What You Should Know About Health Care And The Affordable Care Act.

On August 5 and August 12, Democratic Perspective tackled the very complicated subject of health care. We began by listing some statistics about the U.S. health care system. They’re anything but reassuring. For example:

In the U.S. we spend more than $2.7 trillion per year on health care. That represents more than $8,000 per person and almost 20 percent of GDP. The U.S. spends more than 4 times as much on health care as any other advanced nation with worse results. In addition, we spend almost as much on pharmaceuticals as all of the other nations combined.

Put another way, if the US health system was a country, it would be the 6th largest economy in the world! Yet, according to the most recent survey by the Organization for Economic Cooperation and Development (OECD), the U.S. health system ranks 37th in effectiveness as measured by lifespan and responsiveness. We rank 34th in infant mortality, 26th in number of physicians, 29th for number of doctor consultations per capita and 28th for number of hospital beds per capita.

The skyrocketing cost of health care in the U.S. is being felt in virtually every aspect of our economy.

According to a report by United States Department of Health and Human Services, U.S. companies faced with higher health care costs reduce investments, raise prices, and lower employment. High health care costs also reduce the competitiveness of US firms in international markets. And workers who bear the cost of higher health care spending have less income to spend on other goods and services.

In fact, a report published in The American Journal of Medicine listed medical bills as a major factor in more than 60 percent of the personal bankruptcies in the United States. Amazingly, approximately 75 percent of those bankruptcies involved individuals that actually did have health insurance! About the only ones who aren’t suffering as a result of rising health care costs are health insurance companies, their executives and their lobbyists.

In 2009, at the height of the Great Recession, U.S. health insurance companies increased profits by 56 percent, ending the year with a combined profit of $12.2 billion. That same year, the top executives at the five largest for-profit health insurance companies in the United States combined to receive nearly $200 million in total compensation.

In 2010, the chairman of Aetna, the third largest health insurance company in the United States, brought home $68.7 million. And the CEO of United Health Group received $48.83 million in 2012, ranking eighth on Forbes’ list. Meanwhile, health care related businesses have spent $5.36 billion since 1998 on lobbying in Washington.

From all of this, it should be abundantly clear why something had to be done about our health care industry. That something is the Patient Protection and Affordable Care Act, aka Obamacare.

In most respects, Obamacare was the brainchild of the very conservative Heritage Foundation. It was first promoted during the 1996 presidential election by GOP candidate, Sen. Bob Dole as an alternative to the single-payer system that President Clinton had proposed early in his first term. An almost identical system was signed into law in Massachusetts by then Governor Mitt Romney.

Known as Romneycare, the Massachusetts system has seen employer-supported health coverage increase over the past 7 years. And a poll by WBUR, an NPR-affiliate in Boston, found that 62 percent of Massachusetts residents support Romneycare, while just 33 percent oppose it.

Obamacare is certainly not perfect, but it is a giant step in the right direction. Already, under Obamacare, lifetime limits on insurance coverage have been eliminated helping more than 105 million Americans. 3.1 million young adults under age 26 have gained insurance by being allowed to stay on their parents’ plans.

Obamacare has recovered $10.7 billion in Medicare fraud over the past 3 years. It has helped more than 6.3 million people on Medicare save $6.1 billion on prescription drugs since 2010 and, over the next 10 years, people with Medicare who hit the so-called prescription donut hole will save an average of more than $16,000. An estimated 34.1 million people with Medicare have received one or more free preventive service. Additionally, prevention coverage improved for approximately 54 million Americans through their private health insurance plans.

For the first time ever, insurance companies are required to justify increases in rates of 10 percent or more. 12.8 million Americans have already received a total of $1.1 billion in rebates from private insurers that failed to spend at least 80 percent of their premiums on healthcare. Finally, the life of the Medicare Trust Fund will be extended to at least 2024.

But that’s not the whole story.

CNNMoney reported that under Obamacare, insurance premiums in New York will drop by 50 percent. And Forbes Magazine reported that under Obamacare, Californians were in for a rate shock because premiums are a good deal less expensive than expected.

And contrary to the myths being perpetuated by the GOP, Obamacare will not use tax dollars to fund abortions. It will not lead to a government takeover of healthcare. Instead, it strengthens the existing employer-based health insurance market while making the market fair for consumers by implementing landmark consumer protections.

As previously noted, Obamacare will not raise the cost of healthcare insurance. The Congressional Budget Office (CBO) found that health insurance reform will reduce the deficit by $210 billion in this decade and by more than $1 trillion over 10 years.

