A Trump wall everyone will love

Here's an idea for President Trump and his supporters. Let's build an impenetrable border wall around maybe a third of the United States. Make sure that no immigrants can enter. Make equally sure that no Democrats (or Republicans, for that matter) who favor universal healthcare can enter. Likewise, don't allow any Democrats (or Republicans) who favor gun limitation and regulation to breach the wall.

To live inside the walled paradise, you must be an American citizen who wants to pay for your own healthcare or health insurance with no help from the government, or to go without healthcare altogether. You must own a gun, because only good guys with guns can stop bad guys with guns. And you must be willing for everyone inside the wall to get any kind of weapon they wish to have. Don't worry - since everyone inside the wall will be a Trump supporter too, there won't be any bad guys to contend with. (Pssst - you can keep out people who aren't white, if you wish. I mean, you'll be armed. Heck, you can keep out anyone you don't like.)

Only thing is, you must stay inside the wall. Well, unless you change your mind and unaccountably want to have your guns regulated (or, in some cases, even confiscated) and be forced to buy health insurance. Insurance that would help your neighbor but might never help you! And you'd have to live with all those people you don't like. Some of them don't even speak English! Would you really want to do that?

I mean, look at the financial advantage of living inside your walled community. Treating gunshot wounds costs American hospitals some $2.8 billion a year. That adds up to a lot of insurance premiums. If you choose not to buy health insurance, you won't have to pay a dime of it! But anyway, since you'll all be armed, gunshot wounds won't be a problem. I mean, who would shoot an armed person, right?

And here's the best part - you won't have to pay for this paradise yourself. Tell those immigrant-loving, gun-hating, socialist-healthcare-promoting Democrats (and Republicans) that you'd like your own walled country, and they'll jump at the chance to build it for you!

And then, finally, you can make America - or at least your walled-off portion of it - great again.

A healthcare system that works - is it too much to ask?

[William Blake, Pestilence, c. 1780-84]

Most of my Facebook friends are proclaiming the evils of the AHCA, the new GOP healthcare bill. I agree with them that it is at best deficient and at worst cruel, and I hope it never becomes law (Senators: do your job!).

But I fear that my AHCA-hating friends—as well as those who proclaim the evils of the ACA (Obamacare)—are ignoring the bigger picture. Whether we hate Trumpcare more than Obamacare or Obamacare more than Trumpcare, we all need to consider three things:

1. While a lot of people were helped by Obamacare, some people were hurt by it. We won't be able to fix American healthcare until we listen to their concerns.

A British friend of mine opened up a Facebook discussion about the GOP bill, inviting her American friends to comment. She got plenty of comments from supporters of Obamacare (including me). She also got comments like this: “The cost of premiums have risen dramatically, while the actual coverage is diminished.”

People posted that, under Obamacare, their healthcare insurance costs rose “by double digits,” “massively,” “astronomically,” “by 40% overnight.”

They told about huge premiums—$9000 a year for a single person, $19,200 for a family—with deductibles almost as high as the premiums. “One middle-income person could easily spend $20k before being reimbursed,” someone wrote.

Many family physicians relocated, people said. Insurers shut down, care became less accessible, and confusion reigned. “I’ve spent literally dozens of hours on the phone fighting for care that was promised and then roadblocked,” one man wrote. “It’s a mess.”

These commenters may not know that the average cost of health insurance premiums actually rose considerably less after Obamacare went into effect than in the preceding decade.

They may not realize that the low-cost insurance they had before Obamacare probably did not cover the full cost of catastrophic illnesses, would have gotten increasingly expensive as they got older, and would have bumped them if they ever put in a major claim.

What they do know is that they can't afford healthcare insurance and often can't even find healthcare providers. That's a national disgrace. They need compassion, not lectures about the virtues of Obamacare.

The second thing we all need to remember is this:

2. If people are suffering under Obamacare, they are likely to suffer even more under Trumpcare. We won't be able to fix American healthcare until we recognize that change does not equal improvement.

Under the current GOP plan, some people will be able to save money. They can choose to go without insurance altogether, or they can buy a cheap plan that will help them with minor problems but leave them high and dry if major problems strike. Young and healthy people and people with limited incomes may find one of these options attractive. They may not realize that being uninsured or underinsured could cost them their homes, their credit rating, and even their lives.

Under the current GOP plan, Medicaid, one of the most successful plans for insuring the poor, will be cut back. Once again people will go to hospital emergency rooms for primary medical care (the most expensive possible approach), or will skip it altogether. Insured people may not care if uninsured people die prematurely, but they should at least worry about public health if inadequate healthcare leads to uncontrolled epidemics.

Under the current GOP plan, since a fair number of healthy people will choose to be un- or under-insured, premiums for the rest of us are sure to rise. Even if everybody chose to be insured, premiums would rise, because the GOP still believes, against all evidence, that competition among healthcare providers will contain costs.

