Politics is sometimes shaped by the Law of Unintended Consequences (LUC). The actions that politicians take expecting a particular result can sometimes lead to unanticipated outcomes.
For instance, in 2011 Minnesotans saw the Law of Unintended Consequences come into play when Republican political hacks in the state legislature voted to put a same-sex marriage ban on the ballot. Their thinking was that a majority of Minnesotans, who they assumed were as eager as they were to outlaw marriage equality, would turn out in the 2012 elections to pass the amendment. They then hoped that the voters attracted by the marriage ban would elect anti-LGBTQ Republicans.
It didn’t work out that way. To the surprise of many, the Republican’s same-sex marriage amendment was rejected by 51.9% of Minnesota voters. This made Minnesota the first state to reject such a ban at the ballot box. To make matters worse, Republicans lost control of the Minnesota Legislature.
This allowed state Democrats to pass a statute legalizing same-sex marriage in 2013.
In other words, the heated debate over the Republican-generated ballot measure made Minnesotans more accepting of same-sex marriage, not less. In this way, the Republicans’ ban plan led to a legalization law. Go Law of Unintended Consequences!
Similarly, at the national level, the 70 times congressional Republicans tried and failed to repeal the Affordable Care Act (ACA)/Obamacare forced previously cowed and muted ACA supporters to finally explain the tremendous value of the ACA. As a result of their pro-ACA advocacy during those 70 debates, an overwhelming two-thirds of Americans now support the preexisting conditions protections of the ACA. Support for ACA repeal is now just 17%.
As with same-sex marriage in Minnesota, the once-unpopular ACA became quite popular, thanks to Republicans’ efforts to kill it.
With these LUC examples in mind, I’m hoping that the LUC might come to the rescue when it comes to Team Trump’s relentless efforts to delay his pending criminal trials. Through a series of legal maneuvers, Trump’s army of lawyers has been pushing out the start of trials, presumably so that verdicts and appeals can’t be finalized prior to the November 2024 election.
The chances are good that Trump’s delay tactics will largely do exactly what they are intended to do, help him once again escape legal and electoral accountability. But maybe, just maybe, they could hurt him. Here’s how:
If Trump’s criminal trials were happening this winter or spring, as originally hoped, the damaging information spotlighted during the heavy coverage of the criminal trials could by November be largely forgotten by lightly engaged, easily distracted swing voters. On issue after issue, we’ve seen that swing voters have the attention spans of gnats. The news they’re casually focused on today could easily get forgotten by the time they vote seven months from now.
But if Team Trump’s delay tactics cause the insurrection-related testimony to be dominating the news in early fall, that could make those issues much more top-of-mind for voters during the closing days of the campaign.
Imagine a September and/or October dominated by wall-to-wall news of insurrection trial coverage. This coverage is constantly showing voters alarming images of Trump supporters assaulting police. Imagine swing voters seeing the mountain of evidence showing Trump doing nothing to stop the bloody assault and subsequently praising the rioters. Imagine them hearing law enforcement officers and Trump’s most loyal supporters and staff giving damaging blockbuster testimony about the bloody chaos that Trump created, relished, and glorified.
Imagine that this is what swing voters are hearing in the immediate lead-up to the election, rather than Trump’s most effective criticisms of Biden about the economy and immigration. And all of this is coming to them via a judicial setting, which feels more weighty and credible to them than the 2022 congressional hearings.
Even though the verdict and appeals wouldn’t be completed by Election Day in this scenario, these are hardly the final images Trump’s campaign strategists want in undecided voters’ minds as they head to the ballot box. If the trial timing worked out this way, the delay tactics could unwittingly keep the insurrection nightmare fresher in voters’ minds than would have been the case if the trials hadn’t been delayed and were happening now.
Again, this is a long shot. The more likely outcome is that Trump’s delay tactics will cause him to largely push his law-breaking out of voters’ minds until after the election.
Former Minnesota State Senator Scott Jensen (R-Chaska) announced who he believes is the second most qualified Minnesotan, after him, to run Minnesota’s state government during very challenging times. Jensen picked — fake gjallarhorn, please! — the Minnesota Vikings’ former Center Matt Birk.
A celebrity! Intriguing! Fresh!
An all-white male ticket! That has got to be first for Republicans, right?
Predictably, the Birk announcement got a lot of uncritical news coverage in Minnesota, particularly from local TV and radio newsrooms. These are some of the same jock sniffers who spend roughly one-third of most news broadcasts building up local athletes as heroes.
And who knows, the Birk stunt just might work, politically speaking. After all, this is a state that “shocked the world” and elected an outlandish and churlish former fake wrestler, and then was shocked when he turned out to be an outlandish and churlish fake Governor.
To be fair, Birk is certainly no Ventura. The Saint Paul native is Harvard educated, and not clownish like Ventura . He’s also done a lot of admirable charitable work in the community. On many levels, I admire him.
But he’s applying to be Governor, and he is largely an unknown quantity on policy issues. So maybe the local media should pump the breaks just a bit on the Birk bandwagon. You know, like maybe ask him a few questions about his actual plans and positions?
Reasons for Skepticism
Here’s a few reasons why skepticism is warranted:
He’s an Extremist Abortion Banner. One of the few Birk policy positions we know about is that he supports overturning the 1973 Roe v. Wade U.S. Supreme Court decision that legalized abortion during the first trimester of pregnancy. Birk feels so strongly about this that he refused to join his Baltimore Ravens teammates in being honored at the White House, because Birk would have had to stand in proximity with then-President Barack Obama, who opposes overturning Roe.
Citizen Birk obviously had every right to express that opinion. But he is now applying to be Lieutenant Governor for all of Minnesota, and this position puts him at odds with the a huge majority of the people he seeks to represent. Surveys show that two-thirds (67%) of Minnesotans oppose overturning Roe.
At a time when it looks likely that the court is about to overturn Roe and start allowing state governments to take away women’s abortion rights, Birk’s refusal to listen to two-thirds of his constituents on this timely issue is a particularly big deal.
He’s an Extremist Marriage EqualityBanner. Abortion isn’t the only issue where Birk is out of step with a majority of Minnesotans. In 2012, he very actively campaigned in favor of the Minnesota Marriage Amendment that would have changed the Minnesota constitution to specifically prohibit marriage equality for same-sex couples.
Once again, Birk is on the right wing fringe, ignoring the opinions of two-thirds of his would-be constituents. A 2018 poll shows 67 percent of Minnesotans support same sex marriage.
Birk’s positions on abortion rights and marriage equality would seem to portend how he would come down on other socially conservative changes being pushed by the far-right, such as book banning and “don’t say gay” laws.
He’s Unqualified for the Job. Then there’s the small matter of qualifications. Birk currently has as much directly relevant experience to be a heartbeat away from the top position in state government as current Lt. Governor Peggy Flanagan has to be a professional football player.
After electing a wealthy celebrity with no governing experience President blew up in the nation’s face, maybe we should be a little more cautious about hiring someone who has never done any actual state governance to lead a very complex $48.5 billion per biennium endeavor. How many times do we have to make this same mistake?
He’s Hitched His Wagon to a Extremist Quack. Even if you like Birk as a player, philanthropist, and sports analyst, and I do, you should learn a little more about his running mate Scott Jensen before signing up to be a Jensen-Birk supporter.
For instance, the non-partisan fact-checking organization Politifact cited Jensen as a major source of its 2020 “Lie of the Year 2020 about coronavirus downplaying and denial. This is arguably the most lethal political lie of our times, and Jensen played a very prominent and destructive role spreading it.
Jensen also joined U.S. Capitol insurrectionist Simone Gold and others in suing the federal government to prevent children from receiving COVID-19 vaccines.
But apparently none of this bothered Birk.
COVID denial and anti-vax messaging earned Jensen a lot of love on Fox News and other far-right outlets, but now he is trying to win a plurality of votes in Minnesota, a state with the second highest rate or boosted residents, and where about three-fourths (74%) of voting age residents rejected Jensen’s ignorant, irresponsible medical quackery and got themselves vaccinated.
What We Don’t Know
Beyond the handful of issues cited here, Minnesotans have no idea where Birk stands on a whole host of other important issues.
Paid family and medical leave? Public funding for free birth control, which is proven to dramatically reduce unplanned pregnancies and abortions? Giving Minnesotans the option to buy into MinnesotCare? Prayer in public schools? Which religion’s prayer? Taxpayers subsidizing billionaire sports team owners’ stadiums? Making the wealthiest 1% of Minnesotans, which includes Birk, pay higher taxes to fund education improvements? Accepting Obamacare funding for Medicare expansion in Minnesota? Maintaining the MNsure Obamacare insurance exchange? “Don’t say gay” laws to punish teachers who mention gay people in school? Allowing parents to ban books from school libraries?
In addition, the state where a majority (52.4%) of 2020 voters rejected Trump should know whether Birk voted for Trump in 2016 and 2020, and whether he plans to vote for the insurrection inciter in 2024. We also must know whether Birk supports the Big Lie that Trump didn’t lose the 2020 election.
I’m very interested to know the answers to these questions. Is Birk Trumpy enough to win far-right primary votes, but too Trumpy to win swing voters in the general election? Or will Birk expose himself to be insufficiently Trumpy, and subsequently be a “kiss of death” for Jensen in the primaries, where Trump loyalists are dominant and demand total obedience.
To be clear, I deeply respect the man’s ability to calmly read a defense with another man’s hands nestled firmly in his buttocks. Skol!
But maybe Minnesotans deserve to know more about Matt Birk than that.
So far, Minnesota Governor Tim Walz has largely been a responsive caretaker governor, responding to the crises du jour rather than than actively pushing a progressive agenda and building a legacy for himself.
Governor Walz’s legacy is essentially “pissed off all sides while consumed with thankless pandemic management.” I think he did a reasonably good job managing the pandemic, but he definitely had to make enemies doing it.
One partial break from caretaker mode was his poorly named “ONECare” proposal, which would give Minnesotans the option to buy into MinnesotaCare. MinnesotaCare is a longstanding program serving low-income individuals and families who can’t get employee-sponsored health insurance and don’t quality for Medicaid, which is called Medical Assistance (MA) in Minnesota.
Giving Minnesota health insurance consumers of all income levels this additional option would ensure that every Minnesotan in every county had at least one health insurance option available to them. That’s a big deal. It also would bring more competition to an individual market that sorely needs more competition. Over time, this could result in lower premiums for consumers.
