Health insurance: return of the bad old days

Richard Mayhew, at Balloon Juice, is an insurance industry middle-manager who writes at Balloon Juice. A week ago he wrote a piece entitled "Recission and the Bad Old Days," about all the excuses insurance companies could use to withdraw coverage and dump people into medical bankruptcy. Which of course is an excellent reason to maintain or improve on the ACA.

But I wonder…Mayhew was in the health insurance industry well before the ACA was passed. How did he sleep at night, knowing what was paying his salary? How did any health insurance employees sleep?

And the Trump administration is committing to bringing those times back.

Why So Many Bad Doctors?

Dr. Ben Carson, who everyone remembers from the Republican primary as being uninformed and uncompassionate, is Trump's choice for Director of Housing and Urban Development. Now the word is that Dr. Tom Price, who is anti-abortion, homophobic, ammosexual, and who wants to turn Medicare into an underfunded and inadequate insurance system, is going to be head of Health and Human Services.

Does anyone else think it is odd that such horrific people have medical licenses? Dr. Carson, I gather, is at least an excellent surgeon, but I doubt that Dr. Price is even that. Doctors, as licensed professionals, are required to act ethically. How did Price ever slip through?

Two Baskets

This is from Hillary Clinton's speech, in which she called out that fascists of the alt-right who supported Trump and was roundly blasted for calling all of Trump's supporters deplorable. She was right, and has been consistently misquoted.

Now, she probably ought not to have said this. People hate hearing they are wrong, especially when they are. And her husband's administration had a big part putting people into the second basket, the people who "feel that the government has let them down, the economy has let them down, nobody cares about them, nobody worries about what happens to their lives and their futures, and they’re just desperate for change." Still, I am not at all sure that saying it made much difference. Her words were endlessly twisted during the campaign, apparently out of simple sexism. When Trump said something awful and crazy, he got the benefit of the doubt; when Clinton said something decent, sympathetic, and valid, she got blasted.

So here's the "two baskets" quote, and as things go more and more wrong in a Trump administration we can remember that she got it right.

I know there are only 60 days left to make our case — and don’t get complacent, don’t see the latest outrageous, offensive, inappropriate comment and think well he’s done this time. We are living in a volatile political environment. You know, to just be grossly generalistic, you could put half of Trump’s supporters into what I call the basket of deplorables. Right?

[Laughter/applause]

The racist, sexist, homophobic, xenophobic, Islamophobic — you name it. And unfortunately there are people like that. And he has lifted them up. He has given voice to their websites that used to only have 11,000 people — now how 11 million. He tweets and retweets their offensive hateful mean-spirited rhetoric. Now, some of those folks — they are irredeemable, but thankfully they are not America. But the other basket — and I know this because I see friends from all over America here — I see friends from Florida and Georgia and South Carolina and Texas — as well as, you know, New York and California — but that other basket of people are people who feel that the government has let them down, the economy has let them down, nobody cares about them, nobody worries about what happens to their lives and their futures, and they’re just desperate for change. It doesn’t really even matter where it comes from. They don’t buy everything he says, but he seems to hold out some hope that their lives will be different. They won’t wake up and see their jobs disappear, lose a kid to heroin, feel like they’re in a dead-end. Those are people we have to understand and empathize with as well. —Time.com

25 years to losing

I've discussed the short-term reasons for the Democratic electoral loss in "It's the Sexism, Stupid." But the long-term reason is 25 years of support by both parties for the interests of the wealthy over everyone else. So when Trump offered even a tiny bit of hope, enough voters latched on to it to make common cause with the basket of deplorables and, here we are.

The Case for Auditing the Vote

Or, Jill Stein may have done us an actual service.

J. Alex Halderman:

Were this year’s deviations from pre-election polls the results of a cyberattack? Probably not. I believe the most likely explanation is that the polls were systematically wrong, rather than that the election was hacked. But I don’t believe that either one of these seemingly unlikely explanations is overwhelmingly more likely than the other. — J. Alex Halderman, Director, University of Michigan Center for Computer Security and Society, medium.com

Ron Rivest:

“I wouldn’t be surprised, in light of the DNC, that major voting systems have been compromised,” said Ron Rivest, a founding father of modern encryption systems and a Massachusetts Institute of Technology professor who won the Turing Award, computing’s version of the Nobel Prize. “We do need to be concerned about the integrity of our voting systems in the face of possible attacks by foreign nation-states.— bostonglobe.com”

Barbara Simons:

“If it’s a swing state, those votes could conceivably decide which party wins that state,” said Barbara Simons, past president of the Association for Computing Machinery and an adviser to the US Election Assistance Commission. — bostonglobe.com, previous cite.

