The AHCA repeals fewer than 10 percent of the provisions in the Affordable Care Act. It is an amendment to the ACA that deliberately maintains Obamacare’s framework. It reformulates but keeps tax credits to subsidize premiums. Instead of an individual mandate to purchase insurance, it mandates a premium surcharge of 30 percent for one year following a lapse of coverage. And the bill continues to preserve coverage for dependents up to age 26 and people with pre-existing conditions.
I want to emphasize that last point. The bill does not change the ACA’s federal requirements on guaranteed issue (prohibition on policy denial), essential health benefits (minimum coverage), or community rating (prohibition on pricing based on health status). In short, Obamacare’s pre-existing conditions provisions are retained.
This is, (how should I put this?), ….
a bald-faced lie.
For all its faults, the Affordable Care Act cut the uninsured rate in half in this country, bent the cost curve down, saved at least 50,000 lives, and shaved at least half a trillion dollars off the 75-year debt projections.
What the new bill does change is significant. It ditches means-based and geographically-based subsidies altogether in favor of an age-based subsidy, so that Bill Gates would get a higher tax credit to purchase a plan on the exchange than I would. At least $600 Billion of the revenue that makes the ACA work is cut in the AHCA. The Medicaid expansions, about half of the ACA reduction in the uninsured, are phased out after 2020, affecting millions who will have little to no access to health insurance if this bill becomes law. That will cost tens of thousands of lives every year.
The changes in subsidies, the uncertainty of the non-statutory cost-sharing subsidies, and the phase-out of the Medicaid expansion will trigger a death spiral on the exchanges and for rural hospitals that will deny millions of Americans life-extending health care and cause immense quantities of needless suffering and death. At least 24 million of those insured on the exchanges and through Medicaid because of the ACA will lose coverage. The coverage losses from the exchanges are probably worth at least another ten thousand deaths a year. These losses will hurt Republican voters the most. Coverage loss maps show that the areas of greatest insured reductions are in some of the reddest places in America, like Nebraska, Kentucky, and Kansas.
Even for those who get health insurance through their employers or those of their family members, about 150 million, the bill has a serious problem. The states can petition this administration for exceptions to the mandated coverage provisions. They will get it. Then, there is a provision in the bill to allow large employers in any state to adopt the exemptions of the most backward state, so that employees of large companies can lose hospitalization coverage, or maternity coverage, or prescriptions, or whatever. I guarantee you will see at least some of this.
The idea that this bill makes no significant changes because somebody did a word count and found 90% commonality in the text is a childishly disingenuous dodge. It doesn’t take much textual change to cause suffering for millions.
And for what? To put some money in the pockets of a tiny handful of wealthy donors and to make a political point. Justin Amash is, how to put this delicately, ……
Our Separation of Powers Presidential system is supposed to prevent any one person or small group from seizing control over American government. By constraining executive power with independent legislative and judicial branches that supposedly prevent abuses and excesses. Our federal system puts constraints on the power of the central government, reserving rights and powers to the States.
From the standpoint of the Eighteenth Century, the Separation of Powers system looked like it offered more benefits than problems. Disconnected from the rest of the world by one, and later two, oceans, the United States could afford to bumble and squabble. The only real threats were armed enemies, and nobody would prevent war against them.
The modern world is a different and faster place. Air travel, mass communications, modern weaponry, and a global economy have meant that problems move faster than our multiple veto points can move policy. Like many state systems, ours is designed for conventional interstate war, and that’s an obsolescent threat.
Not only can problems like climate change and gun violence fester and worsen while corporate lobbyists use our veto points to stop effective action, the lack of coherent policy breeds a dissociative type of politics where the bases of both parties see themselves as in opposition. The voters never get to see an ideology enacted, so festering ideological disputes are never resolved. As you can see in the contemporary conservative movement, the incentives are to become more and more extreme, using the language of oppressed minorities to ratchet the rhetoric more and more.
