Charlottesville: Shadows of Darkness

The eclipse came early.  The insanity abroad has been eclipsed by insanity at home.  White nationalists invaded Charlottesville this weekend and the country is bathed in darkness.

When the president attributed blame for Charlottesville to “many sides,” he demonstrated an alarming moral emptiness and intellectual vacuity.

We need presidential resolve and encouragement at such a moment of national crisis.

Much has been said about this overnight, including a retributory Tweet from the “Grand Wizard” himself, David Duke.  Among all the critiques, this one is perhaps the most gut wrenching.

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Duke attacks the President for his ambiguity, for being an ingrate to the White Nationalists “taking back America” in Charlottesville, for his failure to take their side and for failing to condemn instead the counter-demonstrators who opposed their efforts to “preserve” White History, White Culture and White Identity.

And it was not just about color, these white boys flew and wore both Confederate and Nazi symbols, spewed anti-Semitism, pulled down rainbow flags and rejected every individual and collective quality of a diverse, pluralistic society.

This is White Darkness indeed.  It expects to be unleashed from “political correctness” and “in control” with the license and leadership of a bouffant-blond, Aryan-looking White President.

These defenders of White History are the “spiritual” and intellectual descendants of the white American immigrants who, among other things, robbed the indigenous peoples of their land, killed them off with guns and disease, stole Africans from their homes, pressed them into the holds of ships to be transported like animals from Africa, and precipitated the death of millions in a civil war fought over the abominable practice of slavery.  They evoke the Nazi crimes of World War II, defend the Holocaust and justify other nationalist horrors of the modern era.

Yes, Mr. President, please do look in your mirror.  These people voted for you, echoed your words this weekend and proudly wore your absurd MAGA hats while they hissed their hate and wreaked their havoc.  You have enabled them and by your example and, by your silence, you have left them unshackled.

I hope these White Americans represent just a small number of the white Americans who voted for you.  But every white American who did, should also look in the mirror, especially the mirror of history.

Senator Crapo Responds . . . to My Letter

Our federal delegation seems to be failing us on one of the most important issues of our time: health care. For what matters most, they are doing least.

In response to my recent personal letter to Senator Crapo about health care, I received a “form letter,” email response.  (What was I expecting?)

The response completely ignores the issues I raised and reads like an apology for the heartless legislation now before the Senate.  [Senator Crapo’s email is copied verbatim below.]

  • No mention of the CBO scoring that shows tens of millions will lose health coverage under any version of the Senate legislation.
  • No mention of the disproportionate impact on Idaho, because of our already shameful “coverage gap” and the likely losses to already-stretched medical services in our far-flung rural communities.
  • No mention of the disproportionate benefit of tax cuts for the wealthy at the cost of the poor.
  • No acknowledgement that the problems of the current law can be traced to conservative, compromise provisions inserted in the Act; the virulent Republican opposition since; and, the new administration’s squeezing off of legally-mandated support in an effort to force failure–which is like a “caregiver” pressing a pillow over the head of a struggling hospital patient.

Senator Crapo’s email response makes clear the opposition to the current law (the “PPACA”) is based on the right-wing imperatives of unfettered markets and lower taxes. Facts, logic and a concern for the health of society (and our state) do not seem to matter.

For Idaho and Idahoans, this may be the most impactful decision our Senators ever make. Unfortunately, like lemmings (and our Congressmen before them), they appear to be following the partisan crowd in their “rush to the sea.”

In a show of courage, Senators Crapo and Risch should pull back their support and advocate for collaboration with the rest of the Senate (the whole Senate) to find ways to improve the PPACA.

I hope they will muster the courage.  Sadly, Senator Crapo’s apologia does not give me much hope.

 

Senator Crapo’s response to my letter:

July 21, 2017

Jerry Sturgill
Boise, ID

Dear Jerry:

Thank you for contacting me about health care reform. I value the constructive thoughts, opinions, and ideas shared by all Idahoans and welcome this opportunity to respond.

