is the government being used as Big Pharma's research and development branch with all the ridiculous profits going to private corporations?

The LA Times reported:

Since the 1930s, the National Institutes of Health has invested close to $900 billion in the basic and applied research that formed both the pharmaceutical and biotechnology sectors, with private companies only getting seriously into the biotech game in the 1980s.

Big Pharma, while of course contributing to innovation, has increasingly decommitted itself from the high-risk side of research and development, often letting small biotech companies and the NIH do most of the hard work. Indeed, roughly 75% of so-called new molecular entities with priority rating (the most innovative drugs) trace their existence to NIH funding, while companies spend more on “me too” drugs (slight variations of existing ones.)

But if Big Pharma is not committed to research, what is it doing? First, it is well known that Big Pharma spends more on marketing than on R&D. Less well known is how much it also spends on making its shareholders rich. Pharmaceutical companies, which have become increasingly “financialized,” distribute profits to shareholders through dividends and share buybacks designed to boost stock prices and executive pay.

Take Pfizer. Economist William Lazonick has shown that from 2003 to 2012, it spent $59 billion on share buybacks and $63 billion on dividend payouts — for a total payout to shareholders of 146% of net income. All the while, Pfizer benefited immensely from U.S. government spending on life sciences research and drug development.

Why aren't the Democrats talking about this? The profits should accrue to the American people not to Big Pharma which won't even market a drug which isn't profitable. So drugs which cure an illness with one dose will not even be developed or marketed. They want a profitable drug which must be taken every day for life. The US is so devoted to capitalism that it wants the profits from government research to go to private corporations. The American people are being hoodwinked. If the government sold the drugs developed with taxpayer money to the American public at a reasonable price, that would be socialism. Sorry, if you'd rather be taken.

The Left Is Finally Winning the War of Ideas

Published on Wednesday, December 04, 2019

by Truthdig

Simply take a look at the ideas that are dominating the Democratic presidential race, even though the corporate media has tried to ignore these solutions, attack them, dispute them, and then ignore them all over again.

by Lee Camp

 

19 Comments

Our media is owned and operated by the largest, most aggressive corporations in the world leaving little to no room on the air for the anti-war activists offering free hugs and senseless acts of kindness. But that’s why it’s all the more impressive that in so many areas, we are winning the seemingly endless battle for the mindscape of our country. (Photo: Shutterstock)

Good ideas are like viruses. They grow and spread despite our best efforts to stop them. And yes, our bulbous, awkward species does indeed work very hard to catch and kill good ideas.

At the time I write this column, the first Democratic primaries are approaching with the zest and excitement of an unavoidable bowel movement. Even if you read this a year or two or 10 from now, primaries will still be advancing toward you. As sure as the universe expands, the primaries approach. The moment we finish one election season, another is on the horizon.

This serves two purposes. First, it continuously makes voters think that we matter, that we have a lot of sway over the course this country takes. We don’t. (Well, not as much as we think we do.) And the second purpose is to fill the mainstream media airwaves with vacuous political play-by-play for two straight years. For example, by covering the three-point shift in Pete Buttigieg’s likability amongst Iowans (which matters as much as a three-point shift in the average Iowan’s concern about getting trichinosis from undercooked anchovies), the corporate media cogs can avoid talking about the exploitation of American workers or the massive debt crushing most people or the environmental collapse gripping the planet or the highly advanced, highly illegal surveillance state in which we live.

Our electoral politics is a beautiful smokescreen for the ruling elite.

But no matter what happens in these overtly rigged Democratic National Committee primaries, those of us who care about the world and care about our fellow human beings are winning the war of ideas. Simply take a look at the ideas that are dominating the Democratic presidential race, even though the corporate media has tried to ignore these solutions, attack them, dispute them, and then ignore them all over again.

1) Medicare for All

This is the idea that if you’re 5 years old and you break your arm, no matter how little you get paid at your child labor job, you shouldn’t have to fix your broken arm yourself with a papier-mâché cast made from soiled Kleenex and bird poop. Although  Medicare for All was initially put forward by the Green Party and left-wing activists, and now it’s a mainstream discussion. The idea perseveres despite interminable attacks from the moneyed and the well-heeled as they sit neck-deep in mountains of top-shelf health care. (I hear many of them get young blood transfusions just for kicks on the weekend.) The rich continue to espouse one of the worst systems in the developed world, as if it’s somehow justifiable that two-thirds of Americans who declare bankruptcy each year do so partially because of health care costs.

2) The Green New Deal

This is an economic proposal that would give a majority of Americans a job and switch to renewable energy, among other things. Basically it would solve both our fossil fuel death spiral and unemployment problems in one fell swoop. It was put forward initially by the Green Party and left-wing activists, but then it quickly rose to the level of mainstream discussion, resulting in a bill by Congress. This is an impressive feat even though there are criticisms of the Democratic rewriting of the Green New Deal (such as its failure to address the military-industrial complex, which happens to be the largest polluter in the known world, but maybe we’ll find a lost tribe in the Amazon that runs a few hundred thousand warships on diesel and then our Pentagon will drop down to the second biggest polluter).

3) Legalizing Marijuana

If I have to explain what this is to you, then you clearly haven’t turned on a television in the past 50 years nor caught a glimpse of “Teenage Mutant Ninja Turtles” (the show, the movie, the action figure, the comic book, the video game, the candy or the song). The legalization of cannabis in all its nifty forms has rapidly spread across the country—which is not just crucial to people who have gained tremendous medical benefits from cannabis but also crucial for anybody who needs to get viciously baked in order to watch the impeachment hearings (which is the only legitimate way to watch the impeachment hearings).

Marijuana has become so widely accepted that Joe Biden recently became a laughingstock when he called weed a “gateway drug.” Yes grandpa, the evil weed is a gateway drug, and rock music is the devil’s work, and dancing with a girl before marriage can cause one’s phallus to fall off. … Not to mention, who is Joe Biden to tell us not to get a little loopy at the end of a long day? How many prescription meds must it take that guy to simply put on his pants each morning?

4) $15 Minimum Wage

I don’t have to tell you why this matters. The federal minimum wage is $7.25 an hour. You know what you can buy with $7 these days? A Ding-Dong out of the vending machine. So maybe, after a worker has labored for 39 straight hours, he can tether all the Ding-Dong packages together into a rudimentary raft that will allow him to float downriver to somewhere that treats him better. At $7.25 an hour, no one can possibly get by. I did the math: You’d have to work for 3700 years just to afford a ticket to the Mötley Crüe reunion tour. (And they’re not even good. Imagine if you wanted tickets to see someone good.)

5) Distrust of Mainstream Corporate Media

Even if you’re one of these certifiable nut-bags who still turns on CNN or Fox News every day all day, you still understand that you’re not getting the full truth. You might think you’re getting a piece of it, but not all of it. … Also, you should be euthanized.

(Okay, maybe not euthanized, but anyone who leaves cable news on in the background just to feel warm and cozy should at the very least be left on a faraway island to live out their days. If you’re one of them, please stop it. Corporate media crap is not the audio version of your childhood blankey. It’s pathetic PROPAGANDA. … Sorry to yell.)

6) Distrust of U.S.-Backed Coups and War Games

Most Americans are opposed to endless war now. We’re opposed to harming and killing so many millions in the name of propping up our bloated, belligerent empire that eats entire nations and then vomits up new KFC franchise locations. Obviously the growing disgust among most of the country has not managed to stop the bombs from falling, but it’s a start.

I’m sure you don’t have the time to read the entire list of ideas that were once considered far left and are now mainstream vibrant discussions—abolishing ICE, holding police accountable, distrusting the intelligence community AKA the surveillance state, questioning capitalism, ending factory farming, confronting the extreme climate crisis, etc. etc. Sure, our elections are rigged in favor of the two corporate Wall Street-funded parties. And yes, our media is owned and operated by the largest, most aggressive corporations in the world leaving little to no room on the air for the anti-war activists offering free hugs and senseless acts of kindness. But that’s why it’s all the more impressive that in so many areas, we are winning the seemingly endless battle for the mindscape of our country.

Lee Camp is an American stand-up comedian, writer, actor and activist. Camp is the host of the weekly comedy news TV show “Redacted Tonight With Lee Camp” on RT America.