These are not lightweight figures. Rivest in particular is a major figure in cryptography. We may be doing this for all the wrong reasons, but it’s a worthwhile thing to do; audits ought to be routine.

Still, going to be one more excuse for Republicans not to count votes. But then, they don’t need excuses.

Deflationary Policy and the Gig Economy

So, what happens?

Uber and the other Transportation Network Companies

Near as I can figure, Uber will start turning drivers away in harder-hit cities; it's the only way to keep the service going. Who is going to bother working with a service that scarcely will provide any work at all? If Uber is going to keep going, it will have to require drivers to put in minimums, and select from among those who do. And, no unemployment insurance for the now out-of-work drivers.

Of course, the founders having made their pile and then some, they could just fold the company.

AirBNB and similar firms

Likely AirBNB goes under. Most of the "unlicensed hotel" AirBNB sellers and similar do go under; they most likely borrowed to fund their services and will not be able to keep up their payments. The legal AirBNB providers may also get hammered; some of them have borrowed to build extensions to their homes and will have also have trouble making the payments. Some people may lose their homes. On the other hand, it may be that regular hotels in cities that are hit hard enough that the whole market switches to AirBNB instead.

That whole thing about entrepreneurship, capitalism, and so on

You're an entrepreneur if you on take financial risk. During a downturn, businesses go under and small businesses of limited capital, like Uber drivers and small AirBNB sellers, go first.

If a Trump administration tanks the economy, there's going to be a lot of unhappy people!

Deflationary policy, or "Mom, they're nuts!" part II

We have here a Krugman post titled, "Why is deflation bad?"

The short-short summary is: (1) it discourages investment; (2) it makes debt harder to bear; (3) it can lead to mass unemployment. If the Republicans do what they say they're going to do, a slam into depression is possible.

I wonder if the people already impoverished by 30 years of neo-liberal economics will, reject the leadership of the Trump administration, or if instead they will double down, and blame the (Jewish, Muslim, African-American) bankers.

Republican Money or "Mom, they're nuts!"

(This is lifted from my post from September. Short summary: the current Republican leadership is bugfuck on banking and monetary policy.)

In addition to all that follows, there's a not-so-subtle thread of anti-semitism running through this: the postmodern Jewish bankers are destroying our manly gold currency, blasted out of the ground by manly miners.

Mike Pence, VP pick: He’s a goldbug.

The U.S. abandoned [the gold standard] in 1971, and as Krugman notes: Since then the price of gold has increased roughly tenfold, while consumer prices have increased about 250 percent. If we had tried to keep the price of gold from rising, this would have required a massive decline in the prices of practically everything else — deflation on a scale not seen since the Depression. This doesn’t sound like a particularly good idea.

Paul Ryan, Speaker of the House: His idea is from Ayn Rand.

The Fed would have to raise interest rates when commodity prices go up, regardless of the state of the economy. This is all kinds of crazy. Commodity prices have shot up the past decade as developing nations have developed — unrelated to inflation here. It makes no sense to make our economy worse because China's economy is getting better. 

Mitch McConnell, Senate Republican Leader, is not a public gold bug, but he doesn’t like the Federal Reserve and believes there has been substantial inflation in the past eight years (there hasn't.)

Ted Cruz, influential Republican Senator, is a gold bug: "I think the Fed should get out of the business of trying to juice our economy, and simply be focused on sound money and monetary stability, ideally tied to gold.”

2016 Republican Platform is goldbug:

Determined to crush the double-digit inflation that was part of the Carter Administration’s economic legacy, President Reagan, shortly after his inauguration, established a commission to consider the feasibility of a metallic basis for U.S. currency. In 2012, facing the task of cleaning up the wreckage of the current Administration’s policies, we proposed a similar commission to investigate ways to set a fixed value for the dollar. 

With Republican leadership, the House of Representatives has passed legislation to set up just such a commission. We recommend its enactment by the full Congress and the commission’s careful consideration of ways to secure the integrity of our currency.

How do we deal with this?

The Working Class and the Credibility of Liberal Economists

Economist Jared Bernstein complains at the Washington Post "The problem isn’t that the facts aren’t out there; it’s that they don’t seem to be gaining much traction." Yet one cannot credibly argue one is for the downtrodden when one has spent that last 25 years compromising with the people treading on them. People eventually see through you, and then there is nothing left to be said.

Justice has to be seen to be done, as well as done. If the Dems and the policy liberals like Bernstein want the respect of the masses, you have to be for the masses and be seen to be for the masses. Otherwise, why should the masses believe you?

