Posts Tagged ‘Krugman’

Brooks and Krugman

July 21, 2017

Bobo has just made an important discovery:  “Republicans Can’t Pass Bills.”  From his fainting couch, clutching his pearls, he tells us that the G.O.P. used to be willing to govern. Not now.  No shit, Sherlock.  “Gemli” from Boston will have a response.  Prof. Krugman, in “Health Care in a Time of Sabotage,” says Republicans are working hard to make Obamacare fail.  Here’s Bobo:

There are many different flavors of freedom. For example, there is freedom as capacity and freedom as detachment.

Freedom as capacity means supporting people so they have the ability to take advantage of life’s opportunities. You encourage your friend to stick with piano practice so he will have the freedom to really play. You support your child during high school so she will have the liberty to pick her favorite college.

Freedom as detachment is giving people space to do their own thing. It’s based on the belief that people flourish best when they are unimpeded as much as possible. Freedom as detachment is marked by absence — the absence of coercion, interference and obstacles.

Back when the Republican Party functioned as a governing party it embraced both styles of freedom, but gave legislative priority to freedom of capacity. Look at the Republicans’ major legislative accomplishments of the past 30 years. They used government to give people more capacities.

In 1990, George H.W. Bush signed the Americans With Disabilities Act, which gave disabled people more freedom to move about society. In 1996, Republicans passed and Bill Clinton signed a welfare reform law that tied benefits to work requirements so that recipients would develop the skills they need to succeed in the labor force. In 2003, Republicans passed a law giving Americans a new prescription drug benefit, which used market mechanisms to give them more control over how to use it.

These legislative accomplishments were about using government in positive ways to widen people’s options. They aimed at many of the same goals as Democrats — broader health coverage, lower poverty rates — but relied on less top-down mechanisms to get there.

Over the past few decades Republicans cast off the freedom-as-capacity tendency. They became, exclusively, the party of freedom as detachment. They became the Get Government Off My Back Party, the Leave Us Alone Coalition, the Drain the Swamp Party, the Don’t Tread on Me Party.

Philosophically you can embrace or detest this shift, but one thing is indisputable: It has been a legislative disaster. The Republican Party has not been able to pass a single important piece of domestic legislation under this philosophic rubric. Despite all the screaming and campaigns, all the government shutdown fiascos, the G.O.P. hasn’t been able to eliminate a single important program or reform a single important entitlement or agency.

Today, the G.O.P. is flirting with its most humiliating failure, the failure to pass a health reform bill, even though the party controls all the levers of power. Worse, Republicans have managed to destroy any semblance of a normal legislative process along the way.

There are many reasons Republicans have been failing as a governing party, but the primary one is intellectual. The freedom-as-detachment philosophy is a negative philosophy. It is about cutting back, not building.

A party operating under this philosophy is not going to spawn creative thinkers who come up with positive new ideas for how to help people. It’s not going to nurture policy entrepreneurs. It’s not going to respect ideas, period. This is not a party that’s going to produce a lot of modern-day versions of Jack Kemp.

Second, Republican voters may respond to the freedom-as-detachment rhetoric during campaigns. It feels satisfying to say that everything would be fine if only those stuck-up elites in Washington got out of the way. But operationally, most Republicans support freedom-as-capacity legislation.

If you’re a regular American, the main threat to your freedom is illness, family breakdown, social decay, technological disruption and globalization. If you’re being buffeted by massive forces beyond your control, you don’t want legislation that says: Guess what? You’re on your own!

The Republicans could have come up with a health bill that helps people cope with illness and nurtures their capacities, a bill that offers catastrophic care to the millions of American left out of Obamacare, or health savings accounts to encourage preventive care. Republicans could have been honest with the American people and said, “We’re proposing a bill that preserves Obamacare and tries to make it sustainable.” They could have touted some of the small reforms that are in fact buried in the Senate bill.

But this is the Drain the Swamp Party. The Republican centerpiece is: “We’re going to cut your Medicaid.”

So now we have a health care bill that everybody hates. It has a 17 percent approval rating. It has no sponsors, no hearings, no champions and no advocates. As usual, Republican legislators have got themselves into a position where they have to vote for a bill they all despise. And if you think G.O.P. dysfunction is bad now, wait until we get to the debt ceiling wrangle, the budget fight and the tax reform crackup.