Walz has not pushed his proposal particularly hard. Meanwhile, other states’ Governors are leading their states forward.
Colorado and Nevada this year passed public option plans—government-run health insurance plans—that are set to launch in 2023 and 2026, respectively. They join Washington state, which enacted its law in 2019 and went live with its public option in January.
The early results from Washington state’s experiment are disappointing. In many parts of the state, premiums for the public option plans cost more than premiums for comparable commercial plans.
Many of the state’s hospitals have refused to take part in the public option, prompting lawmakers to introduce more legislation this year to force participation if there aren’t sufficient health insurance options in a geographic area. And consumer buy-in is also meager. In its first year of operation, the state health insurance exchange sold only 1,443 public option plans, representing fewer than 1% of all exchange policies.
Michael Marchand, chief marketing officer for the Washington Health Benefit Exchange, the state’s health insurance marketplace, said it’s premature to judge the program by its first year.
During the earlier years of Obamacare, the premiums for many commercial plans were high, he pointed out. Eventually, as insurers became more knowledgeable about the markets, prices dropped, he said.
If Governor Walz would get re-engaged in this issue and actively market his plan, they could learn from the experiences of Washington and avoid it’s mistakes. For instance, in areas where there is insufficient health insurance competition, Walz could require hospitals to participate.
A MinnesotaCare buy-in option is extremely popular — only 11% oppose it, according to a Minnesota Public Radio survey. This is probably in part because it is an option. Any Minnesotan who opposes buying into MinnesotaCare — because of conservative ideology or because MinnesotaCare turns out to be expensive or poor quality — they can vote with their feet, as consumers in the state of Washington are doing.
Fighting for a MinnesotaCare buy-in option makes sense for Walz. The polls consistently show that health care is a top issue for voters, and huge majorities consistently trust Democrats over Republicans on that issue.
Moreover, in the 2022 gubernatorial general election campaign Walz may very well be running against a physician, Scott Jensen. This will ensure that health care is high profile in the race. Therefore, candidate Walz needs to be seen fighting for better health care, and this proposal gives him that platform.
If a MinnesotaCare buy-in option passes, Walz finally has a legacy beyond pandemic management. If Senate Republicans kill it, which seems likely, Walz has a great political argument to make while running for reelection and trying to retake the Senate: “I worked my ass off to give you another health insurance option and bring you some price competition, but Republicans like Scott Jensen opposed it on orders from private insurance lobbyists. If you want to more options and more price competition, vote for me and change the Senate leadership.”
Pushing a public option is a great political option for Walz. So why is he so damn cautious about it?
Trying to pick your least favorite type of Trump supporter is not easy. The competition is stiff, and there are strong arguments for all of them.
Trumpist Typology
Greed Trumpists. There’s the Greed Trumpists, who will put up with any Trump outrage – kids torn from mothers and put in cages, white supremacy encouragement, coordinating with foreign enemies interfering in our democracy — to get a tax cut, even a tax cut that represents relative crumbs compared to the mountains of loaves lavished on billionaires.
Personality Cult Trumpists. There are the Personality Cult Trumpists, many of whom watched far too many episodes of The Apprentice with an uncritical eye. They find Trump entertaining and embrace the myth of Trump’s deal-making skills and “only I can fix it” hucksterism, despite his pandemic response debacle and tax returns that expose Trump as a bumbler of epic proportions.
Bible-Thumpin’ Trumpists. Then there’s the Bible-Thumpin’ Trumpists. They ignore of the dozens of Trump’s extreme anti-Christian actions—serial sexual abuse and infidelity and cutting food subsidies for the poor to name just a couple — that make a mockery of the Golden Rule and the Beatitudes in order to hoard as many Fallwell-endorsed judges as possible.
Tribal Trumpists. Who can forget the Tribal Trumpists, who will let Trump take their loved one’s Affordable Care Act (ACA) health protections and Social Security benefits just to be able to say that their Red Tribe of “real Americans” stuck it to the Blue Tribe of “libtard snowflakes.” Go team!
Changeophobe Trumpists. Changeophobe Trumpists are fearful of our fast-changing world and ever-nostalgic about the glories of what they view as the good old days of their childhoods. They are particularly susceptible to Trump’s promise to “Make America Great Again” by keeping coal dirty, light bulbs inefficient, America white, global competition at bay, and bigotry unchallenged.
Racist Trumpists. The Racist Trumpists are obviously a very strong contender for least favorite. They insist that Trump’s villifying of immigrants and people of color is a “refreshing rejection of political correctness,” instead of a wink and a nod to the full spectrum of racists, from those of us who are sometimes lousy at recognizing systemic racism to full-blown white supremacist activists like the Proud Boys, Aryan Nations, Volksfront, American Freedom Party, Ku Klux Klan, and White Aryan Resistance.
Thug Trumpists. And then there are Thug Trumpists, who can’t recognize the difference between bullying and actual strength, and gravitate towards authoritarian personalities to serve as a binky to make them feel more secure in the face of their overblown fears of our changing and more diverse nation.
False Equivalence Trumpists
But the last month of the election is when we unfortunately have to be hearing a lot from perhaps my least favorite type of Trump supporters — the False Equivalence Trumpists. They continually declare that “both sides do it” to make their vote for the most bigoted, incompetent, and corrupt President in U.S. history seem somehow defensible.
Since last night’s presidential debate, the False Equivalence Trumpists were out in full force, complaining about “both candidates” being equally bad and lamenting that they “once again have to choose the lesser of two evils.”
Though they carry an air of intellectual superiority in their assertions, False Equivalence Trumpists are among the most intellectually lazy of all of the Trumpists types.
Obviously, both candidates have sold out to a special interest, lied, supported an unwise policy, or made a big mistake. Same as it ever was. But from that truth, False Equivalence Trumpists quickly jump to the safety of “both sides do it equally,” instead of digging into the facts to determine which candidate does it more. In a democracy, doing that kind of qualitative differentiation is a voter’s duty, and they consistently shrink from it.
Because False Equivalence Trumpists find it distasteful to be held accountable for supporting an imperfect candidate, they stubbornly cling to the truth of “both sides do it,” but not the whole truth. The whole truth is that any fair-minded analysis comparing Trump and Biden will show that Trump is much more incompetent, much more bigoted, much more dishonest, and much more corrupt.
But this group of Americans lacks either the judgement to see that truth, or the courage to speak it.
The False Equivalence Trumpists are top-of-mind right now because, we are entering the final month of the presidential campaign with about 6 percent of the voters somehow still undecided. Tragically, these pathologically indecisive Americans could be decisive on November 3rd. The fact that the fate of the nation, and maybe even the planet, falls to this group of Americans is crazy making and terrifying.
The 2020 elections are the most important elections of my lifetime, and potentially the most important in American history. Will we replace the most corrupt, bigoted, and incompetent President of our times, and his shameless congressional enablers, or will we go further down the road to authoritarianism and corporatism? That sounds melodramatic, but given what we’ve learned about Trump over the last three years, it’s not an exaggeration.
The stakes are high, so liberals need to step up their game.
This isn’t about trashing liberals. Liberals have done a lot of great things for America. At a time when all of these things were quite unpopular, liberals had enough vision, courage, and commitment to pass Social Security, Medicare, Medicaid, the minimum wage, marriage equality, civil rights, voting rights, environmental protections, and the Affordable Care Act (ACA).
But we grassroots liberals also can be also our own worst enemies. To win in 2020, we need to make five New Years resolutions to do better than we did in 2016.
STOP THE PETTY, PERSONAL ATTACKS. With hundreds of substantive reasons to criticize Trump and his lackeys, there is no reason to stoop to snotty attacks about personal issues like the President’s complexion, hair, waistline, hand size, penis size, verbal slips, and misspellings. The same goes for personally insulting his supporters.
Among the moderate swing voters who will decide the outcome of this election, those kinds of personal shots inadvertently create sympathy for Trump and others who don’t deserve swing voters’ sympathy. I get that they are cathartic, and sometimes tongue-in-cheek. But they’re also and self-defeating in the end, and therefore self-indulgent, so liberals need to get better at taking a pass on the personal shots.
STOP THE CANNABILISM.
Liberals also need to be mindful of Ronald Reagan’s 11th
Commandment, “thou shall not speak ill of other Republicans.”
I understand the temptation to wage civil war. My top presidential candidate, Kamala Harris, has already dropped out of the race, and my second choice, Cory Booker, doesn’t look like he will last much beyond Iowa. Having to go to Plan C is deeply disappointing to me. Having to go to Plan D, E, F, G, H, I, J, or K, a distinct possibility in a field this large, likely will be even more disappointing to me.
In the end, I realize that I am unlikely to be in love with my Democratic Party nominee. But if I can’t be with the one I love, honey, I’ll love the one I’m with. Unless we learn something dramatically scandalous about one of the Democratic candidates in the coming months, I’m pledging to myself that I won’t trash other Democratic candidates, vote for a third party candidate, or sit out the election. For a long time, I’ve even been making monthly donations to the eventual nominee, whomever that ends up being, via the Unify or Die fund.
All liberals should make a resolution to forgo intra-party cannibalism, because it greatly increases the chances that we have four even more catastrophic years with the most corrupt, bigoted, and incompetent President of our times. That can’t happen, so we all have to suck it up and pledge to support the candidate that prevails in the nominating process.
STOP THE SHINY OBJECT CHASING. We all know that President Trump is going to do and say hundreds of things before the election that are mock-worthy and outrageous, but probably are not issues that are going to sway swing voters or motivate non-voters. Every moment we spend talking about those side issues –say, a funny golf story, a boneheaded gaffe, a stupid joke at a rally, a silly exchange with an athlete or celebrity–is a moment we’re not talking about issue differentiators that are more likely to influence voting decisions.
What Trump actions are more deserving of our focus? His giving lavish, deficit-spiking tax cuts to the wealthy. His separating young children from parents and caging them. His taking birth control and other types of reproductive health care away from women. His blocking legislation to control pharmaceutical prices. His cowardly refusal to cross the NRA to support common sense gun safety laws. His erratic Russian-friendly foreign policy decisions in dangerous places like Iran, Syria, the Ukraine, and North Korea. His repeated attempts to repeal Affordable Care Act protections, such as preexisting condition protections for 133 million Americans.