Now, even with one-party government, the State is paralyzed. We narrowly avoided a government shutdown over the weekend. Under conditions like these, it’s easy to see why every American-style government on Earth has collapsed into some kind of discontinuity, coup, crisis, or civil war. It’s also worth noting that, although our system was supposed to protect the people from excesses of government power, the United States has amassed a series of atrocities worthy of its status as a great power.
I don’t understand this idea that the rest of us lack empathy for rural whites. I’m a middle-aged suburban Southern white man, and the cultural and political influence of conservative rural whites was everywhere when I was growing up. A quarter of my state’s resident’s lived in my county when I was a teenager, but it took me an hour to drive 6 miles because the rural whites in my state refused to allow us to spend our tax dollars on mass transit and highway funding. The music and literature of rural whites was mandatory in my school and my home. My school had inadequate sex education because of the power of rural whites. I lived in a group home for awhile, and the rural white version of religion was mandatory. The staff used punishment to try to force me to adopt evangelical Christianity.
In the intervening years, the influence of Southern rural whites was, if anything, even greater. We had a teen pregnancy and STD boom for several years because rural whites imposed a ban on real sex education for suburban and urban youth. Rural whites imposed tax cuts and unnecessary wars that have burdened the federal budget and starved vital public services. How comfortable are you with that bag of pre-washed spinach right now? We’re still fighting the same battles over textbooks that we fought 40 years ago. We failed to restrain climate change to two degrees, very largely due to the political power of rural whites. Rural whites who work in agriculture are the recipients, directly or indirectly, of huge federal aid.
Compare all that to the national response to Colin Kaepernick taking a knee during the National Anthem. Do you remember how the media treated the case of Tamir Rice? How about how the media treats any attack by a brown person as terrorism, but if the same act is committed by a rural white, he’s just a troubled person? Ask rural whites to sympathize with ANYONE else. If you think rural whites are struggling to cope with deindustrialization, ask the people of Detroit or Flint how they are doing.
While I understand the tactical purpose of this point, it makes no moral or political sense. The excessive deference to the preferences of rural whites is a major contributor to the dysfunction of our nation. I fail to see how doubling down on that particular error is going to fix anything.
The media’s response to this event and the long delay that will ensue until Dr. Dao is compensated speak to the culture of impunity for corporate wrongdoing in contemporary America. United has professional attorneys, managers, and PR flacks who can work full time to protect the interests of their company while ordinary citizens have jobs and responsibilities that will not permit them to secure their interests. Government has largely abdicated the job of tipping the balance toward consumers and workers. The result has been a steady drain of power, wealth, and influence toward the wealthy that is working to corrode our social cohesion. Whatever ideological objectives conservatives and neoliberals hope to serve will be undermined by a fragmented and mutually suspicious social order.
I’m a big fan of Mamoru Oshii’s Ghost In The Shell franchise, a manga/animated feature/anime series juggernaut that’s been going. non-stop, for the last 22 years. It combines savvy military-style combat sequences like you might find in the best Masmune Shirow manga with a deeper and more interesting look into the nature of humanity and the effects of technological change on the “soul,” or “ghost,” in the parlance of the franchise.
The story revolves around an anti-cyberterrorism unit of the presumably Japanese government in the 2030s, which is led by veteran security bureaucrat Daisuke Aramaki and commanded in paramilitary and cyberoffensive operations by Major Motoko Kusanagi, formerly of the Ministry of Defense. The orginal manga and animated feature from the late 1980s through mid-1990s were groundbreaking explorations of the alienation of the human mind and spirit in a world increasingly dependent on information technology and the cyberenhancement of the brain and body. Most members of the team, with the exception of recent ex-cop Togusa, have a mix of human and cybernetic parts, with Maj. Kusanagi at the extreme with a completely mechanical body. Although she and everyone else assume that her brain was originally human, the creative ambiguity that the 1995 feature maintains on that score is a major source of mystery and tension in the story, helping to propel it through a mixture of hypnotic action and detailed procedural.
