The Attacks on both Obamacare in particular and our healthcare system in general are fragmented and hard to talk about in a very systematic manner. People have specific things that they think are great and that they think are terrible. They focus on these to criticize or glorify the whole. I find this infuriating. To fix things, we have to know exactly how things work, and what and what doesn't work well. My response, then, will be broken into parts which I hope will make sense when you put them all together.
The questions are whether Obamacare has been worth it, can it survive, should it be replaced, and what should replace it. To answer these questions, I think we have to go back to some basic concepts. Hold on. It's going to get ugly.Read more
"As the camel falls to its knees, more knives are drawn" —Bedouin Proverb.
Despite the fact that the Affordable Care Act (Obamacare) has significantly reduced the number of uninsured in the United States, it has also failed to live up to its promises and has seen a great number of failures. The number of uninsured is still high, premiums are growing, networks are narrowing, insurers are losing money, and the Co-Ops, set up as a significant innovation of the program, are failing and will continue to fail everywhere.
In this hot election season, this has brought out enemies on the Left and the Right. The Left wants Obamacare dumped and replaced with a single payer system. The Right just wants it dumped. Both sides attack the program with cherry picked examples that are nonsense and half truths. It's like watching a mud wrestling match where you know you hate one of the wrestlers, but you can't tell them apart anymore.
I am going to post three articles where I try to get to the bottom of what is really happening. I find the sniping on the Right and the Left mostly useless, but also infuriating. The system is broken and Obamacare has revealed all of the cracks. In the first article, I will talk about the Co-Ops and why they had to fail given the structure of the current insurance system. In the second, I will discuss what's going on with market risk and how the big insurance players, despite their massive resources and sophistication, also found themselves sucked into the whirlpool. In the third article I will talk about what we can and can't do about it.
The Affordable Care Act contained a provision to establish and fund the creation of 50 statewide non-profit insurance Co-Ops. There were several reasons for this. First, there was the concern that the current commercial insurers would not enter the ACA marketplace in large enough numbers to support millions of newly insured. Second, it was rightly believed that insurance markets in the United States tend to be dominated by one main insurer and the Co-Ops would add badly needed competition. Third, the Co-Ops were a compromise meant to forestall a government run "Medicare" option that might have a potential to move the entire country towards single payer insurance. And last, many people unclear of the concept of not-for-profit and citizen boards of directors in the United States thought that the Co-Ops would be less greedy and more consumer friendly.
Because the funding for this program was prematurely and summarily cut during one of our GOP manufactured budget crises coupled with Red State resistance to the idea itself, only 23 Co-Ops were eventually established. Of these, half have failed outright. Most of the rest are very weak and a significant number of these have been quietly put under some form of direct regulatory control. With the sole exception of the Maine Co-Op, the Co-Op program will fail unless radical measures are taken (which I will outline in article three).
The provision of all that sweet, sweet government money ($1.6 billion) drew into it two kinds of speculators. The first were the normal kind who wanted a crack at The Big Federal Pie. The second consisted of people who wanted the program to succeed for various political and occupational reasons. Most, but not all, were blinded by the fact that the mass establishment of these Co-Ops was probably the riskiest start- up venture in American history. While the insurance risk factors played a part in this (and the risk factors are what people focused on) I will argue that structural factors played a bigger role in creating risk here and I will try to outline these as briefly as I can.
A. Creating a Network
One of the main things that insurance companies do in the United States is obtain discounted rates from providers. These rates and their terms are set by individual private contracts. Insurance companies and providers are always recontracting with each other, hoping to gain an advantage. Any insurance company's contracting staff will be large and well funded with the latest complex modeling software and contract language software. And this will be true of any insurance company that already has a well developed network.
The insurance company will try to get the best terms and steepest discounts and then will aggregate these discounts to find an average discount so that it can begin to design its different benefit packages and price them. (It is also necessary to know in what way its member population uses the providers, but I will discuss this later).
The Co-Ops started out with no networks at all, no contracting staff or infrastructure, and a mandate as THE state Co-Op to be prepared to cover any member in the entire state.
What most Co-Ops did was to create "instant networks" by using what is called a "rental network." A rental network is a broad, usually multi-state network that has a very shallow discount with a large number of providers. They are usually used in cases where a business (typically a hospital) will want to create a quasi-network for its own employees, where these workers will get a steep discount for using their own hospital and hospital owned doctors, but will also get some sort of small discount should they go somewhere else. Rental networks are not meant to be used as full networks by insurance companies, because their discounts are so small that they can't compete with regular insurance companies with their own sets of contracts.