Which also seems to explain the results of the recent election. Obama was for the bankers first. Everyone could see it. Why should he or his party be trusted? And, conversely, he clearly was for women and people of color. Of course the white masses resented being left behind. And why not?

As Bernie Sanders knows, but seems not to have said, policy cannot address social equity without also addressing economic equity: the masses will invariably regard both policies as coming from the same sources.

I have a friend who comments that the young white men she went to high school with felt entitled to decent jobs with decent pay without educational effort. She is contemptuous of them. But aren't decent jobs with decent pay a reasonable expectation? Isn't that what we ought to be aiming at for everyone who is willing and able to work? There will always be some people who feel they need someone to be above, and an egalitarian society cannot grant that; privilege must be earned, and cannot be permanent. That group will necessarily be resentful in an equal society. But if the majority loses ground they have common cause with that resentful faction.

The whole idea of "socially liberal and economically conservative” was, in the past few decades, translated to "raise up women and people of color, while doing nothing to maintain the lot of white men as their jobs and security were taken away." How could this fail to provoke resentment? If we are serious about egalitarianism, "everyone or no-one," how can we not, in our policy-making, consider moderating inequities of wealth and making sure that social gains in wealth are shared?

This is going to have to be thought on. I'm sure it can be attacked as a defense of white privilege. I would say, though, that rather than taking privilege away from white men, we ought instead to extend it to women and people of color. We cannot have an upper class without also having a lower class, and that must be forbidden, but we can see that everyone is fed, housed, and clothed, and that everyone has the freedom to live a full life.

On John Scalzi's Blog: An Overview of the Problem

(This was written in response to this post. I am reposting it here, partly so I have these links somewhere where I can find them again.)

I think looking at the proposals for advisers and formally-named cabinet secretaries gives ample reasons for terror. Now, it may be that the Senate will find reasons to reject some of secretary nominations, but I would not count on it. So if, for instance, Sen. Jeff Sessions becomes attorney general, goodbye to Federal civil rights enforcement. And what do we do if we get an anti-abortion Supreme Court majority?

The public response to the election of Trump is one of the most hopeful things I have seen, but it can be worn down by harassment. Just as in the fascist countries in the 1930s, It is likely to be hard to maintain opposition in the face of possibly violent harassment, and we will not be able to count on Federal support against our abusers.

The sheer corruption of the incoming administration, even before Trump is actually inaugurated, is astonishing; we are back to Warren Harding days with much larger amounts of money.

And, finally, the Koch Brothers connection is also troubling. Trump originally promised to protected Medicare and Social Security and is now promising to sign legislation dismantling them both.

BTW, Josh Marshall over at Talking Points Memo is all over this. Could do worse than to pay attention to him, at least before Trump sues TPM out of existence.

Some TPM links:
  Appointments —
    http://talkingpointsmemo.com/dc/trump-cabinet-spex
  Corruption —
    http://talkingpointsmemo.com/edblog/more-details-trump-macri-call
    https://talkingpointsmemo.com/edblog/the-corruption-will-be-endless
  Koch brothers influence —
   http://talkingpointsmemo.com/cafe/behind-make-america-great-the-koch-agenda-returns-with-a-vengeance

Allies in Defeat: A Call For Unity On the Left

Listen up you-all: the Democratic primaries are over: it is time to unify. We lost to Trump due to sexism, racism, bad press, and bad luck, but above all to sexism. If Sanders had been the candidate, we might instead have lost to the Republicans two-foot thick folder of opposition research on Sanders. The party and the candidates knew it: both made concessions to bring the Democratic Party together and, if it hadn't been for the appalling conduct of the press and malfeasance on the part of FBI director Comey, perhaps that would have been enough.

But now, both factions are acting like the cat who bites the vet. The vet isn't the cat's enemy, but the vet is in reach, so the cat is biting. Even more than before it is necessary for Americans to come together to oppose the fascists. So let's do it!

Sanders on Fascism and Party Unity

Sunday, October 21, 2016, Boston, Massachusetts:

“There is a lot of racism in this country. There is a lot of sexism, a lot of homophobia,” he said. “I don’t have to explain to anybody here the racist background of Mr. Trump … I don’t have to tell anybody here about the slurs, the awful things he has said about Mexicans … Muslim people … and obviously … his attitude towards women.”

Sanders urged his audience to unite in order to resist bigotry.

“When we bring millions of people together, here in the wealthiest country in the history of the world, when we do that, there is nothing we cannot accomplish,” he said, acknowledging cheers of affirmation from the audience.