 

Medicare For All: the Real Deal

by Robert Reich

Tuesday, November 19, 2019

Republicans and even some Democrats are out to scare you about Medicare for All. They say it’s going to dismantle health care as we know it and it will cost way too much. 

Rubbish.

The typical American family now spends $6,000 on health insurance premiums each year. Add in the co-payments and deductibles that doctors, hospitals, and drug companies also charge you — plus typical out-of-pocket expenses for pharmaceuticals – and that typical family’s health bill is $6,800.

But that’s not all, because some of the taxes you now pay are for health insurance, too — for Medicare and Medicaid and for the Affordable Care Act. So let’s add them in, again for the typical American household. That comes to a whopping $8,975 a year. Oh, and this number is expected to rise in the coming years.

Not a pretty picture. If you’re a typical American, you’re already paying far more for health insurance than people in any other advanced country. 

And you’re not getting your money’s worth. The United States ranks near the bottom for life span and infant mortality. Or maybe you’re one of the 30 million Americans who don’t have any health insurance coverage at all.

You see, a big reason we pay so much for health insurance is the administrative costs involved in private for-profit insurance. About a third of what you pay goes to the people who oversee billing and collections. And then of course there are the marketing and advertising expenses, and the profits that go to shareholders or private-equity managers.

What happens if we have Medicare for All? 

Let’s first consider a limited version that keeps private insurance — as proposed by candidates including Joe Biden, Pete Buttigieg, and Kamala Harris. The insurance costs remain the same because it’s the same private insurers and the same co-payments and deductibles. The only difference is more of this would be paid through your taxes, rather than by you directly, because the government would reimburse the insurance companies.

This could help bring down costs by giving the government more bargaining leverage to get better prices. But we don’t know yet how much.    

Now, let’s talk about a different version of Medicare for All that replaces private for-profit health insurance, as proposed by Bernie Sanders and Elizabeth Warren. In this version, total costs — including a possible combination of premiums, co-payments, deductibles, or taxes — are even lower. This option is far cheaper because it doesn’t have all those administrative expenses. It’s public insurance that reimburses hospitals, doctors, and pharmaceutical companies directly and eliminates the bloat of private insurance companies.

Economists at the University of Massachusetts-Amherst say Medicare for All that replaces private for-profit insurance would reduce costs by about 10 percent, mostly from lower administrative and drug costs. The Urban Institute estimates that households and businesses would save about $21.9 trillion over ten years, and state and local governments would save $4.1 trillion.

You’d pay for it through a combination of premiums, fees, and taxes, but your overall costs would go way down. So you’d come out ahead.  And everyone would be covered.

You’d keep your same doctor or other health-care provider. And you could still buy private insurance to supplement Medicare for All, just like some people currently buy private insurance to supplement Medicare and Social Security. The only thing that’s changed is you no longer pay the private for-profit corporate insurers.

Any Medicare for All is better than our present system, but this second version is far better because — like Medicare and Social Security — it’s based on the simple and proven idea that we shouldn’t be paying private for-profit corporate insurers boatloads of money to get the insurance we need.

It’s time for true Medicare for All.

Off the Top of My Head

The Speciousness of Medicare for All Who Want It

by John Lawrence, October 25, 2019

At first sight Medicare for All Who Want It (MFAWWI) seems to have advantages over Medicare for All (MFA). But there are a number of ways that the political process could corrupt it just as traditional Medicare was corrupted by Medicare Advantage. The rich and healthy could opt out of government run Medicare and instead join a private insurance plan that catered only to them leaving the poor and sick in Medicare. This is sort of what happened with Medicare Advantage. The money that would be available in a Medicare for All plan would be siphoned off by private insurance plans set up just for the rich and healthy.

In an article for the San Diego Free Press in 2012, I wrote:

But Medicare Advantage has a dark side. With traditional Medicare you can go to any doctor you want, even specialists, without a referral. You can get a second opinion, even a third if you choose. With Medicare Advantage you have to stick to a certain network of doctors, and you can even be refused treatment under some circumstances. Ah, there’s the rub. Medicare Advantage will offer you lures — cheap lures but, when it comes down to those expensive operations, you might be refused the permission to undergo the operation by the insurance corporations. After all, that’s how they make their money – denying service for the expensive stuff while luring you in with the cheap stuff.

In a Medicare for All Who Want It plan, Republicans will be up to the same old tricks they were up to with Medicare Advantage which is really a privatized insurance plan competing with Medicare. And Elizabeth Warren is right. It will seem like a great deal until you come down with a really catastrophic illness and are denied that really expensive treatment. Private insurance may well be offered that is gold plated with really expensive premiums that is really only meant for rich people, but the privatized Medicare Advantage plans for the middle class will continue to be offered which lure people in with free gym memberships and suchlike while denying treatment for really expensive procedures.

That's why I'm coming to the conclusion that Bernie Sanders' or Elizabeth Warren's Medicare for All plans are really superior to the MFAWWI plans touted by Pete Buttigieg, Joe Biden, Amy Klobuchar and others. However, Bernie has laid out a plan in which taxes would increase modestly for most of the middle class and premiums, co-pays and deductibles would be eliminated while Elizabeth Warren has not committed to a funding plan. Both Bernie and Elizabeth have to make it clear why Medicare for All is superior to MFAWWI, and Elizabeth has to come out with a plan for how to pay for it. I think Bernie will raise taxes on the wealthy considerably in order to lessen taxes on the middle class in his funding plan. That's why it's important not to let the wealthy opt out of Medicare for All leaving only the poor and unhealthy in that plan with the rich putting their resources exclusively into private plans.

As time goes on Elizabeth and Bernie have to be clear as to their funding mechanisms. So far Bernie has been more transparent than Elizabeth. And they have to make it clear that their plans don't allow the rich to opt out for a very good reason, and that is that their money is needed to be into the plan so that the middle class and poor are not left with an unsustainably funded plan.

No, Warren and Sanders Are Not the Same

Published on

Friday, October 18, 2019

by Truthdig

Do progressives want the candidate who may be feeling pressured to move to the left or the person whose candidacy is setting the progressive standard?

by Sonali Kolhatkar

 

4 Comments

Sanders has been calling himself a socialist for decades, and he most recently distinguished himself from Warren’s self-proclaimed capitalist label in an interview. (Photo: Brendan Smialowski/AFP/Getty Images)

When Sen. Bernie Sanders, I-Vt., had two heart stents inserted into his arteries in early October, media pundits were quick to foresee the end of his pioneering, movement-based candidacy. Some questioned why it took three days for his family and campaign to confirm the details of his medical condition and others wondered whether age and health would be important factors in his candidacy. Given the documented media bias against Sanders, it is certainly not surprising to see Sanders’ health scare exploited to undermine his candidacy. (Sanders, on the other hand, in his typical fashion, exploited his situation to demand that health care ought to be “a human right.”)

Los Angeles Times opinion writer Rich Benjamin pushed the bias further by saying, “any perception of fatigue and frailty can undercut his effectiveness in competing for the nomination and in the dogfight against Trump if he does beat the rest of the Democratic field.” Benjamin demanded that it was time for “Bernie and his bros”—using a sexist, racist and discredited smear that assumes Sanders’ supporters are mostly pig-headed white men—“to get behind Elizabeth Warren.” In fact, men and women are roughly evenly split among Sanders’ supporters, and people of color are more likely than whites to back him.

Benjamin is echoing a sentiment that has been gaining traction: that Warren is a good enough emulation of Sanders and has adopted enough of his progressive policy proposals for Sanders’ supporters to unreservedly support her. But while a Warren nomination would certainly be a strong sign of progress, particularly in the era of Donald Trump, there are serious distinctions between Sanders and Warren that should not be dismissed.

For example, on health care, although they both back the idea of a “Medicare for All” plan, Warren and Sanders do not take identical positions. Health care is the most important issue for the American electorate. During Tuesday’s Democratic presidential candidate debate, Warren repeatedly avoided admitting that backing a Medicare for All plan would mean that taxes would go up across the board. She sidestepped questions twice, saying, “I will not sign a bill into law that raises their costs, because costs are what people care about.”

But in fact, people care about getting the health care they need more than anything. According to a new poll released on the same day as the debate, “Fifty-six percent of Americans think providing access to affordable health care coverage for all Americans is the responsibility of the federal government, and two-thirds favor the creation of a national, government-administered health insurance plan similar to Medicare that would be available to all Americans.” Vox.com writer Tara Golshan explained that although Warren has endorsed Sanders’ health care plan, “she speaks about Medicare-for-all more in terms of expanding public options for health care, rather than eliminating private insurance altogether.”