Only one group of Americans will be sure to benefit from the GOP plan. "While the Affordable Care Act raised taxes on the rich to subsidize health insurance for the poor, the repeal-and-replace bill passed by House Republicans would redistribute hundreds of billions of dollars in the opposite direction. It would deliver a sizable tax cut to the rich, while reducing government subsidies for Medicaid recipients and those buying coverage on the individual market" (Scott Horsley, NPR, May 4).

Yes, I believe that Obama improved America's healthcare and that Trump will make it worse—but that's not my point. American healthcare was badly flawed before Obamacare, is badly flawed with Obamacare, and will be badly flawed under Trumpcare. It's not all that important to know which system is the very worst. What's vitally important is to come up with a system that works.

3. Our choices are not limited to Trumpcare and Obamacare. Why can't we scrap both plans and come up with something really good?

There are so many models we could choose from, if only we'd pay attention to healthcare systems in other nations.

Do our legislators know that the U.S. spends far more per person on healthcare than Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, or the U.K.—and yet in every one of those nations, people live longer, have less infant mortality, have fewer seniors with two or more chronic conditions, and have less obesity than we Americans do? And that they achieve these results in spite of the fact that in 10 of those 12 nations, more people are daily smokers than in America, and that in all 12 nations, the population is older?

Do our legislators know that in the U.S., for every dollar spent on healthcare we spend only 56 cents on other social programs, whereas in the other 12 countries, for every dollar spent on healthcare they spend between $1.00 and $1.88 on social programs? (You can check these statistics and learn even more fascinating facts about healthcare in other nations here.) Read my post about how healthcare (primarily intervention after a health problem has occurred) is more expensive but less effective than social services (primarily services that may prevent health problems) in keeping a nation healthy. Why are we doing things backwards?

Why aren't our legislators studying the healthcare systems of these 12 nations?

Why don't they notice that the other countries vary widely in how they finance healthcare—some by single payer, some by private insurance, some by a combination—but they all limit what providers can charge?

Why don't they notice that the other countries differ widely in who provides the care—some through the government, some through private providers, some through a combination—but they all provide it to everybody?

Why don't they consider the evidence that social spending prevents illness and therefore lowers treatment costs while improving effectiveness?

Why don't they imitate some system that has already been proven effective, rather than constantly trying to tweak a malfunctioning system that has never manged to keep costs down and has never provided healthcare for all?

And if our lawmakers are incapable of coming up with a satisfactory healthcare system, why do we keep voting for them?

If ignorance is bliss, Congressional Republicans want us all to be deliriously happy

Question: What effect will the Republican healthcare proposal have on (1) the number of people who have health insurance and (2) the federal budget?
Congressional Republican answer: We don't know and we don't care.

Question: Shouldn't we appoint an independent counsel to investigate all those possible connections between Russia and the Trump campaign?
Congressional Republican answer: Not yet--and anyway, a Trump appointee is well qualified to handle any investigation.

Question: Does President Trump have financial interests that violate the Constitution's emoluments clause and/or affect U.S. relations with foreign countries?
Congressional Republican answer: We're not going to look, and we won't let you look either.

Question: Are President Trump's cabinet appointees ethically qualified for high government office?
Congressional Republican answer: Never mind the customary vetting, just confirm them on faith.

Question: What are the underlying causes of gun violence, and how can it be reduced?
Congressional Republican answer: Defund CDC research on guns and violence!

Question: Shouldn't public policy be based on knowledge, not ignorance?
President Trump's answer: "I love the poorly educated."

Well of course he does.

The 2016 Candidates and the Missing Middle

In this oddest of presidential election seasons, one odd fact is rarely mentioned: the curious age spread of the candidates.

At their first inauguration, our 43 U.S. presidents* have ranged in age from almost 43 to almost 70. More than half were in their 50s. Their median age was 55, and so was their average age.

But in 2016, now that we're down to eight candidates (Bush, Carson, Cruz, Kasich, Rubio, and Trump vs. Clinton and Sanders), not a single candidate is in his or her 50s.

Rubio: 45 years, 237 days

Cruz: 46 years, 29 days
Bush: 63 years, 343 days
Kasich: 64 years, 245 days
Carson: 65 years, 124 days

Clinton: 69 years, 86 days

Trump: 70 years, 220 days

Sanders: 75 years, 134 days

A few 50-something wannabes have dropped out of the race (Christie, O'Malley, Paul, Santorum), as did some 60-somethings (Huckabee, Fiorina, Gilmore). If the polls are right, the remaining 60-somethings who have not yet reached Social Security's full retirement age (Bush, Kasich, Carson) will not be in the running much longer. If they drop out, we will be left with no candidate over 46 or under 69 on January 20, 2017. 

I made a chart to see how weird this is. The current candidates' ages are highlighted in yellow.**

To see a chart you can actually read, click here.

