Social Safety Net – Page 2 – The Wrongologist

Saturday Soother – March 11, 2023

The Daily Escape:

Sunset, Santa Elena Canyon, Big Bend NP, TX – March 2023 photo by Rick A. Ludwig. Cliff on left is in Mexico, the one on the right is in US. The Rio Grande is in the middle.

Signs that we’re starting to think about the 2024 election are everywhere. Wrongo wants to connect a few dots regarding Biden’s recent efforts to move the Democratic Party more to the middle on crime and immigration while staying left on financing the country’s social and military needs.

Biden proposed a budget to reduce the deficit, protect Medicare and Social Security, and raise taxes on wealthy individuals and corporations. From the NYT:

“In a speech in Philadelphia on Thursday, Mr. Biden said that his budget was designed to ‘lift the burden on hard working Americans’ and drew sharp contrasts with the proposals that Republicans have offered, which the president argued would threaten the nation’s social safety net programs and benefit the rich.”

This contrasts with Biden’s right-leaning position on the recent DC crime bill. Since DC is controlled by the Congress, it’s legislation can be vetoed by the US Senate. Also from the NYT:

“The Senate…voted overwhelmingly to block a new District of Columbia criminal code that reduces mandatory minimum sentences for some violent offenses, with Democrats bowing to Republican pressure to take a hard line on crime in a move that underscored the rising political potency of the issue ahead of the 2024 elections.”

By an 81-to-14 vote, with 31 Democrats voting with the Republicans, the Senate passed the Republican-written measure to undo the District’s law. It now goes to Biden, who after initially opposing it abruptly changed course and said he would sign it.

So, Biden’s tacking left on spending but to the center-right on crime. He’s making a series of calculated moves to position his Party to compete successfully in 2024. Still, it’s disappointing that Biden and 31 Democrats joined with the Right to deny DC residents the right to govern their own city.

But this shouldn’t be surprising. Last year, Biden and the Democrats turned their backs on labor during their contract battle with the railroads.

Here’s Nick Catoggio in the Dispatch: (Brackets by Wrongo)

“[Biden has]…begun to tiptoe toward the center lately on another major Democratic liability, immigration…..Centrist analysts…have warned Biden and his Party that their political viability depends on escaping the…“cultural bubble” in which an unsecured border is treated as a civic good.”

And last week Biden changed his immigration policy. He’s requiring asylum seekers to seek refuge in nations they pass through rather than waiting to do so in the US.

These new policies bring Biden closer to public opinion. Among Democrats, a plurality want to see the number of asylum applicants increased rather than reduced. Among the overall public, it’s the opposite. Biden is tilting toward the latter.

Biden wants to be seen as strong on crime. Democrats walk a fine line of being against crime but not wanting to wholly support the police. Doing that would risk looking anti-Black in cities that are so important to their political success. Dems support compassionate justice and not retributive justice, so they get tied up in knots when violent crime increases, which is rising in America. The problem of course is that the descriptor “violent” isn’t consistently applied.

Biden’s idea is to try to win more votes from people who are not fanatic MAGA types. That means picking off White suburban voters, Asian voters and Hispanic and Black voters, all of whom are concerned about crime.

Tom Sullivan points out that while the moderate-to-conservative White population is in slow decline, their votes remain significant, and that Democrats shouldn’t ignore them over the next two years:

“Sadly, Democrats often do. Campaigning in concentrated urban areas that tend to vote your way is simply easier and more cost-effective. What it means for largely rural states like North Carolina is that while it remains possible to elect a Democrat like Roy Cooper as governor, Democrats’ urban focus bequeaths him a Republican-dominated legislature…”

Sullivan says the Democrats need to start acting like the big-tent party that they used to be.

And that’s what Biden is attempting to do.

Time to say “enough” to war-gaming the 2024 election. It’s time for our Saturday Soother. The daffodils have sprung through the snow, a sure sign of spring. We turn back the clocks tomorrow night, another win for those who hate dark days.

So, it’s time to take a few minutes to center yourself. Start by sitting in a comfy chair and watch and listen to Lili Boulanger’s “D’un matin de Printemps” (On a spring morning). She wrote this piece in 1917 when she was 23. Boulanger battled bronchial pneumonia throughout her short life, dying a year later at age 24. Here, it is played by the Seattle Symphony conducted by Cristian Măcelaru.

Listen and think about her writing this during the darkest days of her life:

What To Do About Social Security and Medicare

The Daily Escape:

Lupine and poppies, near Glendale, AZ – March 2023 photo by Marion Cart

From Joe Perticone:

“Social Security and Medicare are headed for insolvency—that’s just a mathematical, demographic fact. But when it comes to addressing the problem, there’s virtually nothing the two parties actually agree on. For years, Republicans have waffled between proposing cuts and kicking the can down the road.”