Sanders, on the other hand, was far more candid about the cost of his plan during the debate, saying, “I do think it is appropriate to acknowledge that taxes will go up. They’re going to go up significantly for the wealthy. And for virtually everybody, the tax increase they pay will be substantially less — substantially less than what they were paying for premiums and out-of-pocket expenses.” By acknowledging that taxes will go up while premiums, co-payments, deductibles and “all out-of-pocket expenses are gone,” Sanders was far more honest about what his bill to expand Medicare to every American would entail while also demolishing the right-wing argument about high costs. Later in the debate, he went further and slammed the Democratic Party, challenging it to have “the guts to stand up to the health care industry, which made $100 billion in profit.”

There are differences in other policies too. For example, Sanders’ plan to tax the wealthiest Americans goes much further than Warren’s. His tax rate for billionaires is more than twice that of Warren’s, leading one commentator to declare that Sanders’ plan to tax extreme wealth “makes Warren’s wealth tax look moderate.” Sanders has even said he doesn’t think billionaires should exist.

It has become more and more apparent that Sanders is the only Democratic candidate to have a lengthy track record on progressive politics, compared to those who have discovered their progressive backbones more recently, because they know it plays well to the party’s left-leaning base. Seven years ago, Warren did not back Medicare for All, and 23 years ago she was a registered Republican. In fact, she maintains she is an avowed capitalist. Meanwhile, Sanders has been backing the idea of a Medicare plan expanded to all Americans for at least 10 years. He has been calling himself a socialist for decades, and he most recently distinguished himself from Warren’s self-proclaimed capitalist label in an interview.

When Sanders ran for the Democratic presidential nomination in 2016, media outlets ignored him until he began winning primaries, and even then, experts routinely underestimated his pull and popularity. Progressives were thrilled to finally see a bona fide leftist candidate on a national stage echoing the issues that we longed to hear about, analyzed in ways that targeted corporate profiteers.

After the election ended, the movement that was borne from his candidacy flourished and proliferated into multiple organizations determined to challenge establishment politics from inside and outside the electoral system. Among the successes of that movement was the 2018 election of the outspoken and staunchly progressive Rep. Alexandria Ocasio-Cortez of New York.

While recent polls show Sanders’ popularity as a candidate dipping a few percentage points behind Warren, his performance this week during the Democratic debate (including his characteristic dismissal of concern over the state of his health, saying only that he was “healthy” and “feeling great”), may bump his numbers up in the next poll. Perhaps even more important is the announcement that Ocasio-Cortez will be endorsing his candidacy. Both Warren and Sanders had sought the endorsement of the young and very popular progressive Democrat, and now that Sanders has clinched it, it may well boost his standing.

Minnesota Rep. Ilhan Omar and Michigan Rep. Rashida Tlaib, who are considered part of the four-member “squad” of prominent progressive congresswomen of color, have also decided to throw their weight behind the Vermont senator. Sanders and Omar just co-sponsored a bill to feed all schoolchildren three free meals a day regardless of income. Clearly Ocasio-Cortez, Omar and Tlaib see a distinction between Warren and Sanders.

There is one thing Warren has going for her over Sanders: She’s far more charismatic than he is. At a recent LGBTQ event in Los Angeles, Warren won over the crowd when she was asked how she might respond to a supporter who claimed that marriage should be between one man and one woman. She replied, “I’m going to assume it is a guy who said that. And I’m going to say, ‘Well, then just marry one woman. I’m cool with that.'” With the perfect timing of an improv artist, she waited for applause and added, “Assuming you can find one”—which of course resulted in even more applause.

Yes, Warren’s candidacy would be huge step in the right direction for the United States in the Trump era—especially if she were the most progressive front-runner in the race. But she’s not. In fact, she is arguably being pulled to the left by Sanders’ candidacy. CNBC’s Jim Cramer suggested that if Sanders dropped out of the race, “she doesn’t have to be worried about that [far-left] flank anymore.” So, do progressives want the candidate who may be feeling pressured to move to the left or the person whose candidacy is setting the progressive standard?

Sonali Kolhatkar is a columnist for Truthdig. She also is the founder, host and executive producer of "Rising Up With Sonali," a television and radio show that airs on Free Speech TV (Dish Network, DirecTV, Roku) and Pacifica stations KPFK, KPFA, and affiliates. She is the former founder, host and producer of KPFK Pacifica’s popular morning drive-time program “Uprising." She is also the co-director of the Afghan Women's Mission, a U.S.-based non-profit solidarity organization that funds the social, political, and humanitarian projects of RAWA. She is the author, with James Ingalls, of "Bleeding Afghanistan: Washington, Warlords, and the Propaganda of Silence" (2006).

© 2019 TruthDig

Off the Top of My Head

Medicare For All or For All Who Want It

by John Lawrence, October 18, 2019

This was the crux of the last Democratic debate. Elizabeth Warren and Bernie Sanders are proposing Medicare for All period while Pete Buttigieg, Joe Biden, Kamala Harris and others are proposing Medicare for All who want it. Elizabeth Warren's argument is that even those who have private health insurance that they like may find out some day that they won't be covered if they need some very expensive procedure or operation. I believe this is true, but Warren is being too protective. When that happens and those with private health insurance find out they are left to die by their private health insurance companies, others, observing the situation, will flock to Medicare and abandon their private health insurance the first chance they get so that eventually everyone will be on Medicare. I understand that Warren wants to protect people from bankruptcy and/or death but some people think they know everything and are willing to take the chance. Let them.

The New York Times reported:

Medicare for All would move money from one column (private health insurance spending) to another (federal health spending); it does not automatically increase total costs. … We have our doubts about Medicare for All. But unaffordability is not a reason to oppose it.

“In some estimates, the country would not pay more for health care,” a Times analysis of five studies found. Rather, there would be “a drastic shift in who is doing the paying.” For that reason, it is more accurate to think of Mr. Sanders’s plan not as an outlay of (imaginary) money but as a redistribution of it away from insurers, drug companies, health care providers and higher-income people.

But as the article points out, it's not the cost of insurance that is driving health care costs. It's the costs of the actual procedures and pharmaceuticals themselves which are getting prohibitively expensive and is resulting in insurance companies refusing to cover them especially in life or death situations. The ever-do-eloquent Mr. Buttigieg says:

You take something like Medicare, a flavor of that, you make it available on the exchanges, people can buy in. And then if people like us are right, that that will be not only a more inclusive plan, but a more efficient plan than any of the corporate answers out there, then it will be a very natural glide path to the single-payer environment.

Makes sense to me. While people are being abandoned by their private health care insurance when they come down with some really serious disease, others observing that will flock to Medicare. The "glide path" sounds like a good idea to me. It's the American way. Let people suffer the consequences of their own foolish decisions. Others will learn soon enough.When Mom A, who has Medicare, gets a treatment for cancer that is denied to Mom B, who has private insurance, there will be a big hue and cry by the family of Mom B, don't you think? The private insurance companies will be forced to compete with Medicare. Their profits will be reduced, and they will have to radically change their business model. This is all to the good. It may come about that private insurance is forced to replicate Medicare in most aspects. So it may be a good thing to give people a choice even if in the short run people with private insurance may suffer, even die.

Medicare is a proven, cost effective health insurance and delivery model. Let anyone who wants to join it. It will cause little disruption as far as the government is concerned. After all Medicare is already up and running. Perhaps those who insist on continuing with private health insurance will be eligible for the Darwin award. In the spirit of Charles Darwin, the Darwin Awards commemorate individuals who protect our gene pool by making the ultimate sacrifice of their own lives. Darwin Award winners eliminate themselves in an extraordinarily idiotic manner, thereby improving our species' chances of long-term survival.

Off the Top of My Head

Joe Biden Least Articulate of Dem Candidates

by John Lawrence, September 16, 2019

Give the man credit for his past service, but his time has gone. He can't complete a sentence and gets lost in his own verbage. Talks about playing the record player for your kids? Give me a break. Records ceased being produced about 30 years ago. I don't want a President that has to be scripted, somebody that's just a figurehead, someone that's a safe bet to beat Donald Trump. These times demand someone who has the energy, boldness and fighting spirit to take on the fossil fuel and the gun lobbies. Someone who understands that drastic changes have to be made in the way we consume energy in all its different forms and capacities. Oil and gas must be replaced by renewables. Planet earth is still going to experience the terrible effects of climate change even if we undergo a planet wide conversion to renewables tomorrow. But if we don't do everything possible in the next ten years, planet earth will become a catastrophe for human beings.