The Co-Ops plan was to start with the rental network in order to establish an "adequate" network per the state regulatory rules of wherever they were located, and then as quickly as possible, recontract the providers within it with their own more deeply discounted contracts on their own terms. If they did this quickly enough, they would have a network that would cover everyone, but they would also be able to eliminate the main rental contracts with their own competitive ones.
In practice, given the magnitude of the task and the fact that they were literally starting with nothing, they had no idea how long it would really take or what Co-Op contracts would actually be in place when the Co-Ops "went live" and actually started taking on new members. So in their business planning, they worked backwards from what they knew to be the average discount in the state to the average discount of the rental network. From this they created a fairy tale business plan and sent this to the regulators for approval. No one at either end of this chain believed the plan, which is why the Co-Ops were expected to lose money for the first one to three years of their existence until they could get a real network together. The vast majority of Co-Ops lost money in the first two years, even those that did not fail, because (in part) they simply could not build the network they needed. They had no market clout and their contracting infrastructure was mostly immature.
B. Building an Infrastructure
Modern health insurance companies have massive expensive IT infrastructures. It is commonly said in the insurance business that insurance companies are now basically IT companies with insurance companies attached to them.
The core of the infrastructure is the claims payment system. This system has to be able to adjudicate electronically all claims per all the various separate provider contracts that an insurance company has. The claims system also has to be integrated with the member enrollment system, the billing and payment system, the banking system, the accounting system, the hospital contracting system, and the member services system. All of these are separate things. The work of the large insurance companies is to have all of these systems "in house" and seamlessly integrated with each other. For the Co-Ops, all of these separate systems had to be rented from separate vendors. It was the integration of these systems, which were generally not designed to be integrated, that was usually done in house. For many of the Co-Ops, some of the systems weren't even designed to do what the Co-Ops needed them to do, either in their basic functioning or in the volume of transactions that were required. And in some cases, multiple versions of a system were needed. For example, there were cases where a Co-Op needed one enrollment system for individual members and another for employer group members. Both needed to be integrated with the rest of the system. Against this, the Co-Ops generally had inadequate staffs and had to rely on consultants who themselves were often inadequate, although terribly expensive.
To add to this, the Federal government was building its own enrollment and claims system from scratch (the latter not to pay claims but to do member level claims risk calculations) and required the Co-Ops and anyone else participating in Obamacare to able to integrate with their systems.
As you can imagine, there were massive, expensive, service affecting integration problems within the Co-Ops, within the government (which hit the news), and between the Co-Ops and the government. The Co-Ops did not figure these costs in their start up planning, and why should they have? No one had ever done this before.
C. Building a Staff
The Co-Ops had several staffing problems right from the beginning. The first was the acquisition of qualified management. Co-Ops were, by definition, start up companies and risky ones at that. The best executives and managers in the insurance industry could tell how risky they were, if only by listening to their own senior managers panicking about Obamacare. Not many people were willing to leave safe well developed jobs late in their careers to join a Co-Op at any price. This was not only true of the executives but also the middle managers. And even those seasoned executives and managers who did come over had little experience starting an insurance company from scratch. Nor did they have the "turnaround" experience they would need to fix the inevitable mistakes. And there was another problem with capital. While the Co-Ops were relatively well funded, with a Federal capital development fund that was separate from the claims guarantee fund, the manager found problems with how to spend the money. Aside from the fact that at the beginning there did not exist such things as purchasing departments, which meant that that the Co-Ops (having to build up quickly) were screwed by almost everyone they did business with, they had trouble figuring out how to staff up. They couldn't take their time, which caused hiring standards to slip. But they also didn't know if they should staff up quickly against the possibility of small enrollments (and therefore risk spending to much right off the bat) or staff up slowly against the possibility of high enrollments and therefore risk being understaffed and having basic service issues). What usually happened was the worst of all worlds. They didn't anticipate the integration problems, so they didn't staff for them. They tried to forestall permanent staffing, so they outsourced a lot of things they should have taken in-house right away. In some cases, especially in the second year of Obamacare, their membership increased dramatically over the course of a month or two and they found themselves very understaffed against the volume of membership. The IT integration problems, the staffing quality and quantity problems, the in-sourcing of activities and the inevitable initial mistakes all had to be addressed in "real time" as the Co-Ops were providing health services to actual people. And they had to do this while painting rosy pictures to the Boards of Directors (who being appointed from the membership often had no idea how insurance companies worked to begin with) and regulators who were often hostile towards them.
