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.
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.
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.
"With regard to the idea of whether you have a right to health care, you have realize what that implies. It’s not an abstraction. I’m a physician. That means you have a right to come to my house and conscript me. It means you believe in slavery. It means that you’re going to enslave not only me, but the janitor at my hospital, the person who cleans my office, the assistants who work in my office, the nurses.
Basically, once you imply a belief in a right to someone’s services — do you have a right to plumbing? Do you have a right to water? Do you have right to food? — you’re basically saying you believe in slavery.
I’m a physician in your community and you say you have a right to health care. You have a right to beat down my door with the police, escort me away and force me to take care of you? That’s ultimately what the right to free health care would be."
— Rand Paul in remarks to the Senate Health, Education, Education, Labor, and Pensions Subcommittee.
This is what they believe. If you can’t pay me up front, preferably in gold, kindly go die in the streets like the trash you are. That is all.
Oh, and if Rand Paul is found down, be sure to check his wallet before assisting him in any way. Anything else is tantamount to slavery.
Obama will not blaze a fresh path when he delivers a much-anticipated speech Wednesday afternoon at George Washington University. Instead, he is expected to offer support for the commission’s work and a related effort underway in the Senate to develop a strategy for curbing borrowing. Obama will frame the approach as a responsible alternative to the 2012 plan unveiled last week by House Republicans, according to people briefed by the White House.
Just as we predicted a few days ago, your choices, the entire extent of the debate will be between a center-right proposal (Simpson-Bowles) and a far-right proposal (Ryan plan). Where do you think the Serious Person “sensible middle ground” will be in that fight? Left unsaid will be any discussion of the true driver of deficits: individual healthcare costs. Left unsaid will be: if we had individual health costs of any other Western democracy we’d be facing surpluses and not deficits. Limit rate of growth in healthcare and you fix everything we’re currently fighting over, and without doing it on the backs of the poorest.
It’s now down to just how much of Medicare we will eliminate (er: “privatize”) and what percent of older Americans still get access to it. Then, a couple of years down the road: fewer. In a few more years: gone, because it only serves the poor and they don’t vote. Legislative inertia is literally the only chance that program has for survival.