Polls show those kinds of issues work against Trump with swing voters and non-voters, so those kinds of issues should be the primary focus of conversations at the break room, bar, barbeque, or online chat.
With such a steady stream of Trump’s outrages, it’s difficult to not take the bait from the ever-outrageous tweet stream. I’m far from perfect on this front. But we liberals have to get better about focusing on the issues that matter the most to swing voters and non-voters, and that means shrugging off a lot of the side issues.
FOCUS ON ROOT CAUSES. When deciding how to spend time and resources, liberals should also consider focusing on the root causes of Trump’s electoral success. For instance, rather than only supporting individual candidates, consider supporting groups like Stacey Abrams’ Fair Fight 2020 and the ACLU. Those groups are battling Republicans’ relentless voter suppression efforts aimed at people of color, which threaten to swing close elections to Trump and his political toadies now and for decades to come.
Ensuring that every vote counts and voting is easier will help progressive local, state and federal candidates up and down the ballot. It will help preserve our representative democracy for future generations. Supporting those groups isn’t as obvious to most of us as supporting parties and candidates, but it’s every bit as important.
SPEAK OUT EARLY AND OFTEN. Speaking out against Trump and Republicans in person and on social media is frowned upon by Americans who are “non-political,” ignorant, and/or in denial about what is happening to America. That can make speaking out about Trump unpleasant and exhausting. Goodness knows, no one relishes being called, gasp, “political,” and being accosted by trolls.
But in America today, we have politicians who are all too willing to separate brown-skinned kids from their parents and put them cages indefinitely. We have politicians trying to repeal health protections for 133 million Americans. We have a party that gave a massive, deficit-ballooning tax gift to the wealthiest 1% at a time when we have the worst income inequality since 1928 and record deficits. We have a President taking birth control and other reproductive rights away from women. If we don’t vote out this crew, we could easily have much worse developments on the horizon in a second, even more unhinged Trump term.
All of which is to say one person’s “politics” is another person’s life, livelihood, and rights. A while back, writer Naomi Shulman helped put this issue in proper perspective for me:
“Nice people made the best Nazis. My mother was born in Munich in 1934, and spent her childhood in Nazi Germany surrounded by nice people who refused to make waves. When things got ugly, the people my mother lived alongside chose not to focus on “politics,” instead busying themselves with happier things. They were lovely, kind people who turned their heads as their neighbors were dragged away.”
I’m not saying liberals have be jerks and nags to their friends and relatives. We don’t have to be the turd in the punch bowl. In most cases, we should be calm, respectful, factual and measured when we speak out, even when the respect isn’t deserved and returned, because that’s usually the best way to win hearts, minds, and votes.
But we do have to speak out, because silence implies consent. As Martin Luther King famously said of another movement in another time:
“In the end, we will remember not the words of our enemies, but the silence of our friends.”
The same is true of the movement to save America from Donald Trump and his Republican enablers. I’m about as conflict averse as they come, but unfortunately that excuse just is not going to cut it with so many lives hanging in the balance.
So my fellow liberals, this New Years Eve raise a glass of your favorite truth serum, and make some challenging resolutions that nudge you outside of your comfort zone. Your country needs you now more than ever.
Give leaders in the state of Washington a lot of credit. Governor Jay Inslee and the Washington Legislature recently passed legislation to create a public health insurance option that will save Washingtonians an estimated 5 percent to 10 percent compared to private health plans. Starting in 2021, the privately administered “CascadeCare” plan will be available to Washingtonians in the “individual market,” those under age 65 who can’t get insurance through their employers or another public insurance plan.
That’s significant progress, much more progress than Minnesota Governor Walz and the Minnesota Legislature made during the 2019 session when they failed to even seriously consider a plan to give Minnesotans in the individual market the option of buying into MinnesotaCare. President Trump and his followers are working overtime to sabotage and try to repeal popular Affordable Care Act (ACA) health protections, while Inslee is strengthening the ACA.
We need that kind of leadership in Minnesota. In the 2020 session, champions of the popular MinnesotaCare buy-in option should hold critics accountable for trying to block an initiative that could save consumers at least 10 percent of their health insurance costs.
The Fatal Flaw With Washington’s Law
I say “at least 10 percent,” because Washington leaders caved to medical lobbyists in order to get the law enacted. In the process, they sacrificed significant consumer cost-savings.
One of the primary reasons to give consumers a public option is because public health insurance programs with a huge pool of patients are in a relatively strong position to leverage lower medical costs. You know, like Medicare does. Here’s what a recent Urban Institute study found about Medicare’s ability to control medical costs.
“…average spending on private health insurance per enrollee grew 4.4% per year between 2006 and 2017—faster than the growth of spending per enrollee in Medicaid and Medicare, and faster than the growth of the gross domestic product per capita, which grew an average 2.4% each year.
Per-enrollee spending in Medicare grew an average 2.4% per year while per-enrollee spending in Medicaid grew 1.6% each year. Holahan said Medicare and Medicaid experienced slower spending growth than private insurance because public programs have more leverage over provider payment rates, helping them to keep costs down. Private payers end up paying higher hospital and physician prices.”
In the face of such findings, what do Washington leaders do? They guarantee reimbursements at a rate that is much higher than Medicare. The Seattle Times explains:
The (Washington) law will require health plans to reimburse medical providers and facilities at up to 160% of the federal Medicare rate. That is a higher rate than the original version of the bill, which capped the reimbursement at the Medicare rate.
CascadeCare champions had it right in their original bill. The reimbursement rate for the MinnesotaCare buy-in option should be set at the Medicare rate to allow savings to be passed on to Minnesotans. Washington leaders apparently were spooked by lobbyist threats that caregivers would deny care to patients if they got paid Medicare reimbursement rates.
Physicians Can’t Be Sacred Cows
We will never be able to significantly control health care costs until we demand savings from every part of the healthcare system — pharmaceuticals, medical devices, unnecessary procedures, administrative overhead, and, yes, caregiver reimbursements. American physicians, particularly specialists, are being paid more than physicians around the world, so controlling that cost-driver also must be in the mix. American doctors can no longer be treated like political sacred cows.
As long as lobbyist-cowed legislators keep carving out these kinds of special interest exceptions, medical inflation will continue to skyrocket and keep Americans from accessing health care. Minnesota legislators need to pass the MinnesotaCare buy-in option in 2020, and they should do it without caving to any of the interests driving medical costs making health care unaffordable and inaccessible for millions.
Democratic presidential candidates have been having a white hot debate about whether to support Medicare-for-All, which would move people onto Medicare and eliminate private health insurance plans, or a Medicare buy-in option, which would allow Americans to choose between government-run Medicare and corporate-run health plans.
Substantively, Medicare-For-All is Best
Substantively, Medicare-for-All makes more sense. Going to a government-run single payer system would be the fastest and most effective way to cover all Americans, reduce administrative overhead, stop excessive profiteering, reduce medical costs, make the American economy more competitive, incentivize better health care best practices, and produce better outcomes.
Compared to health systems used by other developed nations that are to varying degrees more like Medicare-for-all would be, the current U.S. system is worst.
Yes, a large tax increase would be needed to finance Medicare-for-All, and Democrats should be honest about that. At the same time, Americans would no longer be paying premiums, deductibles and copays. Many Americans who have subsidized employer-based coverage should see higher pay as employers are freed of that enormous expense. Because of these kinds of issues, 200 independent economists recently signed a letter stating that Americans would be paying less overall with a single government-run system than they pay under the current system, not more.
Politically, Medicare Buy-In Option Is Best
Politically, however, a Medicare buy-in option makes much more sense. Because many Americans get extremely nervous about not having the option to stick with their familiar private health plan, about 75% of Americans support a Medicare buy-in option compared to about 56% who support Medicare-for-All. Given how difficult it will be to defeat Trump in 2020 and pass something in the Senate in 2021 and beyond, political marketability and sustainability is no small consideration.
Harris’s Hybrid
After initially indicating support for Medicare-for-All, Senator Kamala Harris yesterday proposed a thoughtful hybrid approach. While Harris still calls her proposal “Medicare-for-All,” it’s more accurate to call it “Medicare-for-All-Who-Want-It,” since it allows Americans to choose private plans that are required to have the same benefits as Medicare. After a 10-year phase-in to limit transition-related bumps, all Americans would have the kind of coverage Medicare currently offers, with some coverage upgrades.
This approach would achieve much, but not all, of the substantive benefit of Medicare-for-All, and it has enormous political advantages over Medicare-for-All. Importantly, when Trump and the corporate insurance interests attack “government-run health care that takes away your insurance coverage,” those critics can be disarmed with very simple and compelling rebuttals: “If you don’t like it, you don’t have to choose it.” “If it’s as bad as they claim, no one will choose it.”
Those simple, powerful rebuttals, which can only be used with a buy-in option, de-fang the “they’re taking away your health insurance” bite.
Progressive critics like Sanders are criticizing the Harris plan as too “moderate.” It certainly is moderate compared to the Sanders Medicare-for-All plan. But when compared to ACA repeal/Trumpcare, where 20 million lose their coverage and all Americans would lose popular and effective ACA protections, the Harris proposal represents huge progress. Also, the Harris plan offers an important quantum leap forward from the current ACA-driven system.
Importantly, the Harris proposal offers Americans a consumer-driven path to the future. When given a choice, it’s very likely that most Americans will choose the cheaper and better Medicare option over corporate care. Corporate care won’t be competitive with Medicare, because of its higher overhead and the need to make profits. But giving all Americans the ability to comparison shop and vote with their feet is key, so that Medicare-for-All eventually comes to American by popular mandate, rather than government mandate. Taking that consumer-driven approach ultimately will make Medicare-for-All more politically durable.
Though I don’t know all the details yet, I like the general balance Senator Harris has struck. Obama’s former chief Medicare/Medicaid administrator Andy Slavitt said it well:
“Sen. Harris’s plan balances idealism and pragmatism. It says in effect: We have a mandate to get everyone affordable health care and put people over profits — but we don’t need to tear down the things people have and they like in order to do it.”
That’s what Democrats need: Idealism to stay true to their progressive values and excite lightly voting Democratic constituencies such as young people and people of color and pragmatism to smooth over political and logistical challenges and win over critically important moderate swing voters.