Prior to the implementation of the Patient Protection and Affordable Care Act (PPACA), America’s health care system was in need of reform; however, PPACA favors a one-size-fits-all, top-down approach that has led to increased premiums, smaller provider networks and stifled competition between insurers. It is necessary to work toward implementing consumer-driven, state-based health reforms that ensure the American people have access to the health care coverage that is right for them. On May 4, 2017, the U.S. House of Representatives took the first step toward comprehensive health reform by passing H.R. 1628, the American Health Care Act.

The Senate is currently considering various proposals to repeal and replace PPACA. Any successful reform initiative must include provisions that stabilize the insurance market, repeal the individual and employer mandates and job-stifling PPACA taxes. With premiums rising and coverage options disappearing, the status quo of PPACA is no longer an option.

Congress remains actively engaged with governors, stakeholders and consumers to develop an effective system that works for all Americans. America deserves a better process and a better product, and I look forward to doing my part to make this happen.

In the meantime, please feel free to continue to contact me about health care reform or on other matters of interest to you. For more information about the issues before the U.S. Senate as well as news releases, photos, and other items of interest, please visit my Senate website, http://crapo.senate.gov.

Sincerely,
Mike Crapo
United States Senator

 

 

Bodies Were Lying in the Street

One night in New York City, I happened upon a mafia hit, the result of competition for leadership of the Gambino crime family. Current events take me back to that night.

After law school I worked as a corporate finance lawyer at a prominent law firm and spent 10 years in the firm’s New York City office.

My wife and I had both grown up in the West and, to us, the East had always been distant and forbidding.

“It will be an adventure!” I said to her cheerfully. “We’ll spend a couple of years out there, and then move back West.” She glared at me.

I went out ahead to work and look for housing.  For a week or so, I wandered Manhattan in the evenings, searching for an affordable apartment.

On one of those nights, as I made my way back to my humble Lexington Avenue hotel, I passed Sparks Steak House on 46th Street, close to Third Avenue.

It was the night “Big Paulie” Castellano, head of the Gambino crime family, was gunned down on his way to dinner. Police tape closed off 46th street. Lights were flashing. Sirens blared. Bodies were still lying in the street, covered with sheets.

John Gotti, who had ordered the hit, would become head of the Gambino family. Guess he thought he could do a better job than Castellano.

“Better not tell my wife about this,” I thought, as I skirted the crime scene.

This was a dramatic introduction to an ugly part the City at that time. The mafia was distinctly present and projected an image of being above the law, cocky, arrogant and unrepentant.  Just look at this mug shot of John Gotti.

Gotti mug shot

At that time, some in the New York business world seemed to have inherited mafia-like arrogance, rudeness and winner-take-all attitudes. They showed little concern for relationship and trust. In negotiations, I experienced their blatant misrepresentations, threats, verbal abuse and crudeness.  This always injected stress, distrust and delay in the transactional process.

At law school, in my business negotiations class, I had learned that a negotiator will more quickly achieve optimal outcomes with a collaborative approach.  Humility, listening, honesty and respect build trust, foster cooperation and reach mutually beneficial outcomes.

In the face of the belligerent, bullying New York business style, I consistently applied what I had learned in school. My team succeeded in getting hard things done quickly and our practice grew.

This experience keeps coming back to mind (and you can probably guess where I am headed with the story).

I shudder watching from afar the negotiation style of our new President. So far, his lurching administration has left more bodies “lying in the street” than John Gotti.

This approach to “winning” shows little regard for the “other side,” or the greater good, and, with huge arrogance and a small attention span, fails to understand issues, details, process or people.  It is, to me, mafia-like and poisonous to the political setting.

Our governing institutions, with checks and balances, exist to reach collaborative solutions and achieve optimal outcomes for the whole country, without regard to political party, group identity, winners or losers.

As citizens, we must demand collaboration and resist the “me-first” attitudes promoted by the new administration and worse-than-ever partisanship.

