Winning Progressive

(By NCrissie B)

The Preemptive Freakout du Jour is, of course, whether President Obama is about to “cave” in tax and budget negotiations with House Republicans. Last weekend, senior White House advisor David Plouffe said that successful negotiations would require concessions from both Republicans and Democrats:

The only way that gets done is for Republicans again to step back and get mercilessly criticized by Grover Norquist and the Right, and it means that Democrats are going to have to do some tough things on spending and entitlements that means that they’ll criticized on by their left.

Cue the Angst Mongers:

Okay. Deep breath.

Note the speculative scare words, such as “could be a raw deal for the middle class,” and “We have a lot of questions here about where this is going to end up, don’t we?”

Never mind that President Obama has plainly stated that Social Security is “off limits” in these negotiations. Never mind that the math is the math and, despite the chart Ed Schultz showed about the current deficit, a new report by the Congressional Budget Office shows that our long-term deficit is driven almost entirely by rising health care costs for seniors:

The aging of the baby-boom generation portends a significant and sustained increase in coming years in the share of the population that will receive benefits from Social Security and Medicare and long-term care services financed through Medicaid. Moreover, per capita spending on health care is likely to continue to grow faster than per capita spending on other goods and services for many years.

If progressives criticize conservatives for ignoring data they don’t like – and we should – then we can’t ignore data we don’t like … and the CBO’s data are very solid.

To solve our long-term deficit problem, we must flatten the growth curve on health care costs, and President Obama began working on that with the American Recovery and Reinvestment Act, which included funding for computerized medical records and comparative studies of treatment outcomes. The Affordable Care Act also includes provisions to reduce Medicare costs, but Christina Romer – former head of President Obama’s Council of Economic Advisers – wrote in June that Obamacare was only the first step in addressing the health care cost curve:

A natural approach is to strengthen measures already enacted. Once the payment advisory board has a track record, for example, perhaps it could be empowered to suggest changes in benefits or in how Medicare services are provided – say, along the lines of successful demonstration projects.

Likewise, the Bowles-Simpson bipartisan fiscal commission recommended, as part of overall tax reform, limiting the amount of health insurance benefits excluded from taxation. Like the excise tax on high-priced plans, this change would probably increase pressure to keep costs down.

Even larger departures from the current system may be needed. The law creates health insurance exchanges where individuals and small businesses can buy coverage. Including a reasonably priced public plan as an option could exert downward pressure on the price of private health insurance policies by increasing competition.

Yet Dr. Romer did not expect progress anytime soon, concluding:

Sadly, serious debate over further cost-savings measures may be a long way off. Some Republicans seem more interested in just limiting the government’s share of health care expenditures than in slowing overall spending. And some Democrats seem more interested in just preserving existing government programs than in making the entire health care system more efficient.

For the sake of the nation’s fiscal health, and the health and economic security of American families, it’s time to embrace cost containment in health care as the next great legislative challenge.

These are real challenges that demand serious discussions of alternatives and their benefits, costs, risks, and tradeoffs. President Obama and leaders in Congress will debate those. I don’t like all of the options currently on the table. I may or may not like all of the solutions eventually adopted. It’s too soon to know.

But it’s a whole lot more entertaining to have a Preemptive Freakout because … well … President Obama always caves in to Republicans anyway, right? Except he doesn’t:

In policy terms, Obama clearly had gotten the better deal. The trouble was that the political world and the public had been conditioned to see this episode as primarily a clash over the top-tier tax cuts – and on that Obama had not gotten what he wanted. Consequently, the media depicted the compromise as a loss for Obama, and progressive Democrats squawked mightily about the continuation of the tax cuts.

As Corn concludes:

In a recent White House meeting with labor leaders and progressive activists, Obama signaled he is ready to fight the GOPers – and this time dare the Republicans to block continuing the tax cuts for the middle class. But no one ought to forget that Obama, a progressive in his policy preferences, remains a pragmatist. What happened two years ago is not an indication that Obama is likely to yield in the new face-off, but that he will be assessing the political dynamics in gridlocked Washington and be willing to bargain hard for a good deal with true benefits. That’s not caving in. It’s governing.

Yes, it’s governing. But governing is messy, and full of compromises and deals that look icky as we watch them happen. As John Godfrey Saxe famously said: “Laws, like sausages, cease to inspire respect in proportion as we know how they are made.”

Or Saxe would have famously said that, if so many people didn’t wrongly attribute his quote to Otto von Bismark and Mark Twain. Those mistakes happen when people substitute ‘sounds true’ rumors for actual facts. Just sayin’.

