And now, they're coming for your Social Security money - they want your fucking retirement money - they want it back - so they can give it to their criminal friends on Wall Street. And you know something? They'll get it. They'll get it all from you sooner or later. Because they own this fucking place. It's a Big Club: and you're not in it.
"41% of Americans were not aware of the [Supreme Court’s ACA] decision and/or its major finding. That includes 18% of the public who asserted that the decision had not yet been made."
— Kaiser Family Foundationpolling data (PDF link).
On the bright side, 56% of Americans that, uh, actually knew something had transpired in this area prefer that lawmakers “move on to other national issues” rather than “continue to block the law from being implemented.” So there’s that…
"Romney won’t have 60 votes in the Senate. But if he has 51, he can use the budget reconciliation process, which is filibuster-proof, to get rid of the law’s spending."
— Ezra Kleinreflects on President Romney’s potential chances and methods should he try repealing the ACA.
I’m not sure when, if ever, the DC Commentariat will get this through their heads: the next time the GOP holds the Presidency and a non-supermajority in the Senate, the filibuster will be eliminated approximately 30 seconds into the new Congress. Period, the end, carve it in stone.
Reconciliation won’t even be an issue with ACA repeal. It will be a simple majority vote, no filibusters allowed because there aren’t any allowed for any reason. Same with the functional elimination of Medicare, Social Security, and all the other Glibertarian wonders that await us under the Ryan budget plan when and if Romney wins. There’s simply no other way to get their preferred policies through, and the next time they have control of these levers of power they will get their policies through, no matter what it takes. Eliminating the filibuster will be among the more minor procedural changes and will be lost in the shuffle that heralds the end of the New Deal and basically all of the legislative 20th century.
Those are the stakes. Just when, exactly, will anyone in DC realize it? Sometime six to eight years after it all transpires, apparently. I’m assuming David Brooks already has an editorial in the can praising the end of filibusters. For Democrats, anyway.
Matt Yglesias makes a strong case re: the likely philosophical underpinnings of Roberts’ joining the more liberal members of the court to uphold the mandate. Namely that, in the absence of mandate, the Democrats would begin campaigning for Medicare for All. And they’d get it. Maybe not today, maybe not tomorrow, but almost certainly within a millennium or two, and then for a long time.
But! I don’t think nearly that long of a game is needed, though. Presuming Roberts was never going to gut the whole bill, knocking out just the mandate within the political system as currently figured does nothing so well as guarantee the end of the private insurance system we all know and love within 5 or 10 years. This is because, without a mandate, healthy individuals would have powerful incentive not to buy insurance until they are sick. Since the ACA already prevents insurers from refusing coverage for any reason, you’d simply buy insurance on the day you started needing it. That is, to say the least, an unsustainable business model. Some even called for a “poison pill” in the original law designed to create this situation such that even a GOP government would be forced into extending Medicare to all the moment even their constituents could no longer afford insurance premiums.
Roberts knew all of this. He knew he likely couldn’t simply gut the law without adversely affecting the public’s opinion of the Supreme Court in general and the Roberts court in particular, knew he furthermore couldn’t simply kill the mandate without also killing private insurance (gridlock essentially ensured this outcome), and decided the least of these was simply keeping the mandate and letting Congress sort it out. Which, as it happens, was exactly the right decision by any reading of the Constitution and precedent that my not-a-lawyer eyes can detect. Huzzah for democracy.
"In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn’t comply with the new requirements, rather than all of their funding."
It’s almost as if our media aristocracy of inbred Serious People have a vested interest in seeing to it that the middle class, and only the middle class, gets soaked in any economic “compromise.” Amidst reacting to a particularly poor NYT Magazine piece, Dean Baker nails it:
…the piece too quickly dismisses the possibility of getting substantial additional tax revenue from the wealthy. It presents the income share for those earning more than $1 million as $700 billion, saying that if we increase the tax rate on this group by 10 percentage points (from roughly 30 percent to 40 percent), then this yields just $70 billion a year.
However, if we lower our bar slightly and look to the top 1 percent of households, with adjusted gross incomes of more than $400,000, and update the data to 2012 (from 2009), then we get adjusted gross income for this group of more than $1.4 trillion. Increasing the tax take on this group by 10 percentage points nets us $140 billion a year. If the income of the top 1 percent keeps pace with the projected growth of the economy over the decade, this scenario would get us more than $1.7 trillion over the course of the decade, before counting interest savings. Of course there would be some supply response, so we would collect less revenue than these straight line calculations imply, but it is possible to get a very long way towards whatever budget target we have by increasing taxes on the wealthy.
Shocking. And but also, Baker smartly includes the most important issue in any truly serious discussion of American economics and the proper balance of same: the cost of health care:
We pay twice as much per person as people do in other wealthy countries. Since more than half of the tab for our health care is paid by the government, our broken health care system becomes a budget problem. If we paid the same amount per person for our health care as people in other wealthy countries, we would be looking at long-term budget surpluses rather than deficits. The reason that we pay so much more is not that we get better outcomes – we don’t generally. Rather it is that we pay too much to drug companies, hospitals, medical specialists, and others in the health care industry.
Baker’s being generous. We spend as much as five times more per capita than the best performing countries do, all of which achieve uniformly better outcomes than we do. Obviously, the only possible answer here is just get Big Guvmint out of the way so the poor can kindly go die in the streets. It’s the only serious answer to the problem. Well, that and lowering taxes on the wealthiest 1% of the country.
"Most Republican voters believe, with good reason, that Romney stands a strong chance of winning the nomination and beating President Obama. The question is whether he would put repeal front and center—whether he would emphasize it in the general election campaign, and whether he would go to the mat for repeal once in office. Would Romney’s campaign build enough momentum for repeal to achieve 60 votes in the Senate and defeat a potential filibuster? If not, would Romney be willing to advance repeal in the Senate via reconciliation, the complicated and unconventional process that takes only 50 votes but which would also require a far greater expenditure of political capital?"