*SPOILER ALERT. SPECIFIC PLOT POINTS NOT DIRECTLY REVEALED, BUT OUTLINES ARE*
In the live-action feature I saw tonight, that mystery is dispensed with in the opening sequence, robbing the film of a good deal of its narrative power. There is a mystery about the main character’s origins, but it turns out to be a generic action-film kind of mystery, of a different order than the fascinating, labyrinthine story of the original. There seems to have been a certain carelessness in the story, in precisely inverse proportion to the obsessive care that was taken with copying iconic visual impressions from the original, and WOW, were they ever beautiful. One crucial scene involving a sanitation worker was arguably inferior to the original, but the rest are more arresting. This film is GORGEOUS. It was a little off-putting, however, because the scenes tend to remind the viewer that the original told a better story.
One of the annoyances of the film was an irritating pattern of contrived or silly plot points. Why can’t a direct neural connection to a hostile robot be ‘encrypted’ or firewalled? Why were a suspect’s restraints designed to permit suicide? Why was a private corporation allowed to send a combined arms battalion around a megalopolis, blowing stuff up and assassinating government officials? Why do the characters refer to our hero as “Major” when, in this film, she has had no military career, and why do they sometimes use it as a name and sometimes as a rank? If the vast majority of Newport City’s residents are cyberenhanced, why do they need expensive and power-intensive holographic advertising absolutely everywhere? Can’t the same thing be done in a cheaper and more personalized way in Augmented Reality in users’ existing enhancements?
The story is a very straightforward evil-corporation morality play with a villain we can spot in the first scene. This is a huge contrast from the original, in which we spend half the film following our heroes down a blind alley before they begin to piece together what is happening. If this were an original universe, the story’s silly and generic nature would hardy be worth noting, but in a franchise specifically aimed at intelligent and thoughtful Science Fiction fans, it’s a really weird choice. There’s still enough of the odd and alienated vibe from the original to turn off casual action fans, so the question really begins to assert itself: Who is this movie for, exactly?
Having said all that, I did enjoy the eye candy and the meticulously staged action sequences. Pilou Asbæk’s Batou and Takeshi Kitano’s Aramaki are high points. Scarlett Johansson is as watchable as ever in this, even if she’s an odd casting choice for all the obvious reasons. Hollywood has a famously voracious appetite for established content that can attract built-in fan bases in an increasingly crowded entertainment environment, but they might have bitten off more than they can chew with Ghost In The Shell.
Historian Rick Perlstein, in his political history of the mid 1970s, The Invisible Bridge, points out that at many points of Gerald Ford’s partial term as President, he faced a dilemma:
This new presidency [Ford’s] was evolving a theme: Damned if he did, damned if he didn’t.
Rick Perlstein, The Invisible Bridge, Page 309
When President Obama, fresh off the triumph of removing his nation from the quagmire in Iraq and giving the order for the successful assassination of Al Quaeda leader Osama Bin Laden, was confronted with the catastrophe of the Syrian civil War, he was faced with a similar choice: He could do his best to ignore the war and its atrocities and preserve his accomplishment of diminishing our war-fighting in the region, or he could react to a probable no-win situation with deepening involvement in a chaotic free-for-all without apparent good guys where our strikes against the Assad regime would likely strengthen Islamic State or vice versa. When he misspoke about a ‘red line’ being the use of chemical weapons in the Syrian war, he was trapped. Defying most of the advice he received, and in the absence of support on the Hill, he decided to try to negotiate away Assad’s chemical weapons. As we can all see, that approach ultimately failed.
The galling thing is that if he had gone the other way and done what Trump is doing now, that would likely have failed, as well. IS was much stronger in Syria in 2014 than it is now, and any effective program of strikes against the regime would have strengthened Islamic State even more. Obama’s critics in both parties would have seized on the strategic error as evidence of his unfitness for office and military naiveté.