Those attitudes are causing our country, and the world, to become more fearful, angry and divided—and more dangerous and dispirited than ever.

“Lady, Obamacare sucks only because you think it sucks!”

Conservative Republicans have done their best to convince us Obamacare is a failure, even though conservatives designed the very Obamacare mechanisms they now vilify.

We were at our cabin in the mountains on Fourth of July.  Someone, I think it was me, had brought fireworks. We began to set them off.

The rest of the family was gathered around in lawn chairs, except for my mother in law, who, because of her Parkinson’s Disease, was in a wheelchair.

Mid-firework, a Deputy Sheriff suddenly emerged from the darkness. She had seen our celebration from the road. “There’s a fire hazard warning in effect,” she said. “Stop it with the fireworks!”

My automatic reaction, when the sheriff first appeared, was to toss the remaining fireworks into my mother-in-law’s lap, just in case someone might get arrested.

I am reminded of this embarrassing moment as I listen to the “repeal and replace” debate.

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For all the Republican chest beating and finger pointing, it is at least ironic that the mandates, penalties and subsidies that became part of Obamacare were first proposed by conservatives, principally the Heritage Foundation (a conservative “think tank”) and that they were adopted with success into “Romneycare” in Massachusetts.  (Remember that “tar baby”?)

The conservative genealogy of mandates, penalties and subsidies enhanced the likelihood of passage of Obamacare. However, this resulted in an unpolished political amalgam of concessions and compromises, a sort of Rube Goldberg combination of government interventions and free-market “invisible hands.”

The Republicans have since consistently tossed the problems of these mechanisms into the laps of the Democrats–with hyperbolic rhetoric, the 60 or more attempts to repeal, the first Executive Order of the new administration, and now the Republican intimidation from President Trump and the Koch brothers (ouch!  double whammy!).

The effort to repeal and replace Obamacare with Trumpcare (and now the right-wing flanking move against Trumpcare), highlight three conflicting sets of ideas, in increasing order of conservatism.

  • Least conservative is the view that our healthcare system should take care of everyone who needs health care and that market mechanisms should be regulated to reach that result.  Financial aid should be available to help those in need.  (This is “conservative” in contrast to the “liberal” idea of government-sponsored universal health care.)
  • More conservative is government regulation, but less of it, and financial assistance, but not so generous.
  • Most conservative is the approach that government should stay the hell out of health care, and just about everything else. No regulation. No assistance. Health care goods and services left to unregulated, “free” markets.

The first set of ideas explains Obamacare, with its conservative imprint. The second is Trumpcare, as presented to the House today. The third sheds light on the internecine opposition from the far-right. It also reflects the system (or lack thereof) prior to Obamacare.

Sure, Obamacare got off to a rough start, but it has had to drag the anchors of Republican opposition. Nonetheless, it has made material progress toward implementation of outcomes we should all agree on: making health care more affordable and more available to more people.

children in white bath tub on white backgroundIn its short six years, Obamacare has done that. More than 20 million more people are insured. Premiums have risen less quickly than they would have without Obamacare–although there are surely exceptions that deserve to be fixed.

Throwing out this progress is like throwing out babies with bathwater.

And here is something else, lost in the “repeal and replace” hubbub: individual health insurance costs will continue to rise as long as the costs of health care goods and services continue to rise.

Maybe we should focus on that.

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“Medicare for Everyone!”

If you think profit taking in the areas of accident and disease is wrong, if you support efficiency and if you believe we all do better if more people have access to health care, you should agree that Medicare for everyone is a good idea.

The Problems Caused by Healthcare Reform

Step back.  Look at us.  Trumpcare versus Obamacare?  Obamacare versus Trumpcare? We are fighting over competing approaches to the same problems–and ignoring a solution that would be better than both combined.  Medicare.

No matter what, we need a better solution, and quick. While Congress continues its political tug-of-war, we are suffering, individually and as a country. We spend more and get less. The system is rife with inefficiency. Tens of millions are still without health insurance, and tens of millions more stand to lose it. People are dying.