Republicans are correct that Social Security (SS) and Medicare (M) are marching toward insolvency. But they trip over their own feet with their proposals to save them. Republicans are wrong to think they can solve the solvency questions without raising taxes. Once the Republicans take taxes off the table, they’re left without any real solutions to propose.

The Biden administration has done a good job in pre-emptively going after Republican’s ideas about cuts in Social Security and Medicare benefits. The result is that the GOP is squabbling between themselves and scrambling to come up with a plan they could take to the public.

It’s not just the federal debt that should be discussed. Dr. Donald Berwick head of Medicare and Medicaid during the Obama administration wrote in JAMA: (emphasis by Wrongo):

“A total of 41% of US adults, 100 million people, bear medical debts. One of every 8 individuals owes more than $10,000. In Massachusetts, 46% of adults say they skip needed care because of costs. As of 2021, 58% of all debt collections in the US are for medical bills.”

The WaPo explains why people who live in the American South have bad credit scores. It turns out that neither race nor poverty were the deciding factors. It was medical debt:

“Of the 100 counties with the highest share of adults struggling to pay their medical debt, 92 are in the South, and the other eight are in neighboring Oklahoma and Missouri…”

But why the South? Yes, as a region, it’s unhealthy. But there are several Northeastern states where residents struggle with chronic health conditions but have good credit. One thing that stands out is the lack of Medicaid:

“…a recent analysis in the Journal of the American Medical Association…found that medical debt became more concentrated in lower-income communities in states that did not expand Medicaid after key provisions of the Affordable Care Act took effect in 2014.”

So bad health and bad credit are because of Republican governors’ refusal to expand Medicaid to cover more poor people. Leave it to the south to show a MAGA future for all of us: undereducated, unhealthy, and neck-deep in debt.

What’s The GOP Plan For Negotiating On The Debt Limit?

The Daily Escape:

Dream Lake, Estes Park CO – January 2023 photo by Rick Berk Photography

(Wrongo and Ms. Right send healing thoughts to friend and blog reader Gloria R.)

We’re all aware that House Republicans are refusing to lift the debt ceiling unless Biden gives them well, something? And Republicans still haven’t decided what they want. The GOP also wants a balanced budget, but they can’t say what should go, or what should stay.

From the WaPo: (Brackets by Wrongo)

“They [GOP] say they want to reduce deficits — but meanwhile have ruled out virtually every path for doing so (cuts to defense, cuts to entitlements, wiping out nondefense discretionary spending, or raising taxes).”

The fact that Republicans are up in the air about what to do highlights the likely Democratic strategy is against their threats about the debt ceiling. Again, from the WaPo:

“Sensing Republicans are on the verge of a blunder in their schemes to use the debt ceiling to hold the economy hostage and try to extract draconian spending cuts, the White House has developed a two-part response strategy.

Part 1: Lay out the simple argument that Republicans are recklessly inviting an economic meltdown even by talking about a possible default.

Part 2: Force House Republicans to put forward a plan on the table and watch as they struggle with the fallout.”

The Democrats along with Senate Minority Leader McConnell (R-KY) are daring Republicans to put forward a plan. Senate Majority Leader Schumer (D-NY) said:

“If House Republicans are serious about taking the debt limit hostage in exchange for spending cuts, the new rules that they adopted require them to bring a proposal to the floor of the House and show the American people precisely what kind of cuts they want to make….”

Everyone who follows politics knows that Republicans never take much interest in fiscal sobriety when their Party is in control. They agreed to raise the debt limit three times while Trump was in power.

It seems that Republicans are doing the Democrats’ job for them. They are asking for an economic catastrophe and seeking draconian cuts that their base doesn’t want.

Consider the Republican desire to reduce our deficits. They have pledged to balance the budget (that is, to have a zero annual budget deficit) within 10 years. But they haven’t laid out any plausible mathematical path for getting there. And of the current debt ceiling, 90% of it was committed before Biden took his job.

Some Republican House members want to cut military spending, an idea that both Speaker Kevin McCarthy (R-CA) and Rep. Jim Jordan (R-OH) are on board with. But others, including House Appropriations Chair Kay Granger (R-TX), have said defense spending cuts aren’t on the table. Rep. Michael Waltz (R-FL) said:

“We’ve got to get spending under control, but we are not going to do it on the backs of our troops and our military,”

Waltz thinks Republicans should focus on “entitlements programs,” such as mandatory spending programs like Social Security, Medicare, and Medicaid. But the bi-partisan popularity of these programs makes them hard to cut.

