Trump Budget: Slash Social Programs After $1.5 Trillion Gift to Wealthy

Trump message to seniors: just die. 

Once again demonstrating that He and the Republican Party want to bring back the Gilded Age when the wealthy lived in obscene extravagance which many Americans barely survived. After giving the very wealthy and large corporations $1.5 trillion in tax breaks - which has caused the federal deficit to balloon just as every sane commentator predicted - Trump and his enablers in the Republican Party seek to slash Medicare spending in Trump's just announced budget. Rest assured that Medicaid and other programs will be similarly targeted.  For those under 65, Medicare is NOT free.  Recipients pay quarterly premiums and, if they are smart, they purchase a supplement that entails monthly premiums as well.  And for those working past 65, you also continue to pay Medicare withholding tax (I now pay more in Medicare withholding that I did for many years in income tax) - which added to withholding over one's working career can total to a large number. Medicare is anything but an "entitlement."  The same holds true for Social Security.  Thus, Trump's proposal can be described as making working Americans - including the cretins who voted for Trump and the GOP - pay into the Medicare and Social Security systems and then reducing their benefits to give lavish tax cuts to the wealthy.  The Washington Post looks at Trump's budget and the gift it may constitute to Democrats.  Here are article excerpts:

A new proposal by President Trump to slash Medicare spending puts Republicans in a political bind ahead of the 2020 election as Democrats are pitching an expansion of the popular health-care program for all Americans.

Trump’s 10-year budget unveiled Monday calls for more than $845 billion in reductions for Medicare, aiming to cut “waste, fraud and abuse” in the federal program that gives insurance to older Americans. It’s part of a broader proposed belt-tightening effort after deficits soared during the president’s first two years in office in part due to massive tax cuts for the wealthy.

The move immediately tees up a potential messaging battle between Democratic proposals for Medicare-for-all — castigated by Republicans as a socialist boondoggle — and a kind of Medicare-for-less approach. focused on cutting back on spending, from the GOP.

Democrats, including some seeking to challenge Trump in 2020, seized on the proposed Medicare cuts Monday as an example of the GOP seeking to balance the budget on the backs of the elderly and the poor after giving broad tax breaks to the wealthy.

“Make no mistake about it: Trump’s budget is a massive transfer of wealth from the working class to the wealthiest people and most profitable corporations in America,” Sen. Bernie Sanders (I-Vt.), a Democratic presidential candidate, said in a Monday tweet that highlighted Medicare cuts.

In states with large senior populations, such as Florida, political attacks over Medicare cuts have proved so effective that both parties have used them. Sen. Rick Scott (R-Fla.) won his seat after running ads last year accusing Democrat Bill Nelson of voting to cut Medicare.

Trump probably needs to win Florida, Arizona, Pennsylvania and other states with large numbers of seniors to secure reelection in 2020. Older Americans consistently vote at higher rates than younger Americans.

Trump’s proposed Medicare savings are more than three times as large as those in his previous budget, and industry lobbying groups said the reductions would hurt hospitals and seniors. “The impact on care for seniors would be devastating,” Chip Kahn, president and CEO of the Federation of American Hospitals, said in a statement. “Hospitals are less and less able to cover the cost of care for Medicare patients, it is no time to gut Medicare.” Democratic strategists and officials argued Monday that Trump’s budget proposal exposed how little credibility Republicans have in debating health care, and showed signs of confidence that it would sharpen the contrast Democrats are seeking to make in the run-up to the 2020 election.

“It totally eviscerates any integrity to their already pretty flimsy attack,” Sen. Richard Blumenthal (D-Conn.) said. “This assault on Medicare lays bare the real Republican agenda, which is to destroy the health-care safety net. They have no shred of intellectual underpinning or integrity to their attack on Democrats if they make this kind of proposal.”

In last year’s midterm elections, Democrats campaigned aggressively on health care, attacking Republicans over their failed effort to repeal and replace the Affordable Care Act. The dynamic marked a shift from the two previous midterm elections, during which the GOP was the party mainly going on offense on health care, slamming Democrats over the creation of the ACA, also known as Obamacare. “This budget says a lot about the President’s priorities: cut $845 billion from Medicare, while spending billions on his vanity project, the wall,” Sen. Kamala D. Harris (D-Calif.) tweeted, referring to Trump’s request for border wall funding. “This would hurt our seniors and is yet another piece of evidence for why we need a new president.” “It’s a political fumble on the Republican part in the sense that this budget is going nowhere,” he said. “The argument prior to this was the Democrats’ plan versus the status quo. And now it’s the Democrats’ plan versus the Republican plan to cut Medicare.”

Sen. Brian Schatz (D-Hawaii) said on Twitter: “One party wants to expand Medicare and Medicaid and the other wants to cut them. That’s the end of my tweet.”

The question will be whether the racism of Trump's base and that base's hatred of others outweigh their own economic/health care best interest.  If these folks continue to support Trump, they truly deserve to suffer every misfortune imaginable and should get no sympathy from others. 