We spend more and get less. Of all the countries in the world, the US spends the most on healthcare (and health insurance), yet health outcomes here are worse. Our average life expectancy is shorter and we have more chronic health problems.

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Medical goods and services are more expensive here. Citizens of other countries are charged far less. For example, an MRI in Switzerland is is ten times (10x) cheaper. Canadians pay at least half as much for medicine.

So we tend to put off taking care of ourselves. Sound familiar? Americans visit the doctor less often, even though an annual checkup and other preventative measures could avoid problems or catch them early. Or even save your life. If you are like me, this has too often been about saving money–with the hope/fantasy that the problem will go away.

And, as a group, we and the politicians are downright dumb. As a country, we spend less on social services than other countries, even though a few dollars for things like clothes and shelter could reduce chronic and expensive health issues among the most vulnerable members of our society. And face it, everyone else, including you and me, ends up paying for unpaid emergency health care, through rate or tax increases. In this case, an ounce of prevention really would be worth a pound of cure.

Oh, and by the way, of the 13 countries shown in the chart above, ours is the only one without a publicly financed or mandated health care system that assures coverage for all its citizens.

Are we fighting over wrong solutions? Market-centric mechanisms common to both Obamacare and Trumpcare fail to care for everyone and lead to economic exploitation. As argued in previous posts, free markets do not perform well in the health care arena.

I have already given examples of exploitation, with fabulous sums extracted by health insurance providers like Aetna and Humana. Under Obamacare, those two companies alone distributed around $22.0 billion to shareholders. They will do even for better for their shareholders in the years to come, particularly if Trumpcare becomes the law.

And then there’s the inefficiency of this whole dog pile of insurance providers. Massive duplication of overhead expenses–identified in accounting as “Selling and General Administrative Expense.” (Think of stuff like management salaries, marketing and rent. Then think of competing insurance company each paying these kinds of costs, over and over and over again.)

Looking at just Aetna and Humana again as examples: Since 2010, under Obamacare, Aetna reported around $60.5 billion of Selling and General Administrative Expense. During this same period, Humana spent around $44.0 billion, for a combined total of over $104.0 billion.  That’s a lot of overhead, and that’s just two companies.

Aetna and Humana argued that their combination would achieve efficiencies known euphemistically as “economies of scale” (aka “people losing their jobs”). Nonetheless, eliminating just one $15 million/year CEO could create savings that would pay for a lot of health care.

If you believe accident and disease are not conditions to be exploited by the “free market,” if you agree that squeezing some of the redundant costs out of the system is a good idea, and if you agree that more people having access to health care and taking care of themselves would be good for our whole society, you should want the efficiency and accessibility of a “single-payer” system.

Like Medicare.  For everyone.

Medicare Green Road Sign Over Dramatic Clouds and Sky.

 

For comparative country statistics, see this report: Squires & Anderson, “U.S. Health Care from a Global Perspective: Spending, Use of Services, Prices, and Health in 13 Countries,” Issues in International Health Policy, The Commonwealth Fund (Oct 2015) at http://www.commonwealthfund.org/publications/

“Fix Obamacare! Stop Wasting Time and Money Tearing It Down.”

The Republicans have burned a lot of time and money trying to dismantle Obamacare. Instead, they and the Democrats should be collaborating to fix it.

For more than 20 million previously uninsured Americans, health insurance through the Affordable Care Act (the “ACA” or “Obamacare”) has been a boost in ways that cannot be measured in dollars and cents:  better health, lower stress, more productivity, making life better for everyone.

“Instead of collaboration to make Obamacare better, Congress spent $87 million of taxpayer dollars on 60 efforts to repeal it.”

The efforts to “repeal and replace” appear to give priority to cutting taxes for the wealthy, and assuring big profits for health insurers, rather than bringing health care to more Americans.  (By the way, can you imagine how great it would be if everyone here was healthy–or at least healthier?)