And last Sunday, Rep. Nancy Mace (R-SC) was asked to name one thing she was willing to suggest as a spending cut. She instead stated things she wouldn’t put on the table:

“Well, obviously no cuts to Medicare or Medicaid or Social Security….That’s a nonstarter for either side.”

Wrongo has repeatedly suggested tax increases which would help lower deficits, but Republicans have ruled that out.

Instead they’ve changed the House rules so tax cuts will be much easier to pass, and tax increases harder to pass. The House’s rules package now says that any increase in taxes would require a three-fifths vote (60%) rather than a simple majority as previously.

They’ve also proposed doing away with income taxes, payroll taxes, estate taxes and even the IRS itself in favor of a supersized sales tax that would provide most revenue to the government. Republicans would substitute a 30% sales tax on all purchases and in exchange, do away with income, Social Security and Medicare taxes.

That means workers would keep the gross amount of their paychecks. But it also means that buying everything from groceries to automobiles would be hugely more expensive. It also provides a big tax cut for the wealthy and businesses.

The result is a smaller tax burden for the highest earners and a bigger one for people in the middle.

Once you reject trimming entitlements or defense spending and bake in the cost of the GOP’s proposed tax cuts, you’re left with an additional $20 trillion hole in the Federal budget over the next decade.

OTOH, the White House is expected to release its detailed budget in early March. It will build on budgets it has released previously. Republicans want Biden to negotiate on what to do about money we’ve already spent.

Try doing that with YOUR creditors.

A MAGA Idea Wrongo Supports

The Daily Escape:

Sunset, Tucson, AZ – January 2023 photo by Leila Shehab

Sometimes your worst political enemies are on the same page with you. Axios reports that a:

“…threat of cuts to US defense spending has emerged as a flashpoint in House Republicans’ first week in the majority, widening the GOP’s isolationist fault line and exposing the fragility of Kevin McCarthy’s young speakership.”

The backstory here is that according to Bloomberg, among the concessions new House Speaker McCarthy made to secure the job was to agree to vote on a budget framework that caps 2024 discretionary spending at fiscal 2022 levels. Unless the Pentagon is exempted, that could result in a $75 billion drop in defense spending:

“National defense spending, which primarily funds the Pentagon, was about $782 billion in fiscal 2022 and rose $75 billion to $857 billion in fiscal 2023.”

The deal that McCarthy has apparently agreed to would have the House commit to passing bills that would cap all discretionary spending at fiscal year 2022 levels, or roughly $1.47 trillion.

But one of the big wins for Senate Republicans in last year’s budget talks was a bigger defense budget. Sen. McConnell might want to check in with the House MAGA Republicans, since they’re going in the opposite direction.

Wrongo agrees that the idea of cutting $75-$100 billion (or more) from the Pentagon should be up for discussion. Consider that in 2021, the Congressional Budget Office (CBO) released a study that outlined three options for saving over $1 trillion in Pentagon spending over the next ten years without damaging our defense capabilities.

All three options involved cutting the size of the armed forces, avoiding large boots-on-the-ground wars like Iraq and Afghanistan, and relying on allies to do more in their own defense.

Wrongo wrote about the 2021 CBO study here. The CBO report put the potential cut in historical perspective: A $1 trillion cut (14%) over a decade would be far smaller than the cuts to America’s military spending in 1988-1997 (30%), and the 25% cut we had in 2010-2015.

A $1 trillion saving isn’t chump change. Those funds could be used to prevent future pandemics, address climate change, or reduce economic injustice. These are all pressing American problems.

The MAGA’s ideas on defense spending cuts might find support from a few progressives in Congress, including Reps. Barbara Lee (D-CA) and Mark Pocan (D-WI), who pitched a $100 billion haircut for the DoD earlier this year. But this year’s Pentagon budget boost easily passed both the House and Senate on a bipartisan basis.

Both Republican and Democratic House war hawks will resist the idea of cutting defense spending. Some will cite the defense of Ukraine, which will only account for $45 billion of military spending in the coming year. Some will mention Taiwan, citing China’s aggressive military stance toward the island nation.

But how about developing a clear global military strategy along with the willingness to carry it out? Instead of simply talking about how many dollars we should spend.

And the CBO’s proposed strategic shifts don’t account for what could be saved by streamlining the Pentagon by reducing its cadre of over half a million private contractors, many of whom perform tasks at prices higher than it would cost to do the same work with government employees.

The likely outcome is that House Republicans will fail to cut defense spending while sticking to their plan of holding the 2024 discretionary spending flat. So Republicans will focus on social spending to reduce the fiscal 2024 budget to 2022 levels. But if you ask Americans what spending they want to see cut, they will never say that we ought to cut people’s retirement security.