Sanders highlighted the plight of the middle class in America, a problem he frequently spoke about on the campaign trail.

“For 40 years, the middle class of this country has been in decline,” he said. “You see enormous pain and confusion as to why the people on top make huge amounts of money, while the middle class continues to shrink, and 43 million Americans live in poverty.” — The Daily Free Press (Boston University)

Fascist Synergies

This election was won by sexism, racism, bad press, and bad luck, more-or-less in that order. This doesn’t mean that all Trump supporters were sexist and racist; many of them have not taken him at his word. But the sexists and racists tipped the balance, as well as the media sexism that made a woman’s minor failings seem major while ignoring the huge failings of a man.

But Trump…Trump is only part of the story here. The rest of the story is the brutal fairly-tale world of Mike Pence and Paul Ryan. Ryan, I think, imagines himself as St. John Galt; a combination of religious conservative and crazed individualist. But neither of these views relate to the real world. Pence seems to me one of these people who hides himself in religion. Reading his speeches, I am struck by the sheer intensity of his sexual fears, and am left wondering if he is a man intellectually crippled by child abuse.

What none of these people are doing is thinking realistically about consequences: they are doing what they feel is right. Trump is feeding his vast ego. Pence is assuaging his fears. Ryan is fulfilling his fantasies.

Put all of these together and — what? There seems no way to tell, except it is likely to be cruel, destructive, and expensive. And they are playing on a world stage, and in a physical world. We don't know how their various crazinesses will interact with the crazinesses of other countries, and we don't know how this will interact with growing environmental problems.

Bozhe moi!

It's the Sexism, Stupid!

I was involved in one of those interminable discussions of Why We Lost, wherein every pet theory is brought out. I don't buy into these. The loss was not by very large numbers; Trump didn't win by a landslide. There was a lot of luck and bad media involved.

And then I asked myself: what if Hillary Clinton had been male? What if it had been Harry Clinton rather than Hillary?

1. Harry Clinton would not have been blamed for his wife's sexual conduct.
2. Harry Clinton would have protected their e-mail privacy just the way W. Bush did. (Both Bush administrations used insecure servers and deleted millions of emails on the way out of office.)
3. Harry Clinton would have probably been complemented for their stern handling of events in Libya and Syria, and encouraged to do more.

And most likely, in an electoral contest with Donald Trump, Harry Clinton would have won.

Why did I not ask myself this question before the election?

F— the patriarchy.

Hillary Clinton is a better man than Donald Trump!

…and would Donald Trump's sexual conduct — the harassment, the alleged rapes — have been excused if she were Donna Trump?
(2016-11-27 changed the masculine version of Clinton's name to "Harry" from "Hilliard" for the sake of readability.)

New Senate Democratic Leadership

The first fight will be in the Senate over cabinet nominations. If the Democrats don't come out fighting, I think the Republicans will just roll over them. So in one corner we have…

Senate Minority Leader Schumer. The whip will be Durbin, and third-ranking is Patricia Murray from Washington State. Sanders and Manchin will have roles.

Schumer opposed Obama’s Iran deal.

Manchin (D-Coal): “If President-elect Trump comes with good policies, I’m going to be 1,000 percent behind him. Okay? Maybe the rest of my caucus will not, but I’m going to find a pathway forward,”

Murray is the Senator who made the budget deal with Paul Ryan which cut off unemployment insurance to families which direly needed it. One person I know lost theirs on their birthday and is still bitter about it.

Can someone find me some positives here, please? Except for Sanders, who is apparently relegated to a PR role, I don't think this lot is going to fight.

Trump: The Real Estate Developer As Chief Executive

A developer doesn't manage anything beyond their own organization. They make deals, arrange financing, design, and construction, and then move on. Once the developer is done, the responsibility for managing the project goes to the owner and their facilities manager. So, Trump. Who has never managed the on-going business of even one major building and is most likely deeply uninterested in the day-to-day operations of facilities management, which quite literally includes taking out the garbage, as well as other pleasant tasks like cleaning the floors and changing light bulbs.

Many of Trump's deals go sour; the properties go bankrupt and the owners and investors are left to take a loss. But Trump has moved on before they fail.

The work of the executive is mostly on-going management; implementing legislation that is developed in Congress. The Chief Executive also has a role as "head of state"--the visible symbol of the USA. Trump wants to be head of state, but he also has the job of chief executive. So I suppose he will shirk the job, leaving the Koch mouthpiece Mike Pence and his merry men to do the work, which they are not qualified for, and the Republican-led Congress to develop policy, which they also are not qualified for.