Trump has set back America and the world by years in all arenas. The next Democratic President will have to make up for his idiocy before we have a hope of getting back on the right track. And one way or another the roadblocker-in-chief in the Senate, Mitch McConnell has to be nullified. If it takes getting rid of the filibuster, so be it. The budget reconciliation process could help. A budget reconciliation bill is considered under expedited procedures that limit debate and amendments. Like the budget resolution, a reconciliation bill cannot be filibustered in the Senate and therefore needs only a simple majority to move to a final vote. Whatever it takes to restore majority rule and democracy to the US should be undertaken.

The Republicans only want to talk about all the threats to the US while ignoring the biggest one - climate change. They only want to talk about how much more money we should give to the Defense Department, and they equate taking the money away to help actual Americans and fight climate change as socialism. Pretty soon, if we do nothing, our military will be fighting over a few scraps left on the table after climate change devastates the earth. I guess their goal is to let the rest of the earth go to hell while we defend ourselves against all the climate change refugees. Let's get real. The fall of the Roman Empire did not threaten the whole earth. The American empire and Trump's fiddling while earth burns is doing just that. While the US threatens every country in sight that does not kowtow to its imperialism, China is going around the planet building infrastructure. That's why they're a threat to the US. We can't sit back and let China do all this good.

For Christ's sake they're building roads and ports in Papua New Guinea of all places. Of course they are the biggest threat to the US. The world needs to sit back and let us control it by the use of our military with its 800 bases scattered around the world and by our use of sanctions. The US is the world's bully threatening every country that does not do its bidding with military action or sanctions. Climate change refugees from Central America, where there has been massive crop failures due to heat and drought, must be fought back.

That's why Joe Biden's time has past. He never met a credit card company that he didn't do the whims of. As a senator from Delaware -- a corporate tax haven where the financial industry is one of the state’s largest employers -- Biden was one of the key proponents of the 2005 legislation that effectively prevents the $150 billion worth of private student loan debt from being discharged, rescheduled or renegotiated as other debt can be in bankruptcy court. Now the restoration of bankruptcy protection for student loan debtors is a big campaign issue for Bernie Sanders and Elizabeth Warren. Why didn't they bring this out in the Democratic debates?

My pick is for the team of Elizabeth Warren and Cory Booker. They have the energy, the vision, the smarts, the right ethnic and genderific combo and the fighting spirit to put America back on the right track. I love Bernie. He's put all these issues before the American public for years. For years he was a voice crying out in the wilderness. Now his views are almost mainstream, but I think Bernie's approach is too basically monotone. Warren and Booker are much more vibrant and energetic, and they have basically the same agenda as Bernie's. I also think Bernie is too dogmatic with his Medicare for All proposal. Medicare for All Who Want It is a better approach.

All the Democratic Presidential hopefuls on the stage at the last debate were far more articulate and spoke far more intelligently than did Joe Biden. We need a bold new America not Obama 2.0. Thank you.

The Netherlands' Health Care System Could Be a Model for the US

But There is a Role for Private Insurance as Well

 

by Frank Thomas, August 2, 2019

 

I agree that Sanders reform plan [Medicare for All] which puts most insurers out of business is not acceptable by a large segment of the population. I like the Dutch Basic Plan reform plan that replaced the division between public and private health insurance by one universal social health insurance. But that one universal insurance keeps insurers in business. It does so under a central Oversight competitive mechanism that manages effectively and efficiently Basic Plan quality, price, per coverage, provider costs  - resulting in a much lower cost per capita for good coverage than the U.S sky high capita cost for less coverage. (see TABLE 1)   

 

Under the Dutch Basic Plan a medical procedure will cost almost exactly the same anywhere in the country. In America, the insured in any state is hit with 3,6,9 or more different prices for the same medical procedure.  Why? Many things are insanely wrong. A fundamental one is that the insurers are running the system with one primary goal - maximum profits for shareholders. And they are selling policy covrages that vary all over the place in concert with wildly varying out-of-pocket costs for premiums and deductibles. Systemically, there's simply LITTLE to NO standardization of coverage, prices, costs and quality in our failing, egregiously humanly unfair healthcare system only the top 20% can afford with decent coverage. It is drowning and fragmented with too many insurers and giant monopolist firms that are dictating our system of social health care for their own profit benefit first and the insured second. Hospitals and doctors also largely operate as profit-making entities. This is in sharp contrast to the Dutch universal healthcare system which is driven by "central oversight and managed competition."  

 

This leads me to the question:

 

Why Can't Sanders and U.S. Healthcare Reformers Come Up With a Version of the Netherlands' Basic Plan of Universal Healthcare Plan for All That Doesn't Put Most Insurers Out of Business, But Does Provide Better Healthcare at a Much Lower Cost for All?

 

In 2006, the Netherlands transformed its government healthcare insurance system into one Basic Plan of universal social health insurance where "government managed competition" was introduced among private insurers as the driving force in the healthcare system. All living or working adults must be covered by the Basic Plan healthcare insurance. Coverage is required regardless of ability to pay. For low income people, the government subsidizes the Basic Plan individual premium up to 70% of the fixed monthly premium charge which is reset every year, 

 

The mandatory Basic Plan is sold by private non-profit insurance firms. Hospitals are also non-profit entities. Of all the competing insurer firms, six insurers handle about 90% of the Basic Plan for all of Holland's 18 million people. The medical services and medicines covered by the Basic Plan are centrally controlled and approved. They apply uniformly for all of Holland's 18 million people. Upgrades to the Basic Plan are mostly entirely in the hands of the insurers, Government oversight management of the Basic Plan extends importantly to quality, coverage, insurer price, and provider costs (e.g., hospitals,doctors). 

 

The medical services and medicines covered by the Basic Plan are exactly the same for everybody. This generates enormous cost efficiencies (e.g., in purchasing, and provider costs) and stimulates improvements in quality care at reasonable cost. Monthly premiums vary less than +-6% among competing insurers. Today, the Basic Plan monthly premium is euro 120,00 ($ 136.00) for every individual, except children under age 18 who are not charged for Basic Plan coverage. The yearly deductible for everyone is euro 375,00 ($ 425.00).  Links below provide in-depth explanations/critical analyses of Holland's outstanding mandatory Basic Plan universal healthcare.

 

(https://transferwise.com/us/blog/healthcare-system-in-the-netherlands)  

 

See: Health Systems in Transition - vol 18.  No. 2  2016:   "Netherlands- Health System Review," by Madelon Kroneman, Wienke Boerma, et al. 

 

Healthcare performance measurement reports generally give the Netherlands' universal healthcare system high rankings. Of course, problems arise and are emerging in the future with many, many more older people, but the Dutch pragmatically confront and come together to solve them in a timely fashion together to solve them. 

 

TABLE 1                   UNIVERSAL HEALTHCARE COMPARISON CHART - 2017

 

	Type	% of GDP	Per Capita Cost
Australia	2-tier	9.6%	$ 4,798
Canada	single	10.6%	$4,752.00
France	2-tier	11.0%	$4,600.00
Germany	mandate	11.3%	$5,550.00
Netherlands	mandate	13.3%	$5,691.00
Switzerland	mandate	12.4%	$7,919.00
UK	single	9.7%	$ 4,193
US	private	18.0%	$9,892.00

 

Sources: 

  https://www.statista.com/statistics/576000/total-health-expenditure-as-share-of-gdp-in-the-netherlands

             

  https://www.statista.com/statistics/575988/total-health-expenditure-per-capita-in-the-netherlands

 

ADDENDUM I

The Dutch total healthcare system is operated according to four basic related healthcare Acts: the 2006 Health Insurance Act, the Long-Term Act, the Social Support Act, and the Youth Act. The Health Insurance Act is the Dutch comprehensive Basic Healthcare Insurance package required for All and administered by private insurers.