The impossibility (there, I've said it) of constructing an adequate and competitive provider network in the face of major insurance companies, creating a fully integrated claims, enrollment, and financial structure, and a well trained, well organized experienced staff made working conditions at the Co-Ops stressful as they lurched from one catastrophe into another. The level headed leaders who actually thrive in this kind of environment turned out to be rare. So the lights began to go out to a chorus of "I told you so" from politically motivated groups who had their own reasons to want the Co-Ops to fail.
But what about the major established insurance companies with solid networks, infrastructures, and stable well trained staffs? When they entered the Obamacare market, what happened to them?
Here the question of risk enters the picture. With the Co-Ops' basic structural problems, we can look at the questions of pure insurance risk as the coup de grace. But how did the sophisticated risk experts at places like Blue Cross and United Healthcare manage to also shoot themselves in the face?
On the night of September 11, 2001, I got a phone call from a relative who’d seen IRA bombings in London, which she recounted in talking to me about what had happened in New York and Washington earlier that day. Not that these were comparable, she said, but terrorism was an unfortunate reality and that people in places likely to be targeted should be watchful, not scared. I agreed in principle but, with smoke hanging over my neighborhood and rumors still rampant, fear was tough to put aside.
President Obama’s response to Americans’ worry over terrorism—which by some reports is higher now than it has been since the weeks following 9/11—is portrayed on the right as singularly out of touch and insensitive, and even among some supporters as something less than adequate. The issue is getting specific attention in the run-up to his State of the Union address tonight (the last SOTU of his presidency), with some wondering whether he will use the occasion to challenge notions of his perceived indifference to anxieties and concerns over terrorism. But if he does, how should he do it?
The New York Times today explains the difficulty a president faces in appealing to reason, noting what Obama most likely won’t say: that “Americans are more likely to die in a car crash, drown in a bathtub or be struck by lightning than be killed by a terrorist” and that the “Islamic State does not pose an existential threat to the United States.” And there is no way he could say that “a certain number of relatively low-level terrorist attacks may be inevitable” and that Americans may have to adapt to it, as Israelis have, or as my relative said that night in 2001, Londoners had.
It would be good, though, if the president was able to say these things, and more.Read more
The continued relevance of Graham Greene’s The Quiet American was made clear once more thanks to Seymour Hersh's latest article in the London Review of Books. Hersh cites a highly classified report prepared by the Pentagon’s Joint Chiefs of Staff and the Defense Intelligence Agency that undermines Barack Obama’s repeated assertions that there are moderate forces capable of defeating Syrian president Bashar al-Assad. “The assessment,” he writes, “was bleak: there was no viable ‘moderate’ opposition to Assad, and the U.S. was arming extremists.”
A mythical “moderate” force is at the center of Greene’s novel. France’s intervention to maintain Vietnam within its sphere of influence after the Second World War is coming to an end, and a few vanguard Americans are actively supporting an apparently benevolent “third force” opposed to both French colonialism and communism. Thomas Fowler is a cynical British war correspondent who befriends one of these Americans, Alden Pyle, an idealist who is determined to do good “not to any individual person, but to a country, a continent, a world.” Pyle is the perfect foil to the world-weary Fowler. When Fowler discovers the truth about Pyle and his much-hyped “third force,” Fowler is forced to choose between remaining a jaded observer or participating in the conflict.
Within the geopolitical triangle, there is a love triangle involving Fowler, Pyle, and a local Vietnamese woman, Phuong. This adds an element of ambiguity to the characters and keeps the story from being a simple parable. But Greene does have a message: if you believe in the essential goodness of American intervention abroad, then it is easy, perhaps necessary, to think that there are significant local forces that will share American goals--never mind intelligence reports to the contrary. Greene responds to this imperial hubris in The Quiet American, and the epigraph indicates which side he is on: “This is the patent age of new inventions/For killing bodies, and for saving souls,/All propagated with the best intentions.”
The Black Lives Matter movement, which emerged after the 2013 Trayvon Martin case, has been raising havoc on the presidential campaign trail, becoming the subject of heated debate. Republican candidate Ben Carson complained, “The ‘Black Lives Matter’ movement is focused on the wrong targets, to the detriment of blacks who would like to see real change.” Said Rand Paul, another Republican candidate: “I think they should change their name maybe – if they were ‘All Lives Matter,’ or ‘Innocent Lives Matter.’” Some are even calling Black Lives Matter a hate group whose rhetoric is partially responsible for the recent shooting of a sheriff in Texas. [*] In contrast, Cornel West, a proud member of the activist group, insists it is fighting a noble battle against state-sanctioned violence against African Americans.