Cruz and Rubio are younger than every elected president except John F. Kennedy (Teddy Roosevelt was even younger, but he became president when McKinley was assassinated).

Clinton is older than every president except Ronald Reagan. Trump and Sanders are older than any president ever.

Looked at another way, the most likely candidates are either younger than my firstborn or older than me. I find this slightly scary.

----------------------------------------

*Yes, I know Mr. Obama is #44 - that's because Grover Cleveland, who was elected to two non-subsequent terms, is counted twice in most lists but not here.

**Red print indicates names and ages of the 16 presidents who served at least two nearly full terms. Except for Ronald Reagan, none of these was older than 62 at first inauguration.

A prominent Republican's views on health-care reform - in 1974

[From Loma Linda University Scope, summer 1974]

This afternoon while looking through old file folders, I came across the opening page of a 1974 article by Caspar Weinberger called "An honest look at needed reforms in America's health care."

Weinberger was chairman of the California Republican party from 1962-68 and served as Ronald Reagan's Secretary of Defense from 1981-87. When he wrote the article I found, he was Richard Nixon's Secretary of Health, Education and Welfare. His Republican credentials could not be stronger.

Here are some stunning paragraphs from Weinberger:

This can and must be a year of responsible reform for our nation's health care financing system. Right now, 25 million Americans have no health insurance protection at all. Millions more have coverage that is clearly inadequate.

Right now, medical costs are threatening to once again climb at a steep rate, following last month's ending of price controls.

Right now, there are communities and neighborhoods in our nation without doctor or dispensary....

What we need, to close the current gaps, is a national program of comprehensive health insurance.

Such a program must not only cover everybody. It must also ensure quality care, and end the wasteful misuse of our medical resources that our present patch-work coverage encourages.

This misuse is costing us heavily. And it is directly traceable to gaps in insurance coverage....

Nearly forty years ago, one of the nation's most prominent Republicans thought we needed - immediately! - a total overhaul of health-care financing that, truth be told, sounds a lot like what Hillary Clinton proposed in 1993, and far more radical than the Affordable Care Act.

So what has changed since 1974, when responsible health-care reform was urgently needed?

The percent of uninsured Americans has increased. In 2012, 48 million Americans were uninsured. That's 15.4% of the population, compared to the 8.5 percent that were uninsured when Weinberger wrote.

Medical costs have soared. According to the Kaiser Family Foundation, "the share of economic activity (gross domestic product, or GDP) devoted to health care has increased from 7.2% in 1970 to 17.9% in 2009 and 2010. Health care costs per capita have grown an average 2.4 percentage points faster than the GDP since 1970."

We still have a physician shortage, and it's getting worse.

What has changed, it seems, is the Republican Party.
____________________________________________

I wish I had the rest of Secretary Weinberger's article. It was published in the Summer 1974 issue of Loma Linda University's Scope, but their online archive does not include this issue. I have the one page only because it was the reverse side of the last page of an article by my father. Ironically, the title of my father's article was "A theology of hope."

Actually, the U.S. is NOT spending more than any other country on health

Old News: US spends more on healthcare, gets worse results

We Americans are first in the world when it comes to per capita healthcare spending, and yet we don't live as long (we're in 51st place), more of our mothers die in childbirth (we're in 47th place), more of our babies die in their first year of life (we're in 50th place) ... well, you've seen the statistics, and they aren't pretty.

Interesting Spin on Old News: Medical and social spending should be seen as a whole

"The truth is that we may not be spending more," wrote Elizabeth H. Bradley and Lauren Taylor in a 2011 New York Times article—"it all depends on what you count." If you count "the combined investment in health care and social services," such as "rent subsidies, employment-training programs, unemployment benefits, old-age pensions, family support and other services that can extend and improve life," we're in 10th place among developed nations. To compare:

For every dollar we spend on health care, we spend an additional 90 cents on social services. In our peer countries, for every dollar spent on health care, an additional $2 is spent on social services. So not only are we spending less, we’re allocating our resources disproportionately on health care.

Bradley, a professor of public health at Yale, and Taylor, formerly a program manager at the Yale Global Health Leadership Institute, believe that healthcare (primarily intervention after a health problem has occurred) is less effective than social services (primarily services that may prevent health problems) in keeping a nation healthy.

Unfortunately, we Americans do it backwards, and our ratio of healthcare spending to social spending is getting worse. In their forthcoming book, The American Health Care Paradox: Why Spending More Is Getting Us Less (November 2013), Bradley and Taylor write that for every dollar Americans spend on health care, we spend only an additional 60 cents on social services. Here's a picture of OECD spending compared with US spending:

Really Disheartening Current Situation: Many US legislators are trying to cut back social spending

Republicans in Congress are trying mightily to reduce or eliminate food stamps, for example. Yesterday the Health Impact Project (in collaboration with the Robert Wood Johnson Foundation and the Pew Charitable Trust) released a white paper called "Health Impact Assessment of Proposed Changes to the Supplemental Nutritional Assistance Program" (translation: the program formerly known as food stamps). Two scary sentences from the 218-page document:

Using a model employed by the U.S. Department of Agriculture to administer SNAP, Mathematica Policy Research conducted an analysis of how many people could lose eligibility or receive lower benefits under the proposed policy changes in H.R. 1947 and S. 954. Under the changes proposed in H.R. 1947, as many as 5.1 million people could lose eligibility for the program.

