Category Archives: Trumpcare

MN GOPers Aren’t the Health Care Saviors They Claim To Be

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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.

MN DFL Should Champion Importation of Canadian Medications

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Here’s a political idea for the DFL: Find a massively expensive thing that enrages voters.  Then make it dramatically cheaper. Oh, and do it without increasing government spending or taxes.

I understand the skepticism.  It does sound akin to the classic Student Council President campaign promise to reduce the cost of cafeteria soda — a crowd-pleaser but infeasible.

But there actually is such an issue available to Minnesota state leaders –empowering Minnesotans to purchase cheaper prescription medications from Canada.

According to drugwatch.com, prescription drugs are on average 65 percent cheaper in the Canada than they are in the United States. This is because Canada has huge government controlled health care plans using their purchasing power to negotiate lower prices from the pharmaceutical industry, and the U.S. doesn’t. Minnesota state lawmakers can’t change the underlying problem driving high drug prices in the U.S., but they could at least allow U.S. citizens to benefit from the more sane Canadian system.

After all, the Vermont Legislature just did it. Why not Minnesota?

In the upcoming 2018 elections, this should be the top issue Minnesota DFL state legislative candidates stress. Making more affordable Canadian medications available to Minnesotans would improve the lives of ordinary Minnesotans, and it’s a huge selling point with voters. Just ask Mark Dayton, who in 2004 made a lot of political hay by financing busloads of senior citizens going to Canada on medication shopping trips.  This proposal is similar, but it eliminates the long bus rides.

Nearly two-thirds of Americans like this idea. By an overwhelming two-to-one margin, a Kaiser Family Foundation survey found Americans support “allowing Americans to buy prescription drugs from online pharmacies based in Canada.”

This is an easy-to-understand issue to explain the difference between Republicans and DFLers to swing voters, and it especially appeals to seniors, who are the most likely to show up to vote.

This issue communicates important messages:  DFLers hear voters who are struggling to pay their medical bills; Republicans don’t. DFLers are proposing something real and tangible to control health care costs; Republicans won’t. DFLers will put the interests of ordinary Minnesotans over special interest lobbyists; Republicans won’t.

Coupled with the DFL’s MinnesotaCare for All buy-in option, offering cheaper Canadian medications would give Democrats the upper hand on perhaps the number one issue in the 2018 elections.

I can already hear overthinking DFL wonks explaining why they shouldn’t do this. President Trump won’t allow it to happen, they’ll say. I say force Trump’s hand. Though Trump’s HHS Secretary, a former pharmaceutical company executive, calls it a “gimmick,” Trump enthusiastically proposed this very idea during the campaign.

“…the last provision of his new seven-point plan is: “Remove barriers to entry into free markets for drug providers that offer safe, reliable, and cheaper products.”

“Congress will need the courage to step away from the special interests and do what is right for America,” the plan says. “Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe, and dependable drugs from overseas will bring more options to consumers.”

So, either make an honest man of Trump or expose him and his congressional Republican enablers for flip-flopping and being the cause of outrageously high drug prices.

This is the right thing to do, and it’s an extremely popular thing to do.  Empowering Minnesotans to benefit from more affordable Canadian medications should be one of the centerpieces of Minnesota DFLers’ 2018 campaigns.

Strib Poll Uncovers Dark Clouds For Republicans

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Cursor_and_minnesota_republicans_-_Google_Search 2As 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.

Cursor_and_Minnesota_mexico_wall_-_Google_SearchNot 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.

Cursor_and_minnesota_tea_party_-_Google_SearchOkay 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.

Five Reasons Democrats Should Push A Medicare-for-All Option

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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.

Cursor_and_medicare-for-all_jpg__360×216_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.

Mainstream My Ass

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Cursor_and_Trump’s_foreign_policy_goes_mainstream_-_POLITICOAfter 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.

ann_schrantz_horton_-_Facebook_SearchLet’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.

Trumpcare’s Terrible, Horrible, No Good, Very Bad Week

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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.

Gallup_uninsured_chartAnd 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.

Fact Check:  Obamacare Is Not In A Death Spiral

“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.