Sure, Donald Trump is a boob, but that doesn’t explain why Republicans can’t govern from Capitol Hill. The answer is that we’re living at a time when the prospects for the middle class are in sharp decline. And Republicans offer nothing but negativity, detachment, absence and an ax.

And here’s what “gemli” has to say about that:

“It’s hard for Republicans to govern when their slogan is “Give us all of your money, because we would like to have it.” They don’t even say thank you. They’re having trouble passing health care reform because “You’ll be fine as long as you don’t get sick” is hard to package. It ranks right up there with “Vote for us, because you’re stupid.”

This last one plays remarkably well, given that it stuffed Congress full of Republicans and put a complete doofus in the White House.

When they’re not grubbing for money, they’re making national laws against things they find personally disgusting. “Gay people are icky” has been the driving force behind much of their legislation, second only to “Women’s plumbing confuses us.”

America’s infrastructure is due for an update. Not much has happened since FDR and the WPA, when the motto was something like “Building a stronger America.” I don’t want to say that Republicans have been neglectful in this regard, but now it’s “Walk gently across that bridge.”

They’re big fans of the Second Amendment, but somewhere along the way a directive to ensure a well-regulated militia became “Hold still, we want to shoot you.”

Some decry the fact that since the last election nothing seems to be getting done. Under the circumstances, I’d say that’s a very good thing. It’s why the Democrat’s new motto is, “Never again.””

Now here’s Prof. Krugman:

Is Trumpcare finally dead? Even now, it’s hard to be sure, especially given Republican moderates’ long track record of caving in to extremists at crucial moments. But it does look as if the frontal assault on the Affordable Care Act has failed.

And let’s be clear: The reason this assault failed wasn’t that Donald Trump did a poor selling job, or that Mitch McConnell mishandled the legislative strategy. Obamacare survived because it has worked — because it brought about a dramatic reduction in the number of Americans without health insurance, and voters didn’t and don’t want to lose those gains.

Unfortunately, some of those gains will probably be lost all the same: The number of uninsured Americans is likely to tick up over the next few years. So it’s important to say clearly, in advance, why this is about to happen. It won’t be because the Affordable Care Act is failing; it will be the result of Trump administration sabotage.

Some background here: Even the A.C.A.’s supporters have always acknowledged that it’s a bit of a Rube Goldberg device. The simplest way to ensure that people have access to essential health care is for the government to pay their bills directly, the way Medicare does for older Americans. But in 2010, when the A.C.A. was enacted, Medicare for all was politically out of reach.

What we got instead was a system with a number of moving parts. It’s not as complex as all that — once you understand the basic concept of the “three-legged stool” of regulations, mandates and subsidies, you’ve got most of it. But it has more failure points than, say, Medicare or Social Security.

Notably, people aren’t automatically signed up for coverage, so it matters a lot whether the officials running the system try to make it work, reaching out to potential beneficiaries to ensure that they know what’s available, while reminding currently healthy Americans that they are still legally required to sign up for coverage.

You can see this dependence on good intentions by looking at how health reform has played out at the state level. States that embraced the law fully, like California and Kentucky, made great progress in reducing the number of the uninsured; states that dragged their feet, like Tennessee, benefited far less. Or consider the problem of counties served by only one insurer; as a recent study noted, this problem is almost entirely limited to states with Republican governors.

But now the federal government itself is run by people who couldn’t repeal Obamacare, but would clearly still like to see it fail — if only to justify the repeated, dishonest claims, especially by the tweeter in chief himself, that it was already failing. Or to put it a bit differently, when Trump threatens to “let Obamacare fail,” what he’s really threatening is to make it fail.

On Wednesday The Times reported on three ways the Trump administration is, in effect, sabotaging the A.C.A. (my term, not The Times’s). First, the administration is weakening enforcement of the requirement that healthy people buy coverage. Second, it’s letting states impose onerous rules like work requirements on people seeking Medicaid. Third, it has backed off on advertising and outreach designed to let people know about options for coverage.

Actually, it has done more than back off. As reported by The Daily Beast, the Department of Health and Human Services has diverted funds appropriated by law for “consumer information and outreach” and used them instead to finance a social media propaganda campaign against the law that H.H.S. is supposed to be administering — a move, by the way, of dubious legality. Meanwhile, the department’s website, which used to offer helpful links for people seeking insurance, now sends viewers to denunciations of the A.C.A.