I believe a credible variation to Sanders’ Medicare for All without insurers is a Medicare Basic Healthcare Option” (MBHO) for All. This would be a standard healthcare package contractually competed for by insurers, sold to the public and administered by private insurers. I see this approach, or some variation thereof, as a potential credible alternative to Sanders’ Medicare for All without insurers. The MBHO insurance plan is similar to the Dutch mandatory Basic Plan for All with one Big exception – it’s optional. It would be a marked improvement on Obama’s healthcare plan option which has been made worse by the Trump Administration’s changes. Despite that and other obvious weaknesses in Obamacare, millions of Americans are very thankful Obama’s plan is alive and doing well.

The Dutch Basic Healthcare Plan for ALL, a ‘radical reform’ that took place with passage of the 2006 Health Insurance Act, has following key policy principles:

• Access to quality, affordable Basic healthcare has no preconditions.

• Standardization of a Basic coverage package is government set and required for All for comprehensive short-term medical services, hospital care and prescribed medications - vastly improving efficiency, quality and lowering system administrative costs.

• Focuses healthcare policy on managed competition given the inherently imperfectly competitive nature of healthcare markets

• The Health Insurance Act entitles all residents to a comprehensive Basic standard health insurance package at a standard premium/deductible cost – implemented by private, competitive health insurers and healthcare providers where quality, price, coverage are government oversight-controlled.

• Insurance firms offering the Basic plan are not-for-profit cooperatives; profits made on the standard Basic plan are allocated to the reserves or they are returned in the form of stable, if not lower, premiums. Hospitals are also generally non-profit entities.

The Dutch hospital market has gotten increasingly concentrated through mergers the past few decades. Competition can lead to much-improved efficiencies, quality and accessibility if adequate alternatives are available to consumers and/or insurers. But studies have shown that on-going, unstoppable hospital consolidation enhances hospitals’ market power. That can undermine the objective of introducing more competition into the market. That’s why Dutch government policy focuses on regulating the hospital market and insurers, while also simultaneously introducing incentives for competition between providers and insurers.

In conclusion, I don’t see why a practical scale variation of the Dutch (or Canadian) universal public-private healthcare models cannot be achieved in our country by MEDICARE BASIC HEALTHCARE OPTION. If structured well, over time such a plan could potentially vastly improve our comparatively exceptionally inefficient, costly, poor coverage, non-standard healthcare system.

This Medicare Basic Healthcare Option (MBHO) would encompass following key policies:

• A Basic standard optional insurance plan for All with no preconditions. The standard coverage package would be defined and set by Medicare.

• Upgrades ‘not covered by the Basic Option would be the primary responsibility of insurers with oversight control by Medicare.

• A standard national premium structure would be set for the Basic Option that is adjusted on a regional basis up or down by an average income and/or cost-of-living index.

• The standard premium for low income people would be subsidized by Medicare.

• Medicare would be the chief purchasing agent and awarder of regional contracts to providers/insurers who meet MBHO provisions on access, price, quality, medical services, hospital care, prescribed medications available to All who choose the Basic Option.

It’s incredible how talented and advanced our nation is in its medical research, in our precision-reaching of a planet millions of miles away, in our landing of a missile within one meter of the target thousands of miles away.

BUT, here we are … unable to come together on a quality, cost-effective, affordable Basic healthcare system for all our citizens! The Netherlands’ standard Basic Plan system for All is simple, with good coverage at a reasonable annual premium cost for every individual age 18 and above of $1,630 (euro 1,440) and the deductible is $435 (euro 385). This compares to a much higher U.S. average individual insurance cost … and for less coverage. Also there are no co-pays in the Netherlands on the Basic plan while they are considerable in the US.

I think Sanders’ single-payer Medicare Plan without insurers is the right thing given our deeply sick, complex, for-profit healthcare system. Unfortunately, this ideal solution appears to be politically impossible. Apparently it’s too big a step; there’s simply much resistance by many people who do not want their healthcare insurance plan changed. If the U.S. healthcare insurers and hospitals were mainly non-profit entities as is the case in the Netherlands, this resistance might disappear. Perhaps in this situation, Biden’s solution to seriously repair Obamacare is a credible first step - providing substantive changes are indeed made along lines, for example, of incorporating some of the best parts of Holland’s radically reformed 2006 standard Basic healthcare system.

Potentially considerable cost and quality improvements from a Medicare Basic Healthcare Option that standardizes quality, coverage and affordable prices for All. This would encourage more and more people of all income levels to eventually go for the Medicare Basic Healthcare Option. This in turn will expand opportunities to further improve provider purchase costs, coverage and quality. It’s important to note that Holland’s universal Basic Healthcare plan package covers at least 80% of all possible short-term medical services and prescription drugs needed for people of all income levels and health conditions. Upgrades like physical therapy or cosmetic surgery can be purchased direct from insurers at an adjusted premium.

The U.S. battle is between Sanders’ universal single-payer solution without the high profit-making insurers and Biden’s serious repair solution to Obamacare working in cooperation with insurers and local communities in establishing a national standard Medicare Basic Healthcare Option. Even Canada’s so-called single-payer system works well with insurers who come up with market prices for good coverages that don’t vary wildly among provinces at a very competitive premium-deductible cost per individual or family that’s one-half the cost of a typical U.S. insurer.

We are buried in a brutally polarized political system – that’s demonstrating an outright deplorable incompetence in creating and playing politics with an insanely costly, poor standard coverage, super complex national healthcare system. The system is shamefully the most costly for less coverage compared to European systems and systems of economically advanced nations like Japan and Australia.

We could learn a lot from the quality, comprehensive medical coverage and affordability of the Netherlands’ standard Basic healthcare insurance package required for ALL … and generally approved by all citizens. I would say the same about Germany’s or UK’s, or Canada’s healthcare systems or any of the Scandinavian country systems. We Americans think we know it all … but we don’t, especially when it comes to the development and management of humanly fundamental social protection legislation for all Americans. 

ADDENDUM II

ATTENTION : KAMALA HARRIS

I applaud your attempt to put forward a Medicare Option Plan that includes the insurers. Joe Biden is doing the same thing when he says significantly improve the Affordable Healthcare Plan, called Obamacare.

BUT, as I note in detail in describing the Dutch universal non-optional Basic Plan that an variation to that plan, like your and Biden’s options WILL NOT WORK unless following conditions are met.

• The much needed scale of standardization in our complex national healthcare system will not be achieved without Medicare first defining one standard embracive coverage package that applies to all applicants and insurers. A transparent standard benefits package that insures comprehensive coverage - and profoundly simplifies the system. Insurers must accept that coverage package. They and providers (e.g., hospitals) deal with a single set of rules and billing procedures. A big plus with such a system in the Netherlands is that insurers and hospitals act largely as non-profit entities. This will be difficult in the states where healthcare for maximum corporate insurer profits is deeply imbedded. Even non-profit insurer firms in the U.S. have exorbitant salaries.

• The individual monthly insurance premium and annual deductible costs should also be standard nationwide (or at least regionally). In the Netherlands, the premium and deductible costs for an individual 18 or older under the Basic Universal Plan are at reasonably affordable levels of $136 monthly and $435 annually, respectfully. And that’s for excellent coverage with no co-pays or playing the profit maximizing games of setting limits or exclusions under the standard Basic Plan for all.

• The government should subsidize the premium cost up to, say, 70% (as does the Netherlands) depending on gross income levels below $35,000 per year. This could be funded by a small federal tax of +- 0.015% on everyone’s annually reported adjusted gross income.

• Medicare should NOT accept insurers whose executive salaries are sky high – a perversely greedy condition that pervades every inch of our healthcare system (but NOT in Europe).

• Insurers cannot retroactively revoke insurance based on errors in applying for the Medicare Option plan. Obama’s Affordable Care Act had an individual mandate - as does the Netherlands’ Basic Plan - that no-one can be rejected for plan coverage in any way, including a history of prior sickness. Not surprisingly, Trump’s administration has established numerous loopholes that undermine the insurance protections of Obamacare.

• Our U.S. current private healthcare insurance system is primarily employment based and covers two-thirds of the population. Many people are happy with this but it comes with limits and exclusions regarding coverage and co-pays. And, most importantly, there is no standardization. So the premium and deductible out-of pocket costs still end up being extremely high vs. European plans. This problem and the insurer/provider being in business for maximum profit must be resolved in a clever way if a quality, affordable U.S. Medicare Option plan is ever to work successfully.