Among political reporters and pundits, the fashionable take on Democratic presidential candidates is that they’re recklessly veering too far to the left, consequently putting their chances of defeating Donald Trump at risk. That critique is all the rage.
“But the Democrats are in danger of marching so far left that they go over a cliff. That’s not just my view. Mainstream reporters, who tend to be less sensitive to liberal positions that match their personal views, are openly acknowledging and debating the dramatic shift. It was even on the front page of The New York Times.”
“The Democratic debates this past week provided the clearest evidence yet that many of the leading presidential candidates are breaking with the incremental politics of the Clinton and Obama eras, and are embracing sweeping liberal policy changes on some of the most charged public issues in American life, even at the risk of political backlash. But with moderate Democrats repeatedly drowned out or on the defensive in the debates, the sprint to the left has deeply unnerved establishment Democrats, who have largely picked the party nominees in recent decades.”
“That sound you heard in Miami on Wednesday evening? El partido demócrata dando un fuerte giro a la izquierda. The screech of a Democratic Party swerving hard to the left. As the first 2020 Democratic debate wrapped here, there was a palpable sense that the 10 contenders on stage were reflecting the sentiments of the most liberal corners of the party.”
Yes, Democrats are more liberal than they have been in my lifetime. Yes, it’s possible that they could eventually go too far. But I disagree with the punditosphere that Democrats have hit that point.
Why Moving Left?
The explanation of aghast pundits has been that Democrats are supporting progressive policies for two primary reasons:
Echo Chamber Parrots. First, they argue that Democrats are more liberal because they spend too much time in self-reinforcing “echo chambers” — social media and cable news channels where like-minded ideologues radicalize each other and get isolated from opposing viewpoints. Pundits say candidates spend too little time in the habitat of “real people,” which they usually identify as Mayberry-esque Main Street cafes.
Liberal Bidding War. Also, pundits explain that Democrats are now more liberal because they’re desperately trying to out-liberal each other to court ultra-liberal primary and caucus voters.
These are both very real occupational hazards for politicians, and valid contributory factors for the shift to the left. I don’t disagree with them, but they’re not the only explanations.
Democrats Are Listening To Americans
Many reporters and pundits are missing or under-emphasizing another explanation that is at least as important,:
Listening To Americans. Democrats are moving left because they are actually listening to Americans.
Democrats are not just marching in lockstep with Rachel Maddow, Moveon.org, Daily Kos, Paul Krugman, and Bernie Sanders. They’re not just trying to one-up each other. They’re also reading the survey research.
The American Prospect recently compiled a long list of recent survey polls showing overwhelming majorities of Americans embracing a broad range of progressive attitudes and policies, excerpted below. Remember, the following is dozens of independent statistically significant surveys speaking, not the liberal American Prospect magazine speaking:
The Economy
82 percent of Americans think wealthy people have too much power and influence in Washington.
78 percent of likely voters support stronger rules and enforcement on the financial industry.
Inequality
82 percent of Americans think economic inequality is a “very big” (48 percent) or “moderately big” (34 percent) problem. Even 69 percent of Republicans share this view.
66 percent of Americans think money and wealth should be distributed more evenly.
72 percent of Americans say it is “extremely” or “very” important, and 23 percent say it is “somewhat important,” to reduce poverty.
59 percent of registered voters—and 51 percent of Republicans—favor raising the maximum amount that low-wage workers can make and still be eligible for the Earned Income Tax Credit, from $14,820 to $18,000.
Taxes
76 percent believe the wealthiest Americans should pay higher taxes.
60 percent of registered voters believe corporations pay too little in taxes.
87 percent of Americans say it is critical to preserve Social Security, even if it means increasing Social Security taxes paid by wealthy Americans.
67 percent of Americans support lifting the cap to require higher-income workers to pay Social Security taxes on all of their wages.
Minimum Wage
54 percent of registered voters favored a $15 minimum wage.
63 percent of registered voters think the minimum wage should be adjusted each year by the rate of inflation.
Workers’ Rights
74 percent of registered voters—including 71 percent of Republicans—support requiring employers to offer paid parental and medical leave.
78 percent of likely voters favor establishing a national fund that offers all workers 12 weeks of paid family and medical leave.
Health Care
60 percent of Americans believe “it is the federal government’s responsibility to make sure all Americans have healthcare coverage.”
60 percent of registered voters favor “expanding Medicare to provide health insurance to every American.”
64 percent of registered voters favor their state accepting the Obamacare plan for expanding Medicaid in their state.
Education
63 percent of registered voters—including 47 percent of Republicans—of Americans favor making four-year public colleges and universities tuition-free.
59 percent of Americans favor free early-childhood education.
Climate Change and the Environment
76 percent of voters are “very concerned” or “somewhat concerned” about climate change.
68 percent of voters think it is possible to protect the environment and protect jobs.
59 percent of voters say more needs to be done to address climate change.
Gun Safety
84 percent of Americans support requiring background checks for all gun buyers.
77 percent of gun owners support requiring background checks for all gun buyers.
Criminal Justice
60 percent of Americans believe the recent killings of black men by police are part of a broader pattern of how police treat black Americans (compared with 39 percent who believe they are isolated incidents).
Immigration
68 percent of Americans—including 48 percent of Republicans—believe the country’s openness to people from around the world “is essential to who we are as a nation.” Just 29 percent say that “if America is too open to people from all over the world, we risk losing our identity as a nation.”
65 percent of Americans—including 42 percent of Republicans—say immigrants strengthen the country “because of their hard work and talents.” Just 26 percent say immigrants are a burden “because they take our jobs, housing and health care.”
64 percent of Americans think an increasing number of people from different races, ethnic groups, and nationalities makes the country a better place to live. Only 5 percent say it makes the United States a worse place to live, and 29 percent say it makes no difference.
76 percent of registered voters—including 69 percent of Republicans—support allowing undocumented immigrants brought to the country as children (Dreamers) to stay in the country. Only 15 percent think they should be removed or deported from the country.
Abortion and Women’s Health
58 percent of Americans believe that abortion should be legal in all or most cases.
68 percent of Americans—including 54 percent of Republicans—support the requirement for private health insurance plans to cover the full cost of birth control.
Same-Sex Marriage
62 percent of Americans—including 70 percent of independents and 40 percent of Republicans—support same-sex marriage.
For people who suffered through eras when the NRA, the Catholic Church, the health insurance lobby, the Moral Majority, the National Federation of Independent Businesses, the U.S. Chamber of Commerce, Americans for Tax Reform, and trickle downers like Reagan, Gingrich and Bush dominated politics and policymaking, these findings are pretty stunning.
Make no mistake, America has changed. A solid majority of Americans now are supportive of left-leaning policies, whether or not they self-identify as “liberal.” In a representative democracy, public opinion is supposed to have a powerful impact on candidates and policymakers, and it is.
“Scaring the Independents”
“Harumph,” say the grizzled veteran pundits and reporters. Hubris-laden Democrats are going to scare away the Independent voters and be responsible for four more years of Trump.
That’s certainly a danger, and an important thing to monitor in coming months. But remember, all of those polls listed above have a representative number of Independent voters in their samples, and breakouts show that on most issues a solid majority of Independents also are backing very progressive policy positions.
In addition, when you look at how Independent voters are currently leaning, they are leaning in the Democrat’s direction by a net nine-point margin.
Obviously, these polls are just a snapshot in time, so Democrats could still lose Independent voters after they are exposed to hundreds of millions of dollars worth of attacks. However, it’s worth noting that, after watching Democrats being lambasted for embracing progressive positions in recent years, Independents are still leaning fairly decisively blue.
Expanding the Electorate
Finally, let’s not forget that it will be easier for Democratic candidates to win if they can expand the electorate. That is, Democrats need to make the overall size of their electorate larger than it has been in past presidential election by motivating and activating the parts of their coalition that have traditionally voted in relatively low numbers, such as low-income people, people of color and young people. Even just a few percentage points improvement with those groups could impact the outcome of the 2020 elections up and down the ballot.
Positions in the “mushy middle” — ACA stabilization tweaks, incremental tax reform, inflation adjustments only to the minimum wage, semi-punitive immigration law changes, Pell Grant adjustments, etc. — probably won’t particularly motivate and activate these important voters.
Bolder progressive policies — Medicare-for All, Medicare buy-in option, repealing Bush and Trump tax cuts for the wealthy to fund help for struggling families, increasing the minimum wage to $15 per hour, family medical leave benefits, bold immigration law changes, higher education loan forgiveness — might.
Short-term Needs. So even if supporting progressive policies were causing Democrats to lose amongst Independent voters — and remember, so far the data seems to indicate that they aren’t — there is an argument for Democratic candidates to take those progressive stands anyway, in order to keep young people, poor people, and people of color from sitting out election day in large numbers, or backing a left-leaning third party candidate.
Long-term Needs. Appealing to those lightly voting groups with progressive policies is also important for the long-term future of the Democratic Party, not just the 2020 election. That’s because people of color are the fastest growing portions of the population, and today’s young people obviously will be voting for many years. Making those groups into committed members of the Democratic coalition would pay long-term dividends.
More Room To Grow. Still, some maintain that voter turnout is going to be so large in 2020, due to the polarizing nature of President Trump, that the size of the electorate will be maxed out without having to motivate lightly voting groups with progressive policies.
But when you look at the dramatically lower than average turnout figures for loyal Democratic constituencies in 2018, when their turnout levels were actually very high compared to 2014, it’s clear there is still much room for growth with these groups. For instance, 36% of young people voted in 2018, compared to 53% of the total population. Again, even an increase of a point or two in some of these categories could be decisive.
Who’s Out of Touch?
So yes, Democrats have indeed moved left in recent years. That much is obvious. But given this consistent stream of survey research from a wide variety of sources, I can’t agree with those who conclude that Democratic candidates are the ones who are “out of touch” with the pulse of the American people.
During last night’s Part I of the Democratic Presidential debate, moderators and candidates acted as if candidates must make a choice between advocating for Medicare-for-All and a Medicare buy-in option. It was one of the few areas of division among the progressive candidates
Why? Progressives should be simultaneously advocating for both policies.
Stop Bashing Buy-In Option
Medicare-for-All advocates like Sanders and Warren need to stop taking cheap shots at a Medicare buy-in option.