And yes, Ed Schultz, I’m sayin’ it to you, and the others who are busy with their Premptive Freakout. Enough. Go climb a tree and nibble on a macadamia. It’s a lot better for your blood pressure. And mine.

(Crossposted from Blogistan Polytechnic Institute (BPICampus.com))

In yesterday’s post, we explained how Republicans’ pathological opposition to health care reform is motivated by the GOP’s fear that reform will demonstrate that government can be successful in improving the lives of everyday Americans.  Because of this fear, conservatives have sought to derail President Obama’s Affordable Care Act (“ACA”) through lawsuits, 31 separate and pointless votes by House Republicans to repeal the law, refusals by GOP Governors to implement various portions of the law, and more than a quarter-of-a-billion in advertising attacking the law.

Today’s post will look at perhaps the most cynical branch of the GOP’s anti-health care reform effort – the refusal of various Republican-led states to develop health insurance exchanges. Such refusal initially appeared to be just symbolic, as the federal government will establish exchanges for those states.  But conservatives are now pushing the argument that an apparent drafting error in the ACA means that families earning under $88,000 per year who purchase insurance through a federally-created exchange (rather than a state exchange) cannot receive the significant tax benefits that were included in the ACA to make purchasing insurance more affordable.  In other words, the GOP’s obsession with trying to defeat health care reform is now threatening to come at the cost of hundreds or thousands of dollars per year for working and middle class families.

A core element of the ACA’s effort to expand insurance coverage to 32 million more Americans is a grand bargain under which people are required to purchase insurance (or else pay a fine) while insurance is to be made fairer and more affordable through health insurance exchanges and tax credits.  The exchanges are essentially an on-line marketplace in which insurance companies are required to meet certain standards and where it will be easy to make side-by-side comparison of the insurance options available.  Whether created by a state or the federal government, the exchanges will be overseen by the federal Office of Personnel Management and/or state-based non-profits to help ensure fairness and transparency.  As for affordability, the ACA provides sliding scale refundable tax credits to people earning up to approximately $88,000 for a family of four, or $43,320 for an individual, in order to limit spending on health insurance premiums to between 2 and 9.5% of income.

Conservatives are seeking to disrupt this bargain by seizing on an apparent error in the drafting of the law.  The error stems from the fact the provisions calling for states to create health insurance exchanges are found in Section 1311 of the ACA, while the ability of the federal government to create an exchange in a state that fails to do so is found in Section 1321 of the ACA.  Yet Section 1401 of the ACA, which establishes the tax credits for families earning up to $88,000 per year, provides that the credits are for people who enrolled in a health insurance plan “through an Exchange established by the State under 1311.”  In other words, a strict reading of the text of the ACA suggests that refundable tax credits should only go to people purchasing insurance through an exchange created by a state under Section 1311, not through an exchange created by the federal government under Section 1321.

Conservatives have seized on this language as another way to attack health care reform.  For example, in a paper ridiculously titled “Taxation Without Representation,” conservative law professor Jonathan Adler and the Cato Institute’s Michael Cannon contend that Congress intended to limit tax credits to only state-created exchanges and that, even if Congress did not specifically intend such limitation, the plain language of the statute should govern on this issue.  And conservative legislators, such as Orrin Hatch (R-UT), have attacked IRS regulations that extend the tax credits to everyone purchasing insurances instead of just people purchasing insurance through state created exchanges.   Other scholars, such as Law Professor Timothy S. Jost, counter that this is clearly a situation involving just poor drafting that a court can ignore or correct because it is obvious that Congress never intended to limit health care tax credits only to states where the state itself created the exchange.

To our knowledge, no one so far has filed any litigation challenging the IRS regulations extending the tax credit to all exchanges, rather than to just state exchanges.  But, in the absence of a Congressional fix (which is a virtual impossibility given GOP control of the House), it seems inevitable that such a challenge will be pursued.  And if and when such litigation is pursued, it will be useful to remind voters and the media that the only impact of such litigation would be to significantly increase the cost of health insurance to middle and working class Americans in states like Texas where the Governor had decided to forgo creating a state level health insurance exchange.

With the Supreme Court having upheld the constitutionality of the Affordable Care Act (“ACA”), the majority of Americans have made clear that they want to move beyond the debate over health care reform and let the law be implemented.  Republicans, however, have apparently not gotten the message, as they have continued their incessant and unfounded attacks on the ACA.   For example, we have witnessed:

* 31 House Repeal Votes: House Republicans took their 31st vote since January 2011 to repeal, defund, or dismantle health care reform, with no proposal to replace any of the significant benefits of the law.  All 31 votes were, of course, pointless as repeal legislation would not pass the Senate or, even if it did, it would be vetoed by President Obama.  Yet House Republicans continue to hold these votes, with one GOP Congresswoman Marsha Blackburn saying that she wished the House would vote to repeal the ACA every day.