The potential purchasing and administrative cost economies where insurance firms play a role with central government oversight and control of a standard quality, pricing, coverage package are enormous – as proven by the Dutch, Swiss, and German systems. And unlike our Medicare Advantage health plans – where private insurers overbill Medicare in the hundreds of millions annually for sick patients who are not so sick or have reported medical conditions that cannot be proven - the profoundly simple, transparent EU healthcare systems don’t have such problems.

Perhaps you and Joe Biden could merge the best of each other’s ideas and the brains of experts to significantly reform an Obamacare Option. This would include re-installing the provisions Trump’s Administration has taken away. Actions that constrain access to Obamacare and make it more expensive.

For a Medicare Option alternative, we should adopt in a constructive way the standard plan conditions and operating rules noted above that work so well in providing better coverage at a much lower cost in Canada and European countries with populations of 10 million to 70 million. Greatly reducing plan complexity, increasing plan standardization, scale purchasing of drugs and medicines, and equipment will deliver massive cost efficiencies and better healthcare coverage.

If we can’t take this first step as a precursor for a much, much broader public acceptance of a universal basic plan centrally controlled by Medicare, then we will likely remain a 3^rd world country when it comes to comprehensive, quality basic healthcare at an affordable cost for the average American.

ATTENTION : KAMALA HARRIS

by Frank Thomas

ADDENDUM II. August 2, 2019

I applaud your attempt to put forward a Medicare Option Plan that includes the insurers. Joe Biden is doing the same thing when he says significantly improve the Affordable Healthcare Plan, called Obamacare.

BUT, as I note in detail in describing the Dutch universal non-optional Basic Plan that an variation to that plan, like your and Biden’s options WILL NOT WORK unless following conditions are met:

 

• The much needed scale of standardization in our complex national healthcare system will not be achieved without Medicare first defining one standard embracive coverage package that applies to all applicants and insurers. A transparent standard benefits package that insures comprehensive coverage - and profoundly simplifies the system. Insurers must accept that coverage package. They and providers (e.g., hospitals) deal with a single set of rules and billing procedures. A big plus with such a system in the Netherlands is that insurers and hospitals act largely as non-profit entities. This will be difficult in the states where healthcare for maximum corporate insurer profits is deeply imbedded. Even non-profit insurer firms in the U.S. have exorbitant salaries.

• The individual monthly insurance premium and annual deductible costs should also be standard nationwide (or at least regionally). In the Netherlands, the premium and deductible costs for an individual 18 or older under the Basic Universal Plan are at reasonably affordable levels of $136 monthly and $435 annually, respectfully. And that’s for excellent coverage with no co-pays or playing the profit maximizing games of setting limits or exclusions under the standard Basic Plan for all.

• The government should subsidize the premium cost up to, say, 70% (as does the Netherlands) depending on gross income levels below $35,000 per year. This could be funded by a small federal tax of +- 0.015% on everyone’s annually reported adjusted gross income.

• Medicare should NOT accept insurers whose executive salaries are sky high – a perversely greedy condition that pervades every inch of our healthcare system (but NOT in Europe).

• Insurers cannot retroactively revoke insurance based on errors in applying for the Medicare Option plan. Obama’s Affordable Care Act had an individual mandate - as does the Netherlands’ Basic Plan - that no-one can be rejected for plan coverage in any way, including a history of prior sickness. Not surprisingly, Trump’s administration has established numerous loopholes that undermine the insurance protections of Obamacare.

• Our U.S. current private healthcare insurance system is primarily employment based and covers two-thirds of the population. Many people are happy with this but it comes with limits and exclusions regarding coverage and co-pays. And, most importantly, there is no standardization. So the premium and deductible out-of pocket costs still end up being extremely high vs. European plans. This problem and the insurer/provider being in business for maximum profit must be resolved in a clever way if a quality, affordable U.S. Medicare Option plan is ever to work successfully.

The potential purchasing and administrative cost economies where insurance firms play a role with central government oversight and control of a standard quality, pricing, coverage package are enormous – as proven by the Dutch, Swiss, and German systems. And unlike our Medicare Advantage health plans – where private insurers overbill Medicare in the hundreds of millions annually for sick patients who are not so sick or have reported medical conditions that cannot be proven - the profoundly simple, transparent EU healthcare systems don’t have such problems.

Perhaps you and Joe Biden could merge the best of each other’s ideas and the brains of experts to significantly reform an Obamacare Option. This would include re-installing the provisions Trump’s Administration has taken away. Actions that constrain access to Obamacare and make it more expensive.

For a Medicare Option alternative, we should adopt in a constructive way the standard plan conditions and operating rules noted above that work so well in providing better coverage at a much lower cost in Canada and European countries with populations of 10 million to 70 million. Greatly reducing plan complexity, increasing plan standardization, scale purchasing of drugs and medicines, and equipment will deliver massive cost efficiencies and better healthcare coverage.

If we can’t take this first step as a precursor for a much, much broader public acceptance of a universal basic plan centrally controlled by Medicare, then we will likely remain a 3^rd world country when it comes to comprehensive, quality basic healthcare at an affordable cost for the average American.

Frank Thomas

August 2, 2019

The Netherlands

Is there a middle road on Medicare-for-all? Kamala Harris thinks so

.     BY PAIGE WINFIELD CUNNINGHAM with Paulina Firozi from the Washington Post THE PROGNOSIS Sen. Kamala Harris (D-Calif.) speaks at the 25th Essence Festival in New Orleans. (Gerald Herbert/AP) Is there a way to do Medicare-for-all without wiping out the country's private insurance system? Sen. Kamala Harris (D-Calif.) says there is. Here's her solution: Let people keep private plans, but have the government help pay for it. Harris aims to reach universal health coverage by expanding Medicare to everyone, but through private plans that are paid by the government to administer medical benefits. Harris released her proposal yesterday, adding to the proliferating pile of health policy proposals from the Democratic candidates, who are preparing for their second debate tonight and Wednesday. The 2020 presidential candidate has finally clarified where she stands on the perplexing issue, after months of confusing statements about whether or not she'd eliminate commercial health insurance. In the past, Harris signed onto the sweeping Medicare-for-all bill envisioned by her rival, Sen. Bernie Sanders (I-Vt.), who wants the federal government to directly cover the health expenses of all Americans. Democratic presidential hopefuls Joe Biden, Bernie Sanders and Kamala Harris speak during the Democratic primary debate in June. (Saul Loeb/AFP/Getty Images) But what Harris is proposing now isn’t quite Medicare-for-all. It’s more like Medicare Advantage-for-all, a popular alternative version of Medicare that currently covers about 1 in 3 seniors. In Medicare Advantage, private plans bid for the rights to sponsor Medicare plans, in contrast to traditional Medicare, in which doctors and hospitals directly bill the federal government. The program is basically Republicans’ favorite flavor of Medicare, because it so heavily involves the private sector. So using Medicare Advantage as a starting point for health reform could be smart politics for Harris, especially if she eventually finds herself in the general election. Expanding coverage via private means is a more comfortable idea for many Americans. It certainly is for Tom Scully, former administrator of the Centers for Medicare and Medicaid Services under GOP President George W. Bush, who called the idea a “brilliant masterstroke.” “There’s a hell of a big difference between Medicare-for-all and Medicare Advantage-for-all,” Scully told me. “I think [Harris] was brilliant to figure that out.” In her plan, laid out via a Medium post, Harris wants to give people the option of either enrolling in traditional Medicare or buying a Medicare Advantage-type plan while tacking on more benefits, such as mental health care. She’d let people immediately start buying into traditional Medicare and over a 10-year period would phase in privately run Medicare plans to cover newborns, the uninsured and, eventually, everyone who currently has workplace or Obamacare coverage. The approach allows Harris to embrace the most popular parts of Medicare-for-all — its generous set of medical benefits — while dodging its most controversial aspect of eliminating private health coverage. Harris had wavered on that question for months, on two separate occasions appearing to advocate banning private plans and each time walking back those remarks. “Essentially, we would allow private insurance to offer a plan in the Medicare system, but they will be subject to strict requirements to ensure it lowers costs and expands services,” Harris wrote. “If they want to play by our rules, they can be in the system. If not, they have to get out.” Andy Slavitt, who headed CMS under President Barack Obama, called her plan “an effort to balance idealism and pragmatism.” “The use of Medicare Advantage is a clever approach to getting there,” he told me. Indeed, Harris’s plan could be viewed as a middle ground between the dramatic health insurance overhaul suggested by Sanders and the incremental approach of a government-financed “public option” backed by former vice president Joe Biden. If you’re watching the debate, stay tuned for potential clashes between Biden and Harris on the subject when they share the stage Wednesday night. Harris’s rivals were already jumping all over her yesterday, slamming her for trying to have the best of both worlds and charging that it would instead lead to the worst of both worlds. “This new, have-it-every-which-way approach pushes the extremely challenging implementation of the Medicare for All part of this plan ten years into the future, meaning it would not occur on the watch of even a two-term administration,” said Biden spokeswoman Kate Bedingfield. “The result? A Bernie Sanders-lite Medicare for All and a refusal to be straight with the American middle class, who would have a large tax increase forced on them with this plan,” she added. Sanders campaign manager Faiz Shakir told Politico that Harris's plan “introduces more corporate greed and more profiteering within Medicare.” And the health-care industry, which has formally banded together to fight Medicare-for-all-like proposals, appears no more open to Harris’s proposal than to what Sanders or Biden have suggested. The Partnership for America’s Health Care Future, a coalition that includes the major trade groups for health insurers, hospitals and other players, released a statement calling it a “one-size-fits-all government-run system.” “No matter how candidates try to thread the needle, Medicare for all, Medicare ‘buy-in’ and the ‘public option’ would all lead to the same harmful consequences — including unaffordable tax increases, the elimination of consumer choice, threats to patients’ access to their doctors and treatments and a diminished quality of care,” Lauren Crawford Shaver, the group’s executive director, said in a statement. Today the coalition is launching a six-figure ad campaign that includes digital ads in Detroit and Washington, and this national television ad: Harris’s proposal is too new for there to be polling data on it. But a new survey from the Kaiser Family Foundation underscores how Americans seem to prefer step-by-step approaches to getting everyone covered versus a system-wide transformation that might cost them their own coverage. Nearly two-third of respondents said they favor a public option that would compete with private plans and be available to all Americans. Just over half of respondents said they favor a national Medicare-for-all plan, slightly down from 56 percent who expressed support in April.