As it is, the consequences are likely to be open-ended. Syria is allied to both Iran and Russia, meaning that its retaliation could appear anywhere along the spectrum of escalation, from suicide bombings to nuclear war. Syria has retaliated against American interests for less in the past, from nightclub bombings to the destruction of the Marine barracks in Lebanon. The Syrian regime seems likely to have carried out the Lockerbie bombing in 1988, as well. The American government blamed Libya for those attacks, for what I believe to be political reasons. I’m convinced that Syria launched those attacks as part of a campaign to drive the United Sates out of the Middle East. Those acts were carried out in retaliation for far less serious offenses by the US against the regime than Trump’s attacks on Syria last night, and against a regime less desperate and less ruthless than the war-ravaged government led by Hafez’ younger son.
President Trump believed that decisive action would show him, despite all evidence to the contrary, to be a better President than Barack Obama. He might want to be careful what he wishes for.
“… government had always been big for people like us [whites], and we were fine with that. But beginning in the 1960s, as people of color began to gain access to the benefits for which we had always been eligible, suddenly we discovered our inner libertarian and decided that government intervention was bad …”
― Tim Wise, Dear White America: Letter to a New Minority
For four decades, the story of American politics has been the story of the triumph of conservative ideology in government. From the rise of Reagan to the impeachment of Clinton and the triumph of Trump, conservative messaging has driven political debate in the United States. Even at their lowest point in 2006-9, the conservative-dominated Republican Party was able to push back against liberals and moderates in both Federal and Sate government. The high point of Democratic legislative power, the Patient Protection And Affordable Care Act of 2010, was based on conservative ideas, took the form of a giveaway to private industry, and was explicitly modeled after Gov. Romney’s popular health care reform in Massachusetts. The “public option” idea for the legislation was removed to get conservative Democratic support in the Senate.
In broader strokes, public higher education, which was once almost free in much of the country, is now increasingly unaffordable for families without substantial savings, placing education and opportunity out of reach for a large and growing share of America’s youth. The top tenth of one percent of income earners, deriving most of their revenue from investments, pay a fraction of the tax rate of those they employ. Financial services represent the largest sector of the economy. Business regulation has been largely dismantled, permitting multi-billion dollar companies to operate with illegal business models. Education and health care are increasingly influenced by politicized Christian radicals.
With all this success, it was natural for GOP leaders to assume that the broader public supported their anti-government, pro-business views for the same ideological reasons they did, thumbing through well-worn copies of Von Mises, Hayek, or Rand. With the ascension of Donald Trump and the collapse of Paul Ryan’s American Health Care Act under the weight of angry town halls across the nation and a 17% approval rate, that assumption has earned some scrutiny. The question remains, however: If middle-aged white voters didn’t share the minarchist ideas of the House GOP caucus, why did they keep returning them to office?
One answer that suggests itself is that the pro-police, pro-military, theocratic, anti-government platform of the Republican Party appeals to people with, ahem, ethnonationalist, views.
You start out in 1954 by saying, “N*gger, n*gger, n*gger.” By 1968 you can’t say “n*gger”—that hurts you, backfires. So you say stuff like, uh, forced busing, states’ rights, and all that stuff, and you’re getting so abstract. Now, you’re talking about cutting taxes, and all these things you’re talking about are totally economic things and a byproduct of them is, blacks get hurt worse than whites.… “We want to cut this,” is much more abstract than even the busing thing, uh, and a hell of a lot more abstract than “N*gger, n*gger.”
Lee Atwater, 1981
The roots of the modern War On Drugs are to be found during the Presidency of Richard Nixon, whose chief domestic policy advisor told Harper’s writer Dan Baum:
“You want to know what this was really all about? The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
Nor should be be completely blind-sided when, decades into this process of racialized radicalization, some of the those the Party manipulated this way become the Party’s leaders and the dog whistle becomes a megaphone:
‘Racial Anxiety‘ or ‘Racial Resentment‘ have become the largest drivers of support for Republicans and their policies. For a crucial margin of white voters, feelings of white victimhood are their conservatism. Far from laissez faire, they’re closer to the ideology of Herrenvolk Democracy, in which democratic participation and the benefits of the State should be reserved for members of the majority culture.