* Rejection of Medicaid Expansion: At least four GOP-run states – Texas, Louisiana, South Carolina, and Florida – have announced that their states will not accept the expansion of Medicaid provided for as part of health care reform, even though the federal government would be picking up 100% of the cost from 2014 through 2016, 93% of the cost for 2014 through 2022, and 90% of the cost thereafter.  Under the ACA, Medicaid is to be expanded to cover people whose income is up to 133% of the poverty line, and the increase in coverage is expected to save states billions of dollars by reducing spending on uncompensated care.  Yet these GOP-run states are proposing to forgo these benefits, even as those states have some of the highest rates of uninsured people in the nation.

* Refusal to Set Up Consumer-Friendly Health Insurance Exchanges: A number of Republican-led states, such as South Carolina, Georgia, Texas, Florida, Wisconsin, Ohio, Louisiana, and Oklahoma, are refusing to or delaying the set up the health-insurance exchanges (through which consumers who are not covered by the government or through businesses with more than 50 employees can purchase coverage). While the ACA provides that the federal government will create health care exchanges in states that fail to do so, conservatives are now arguing that people living in states without state-created health care exchanges will not be eligible for the tax subsidies that the health care reform law provides to make insurance affordable for families earning under $88,000 per year.  We’ll have more on this topic in a future post.

* A Quarter-of-a-Billion  Dollars in Anti-Reform Spending – Conservatives have spent approximately $250 million on advertising attacking health care reform, compared to only $75 million in pro-reform advertising.

The GOP’s continued, over-the-top opposition to health care reform can only be described as pathological. The law passed by Congressional Democrats and President Obama eschewed the liberal dream of Medicare for all and instead took an idea developed by the conservative Heritage Foundation and melded it with moderately progressive ideas about regulating the insurance industry, making insurance more affordable, and curbing escalating health care costs.  Yet the GOP has treated the ACA as if it were a socialist plot that they must battle to the death.

The question one has to ask then is why is the GOP so pathologically obsessed with stopping health care reform. Partisan gain and hatred of President Obama certainly play a role.  But we think that the primary factor motivating the GOP here is fear of the fact that health care reform will work to improve the lives of tens millions of average Americans and, therefore, undermine the entire ideological basis for today’s Republican Party.

Over the past few years, the GOP has entirely internalized Ronald Reagan’s infamous statement that “government is the problem” to the point where much of the GOP agenda thrives on the rejection of government as a source of social good. And incompetent governance under President W. Bush, unprecedented obstructionism by Congressional Republicans during the Obama Administration, and budgetary cutbacks to important government services have led many people to buy into the GOP’s anti-government message.  At the same time, most of the ways that government directly improves our lives – environmental regulations, workplace safety rules, Social Security, Medicare, infrastructure investments, etc. – have been around so long that many Americans simply take these things for granted, rather than realizing the importance of the progressive politics and policies that make those programs possible.  Combined, the GOP’s consistent painting of government as the enemy and the lack of concrete new reminders that government often can be a useful tool for improving society has created a large political opening for the GOP.

Health care reform, however, threatens to change that dynamic. Before health care reform, our health care system was broken,with 50 million Americans uninsured, excessive costs for not great levels of care, and widespread abusive insurance company practices such as denying coverage to people with pre-existing conditions, and cutting off people’s benefits as soon as they get sick.   Health care reform certainly will not fix all of those problems, but it will vastly improve health insurance and care in numerous ways that directly benefit tens of millions of Americans by, for example:

* Forbidding pre-existing condition exclusion policies

* Forbidding annual and lifetime caps on benefits under health insurance policies

* Preventing recissions, which is the industry practice of accepting your premiums for years on end, but then cancelling your coverage as soon as you get sick

* Requiring insurance companies to spend at least 80% of your premiums on providing health care services, which has led to $1.3 billion in refunds to consumers

* Requiring health insurance companies justify rate increases of more than 10%.

* Closing the Medicare prescription drug coverage doughnut hole

* Eliminating co-pays for preventive care services

* Requiring insurance companies to cover under their parents’ policies adult children until they reach the age of 26

* Expanding health insurance coverage to 32 million more Americans through providing tax credits to make coverage more affordable for families earning under $88,000 per year and small businesses, and by expanding Medicaid

In short, the GOP tells people that government is the problem.  But the tens of millions of people who will be able to get affordable insurance, who will not have to worry about coverage if you have a pre-existing condition, or who detect a disease at an early, more treatable stage due to free preventive care services will experience first hand that government can be a tool for improving the lives of average Americans.  And that is what scares the GOP so much about President Obama’s health care reform.