According to the Black Lives Matter mission statement: “#BlackLivesMatter is an ideological and political intervention; we are not controlled by the same political machine we are attempting to hold accountable. In the year leading up to the elections, we are committed to holding all candidates for office accountable to the needs and dreams of Black people…”
So far, the primary methodology of accountability has been to interrupt the public appearances of presidential hopefuls and bombard them with questions about their sense of responsibility for the current state of affairs and their plans to eradicate racial injustice. Black Lives Matter has crashed public appearances by Bernie Sanders, Hillary Clinton, and Martin O’Malley.
At an O’Malley appearance a few weeks ago, lieutenants of the movement leapt to the stage, commandeered the mike, and demanded that O’Malley answer the seemingly rhetorical question, “Do black lives matter?” With great conviction, the former governor huffed, “ All lives matter.” The duo practicing the politics of disruption were not satisfied and reacted to O’Malley’s answer as if to say “Wrong!”
O’Malley, who has a strong record on civil rights, was profoundly perplexed. After all, you don’t need to be a logic professor to understand that “all lives matter” implies “black lives matter.” But despite his good intentions, maybe O’Malley in his puzzlement was missing something.Read more
Earlier this month, I happened to turn on the PBS NewsHour and caught a roundtable discussion on President Obama’s decision to send another 450 military “advisers” to help train the Iraqi army in its fitful fight against ISIS. One of the panelists was Commonweal contributor Andrew Bacevich, author of The Limits of Power: The End of American Exceptionalism, among other books. Also on the panel were Ret. General Anthony Zinni, former commander of U.S. Central Command, Michele Flournoy, former undersecretary of policy at the Department of Defense, and Leon Panetta, former secretary of defense. Zinni, Flournoy, and Panetta were all supportive of sending more advisers and even expanding the scope of the rules of engagement. Not surprisingly, Bacevich was skeptical. As he saw it, whatever skills the U.S. military might instill in Iraqi forces, they will not “be able to transfer the will to fight, which would seem to be the fundamental problem.”
Panetta was hawkish and optimistic about an expanded U.S. military mission. He seemed to think that the Shiite-led government in Baghdad could be pressured into arming its Sunni and Kurdish partners in the north. “We’ve got to push the Iraqis,” he said. No one asked why we would have more leverage with the Shiites now than we did when we had a hundred thousand troops in Iraq. Panetta insisted that ISIS posed a grave threat not just to U.S. interests abroad, but to our domestic security. Bacevich responded that Panetta was “vastly exaggerating” any threat ISIS might pose to the United States. Given the disasters of the Iraq and Afghanistan wars, we “ought to be a little bit humble” about thinking that U.S. military can fix problems in that part of the world. Bacevich observed that we had in fact created many of those problems by invading Iraq in 2003. “The evidence is quite clear,” he said. “U.S. military intervention in this region creates greater instability, not stability.”
Isn’t that a simple statement of fact? Evidently not to Panetta. He reads recent history quite differently. “The fact is, we’re good at counterterrorism,” he said. “The reality is that we know how to do this without deploying the 101st Airborne or a large number of brigades.”
I confess to being nonplussed by that statement. Does Panetta honestly think Iraq and Afghanistan have been rousing counterterrorism success stories? I suppose that might be true if the goal was to occupy both countries indefinitely. But there are limits to American dominance, and limits to what we should ask of our men and women in the armed forces.
To his credit, Bacevich was having none of what Panetta was selling. “With all due respect,” he answered the former secretary of defense, “we don’t know how to do this.”Read more
We've just posted three new stories to the homepage.
1. In his latest Letter from Rome, Robert Mickens suggests the possible reasons behind the Vatican Secretary of State's "apocolyptic assesment of the the Irish referendum" is culture, "particularly Italian culture," because Italy is "the most conservative country in all of Europe when it comes to social conventions and customs," especially concerning the family.
Mickens also reveals who exactly has been holding "secretive meetings and initiatives" in the run-up to October's Synod on the Family that deal with "some of the more thorny issues" the bishops will be debating, including the Kasper proposal.
2. The Editors present reasons, if the Amtrak derailment isn't enough of one, for why the U.S. government’s failure to invest in infrastructure must change:
The United States now spends less than 2 percent of its GDP on infrastructure, less than half of what Europe spends—and less than half of what we were spending in the 1960s....The American Society of Civil Engineers gave [the nation's infrastructure] a grade of D+... [and] noted that the average age of the country’s 84,000 dams is fifty-two, and that one in nine of its bridges is considered structurally deficient. Every few years one of these bridges collapses, occasioning a brief outburst of bipartisan concern on Capitol Hill. Then nothing changes.