 Lest you think this has nothing to do with health care, the document points out that

it is well established in the literature that food insecurity (defined as difficulty in obtaining enough to eat) increases the risk of diabetes, heart disease, and depression or anxiety in adults; and asthma, cognitive impairment, or behavioral problems in children. Children in food-insecure families are more likely to be hospitalized in early childhood than those from food-secure households. Medical costs related to food insecurity in the United States amount to as much as $67 billion per year in 2005 dollars.

At the same time, Republicans in Congress are still trying to repeal the Affordable Care Act.

Hey, let's go back to 1900 before any of those lefty innovations got started!

No income tax! No government-backed social welfare programs! No Department of Health and Human Services! No Department of Education! No Medicaid or Medicare! No Social Security! No Maternal and Child Health Program!

Paradise, right?

Except that if you were lucky enough to make it to age 20, your lifespan was 62 if you were a white male, nearly 64 if you were a white female, and a lot lower if you weren't white at all. Worse, you had a 23% chance of dying before your 20th birthday. And out of 100,000 women who gave birth in 1900, 600-900 died (compare with 21 in the U.S. today).

Well, that's one way to keep Social Security from going broke...

Advice for November 6: Choose your battle wisely

Vice-President Aaron Burr spoils his political career by
killing former treasury secretary Alexander Hamilton.

Yesterday during the Prayers of the People at St Barnabas, someone in the congregation spontaneously thanked God that the American election season is almost over. Everyone laughed.

One reason this election has brought out the worst in us is that we are fighting two battles at once. I fear that, no matter who wins the presidency, we will continue to fight these battles. We will probably still be fighting them in 2016.

We are fighting an economic battle between those who believe that the federal government should spend tax dollars on the military and little else, and those who believe that the federal government should also play a major role in assuring health care for all, supporting the indigent and elderly, rebuilding our infrastructure, and aiding disaster-stricken areas.

At the same time, we are fighting a moral battle between those who believe the federal government should allow individuals the freedom to decide whom to marry and whether to carry a child to term, and those who believe the federal government should outlaw abortion and recognize only heterosexual marriages.

The two major parties have divided up our concerns in unexpected ways. The Democratic ticket is communitarian in economics and libertarian in morals; the Republican ticket is just the reverse. This creates a problem for people who are consistently communitarian or libertarian.

A lot of students at Miami University of Ohio, as Bill Keller points out today in "The Republican Id," are consistently libertarian: they are enthusiastic about Republican economics but reject Republican morals. For them, economics trumps morals: the majority support Romney.

Most Catholic bishops, on the other hand, are consistently communitarian: they support Democratic economics but reject Democratic morals. For many bishops, morals trump economics (see David Gibson, "Catholic bishops make last-minute push for Romney"): they too support Romney.

The students are far smarter than the bishops.

If Romney and Ryan are elected, there's a good chance that federal programs such as Social Security, Medicare, and Medicaid will be gutted (click here for five good reasons to be worried, even if you're over 55), along with smaller programs such as highway construction, education, and food stamps. There's not much chance, however, that abortion or gay marriage will go away. Overturning Roe v. Wade would not outlaw abortion; it would return the question to the states. As long as a woman had enough money, she could simply travel to wherever abortion was available.

If you're a student at a highly rated university like Miami, you probably figure you'll be one of the elites that would be helped by Romney/Ryan economics. As one of those elites, you could find your way around Republican moral strictures. So yes, as long as you're not concerned about people who haven't done as well as you, it makes sense for you to vote for survival of the fittest. (In a decade or two you may discover you're less fit than you thought you were, but you can vote differently then.)

The Catholic bishops, on the other hand, are showing themselves to be as wise as doves and as harmless as serpents. Even if they get their way - in the name of religious liberty! - Americans will continue to use contraception. They will continue to marry or live with whomever they please. They will continue to get far too many abortions (though if abortion goes underground, a lot more women will die).

Catholic bishops have little effect on American morals (even among their own parishioners: click here to see statistics on abortion rates and here to see statistics on contraceptive use among Catholics), but if they tip the election to Romney/Ryan, they may have a major effect on American economics - an effect that goes against more than a century of Catholic social teaching. In the name of freedom and small government, more families will struggle to put food on the table, to send their children to college, to find adequate housing, to care for their aging parents. Americans will continue to die younger than people in countries with universal health care. Our highways and bridges will deteriorate, and environmental pollution will increase. We may tumble back into recession or even depression.