Is the Republic to end because of incompetence?

The Fate of the ACA in the Trump Administration

We now have Trump saying, “Trump told the Wall Street Journal in a Friday interview that he wants to keep the prohibition against insurers denying coverage because of patients pre-existing medical conditions, and allow children to stay on their parents’ health insurance plans until they’re 26.”

This will, of course, probably destroy the individual health insurance market, or at least make it very much more expensive. But the ACA is profitable for a wealthy industry, and this may protect it. When all is said and done we may be more likely to see modest changes to the ACA (I am guessing a relaxation of the MLR limits) and modest cuts to Medicare (or possibly a greater push for privatization), sold, respectively, as “repeal and replace” and “improvements/Obama’s fault.”

(Edited for clarity the following day.)

Narratives: What James Kwak Said

At the end of the day, we know that the “white working class” supported Trump much more strongly than it supported Romney, but we can’t tell from polling data if that was because of their judgments about Trump’s policies, their feelings about race, or their feelings about their economic status. In practice, different people in the same demographic group make political choices based on different combinations of those (and other) factors. I think it’s important to try to understand the relative importance and the interactions of these different motivations, and how those have shifted over time. But if there’s one thing I want you take away, it’s that you can’t answer these questions by looking at aggregate polling data—even though many people will try to do exactly that in the next few days. — Narratives

The Ammosexual and Misogynist Votes

(An earlier version of this was posted in comments [comment still in moderation] to Crooked Timber.)

Yesterday, elsenet, someone told me that Donald Trump’s sexual assaults were minor, and, besides, Trump had promised to protect “second-amendment rights.” And so, we have elevated a sex offender to the most powerful elected office in the world. I have been saying for years that there are very few things in current politics that are not, at least in part, influenced by masculinity doubts and this is a stunning confirmation of it.

Just how much did “second-amendment rights” argument influence the election, and how much sexism, not just in misogyny directed at Hillary Clinton, but in the forgiveness of Trump’s assaults?

This implies policy. First, of course, the feminist argument may reasonably be relied on. Why, during all the madness of this campaign, was the question “Would you leave your teenage daughter alone with Donald Trump?” not asked often? That reaches past the issues of policy to simple human basics and would sway many conservatives. But, second, we need to undertake to change popular thinking about firearms and lethal force, debunking the claim that the Second Amendment was intended as an unlimited firearms license. Rural people who genuinely depend on firearms must also be reassured that their firearms will not be taken away. I know a farmer who routinely defends her chickens from coyotes with a .22, so this is a very real issue for rural people.

We lost, at least in part, to misogyny and the desire of rural people to protect their families and property.

Now What?

Me, on Brexit: "If enough of these factions, all alike and all hating each other, come together the global economy will unravel. The networks of trade that make us a rich world, if not all of us rich people, will be dismantled and all nations will be the poorer for it. Refugees will be turned away to be crushed under brutal autocrats. Possibly shooting wars will follow." And here we are. Now what?

Vote. Vote! VOTE!

Your vote counts, and your political opponents know it. So make your voice heard!

Vote. Vote!

It is a curious fact that, even among the opponents of democracy, the vote is considered important. That is why there is so much effort to persuade people not to do it, to persuade people to vote for candidates who can't possibly win, to prop up splitter candidates, to make it difficult to get permission to vote, to revoke people's permission to vote, to lose people's permission to vote, to falsify the vote, to not count the vote, to claim the vote isn't valid. Your vote counts, and your political opponents know it. That's why they don't want you to do it.

And vote downticket, too! The Senate is up for grabs, and it makes a difference!

Vote.

It is a curious fact that, even among the opponents of democracy, the vote is considered important. That is why there is so much effort to persuade people not to do it, to persuade people to vote for candidates who can't possibly win, to prop up splitter candidates, to make it difficult to get permission to vote, to revoke people's permission to vote, to lose people's permission to vote, to falsify the vote, to not count the vote, to claim the vote isn't valid. Your vote counts, and your political opponents know it. That's why they don't want you to do it!

On the revelation that Melania Trump violated immigration law

Article at Talking Points Memo: Melania Trump Modeled in US Illegally Without Work Visa

I don’t expect an official response from the Clinton campaign, but Clinton will probably be asked, and I’m worried about the impact on voting. Clinton cannot say Melania deserves amnesty without losing votes. Clinton also cannot say “Deport Melania” without looking heartless. (Don’t underestimate the sympathy that Melania will get, just for her appearance.) So what ought Clinton say? This is such a mess of an election that this might even work to Trump’s advantage.