Obamacare will not make businesses suffer. The CBO found that it will lower health insurance premiums for the same insurance plan by up to 4 percent for small businesses and 3 percent for large businesses. (Estimates indicate that reform could save businesses $2,000 per person in health costs.) Obamacare will not cause employers to stop offering insurance to their workers, either. As already noted, under a similar system in Massachusetts, the percent of businesses offering insurance has increased.

Finally, Obamacare will not pay for healthcare for undocumented immigrants and it will not use taxpayer money to pay for abortions.

Want to learn more? Check out the March 4, 2013 Time Magazine cover article entitled “Bitter Pill” and the documentary “Escape Fire” which recently appeared on CNN. Or check out any of the following links:

http://www.whitehouse.gov/healthreform

http://www.forbes.com/sites/rickungar/2013/05/24/unexpected-health-insurance-rate-shock-california-obamacare-insurance-exchange-announces-premium-rates/

http://money.cnn.com/2013/07/17/news/economy/obamacare-health-insurance-new-york/index.html

http://www.uofmhealth.org/news/archive/201307/how-do-physicians-view-proposed-policies-cut-costs-health

http://www.hsph.harvard.edu/news/magazine/winter10assessment/

http://www.kaiserhealthnews.org/daily-reports/2013/july/24/docs-and-health-care-costs.aspx

http://www.forbes.com/sites/davechase/2012/10/05/escape-fire-artists-will-transform-healthcare/

CORRECTION:  On the August 12 show, my memory failed me.  I not only erroneously labeled Sen. Ben Nelson from Nebraska a Republican (He’s a Democrat). I said that he voted against the ACA (He in fact, provided the 60th vote after an amendment was added giving more Medicaid dollars to Nebraska. That provision did not become part of the final bill.) My apology for the errors.

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The Affordable Health Care Act: What It Will Do For You Beginning in 2014 — Podcast August 12, 2013


Obamacare: The Best Is Yet to Come. Democratic Perspective’s Mike Cosentino, Gary LaMaster and Steve Williamson continue their review of the Affordable Health Care Act. What can we expect beginning next year? Lots of good stuff: restrictions on annual payout limits; free (no co-pay ) annual checkups and other free wellness and preventive medicine services; equal insurance costs for women; insurance exchanges where those not covered by employers can shop for a range of plans and providers without any confusing fine print, elimination of the Medicare doughnut hole, coverage for the self-employed who can’t currently get or afford coverage, and reduced insurance costs for all. Not bad for a piece of legislation that the Republican-controlled House of Representatives has tried to repeal some 40 times.

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A Realistic View Of US Foreign Policy In The Middle East.

On July 29, 2013, Democratic Perspective hosted Stephen M. Walt, professor of international affairs at Harvard University’s John F. Kennedy School of Government. Professor Walt is an author, a widely respected expert on foreign policy and a leading proponent of the realist approach to international affairs. He is co-author of the controversial book, The Israeli Lobby and US Foreign Policy, a review of the influence of Israel and its US lobbyists on US Middle Eastern policy.

We began the interview by asking how we can move peace forward in the Middle East.
He replied, “As valuable as it would be to have peace arrangements between the Israelis and the Palestinians after many decades and suffering on both sides, it’s a mistake to think that it is a master key that unlocks everything else.”

“If we magically got a peace deal tomorrow…that satisfied both sides reasonably well,” Walt continued, “It would have virtually no impact on what is going on in Syria. It would have relatively little impact on the struggle for power occurring in Egypt. It would not in the short term affect the conflicts between Sunni and Shia in Iraq or between Arabs in the Gulf and their concerns about Iran. It would some very positive effects for Israel and positive effects for the Palestinians. It would certainly go a long way in removing one of the sources of anti-Americanism in that region. But there are lots of other problems in that part of the world that would not be directly affected by even something as wonderful as an Israeli-Palestinian peace deal.”

We then asked what Secretary of State John Kerry should be doing as far as the peace process is concerned.

Walt responded, “The most important thing that Kerry has said, and he’s said this a number of times now, is that the window for some kind of two-state solution is closing, and some people believe that it’s already closed. He’s basically saying we have a year or two that we might be able to do something. For many years that’s been seen as the least bad alternative to finally resolve this lengthy conflict…the creation of a Palestinian state on virtually all of the West Bank and Gaza, and the establishment of secure borders for these two countries. He’s saying that, given all of the trends, if this doesn’t happen soon, it’s not going to happen ever. We’ll have to start thinking of alternatives and most of those alternatives look much worse. What’s missing, as near as we can tell from the outside, is anything that looks like a significantly different American approach to the problem.”
“There’s no sign that the United States is either going to propose a plan of its own or use its leverage with both sides, not just one, to try and force a deal,” said Walt.