Here's my point. Our next president's policies will probably have a major effect on America's economic health and, very likely, the economic health of the world. His policies will probably have a minor effect, if any effect at all, on America's morals.

If you like Romney/Ryan's Darwinian proposals, if you think the financiers who are paying for their campaign will help the middle class, if you believe that trickle-down economics help the poor (or if you think the poor shouldn't be helped), if you think business can thrive in the absence of a strong infrastructure, if you think climate change is a hoax, and if you trust for-profit health insurance companies with your life, then by all means vote for Romney-Ryan.

Just don't think they're going to bring about moral renewal in America.

The foreign policy debate, the four horsemen of the Apocalypse, and four candidates

Albrecht Dürer, ca 1497-98
The Four Horsemen
of the Apocalypse

Tonight's debate between President Obama and Governor Romney is about foreign policy. This may be the most important topic of the entire [interminable] election season, both to America's future and to the future of the whole world.

If our leaders get foreign policy wrong, we may suffer more than a severe recession. Think world economic collapse. Rampant terrorism. All-out nuclear destruction. Conquest, war, famine, death (the four horsemen of Revelation 6).

Unfortunately, tonight's debate is likely to have fewer viewers than the first two presidential debates: it will be competing against Monday night football. We Americans have priorities.

And, as writers for Forbes magazine recently pointed out, learning foreign languages--perhaps the most important tool for understanding other cultures--is not high on our priority list. Though demand for foreign language learning is increasing, "schools at every level are balancing their budgets and offsetting reductions in government allocations by cutting their offerings and/or eliminating foreign language requirements."

In 2001, before the latest round of language cuts took place, only about one in four Americans could carry on a conversation in a second language (Gallup poll). Half of these were native Spanish speakers. By contrast, "just over half of Europeans (54%) are able to hold a conversation in at least one additional language, a quarter (25%) are able to speak at least two additional languages and one in ten (10%) are conversant in at least three" (Europabarometer survey, 2012).

President Obama agrees about the importance of speaking foreign languages and has apologized for not speaking any himself (though he apparently knows some Indonesian from his childhood).

Governor Romney claims to speak French. After listening to him read a speech at the Salt Lake City Olympics, I'm guessing that he's far from fluent without a script.

Vice-President Biden and Congressman Ryan, as far as I know, speak no foreign languages at all.

OK then, what about the foreign affairs knowledge and experience of these men who want to lead the world?

President Obama lived in Indonesia from 1967 to 1971, between the ages of 6 and 10; for part of that time he attended local schools. His undergraduate major at Columbia University was political science with a subspecialty in international relations. Between 1981 and 2006 he traveled to Indonesia, Pakistan, India, Kenya (three times), and Europe.

Governor Romney lived in France from 1966 to 1968, between the ages of 19 and 21, working as a Mormon missionary. I was unable to find evidence of other overseas trips before this summer's tour of Europe and Israel--a trip that may have contributed to the fact that "the reputation of the US in Europe risks sinking back to Bush-era levels of unpopularity if Mitt Romney becomes president, according to new international polling published on Tuesday" (The Guardian, September 11).

Vice-President Biden was for many years a member of the Senate Committee on Foreign Relations and chaired that committee three times. Over the years Biden has met with dozens of heads of state. The Council on Foreign Relations summarized his positions and achievements (up until 2008) here.

As far as I can tell, Congressman Ryan has had no particular education or experience in foreign policy.

Not so long ago the United States had an administration that understood so little about the world, they really believed they could overthrow the Iraqi regime without giving Iran a license to do their worst--and they really thought that if they did this, Iraqis would fall to their knees in gratitude. We don't need another administration with that kind of dangerous naïveté.

Today the New Yorker magazine, in a long and thoughtful article dated October 29, endorsed President Obama. Here is what they said about Governor Romney's approach to foreign policy:

Holding foreign bank accounts is not a substitute for experience in foreign policy. In that area, he has outsourced his views to mediocre, ideologically driven advisers like Dan Senor and John Bolton. He speaks in Cold War jingoism. On a brief foray abroad this summer, he managed, in rapid order, to insult the British, to pander crudely to Benjamin Netanyahu in order to win the votes and contributions of his conservative Jewish and Evangelical supporters, and to dodge ordinary questions from the press in Poland. On the thorniest of foreign-policy problems—from Pakistan to Syria—his campaign has offered no alternatives except a set of tough-guy slogans and an oft-repeated faith in “American exceptionalism.”

I am posting this four hours before tonight's debate begins. I sincerely hope both candidates show broad knowledge and deep wisdom about questions of foreign policy, because one of them is going to win this election. I also hope that voters have enough wisdom and understanding to be able to tell when they are speaking truth and when they are blowing smoke.

A lot depends on the winner's understanding of and ability to work with other nations. A lot.

P.S. None of the four candidates served in the military. None of Governor Romney's five sons served in the military. One of Vice-President Biden's sons joined the National Guard and has done a one-year tour of duty in Iraq.