And there may be worse to come: Insurance companies, which are required by law to limit out-of-pocket expenses of low-income customers, are already raising premiums sharply because they’re worried about a possible cutoff of the crucial federal “cost-sharing reduction” subsidies that help them meet that requirement.

The truly amazing thing about these sabotage efforts is that they don’t serve any obvious purpose. They won’t save money — in fact, cutting off those subsidies, in particular, would probably end up costing taxpayers more money than keeping them. They’re unlikely to revive Trumpcare’s political prospects.

So this isn’t about policy, or even politics in the normal sense. It’s basically about spite: Trump and his allies may have suffered a humiliating political defeat, but at least they can make millions of other people suffer.

Can anything be done to protect Americans from this temper tantrum? In some cases, I believe, state governments can insulate their citizens from malfeasance at H.H.S. But the most important thing, surely, is to place the blame where it belongs. No, Mr. Trump, Obamacare isn’t failing; you are.

Krugman’s blog, 7/17/17

July 18, 2017

There was one post yesterday, “The Healthcare Debacle: The Roles of Ignorance and Evil:”

The important things to understand about the Republican health care bill are that it is (a) a cruel assault on the health and financial security of tens of millions of Americans (b) being sold via a campaign of lies that is unprecedented in US politics. Defeating this bill, and/or making its supporters pay a massive political price, is priority #1.

But there are a number of secondary questions, involving how Republicans got to this point. Some of these are big and long-term: how did a whole party succumb to such moral rot? Others are more tactical: how did they get into this immediate political mess?

So I was struck by today’s report in Politico suggesting that leading Republicans — in Congress as well as the Trump administration — thought repealing Obamacare would be quick and easy:

The longer Republican efforts to repeal Obamacare flounder, the clearer it becomes that President Donald Trump’s team and many in Congress dramatically underestimated the challenge of rolling back former President Barack Obama’s signature achievement.

The Trump transition team and other Republican leaders presumed that Congress would scrap Obamacare by President’s Day weekend in late February, according to three former Republican congressional aides and two current ones familiar with the administration’s efforts.

How could they have believed this? Anyone who paid the least attention to health issues knew that the ACA had dramatically reduced the number of uninsured, and that rolling it back would have devastating effects on many people — including many working-class whites. Never mind the morality: It should have been obvious that the political cost of repeal would be very high.

But apparently nobody with influence in the GOP saw the obvious. Why?

The answer, I think, is that they were living in a bubble created out of their own ignorance and cynicism.

They had spent years attacking Obamacare for things they had no intention of fixing — in fact, had every intention of making worse — like high deductibles. They appear never to have considered what would happen if they were called upon to deliver on their promises to make these things better.

They also appear to have been so wrapped up in their own propaganda that they never noticed the good Obamacare was doing. You saw that when the Indiana GOP asked for “Obamacare horror stories” and were flooded with testimonials instead.

Truly, Republicans, you know nothing. And it’s finally starting to matter.

 

Blow and Krugman

July 17, 2017

Mr. Blow says “Trump Savagely Mauls the Language,” and that listening to the president speak is a dizzying experience for anyone interested in candor, clarity or concision.  Prof. Krugman, in “Republicans Leap Into the Awful Known,” says the terrible truth about their health plans isn’t debatable.  Here’s Mr. Blow:

I know that there are things of graver consequence in Donald Trump’s regime than his diction, but as a person whose vocation concerns him with language, I am simply appalled by Trump’s savage mauling of that language.

His usage isn’t only idiosyncratic or some act of bungling idiocy, although it is surely both. But his usage is also a way of reducing language to the point that it is meaningless because the use of it is mindless, and in that compromised state, language becomes nearly worthless. As a consequence, truth becomes relative, if not altogether removed.

You see, Trump’s abuse of language isn’t simply a thing to blithely mock.

It is something with which we must all take great umbrage, because it has the power to degrade truth itself.

Yes, I could focus on the disastrous and callous Republican health care bill inching closer to a vote in the Senate.