Trump May Try to Kill Medicaid by Executive Fiat

To me one of the prime signals that the Republican Party is the antithesis of so-called Christian values that per the gospels include caring for the poor, the sick, the hungry and the homeless is the party's incessant obsession with killing Medicaid and other government programs that assist these desperate populations.  The GOP's basic message if you are a member of any of these categories is basically, "do us a favor and just die."  What's disturbing is that evangelical Christians - today's Pharisees motivated by hate rather than Christ's message - fully support the GOP agenda, or at least until grandma needs to go into a nursing home or they lose their job and their health insurance.  Besides being un-Christian, this mindset is stupid and these greed driven cretins fail to grasp that America's healthcare costs are sky high because we do not cover preventive care and force many to rely on non-profit hospital emergency room care - the least cost effective means there is.  Add to this the failure to catch illnesses when they have an inexpensive fix and it's a recipe for fiscal disaster.  The result is that ALL OF us end up paying ridiculously high hospital costs as hospitals seek to recover lost revenue. Medicaid is one mechanism that addresses this ass backwards approach of America's broken healthcare system and recognizes the lives of the less fortunate.  So what does Der Trumpenführer want to do?  Basically kill Medicaid as we know it, in part to pay for his tax cuts to the obscenely wealthy and, in my view, in part because he sees the poor as little more than vermin.  A piece in New York Magazine looks at this dangerous Trump/GOP agenda.  Here are highlights: 

One of the most ancient Republican policy hobbyhorses has been eliminating Medicaid’s status as a federal-state entitlement program guaranteeing health-care services for low-income Americans and certain other categories of needy people. You think killing Obamacare is an obsessive Great White Whale for conservatives? Attacks on Medicaid’s basic structure date back at least to the beginning of the Reagan presidency (fittingly, since the Gipper was one of the most visible opponents of the original Medicare and Medicaid proposals back in the early 1960s). In fact, an effort to arbitrarily “cap” federal Medicaid payments was one of the few early legislative setbacks for his administration.

GOP efforts to turn Medicaid into a “block grant” (i.e., a proposal in which the federal government would appropriate a fixed sum of money that states could use to deal with the Medicaid population, with the federal contribution expected to wither away over time), terminating any individual entitlement to benefits, have come back over and over again like a recurring nightmare. There was a Medicaid block grant in the 1995–96 Gingrich budgets that Bill Clinton repeatedly vetoed. George W. Bush proposed the same thing in 2003. It was a regular feature of all those “Ryan Budgets” during the Obama administration. And most recently, Republicans tried to smuggle it into law as part of their unsuccessful bills to “repeal and replace” Obamacare, under the guise of rolling back Obamacare’s expansion of Medicaid.

Even as such frontal assaults on Medicaid continued, the Trump administration, under Medicare and Medicaid director Seema Verma, has been working hard at using “waiver” powers originally designed to help states cover more people under Medicaid to let them move in the opposite direction via work requirements and other provisions aimed at discouraging eligibility. Last year there was even talk of letting conservative states impose an arbitrary lifetime limit on how long childless adults could receive Medicaid benefits, which would have been a pretty clear abrogation of congressional authority . . . .

Now, with the 2018 midterm elections ending any fantasies of Republican-style “health-care reform” legislation making any progress before 2021 at the earliest, Verma is reportedly contemplating a giant and audacious leap into the past: turning Medicaid into block grants via state waivers, or to put it another way, abolishing Medicaid as we have known it by executive fiat. Politico first reported the scheme:

The Trump administration is quietly devising a plan bypassing Congress to give block grants to states for Medicaid, achieving a longstanding conservative dream of reining in spending on the health care safety net for the poor. … new limits could apply to all Medicaid populations — including nursing home patients — or just a smaller subset like working-age adults.

Any way you slice it, though, any block-grant-by-waiver initiative would change Medicaid’s basic structure and purpose, with the clear intention of abrogating congressional powers. The reaction from Democratic Members of Congress has been predictable:

“Hell no,” Sen. Bob Casey (D-Pa.) wrote on Twitter on Friday evening, vowing to oppose the administration’s block grant plan “through legislation, in the courts, holding up Administration nominees, literally every means that a U.S. Senator has.” 

If Verma goes ahead with this scheme, a legal challenge will most definitely arise. But it’s an indication of how determined conservatives are not just to fight the long-term trend of making Medicaid a de facto universal health coverage program for the poor, but of rolling it back as far as possible.

But make no mistake: most ideologically-prone Republicans hate Medicaid with the heat of a thousand suns, and they won’t give up trying to hamstring it, restrict it, cut it, or kill it so long as a devious way to go about it has yet to be deployed.

I truly do not see how a decent, moral person can be a Republican any longer.

Republican Blatant Lies on Health Care

I view quality health care for all citizens as something very important.  First, if one is a moral person - I can't say Christians because evangelicals continue to prove themselves to be both morally bankrupt and hypocrites nearly daily - the welfare of others, especially children and the elderly ought to concern you.  Secondly, Americans pay the highest costs for health care of any developed nation because we fail to cover preventive care and as a result have people flooding ER's with catastrophic illnesses that could have been either avoided or greatly lessened in magnitude.  These un-reimbursed costs get passed on to everyone else and drive up insurance premiums.  The simple math is that to save money, one needs to spend money on basic and preventive care.  A third reason is that from personal experience when one of my children came down with a rare and very deadly disease, I understand how unexpected medical bills can ruin one financially.  Even with "excellent insurance" all of our savings were wiped out and it took me four years to pay off the balance of the bills.  But for a well paying job, I'd have been forced into bankruptcy.  

