These days words and meanings are everything, and are often deployed with special aplomb to distort and divert inquiring minds from truth. I've already - in previous posts - noted many historical examples, such as the substitution of the vanilla term "scandal" for actual, multi-layered conspiracies such as Watergate and Iran -Contra. The effect being to divert the historically purposive mind from political conspiracy to well, something "scandalous" - like the Clinton- Monica Lewinsky nonsense. Thus are events riven with historical and political gravitas reduced to gossip-style, forgettable one offs.
Similar word twisting perversion occurred with using the term "death taxes" for estate taxes, the better to spare the wealthy from having to pay their fair share in a democratic, supposedly fair society. Now, the latest addition to this sordid verbal jui jitsu involves the terms used for the atrocity known as the Senate health care bill which demolishes Obamacare and has cynically been named the 'Better Care Reconciliation Act. of 2017.'
The Wall Street Journal added to this perversion in its editorial yesterday ('The Senate Health Care Advance') by first using the term "Senate" when only the Reepo contingent pushed it through, and second, calling it "health care" when in it is all about tax cuts, and third, using the word "advance" when it is in fact a major regression for 75 million fellow citizens.
There are other aspects of the WSJ editorial I also want to call into question and criticize from a historical, economic and political perspective. Why? Because getting at the true nature of this misbegotten piece of "legislation" requires doing so, at least to the same degree as when I take care to classify solar flares by their x-ray output. Hence, I cannot in good faith conflate an X-1 flare with an X-9 event, like the WSJ does with its ACA and Medicaid "facts". But WSJ editorials are not known for being factual but circulating Rupert Murdock propaganda.
"The legislation replaces Obamacare's subsidies with tax credits for people who buy insurance on the individual market"
The use of "tax credits" betrays the true intent of this bill as a tax plan, as opposed to a health care bill. Tax credits are the standard conservo solution to genuine fiscal holes, but are really useless gestures. After all, they do absolutely nothing for people in serious medical distress, say to be able to afford actual, meaningful tresatments. They are little better than a useless dollop or dressing, and as one mother of an autistic child put it in a TIME essay last year, would barely cover $1200 of her $30,000 yearly needs. But they do create the illusion of offering something, I mean look at the term "credit", after all. But in terms of health care which I already noted increases inexorably, it is subsidies that pay the freight, not "tax credits!"!
And subsidies would more than be the solution if this country pared back its defense spending to half the GDP proportion, say to what it was before 9/11. After all, a nation that outspends the next 13 together in defense can't possibly be "on the ropes"! Only a moron would believe so. Hence, as former defense analyst Chuck Spinney once put it, let's cut the defense share of GDP back to 2.4 % to 2.2 %. THEN we can make room for providing subsidies via the original ACA which, let us be clear, was the reincarnation of an original REPUBLICAN health care law (also known as "Romney Care")
"Medicaid was originally meant for poor women, children and the disabled - which Obamacare opened to able-bodied, working age adults above the poverty level".
This takes no account whatsoever that health care access (and needs) must expand as a population increases and economic legislation alters over time. Point of fact, the population of the U.S. was about half what it is today at the time (1965) Medicaid came onstream. In addition, the poverty level has barely changed since then, remaining far too statistically "lowballed" for the very purpose of limiting access to benefits.
Now add in the economic forces of globalization - globalized labor markets (and destruction of the U.S. manufacturing sector), and mass corporate downsizing in the 90s, and the case can be made that the original intended beneficiary base of Medicaid was simply way too meager, too small, by 2000. To put it another way, most lower middle and working class citizens - even with jobs - were in essentially the same economic position as "poor women and children" in the late 1960s. Of course, it is in the Journal's best propaganda and spin interests not to process this.
To fix ideas, consider the Denver Post article ('4 in 5 Adults Face Poverty At Some Point In Lives', July 29, 2013). According to the article:
"Although ethnic and racial minorities are more likely to live in poverty, race disparities in the poverty rate have narrowed substantially since the 1970s, census data show.
Economic insecurity among whites also is more pervasive than is shown in government data, engulfing more than 76% of white adults by the time they turn 60, according to a new economic gauge to be published next year in the Oxford University Press."
The Post article further notes that "measured across all races" the risk of economic insecurity rises to 79% or nearly 4 in 5. Pardon me, but this indicates a nation of rising inequality and the degradation of most citizens in terms of their economic welfare. Above all, it shows the need for vastly expanded medical benefits given the deplorable economic inequality ensures most can't afford the health care they need- so must depend on a decent federal government to provide it. An "entitlement"? Perhaps, but how else will our people get the medical treatments they need and deserve?