Wrongo has little hope that this 118^th Congress will work to solve the three great problems that face America: Our revenue problem, our social spending/cost inflation problem, and our defense spending problem. As Jennifer Rubin says in the WaPo:

“The danger for the GOP has always been that a short stint in irresponsible governance will wake up the electorate to their manifest unfitness, thereby dooming the party’s chances in 2024. The danger for the country is that, in the meantime, the MAGA extremists will do permanent damage to the U.S. economy and national security.”

The hard Right MAGAs and the anti-democracy Republican Party must be made into a permanent minority, as it was during the Roosevelt years, and for decades thereafter.

The battle for 2024 starts now.

Thanksgiving Week

The Daily Escape:

Turkeys on the fields of Wrong – November 2018 photo by Wrongo

(This is the last column before Thanksgiving. Words from Wrongo will resume on 11/28.)

Thanksgiving is Wrongo’s favorite holiday. As a secular holiday, you’re not required to do anything. The celebration is subdued, and around here, we focus on gratitude. Wrongo always thinks about how grateful we should be to live in this wonderful country of ours, and how grateful we are for all of America’s gifts.

We’re lucky to live in a land of plenty: Most of us have employment, most have access to quality healthcare. Most of us have a warm place to sleep at night, most have hope for their kids’ future.

There are many of us who do not have those things, and it is our collective responsibility to help them get to a place where they are physically and mentally secure. They need our help. And we know what to do, and we know how to do it.

This is our 2498^th column. Wrongo wants to thank all who have stuck around since the beginning in 2010. He thanks all of you who read it now, and that includes readers in more than 60 countries. Special thanks to long haulers Monty B, Fred VK, David P, Pat M, and Terry McK, among others. Wrongo is very grateful to all of you!

Wrongo’s wish is that you allow yourself to feel gratitude today and share it with those around you. The secret of life is to affect others in a positive way.

We’re truly grateful for those who came before us, and to our family members and friends who we can’t be with today. We’re thankful to those who are on the front lines in military service, or at home in our hospitals, schools, firehouses, and police stations. Happy Thanksgiving!

The NYT has an article about how online gambling companies have gotten their noses under the tents at colleges and universities:

“In order to reap millions of dollars in fees, universities are partnering with betting companies to introduce their students and sports fans to online gambling.”

The Times says that Michigan State University’s athletic department inked a deal with Caesars Sportsbook in 2021. Caesars proposed a deal worth $8.4 million over five years. Michigan signed on the line. Other schools have also struck deals to bring betting to campus. More from the NYT:

“After Louisiana State University signed a similar deal in 2021 with Caesars, the university sent an email encouraging recipients — including some students who were under 21 and couldn’t legally gamble — to “place your first bet (and earn your first bonus).”

Since the Supreme Court’s decision in 2018 to let states legalize online betting, gambling companies have been working to convert traditional casino customers, fantasy sports aficionados and players of online games into a new generation of digital gamblers.

And universities, with their captive audience of easy-to-reach students, have emerged as an especially enticing target. So far, at least eight universities have become partners with online sports-betting companies.

And a dozen other universities’ athletic departments and booster clubs have also signed agreements with brick-and-mortar casinos. For example, Turning Stone Resort and Casino is the official resort of Syracuse University’s ‘Cuse Athletics Fund. These gambling partnerships bring in funds that schools can use to sign marquee coaches and build their sports teams.

Wrongo rarely gambles, but he has a mostly lassiez faire attitude about it. He’s skeptical about prohibiting it. But the idea by universities of “let’s introduce our students to online gambling for our profit” sounds, well, wrong. The hypocrisy here is that the sports betting companies are offering “a piece of the action” to schools that not long ago swore that gambling would ruin college sports.

It isn’t exactly the same, but do you recall that back in the 80s, banks introduced credit cards and credit card debt to students? And how did that work out? You can almost imagine hearing: “Want to go double or nothing on those student loans, kid?” The most relevant quote from the NYT is:

“College athletics have become profit maximizing opportunities for athletic directors and coaches.”

Wrongo thinks this has nothing to do with the educational mission of colleges and universities. OTOH, the ol’ ball coach is saying: “Wanna bet”?

Let’s cruise into the holiday by listening to a tune that is new to Wrongo, Josh Groban’s “Thankful” performed live from his “Noel” album. It’s on point with Wrongo’s thinking about Thanksgiving:

Lyrics:

Somedays we forget
To look around us
Somedays we can’t see
The joy that surrounds us
So caught up inside ourselves
We take when we should give.

So for tonight we pray for
What we know can be.
And on this day we hope for
What we still can’t see.

It’s up to us to be the change
And even though we all can still do more
There’s so much to be thankful for.