Yes, I could use my energy and column inches to continue to catalog the thickening intrigue of the Russia investigation, and in particular, thegrowing number of people in the meeting where Donald Trump Jr., Jared Kushner and Paul Manafort met with a Russian lawyer.

The revelations keep coming, although Trump Jr., in an exchange with Fox News’s Sean Hannity last week, promised that what we knew at that time was “everything” there was to know. Either there is a new definition of “everything” of which I’m unaware, or Trump Jr. is doing what the Trumps do: lie until there is no alternative but to tell the truth, and even then only reveal as much truth as circumstances compel.

Trying to draw the truth out of these people is like trying to squeeze blood from a turnip — impossible.

I would submit that the Trumps lie in two ways: first, by directly and intentionally saying things they know well aren’t true, and second, by obfuscating with linguistic obtuseness, by overusing a nebulous relativism and by spouting an excess of superlatives to stand in for meaningful description and disclosure.

So, let’s take Trump’s responses during a press conference with President Emmanuel Macron of France last week. (By the way, that trip was marked by an embarrassingly pronounced inelegance by Trump, from the casual sexism of commenting on the French first lady’s bodyto the awkwardtestosterone-measuring handshakes.)

Trump has several verbal tics. One is that when he’s trying to flatter and finagle, everything is beautiful: countries, cities, people, bills, questions, even chocolate cake.

As The Washington Post pointed out last week:

“Beautiful” is one of President Trump’s favorite words. He’s used it at least 1,500 times on Twitter and in speeches since he began running for office, according to the database at Factbase. He uses it indiscriminately, the way a teenager might use ‘cool.’”

It is a device rather than a descriptor.

There was more: During the press conference with Macron, Trump twice referred to the 39-year-old Trump Jr. (who is the same age as the Macron, by the way) as a “young man.” That’s a stretch, but one used to make the Mini-Monster sound more innocent than his emails suggest he is.

At one point, Trump exclaimed: “France is America’s first and oldest ally. A lot of people don’t know that.” Actually, everyone who was awake in history class and reads books knows that. Alas, “a lot” is a relative term. More importantly, this is, I believe, projection, one of Trump’s compulsive traits. What he is guilty of is exactly what he accuses others of being guilty of. I would wager that Trump didn’t know that France was our oldest ally until preparing for this trip.

Trump complains endlessly about the media using anonymous sources, but Trump himself is addicted to anonymous sourcing, as demonstrated during the press conference. Trump discussed the Russian lawyer who met with his son:

“Somebody said that her visa or her passport to come into the country was approved by Attorney General Lynch. Now, maybe that’s wrong. I just heard that a little while ago. But a little surprised to hear that. So she was here because of Lynch.”

Who is “somebody”? Why are you repeating something at an official press conference with another head of state in another country that you freely admit may be wrong? And if you admit that it may be wrong, how can you state declaratively that “she was here because of Lynch”?

Trump also seemed to crack the door on revisiting his hugely reckless withdrawal from the Paris climate accord, but then added, “But we will talk about that over the coming period of time.” What does that mean? It means nothing, is what it means. It means, “I’m saying things amenable to the French while I’m in France because I’m like a chameleon: a lizard who can adjust his appearance for his environment.” That “coming period of time” will never come.

Listening to Trump speak is a dizzying experience for anyone interested in candor, clarity or concision. It’s as if he puts language through a meat grinder and what emerges is nearly unrecognizable, in either comprehension or certitude.

Covfefe.  Now here’s Prof. Krugman:

Sometime in the next few days the Congressional Budget Office will release its analysis of the latest version of the Republican health care plan. Senator Mitch McConnell is doing all he can to prevent a full assessment, for example by trying to keep the C.B.O. from scoring the Cruz provision, which would let insurers discriminate against people with pre-existing conditions. Nonetheless, everyone expects a grim prognosis.

As a result, White House aides are already attacking the C.B.O.’s credibility, announcing in advance that whatever it says will be “fake news.” So why should we believe the budget office, not the Trump administration? Let me count the ways.

First, this White House already has a record of constant, blatant lying about health care that is, as far as I can tell, without precedent in modern history. Just a few days ago, for example, Vice President Mike Pence made the completely false assertion that Ohio’s expansion of Medicaid led to a cutback in aid for the disabled — a lie that the state’s government had already refuted. On Sunday, Tom Price, the secretary of Health and Human Services, claimed that the Senate bill would cover more people than current law — another blatant lie. (You can’t cut hundreds of billions from Medicaid and insurance subsidies and expect coverage to grow!)