10 grumpy observations about the first debate

1. Mitt Romney is a bully. We knew that.
2. Barack Obama doesn't know how to stand up to bullies. We knew that too.
3. Jim Lehrer really doesn't know how to stand up to bullies. Jim, just cut the mike.

4. Neither candidate stuck to facts. We are not surprised.
5. This may be because neither candidate knows what is factual. This is worrisome.
6. Or it may be because neither candidate cares about facts. This is even more worrisome.

7. America's economy is in profound poop. No surprise there.
8. Neither candidate has a plan that will help very much. No surprise there either.
9. Only once was the word "sacrifice" uttered--after the debate was over, by commentator Mark Shields (click this link and listen to minutes 7:06-7:24), who pointed out that the concept was entirely missing from Romney's discourse. Shields may know more about how to fix the economy than either candidate does.

10. Will the presidential debates sway the undecided voter? This SNL clip says it all.

Alas, I can't get the actual clip to embed on my blog.
Click HERE to see it. It's less than 2 minutes long.

Our nonpartisan American runaway train

Art by Stephen Slade Tien
via Wikimedia Commons

I freely admit what you already know: I am a wonk. So when the book I'm reading, The Moral Measure of the Economy, laid out a bunch of fearsome statistics going up to 2005, I was compelled to update them. I'm not going to bore you with all the stats. I'd just like you to notice one thing that seemed odd to me. Maybe you can tell me what's going on.

We all know that the gap between rich and poor is getting wider. What I didn't know was that, whatever the forces may be that are driving rich and poor apart, they don't seem to be related to one party or the other.

Here's what the book says:

In 1985, the average income of the top 5 percent of families was 13.5 times as much as the average income of the bottom 20 percent. In 2004, the top 5 percent made almost 21 times as much as the bottom 20 percent.

So I looked up the Census Bureau table that gives this information (it's here; go to Table F-3 and click "All Races" for the Excel file), and I calculated the ratio for each year since 1966, and I made this chart. The short silver bars at the bottom represent the average income of the bottom 20%. The long green bars represent the average income of the top 5%. See the gap widen ...

Here's what seems odd to me:

• From 1966 to 1981, the ratio is pretty stable: seven years of stable Democrats, nine years of stable Republicans.
• In 1982 the gap starts to increase. It gets steadily larger through eleven Republican years.
• In 1993 the gap suddenly jumps from 1:16 to nearly 1:20. From then on, through ten Democratic years and eight Republican years, it never goes below 1:18. Since 2000, it has always been nearly 1:20 or higher.

Something is causing our nation to become more and more unequal (in opportunity as well as in income, as Joseph Stiglitz points out in The Price of Inequality: you can read an excerpt here). Whatever it is, neither Democrats nor Republicans have effectively dealt with it.

Economics is a complicated science: 

     - is our rising inequality a failure of understanding? 

Tax hikes, even for the rich, are hard to get through Congress: 

     - is it a failure of will?

The princes of Wall Street, Wal-Mart, and multinational corporations are doing just fine: 

     - is it a triumph for their lobbyists, who spend more and more every year?

And if we find it distressing, who are we supposed to vote for, anyway?

Good government, bad government--"everybody's confused"

Before beginning the next paragraph, please click here and listen to Mavis Staples and Jeff Tweedy performing "Only the Lord Knows." If you haven't already bought the whole album - it came out two years ago - you really should. Especially during this acrimonious election season. (I commented on it here.) Mavis and Jeff knew what was coming in 2012...

I pick up the paper, I put down the paper,

Turn on the TV, I get confused.

People on this side say the people on that side,

They lyin', say they lyin'--everybody's confused.

OK, now imagine taking a dozen or so suburban Catholics--some of them staunch conservatives, others committed liberals--and making them talk to one another about public policy for two and a half hours every Wednesday evening during the two months leading up to the election. Give the group a sexy name, like "Living Solidarity: Government, the Federal Budget and the Common Good" (such a name keeps a group's size manageable). Ask them what they think the government does well, and what it does badly. Try to keep them from killing each other.

Actually things went surprisingly smoothly at my parish's adult-ed group last week. The moderator told us repeatedly and in manifold ways that we must be polite to one another, and we were, even when talking about government successes and failures. And then we learned that one of our assignments would be to strike up a two-minute conversation with a stranger, each week on a different topic. This week's homework: "Ask someone you don't know: What is something you appreciate that government does? What is something you hate about what government does? Be specific."

Oh, right. If someone standing in line behind me at Trader Joe's tried that on me, I'd ask him to watch my cart while I dashed back to the produce department to pick up more broccoli rabe. No way am I going to let some political nut turn my peaceful shopping expedition into a shoot-out. And no way am I going to turn myself into an agent provocateur either.