Look beyond ourselves
There’s so much sorrow
It’s way too late to say
I’ll cry tomorrow
Each of us must find our truth
It’s so long overdue

So for tonight we pray for
What we know can be
And every day we hope for
What we still can’t see

It’s up to us to be the change
And even though this world needs so much more
There’s so much to be thankful for

Saturday Soother – August 27, 2022

The Daily Escape:

Super moon over Lake Champlain, Burlington, VT – August 2022 photo by Adam Silverman Photography

Republicans are outraged this week about Biden’s cancellation of student loan debt! Americans now owe a total of more than $1.6 trillion for higher education. From the WaPo: (emphasis by Wrongo)

“The result is one of the most significant changes to American higher education policy in decades — and a new cornerstone of the president’s economic legacy. Biden’s decision will dramatically change the financial circumstances of tens of millions of Americans, fully erasing the student loans of roughly 20 million people.”

Student debt played a minor role in American life through the 1960s when Wrongo accrued his $5k of college debt while attending Georgetown. But it increased during the Reagan administration. It then shot up after the 2007-2009 Great Recession as states made huge cuts to funding for their college systems.

But the argument that “tuition has gone up because public support for higher education has declined” isn’t the only one. While it’s valid for some institutions, it doesn’t explain the “arms race” among colleges and universities to add student amenities and layers of administrative staff over the past 10 years.

Over the last decade, revenue at independent (non-religious) private colleges and universities in the US has increased by 148% on an inflation-adjusted (real) per student basis. At religiously affiliated private colleges and universities revenue has increased by 87% in real per-student terms over the last 10 years.

Meanwhile, at public institutions, revenue has increased by just 23.4% on the same basis. However, this is still 36% greater than per capita GDP growth over the same 10 years.

The headline is that our elite educational institutions have gotten obscenely wealthy. And many of our second tier institutions chased after them, causing education budgets everywhere to explode.

It’s become another example of America’s new gilded age.

Opinions differ about the ethics of loan forgiveness for student debt, and that’s understandable. The general thrust of the Republican railing about the educational loan forgiveness is about how unfair it is when one group of Americans is getting a benefit at the cost of other Americans.

This tweet from former Trump White House press secretary Sarah Huckabee Sanders is on point for most of the GOP:

“Joe Biden wants those who didn’t go to school, didn’t take out loans, or already paid off their loans to pay off $300 billion of other people’s debts…..It’s socialism, it’s un-American, and only makes his record-setting inflation worse.”

But it isn’t socialism when our government bails out one group at the expense of another; it happens all the time. No Republican complained about the Trump tax cuts which were directed at America’s wealthy and its corporations. No Republican complained about the bank bailout in 2008. No Republican objected when Trump gave $16 billion to farmers hurt by the Trump tariffs.

Second, despite what the GOP is saying, the $300 billion in loan forgiveness isn’t inflationary. It’s true that it’s money that student borrowers won’t be paying back. But because of the student debt moratorium, they had already stopped payments in 2020, so there’s no change going forward. They simply won’t have to restart making payments on that $10,000 of debt.

It isn’t clear that there will be much impact to inflation or the Consumer Price Index. Since they weren’t making payments, it’s likely they were already spending those funds that might have gone to loan repayments. So no new spending.

We can have a debate about how much higher education should cost per student. We live in a society that is a whole lot wealthier than it was 40 years ago, but many of our students do not come from those few wealthy families.

The political calculus of Biden’s decision will be seen in November. The WaPo reported that a majority of Americans support limited debt forgiveness. Biden’s pollster, John Anzalone said:

“This is a motivator for young people….It’s a huge issue for young people — the support levels for them are in the high 60s.”

Let’s hope they turn out to vote on November 8.

Now, it’s time for our Saturday Soother, where we decompress from another week of body blows to America and find a few moments to gather ourselves for the week to come.

Here on the Fields of Wrong, we had a day of very satisfying brush clearing although we’re still waiting for rain.

Go get a big mug of decaf cold brew coffee and grab a chair in the shade. Now listen to Schubert’s “Impromptu in G flat Op. 90 No. 3”, written in 1827, and played here in 2012 by Olga Jegunova at the Bishopsgate Institute in London:

Schubert really understood how to capture emotion in his music.

Schumer and Manchin Love Bipartisanship, Hate Diabetics

The Daily Escape:

Full moon, 4:00 am, Burlington, VT harbor -July 2022 photo by Adam Silverman Photography

Senate Democrats have been working on a prescription drug pricing reform proposal aimed at lowering the cost of prescription drugs by allowing Medicare to negotiate prices for up to 20 drugs.

The House passed similar legislation which was considered by the Senate last year. That bill included language that would have made all insulin products subject to Medicare price negotiation and would have capped Medicare beneficiaries’ insulin copays at $35 per month.