(By Fay Paxton, cross-posted at The Pragmatic Pundit)

If I hear that right-wing narrative about how the federal government and its do-gooder programs are holding America back one more time, like Rick Santorum, I’m liable to puke.  “If only government would get out of the way, along with its regulations, its taxes and its social safety net.. “ they sing.   They spout platitudes about bygone days, a rose-colored social construct, and the sanctity of the Constitution.  The irony is, the very politicians and citizens who can lay claim to middle and upper class status (and fight so ferociously to withhold it from everyone else) can do so only because of a government “New Deal” that lifted their parents or grandparents from the ravages of the Great Depression.

The Tea Party and Justice Broccoli invoke the Tenth Amendment and “states rights”, but, in fact, the Constitution represents the shift of power from the states to the national government.  It eradicates states’ sovereignty which had existed under the Articles of Confederation.  The goal of the Constitutional Convention was to create a federal system that could address national problems and make the country competitive with Europe.  It also sought to protect the new nation from outside forces as well as those within.  Unlike the idiots who represent our government today, the Founders who drafted the Constitution, quite sensibly saw danger in disunity.

The Tenth Amendment states simply that: 

“The powers not delegated to the United States by the  Constitution, nor prohibited by it to the States, are reserved to the States respectively or to the people.” 

Now think about it, what exactly does that mean?  Then consider that the very first Article of the Constitution, the touchstone of our nation,  states,  “ALL LEGISLATIVE POWERS herein granted shall be vested in a Congress of the United States.”  So what then are the powers not delegated to the Congress by the Constitution?  The Tenth Amendment is nothing more than a seed of peace, added to appease the State’s Rights advocates, who even today are still fighting the Civil War and that includes Justice Broccoli, et al.

I speak of the Tenth Amendment because the tortured interpretation of its meaning places us where we find ourselves today.  It is the basis for the “laboratories of democracy” concept that many refer to regarding healthcare.  Never mind that we’ve already had healthcare experiments.  In 1994 Kentucky enacted reforms regarding preexisting conditions, but without an individual mandate. Kentucky was forced to repeal the reform when insurance costs rose so steeply insurers pulled out of the market altogether. Initiatives introduced in New York and New Jersey faced similar problems.  While, in Massachusetts, where reform was coupled with an individual mandate, the system has worked.  How many laboratories do we need?

And finally, there’s that pathetic whine about “loss of liberty”.  A decision that Congress has the power to enact the individual mandate speaks only to whether the government has the power to require citizens to participate in health insurance.  Nothing more, nothing less. The framers gave Congress the power to address problems of national scope that could not adequately be left to the states. Healthcare is precisely such a problem. One that has been broached by both Democratic and Republican presidents for nearly a century.  Clearly, were states up to the task, we would not have this dilemma.  The same can be said of the Republicans, who now have ALL the answers, but apparently had none when they occupied the House, Senate and White House from 2001 to 2007.  They should change their name to the Reactionaries.

My friend argues that if the government can tell us to buy health insurance, they will soon tell us we must buy an electric car or place solar panels on our homes.  An asinine theory, for we have a choice to purchase a car or not, to buy a house or not. Illness, an accident or debilitating disease is not a choice.  Besides, the individual mandate is aimed at people who fail to acquire insurance, and then cannot pay the cost of their own health care when they need it. That cost is ultimately borne by the rest of us. The Congressional Budget Office estimated that in 2008 the uninsured shifted $43 billion of health care costs to those of us who are covered.

Have you noticed that those who yell loudest are already insured and are therefore not affected by the new law?  Whatever the case, absolutely nothing in the Constitution even remotely guarantees a right to be a free rider and to shift the costs of one’s health care to others.

According to Justice Broccoli,  “If every person comes within the Commerce Clause power of Congress to regulate by the simple reason that he will one day engage in commerce, the idea of a limited Government power is at an end.”

Congress plainly can tax for the purpose of providing health insurance. It does so already, through Medicare and Medicaid. Of course, Medicare contributions are a tax, not a purchase.  Or is it?  Isn’t it a purchase of insurance?  Whatever, to my way of thinking, an obligation to pay has the same effect whether we call it a tax, purchase, fee, fine, penalty or contribution. In fact, Medicare is even worse than the Affordable Care Act, because it requires an investment over a lifetime, that God forbid, one might not live long enough to collect.  But of course, Medicare forces us to buy health insurance from the government, rather than from private insurers, even though the option is available. In the final analysis, the problem, solution, intent and end result are the same.