When asked how US support is bad for Israel, Walt said, “I think the most obvious example of this is that the US has turned a blind eye to the Israeli settlements since 1967.”

“It has been the official policy of the US government, going all the way back to Lyndon Johnson, to oppose the construction of Israeli settlements on the West Bank territories that were conquered during the Six-Day War…we have said repeatedly these settlements are an obstacle to peace. Some American presidents have said it’s illegal. But the United States has never done anything concrete to actually stop them,” he added.

“In fact, given that we give Israel between $3 and $4 billion a year, we are, in effect, directly subsidizing them. And we’re also providing some diplomatic protection by vetoing UN Security Council resolutions that are critical of this policy. The danger here is that it has allowed Israel to continue to establish the settlements. There are now over a half million people living outside the original 1967 border. And this has created a situation where a two-state solution may now be impossible. And it’s also made it impossible to be simultaneously democratic and a Zionist state because, if you look down the road, eventually there may be more Arabs than Jews living there. This may be the single most serious threat to Israel’s future. And the United States has essentially been the enabler of this policy even though we opposed it,” Walt stated.

You can hear more of Walt’s observations about US foreign policy and the Middle East by listening to the entire interview on the podcast below.

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The Affordable Health Care Act: What It’s ALREADY Done For You — Podcast August 5, 2013


Obamacare: What Does the Evidence Tell Us? Democratic Perspective’s Mike Cosentino, Gary LaMaster and Steve Williamson review the Affordable Health Care Act. Not only are the pieces of the ACA already in effect working out better than expected, but the evidence from states which are already in the advanced planning stages prior to its full implementation in 2014 suggests that it will indeed cover more people, be even more affordable than predicted, and save money on both medicare and prescription costs. Republicans who are still trying to repeal it are looking more mean-spirited — and more foolish — every day.

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Stephen M. Walt Interview — Podcast July 29, 2013


American Foreign Policy in the Middle East: What Are the Prospects for Success? Democratic Perspective’s co-hosts Mike Cosentino and Steve Williamson interview Stephen M. Walt, professor of international affairs at Harvard University’s John F. Kennedy School of Government about U.S. Foreign Policy and the Middle East. Professor Walt is a widely respected expert on foreign policy, whose books The Origins of Alliance and Revolution and War have become standards in the field.

He is also the co-author, with John J. Mearsheimer, professor of political science at the University of Chicago, of The Israel Lobby and U.S. Foreign Policy, a review of the influence of Israel and its U.S. lobbyists on U.S. Middle Eastern policy, published in 2007, which has since caused a significant controversy world-wide.

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Immigration Nation.

On July 22, 2013, Democratic Perspective took on the politically-charged subject of immigration policy and Senate Bill 744, the Immigration Reform Bill that recently passed the US Senate.

It seems almost everybody has an opinion about immigration. But many lack an understanding of its causes. And many conflate illegal drug trafficking with illegal border crossings by people simply looking for work and a chance to improve conditions for themselves and their families…the same motivations that led to previous waves of immigration into the United States.

The original immigrants, including our Founding Fathers, didn’t wait in lines. They didn’t apply for entry. They weren’t welcomed by the original population. But they came anyway. In fact, our nation was built by immigrants who came here for opportunity or were displaced for economic, religious or political reasons. They came from virtually every nation and region on Earth.

It was because of this that America became known as the Great Melting Pot.

The first political opposition to immigration didn’t come until 1843 when the Know Nothing Party (that’s not an opinion, it’s the real name) objected to the arrival of Irish and German Catholics. But the first immigration law was the Page Act of 1875, also known as the Asian Exclusion Act, designed to limit the influx of Asians settling on the west coast during the Gold Rush. In 1917, the Literacy Act further limited immigration, followed by the Immigration Act of 1924, and the Internal Security Act of 1950.

By far the most controversial immigration law came in 1954. Known as Operation Wetback, the new law led to the apprehension and deportation of more than one million Mexican immigrants within the first year. Many of those deported were not allowed to reclaim their possessions. They were often stranded without food or employment. And some were simply left in the desert.

Despite that sad episode, immigrants kept coming across the southern border until, today, it’s estimated that 11 million undocumented people are living here. Most came here through a school or work visa and simply overstayed the allotted time.