Earlier this month, Senate Democrats (including Manchin), reached a deal on a plan that would allow Medicare Part D to negotiate the prices of up to 20 prescription medications directly with pharmaceutical corporations, a proposal that is overwhelmingly popular with voters across party lines.

But the Senate Finance Committee has just left insulin out of the package they plan to send to the floor of the Senate. From Yahoo News: (parenthesis by Wrongo)

“Staff for the Democrats on the Senate Finance committee said the provisions were removed because a separate bipartisan Senate bill (the Insulin Act) includes the monthly $35 insulin cost cap for people with Medicare or private insurance.”

But that separate bill is facing an uphill battle because it would need 60 votes in the Senate to cross the filibuster hurdle, while the drug pricing reform bill is expected to be part of the Senate’s reconciliation process, requiring only 51 votes to become law.

Bloomberg Law reports that Schumer: (emphasis by Wrongo)

“…has said he plans to hold a vote soon on a measure from a bipartisan duo to cap the out-of-pocket cost of insulin at $35 a month. But passing the legislation from Sens. Susan Collins (R-ME) and Jeanne Shaheen (D-NH) requires the support of Republicans, and key GOP senators say they’re not ready for a vote right now.”

Naturally, diabetics and their interest groups are up in arms. That people have to pay huge sums for insulin is a very visible problem among all of the problems with America’s health care system. That Democrats may cave on fixing this in favor of making the path harder reveals much about the Dem’s ability to govern.

From Common Dreams: (brackets by Wrongo)

“Insulin prices in the US [are] seven times higher than those found in peer countries [and] are so steep that experts have accused the federal government and pharmaceutical industry of violating human rights. More than 37 million people in the US have been diagnosed with diabetes….Because just three pharmaceutical corporations control the nation’s lucrative insulin market, the century-old drug can cost a person without adequate health insurance more than $300 per vial.”

So, an oligopoly controls insulin.

The massive coverage gaps inherent in our for-profit healthcare system have left millions of people across the US who rely on insulin, unable to afford it. Corporate profiteering is forcing many people to ration the drug or forgo it, often with deadly consequences.

Considering the fact that insulin is more than 100 years old, it should be as close to free as possible. Why not set up a not-for-profit co-op to manufacture insulin, which would then be available for the cost of production? One such organization that’s trying to do just that is the Open Insulin Foundation. However it isn’t clear that they have launched production of insulin at this point.

The drug pricing reform bill would start negotiating with drug manufacturers sometime in the next three years and wouldn’t be fully implemented until 2030, so it’s weak tea to begin with. And it’s only for 20 drugs, and the most used one is no longer included.

Schumer and Manchin are responsible for taking insulin out of the bill that will certainly pass, in favor of it being in a stand-alone bill that probably won’t pass, because they still don’t have the Republican votes they need to pass a separate insulin bill.

Unless Democrats abandon their efforts to convert Republicans to bipartisanship, Wrongo’s days of funding their election campaigns are over.

Saturday Soother – June 18, 2022

The Daily Escape:

Rainy morning, with Vista House at Crown Point in right foreground, Columbia River Gorge, WA – June 2022 photo by David Leahy Photography

Wrongo has written before about the crushing burden of consumer debt in the US. Medical debt is an American disgrace, and Noam Levey, Kaiser Health News (KHN) Senior Correspondent has written an excellent piece about it. He says that 100 million people in America, some 41% of adults, owe some level of debt to healthcare providers.

But most studies don’t reveal the actual extent of the debt because much of it appears as credit card balances, loans from family, or payment plans arranged with hospitals and other medical providers. To calculate the true extent and burden of this debt, KHN partnered with NPR, and the Kaiser Family Foundation (KFF) to conduct a nationwide poll designed to capture not just bills patients couldn’t afford, but other forms of borrowing used to pay for health care.

The results are contained in the KFF Health Care Debt Survey. The KFF poll found that half of US adults don’t have the cash to cover an unexpected $500 health care bill. As a result, many simply don’t pay their medical bills. The flood of unpaid bills has made medical debt the most common form of consumer debt in America.

Over the past five years, more than half of US adults report they’ve gone into debt because of medical or dental bills. Moreover, a quarter of adults with health care debt owe more than $5,000, and about 20% with any amount of debt said they don’t expect to ever pay it off.

Debt incurred for health care is forcing many families to cut spending on food and other essentials. The poll also found that millions are being driven from their homes or into bankruptcy:

So, if 100 million people were in debt and 17% declared bankruptcy or lost their home, that’s 17 million people! The KFF poll found that the debt is also preventing Americans from saving for retirement, investing in their children’s educations, or buying a home. And debt from health care is nearly twice as common for adults under 30 as for those 65 and older. And that age cohort is supposed to be much healthier than the elderly.