Polls indicate that a majority of Americans similarly deem health care and access to health care insurance as important, especially when it comes to pre-existing conditions.  Yet what do Republicans want to do?  Gut the Affordable Health Care Act, allow insurance companies to deny coverage to those with pre-existing conditions (or charge them exorbitant rates).  Worse yet, to finance the Trump/GOP tax cuts they want to make cuts in Medicaid and Medicare.  But heven forbid that they be honest with voters about their agenda.  Instead, as a column in the New York Times notes, the blatantly lie.  Here are column excerpts:

Republicans no longer bother with deceptive presentations of facts. Instead, they just flat-out lie.

What do they lie about? Lots of things, from crowd sizes to immigrant crime, from steel plants to the Supreme Court. But right now the most intense, coordinated effort at deception involves health care — an issue where Republicans are lying nonstop about both their own position and that of Democrats.

The true Republican position on health care has been clear and consistent for decades: The party hates, just hates, the idea of government action to make essential health care available to all citizens, regardless of income or medical history.

This hatred very much includes hatred of Medicare. Way back in 1961, Ronald Reagan warned that enacting Medicare would destroy American freedom. Maybe it’s just me, but I don’t think that happened. Newt Gingrich shut down the government in an attempt to force Bill Clinton to slash Medicare funding. Paul Ryan proposed ending Medicare as we know it and replacing it with inadequate vouchers to be applied to the purchase of private insurance.

And the hatred obviously extends to the Affordable Care Act. Republicans don’t just hate the subsidies that help people buy insurance; they also hate the regulations that prevent insurers from discriminating against people with pre-existing conditions. Indeed, 20 Republican state attorneys general filed a lawsuit trying to eliminate protection for pre-existing conditions, and the Trump administration has declined to oppose the suit, in effect endorsing it.

So if you’re a voter who cares about health care, it shouldn’t be hard to figure out where the parties stand. If you believe that Medicare is a bad thing and the government shouldn’t protect people with pre-existing conditions, vote Republican. If you want to defend Medicare and ensure coverage even for those who have health problems, vote Democrat.

But Republicans have a problem here: The policies they hate, and Democrats love, are extremely popular. Medicare has overwhelming support. So does protection for pre-existing conditions, which is even supported by a large majority of Republicans.

Now, you might imagine that Republicans would respond to the manifest unpopularity of their health care position by, you know, actually changing their position. But that would be hopelessly old-fashioned. As I said, what they’ve chosen to do instead is lie, insisting that black is white and up is down. Thus Josh Hawley, as Missouri’s attorney general, is part of that lawsuit against Obamacare’s regulation of insurers; but in his campaign for the Senate, he’s posing as a defender of Americans with pre-existing conditions. Dean Heller, running for re-election to the Senate in Nevada, voted for a bill that would have destroyed Obamacare, including all protection for pre-existing conditions; but he’s misrepresenting himself just like Hawley is. All of which brings me to a remarkable op-ed article on health care in USA Today, which was published under Donald Trump’s name . . . Part of the article claimed that the Trump administration is defending health insurance for Americans with pre-existing conditions, when the reality is that it has tried to destroy that coverage. And what did “Trump” say Democrats would do? Why, that they would “eviscerate” the current Medicare program. Oh, and that they would turn America into Venezuela. Because that’s what has happened to countries that really do have single-payer, like Canada and Denmark.

Why do Republicans think they can get away with such blatant lies? Partly it’s because they expect their Fox-watching followers to believe anything they’re told.

But it’s also because they can still count on enablers in the mainstream news media. After all, why did USA Today approve this piece? Letting Trump express his opinion is one thing; giving him a platform for blatant lies is another. And as fact-checker Glenn Kessler of The Washington Post put it, “Almost every sentence contained a misleading statement or a falsehood.” Even the president of the United States isn’t entitled to his own facts.

So will the G.O.P.’s Big Lie on health care work? We’ll find out in a few weeks.

The Backlash Against the Civil Rights Movement Continues

A persistent question is why working class and ow income whites continue to vote Republican when the GOP agenda is decidedly against their own best economic interests.   The answer, sadly, can be summarized in one word: racism.  This same racism is what propelled Donald Trump to the White House even though he lost the popular vote by nearly 3 million votes. The phenomenon is akin to what my ahead of her time New Orleans belle grandmother said about poor whites: they needed blacks to be inferior to them to assure that they were not the lowest in the social pecking order. The Civil Rights movement ended much of the ability of these whites to openly discriminate, so now they shortsightedly vote for Republicans who want to slash the social safety net because in their warped minds, it will keep blacks and other non-whites subordinate to them.  Meanwhile, they are the ones benefiting the most from the targeted programs.  It's idiocy, but that is what defines the Trump base in general, racists and seemingly low intellect. A lengthy column in the New York Times looks at the phenomenon.  Here are highlights:

One question that has troubled Democrats for decades is freshly relevant in the Trump-McConnell era: Why do so many voters support elected officials who are determined to cut programs that those same voters rely upon?  Take Kentucky, which has a median household income that ranks 45th out of the 50 states.