So I put my questions on my Facebook page, Madame Neff's Salon, and discovered that some people hate speeding tickets while others appreciate them. Other than that, here are the answers I got:

What is something you appreciate that government (federal, state, or local) does?
Emergency services like fire, police, and ambulance. The Post Office, which--unlike FedEx, UPS, or the Pony Express--is required to serve all areas of the U.S. Schools. A good legal system. Enforcement of laws and rights: property rights, religious rights, right to protest, freedom of speech. OSHA. The FDA drug review. Health care. Programs that help poor people and those who experience disasters. Programs that guarantee clear air, water, safe food, safe buildings, etc. Roads, transportation,some communication. A state program for at-risk children that offered subsidized physical, occupational and speech therapy for our son. Medicare.

What is something you hate that government (federal, state, or local) does?
Picky laws: Prohibiting plastic bags. Outlawing marijuana. Banning large sugary drinks. Banning smoking outside. Subsidies to private enterprise (tax breaks, funding research and development, etc.) without demanding repayment or a share of profits. Unnecessary war. War without the approval of Congress. The salaries of elected or appointed government officials. Torture.

If I got back in line at Trader Joe's, broccoli rabe in hand, and still had to answer the questions, I'd probably tell the pushy stranger that I really like--or would like--excellent public education, universal health care, Social Security, interstate highways, food security programs, regulations to protect the environment, regulations to keep financial institutions honest, family health-care leave, paid maternity leave... well, by the time I got to that many points here in Republican DuPage County, I expect my interlocutor would have scooted into another check-out line, as far from me as possible.

But if he stayed to listen, I'd also tell him that I really hate the way our government--federal, state, and local--promises so many of these good things but then refuses to fund them. On a more personal level, I hate the way so many Americans think we should have more services but lower taxes. Read, for example, Greg Sargent's article in the August 2 Washington Post, "Americans hate government, but they love Medicare, Social Security, and environmental regulations."

I'm looking forward to hearing my classmates' opinions. I think we can manage not to throw overripe fruit at one another, especially if we keep in mind Mavis and Jeff's call to humility:

What to do, what to do now?--

Only the Lord knows, and he ain't you.

Listen to them!

52 years later, is the church threatened or threatening?

In 1960 when John F. Kennedy became the Democratic candidate for President of the United States, a lot of people panicked. The ironically named "Citizens for Religious Freedom," a group of some 150 evangelical and mainline Protestant leaders, issued a manifesto declaring that, in the words of the Reverend Norman Vincent Peale, "Our American culture is at stake." With a Catholic at the helm, they feared, the pope would call the cards.

Fifty-two years ago today, Kennedy gave a memorable speech to the Greater Houston Ministerial Association. Telling the group of Protestant ministers that he believed in an America where "no religious body seeks to impose its will directly or indirectly upon the general populace or the public acts of its officials," he promised that

whatever issue may come before me as president — on birth control, divorce, censorship, gambling or any other subject — I will make my decision in accordance with ... what my conscience tells me to be the national interest, and without regard to outside religious pressures or dictates.

The speech probably gave him the edge he needed to win the presidency.

Fifty-two years later, six of the nine Supreme Court justices, 28% of the members of Congress, and both vice-presidential candidates are Catholics. Not everyone is happy with recent Catholic-supported efforts to limit access to abortion and contraception, but nobody seriously suggests that the pope is ruling America. In fact, it's the Catholic bishops who are panicking. "Across America, our right to live out our faith is being threatened," they warned parishioners in a recent bulletin insert.

Church and state have had a rocky relationship at least since the fourth century CE, when the emperor Constantine legitimized Christianity and gave the keynote address at the Nicene Council. Should religious lobbying groups help to make public policy? Should public policy exempt religious groups from otherwise universal requirements? Yes, and yes, says the United States Conference of Catholic Bishops. No, and no, says Americans United for the Separation of Church and State.

The answers are not always clear. An enormous amount of spin (from all sides) has muddied the waters. If you are at all concerned that, in America today,

• the state has too much power over religion, or
• the church has too much influence on the state, or
• church and state are altogether too cozy with one another--

I recommend reading two short articles on this anniversary of the Houston speech.

First, read the speech itself. It is beautiful literature. Historically significant. As relevant today as in 1960. Still powerfully moving.

Then take Emily C. Health's perceptive quiz, "How to Determine If Your Religious Liberty Is Being Threatened in Just 10 Quick Questions."

Romney's plan covers preexisting conditions - for the rich and the lucky

"You shouldn't have let his health insurance lapse."

For just a moment I thought Romney was actually moving toward the middle. On Sunday's Meet the Press he said he wouldn't get rid of all health-care reform. One thing he planned to do, he said, "is to make sure that those with preexisting conditions can get coverage.”

And then later, of course, his campaign clarified: He would make sure that those with preexisting conditions would be covered if they had continuous insurance coverage. In other words, he would continue to enforce the Health Insurance Portability and Accountability Act of 1996. Well, whew.