The reality is, without a filibuster-proof Senate majority, Medicare-for-All simply can’t pass for a while. Therefore, progressives need a Plan B that helps as many Americans as possible, shows that Democrats can deliver on their health care rhetoric, and advances the cause of Medicare-for-All.
It helps more Americans in the short-run by bringing much more price competition to the marketplace and ensuring every American has at least one comprehensive coverage option available to them, even in poorly served areas.
Beyond helping Americans in the short-term, a buy-in option also advances the cause of Medicare-for-All. Americans have been brainwashed by decades of conservatives’ vilifying of “government run health care,” but a buy-in option will give younger generations of Americans first-hand evidence showing that Medicare is not to be feared. It will show millions of Americans that Medicare is cheaper and better than conservatives’ vaunted corporate health plans.
And that will help disarm conservatives’ red-faced criticisms of “government run health care” and Medicare-for-All.
Stop Bashing
Medicare-for-All
At the same time, champions of a Medicare buy-in option like Biden and Buttigieg need to stop railing on a Medicare-for-All.
Even though Medicare-for-All can’t pass right away, progressives need to keep explaining what the world’s other developed nations figured out a long time ago, that a single payer government-run is the only real solution for any nation that hopes to control costs, cover everyone, and improve health outcomes.
For far too long, progressives have been afraid to educate Americans about why a single-payer system is needed. When fearful progressives sensor themselves from explaining why Medicare-for-All is needed, they leave the stage to conservative and corporate demagogues relentlessly spreading myths about the evils of “government-run health care.”
And when progressives leave the stage to conservative demagogues — surprise, surprise – progressives lose the debate.
Start Pushing Both
What would it sound like to advocate these two positions simultaneously? It could sound something like this:
Ultimately, we must cover everyone, control skyrocketing costs, and improve health outcomes. And you know what? Ultimately, the only way to do that is Medicare-for-All.
In America, Medicare has proven effective and is popular with those who use it. In developed nations around the world using government-run systems like Medicare, everyone is covered, costs are much lower and health outcomes are much better.
So Medicare-for-All must to be our ultimate goal. We have to keep our eyes on that prize. We need it as soon as possible.
At the same time, the Republican-controlled Senate won’t pass Medicare-for-All. That’s reality folks.
Given that reality, what can Democrats do right now to both help the American people and pave the way for Medicare-for-All in the long-run? A Medicare buy-in option. A buy-in option has lots of public support among Republican voters, so it has a much better chance of passing the Senate than Medicare-for-All.
Let Americans choose between corporate care and Medicare. If they want to keep their private health insurance, they can. But given them another option.
President Trump is afraid to give Americans make that choice. I’m not. He knows Americans will like Medicare better, and doesn’t want to give them that option. I’m not afraid, because I know that a Medicare plan that isn’t required to profit off of patients will be cheaper and better that corporate care. So let Americans choose.
Enacting a buy-in option now will show more Americans that they have nothing to fear from Medicare coverage. And that will help us move the American people towards embracing Medicare-for-All.
Pols and pundits keep framing this issue as if it must be a battle to the death for progressives. But Medicare-for-All versus a Medicare Buy-in Option is a false choice. Progressives should be advocating for both, and stop savaging each other on the issue.
As we count down Mark Dayton’s final days as Governor of Minnesota, it’s worth reflecting on one of the more peculiar figures in recent Minnesota political history.
If mad political scientists had set out to create the perfect politician, rest assured it would look nothing like Mark Dayton.
In a profession where optimism sells, Governor Eeyore came across as perpetually gloomy.
In a job where gregariousness and charm are needed to build winning coalitions, Dayton wasn’t very willing or able to glad-hand with legislators or other power brokers.
In a business where glibness is an invaluable asset, Dayton was often difficult to understand and unpersuasive in his speaking style. (Some of this may have been due to an underlying health issue, but the political challenge remains.)
In a grueling endeavor where energy and stamina are needed, Dayton’s chronic health issues have slowed him in his job and on the campaign trail.
And in a job where charisma often wins converts, Dayton possessed all the charisma of a lump of lutefisk.
Poor Governor Dayton. He lacks the hard-wired optimism of Hubert Humphrey, charm of Tim Pawlenty, glibness of Norm Coleman, energy of Paul Wellstone and charisma of all of the above.
But somehow, some way, Mark Dayton became a successful Governor.
He raised taxes on the wealthiest Minnesotans and increased the minimum wage without crashing the economy, as his conservative critics had promised would happen.
He expanded Medicaid and faithfully implemented the Affordable Care Act (ACA), which led to Minnesota having the best rate of health insurance coverage in state history, and one of the best in the nation.
He paid back millions that Pawlenty had borrowed from schools, and increased investments in them.
He refused to use the budget gimmicks Pawlenty employed to avoid tough choices, which helped end Minnesota’s long run of budget shortfalls, and allow Minnesota to earn a coveted AAA bond rating, which will save taxpayers millions in future years.
While implementing these progressive policies, Minnesota’s economy has boomed, outperforming the national economy and the economy that conservative Governor Scott Walker built in neighboring Wisconsin.
It also should be noted that Dayton’s family inheritance made it possible for him to self-fund his rise to political power. Ordinary people with Dayton’s political disabilities could not have achieved what Dayton did in his career. That’s a problem for our democracy.
But the fact remains, Dayton achieved all of this without a lot of political talent. He mostly accomplished those things due to his decency, candor, policymaking expertise, disciplined focus, and commitment to doing the right thing for vulnerable Minnesotans and our common good.
In the end, I’d take those things over all the optimism, glibness, gregariousness, energy, stamina and charisma in the world. Somehow, Dayton the un-politician made it work.
Minnesota gubernatorial candidate Jeff Johnson (R-Plymouth) is crying foul over an Alliance for Better Minnesota television ad that says Johnson’s health care proposals would take health care away from Minnesotans who need it.
But the Alliance’s ad is accurate. Without question, the health care “reform” approach candidate Johnson is promoting during his campaign would take health care away from Minnesotans who need it.
Let’s break down the proposed JohnsonCare plan, piece-by-piece.
Johnson Eliminating ACA Protections
Johnson wants to make the Affordable Care Act (ACA) a thing of the past in Minnesota, via a federal waiver granted by the Trump Administration. More specifically, Johnson wants to eliminate the ACA approach that has:
Protected Record Numbers of Minnesotans. Under the ACA framework, Minnesota achieved the highest rate of health care coverage in state history.
Made Previously Unaffordable Protections Affordable. For lower and middle-income Minnesotans who don’t get coverage through their employer, the ACA has provided hundreds of millions in financial assistance to reduce or eliminate premium costs.
Strengthened Minnesotans’ Protections. The ACA also banned the hated preexisting condition denials, insurance payment limits, and dangerous junk coverage. Because fewer Americans are no longer living one illness or injury away from being crushed by a mountain of bankrupting medical bills, personal bankruptcies have decreased by 50 percent during the time the ACA has existed.
If Johnson eliminates the increasingly popular ACA protections in Minnesota, that all goes away. So yes, in several different and dramatic ways, Johnson absolutely would take health care away from Minnesotans who need it. The ad is correct about that.
Johnson’s False Claims
Johnson’s criticism of his opponent’s health care proposal is also utterly ridiculous. Johnson says claims opponent Tim Walz “wants to eliminate private health insurance and force all Minnesotans onto one government program.”
The reality is, Walz supports a MinnesotaCare buy-in option. Under that approach, Minnesotans would have the option of either buying private plans or buying into the MinnesotaCare program, which is a government program operated by private health insurance programs.
In other words, Johnson’s claims that Walz wants to “eliminate private health insurance” and “force all Minnesotans onto one government program” are flat wrong.
If Walz is proposing a government-run single payer plan in the short-term, I’m not aware of it. Even if that were true, Johnson’s inference that eliminating private insurance in favor of government run health care would hurt Minnesotans is also wrong. After all, Medicare, a government-run health plan, is popular and effective. Medicare is helping Minnesotans, not hurting them.
Moreover, government run health plans are used in many other developed nations. Compared to the United States, consumers in those nations have 1) universal comprehensive coverage, 2) lower overall health costs and 3) better overall health outcomes.
JohnsonCare and TrumpCare
Instead of the ACA, Johnson wants to back a high risk pool program that was very expensive for both consumers and taxpayers when it was used pre-ACA. Minnesota Public Radio reported:
Craig Britton of Plymouth, Minn., once had a plan through the state’s high-risk pool. It cost him $18,000 a year in premiums.
Britton was forced to buy the expensive MCHA coverage because of a pancreatitis diagnosis. He calls the idea that high-risk pools are good for consumers “a lot of baloney.”
“That is catastrophic cost,” Britton says. “You have to have a good living just to pay for insurance.”
And that’s the problem with high-risk pools, says Stefan Gildemeister, an economist with Minnesota’s health department.
“It’s not cheap coverage to the individual, and it’s not cheap coverage to the system,” Gildemeister says.
MCHA’s monthly premiums cost policy holders 25 percent more than conventional coverage, Gildemeister points out, and that left many people uninsured in Minnesota.
Johnson also wants to promote “junk,” “short-term,” or “skinny” plans, which are cheap because they don’t cover basic protections. Promoting junk plans to reduce health care costs is like promoting cheaper cars lacking seat belts, airbags, crumple zones, safety glass, and anti-lock brakes. They look good if you’re only considering the price tag, but they’re a disaster when you and your family are in dangerous situations and desperately need those life-saving protections.
On health care, as with so most other issues, Jeff Johnson is aping Trump. President Trump is obsessed with eliminating Americans’ ACA protections in favor of a skimpy TrumpCare replacement. Trump insists that TrumpCare will cover everyone and cut costs, while the nonpartisan Congressional Budget Office finds that 23 million Americans would lose their protections, and millions more would pay higher premiums.
So Minnesotans, if you like TrumpCare – and only 17% of Americans do – you’re going to love JohnsonCare.
Blue wave? We’ll see. In an off-year election when too many Democrats typically don’t vote, Democratic candidates and activists have a lot of work to do before they can win over enough 2016 Trump voters to fuel a wave that will turn the national political map blue.
The kind of work I’m talking about isn’t door knocking, fundraising and get-out-the-vote organizing. That’s very important too, but I’m talking about messaging. So far this election season, much of the Democrats’ messaging has been ineffective to harmful.