Over the past half century, residents of Kentucky have become steadily more reliant on the federal government. In the 1970s, federal programs provided slightly under 10 percent of personal income for Kentucky residents; by 2015, money from programs ranging from welfare and Medicaid to Social Security and Medicare more than doubled to 23 percent as a share of Kentuckians’ personal income.

Twenty years ago, there was only one county (out of 120) in which residents counted on the federal government for at least 40 percent of their personal income. By 2014, 28 counties were at 40 percent or higher.  But as their claims on federal dollars rose, the state’s voters became increasingly conservative. In the 1990s, they began to elect hard right, anti-government politicians determined to cut the programs their constituents were coming to lean on.

Suzanne Mettler, a professor of government at Cornell, describes these developments — which can be found in states across the South, the Mountain West and the Midwest — in her new book, “The Government-Citizen Disconnect.”

Mettler gives the example of the Republican congressman Andy Barr, who “represents the Sixth District, which includes McCreary and Wolfe Counties. In both counties, 52 percent of income — approximately $12,000 per resident — flows from federal social policies.”

In the adjoining Fourth District, Representative Thomas Massie, also a Republican, “resides in Lewis County, in which 43 percent of income comes from federal government transfers.” Massie, Mettler notes, “stridently opposes social welfare spending, having been among the group of Republicans who forced the end of the long tradition of bipartisan cooperation on the farm bill in 2013 because they opposed its inclusion of the food stamp program.”

There is, however, one thread that runs through all the explanations of the shift to the right in Kentucky and elsewhere.

Race, the economists Alberto F. Alesina and Paola Giuliano write “is an extremely important determinant of preferences for redistribution. When the poor are disproportionately concentrated in a racial minority, the majority, ceteris paribus, prefer less redistribution.”

Alesina and Giuliano reach this conclusion based on the “unpleasant but nevertheless widely observed fact that individuals are more generous toward others who are similar to them racially, ethnically, linguistically.”

In their 2004 book, “Fighting Poverty in the U.S. and Europe: A World of Difference,” Alesina and Edward L. Glaeser, an economist at Harvard, found a pronounced pattern in this country: states “with more African-Americans are less generous to the poor.”

This pattern continues today. The states with the lowest ceiling on maximum grants in the Temporary Assistance to Needy Families program (which replaced traditional welfare in 1996) are in the region with the highest percentages of African-Americans, the South, and are overwhelmingly represented at the state and federal level by conservative Republicans.

Let’s start with a concept known as “last place aversion.” In a paper by that name, Ilyana Kuziemko, an economist at Princeton, Taly Reich, a professor of marketing at Yale, and Ryan W. Buell and Michael I. Norton, both at Harvard Business School, describe the phenomenon in which relatively low income individuals “oppose redistribution because they fear it might differentially help a ‘last-place’ group to whom they can currently feel superior.” Those thus positioned “exhibit a particular aversion to being in last place, such that a potential drop in rank creates the greatest disutility for those already near the bottom of the distribution.”

Among the findings of this group of researchers: people “making just above the minimum wage are the most likely to oppose its increase.”

Applying last-place aversion theory to means-tested federal programs for the poor reveals that the group most likely to voice opposition is made up of relatively poor whites right above the cutoff level to qualify for such programs.

Even more important than “last place aversion,” though, is the issue of what we might call deservingness: white Americans, more than citizens of other nations, distinguish between those they view as the deserving and the undeserving poor and they are much more willing to support aid for those they see as deserving: themselves.

“Americans believe that the poor are lazy; Europeans believe the poor are unfortunate,” report Alesina and Glaeser. . . . This distinction often translates into a differentiation between poor whites and poor minorities.

Among white respondents, the differences in the responses were striking: More than half, 58 percent, said average Americans got less than they deserved; 28 percent, however, said that African Americans do not get what they deserve.  The difference, Tesler wrote, grows out of a “double standard in deservingness.”

Mick Mulvaney, Trump’s director of the Office of Management and Budget, addressed his view of the division between the deserving and undeserving poor in a column published by the Post and Courier in Charleston, S.C.:  For years, we’ve focused on how we can help Americans receive taxpayer-funded assistance. Under President Trump’s leadership, we’re now looking at how we can respect both those who require assistance and the taxpayers who fund that support. For the first time in a long time, we’re putting taxpayers first. Taking money from someone without an intention to pay it back is not debt. It is theft. This budget makes it clear that we will reverse this larceny.

[A] key factor distinguishing counties that moved in a decisively Republican direction in 2016 was not the absolute number of African-Americans or immigrants, but the rate at which minority populations were growing.

The broader reality is that the Civil Rights revolution of the 1960s unleashed both progress and a backlash that continues to resonate in American politics five decades later. This backlash is in many ways more insidious than the blatant discrimination of the past and potentially more dangerous. It is an object of constant political anxiety for the left and continuous, concerted, calculated manipulation by the right, made more overt by [Trump]the president of the United States, who has dispensed with the dog whistle and picked up a bullhorn.