Perversely, about 1 in 7 people with medical debt said they’ve been denied access to a hospital, doctor, or other provider because of unpaid bills. An even greater share (two-thirds) have put off care that they, or a family member need because of the cost.

Hospitals are among the culprits. They are capitalizing on their patients’ inability to pay. Hospitals and other medical providers are pushing millions of patients who can’t afford to pay into credit cards and other loans. These are high interest rate loans, carrying rates that top 29%, according to research firm IBISWorld.

This collections business is fed by hospitals, including public university systems and nonprofits granted tax breaks to serve their communities, who sell the outstanding debt to collections companies.

Welcome to the best country on earth, (maybe) one that doesn’t have the best health care system (and certainly one without health insurance for all). We have a system which shackles 100 million people to medical debt while at the click of a computer mouse, we send $billions in armaments overseas before those same dollars are recycled into the coffers of our Military-Industrial complex.

That’s all for this week. It’s time for our Saturday Soother, when we take a break from the J6 public hearings and whether Ginni Thomas was another Trumpist plotter. Let’s focus on calming ourselves for whatever insults are coming next week.

Here at the Mansion of Wrong, we’re engaged in an air conditioning project, adding more central air to our home. Hey, we’re aware of the crummy stock market, and the rampant inflation, but consume we must.

To help you clear your head on this warm weekend, grab a seat outdoors and brew up a cup of Supernatural coffee ($18.45/12 oz.) by Lee, MA’s own Barrington Coffee Roasting Company. This espresso is said to have flavors of Concord grape, dark chocolate, plum and tangle berry pie!

Wrongo has no idea what tangle berries look like, much less what they taste like.

Now, put on your wireless headphones and listen to the “Adagio for Oboe, Cello, Organ and Strings”, also known as “Elevazione” or “All’Elevazione” by Domenico Zipoli.

Zipoli was an Italian Jesuit priest who lived much of his life in what is now Argentina. He studied with Scarlatti, became a Jesuit, worked as a missionary, and died in 1726 in Argentina at age 38. If fate had granted Zipoli another 20 to 25 years, he might be regarded today as a major composer. Here it’s performed in 2015 by the Collegia Musica Chiemgau conducted by Elke Burkert :

Which States Are The Best for Working Moms?

The Daily Escape:

Sunrise, Columbia Hills, WA – May 2022 photo by Mitch Schreiber Photography

Each year, WalletHub ranks the best and worst states for working mothers. Below is an overview of their methodology and findings: Women make up nearly half of the US workforce, and nearly 68% of moms with children under age 18 were working in 2021. That share of the workforce declined during Covid, dropping around 1.3% between Q3 2019 and Q3 2021 (compared to 1.1% for men).

We know that women face an uphill battle in the workplace, with their average hourly wage being just 84% of what men make. They face other non-financial problems as well. Parental leave policies and other childcare support systems vary by state, but the quality of infrastructure — from cost-effective day care to public schools, is far from uniform.

WalletHub compares state performance across 17 metrics to rank the best & worst states. They compared the 50 states and the District of Columbia across three key dimensions: 1) Childcare, 2) Professional Opportunities and 3) Work-Life Balance:

“We evaluated those dimensions using 17 relevant metrics…with their corresponding weights. Each metric was graded on a 100-point scale, with a score of 100 representing the most favorable conditions for working moms. We then determined each state and the District’s weighted average across all metrics to calculate its overall score and used the resulting scores to rank-order our sample.”

WalletHub’s weighted average for the three categories was as follows: Childcare = 40 possible points, Professional Opportunities = 30 possible points, and Work-Life Balance = 30 possible points, totaling 100 points available per state. That translates into the overall total score below. Here are the top 10 US states for working mothers with individual state rankings by category:

It’s very telling that America’s best score was 62.99 out of 100, meaning that all states have a long way to go to make us a nation that supports women and mothers. Wrongo is happy to note that Connecticut is #1 in job opportunities for women. Here are the bottom 10 states:

Note that only California of the bottom 10 states is an urban (and blue) state. It gets killed in the rankings because of its terrible performance on childcare. If you are interested in how your state ranked, you can see an interactive map of all the states here. WalletHub also compared the top and bottom five states across a few of their metrics. Here’s what those rankings show:

According to a recent report, more than 2.3 million American women have dropped out of the labor force since the start of the pandemic. Solving the problems that keep these women out of the workforce should be a focus for all of the states.

This is particularly true for service and front-line workers whose work scheduling can be unpredictable and for many jobs, there is limited flexibility. Companies should do more. They can create more flexible work environments, allowing parents to take short-term time off. They can strive to eliminate schedule unpredictability for hourly workers. Companies can also work to change their culture to better recognize work-life balance.