Read all of 'Signal Failure.'
3. George Dennis O'Brien, pondering the future direction of Catholic education, looks backward:
The dominant style of higher education in the ancient world was not academic but humanistic, directed at educating future political leaders who needed to learn the art of persuasion.... [T]he humanistic “classical curriculum” dominated American colleges from colonial times until the end of the nineteenth century.
Are Catholic institutions replacing the humanistic style with the "academic style of close argument and verifiable truths"?
We’ve just posted our June 1 issue to the website. Among the highlights:
Amanda Erickson describes the struggle of a Catholic parish community in Freddie Gray's Baltimore neighborhood to respond adequately, in the wake of the riots, to the root causes of hopelessness there:
The life expectancy of those born in Sandtown-Winchester is thirteen years shorter than the national average. Those are problems that can’t be fixed by one man, or in one morning. So instead, Rev. Bomberger grabbed a broom and headed across the street.
Andrew Bacevich reviews Andrew Cockburn’s “imperfect but exceedingly useful book,” Kill Chain: The Rise of the High-Tech Assassins, about the motives behind and justifications for targeted assassinations and drone warfare—now common practices in U.S. foreign policy.
Cockburn quotes one U.S. Air Force general bragging, “We can now hit any target anywhere in the world, any time, any weather, day or night.” Yet why bother with bombing bridges, power plants, or communications facilities, when taking out Mr. Big himself provides the definitive shortcut to victory? Here was the ultimate critical node: Decapitate the regime. As an approach to waging war, what could be more humane, not to mention efficient?
Plus: New poetry from Marie Ponsot, Celia Wren explains why the once-promising plotlines of Mad Men hit a dead end, Paul Johnston reviews the latest from Reading Lolita in Tehran author Azar Nafisi, Molly Farneth reviews the latest, uncomprehensive but newly non-Eurocentric Norton Anthology of World Religions, and Charles Morris reveals the dirty little secret of major-league banking bankers don't want to believe.
See the full table of contents here.
We've posted two new stories to the website.
First is Robert Mickens's latest Letter from Rome, in which he tracks the angry reactions of traditionalist-leaning Catholics to certain words from an archbishop (one of Francis’s most trusted theologians) interviewed by an Italian newspaper. He also examines the continuing threats of schism from these Catholics "should Pope Francis and the Synod of Bishops allow for changes in church teaching on marriage" and gives an interesting look into how Opus Dei has taken advantage of the saint-making process, which was streamlined by St. John Paul II in 1983.
Read the whole thing here.
Next, the editors weigh in on the European Union’s welcome, if belated, announcement to take an active role saving refugees and expediting asylum requests for the hundreds of thousands fleeing war, poverty, and religious and ethnic persecution in Africa:
…certainly the nations that are blessed with relative economic strength—and whose military and political missteps have helped bring about the crisis in [Africa]—owe it to the afflicted to stop the loss of lives at sea.
Could the Obama administration’s response to the migration crisis in Central America be a useful model for European nations dealing with their own migration crisis?
Read the whole editorial here.
On the website now, our May 15 issue. Here are some of the highlights:
Isolate the contagion. Prevent transmission. Treat outbreaks instantly and aggressively.
Classical theology has the angels deciding their destiny in a single, unalterable choice. I sometimes dream of being able to imitate such an act, one that would free me from all my ambiguities and contradictions, my half-hearted aspirations and ineffectual resolutions. This is not the way things work, however...
Read all of "Knowing Jesus" here.
Eve Tushnet reviews an exhibit produced by over 40 artists at the National Museum of African Art that recreates Dante's Divine Comedy on three floors:
I’m sitting in hell with a couple of little boys, who are trying to prove they’re not scared. We’re watching a cloth-wrapped figure prostrate itself and bang its fists against the floor, as sobs and wordless singing give way to a howled “I, I, I surrender!”
Read about the beautiful, horrific, beatific and redemptive show here.
Also in the May 15 issue: James Sheehan on how Greece and Ukraine are "testing Europe"; reviews of books about abortion, the short history of the black vote, a young Lawrence of Arabia, and secular humanism—plus poetry from Michael Cadnum, Thomas Lynch, and Peter Cooley; and Elizabeth Kirkland Cahill reflects on bodily decrepitude and wisdom.
E.J. Dionne Jr. provides a deeper look into social problems in Baltimore--how globalization of the economy, technological change, and deindustrialization have taken manufacturing jobs out of the city without ever replacing them. Dionne interviews Thomas J. Vicino, author of Transforming Race and Class in Suburbia: Decline in Metropolitan Baltimore, who explains:
“This is a double-whammy for poor black people left in the city....They are not in a position to share in the development downtown and, with the loss of manufacturing jobs, they are left, at best, with access to relatively low-paying service jobs. This, in turn, creates a spiral for those left behind, damaging families and devastating neighborhoods.”