On social media and on the campaign trail, I see a lot of self-indulgent, self-righteous scream therapy from the left. There is a lot of snide mocking and scolding of Trump voters. Trump voters are called “stupid,” “naive,” “racist,” and worse. As Trump becomes more untruthful, unhinged and un-American by the day, frustrated progressives lash out with greater ferocity at the 46 percent of Americans who voted for Trump in 2016.
Ridiculing Trump voters on a personal level is never politically helpful. But it is a bit more understandable during party caucus and primary season, when Democratic candidates are trying to out-liberal each other when preaching to the progressive, anti-Trump choir. But in the summer and fall of 2018, when Democrats need to appeal to 2016 Trump voters rather than other Democrats, they need to stop scolding.
Pushing Trump Voters Into Deeper Entrenchment
Don’t get me wrong. I love a good cathartic rant as much as the next guy or gal, and I’m frustrated with Trump voters too. But we all need to get more self-disciplined. All this constant chiding does is make 2016 Trump voters more defensive and prone to rationalizing another vote for Trumpublican congressional apologists in 2018. Every time I observe a Trump voter being castigated by a cocksure progressive candidate or activist, I can feel Trump voters getting more deeply entrenched in the Trump column.
Open-minded Trump voters, and there are some, need a face-saving way to justify and explain a move away from Trumpism. So for messaging during the 2018 campaign, the villain needs to be Trump and his post-election flip-flops, not Trump voters. The messaging needs to focus on Trump’s failure to keep his 2016 promises to Trump voters, not on Trump voters being stupid in 2016. That’s an important nuance.
Here’s what it would sound like for a candidate to run against Trump lies rather than Trump voters:
I don’t blame Trump voters for wanting a president who promised he would drain the special interest swamp in D.C. I wanted that too. But the fact is, as president, Trump did the complete opposite.
And I don’t blame Trump voters for wanting someone who promised to make the wealthiest 1 percent to pay more, not less. I wanted that too. But the fact is, as president, Trump did the opposite.
I certainly don’t blame Trump voters for wanting someone who promised better health care protections. I wanted that too. But again, as president, Trump did the opposite.
So, if I seem angry, I am. But I’m not upset at Trump voters. I’m furious at President Trump for lying to his voters and all Americans.
As mad as I am, Trump voters have a right to be a thousand times angrier at Trump. When someone lies to you, it’s because they don’t respect you enough to be honest. They lie because they think you’re too stupid to know the difference. But in 2018, Trump is going to learn that many of his 2016 voters aren’t stupid, and they now see through his betrayals and lies.
Some Won’t Be Persuaded
I’m not naive about this. I understand that this messaging nuance won’t persuade every Trump voter. Nothing will persuade Trump voters who are deeply racist, closed minded, or hopelessly brainwashed by the propaganda spewed on Fox News and conservative talk radio.
But this approach gives progressives a shot at winning a modest subset of Trump voters, such as the many voters who were more anti-Clinton than pro-Trump. Given that Trump lost the popular vote in 2016 by 2 percent, the attraction of even 5 percent of those 2016 Trump voters could be enough to make Nov. 6, 2018, into a Blue Tuesday.
Winning in 2018 and limiting Trump damage is worth taking a pass on the cathartic message of “I told you so.” So my fellow Democrats, if only for the next five months, let’s get disciplined and stop nagging Trump voters.
Note: A version of this commentary also appeared in MinnPost.com.
Exuberant Minnesota Republicans seem to think they have a winning health care issue for the 2018 election season–reinsurance. And they do deserve a great deal of credit for helping to enact a state reinsurance program that is reducing premiums for Minnesotans in the individual market. The individual market is for the 162,000 Minnesotans who can’t get insurance from their employer or the government.
While their claim that premium increases in 2016 and 2017 were due to DFL policies is ridiculous, it is true that the Minnesota reinsurance program they helped pass is helping those consumers. As the Star Tribune reported:
Jim McManus, a Blue Cross spokesman, said that were it not for the state’s reinsurance program, the carrier’s Blue Plus HMO would be seeking an average individual market premium increase of 4.8 percent as opposed to the 11.8 percent decrease cited Friday by Commerce
Impressive, and Republicans deserve credit for this.
The Rest of the Story
But as Ricky Ricardo would say, before Minnesota Republicans can credibly brand themselves health coverage saviors, they still have some splainin to do.
Why Not National Reinsurance? First, they need to explain why their party – in complete control of the U.S. Senate, U.S. House and the Presidency and entire U.S. Executive Branch of the federal government – doesn’t enact reinsurance to help all Americans. Because of economies of scale and the need for market consistency, a national reinsurance program makes much more sense than a hodgepodge of variable state programs.
Moreover, if stabilizing the market and helping consumers pay less is good for Minnesotans, wouldn’t it be even more awesome to do that for all Americans? That’s likely why 75% of Americans support enacting reinsurance at the national level.
Why Sabotage the ACA? So why aren’t Rep. Erik Paulsen, Rep. Jason Lewis, Rep. Tom Emmer, Jeff Johnson or former Governor Tim Pawlenty pressing for reinsurance at a national level? Because they and their White House puppet master would rather sabotage the remarkably effective Affordable Care Act (ACA) than improve the ACA to help American families.
The list of things Trump and his congressional Trumpbulicans are doing to irresponsibly sabotage American families benefiting from ACA protections is long and breathtakingly irresponsible. This is hurting tens of millions of struggling Americans. Republicans are ignoring the 71% of Americans who say the Administration should do all it can to make the the ACA work, compared to just 21% who support efforts to make the ACA fail and replace it later.
Why Oppose Adding A MinnesotaCare Buy-in Option? The other thing Republicans boasting about the state reinsurance bill need to explain is this: Why aren’t they supporting giving the 162,000 Minnesotans in the individual market a MinnesotaCare buy-in option?
The MinnesotaCare buy-in option would achieve much of what Republicans profess to support — more plan and doctor choices for consumers in sparsely populated areas, guaranteed coverage for all Minnesotans in sparsely populated areas, and more competition to control prices.
The fact that Minnesota Republicans won’t support the common sensical MinnesotaCare buy-in option proposal, won’t push for a national reinsurance program, and continue to actively sabotage the ACA makes their gloating about being health care saviors ring very hollow.
This week, statewide coverage featured Minnesota Republican Congressman Erik Paulsen, Tom Emmer and Jason Lewis mugging with President Donald Trump’s lead partner in crime, Vice President Mike Pence.
The news coverage serves as a helpful reminder to Minnesotans that these three gentlemen have enabled Donald Trump’s disastrous presidency every step of the way. They have slavishly voted for the mean-spirited Trump agenda about 90% of the time. It reminds us that the reelection of Minnesota’s Trumpublican Trio is effectively a referendum on Trump’s corruption, chaos, incompetence, and extremism. A few things that Minnesotans should be reminded of during campaign season:
WEAKENING OUR HEALTH PROTECTIONS. These three congressmen repeatedly supported Trumpcare, which would have stripped health protections from 51 million Americans, and only had the support of 17% of Americans. They are also complicit with Trump’s ongoing sabotaging of the historically effective Affordable Care Act protections. Moreover, they oppose efforts that would make health protections much more available and affordable, such as with a national reinsurance program, restoration of the Cost Sharing Reductions (CSR) they cut, and giving Americans the option of buying into the popular and efficient Medicare program.
Oh, and by the way, these self-proclaimed “deficit hawks” put the $1.5 trillion cost of their lavish tax giveaway to the wealth on the federal credit card that our kids and grandkids now have to pay. Absolutely shameless.
PUTTING TRUMP ABOVE THE LAW. They have turned a blind eye to Trump’s repeated obstruction of justice during the investigation into Russia’s attack on America’s democratic jewel, our free and fair elections. This obstruction of justice is far more extensive than the actions that forced President Nixon out of the White House, but the Republicans of 1972 had enough integrity to fulfill their oversight duties and push Nixon out, while these contemporary Republicans are cavalierly shrugging it off.
PUTTING CORPORATIONS’ NEEDS OVER ENVIRONMENTAL PROTECTIONS. They have marched lockstep behind Trump as he has racked up the worst environmental record in our lifetime. For instance, Trump made the United States the only nation on the planet to not sign the Paris accord on climate change.
These are just a few examples, but the list of pro-Trump votes is a long one. According to FiveThirtyEight, Rep. Emmer votes with Trump 87% of the time, Rep. Lewis votes with Trump 90% of the time and Rep. Paulsen votes with Trump 97% of the time. Clearly, a vote for Emmer, Lewis, and Paulsen is effectively a vote for the historically unpopular Trump. Minnesotans who are fed up with Trump need to be speaking out, donating and organizing against them.
On dozens of issues, President Trump deserves criticism. In fact, one of the central challenges of the anti-Trump resistance is that he offers up so many examples of lies, corruption, destructive policies and incompetence that it can be difficult to remain focused on the things that most matter to swing voters who will decide the all-important 2018 elections.
With so much outrageous behavior in the White House, Trump resisters don’t need to overstep. Moreover, overstepping detracts or distracts from more persuasive critiques.
But like the conservative base, the liberal base frequently does overstep with their critiques. Let me count the ways:
Appearance. The President is orange complected, obese and has bizarre hair. We all can see that on our own. Repeating it ad nauseam doesn’t win any converts, distracts from consequential issues, and makes the messengers look petty and small. So just stop.
P.S. The same applies to Trump’s staff. Snarky jokes about the appearance of Kellyanne Conway, Sarah Huckabee Sanders, and Steven Bannon detract and distract from real issues and make the messengers look like shallow bullies.
Junk. The obsession with presidential phallic matters is wrong on many levels. It’s pure speculation, has absolutely no bearing on his job performance, and makes critics sound like small-minded middle schoolers. Think of it this way: What would liberals think if conservatives constantly commented on some aspect of a Senator Clinton’s genitalia?
Daughter. The fact that Trump says his daughter is beautiful and smart doesn’t mean there’s something creepy going on between them. That’s a leap too far that too many liberals make with absolutely no evidence. It’s not fair, and it hurts them more than it hurts the President.
Wife. Sorry, but you can’t make conclusions about a marriage based on body language alone, something that is done constantly by Trump critics on social media. Besides, plenty of Presidents with troubled marriages were effective. So move on to more important issues.