"The Senate waits four years instead of three but pegs the (block) grants to inflation with no adjuster."
As former Medicaid administrator Andy Slavitts observed last night ('Last Word') this translates on average to a state cut of 25 percent per individual beneficiary. This portends serious losses of benefits for most of a state's population especially given no adjuster. But again, this exposes this sham law for what it is, a tax cut plan for the rich as opposed to providing for the most medically disabled and adversely affected among us. Unless states trapped in a zero sum budget scenario compensate - say by taking funds from roads or preschool- thousands of state citizens will be left to scramble. The very Darwinian nature of the Repuke bill is here exposed, pitting one segment of citizen interests (and citizens) against all others. In other words, a return to the law of the jungle but in economic warfare form.
"The Senate includes about $100 billion for a stability fund .....and could be used by creative Governors to support insurance markets in states like Maine and Alaska"
In other words, the Reep Senate bill creates a slush fund that can be used to bribe state Governors (especially in high premium states) to cooperate with the for -profit sharks to set up costlier protection rackets - passed off as health insurance. (See William Rivers Pitt's sterling analogy at the end of yesterday's post.) By use of creative accounting the state Governors can then make it appear health exchanges are really working - as they would be under a properly redone ACA- when they're only on temporary support from the limited slush fund. When the slush fund is exhausted the premiums across the board will shoot through the literal roof.
"The Senate wouldn't allow states to apply to relax the community ratings regulation which limits how much premiums can vary among individuals with different health risks."
In other words, if instead of being a 70 y/o Medicare beneficiary with prostate cancer, I was ten years younger and lived in a high premium state (e.g. AK) , insurers could charge me up to five times more in premiums (say $5,000 a month instead of $1,000) precisely because my health risk would be recognized as greater from being diagnosed with prostate cancer. It doesn't take a genius to figure out that the end result of this sort of draconian solution would necessarily see fewer men going in for PSA tests, for the very reason they would wish to escape a possible negative diagnosis with adverse consequences to their insurance premiums. By the same token we'd likely see fewer people going in for colonoscopies as well as skin exams (which I also recently had - with one suspicious mole removed for biopsy).
"Importantly, the Senate bill also repeals all of Obamacare's tax hikes .....including the 3.8 percent surtax on investment income."
Left unsaid is that it was precisely these tax hikes that helped pay for the individual subsidies for the low income citizens with unmet health care needs. What the Reeps have done is to basically cut out the tax hikes and gut the subsidies, replacing them with "tax credits". So, whereas before a citizen might have had $20,000 to cover the costs of a prostate cancer treatment he will now be lucky to get a chump change $500 tax credit. This would barely be enough to cover his pain meds and basic tests, far less any kind of real treatment (say focal cryotherapy) Again, all of this exposes the Senate bill as an outright sham, a tax cut bill NOT a health care bill. For reference a person with a $1 million annual income would gain $54,000 each year in tax cuts. Almost enough to buy a new Lexus.
The Journal even confirms this tax cut imperative when the editorial states:
"Some Senators pushed to keep the surtax to avoid the tax cuts for the rich label and spend the revenue on something else."
Too late now, assholes, you're busted! We all know this is a damned tax cuts for the rich Trojan horse being rolled out like a new health plan. Only a certified halfwit would believe otherwise.
"It's not too much to say that this is a defining moment for whether the GOP can ever reform runaway entitlements. If Republicans, the next stop is single payer."
Then by all means let us hope they fail and miserably!
To summarize, these are the facts not processed in the WSJ's editorial:
1) There are vastly more poor citizens than rich in the U.S. of A.
2) The medical needs of an expanding population with few resources, income to begin with will always grow exponentially in relation to economic budgets for which yearly predictability is sought.
3) At the same time the costs of those medical needs must always expand, never decrease because medical inflation always exceeds other forms.
4) Therefore, by dint of (1)- (3) it is budget allocations for genuine health care which must always be given priority in a nation that seeks genuine national security. After all, a sick population can never be a secure one, nor - by extension - can the nation they inhabit.
5) Tax cuts even disguised in a health care bill (so called) can never work and have been proven not to work. They only increase deficits by cutting revenue and make a country less able to come to terms with its long term liabilities. To use economist Paul Krugman's term, they are a "zombie idea" because the Repukes keep bringing them back even after their efficacy has been disproven.