Like past immigrants, today’s immigrants come to the US for opportunity. Some have been displaced by political persecution. Some have been displaced for economic reasons. The US-backed wars in El Salvador and Nicaragua led to refugees coming to the US to escape the violence in their homelands. And NAFTA (North America Free Trade Agreement) led to large US agribusinesses dumping corn in Mexico and Central America, making it impossible for small farmers to succeed and driving them into cities looking for work. When they couldn’t find work, they moved to Mexican cities along the border hoping to catch on at one of the factories. Eventually, they came to the US.

In recent years, the US government has poured money – $106 billion since 2007 – into a fence and the Border Patrol in an attempt to block illegal immigration. Homeland Security reported 365,000 apprehensions by the Border Patrol in 2012. As a result, illegal immigration is now estimated at net zero, or likely even negative.

Yet S.744 calls for spending $34 billion more to secure the border.

The bill would double the current size of the Border Patrol along the southern border, making the force larger than the FBI. It would complete the “danged” fence. And it would add a variety of new technologies, including drones, to prevent illegal border crossings.

The result of weeks of floor debate and months of private negotiations by the Gang of Eight — a group of four Democrats and four Republicans including Sen. John McCain (R-Ariz.), Sen. Robert Menendez (D-N.J.) and Sen. Marco Rubio (R-Fla.), the bill eventually passed by a vote of 68-32 with fourteen Republicans crossing the aisle.

If passed by the House and signed into law by President Obama, the bill would establish a 13-year pathway to citizenship for millions of undocumented immigrants. Following are the basics of the bill:

1. S.744 requires that a series of enforcement measures go into effect prior to completing the legalization process.

2. Provides a path to Lawful Permanent Residence (“green card”) for the existing undocumented population by creating a new Registered Provisional Immigrant (RPI) program.

3. Before those with RPI status can apply for Lawful Permanent Resident status, certain security goals, or “triggers,” must be met, including increased border security and a fully-implemented E-Verify employment verification.

4. S.744 creates an independent Department of Homeland Security Border Oversight Task Force, with 29 members appointed by the President, including 12 members from the northern border region and 17 from the southern border region.

5. The bill addresses immigration removal, detention, and court processes, including authorizing access to counsel for certain vulnerable populations, giving immigration judges more opportunity to make case-by-case determinations on removal decisions, and streamlining the asylum program.

6. It increases penalties for certain criminal activities, making it more difficult or impossible to become a legal resident due to drunk-driving convictions, gang activity, domestic violence, passport fraud, and identity theft.

Following passage by the Senate, House Speaker John Boehner pronounced the bill dead on arrival in the House. He has ruled out taking up the Senate bill and suggests that the House may address some of the issues on a piecemeal basis. Many House Republicans have announced outright opposition to any immigration bill that offers a path to citizenship for those in our country illegally, while Democrats are opposed to any bill that falls short of citizenship for all 11 million who are in the country illegally. So the likelihood of immigration reform is tenuous at best.

You can read the entire Senate bill at the Immigration Policy Center website.  Be sure to explore the site because it contains many other articles and reports that you may find educational and useful.

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Immigration Reform and Senate Bill S744 — Podcast July 22, 2013


Immigration Therapy: U.S. Senate Bill S744 and the Prospects for Genuine Immigration Reform. Gary LaMaster joins Democratic Perspective co-hosts Mike Cosentino and Steve Williamson to discuss what we mean when we say immigration reform,  why it’s crucial to the future of the U.S. economy and U.S. civil society, and where S744 falls short of what we might have hoped.

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This Explains Everything.

Ever wonder why conservatives often seem to vote against their self-interest? Why people who are struggling financially vote to protect the wealthy? Why conservatives dislike government programs even though they benefit from them? Why the wealthy and the powerful believe they are oppressed?

In his book, The Reactionary Mind: Conservatism from Edmund Burke to Sarah Palin, Professor Corey Rubin describes the fundamental principles behind conservatism. In doing so, he provides answers for these questions and more.

Contrary to William F. Buckley, who once described a conservative “as someone who stands athwart history yelling ‘stop’ when no one else is inclined to do so,” Rubin has written that, although conservatives define themselves as defenders of tradition and values, they are more reactionary than conservative. They defend the interests of the powerful against the interests of the powerless; aristocrats and land owners against peasants; factory owners against labor unions; husbands against wives.

During a recent interview on Democratic Perspective, we asked him to explain his thoughts.