What is most upsetting is that these same conservatives, through their politics, have done their best to cripple Obamacare and now use the damage they have wrought as a cover for their efforts to repeal and replace it.

I am not saying Obamacare is perfect.  Even President Obama called for improvements. But instead of collaboration to fix the current law, Congress spent $87 million of taxpayer dollars on 60 unsuccessful attempts to repeal it.

Those who sponsored those efforts knew full well that President Obama’s veto pen was always ready.  The only explanation for their bullheaded behavior is that it was a craven, partisan effort to manipulate public opinion and weaken Obamacare.

“Conservatives, through their politics, have done their best to cripple Obamacare and now use the damage they have wrought as a cover for their efforts to repeal and replace.”

They have now turned up the volume on words and phrases, like “disaster,” “imploding,” “death spirals,” and other highly-charged rhetoric that exaggerates and misleads.  (Remember “Death Panels”?)

Of course, this has been calculated to further undermine confidence in the current law and drive away demand from the individual insurance markets.

In addition, on the very day of his inauguration, President Trump’s first order of business to call for “repeal and replacement” of Obamacare and non-enforcement of its mandate and penalties.  For the continued viability of Obamacare, this was like draining the air from your tires and putting sugar in your gas tank.

The new American Health Care Act (the “AHCA” or “Ryancare”) has problems that become more apparent every day.  It is based on false economics, false hope and deserves to fail.  Then, attention should turn to fixing Obamacare, to make it work better, more fairly and for more people.

It’s time to fix Obamacare and to stop the waste of time and money tearing it down. “Collaboration” is NOT a dirty word.

Nor, by the way, is “Public Option.”

10-ways-Congress-could-have-spent-87-million-if-they-hadnt-blown-it-on-60-Obamacare-repeal-votes

 

 

 

“The only thing we have to fear is fear itself!”

Here was the fear described by President Franklin D. Roosevelt in his first inaugural address, “nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance.”

From the other side of the coffee shop, close to the door, came shouted words of accusation.

A man was yelling at the shop’s young manager.  He accused her of being responsible for the theft of his lap top computer.  Apparently, hours before, he had left it unattended at one of the shop’s several tables and, he claimed, it had been stolen.

As he turned to shout at customers, I jumped from my seat and rushed to see if I could help.

The manager and I coaxed the man out the door, and I stood with him in the cold while the manager went to call the police.  The poor guy was wild-eyed, disheveled and smelled of alcohol.

I tried to calm him down and help him understand his own responsibility for the loss of the computer. But he challenged my involvement.

“What makes you think you can tell ME what to do?” he spluttered. “Who are YOU?”

“I’m just a regular guy,” I said. “Standing up for what is right.”

Thankfully, the police arrived quickly and I stepped away, back into the shop.

The manager, in tears, came to thank me for my intervention and to fill out an incident report.

Later, at home, I told my wife about the episode.

“What if he had a gun?” she cried.

Had not thought of that.

The next day I read about another wild-eyed drunk who menaced two Indian men in a Kansas bar.  The man had been ejected from the bar but came back with a gun, killed one of the Indian men, wounded the other and shot a young American who had tried to wrestle the gun away.

I marveled at the heroism of the young American, but trembled as I remembered the coffee shop incident of the day before and Idaho’s new “permitless” concealed carry law.

Here was the fear described by President Franklin D. Roosevelt in his first inaugural address, “nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance.”

fdr inauguration

Fear is again doing its best to take hold, competing with our better instincts to help others by causing indecision, hesitation and moral uncertainty.

Because of fear, belligerence is on the rise. Immigrants are being rounded up and roughed up by those with new authority.  Refugees, who desperately seek sanctuary, are being turned away by baseless travel bans.  Senseless acts of vandalism and violence against innocent Jews, Muslims and people of color have multiplied.

Do we have the courage to resist?  To confront verbal and physical violence?  To oppose politicians and policies that fuel fear with falsehoods and conspiracy theories?

For my part, I certainly hope so.  The costs of cowardice are too high.