The four justices said people who don’t want health insurance are “quite simply not participants in that market, and cannot be made so (and thereby subjected to regulation) by the simple device of defining participants to include all those who will, later in their lifetime, probably purchase the goods or services covered by the mandated insurance.”

This ignores the very purpose and idea of insurance.  It provides  protection against a possible eventuality.  Medicare presumes that people will reach age 65 and need medical attention.  An employed 22 year-old is not exempt because they refuse to project 43 years into the future.  Consequently, in that same vein, the  Medicare mandate legislates “inactivity” for 43 years. Would it really be erroneous to suggest that Medicare “purchases” future healthcare coverage?  And since the 22 year-old cannot actually benefit from the purchase, can the purchaser be considered “inactive”? Such knit-picking analogies could go on forever.

Justice Broccoli wrote:  “Indeed, the main objection many have to the Mandate is that they have no intention of purchasing most or even any of such goods or services and thus no need to buy insurance for those purchases.”

Despite proclamations about Justice Broccoli’s superior intellect, this is far-flung reasoning.  People require medical care and in fact die, at every stage of life.  The question is not whether one wants it, but whether it is needed.  One may not want a vaccination, afterall who actually plans to contract polio, yet it is mandated none the less.  Such a statement indicates that he was less worried about the interpretation of the Constitution and the economic viability of the nation than he was about the boundaries of government authority.

The argument  that the framers could not possibly have envisioned a congressional power to force purchases is upended by the fact that in 1798, Congress required seamen to buy hospital insurance.  Some believed the Justices felt the Merchant Marine law outdated, but when giving his snide dissent to the immigration law, Justice Broccoli had no problem reaching all the way back into the caverns of abolitionists.

More importantly, the Justices initially determined they could hear the case because the mandate did not represent a tax.  Only to turn full circle and determine the mandate could only be legitimate because it is a tax.  But wait!  If the mandate is a tax, how does the court have the right to pass judgment at all before it goes into effect?  This is the kind of insidious legal beagle double-speak one should expect to hear at a bond hearing.  Instead of hallowed halls of deliberation, the Supreme Court sounds more like  “Let’s Make a Deal” with Justice Roberts assuming the role of Monty Hall.

I see absolutely nothing heroic or commendable about the Robert’s decision. The justices ignored precedent, Congress’s right and duty to regulate and secure the economic welfare of the nation,  and the Constitution in favor of an ideology that is entrenched in the defunct Articles of Confederation.    I do not accept that any of them had serious doubts about the Constitutionality of the minimum coverage provisions of the Affordable Care Act, but were simply determined to reinterpret the limits of the Commerce Clause, undermine the Federal government and who knows, perhaps even this President.  So it came down to, you give me the Medicaid that Conservatives mortally despise and I’ll give you the mandate.

People who shudder at the prospect of the nation becoming a “nanny state” should be equally concerned when “nanny judges” tell us what laws we can write.

(By Joanne Boyer, cross-posted at Wisdom Voices)

There are few people today – in any walk of life – who have the courage and wisdom of Wendell Potter. Potter’s determined passion to help educate the American public and help them understand the “deadly spin” of the for-profit health insurance industry serves as a centering force in a world that appears to be turned upside down no matter where one looks.

Potter, a former public relations executive with CIGNA, reached deep within his soul about five years ago after a life-changing event and became determined his legacy would carry far more than the words “retired health insurance executive.” Few have understood – or participated first hand – in the intentional deceit by the health insurance companies of how the for-profit health care system functions. Potter will be the first to tell you how he helped to malign Michael Moore and his movie Sicko. How things have changed. Today, the two share the podium at conferences discussing the horrifically broken U.S. health care system.

In his book Deadly Spin (see summary below), Potter provides not just an exposé of health insurers but a stark warning that corporate spin is distorting our democracy. But yet it is more than just his knowledge and “insider’s understanding” of this industry that make Potter such a force in the debate that will continue for years on how to reform a health care system that is rigged to work for corporate interests rather than people.

It is that quiet sense of speaking truth to power; the inner knowledge that he possesses that helping people is what matters in life. No screaming from a pulpit, no finger-pointing in anyone’s face. Rather a calm resolve that comes only from an inner peace that moves one forward through immeasurable odds. He remains a beacon of hope in 21^st century America that we may once again “turn our hearts” to something of value – something that is not measured in dollars and cents.