“If you ask conservatives today, some of them will say they stand for defense of tradition,” Rubin began. “Others will say they stand for defense of freedom. But those two values are often in conflict. Certain kinds of freedoms, such as market freedoms that Republicans like to defend, uproot traditions. They uproot communities. They change things all the time,” said Rubin. “So the question really is that if these two values are in such contradiction, is there something that actually brings these values together?”

“Through a lot of historical research I’ve done going back to the foundations when conservatism first arose in reaction to the French Revolution, what I’ve come up with is that conservatism is always, most consistently a movement of reaction to some kind of movement or democratic action from below. The movement can change. It can be abolition of slavery. It can be labor unions for workers. It doesn’t matter. It can change across time.”

“Conservatism is the movement in reaction against those movements,” Rubin explained.
“What it tries to do is not simply defend power and privilege. It has to defend power and privilege in a way that makes sense to a large group of people,” he continued, “and in doing that, what it does is come up with a new defense of power and privilege…something that seems more modern, more democratic , and more appealing to a broad swath of the population.”

This explains the alliance of the right wing populists like the Tea Party with large corporate interests like the Koch brothers. It also explains the juxtaposition of Burke and Palin in the book title, according to Rubin.

“A lot of people look askance at that, but these two figures have something very much in common despite all their differences, and that is that they’re outsiders. Burke was a major outsider in the British establishment. He was from a Catholic family. He was Irish. And he was not an aristocrat. Likewise, Sarah Palin is a woman. She’s from a state that many people don’t even think is part of the United States. She’s very much an outsider. And that outsider quality is really important to conservatism because it’s a way of saying to the majority, to the broad population, “look, our chief spokesperson is this person from the outside. And that outsider brings a certain kind of scrapiness and a populist appeal that can help reinvent conservatism for it to become a mass ideology,” said Rubin.

Rubin argues that the government programs supported by the left actually make people more free. Programs such as government-supported healthcare and unemployment insurance give employees more freedom to leave a bad job, because they are not dependent on the employer for health care and they can take the time necessary to find a better job. But conservatives see these things as oppressive to employers.

“I think that’s the fundamental battle between the left and right,” said Rubin. “How many people and what kind of people get to have freedom. It’s not about a battle between one side that stands for freedom and the other side stands for government. I think that’s completely the wrong way to look at it. It’s really who in the society gets to be free and who doesn’t.”

“When freedoms are exclusive to one group of people – my freedom to not allow you into my restaurant or something like that – we have another word for that. It’s a privilege,” Rubin continued. “And I think what conservatism has always stood for going back to the very beginning, is the understanding of freedoms and rights as the privilege of a few. That’s always been the battle. When the Confederacy seceded from the Union, it was in the name of freedom, and very sincerely so. It was the freedom of the slave holder and it was understood as a kind of freedom, which it was.”

According to Rubin, these battles are never won permanently. “Things can always go backwards,” he said. “I think in this country we have a myth of progress that everything moves forward. But we forget. When slaves were emancipated, there was about a 12-year period in which there was a great deal of progress that was made. It was called Reconstruction. And then it was pushed back and defeated and then we got 75 years to 100 years of Jim Crow after that. My point is that you move forward on things…voting rights is a good example. We thought we had won on voting rights, then it got pushed back.”

Posted in Capitalism, Class Conflict, Conservative Paranoia, Democratic Governance, Economic Theory, Entitlements, Government, Interviews, National Politics | Tagged , , , , , , | Comments Off on This Explains Everything.

Corey Robin Interview — Podcast July 15, 2013


What Conservatives Want, and Why They Want it: Corey Robin, Associate Professor of Political Science at Brooklyn College and the CUNY Graduate Center, talks to Democratic Perspective’s Steve Williamson and Bill Timberman about the thinking that led to his 2011 book, The Reactionary Mind: Conservatism from Edmund Burke to Sarah Palin. Conservatives claim to be the defenders of tradition and traditional values, but from its earliest manifestations in upper class reaction to the French Revolution, Professor Robin argues, modern conservatism might more accurately be described as a radical, and often successful, defense of elite power and privilege.

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Genetically Modified Organisms: Benefit or Threat? — Podcast July 8, 2013


What Do We Really Know About Genetically Modified Organisms? Democratic Perspective’s Mike Cosentino and Gary LaMaster discuss the latest scientific, economic, and political implications of the increasing use of genetically modified plants, animals and microorganisms, as well as what we know so far about their impact on human health and well-being.

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