Off the Top of My Head

How to Counter China's BRI Initiative: A Worldwide Green New Deal

by John Lawrence, July 24, 2019

The American political establishment is all worried about China's Belt and Road Initiative (BRI) because it forges alliances with many countries especially, but not limited to, those of the Eurasian land mass including Russia. They do this by partnering to build infrastructure in those countries thereby increasing trade with China primarily. The Chinese approach is basically the equivalent of Dale Carnegie's book, "How to Win Friends and Influence People." The American approach is to threaten other countries with its military might or its weaponized dollar. These are the only things in the American playbook. Other American interactions with third parties have been left to the private sector because the American government has been hollowed out to the point that all activities with the exception of the military and the use of sanctions have been left to the private sector. America cannot even repair its own infrastructure much less build infrastructure in the rest of the world like China is doing. China can do this because it has a government capable of launching huge initiatives. Unless those initiatives are of a military nature, the US can do nothing of the sort.

Therefore, I have a great idea (I think). The Democrats should think big and their agenda should be (in addition to universal health care which I will discuss later) a Worldwide Green New Deal (WWGND). Climate change will not be ameliorated that much by just greening America. Most of the greenhouse gasses are being emitted elsewhere. So a Green Marshall Plan or a Worldwide Green New Deal is in order, and it will counter China, not militarily like the Washington Republican establishment is trying to do (after all if all you possess is a hammer every problem must be solved by hammering), but by peaceful green development exactly like China is trying to do although I don't know how much the emphasis with the BRI is on green.

Some quibbles with the Green New Deal as presently constituted: it guarantees a government job for anyone who needs a job. No, leave this part out, because the Republicans will slaughter you over this. A Worldwide Green New Deal is necessary not only to save the planet, but to counter China's growing influence in the world. This would be a peaceful competition instead of the military one that has borne no fruit over the last years since WW II. The wars since then have been a waste and a tragedy that have only destroyed infrastructure and alienated major parts of the world's population. A WWGND will also be a change in foreign policy vis a vis the rest of the world. It will say we are not here just to try and control you militarily or to destroy your economies with sanctions if you don't obey our orders. It would be saying to the world "let's have a peaceful competition with China and save the world from the worst effects of climate change at the same time."

The US political establishment is apprehensive about China. It is getting defensive about China. That's why it is taking the attitude towards Huawei which is outdcompeting American companies. The US is trying to use sanctions to block Huawei's progress since it is on the losing end of the competition. But America has no industrial policy; China does and this makes all the difference. America can only react defensively using threats both military and dollarized.

Now regarding universal health care, as much as I like Bernie Sanders, I think Medicare for All as a plank in the platform has to go. The Republicans will slaughter us over that. Hickenlooper and others have a better idea: Medicare for All Who Want It. The rest can stay with their private insurance. Evidently, 180 million Americans are covered by employer based insurance, and, evidently, they like it. This would be similar to restoring the public option that was lobbied out of Obamacare. Let people opt in to Medicare, but don't force them to. This is the winning agenda item. Over the years as more and more people become disenchanted with private insurance, they will start opting in until the point will be reached that effectively Medicare For All will be realized. This is the way to make universal health care evolutionary instead of revolutionary.

The American Republican poltitical establishment is taking a defensive, fearful attitude towards China's BRI. They are trying to control the world not by military supremacy but by peaceful development in conjunction with their neighbors. How dare they! The US has invested the whole ball of wax into military domination of the world to put America first. After all we beat communism leaving America as the world's dominant empire. But if America doesn't change course it will be left in the position of trying to hold back China's peaceful initiatives with its threats of military action and sanctions.

One last note: the US will have to replace the privately owned Federal Reserve with a public central bank in order to fund a WWGND. Ellen Brown has discussed this in detail. Lincoln essentially did this with his issuance of greenbacks to fight the Civil War and build the transcontinental railroad. It worked for him and us.

Let's Take a Look at the Netherlands Universal Health Care System

But There is a Role for Private Insurance as Well

 

by Frank Thomas

 

I agree that Sanders reform plan [Medicare for All] which puts most insurers out of business is not acceptable by a large segment of the population. I like the Dutch Basic Plan reform plan that replaced the division between public and private health insurance by one universal social health insurance. But that one universal insurance keeps insurers in business. It does so under a central Oversight competitive mechanism that manages effectively and efficiently Basic Plan quality, price, per coverage, provider costs  - resulting in a much lower cost per capita for good coverage than the U.S sky high capita cost for less coverage. (see TABLE 1)   

 

Under the Dutch Basic Plan a medical procedure will cost almost exactly the same anywhere in the country. In America, the insured in any state is hit with 3,6,9 or more different prices for the same medical procedure.  Why? Many things are insanely wrong. A fundamental one is that the insurers are running the system with one primary goal - maximum profits for shareholders. And they are selling policy covrages that vary all over the place in concert with wildly varying out-of-pocket costs for premiums and deductibles. Systemically, there's simply LITTLE to NO standardization of coverage, prices, costs and quality in our failing, egregiously humanly unfair healthcare system only the top 20% can afford with decent coverage. It is drowning and fragmented with too many insurers and giant monopolist firms that are dictating our system of social health care for their own profit benefit first and the insured second. Hospitals and doctors also largely operate as profit-making entities. This is in sharp contrast to the Dutch universal healthcare system which is driven by "central oversight and managed competition."  

 

This leads me to the question:

 

Why Can't Sanders and U.S. Healthcare Reformers Come Up With a Version of the Netherlands' Basic Plan of Universal Healthcare Plan for All That Doesn't Put Most Insurers Out of Business, But Does Provide Better Healthcare at a Much Lower Cost for All?

 

In 2006, the Netherlands transformed its government healthcare insurance system into one Basic Plan of universal social health insurance where "government managed competition" was introduced among private insurers as the driving force in the healthcare system. All living or working adults must be covered by the Basic Plan healthcare insurance. Coverage is required regardless of ability to pay. For low income people, the government subsidizes the Basic Plan individual premium up to 70% of the fixed monthly premium charge which is reset every year, 

 

The mandatory Basic Plan is sold by private non-profit insurance firms. Hospitals are also non-profit entities. Of all the competing insurer firms, six insurers handle about 90% of the Basic Plan for all of Holland's 18 million people. The medical services and medicines covered by the Basic Plan are centrally controlled and approved. They apply uniformly for all of Holland's 18 million people. Upgrades to the Basic Plan are mostly entirely in the hands of the insurers, Government oversight management of the Basic Plan extends importantly to quality, coverage, insurer price, and provider costs (e.g., hospitals,doctors). 