Many Veterans Would Suffer Under Trumpcare

With the 4th of July tomorrow, there will be many Congressional Republicans out and about glad handing constituents at 4th of July celebrations and bloviating about how they "support our troops - even when they don't in fact.  Some will go even further and loudly claim support for America's military veterans even though they are poised to actively harm thousands of veterans if Trumpcare is signed into law.  I have touched on this topic before, but it bears repeating and many in the military and many veterans need to have a wake up call that will have them aware of the danger and just maybe convince them to stop reflexively voting Republican.  A piece in the Washington Post looks at the looming harm that many veterans could well fall victim to thanks to their duplicitous Republican "friends" in Congress.  Here are highlights:

As Republicans strive mightily — and perversely — for a health-care system that would increase the uninsured by 22 million people, they should ponder the impact on a particularly deserving group — veterans.

It’s not unexpected that heartless GOP plans would be hard on the vulnerable, but do they realize that includes many who continue to suffer from their service?

These are people largely supportive of Republicans . . Republicans [claim to] honor veterans, but you can’t tell it by their current health-care proposals.

The GOP plans do not directly affect the Veterans Affairs Department’s extensive system of health services. About 7 million vets, however, get their care outside of VA services. After the Affordable Care Act, a.k.a. Obamacare, kicked in, the number of vets without insurance dropped by almost 40 percent, according to Sen. Jon Tester (Mont.), the ranking Democrat on the Senate Veterans’ Affairs Committee, and other committee members.  Republicans would reverse that trend. 

Tester and his Democratic colleagues said the Senate bill could:

·        Result in nearly 1.75 million disabled and low-income veterans losing Medicaid coverage
·        Impose a tax on 600,000 veterans, forcing them to pay up to five times more for health insurance
·            Cause more than 5 million veterans difficulty in finding services at rural hospitals
·        Generate increased mental health-care fees for the many veterans who suffer post-traumatic stress from the wars in Iraq, Afghanistan and Vietnam
·        Result in up to 7 million veterans losing tax credits to help pay for medical care
·        Cause about 7 percent of veterans to lose access to care for opioid or other substance abuse problems.

In five recent polls, the approval ratings for the Republican health-care plan ranged from a miserable 16 percent to a pitiful 30 percent, sometimes with a significant percentage undecided.

“This plan, written in secret, will devastate thousands of elderly, disabled and rural veterans who go outside of the VA for all or some of their health care,” Tester said. . . . . He was joined in outrage by Democratic Sens. Patty Murray (Wash.), Richard Blumenthal (Conn.), Joe Manchin III (W. Va.), and Sherrod Brown (Ohio).

“Our country makes a promise to take care of the men and women who serve, but Trumpcare would do just the opposite,” Murray said.

Added Blumenthal: “Every Member of Congress who plans to support this bill needs to imagine looking a veteran in the eye and telling them why their mental-health care for PTS (post-traumatic stress) has been halted, or why they can no longer afford treatment for traumatic brain injury sustained while serving their country.”

Again, the moral bankruptcy of today's Republican Party is nearly complete.

The Growing Support for a Single Payer Healthcare System

Last evening the husband and I were reviewing plan options for his salon staff (and us since I am about to roll off of coverage through my former employer that was far cheaper due to the size of the company).  The best description is to say that there are NO attractive options with the costs for us as a couple totaling to well over $1,500 per month ($18,000 per year).  That exceeds the individual annual payments on any of the mortgages on our properties and exceeds what we spend per year even when my hand surgery last year is factored in.  The winners in this game, of course, are the health insurance companies which laugh all the way to the bank.  It's little wonder that (i) health insurance companies are nearly universally hated and (ii) that more and more Americans - other than the wealthy, of course - support a single payer system.  A column in the Washington Post looks at this trend which collides head on with the GOP's effort to throw Americans off of insurance coverage to pad the wallets of the wealthy and insurance companies.  Here are excerpts:

Despite the rise of the tea party and unified Republican control of government, one decidedly anti-free-market idea appears ascendant: single-payer health care.

And it’s no wonder, given that a record-high share of the population receives government-provided health insurance. As a country, we’ve long since acquiesced to the idea that Uncle Sam should give insurance to the elderly, veterans, people with disabilities, poor adults, poor kids, pregnant women and the lower middle class.

Many Americans are asking: Why not the rest of us, too?

A recent survey from the Economist/YouGov found that a majority of Americans support “expanding Medicare to provide health insurance to every American.” Similarly, a poll from Morning Consult/Politico showed that a plurality of voters support “a single payer health care system, where all Americans would get their health insurance from one government plan.”

Divining the longer-term trend in attitudes toward this idea is difficult, as the way survey questions on the topic are asked has changed over time. Views of a health-care system in which all Americans get their insurance from the government single payer vary a lot depending on how you frame the question. Calling it “Medicare for all,” for example, generally elicitsmuch stronger approval, while emphasizing the word “government” tends to depress support.

But at the very least, some survey questions that have remained consistent in recent years show support has been rising back up over the past few years for the broader idea that the federal government bears responsibility for making sure all Americans have health-care coverage.

The increase in the share of Americans on government insurance is partly due to demographics (baby boomers aging into Medicare) and partly due to deliberate policy changes growing the pool of Americans eligible for government insurance (such as the creation of the Children’s Health Insurance Program and Obamacare’s Medicaid expansion).