We at Wisdom Voices are honored to have had the opportunity to have talked one-on-one with Wendell Potter on a recent visit to Minneapolis, a week before the Supreme Court ruling on the Affordable Care Act. As our July Progressive Profile, we have decided to let his own words do the talking. And we strongly encourage readers to get a copy of Deadly Spin and make it mandatory reading for anyone who treasures our American heritage.

For more of the facts of who Wendell Potter is, we invite you visit his web site. Our goal is to provide more of the “why” Wendell Potter pursues the tireless and thankless job of trying to make health care work for people and not corporations. In the truest tradition of providing today’s “wisdom voices”, we present Wendell Potter – in his own words.

On why he decided to have a change of heart/soul on what he was called to do with his professional life:

“I think a lot had to do with the fact that I was born to a working class family in the southern Appalachians. I was fortunate enough to get a good education and I wanted to be a journalist. I was trained to be someone who wanted to try to write in ways that revealed truth and provided people with information that would help them understand things better. I think had it not been for that, I probably would not have done what I ultimately did.

“I left my journalism career and got into public relations more than 35 years ago, and I ultimately wound up in the health insurance industry. I had a very successful PR career, but I still had that training as a journalist and I still knew where I came from.

“I went back to visit my family in Tennessee 5 years ago and I read about something called the Health Care Expedition that was being held not too far from where I grew up. I had never heard of anything like this before. There were articles that people would be traveling from hundreds of miles away – from Ohio, South Carolina, Georgia. It was being held at the Wise County (Virginia) Fair Grounds. So I was very curious and decided to go check it out. When I got there I saw something I never expected to see

“I saw people lined up by the thousands at this three-day event trying to get care that was being provided free. That morning, people were soaking wet because it had been raining. They were lined up to get care that was being provided in barns, and then it hit me. I realized that those people could have been my neighbors, people I had grown up with, people I had shared cultural roots with. I realized that what I was doing for a living, in some way, was making it necessary for those people to have to resort to those lengths in order to receive care.

“I made a commitment that day that I would figure out some other way to make a living and ultimately did. That was an eye opener for me. Had I not been from that region, had I not gone back home at that time, had I not been curious enough to check it (the health exposition) out. There were many things that impacted me. It was a reminder as I began to think more of my life. I realized that what I was doing was in many ways the opposite of what I was trying to do in my first career (journalism). Then, I was trying to educate and enlighten and inform people. Now, more often than not, I was trying to obscure and misdirect the truth. I became so utterly ashamed of what I had become that I ultimately walked away from that job a few months later.”

On why others within the industry chose not to follow Potter’s path:

“We get stuck. We have tuition payments, car payments, and house payments. We have a lifestyle we’ve grown accustomed to. Our egos (and sense of who we are) are wrapped up in what we do. It’s hard to walk away from that. People think it’s impossible to walk away from that. I realized that it was not.

“It’s been a blessing. I don’t make near as much money, but I can’t think of any measure in which this has not been a blessing. I’ve met some of the most wonderful people since I’ve been away from that industry and have had experiences I would never have had. I’ve been stretched in ways I couldn’t imagine. I was never one who wanted to speak in front of an audience or to go in front of a camera. But I’ve overcome that. It was necessary if I was going to be doing what I was going to be doing. I had to walk through my fears.

“I keep a gratitude journal and that is so helpful for me to have reminders of just how much joy I have in my life. That keeps me centered. I’m just so grateful to be doing what I’m doing. As I was contemplating making this decision, I was thinking about my own legacy – what I would want my legacy to be when I’m no longer on this earth. I realized that I sure didn’t want it to be ‘a retired insurance company executive’. I knew that I had some things that I thought I could and should do, that if I didn’t do, I would regret on my death bed.”

On the Supreme Court:

“Ultimately, there are certain things beyond my control. I can’t control what the Supreme Court is going to do. I have to look at that with detachment. I can’t control that. That’s just the reality I have to accept. And we have to work with reality. Once we know what the Supreme Court is going to do, then we can develop a strategy of how to go forward.

“It will be a decision and we will have to figure out what happens next. What I do think and hope is that advocates for single payer and universal coverage and advocates for meaningful health care reform will start to think more strategically and cohesively. I’ve observed that a lot of advocates don’t see eye-to-eye on how things should be, which result in tensions and resentments; and that’s not healthy, it’s counterproductive.

“What I would like to do is hopefully become someone who can help build bridges in the advocacy world. To get people to see that we share common goals; we may see the paths as being different on how to get to the ultimate ideal/objective, but if we don’t start working together.