Enter Paul Ryan, from youth a believer in Austrian and monetarist economics and in Ayn Rand, the novelist and pop philosopher who viewed the wealthy as the possessors of all moral merit. Ryan probably believes that refraining from taxing the wealthy would produce more wealth overall, but supports it regardless as a moral value. He may be tactically pragmatic, but has demonstrated an unwavering commitment to shrinking the role of the State as a moral and ideological crusade, which is what he has in common with the ideological leadership of the Tea Party and the members of the House Freedom Caucus. Unlike Lee Atwater and John Ehrlichman, they no longer see law-and-order and anti-tax policies as racial code. The grifters fooled their successors.
So, when Caucus members and Republican “mainstream” congresspersons, who are ideologically identical, ran into a buzzsaw at town halls from red-state crowds dependent on Obamacare, they had a conceptual as well as tactical problem. They had made the mistake of taking the sales pitch for the product because they are the generational inheritors of the modern conservative movement, not its architects. They either will not acknowledge or don’t realize the role of white racial resentment in forming conservative allegiance in the general population.
For a decisive minority of white people in the nation’s interior, the consequences of deindustrialization can naturally be blamed on trade, aid, the rising minority share of the population, and immigration, even if the facts do not support that conclusion. Neither do they see any conflict between that view and the other tenets of modern American conservatism. Unlike the ideologues in the conservative media and on the Hill, they see no conflict between interventionist, protectionist Herrenvolk Democracy and “religious freedom” laws, the Drug War, and “tax reform.” This explains why, despite the protestations of pundits, the vast majority of Republican voters had no trouble touching Trump on their voting screens. Paul Ryan may have forgotten he was talking in code, but the voters didn’t. They wanted the benefits of the State, as manifested in the ACA, at the same time as they wanted the racially-specific “undeserving” excluded from such benefits. That’s why the House GOP’s American Health Care Act, which would have penalized exactly the modest-income middle-aged whites who were Donald Trump’s margin of victory in the Rust Belt, had a 17% approval rate even though it was what the GOP had been promising for years.
Ultimately, American Conservatism is in a crisis because its leaders don’t know what movement they’re leading.
Despite all of that, I don’t think it makes any sense to blame Donald Trump. In the final analysis, it’s not his fault that he doesn’t know how to relate to the world, or even to objective reality. Projecting childish fantasy and treating the middle class and the poor with contemptuous disregard has worked well for him throughout his life, keeping him in business decades after he should have been driven to the poorhouse. He sells crappy wine and steak, signs up students to a fraudulent “university,” cheats workers and contractors out of what he agreed to pay them over and over again, commits serious acts of violence as a boy against teachers and fellow students, and no real consequences ever materialize. Seven decades of privilege have built a wall between Donald Trump and the objective universe, Affluenza Boy writ large. What did we think was going to happen? Donald Trump as President is a living symbol of the price we pay for our decision to give impunity to the rich. He is our national comeuppance.
It is our responsibility as citizens to demand that the rich do not enjoy undue privilege. It’s on us to punish politicians who strip legal services for the poor so that only the rich enjoy due process while the poor are forced to plead guilty to crimes they didn’t commit. It’s our job to throw prosecutors out of office who let the rich get away, quite literally, with murder.
We must vote out elected officials who dole out favors for cash, who take outright bribes or whose family members take well-paid jobs for which they don’t have to show up. We have to punish legislators who vote to exempt “investment” income from taxation while soaking workers by hiking their payroll taxes and denying them the benefits they have earned. We have to make it hurt to be a Janissary for the rentier class. We have failed, not Donald Trump.
When we demand that citizens who run for office tell us what we want to hear instead of the often unpleasant truth, we are begging to be lied to. When we demand to be entertained all the time, we are agreeing to be manipulated. When we insist that the governance of a nation of 320 million people (in a world of seven and a half billion) never confront us with complexity or hard choices, we are voting for narcissistic, empty-headed used car salespeople. That’s why Donald Trump is uniquely qualified to be President in Twenty-First Century America. In a very real sense, he is the ultimate contemporary American.