In both the recent YouGov and Morning Consult polls, for example, the age group most opposed to single payer was the only one that basically already has it: those 65 and up. In other words, single payer for me but not for thee.

That’s not because older Americans hate their experience with Medicare and wouldn’t wish something similar upon their worst enemy. To the contrary, those on Medicare are more satisfied with how the health-care system works for them than people on private insurance are, according to Gallup survey data.

Rather, seniors are probably worried that expanding government coverage to more Americans could put their own generous benefits at risk. 

Trump supporters with deep hostility toward Obamacare, among other government programs. Some of these Trump supporters are, perhaps puzzlingly, themselves Obamacare beneficiaries, receiving government subsidies for private insurance on the individual exchanges. But often what these Trump voters say they want is not a return to pre-Obamacare days; rather, they want in on the great insurance deal that they think their lazy, less-deserving neighbors are getting.

House Speaker Paul D. Ryan (R-Wis.) and his congressional compatriots seem to further believe — despite all evidence to the contrary — that the private sector is on the verge of some innovation that will magically reduce health-care costs and give all Americans the coverage and care they yearn for. 

Americans as a whole pay through the nose for the least efficient and most costly health care system in the world.  Why can't this country learn from the experience of other advanced nations and opt for universal coverage and a single payer system?  Two reasons, I suspect: (i) many of the wealthy don't give a damn about their fellow citizens, and (ii) the evangelical Christians hate most of their fellow citizens and want to keep their monies for themselves.  

Are People Waking Up to Fact GOP's "Small Government" Agenda Is Killing GOP Voters?

For years now - perhaps decades - the Republican Party has been wooing working class white voters to vote against their own economic best interests through appeals to racism, religious extremism, and other forms of hatred towards others.  It worked yet again in the 2016 presidential election.  Now, these manipulated voters who have been played for fools time and time again may be belated waking up to the fact that GOP policies are literally killing them.  The uprising of Trump voters and working class whites against the GOP plan to kill Obamacare is a case in point - especially after many receiving health care benefits woke up and discovered that the new found benefits they enjoying (and depending on to survive) derived from Obamacare.  Yes many will continue to fall for the GOP's toxic brew of racism/religious extremism/xenophobia, but perhaps the tide is finally turning, although not in time to have avoided the Trump/Pence nightmare.  A piece in New York Magazine looks at this possible awakening.  Here are excerpts:

In his inaugural address, President Trump vowed that “the forgotten men and women of our country will be forgotten no longer.” He then suggested that the government has a responsibility to provide its “righteous people” with “great schools for their children, safe neighborhoods for their families, and good jobs for themselves.”

The hedge-fund billionaire who bankrolled Trump’s campaign takes a different view. Robert Mercer reportedly believes that “human beings have no inherent value other than how much money they make,” and that “society is upside down” because “government helps the weak people get strong, and makes the strong people weak by taking their money away, through taxes.”

Thus far, Trump’s governing style has been more in keeping with his donor’s private views  . . . . The president has backed a health-care plan that finances a tax cut for millionaires by throwing millions of “forgotten” Americans off of Medicaid — while proposing a budget that would slash spending on public housing, food assistance, after-school programs, and development funds for poor rural and urban areas.

The fact that the new Republican president is serving as a loyal general in the one percent’s class war would be wholly unremarkable, had Trump not campaigned as a populist outsider. But then, if Trump hadn’t run as a populist outsider, it’s quite possible that there wouldn’t be a new Republican president.

Typically, Republicans attribute the despair of impoverished communities to the moral failings of individual poor people. But Trump never lamented the “culture of poverty.” Instead, he blamed the misery of the “forgotten” on rapacious elites who had failed to protect the “righteous” people’s economic interests. . . . This message — when liberally (or, perhaps illiberally) salted with appeals to white racial resentment — proved to be a winning one.

Trump gave the GOP the rebrand it desperately needed. But, thus far, he’s made few alterations to the actual product. And, judging by their failed attempt to pass a supply-side tax cut dressed as a health-care bill, Republicans believe that the only thing their agenda ever lacked was a racist reality star as its salesman.

But they are wrong about that: Movement conservatism is failing politically because its policies have never had less to offer the voters it relies on.

New research on the surging death rate among white, non-college-educated Americans offers a harrowing testament to this fact. In 2015, Princeton economists Anne Case and Angus Deaton discovered that an epidemic of suicides and substance abuse was driving up the mortality rate of middle-aged, working-class, white Americans — even as medical advances were pushing down that rate for college-educated whites and every other racial and ethnic group. . . . .  the great recession, black and white non-college-educated workers have seen their mortality rates rise, across every age group. And working-class African-Americans still suffer higher death rates than white ones do.

However, only the non-college-educated white population has seen a nearly continuous rise in its mortality rate over the last two decades. And that jump has been driven by a uniquely high spike in “deaths of despair.”

[N]on-college-educated white workers have seen their economic prospects drop from a higher peak — and no countervailing narrative of cultural progress has arrested their sense of decline. This foreboding can pervade whole communities, and lead their most vulnerable members to seek relief in drinking, drugs, or death. . . .  economists suggest that these breakdowns are “rooted in the labor market.” 