On what keeps him hopeful:

“You have to look at this fight and know that we’re in for the long haul and we can’t expect instant gratification. We have to know that it takes time for significant change particularly when you’re fighting entrenched special interests. It took a long time to get the Civil Rights Act passed, to get Medicare passed. But, on the other hand, we’re seeing things today that may be able to be changed more rapidly than they have been in the past. That doesn’t mean that it’s going to be an easy slog to get to universal coverage, because it’s not. It’s going to take time. But it’s a possibility and unless we keep the faith, keep going despite discouragement, then the other side wins.”

On Deadly Spin:

“I call it ‘invisible persuasion’ and I’m hoping the book sheds some light on this and makes it more visible to people so they know how it’s done and how corporate spin has shaped the health care debate.

“In the book, I try to give people tools how to be wise to manipulation and what to look out for. People should know that most of the advertising being done (to discourage health care reform) and the organizations that are sponsoring them are in many cases just front groups for the insurance industry. It’s been estimated that $250M has been spent trying to discredit the health care law. When you get that kind of spending, it’s no wonder people don’t know what’s in the law. This is done purposely. In this book, I try to explain why that happens and where that money comes from and how all of us are susceptible to this type of persuasion.”

On his advice to the public:

“Be skeptical about what you hear. Know that almost everyone you hear expressing a point of view has an agenda. Don’t outsource your thinking to TV commentators. Take the time to try and educate yourself.

“If you don’t know what’s in the Affordable Care Act, try to educate yourself. There are more reliable places to get information. For example, Consumer Reports provides factual information on the ACA. One of the key ways why the special interests are so successful is they know we outsource our thinking – we are so willing to let others think for us…and we’re so gullible.

“We all lead busy lives, but educating yourself is important. Think beyond yourself. Think about your children and the kind of world we’re creating for them. It’s important to spend a little time to get informed before you pull a voting lever.”

Deadly Spin: Attacking the Corporate Strategy To Keep Us Ignorant

Did you ever wonder about why and how the general public stays so ill-informed on what is really in the Affordable Care Act or just how and why we remain the only industrialized nation in the world with a for-profit insurance company?

Wendell Potter explains it all in his book Deadly Spin. From clandestine meetings carefully organized to leave no paper trail to creating third party front groups, Potter lets the reader in on the dirty secrets most big corporations would rather have the masses be in the dark about because the stakes are high and the profits even higher.

“I wrote the book because I wanted people to have a better understanding of just how the special interests are able to manipulate public opinion and how the vast majorities of people just don’t have a clue,” said Potter. “And how effective it is to get people to think, act and vote against their own self-interests…and how corporate interests are capable of influencing public policy through public opinion.”

Michael Moore, at one point an adversary of Potter’s, sums up the book best: “You’re the Daniel Ellsberg of corporate America. I mean, what that man did during Vietnam helped to end that war…. People should read this book. The whole book lays it right out there about how the health insurance companies had bamboozled this country and lied, just outright lied about things.”

For information on how to order the book, click here.

(By NCrissie B)

Yesterday we parsed the legal issues of the Supreme Court decision on the Affordable Care Act, and how each judge voted on each issue. Today we look at what the decision will likely mean, in terms of precedent, policy, and politics.

Precedent Winners and Losers

Since the Court’s decision was released, there have been both concerns and celebrations about whether Chief Justice Roberts’ opinion set “conservative traps” for future cases. We’ll discuss the political issues below, but the legal argument for a “conservative trap” presumes the ACA fell within Commerce Clause precedent, thus this decision “narrowed” Congress’ authority to regulate commerce.

I disagree. There are reasonable arguments for why health care presents a unique case for Congress to require people to buy health insurance. Yet this fact remains: there was no Supreme Court precedent reading the Commerce Clause as giving Congress authority to compel demand for a private good or service. The Court has long held that Congress can regulate the supply of goods and services, from production to distribution to marketing to whether some businesses can refuse some customers. Chief Justice Roberts’ holding did not “narrow” those precedents. He and the dissenters refused to extend that Commerce Clause regulatory power to demand, holding that Congress cannot make it illegal to not buy a private good or service. (Note: In a separate opinion, Justice Clarence Thomas would have narrowed Congress’ regulatory power under the Commerce Clause. His lone opinion is not binding.)