Golf. Yes, it’s outrageously hypocritical that the man who constantly criticized President Obama for golfing and vacationing too much golfs and vacations much more than Obama did. But Trump is a failure because he is incompetent, an ultra-conservative and corrupt, not because he isn’t sitting at his desk enough. So let’s stay focused on making THAT case.
So please, my fellow progressives, continue to criticize President Trump and his shameless Trumpublican enablers. TrumpCare cruelty. Tax handouts to billionaires and corporations. Russiagate. Foreign bribes. Deficit spending hypocrisy. A racist, unnecessary wall financed by Americans. Obstruction of justice. Medicare and Medicaid cuts. Serial lying. Climate change idiocy. Gun protection obstruction. The sexual assault admission. Racist immigration policies. Childish, dangerous warmongering. There is a very long list of things that liberals should stress in the 2018 elections.
As the 2017 Minnesota legislative session heads into the home stretch and President Trump is creating a constitutional crisis, the news for Minnesota Republicans in the recent Star Tribune survey is not great.
To recap, most Minnesotans are…
Digging Dayton. An overwhelming 62% of Minnesotans approve of the job being done by Minnesota Republicans’ primary antagonist, DFL Governor Mark Dayton. Less than half as many Minnesotans (29%) disapprove of the job Dayton is doing.
Implication: He’s grumpy, boring, wonky, and unabashedly liberal, but Governor Eyeore remains quite popular with a strong majority Minnesotans. Despite Republicans’ best efforts to frame Dayton as being metro-centric and out-of-touch with Greater Minnesota, a majority in every region of the state approve of the job he is doing. As high stakes budget and policy negotiations between Dayton and legislators begin, Dayton is in a relatively strong position to push his progressive agenda.
In the Dumps About Trump. Only 40% approve of the Republicans’ national leader, President Donald Trump. This marks an all time historical low-point among Presidents, at a time that is supposed to be a President’s “honeymoon period.” For context, eight years ago, during dire economic times, the newly elected President Obama had a 62% approval rating.
Implication: To state the obvious, “all time low” is not good. Republicans who remain steadfastly loyal to their party’s unpopular President could be more vulnerable in the upcoming 2018 mid-term elections. While the conventional wisdom would be for Republican incumbents to distance themselves from the toxic Trump, it’s difficult for them to do so, because Trump remains popular with the narrow band of Trump diehards. Republican incumbents need those voters on their side in order to survive 2018 primary and general elections. With Trump this unpopular, Republican incumbents are in a political bind.
Swooning for DFL Senators. In comparison to Trump’s 40% approval rating, 58% of Minnesotans approve of DFL Senator Al Franken, and 72% approve of Senator Amy Klobuchar.
Implication: Franken and Klobachar remain popular as they relentlessly criticize Trump and his policies, which should embolden other DFLers to do the same. Also, Klobuchar looks difficult for Republicans to defeat in 2018, and both Franken and Klobuchar should be helpful surrogates for down ballot DFL candidates in 2018.
Not Feeling The Mandate. Trump mandate? What mandate? Most Minnesotans don’t like Trump’s policies any better than they like him personally. About two-thirds (65%) oppose Trump’s signature campaign issue – building a Mexico wall. Only 29% support that idea. The survey also found that Minnesotans oppose Trump’s proposals to accelerate deportations, and his Muslim travel ban.
The only ray of hope in the survey for President Trump was that 70% of Minnesotans support his drive-by Syrian missile strike, proving once again that Americans still love military actions, as long as victory can be declared within a matter of days.
Implication. It turns out those “real Americans” at the Trump rallies who cheered wildly about the Mexico wall and Muslim ban are not very representative of most Minnesotans. Therefore, stressing those issues would seem to hurt Republicans more than help them, at least with moderate swing voters. However, the one thing that perhaps could make Trump more popular is a quick, easy military victory. Don’t think for a moment that a drive-by war has not crossed Trump’s compulsively self-promotional mind. In other words, it’s probably not a good time to plan a vacation to Grenada.
Nyet On Russiagate Coverup. Republicans steadfastly maintain that no one cares about the Russian controversy. But even prior to the disturbing Comey firing, a majority of Minnesotans (55%) indicated that they would like to see an independent investigation of the Trump campaign’s ties to the Russian interference in the U.S. presidential election, while 39% say there should be no such investigation.
Implication: If Republicans continue to cover up and downplay the Russia controversy, it will not pass the smell test with a majority of Minnesotans.
All Aboard On Trains. By a strong twenty-point margin (54% support to 34% oppose), Minnesotans support building two extensions of light rail transit (LRT), from Minneapolis to the southwester suburbs and Minneapolis to the northern suburbs.
Implication: Republicans should think twice about making LRT their poster child for wasteful spending. Despite Republican operatives and talk radio jocks aggressively bashing LRT over many years, most Minnesotans, including plenty of voters in swing suburban districts, support LRT expansion.
Okay With O’Care. Then there is Obamacare. Republicans seem supremely confident that Obamacare is wildly unpopular. But a narrow plurality of Minnesotans actually is okay with it. Forty-nine percent of Minnesotans say Obamacare has been “mostly good,” while 44% say it has been “mostly bad.” This issue polled better for Republicans than most other issues, but this finding isn’t very encouraging for Republicans who are dead set on repealing Obamacare and replacing it with a Trumpcare plan that offers many fewer patient benefits.
Implication: As Republicans prepare to replace Obamacare with something that the nonpartisan Congressional Budget Office (CBO) says will erases all of the Obamacare coverage gains, these numbers spotlight the political risk that Republicans are taking. Republicans are beginning to learn that the only thing many Americans hate more than Obamacare is lack of Obamacare.
Loving Local Control. By a whopping 34-point margin (60% oppose, 26% support), Minnesotans oppose the GOP-backed proposal to prevent Minnesota towns and cities from passing work-rule ordinances, such as minimum wage increases. In every region of Minnesota, a majority oppose limiting local control.
Implication: This is another loser issue for Republicans. How in the world did the party that constantly preaches about the need for “local control” end up on this side of the issue?
Wrong Tax Cuts. Inexplicably, the Star Tribune apparently didn’t poll on what seems like the overarching question of this legislative session: What should legislators do with the state budget surplus? That is, should they spend it, cut taxes or save it for a rain day (i.e ask about “all,” “most,” “some,” or “none” for each category). Instead, the Star Tribune only asked how to cut taxes, as if tax cutting were the only thing being debated.
Even within that narrow fiscal category, the news wasn’t great for Republicans. Republicans propose tax cuts targeted to narrow constituencies — smokers, farmers, retirees, people with student loan debt, business owners and others. But most Minnesotans (45%) would rather just cut income taxes for all, perhaps because it’s simple and broad-based. Less than 20% of Minnesotans support the Republican-recommended constituency-by-constituency approach, while the rest support Jesse Ventura-style rebates (30%).
Implication: Tax-cutting remains the Republicans’ bread-and-butter issue, and it should be a pretty easy sell. Still, Minnesota Republicans can’t even seem to do that right. They somehow managed to find the most unpopular way to cut taxes, which might somewhat limit the electoral benefits they stand to gain from the tax cuts.
Political tides ebb and flow, so today’s viewpoints could be very different at election time18 months from now. But as it currently stands in the dawn of the Trump era, Minnesota Republicans are not exactly winning so much they’re tired of winning.
As the next iteration of Trumpcare/Ryancare is finalized by warring conservatives, it’s fair to demand that Democrats share their post-Obama vision for health care.
Yes, Democrats need to be fighting efforts to repeal and replace the increasingly popular Obamacare/Affordable Care Act (ACA) system with Trumpcare/Ryancare. Though the ACA is the spurned love child of the Heritage Foundation, Orin Hatch, Newt Gingrich and Mitt Romney, it’s much more humane than Trumpcare/Ryancare, which would cause at least 24 million Americans to lose their Obamacare health coverage, and many more if states choose to further weaken protections.
But for the long haul, Democrats need to set their sights higher than Obamacare. They must become full-throated champions for allowing Americans the option of buying into the Medicare system. Here are five reasons why:
Reason #1. Medicare is popular “government run health care.” For decades, Republicans have robotically vilified “government run health care” and “socialized medicine,” presuming that Americans agree with them that government will screw up anything it undertakes. And Democratic politicians have cowered in fear.
However, Medicare is a notable exception to that rule. While the private sector-centric Trumpcare/Ryancare has 17% approval and Obamacare has 55% approval, Medicare has the approval of 60% of all Americans, and 75% Americans who have actual experience using Medicare. It’s not an easy thing for a health plan to become popular, so Medicare’s relative popularity is political gold. Democrats need to tap into it.
Reason #2. Medicare is better equipped to control medical and overhead costs than private plans. Medicare has a single administrative system, while dozens of health insurance corporations have dozens of separate and duplicative administrative bureaucracies. That decentralized approach to administration is expensive.
Also, for-profit health insurance corporations have to build profits and higher salaries into their premium costs. For instance, the insurance corporation United Health Care, to cite just one of dozens of examples, pays it’s top executive $33,400,000. That’s 135 times more than the not-for-profit Medicare system pays its top executive, about $247,000.
Medicare also is large enough that it has a great deal of negotiating leverage. It could have even more if Congress empowered Medicare to more effectively negotiate pharmaceutical prices.
Because of all of that, the Center for Budget and Policy Priorities finds:
Medicare has been the leader in reforming the health care payment system to improve efficiency and has outperformed private health insurance in holding down the growth of health costs… Since 1987, Medicare spending per enrollee has grown by 5.7 percent a year, on average, compared with 7.0 percent for private health insurance.
So, if Democrats want to better control health care costs to help the economy and struggling Americans, the Medicare model offers the best hope for doing that, not the corporate-centric model that we currently are using.
Reason #3. A Medicare-for-All option is very politically viable. Most Democratic politicians understand that a Medicare-for-All option makes good sense policy wise, but shrug it off as politically infeasible. They’re dead wrong.
By a more than a 5-to-1 margin, Americans support having a Medicare-for-All option. An overwhelming 71% support it, while only 13% oppose it. If you won’t try to sell a proven progressive idea that is supported by a 5-to-1 margin, you have no business being in progressive politics.
While “government-run health care” has been a weak brand for brand for Democrats, they have a clear path for rebranding their agenda. Medicare brand equity is right there waiting for Democrats to take advantage it, if they’ll only open their eyes to the opportunity.