The biggest hypocrisy of the anti-abortion movement and the Supreme Court’s apparent decision on abortion is that the Justices and the Republicans are willing to go to the mat to protect the unborn, but that commitment mysteriously vanishes once a child exits the womb.

In many cases, these same zealots are actively hostile to programs that would benefit children.

Parenthood is humankind’s most important job; but there’s no internship, no training program, no handbook. You dive into it and are expected to figure things out on your own. It’s true that parents should bear the responsibility and costs of raising a child, but, government intervention should be available, depending on local conditions and income levels. Some parents simply need help.

At a time when Republicans and the Supreme Court seem to be willing to discount the value of women in our society, it’s important that we battle their views on the economic front as well as on the political front.

Monday Wake Up Call – January 31, 2022

The Daily Escape:

Mount Saint Nicholas, Glacier NP, MT – January 2022 photo by Jack Bell Photography

Anyone else thinking that our national party bus is about to stall out in the slow lane on America’s Boulevard of Broken Dreams?

Here’s an under-the-radar story: In 2020, the Trump administration hatched a plan to gradually transition traditional Medicare over to private firms. It’s called Direct Contracting (DC) and is operated by Direct Contracting Entities (DCEs). Currently, there are 53 of them in Phase One of an experimental program operated by the Centers for Medicare and Medicaid Services (CMS).

Under the program, the DCEs receive a fixed amount of money annually to cover care for each traditional Medicare enrollee whose primary care doctor (or group) has signed up with that DCE. The DCEs must pay for all of the care of those people assigned to them. To date, the CMS has auto-assigned hundreds of thousands of people to DCEs.

Since no one on Medicare has voluntarily signed up to work with a DCE, it’s unlikely they know of, nor understand what’s happening. And the CMS doesn’t require DCEs to tell people that they have the right to opt-out.

The idea behind DCEs is to shift a portion of the financial risk of the elderly’s medical care away from traditional Medicare by capping the payments to a third party that’s responsible to pay for it. This is the latest in many efforts by CMS and Congress to control the rising costs of healthcare.

Wrongo and Ms. Right have recently noticed a blizzard of direct mail offers to convert our traditional Medicare to an all-in insurance program. It’s probable that some of these are from DCEs.

The anticipated advantage of the DCE experiment is that Medicare’s out-of-pocket costs will be capped. The DCEs contract with CMS is for an agreed-upon annual payment. They have to pay for care and also make a profit based on that fixed revenue amount from the government. In addition to the normal profits from providing services, DCEs can keep as much as 40% of the money they don’t spend on care.

But there’s no such thing as a free lunch, and it seems to Wrongo that this creates yet another financial incentive to deny otherwise necessary treatments. It’s possible that the DCEs could pay doctors to steer patients away from specialty care. This means that someone enrolled in a DCE has reason to worry that their primary care doctor might limit their access to more costly care.

Direct contracting is supposed to be a pilot program, yet Medicare has no plans to limit the number of people it enrolls in these new plans. Instead, Medicare has announced plans to enroll 100% of traditional Medicare members into DCE-like programs by 2030.

Congress did not authorize the wholesale overhaul of traditional Medicare, so why is this happening? And so far, the Biden administration appears to be willing to continue playing Trump’s cards.

Many of the DCEs are owned by Private Equity (PE) firms. It doesn’t take a chess master to see that the PE firms will ultimately sell out to the insurance industry. And it wouldn’t be a big leap from that to fully privatize Medicare.

Time to wake up America! Did we elect Biden to privatize Medicare? The word “privatize” should scare the hell out of Americans. But unfortunately they’ve been fooled into believing that by some magic miracle of economics, it’s to their benefit.

To help you wake up, today we spend a few minutes with Neil Young. Wrongo appreciates Neil Young saying he wanted his music removed from Spotify if Joe Rogan is allowed to continue spewing his anti-Vaxx trash there.

This was an easy business decision for Spotify. They picked the popular podcaster Rogan with the $100 million-plus exclusive deal, over the cranky 76-year-old rocker whose last gold album was nearly two decades ago. Someone who hasn’t been on the Billboard charts since 1982.

Joni Mitchell and Dave Grohl have now said they will follow Young in leaving Spotify.

Let’s watch and listen to Neil Young playing “Hey Hey, My My” at Farm Aid in Champaign, Illinois on September, 1985. Young is a co-founder and board member of Farm Aid, along with Willie Nelson and John Mellencamp:

Neil won’t burn out or fade away.

Sample Lyric:
Out of the blue
and into the black
You pay for this,
but they give you that
And once you’re gone,
you can’t come back
When you’re out of the blue
and into the black.

“You pay for this, and they give you that”. Listen up Medicare!

The Wrongologist

Geopolitics, Power and Political Economy

Category: Social Safety Net