The point is that on this issue (and others, of course), the Trump administration and its allies have negative credibility: If they say something, the default assumption should be that they’re lying.

Second, the C.B.O. is hardly alone in its negative assessments of Republican health care plans. In fact, just about every group with knowledge of the issue has reached similar conclusions. In a joint letter, the two major insurance industry trade groups blasted the Cruz provision as “simply unworkable.” The American Academy of Actuaries says basically the same thing. AARP has condemned the bill, as has the American Medical Association.

Third, contrary to White House disinformation, the C.B.O. actually did a pretty good job of predicting the effects of the Affordable Care Act, especially when you bear in mind that the act was a leap into the unknown: We had very little experience of how an A.C.A.-type system would work.

True, the C.B.O. overestimated the number of people who would buy insurance on the exchanges the act created; but that was partly because it overestimated the number of employers who would drop coverage and send their workers to those exchanges. Overall gains in coverage have been reasonably well in line with what the C.B.O. projected — especially in states that expanded Medicaid and did their best to make the law work.

Finally — and this seems to me to be the most compelling argument of all — predicting the effects of destroying the A.C.A. is much easier than predicting the consequences when it was enacted, because what the Senate bill would do, pretty much, is return us to the bad old days. Or to put it another way, what McConnell and Senator Ted Cruz are selling is a giant leap into the known, taking us back to a system whose flaws are all too familiar from recent experience.

After all, before Obamacare, most states had more or less unregulated insurance markets, similar to those the Senate bill would create. Many of these states also had skimpy, underfunded Medicaid programs, which would be the effect of the bill’s brutal Medicaid cuts.

So while careful, nonpartisan modeling, the kind the C.B.O. excels in, is important, you don’t need a detailed analysis to know what American health care would look like if this bill passes. Basically, it would look like pre-A.C.A. Texas, where 26 percent of the nonelderly population was uninsured.

And lack of insurance wouldn’t be the only problem: Many people would have “junk insurance” — insurance with deductibles so large or coverage limitations so extensive as to be effectively useless when needed.

Now, some people might be satisfied with that outcome. Hard-core libertarians, for example, don’t believe making health care available to those who need it is a legitimate role of government; letting some citizens go bankrupt and/or die if they get sick is the price of freedom as they define it.

But Republicans have never made that case. Instead, at every stage of this political fight they have claimed to be doing exactly the opposite of what they’re actually doing: covering more people, making health care cheaper, protecting Americans with pre-existing conditions. We’re not talking about run-of-the-mill spin here; we’re talking about black is white, up is down, dishonesty so raw it’s practically surreal. This isn’t just an assault on health care, it’s an assault on truth itself.

Will this vileness prevail? Your guess is as good as mine about whether Mitch McConnell will hold on to the 50 senators he needs. But the mere possibility that this much cruelty, wrapped in this much fraudulence, might pass is a horrifying indictment of his party.

And you can bet your last dime that when the shit hits the fan with this thing the Democrats will be blamed.  It’s how the Republicans and their base (which is truly base) roll.

Krugman’s blog, 7/15/17

July 16, 2017

There was one post yesterday, “Ted Cruz’s Giant Leap Into the Known:”

When it comes to health care, there are lies, damned lies, and CBO-bashing.

Republicans are deploying all three strategies, with Mike Pence’s vile lie about the disabled – the utterly false claim that Medicaid expansion has actually hurt those most in need of help – drawing lots of justified outrage. But the really big push over the next couple of days will be the attempt to trash CBO estimates that are almost sure to show massive losses, even if the CBO is somehow prevented from considering the Cruz amendment.

One answer to this stuff is to notice that everyone, and I mean everyone, who knows something about insurance markets is declaring the same thing: that this proposed bill would be a disaster. We’ve got the insurance industry declaring it “simply unworkable”; the American Academy of Actuaries saying effectively the same thing; AARP up in arms; the Urban Institute forecasting disaster; and more.