This cycle hurt working-class whites as well, Vicino added, “but whites were in a better position to move elsewhere, whereas black mobility was limited by housing discrimination.”
Reading all of "The Roots of Baltimore's Anguish" is worth your time.
Also, in “Does the Earth Have Rights?,” Robin Darling Young writes on the anticipation (and political polarization) surrounding Pope Francis's upcoming encyclical on the environment. Both Climate skeptic Catholics and non-Catholics with assumptions about the church's views on science will be surprised to learn just how traditionally Catholic progressive scholarship is. In Young's view this raises serious questions:
How [are we] to balance individual moral responsibility, described in the moral teachings of the church, against a general Catholic or human responsibility as developed in more than a century of modern Catholic social teaching?
More broadly and just as important:
What could it mean for nature itself to have rights—rights that are being flagrantly violated by human beings? And what could it mean for Catholic theology if a pope says this?
Read the whole thing (and get thinking) here.
During her 2008 presidential campaign, Hillary Clinton talked a great deal about religion. At one point, she and Barack Obama faced off in a “Compassion Forum” in which they were interviewed about their beliefs. Clinton used the occasion to continue assailing Obama for his quote that some embittered Americans "cling to guns or religion":
… from my perspective, the characterization of people in a way that really seemed to be elitist and out of touch is something that we have to overcome.
You know, the Democratic Party, to be very blunt about it, has been viewed as a party that didn't understand and respect the values and the way of life of so many of our fellow Americans.
And I think it's important that we make clear that we believe people are people of faith because it is part of their whole being; it is what gives them meaning in life, through good times and bad times. It is there as a spur, an anchor, to center one in the storms, but also to guide one forward in the day-to-day living that is part of everyone's journey.
Contrast that to the speech Clinton gave last Thursday at the Women in the World Summit in New York:
Yes, we’ve cut the maternal mortality rate in half, but far too many women are still denied critical access to reproductive health care and safe childbirth. All the laws we’ve passed don’t count for much if they’re not enforced. Rights have to exist in practice, not just on paper. Laws have to be backed up with resources and political will. And deep-seated cultural codes, religious beliefs and structural biases have to be changed.
That last sentence was an applause line, as you can see from the video (at 8:55). The italics are mine, but they reflect the emphasis Clinton put on these words through a change in tone, cadence and gesture.
The remark can be decoded in a variety of ways, but a reasonable reading is that Clinton called for efforts to change religious beliefs that oppose abortion. (I directed an email to the campaign press operation to ask if this was so, but received no response.)
The House of Representatives is scheduled to vote this week on repealing the federal estate tax, and while more Republicans favor this repeal than Democrats, I can’t be equally sure the rich favor it more than the poor. The reason is a conversation I had as a reporter in the mid-1990s with the late George McGovern, who lost the presidency so soundly in 1972.
I was interviewing McGovern about his book chronicling his daughter’s tragic death, not about taxes. But when I mentioned that I had cast my first presidential vote for him, we talked a while about national debates that never go away.
Although “income inequality” wasn’t a term then in use, the issue has always been with us. One way to lessen income inequality is the estate tax, designed to ensure that vast fortunes don’t stay wholly within certain families, thereby building up the wealth gap for generations to come.
McGovern specifically brought the estate tax up, not me. During his presidential campaign he had advocated raising the tax, he said, and one of his biggest surprises was the vigorous resistance he encountered among the poor and middle class, people who would likely never have to pay it.
Whether they had money or not, McGovern said, they thought someday they might. And if that day ever came, they wanted their heirs to hold onto every bit of it.Read more
For my 18th birthday I got a subscription to National Review from my grandfather. When I thanked him he replied brusquely, "You've spent your whole life in that house getting one side of the story. I thought it was time you heard the other side."
As I was preparing to go to college in a faraway city, that was music to my ears—I was moving out of my parents' house anyway, and this meant I'd be exposed to even more new ideas. As the year went on however, I read each new issue with a growing sense of disappointment: not because the ideas were conservative, but because so many of the articles were just flat-out illogical and poorly argued.
Those memories came flooding back when reading David French's article, "Is Obama Really a Christian?", in the current issue of the magazine. What's most striking—and disappointing—about the piece is its smallness of mind. When all the huffing and puffing is done about Rev. Wright, Black liberation theology, and the callers to Christian radio shows who are (still) convinced the president is a Muslim, French's argument boils down to the fact that President Obama is a member of the United Church of Christ...and acts like it.