 

The medical services and medicines covered by the Basic Plan are exactly the same for everybody. This generates enormous cost efficiencies (e.g., in purchasing, and provider costs) and stimulates improvements in quality care at reasonable cost. Monthly premiums vary less than +-6% among competing insurers. Today, the Basic Plan monthly premium is euro 120,00 ($ 136.00) for every individual, except children under age 18 who are not charged for Basic Plan coverage. The yearly deductible for everyone is euro 375,00 ($ 425.00).  Links below provide in-depth explanations/critical analyses of Holland's outstanding mandatory Basic Plan universal healthcare.

 

(https://transferwise.com/us/blog/healthcare-system-in-the-netherlands)  

 

See: Health Systems in Transition - vol 18.  No. 2  2016:   "Netherlands- Health System Review," by Madelon Kroneman, Wienke Boerma, et al. 

 

Healthcare performance measurement reports generally give the Netherlands' universal healthcare system high rankings. Of course, problems arise and are emerging in the future with many, many more older people, but the Dutch pragmatically confront and come together to solve them in a timely fashion together to solve them. 

 

TABLE 1                   UNIVERSAL HEALTHCARE COMPARISON CHART - 2017

 

	Type	% of GDP	Per Capita Cost
Australia	2-tier	9.6%	$ 4,798
Canada	single	10.6%	$4,752.00
France	2-tier	11.0%	$4,600.00
Germany	mandate	11.3%	$5,550.00
Netherlands	mandate	13.3%	$5,691.00
Switzerland	mandate	12.4%	$7,919.00
UK	single	9.7%	$ 4,193
US	private	18.0%	$9,892.00

 

Sources: 

  https://www.statista.com/statistics/576000/total-health-expenditure-as-share-of-gdp-in-the-netherlands

             

  https://www.statista.com/statistics/575988/total-health-expenditure-per-capita-in-the-netherlands

 

ADDENDUM

The Dutch total healthcare system is operated according to four basic related healthcare Acts: the 2006 Health Insurance Act, the Long-Term Act, the Social Support Act, and the Youth Act. The Health Insurance Act is the Dutch comprehensive Basic Healthcare Insurance package required for All and administered by private insurers.

I believe a credible variation to Sanders’ Medicare for All without insurers is a Medicare Basic Healthcare Option” (MBHO) for All. This would be a standard healthcare package contractually competed for by insurers, sold to the public and administered by private insurers. I see this approach, or some variation thereof, as a potential credible alternative to Sanders’ Medicare for All without insurers. The MBHO insurance plan is similar to the Dutch mandatory Basic Plan for All with one Big exception – it’s optional. It would be a marked improvement on Obama’s healthcare plan option which has been made worse by the Trump Administration’s changes. Despite that and other obvious weaknesses in Obamacare, millions of Americans are very thankful Obama’s plan is alive and doing well.

The Dutch Basic Healthcare Plan for ALL, a ‘radical reform’ that took place with passage of the 2006 Health Insurance Act, has following key policy principles:

• Access to quality, affordable Basic healthcare has no preconditions.

• Standardization of a Basic coverage package is government set and required for All for comprehensive short-term medical services, hospital care and prescribed medications - vastly improving efficiency, quality and lowering system administrative costs.

• Focuses healthcare policy on managed competition given the inherently imperfectly competitive nature of healthcare markets

• The Health Insurance Act entitles all residents to a comprehensive Basic standard health insurance package at a standard premium/deductible cost – implemented by private, competitive health insurers and healthcare providers where quality, price, coverage are government oversight-controlled.

• Insurance firms offering the Basic plan are not-for-profit cooperatives; profits made on the standard Basic plan are allocated to the reserves or they are returned in the form of stable, if not lower, premiums. Hospitals are also generally non-profit entities.

The Dutch hospital market has gotten increasingly concentrated through mergers the past few decades. Competition can lead to much-improved efficiencies, quality and accessibility if adequate alternatives are available to consumers and/or insurers. But studies have shown that on-going, unstoppable hospital consolidation enhances hospitals’ market power. That can undermine the objective of introducing more competition into the market. That’s why Dutch government policy focuses on regulating the hospital market and insurers, while also simultaneously introducing incentives for competition between providers and insurers.

In conclusion, I don’t see why a practical scale variation of the Dutch (or Canadian) universal public-private healthcare models cannot be achieved in our country by MEDICARE BASIC HEALTHCARE OPTION. If structured well, over time such a plan could potentially vastly improve our comparatively exceptionally inefficient, costly, poor coverage, non-standard healthcare system.

This Medicare Basic Healthcare Option (MBHO) would encompass following key policies:

• A Basic standard optional insurance plan for All with no preconditions. The standard coverage package would be defined and set by Medicare.

• Upgrades ‘not covered by the Basic Option would be the primary responsibility of insurers with oversight control by Medicare.

• A standard national premium structure would be set for the Basic Option that is adjusted on a regional basis up or down by an average income and/or cost-of-living index.

• The standard premium for low income people would be subsidized by Medicare.

• Medicare would be the chief purchasing agent and awarder of regional contracts to providers/insurers who meet MBHO provisions on access, price, quality, medical services, hospital care, prescribed medications available to All who choose the Basic Option.

It’s incredible how talented and advanced our nation is in its medical research, in our precision-reaching of a planet millions of miles away, in our landing of a missile within one meter of the target thousands of miles away.

BUT, here we are … unable to come together on a quality, cost-effective, affordable Basic healthcare system for all our citizens! The Netherlands’ standard Basic Plan system for All is simple, with good coverage at a reasonable annual premium cost for every individual age 18 and above of $1,630 (euro 1,440) and the deductible is $435 (euro 385). This compares to a much higher U.S. average individual insurance cost … and for less coverage. Also there are no co-pays in the Netherlands on the Basic plan while they are considerable in the US.

I think Sanders’ single-payer Medicare Plan without insurers is the right thing given our deeply sick, complex, for-profit healthcare system. Unfortunately, this ideal solution appears to be politically impossible. Apparently it’s too big a step; there’s simply much resistance by many people who do not want their healthcare insurance plan changed. If the U.S. healthcare insurers and hospitals were mainly non-profit entities as is the case in the Netherlands, this resistance might disappear. Perhaps in this situation, Biden’s solution to seriously repair Obamacare is a credible first step - providing substantive changes are indeed made along lines, for example, of incorporating some of the best parts of Holland’s radically reformed 2006 standard Basic healthcare system.

Potentially considerable cost and quality improvements from a Medicare Basic Healthcare Option that standardizes quality, coverage and affordable prices for All. This would encourage more and more people of all income levels to eventually go for the Medicare Basic Healthcare Option. This in turn will expand opportunities to further improve provider purchase costs, coverage and quality. It’s important to note that Holland’s universal Basic Healthcare plan package covers at least 80% of all possible short-term medical services and prescription drugs needed for people of all income levels and health conditions. Upgrades like physical therapy or cosmetic surgery can be purchased direct from insurers at an adjusted premium.

The U.S. battle is between Sanders’ universal single-payer solution without the high profit-making insurers and Biden’s serious repair solution to Obamacare working in cooperation with insurers and local communities in establishing a national standard Medicare Basic Healthcare Option. Even Canada’s so-called single-payer system works well with insurers who come up with market prices for good coverages that don’t vary wildly among provinces at a very competitive premium-deductible cost per individual or family that’s one-half the cost of a typical U.S. insurer.

We are buried in a brutally polarized political system – that’s demonstrating an outright deplorable incompetence in creating and playing politics with an insanely costly, poor standard coverage, super complex national healthcare system. The system is shamefully the most costly for less coverage compared to European systems and systems of economically advanced nations like Japan and Australia.

We could learn a lot from the quality, comprehensive medical coverage and affordability of the Netherlands’ standard Basic healthcare insurance package required for ALL … and generally approved by all citizens. I would say the same about Germany’s or UK’s, or Canada’s healthcare systems or any of the Scandinavian country systems. We Americans think we know it all … but we don’t, especially when it comes to the development and management of humanly fundamental social protection legislation for all Americans.