— Jeffery H. Andersonmakes me wonder if he’s even been paying attention. If we assume that the posited chain of events occurs: GOP holds some kind of House majority and gains a new but non-60 vote majority in the Senate (and, of course, President Mittmentum) then it doesn’t take a rocket scientist to derive the complex psychohistorical formulas for what happens next?!?!?
The GOP eliminates (by simple majority) the filibuster on the first day of the new Congress. The MSM declares this an entirely reasonable, “sensible center” approach to governing. Wholesale dismantlement of the New Deal follows, coupled to and justified by the oncoming tax revenue collapse from a 0% effective tax rate on the rich and consumption-based, maximally regressive tax on everyone else.
It’s what they’ve been talking about for years. They are entirely serious. They mean to do it at the first opportunity, and this would be it. There will be no fiddling with reconciliation or anything approaching “normal order” as we define it in 2011. How many times do they have to say this stuff before someone in the MSM takes them seriously and asks a follow-up or two? Or, for that matter, before The Democrat starts using these positions against them. (Shrill! Class War!!).
The far-right GOP candidates and elected officials are not “blowing smoke” or “providing red meat” for the “true believers.” This is who they are. Everyone else can kindly go die in the streets.
So what do Obama and the Democrats do if the individual mandate in the new health care law gets struck down by the Supreme Court?
Immediately propose what they should have proposed right from the start — universal health care based on Medicare for all, financed by payroll taxes. The public will be behind them, as will the courts.
This is utterly wrong on all counts. It utterly and willfully ignores the year of political sausage making that only managed to barely result in a marginally workable plan that squeaked by under reconciliation rules. The law enacting Reich’s paragraph couldn’t have passed a majority of Democrats at the time, and you’ll recall there were commanding majorities in both houses of Congress then. Aren’t now. And this wouldn’t even see the floor, no matter how passionately Obama or Bernie Sanders or Nancy Pelosi or Jesus Christ Himself argued for it.
What, then, needs to happen if the mandate section of the ACA is struck down? The death spiral needs to happen is what. The ACA without a mandate will destroy the private insurance companies within a decade. But,long before that happens, when the moment arrives that the mega-rich can no longer afford premiums, the party in power on that day, whichever that may be, will be forced to enact Medicare for all. Immediately. Not because they want to, but because it will be the only way forward. And that is the one and only way it ever gets passed. Not through rousing speeches or acting tough or with anything less than a 70-80 seat majority in the Senate and a few hundred in the House coupled to a far more progressive Democratic President than is currently serving.
And until the moment that we as citizens, they the politicians, they the DCCC (and like groups that run the party, its messaging, goals, and determine its candidates), and especially they in the form of the broader media internalize this and begin to act on it accordingly, we and they will fail. Period.
How to square the circle: Assuming Medicare for all tomorrow and that you can find a way to return the dollars in-between the red and blue lines to the people paying it: the American worker with employee provided health insurance. Right now, that’s all invisible income, spirited away into the employer-shared costs of providing coverage. It’s the underlying reason that real wages have been stagnant for most of my lifetime. Turn that into real wages and the broader economy would explode. There would suddenly spring into existence a middle class with (gasp) actual purchasing power. Who knew?!?
Naturally, the plutocrats would, at least initially, turn that space into more profits for themselves. Sooner or later, though, it seems likely that constraints on quality workers would gradually bring the money over into regular salary as companies competed to find highly trained folks. You’d still have to solve the manufacturing issue and/or something to do with all that idle but essentially untrained labor force out there…but it would be a start.
At any rate, a few more than the 17 Americans vaguely cognizant of this cost gap need to be made painfully and continually aware of it. Every day, every hour, every time a microphone is switched on with a Democrat behind it. Complete with this graph. That Medicare, far from being “expensive,” saves money in dramatic fashion. And that, since they, the average hardworking healthcare consumer, cannot buy into that massive bargaining pool or something very much like it, they are being robbed. Every. Single. Day. With malice aforethought. And that they have precisely one party, the GOP, and Joe Lieberman to thank for it.
But that would be shrill. And Weiner lied to his fellow Democrat. That’s what’s important here.
Everyone knows — or should know — that the United States spends much more than any other country on health care. But the Kaiser Family Foundation broke that spending down into two parts: the government’s share and the private sector’s share (both measured as a percentage of total gross domestic product), then compared the results to figures from 12 other countries that are members of the Organisation for Economic Co-operation and Development. And here’s the shocker: Our government spends more on health care than the governments of Japan, Australia, Norway, the United Kingdom, Spain, Italy, Canada or Switzerland.
Think about that for a minute. Canada has a single-payer health-care system. The government is the only insurer of any note. The United Kingdom has a socialized system, in which the government is not only the sole insurer of note but also employs most of the doctors and nurses and runs most of the hospitals. And yet, measured as a share of the economy, our government health-care system is the largest of the bunch.
And it’s worse than that: Atop our giant government health-care sector, we have an even more giant private health-care sector. Altogether, we’re spending about 16 percent of the GDP on health care. No other country even tops 12 percent. Which means we’ve got the worst of both worlds: huge government and high costs.
It’s also important to note that, even with this high spending, we’re getting worse outcomes than all the Western countries spending 5-7x less than we do. And, of course, if we had the costs of any of these countries we’d be facing surpluses todayinstead of deficits. But we’re told the only road forward for our country is to slash Medicare, Medicaid, and the rest of the social safety net and give the money to the richest 1%. Saying anything else isn’t Serious.