Movement conservatism’s other anti-poverty prescription — instilling self-reliance in the poor by kicking them out of their welfare hammocks — also withers under the paper’s scrutiny. The United States has the thinnest safety net of any major, western nation. And it is also the only such country in which non-college-educated white workers are dying much younger than they used to. . . . . the rationale behind House Republicans’ push to add work requirements to Medicaid — that providing a minimum standard of health care to the indigent unemployed breeds an unhealthy dependency — is hard to reconcile with the superior health outcomes of workers in European nanny states.

[T]he GOP has grown more radically right wing; income has grown more concentrated at the top; and Republicans have grown ever more dependent on the nonaffluent for votes.
Now, even the GOP base supports more government spending on health care and opposes tax cuts for the rich.

Republicans can continue putting the superstitions of misanthropic billionaires above the needs of their downscale voters. But in doing so, they will send more “forgotten men and women” to early graves. And, eventually, the righteous people may take the GOP down with them.

One can only hope that this growing realization accelerates and that some will learn to change the channel from Fox News.  

Gutting Healthcare for the Poor to Give Tax Breaks for the Rich

Unlike Speaker of the House Paul Ryan, I no longer belong to the Catholic Church and make no claims about my religiosity and loyalty to the Church - even as Ryan backs policies opposed to both the Gospel message and the Church's social gospel teachings.  I'd go even further and say that I don't even like to be called a Christian because of the negative connotations that term now carries thanks to the evangelical and fundamentalist Christians and their hate and bigotry fueled beliefs.  Yet I can recognize the moral bankruptcy of the GOP healthcare "reform" plan that will deprive millions of health insurance coverage in order to fund massive tax cuts to corporations and the most wealthy individuals.  Paul Ryan's "freedom to choose" coverage is simply a total lie since millions will have no choice and no financial ability to purchase coverage, including the elderly.  Both Ryan and his plan are despicable.  Here are highlights from a piece in The Atlantic:

If the terminology of Republican Medicaid policy—“per-capita caps,” “block grants,” “inflation targets”—seems a bit arcane, Monday’s release of the Congressional Budget Office’s report on the GOP’s repeal-and-replace bill makes it pretty simple: The current health-care proposal is about rationing care to fund tax cuts for the U.S.’s highest earners.

In the past, accusations of care-rationing have been a favorite attack on the Affordable Care Act by Republican leaders such as House Speaker Paul Ryan and House Majority Leader Kevin McCarthy. Yet Republican efforts to cap and cut Medicaid make pretty clear that the strategy is to pay for tax cuts that largely benefit the highest earners by forcing governors to become rationers-in-chief—making painful choices regarding how to best ration or deny health care to those in nursing homes, with disabilities, and/or near the poverty line (and that’s in addition to the 14 million Americans who are projected to be completely denied Medicaid coverage over the next decade under the Republican proposal).

[T]he current Republican bill would lead to painful limits on treatment that would “force states to ration care and deny some Americans lifesaving treatments or nursing home care.”Rationing care to fund high-income tax cuts is not just the byproduct of the Republican Medicaid plan, but rather at the heart of it. The motivation of nearly every GOP health-care proposal past and present—to end the guarantee of coverage for those eligible for Medicaid, and replace it with spending caps—has always had more to do with supply-side fiscal policy than health-care reform.

[T]he AHCA seeks to accomplish the GOP’s long-sought goal of undermining Medicaid’s guarantee of necessary health care for all those eligible through an effort to artificially cap and constrain spending. This time, Republican congresspeople have modified the vehicle for capping Medicaid spending, opting for what’s called a per-capita-cap (PCC) over block grants, which are lump-sum transfers from the federal government to states. The PCC limits federal contributions to states based on the number of people in five different categories of health-care needs. Like a block grant, the per-capita cap offers no flexibility for unexpected costs, which will put governors in the position of having to ration care anytime there are spikes in health-care costs—even if they occur due to reasons beyond any state official’s control.

On virtually every measure, Medicaid is far more efficient than any other part of the American system. A study from the Kaiser Family Foundation found that, after adjusting for differences in health status, Medicaid costs 22 percent less per adult beneficiary than does private insurance. And its growth rates have also shown an effective use of funds. So, it’s misleading to suggest that Medicaid should be targeted because it’s inefficient.

A likelier motivation is that while Medicare and Social Security have more funding and thus are larger spending-cut targets for supply-siders, many Republicans (perhaps including Donald Trump) fear a middle-class backlash if either of those programs are tinkered with. But many Republicans seem to believe they can mislead middle-class families into believing that Medicaid is only for the poor, and cuts to it would not impact them.Yet those making such a cynical calculation might come to regret it.

First, there has already been significant backlash against pulling back from the Medicaid expansion included in the Affordable Care Act.

Second, even beyond that expansion, Medicaid is a lifeline for about 70 million Americans—a little more than 20 percent of the population—many of whom rely on it for long-term health services. For instance, nearly two-thirds of all Americans in nursing homes are covered by Medicaid. And Medicaid covers 44 percent of all children with special health-care needs, as well as half of all women with serious disabilities.