Yesterday Washington Post blogger Ezra Klein asked, "Who would be left out of Romney’s preexisting conditions plan?" Answer: "About 89 million Americans."

If you have a pre-existing condition, are covered by a good insurance policy, and qualify for and can afford a COBRA policy, you'll be OK for 18 to 36 months. After that you're on your own.

But people buy COBRA policies because they are out of work, and COBRA's rates are steep for the unemployed: about $500/month for an individual and nearly $1400/month for a family.*

If you have a preexisting condition and can't  afford COBRA, you could lose or be unable to get health coverage under Romney's plan:

• if you're the nonemployed wife or child of a man who retires or dies or loses his job
• if you stop working for several months to care for an aging parent or an ill family member
• if you lose your job due to serious illness or injury
• if you are unemployable due to mental or physical disabilities
• if you take an unpaid maternity leave
• if you're looking for your first job and you are not covered by your parents' insurance
• if your company decides to stop offering a health-insurance benefit
• if the only company who will hire you does not offer a health-insurance benefit
• if your company goes out of business, and it takes you longer than 63 days to find a new job

I understand why preexisting conditions must be tied to continuous insurance coverage: you can't have people signing up for insurance only after they've had the diagnosis or the accident. And indeed, preexisting conditions are tied to continuous insurance coverage in Obamacare (to use the Republicans' preferred term), in socialized medicine (to use another term they favor, even though they usually use it erroneously), and in those developed nations who finance health care through private insurers.

The difference between Romneycare and all those other plans is this: With the other plans, everybody has continuous insurance coverage. With Romneycare, you can have continuous insurance coverage if you can personally afford it, if you are able to work, and if you're lucky.

_______________________________
*In 2010 an individual policy cost $429 a month and a family policy cost $1170. Those are the latest figures from the Kaiser Foundation; since health-care insurance rates have been rising between 8 and 9% a year for several years, it is reasonable to assume that the average Cobra policy now costs about $505 (individual) or $1377 (family) per month.

Two political conventions, two Catholic leaders

New York's Cardinal Dolan may have tried to offend everybody in just eight days, though the Republicans seem not to have noticed his blessing on recent immigrants who have come to America in search of jobs. Democrats, however, did not miss his call for protection of the unborn, his veiled allusion to gay marriage, and his call for "religious freedom in full," which to him means freedom for Catholic institutions to deny contraceptive coverage to employees. (You can read the full text of both benedictions here.)

It must be tricky, being a bishop-politician. The Republican position on abortion sounds very Catholic, but its approach to the economy goes counter to over a century of Catholic social teaching. The Democratic platform upholds Catholic social teaching, but it also affirms Roe v. Wade.

Faced with this split, Cardinal Dolan, a great admirer of Paul Ryan, did what the Catholic hierarchy has typically done, at least in recent years--he paid little attention to social justice and focused mainly on sex. No wonder Andrew Sullivan, in a blistering op-ed piece, dubbed him "The Republican Party Cardinal."

Enough about the Cardinal. Another Catholic speaker at the Democratic National Convention was much more inspiring. Here's Sister Simone Campbell, executive director of Network, a social-justice lobby criticized by the Vatican last spring for spending too much time fighting poverty and too little time fighting abortion and gay marriage. Like Cardinal Dolan, she offered to speak at both conventions. The Republicans did not get back to her.

Saving Medicare the Republican way

It's a promise: "A Romney-Ryan administration will protect and strengthen Medicare, for my mom’s generation, for my generation, and for my kids and yours." That's what Paul Ryan told the Republican National Convention last night in his acceptance speech.

How do the Republicans plan to do this? The Republican Platform spells it out: "The first step is to move [Medicare and Medicaid] away from their current unsustainable defined-benefit entitlement model to a fiscally sound defined-contribution model."

Right--that has worked so well for pension plans.

Once upon a time we were told that the 401(k) defined-contribution plans would let us retire rich. We could choose our own investments! No intermediaries would take hefty cuts! The miracle of compounding interest would do the rest!

But then interest rates tumbled, and financial institutions took hefty cuts anyway, and our houses lost a third of their value, and most of us forgot that we really needed to be socking away the maximum allowable percentage of our salaries if we planned to continue eating in retirement.

You might want to check out David Callahan's article, "A Perfect Failure: Why the 401(k) Has Been a Flop." Or you might just want to consider your own 401(k). Will you have saved a million dollars by the time you retire? That's how much you'll need if you want to draw out a modest $40,000 a year, and if you want your savings to last as long as you do.

Now ask yourself: do you really want an individualized, free-market Medicare along with your individualized, free-market 401(k)?

Soon-to-retire Boomers will remember a sentence reportedly uttered by an American officer in Vietnam: "We had to destroy the village in order to save it." That's pretty much how Mr. Ryan plans to save Medicare.

I do hope Messrs Obama and Biden come up with a better idea.