Barack Obama may believe in black-liberation theology, or he may not. He may have a close relationship with God, or he may not. We can’t know his heart. But when it comes to his civic religion, President Obama is his church’s—and liberal Christianity’s—great and mighty instrument.
In reaching that conclusion, French betrays a startling degree of ignorance about the UCC and the broader Christian tradition. As Charlie Pierce noted on Esquire's Politics blog,
The UCC is a direct theological descendant of the Congregationalism that brought the Pilgrims here. Gradually, after the Great Awakening of the mid-18th Century, while losing people to Unitarianism, the Congregationalists began to merge with other denominations until the UCC was formed. But, right from the time the Pilgrims got on the boat, the church had a tradition of self-governance and a fundamental revulsion at the notion of an ecclesiastical hierarchy. It's not the New-Age-y self-help group that (French) seems to think it is. That the UCC is extensively involved in various causes that give the author the willies is his problem, not the church's.
Except for a passing mention that some Catholics didn't agree with some of Bill Clinton's policies, French demonstrates no awareness of Christian theology, traditions or practices outside of those within the relatively narrow confines of American Protestantism in recent decades. If only he'd been writing for a journal of serious conservative intellectual thought, maybe he'd have found an editor to introduce him to a world of Christian conservatism and orthodoxy that extended beyond his own experience.
President Obama roasts Governor Scott Walker ... and himself:
Despite a great performance tonight, Scott has had a few recent stumbles. The other week he said he didn’t know whether or not I was a Christian. And I was taken aback, but fortunately my faith teaches us forgiveness. So, Governor Walker, as-salamu alaykum. (Laughter and applause.)
Scott also recently punted on a question of evolution, which I do think is a problem. I absolutely believe in the theory of evolution — when it comes to gay marriage.
And, finally, Governor Walker got some heat for staying silent when Rudy Giuliani said I don’t love America — which I also think is a problem. Think about it, Scott — if I did not love America, I wouldn’t have moved here from Kenya. (Laughter and applause.) Still trying to deal with the overstaying the visa thing. But hopefully the court is okay with the immigration initiatives.
The rest is here. (And happy Laetare Sunday!)
Saturday marks the fiftieth anniversary of the Freedom March across the Edmund Pettus Bridge in Selma, Alabama. On hand for the jubilee celebration will be Barack Obama. Last November, on the night it was learned that Ferguson police officer Darren Wilson would not be indicted for the shooting death of Michael Brown, the president spoke briefly on the rule of law and the need for peaceful protest. He went on to say: "What is also true is that there are still problems, and communities of color aren't just making these problems up. Separating that from this particular decision, there are issues in which the law too often feels as if it is being applied in discriminatory fashion. I don't think that's the norm. I don't think that's true for the majority of communities or the vast majority of law enforcement officials. But these are real issues. And we have to lift them up and not deny them or try to tamp them down."
What would seem a blow against entrenched denialism was struck earlier this week when the Justice Department released its report detailing civil rights abuses by Ferguson's police force and municipal officials -- practices that Conor Friedersdorf likened to the kind of criminality favored by the Mafia. The repugnance of the behaviors documented (including taser attacks, canine attacks, physical and verbal intimidation, unlawful detainment, and implementation of an extortionate system of compounding fines for minor traffic violations, all targeting people of color) support the analogy. Not all municipalities resemble Ferguson; the problem is that any do. “What happened in Ferguson is not a complete aberration,” the president reiterated Friday. “It’s not just a one-time thing. It’s something that happens.” Meanwhile, criticism of the Justice Department's report from certain quarters as politically motivated isn't just off-base, or offensive; it also simultaneously reflects and reinforces what's illustrated by the findings.
Last year, which in addition to the police-related death of Michael Brown also saw those of Eric Garner, Tamir Rice, and Akai Gurley, marked as well the twenty-fifth anniversary of Spike Lee's film Do the Right Thing. The 1989 release was preceded by a stream of ugly commentary masquerading as criticism from nominally reputable pundits and reviewers who took issue with the movie's climactic depiction of a riot. David Denby: "If some audiences go wild, he's partly responsible." Joe Klein: "David Dinkins [then running for mayor of New York] will also have to pay the price for Spike Lee's reckless new movie about a summer race riot in Brooklyn, which opens June 30 (in not too many theaters near you, one hopes)."Read more
“In the event of a nuclear attack, which of these items would be the most helpful? Rank them in order of importance.”