Third, the program has made care more equitable for children: Under Medicaid, over 40 million children are eligible for guaranteed comprehensive health coverage—including access to physical and mental-health therapies, dental and vision care, and medical equipment—so that childhood health conditions can be discovered and treated before they become serious or disabling.

And finally, many, many Americans care deeply about the hardship such Medicaid cuts would bring to their country’s poorest citizens. Which leads to the question: Since Medicaid is already among the most efficient uses of health-care dollars, what crucial services will be rationed to cut projected spending by 25 percent in 2026?  

Obviously, Paul Ryan and the GOP care nothing about the poorest Americans who they seemingly wish would simply just die.

Hospitals and Health Groups Denounce GOP Healthcare Bill

Ready to screw over working class families

To the surprise of few, the Republican Party's proposed replacement for the Affordable Health Care Act is a true abortion and despite the bloviating - translate lies - of Republicans, the plan would leave millions without the ability to secure coverage.  Two of the components Congressional Republicans blather about the most are basically worthless to lower income Americans: (i) tax credits, and (ii) health savings accounts ("HSA").  If you aren't making much money and are paying little in taxes, giving you a tax credit goes nowhere near providing the funds to purchase healthcare coverage.  The same more or less goes with having an HSA.  If you don't have the funds to fund the account - and most working class Americans don't - you are left with nothing.  In short, the GOP message to many Americans is that if you get sick, just go ahead and die.  As Congressman Joe Kennedy III noted, the plan is the reverse of the Gospel message Republicans falsely claim to honor.  The New York Times looks at the condemnation coming from hospitals - some of which would likely go into bankruptcy under the GOP plan - and other health care groups.  Here are excerpts:

Influential groups representing hospitals and nurses came out on Wednesday against a Republican bill to repeal and replace the Affordable Care Act, joining doctors and the retirees’ lobby to warn that it would lead to a rise in the uninsured.

In a letter to lawmakers, major hospital groups wrote, “As organizations that take care of every individual who walks through our doors, both due to our mission and our obligations under federal law, we are committed to ensuring health care coverage is available and affordable for all.”

The groups, including the American Hospital Association, the Association of American Medical Colleges, the Catholic Health Association of the United States and the Children’s Hospital Association, said they could not support the bill “as currently written.”

The hospitals and the American Nurses Association joined the American Medical Association and AARP, which rejected the bill on Tuesday.

Squeezed between wary health care providers and angry conservatives who believe that the bill leaves too much of the Affordable Care Act in place, the Republican leadership and President Trump appear to be facing an uphill climb.

But the White House appears increasingly confident about the prospects for a health care overhaul to pass in the House. In a meeting with conservative leaders in the Oval Office on Wednesday, Mr. Trump said he anticipated the most trouble in the Senate, where moderate and conservative lawmakers are opposing the plan for different reasons. He said he was prepared to pressure holdout senators by holding the kind of stadium-style rallies he led during his presidential campaign.

The array of groups taking strong positions against the bill is evidence that its potential consequences extend far beyond health insurance coverage, to much of the nation’s economy.

The congressional Joint Committee on Taxation issued estimates this week showing how much revenue the government could lose starting in 2018 under the Republican bill, which the party has called the American Health Care Act, as a result of repealing taxes on drug makers (nearly $25 billion over 10 years), insurers (nearly $145 billion), makers of medical devices (nearly $20 billion), and high-income households (more than $270 billion from taxes on earned income and investment income).

The A.M.A., which has nearly 235,000 members and calls itself the voice of the medical profession, sent a letter to leaders of the two committees on Tuesday saying it could not support the Republican bill “because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations.”

In particular, the group said it opposed a plan to replace the sliding, income-based premium tax credits provided under the Affordable Care Act with fixed credits based on age. The current system, it said, “provides the greatest chance that those of the least means are able to purchase coverage.”

America’s Health Insurance Plans, the health insurance lobby, released its own lengthy statement on Wednesday. In a letter to the leaders of the House committees that drafted the bill, Marilyn B. Tavenner, the group’s chief executive, warned Republican leaders that their plans to change Medicaid financing, among other things, could harm coverage and care.

A day earlier, AARP — the association of middle-aged and older Americans that is another crucial supporter of the Affordable Care Act — declared its opposition to the bill and even started running an ad against it. In a letter to Congress, the group said the bill would increase health costs for people ages 50 to 64, could lead to cuts in Medicaid coverage of long-term care and would allow insurers to charge older people five times as much as younger ones.

There was also a creeping concern about how quickly the bill was moving. Senator Mitch McConnell of Kentucky, the Republican leader, essentially promised to move the bill to the Senate floor without the hearings and other processes that are normal for such a far-reaching piece of legislation. He had promised when Republicans took the majority that they would honor normal Senate processes and traditions.

“I think if that’s the approach they take,” Mr. Rubio said, “they won’t have the votes in the Senate.”

Note the $270 billion tax cut to high income households and huge cuts to insurance companies.  That is what this bill is really all about.  Working class whites who fell for the GOP's appeals to racism, bigotry and religious extremism are about to learn that the GOP cares nothing about them and is going to f*ck them over thoroughly.  I have no pity for these people if this happens.  They did this to themselves and deserve to suffer greatly.