Reason #4. A Medicare-for-All option will expose private health corporations as uncompetitive. Right now, one of the Democrats’ biggest political problems is that too many Americans have been brainwashed by conservatives into believing that the private sector is always more efficient and effective than the public sector. In other areas that don’t involve “public goods,” that is true, but not with health insurance.
The best way to bust that “private is always best” myth is to allow Medicare to sit alongside corporate health plans in the individual marketplace. If American consumers choose Medicare over private plans, because Medicare proves itself to be the cheapest and best option, then the conservatives’ “private is always best” myth finally will be busted.
Reason #5. A Medicare-for-All option can serve as a bridge to the best health care model – a public single payer system. The research is clear that countries who have single payer health care financing have better and cheaper health care than the United States has with it’s substantially private sector based health care system. For example, the nonpartisan, nonprofit Commonwealth Fund finds:
Even though the U.S. is the only country without a publicly financed universal health system (among 13 high-income countries: Australia, Canada, Denmark, France, Germany, Japan, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States), it still spends more public dollars on health care than all but two of the other countries. …despite its heavy investment in health care, the U.S. sees poorer results on several key health outcome measures such as life expectancy and the prevalence of chronic conditions.
Obscure research reports like this aren’t proving persuasive to American voters. But when younger Americans are able to see for themselves through their shopping that Medicare is cheaper and better than private health insurance options, Medicare will build a bigger market share. After Medicare earns a larger market share, Americans may ultimately be much more open to shifting from a Medicare-for-all option to a Medicare-for-all single payer system that the United States ultimately needs in order to compete in the global marketplace and become a healthier nation.
It’s not enough for Democrats to only expose the reckless Trumpcare/Ryancare model and defend Obamacare status quo. They must also promote a Medicare-for-All vision for moving America forward. With the current President and Congress, a Medicare-for-All option obviously can’t pass. But aggressively promoting over the coming years will improve the chances that this Congress and President will soon be replaced and that a Medicare-for-All option can be enacted in future years.
After a few TV-friendly bombings this week, many in the mainstream media and pundit-o-sphere are falling all over themselves to declare President Trump mainstream. That’s right, it seems our Muslim-banning, emoluments-pimping, Russia-colluding, climate change-denying, serial-lying President is now pretty much equivalent to Obama, the Bushes, the Clintons, Reagan and Ford.
For instance, Politico’s headline is “Trump’s Foreign Policy Goes Mainstream,” and it reports:
“(T)he substance of Trump’s decisions in his first 79 days in office reveals a surprisingly conventional approach, with personal quirks layered on top, according to a half-dozen foreign policy experts.”
Similarly, the Wall Street Journal headline reads “Five Big Players Steer Trump’s Foreign Policy Towards the Mainstream” and National Public Radio (NPR) offers “Trump’s Flip Flops on Economics Move Toward the Status Quo.”
Okay, so the President recently has said a few sane things, such as NATO shouldn’t be defunded after all and Russia really should stop enabling the gassing of innocent children. Super. But before we throw the President a ticker-tape parade, let’s remember it was utterly outrageous that a presidential candidate or President ever took the opposite positions in the first place.
Let’s also remember that in the same week the media declared Trump mainstream, we learned that a federal judge found probable cause that Trump’s campaign may have colluded with the Russians to undermine American democracy, and that the President threatened to withhold lifesaving assistance from poor people if Democrats don’t back his extremely unpopular Trumpcare plan to take health coverage from 24 million Americans. We also read the Los Angeles Times, Newsday, Rolling Stone, and Wall Street Journal reporting and opining about the President’s unprecedented level of lying.
Yeah sure, but did you hear that the President failed to publicly praise his most empowered white nationalist? Moderate!
How does this happen? Former top aide for President George W. Bush David Frum explains:
“As President, Donald Trump benefits from two inbuilt biases of mainstream pundits:
“Bias 1 favors fair-mindedness: the wish to offer tips of the hat along with shakes of the finger. This bias exerts itself extra strongly with a bad actor like Trump. The worse he does, the more eagerly the pundit seeks something to praise. We’ve all experienced this. ‘There has to be something good to say about Trump. Even Hitler liked dogs!’
“Bias 2 is the bias in favor of surprise and novelty. Pundits don’t want – bookers won’t book – endless repeats of ‘He’s a liar & a crook.’ How much more interesting to say: “He’s a liar and a crook, but …” How boring to insist that the first part must always overwhelm the latter.
“And so TV punditry flits from one seemingly clever (but actually deeply false) pivot to another, chasing insight & missing truth.”
Say it with me people: This presidency is lightyears away from normal. An American President who bans people from entering a country that was founded on the principal of religious liberty because of the deity they worship…who empowers white nationalists that the neo-Nazis and Klansmen cheer…who praises murderous, democracy-hacking dictators as “strong” role models…who appoints his business-operating family members with no relevant experience to the most sensitive positions in the world…who covers up his tax returns so he can profit from policy positions and accept foreign bribes without Americans knowing it…and who lies at a rate that we have never seen in national history is not normal, moderate, or mainstream.
We have to judge presidents based on their overall body of work. And when a very high percentage of a President’s body of work is utterly outrageous and dangerous to the republic and world, we can’t give anything close to equal billing to the low percentage of his actions are not outrageous. This week’s shamelessly fawning news coverage aside, Donald J. Trump remains the mother-of-all-abnormal Presidents.
America currently has a health reform model that has given it the highest rate of health insurance coverage in history, covering more than 20 million of its most difficult to insure citizens. It has helped those 20 million Americans avoid having their lives ruined by crushing medical bills, or shifting those costs onto other Americans.
And despite years of heavily-financed and relentless attacks on the model, most Americans now have a favorable impression of it.
The Affordable Care Act (ACA) system isn’t perfect. Yes liberals, a Medicare for All system would be much more effective and efficient than the current ACA system. Yes conservatives, this ACA needs adjustments, though, to borrow from Mark Twain, the reports of its death spiraliness have been greatly exaggerated.
“You could, I think, relatively simply address the issues that the exchanges have,” said Dan Mendelson, president of Avalere Health, a health consulting firm, noting that other major programs including Medicare have been tweaked repeatedly since their creation.
Now President Trump and the Republicans want to blow up the ACA model — the one that covered the most Americans in history — in favor of a model that will cause an estimated 6 million to10 million Americans to lose their coverage. Their alternative particularly hurts the low-income, rural and elderly. To add insult to injury, it shoehorns in a grotesquely large tax cut for the wealthiest Americans, at a time when we have the worst inequality in incomes since the 1920s. The alternative is vehemently opposed by doctors, nurses, hospitals, seniors, conservatives, and liberals. And Republicans promise to pass it within three weeks, without cost estimates if necessary, after complaining about the ACA being “rammed through” over 13 months.
This is the political and policymaking genius that is Trumpcare.
Will Rogers said, “this country has come to feel the same when Congress is in session as when the baby gets hold of a hammer.” Never has that been more true than now.
For Minnesotans who can’t get health insurance from an employer, Minnesota Republican legislators have been demanding improvements.
Out on the campaign stump, Republicans say they want more health plan options than are currently available. They want health insurance companies to feel more competitive pressure to keep a lid on premiums. They want consumers to have a broad network of health care providers available to them. They want assurances that there will always be at least one solid coverage option available to every Minnesotan, even when health insurance companies decide to pull out of the marketplace, as they have in recent years. Those are all good goals.
To achieve them, Republican state legislators should work with Governor Dayton to give Minnesotans a MinnesotaCare for All option.
Background
Currently in Minnesota, those who can’t get health insurance from an employer can get coverage from one of three sources:
TOP TIER.For Minnesotans who can afford premium costs, they can purchase coverage from nonprofit health plans – UCare, HealthPartners, Medica, and Blue Cross. (As part of the federal Affordable Care Act, about 60% of those buying from these companies through the MNsure online shopping tool are offsetting premium costs with federal tax credits, which this year are averaging over $7600 per year.)
MIDDLE TIER. For Minnesotans who can afford some, but not all, of the premium cost, they can purchase MinnesotaCare at a subsidized rate that varies depending on household income.
LOWER TIER. For the poorest Minnesotans who can’t afford any of the premium cost, they can get Medical Assistance at no cost to them. Medical Assistance is Minnesota’s version of the federal Medicaid program.
MinnesotaCare for All Option
Governor Dayton proposes to give those in the top tier an additional option. He wants to give those consumers the option of buying into that middle tier — the public MinnesotaCare program.
Adding a MinnesotaCare for All option would achieve what Republicans say they want – more options for consumers, more marketplace competition to drive down prices, a guarantee that at least one plan option will always be available to Minnesotans, and consumer access to a broad network of Minnesota health care providers statewide.
A fact sheet from the Governor’s office elaborates on the consumer benefit:
Purchasing quality health coverage through MinnesotaCare is less expensive than buying coverage directly from a private insurer, because it leverages the buying power of more than 1 million Minnesotans enrolled in public plans.
Minnesotans who purchase MinnesotaCare would get high-quality health coverage for approximately $469 per month, on average. That is more than 12 percent ($69) less than the average statewide premium of $538 for private insurance in 2017.
Under the Governor’s proposal, families would spend on average $838 per person less in 2018 than in 2017 on their health insurance premiums.
After a one-time startup investment ($12 million), the cost of Governor Dayton’s plan would be funded entirely by the premiums of Minnesotans who choose to buy MinnesotaCare coverage. If the Legislature enacted this proposal by April 1, Minnesotans could purchase MinnesotaCare coverage as early as the 2018 open enrollment period.
Why would Republicans not want this for Minnesota consumers? If the Governor’s claims about the MinnesotaCare option turn out to be accurate, many of the Republicans’ stated goals for the individual market would be achieved.
At the same time, if the Governor’s MinnesotaCare-related claims about lower prices and better health care network turn out to be inaccurate or inflated, Minnesotans will surely reject the MinnesotaCare option. If it is to their advantage, consumers will choose a nonprofit health insurance company, or a for-profit health maintenance organization (HMO), which the Governor recently agreed to authorize as part of a compromise with Republican legislators.
With the addition of the MinnesotaCare option, private, nonprofit and public options all would be available to Minnesotans who are shopping and comparing via MNsure. Then the politicians could get out of the way, and let the consumers choose the option that works best for them.