Instead, Chief Justice Roberts and the majority held the ACA can be read not as compelling demand, but rather as using the tax code to induce demand, an authority the Court has long recognized in the Taxing and Spending Clause. Congress could not order people to buy health insurance under penalty of criminal prosecution, but Congress could (and did) make health insurance more attractive by offering premium subsidies for median- and lower-income Americans, as well as by imposing a “shared responsibility payment” – a tax – on people who could afford insurance but refuse to buy it.

The “shared responsibility payment” prescribed in the ACA will not be more than the cost of health insurance, and it may be less depending on one’s income and other factors. As Chief Justice Roberts noted, some families may decide their best economic course is to forgo insurance and pay the tax. If they stay healthy, that may be indeed be their best choice. But if they get seriously injured or suddenly ill, the insurance they buy might not cover costs incurred before they bought the policy, and they may find that paying the tax rather than having insurance wasn’t so smart after all. If they can’t pay those pre-insurance costs, losses incurred by the hospital and other health care providers will be offset, in part, by the “shared responsibility payment” the uninsured person had been paying.

Here are my winners and losers, in terms of legal precedent:

• Winners: Congress, Supreme Court, Nudgers, Voters – Congress won, as the Court recognized that the ACA fell within long-standing constitutional precedent. The Supreme Court did not interpose themselves as a super-legislature, and issued a reasoned opinion. Nudge advocates won, as the Court reaffirmed Congress’ authority to use the tax code to encourage socially beneficial behavior and discourage socially harmful behavior. And voters won. Chief Justice Roberts and the majority held that, so long as Congress and the president do not transgress the Constitution, elections and their consequences must be respected.
• Losers: Paul Ryan, Republicans – The surprising losers are Rep. Paul Ryan (R-WI) and Republicans, whose Medicare ‘reform’ plan would have given vouchers to seniors and required them to buy their own health insurance. Unless the plan is rewritten to make private insurance an option and/or include a tax penalty for seniors who don’t buy insurance, I don’t see how it would survive Court scrutiny under this precedent.

Policy Winners and Losers

In terms of policy, the outcomes are a little clearer:

• Winners: – As Paul Krugman and many others noted, the big winners Thursday were most Americans who need health insurance. Once the exchanges and Medicaid expansion are fully implemented, almost all Americans will be able to get health insurance through their employers, or individually in a better-regulated market, or through federal or state programs. While the ACA is not a perfect bill, it is a huge step forward.
• Losers: – Yet not everyone will benefit immediately. Many Republican-led states may refuse to implement the Medicaid expansion, at least until they and voters no longer associate it with President Obama and Democrats, denying affordable care tens of thousands of low-income Americans. While Gov. Bobby Jindal (R-LA) and some other Republican governors have declared they will not implement state insurance exchanges, that is less troublesome. Under the ACA, if a state refuses to create a health insurance exchange, the federal government will create it instead.

Political Winners & Losers

Although pundits and other prognosticators began weighing in on this within seconds after the decision was released, I left it for last. While elections are important, we progressives cannot forget that government must be about something more than who wins the next election. The ACA is a legislative landmark, and a huge step toward ensuring universal access to health care in the U.S.

But there’s also some self-interest involved. I didn’t make a prediction about the Court’s ruling on the ACA, because my experience has been that Court decisions are not very predictable. Likewise with the political responses to Court decisions.

Those on the right have been dancing with joy over Chief Justice Roberts “declaring ObamaCare a tax,” even as some of them say that must have happened in an epileptic fit. In the RedState article linked above, Erick Erickson claimed the Supreme Court “just handed Mitt Romney the White House,” by firing up a dormant Tea Party while lulling progressives into a false sense of security. I wouldn’t measure the drapes yet.

While studying Go in Okinawa, I once asked my sensei if I’d just made a good move. He replied: “Good move, bad move, all is next move.” And here as well.

If President Obama, Democratic candidates, and we activists use this decision as a springboard to discuss the many positive (and popular!) elements of the Affordable Care Act, this becomes a win-win. We should emphasize that the Supreme Court found the ACA is a kind of solution, authorized by an enumerated power, that our federal government has used and our courts have upheld for two centuries.

And we should emphasize that – contrary to spin from Republicans and some on the Professional Left – the Supreme Court did not rule that health insurance premiums are taxes paid to a private corporation. Instead, the Court said people can refuse to buy health insurance, but they can’t be freeloaders. They owe a “shared participation payment,” a tax to offset the inevitable costs when they need health care and haven’t prepared to pay for it. That is called “personal responsibility.”

If progressive Democrats make the right “next moves,” this landmark Supreme Court decision on this landmark Democratic achievement will become a political win-win. It’s your move….

(Crossposted from Blogistan Polytechnic Institute (BPICampus.com))