So, the next time you hear of some absurd lie or horrible misdeed emanating from the White House, don’t blame Republicans on the Hill. Don’t point your finger at the media or decry right-wing radio. Don’t look to the Klan or the Nazis. No, instead take a long, hard, look in the mirror. Donald Trump is not some alien monster, installed by shadowy foreign forces. He is us. He is you and he is me.
The only economic program centrist politicians had to offer in the Western world over the last 30 years was the continuation of globalization, offset with redistribution to compensate the “losers.” Whenever fiscal constraints appeared, those redistributive measures were the first to go, even if they weakened government accounts. Thus were low-wage workers sold out.
The victory of the Leave campaign in the UK and the Republican nomination of Donald Trump in the United States represent a revolt of working-class voters against the mainstream politicians who mortgaged their futures. Only time will tell what the long-term results will be, but the chances of a trans-Atlantic recession in the short-term just got a whole lot better.
The only possible bright side is that this marks the first time in contemporary economic history that the wealthy have paid a direct, tangible price for screwing over working people. This might change the political and economic calculus of class warfare. In the meantime, of course, the poor will suffer the worse. What else is new?
The triumph of a thrice-married reality TV star in one party and the surprising success of a 74-year old “Socialist” curmudgeon from Vermont in the other has had American political pundits flinging mea culpas like an alcoholic the day after a family wedding. We had all gotten used to the predictable structure of American national politics and 2016 has been a shock in terms of what has happened. The apparent reasons it happened, however, aren’t particularly surprising.
For two generations, the parties have campaigned on platforms of improving the material lives of their electoral bases while carefully, deliberately, impoverishing them and their progeny. By allowing business to crush unions, outsource jobs, dodge taxes, poison workers and citizens with impunity, systematically defraud the public, and force employees to individually negotiate their pay, American government has decisively shifted the balance of power away from workers, consumers, and the public toward shareholders and corporate managers. The inevitable result has been a stagnation and decline of real purchasing power for average Americans even as necessities like housing, education, and healthcare have become dramatically more expensive in a way that undercuts all the happy talk about the benefits of technological change. What has been clear this year is that voters have noticed.
Although the rhetoric is different, what Trump and Sanders have in common is that they connect with the anger of ordinary Americans about the loss of their economic power and firmly associate it with political malpractice. Both Sanders and Trump have accused our political leaders many times of corruption. The bleating of mainstream pundits about this “extreme” rhetoric does nothing to obscure the fact that this charge is obviously true. The fact that those who write the laws that define bribery are the same ones who benefit from the cozy exchange of “access” for the endless quantities of money needed to buy thousands of 30-second TV advertisements to bludgeon the public subconscious into submission does nothing to change this fact.
What this year’s craziness tells us is, I think, that a plurality of the public has finally gotten the word about what’s been done to them; and that the magic of the 30-second TV ad has died. The only “establishment” candidate to achieve any success in this cycle’s nomination contests has been a virtual former co-President, as well as a retired Senator and cabinet secretary of senior rank. Even Hillary Clinton, however, still hasn’t clinched her nomination against an idiosyncratic misfit who wasn’t even a Democrat 18 months ago. Bernie Sanders started his quixotic quest for the nomination polling at three percent.
Meanwhile, the scion of the Bush Dynasty blew $150 million to go exactly nowhere in the family business. Political heavyweights (sorry) like Chris Christie, John Kasich, Lindsay Graham, and Marco Rubio disappeared like coffee at a twelve-step meeting. Everywhere, the conventional approach to campaigning has failed in unpredictable contests against strategies built around mobilizing rage.
It is in this context that Sanders’ favorable poll performance against Trump makes sense. It’s why I’m skeptical about Clinton’s prospects against the orange menace. It was, after all, during her husband’s administration that some of the most damaging trends accelerated or originated. In any case, it’s time to take conventional wisdom out behind the barn and put it out of its misery.