This was one of the first worksheets I remember from elementary school. There were about twenty illustrated items. My classmates and I were perplexed. Sure, we had probably watched a filmstrip that mentioned the Geiger Counter, but none of us could remember what it did. And why would we want a broom? Would we be that concerned with the tidiness of our fallout shelter?
IT WAS ABOUT 1983. That same year, the Russians shot down a Korean civilian airliner over the Sea of Japan; the U.S. Catholic Bishops issued a lengthy warning about the buildup of nuclear weapons; and on September 26, a Soviet Lieutenant Colonel secretly saved the world from accidental Armaggedon. But more about Stanislav Petrov later.
Growing up in the early 1980’s, not far from North American Aerospace Defense (NORAD) and the Air Force Academy, the Cold War was a hot topic – even for kids. Popular videos on the burgeoning MTV network, such as Genesis’ “Land of Confusion,” satirized and lamented the possibility of nuclear annihilation. Dads took their sons to see “Top Gun” in theaters, and we cheered when Russian MIGs were splashed in the ocean. “Red Dawn” was always checked out of the video store. One of my favorite books, still there in my parents’ house, was titled “Great Warplanes of the 1980’s.”
KIDS TODAY don't have the same fears. They don’t know that the broom is to sweep nuclear fallout off your friends.
The globally-aware college students that I teach don’t think about nuclear annihilation. Environmental degradation? Yes. Terrorism? Yes. Economic inequality? Yes. Racial injustice? Absolutely. But if they think about nuclear weapons at all, it’s in the context of who might acquire them – namely, North Korea or Iran. The notion that the arsenals of the already nuclear-armed states should be at the center of moral concern seems outdated, like referring to music videos being shown on MTV.
The fact is, the nuclear capabilities that already exist have grown in power beyond human comprehension, and there have been enough “close calls” regarding their deployment to warrant the gravest of fears. In recent years, many influential voices have made the case that – regardless of whether nuclear weapons ever made us more safe – they certainly no longer do so.Read more
An unnoticed side-effect of the Republican victory in the mid-term is the decision to launch the party's own foreign policy. John Boehner, Speaker of the House, has invited the governor of Israel, our 51st state, Benjamin Netanyahu to address a joint session of Congress. This appears to be part of the continuing effort of members of Congress to deep-six negotiations between the P5+1 and Iran over the latter's nuclear program. The Congress has threatened to pass legislation increasing the sanctions against Iran. In his State of the Union speech, President Obama said he would veto such legislation, arguing that it would likely end the negotiations and raise the specter once again of bombing Iran's nuclear facilities. Presumably, Boehner thinks that a pep talk from Netanyahu would rally votes to override any veto.
It is not Boehner's responsibility to invite Netanyahu and the White House has objected. It is not Netanyahu's responsibility to interfere in U.S. politics. Perhaps common sense will prevail. Netanyahu will stay home. Congress will not pass further sanctions. Obama cannot therefore veto them. Talks will continue and perhaps an agreement will be reached. Stay tuned.
The Forward has this analysis: "Did Benjamin Netanyahu and the GOP just pull off a coup--or lay an egg?" Jim Lobe has a good round-up of everyone who wasn't asked about the visit, and is now angry, as well as some speculation about who actually proposed it, not Boehner or McConnell he opines.
Yesterday, the Departments of Health and Human Services, Labor, and Treasury published a proposed new rule that would require all insurance plans available on the health-care exchanges to disclose whether they cover abortion in their summary of plan benefits.
As I reported last year, and earlier this year, finding out whether the plan you're shopping for includes abortion coverage has been nearly impossible. According to the new proposed rule, an insurer offering plans on a health-care exchange must explicitly indicate whether or not elective abortion services are included. That is, if such coverage is included, the summary of benefits must list it "in the covered services box," according to the proposed rule. If abortion is not covered, the insurer must list "abortion" in the "excluded services box." Finally, "plans that cover only excepted abortions [elective abortions] should list in the excluded services box 'abortion (except in cases of rape, incest, or when the life of the mother is endangered)' and may also include a cross-reference to another plan document that more fully describes the exceptions."
The new rule, if adopted, would strengthen another rule, proposed by the Obama administration last month, requiring insurers to disclose their plans' abortion coverage before a customer signs up for the policy. Previously the Affordable Care Act only required insurers to disclose abortion coverage "at the time of enrollment." It wasn't clear whether that meant before a person signed up for a plan, at some point after she had begun the signup process, or after she had already completed it. These two rules, if finalized, would allow customers shopping on the exchanges to readily tell whether the plans they're considering cover abortion well before they've purchased a policy.
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