But, say the usual suspects, CBO got the effects of the ACA all wrong. Actually, it didn’t. Yes, it overestimated the number of people who would sign up for the exchanges. But this was largely because it overestimated the number of employers who would drop coverage and send their workers to the exchanges. Overall, its estimates of coverage gains and premiums weren’t that far off, especially when you consider that this was a big leap into the unknown: aside from limited experience in Massachusetts, we didn’t have very good evidence on how an ACA-type system would work.

Which brings me to a point I haven’t seen emphasized: whereas the creation of the ACA was a leap into the unknown, Trumpcare – or maybe we should call it Cruzcare – is a leap into the known. Before the ACA, most states allowed insurers to discriminate based on medical history. Many also restricted access to Medicaid as much as they could. So we have a very good idea what health care in America would look like if the BCRA passes: it would look like health care in unregulated, low-aid states pre-ACA.

Or to not put too fine a point on it, it would look like health care in Texas circa 2010, with 26 percent of the nonelderly population uninsured.

So the burden of proof should lie completely with anyone who claims that this bill would NOT cause drastic coverage losses. It would establish a system very much like that which existed in those parts of America in which vast numbers of people lacked coverage in the past; why would this time be different?

 

Krugman’s blog, 7/14/17

July 15, 2017

There was one post yesterday, “The New Climate Of Treason:”

The title of this post comes from a once-famous book about the senior British officials who, it turned out, spied for Stalin. I found myself thinking about that book’s title while watching the conservative movement react to news that yes, the Trump campaign was in contact with Russian agents, and was willing, indeed eager, to engage in collusion.

With very few exceptions, this reaction has taken two forms: defining collusion down, or celebrating it. Some are arguing that saying “I love it!” when Russian agents offer damaging information about your opponent doesn’t count as collusion unless it’s sustained (which it might have been, by the way – we just don’t know yet), or unless it determined the election outcome. By that standard, of course, Kim Philby did nothing wrong, since the West ended up winning the Cold War.

Others are basically saying that cooperating with a foreign dictator is no big deal if it protects us against real threats, like universal health care.

The important thing to notice is that almost the entire conservative movement has bought into one or both of these arguments. After all the flag-waving, all the attacks on Democrats’ patriotism, essentially the whole GOP turns out to be OK with the moral equivalent of treason if it benefits their side in domestic politics. Which raises the question: what happened to these people?

One answer might be that right-wing ideology, the commitment to tax cuts for the rich and pain for the poor, has such a grip on conservative minds that nothing else matters. But while this is true for some apparatchiks, my guess is that it’s not nearly as true for many – certainly not for the Republican base in the general public. So why has partisanship become so extreme that it trumps patriotism?

Well, I have a thought inspired by something my CUNY colleague Branko Milanovic wrote recently about civil wars. Branko – who knows something about Yugoslavia! – argues against the view that civil wars are caused by deep divisions between populations who don’t know each other. The causation, he argues, goes the other way: when a civil war begins for whatever reason, that’s when the lines between the groups are drawn, and what may have been minor, fairly benign differences become irreconcilable gulfs.

My suggestion is that something like this happened to America, minus the mass bloodshed (so far, anyway.)

The radicalization of the GOP began as a top-down affair, driven by big-money interests that financed campaigns and think tanks, pushing the party to the right. But to win elections, the forces engaged in this push cynically appealed to darker impulses – racism first and foremost, but also culture war, anti-intellectualism, and so on. To make this appeal, they created a media establishment – Fox News, talk radio, and so on – which drew in many working-class whites. This meant that a large segment of the population was no longer hearing the same news – basically not experiencing the same account of reality – as the rest of us. So what had been real but not extreme differences became extreme differences in political outlook.

And political figures either adapted or were pushed out. There once were Republicans who would have reacted with horror to Trump’s embrace of Putin, but they’ve left the scene, or are no longer considered Republicans.

This has troubling implications for both the short and the long run. In the short run, it probably means that no matter how bad the Trump revelations get, most Republicans, both in the base and in Congress, will stick with him – because taking him down would be a victory for liberals, who are worse than anything.

In the long run, it makes you wonder whether and how we can get the country we used to be back. As Branko says, there was a time when Serbs and Croats seemed to get along fairly well, indeed intermarrying at a high rate. But could anyone now put Yugoslavia back together? At this rate, we’ll soon be asking the same question about America.

 

Krugman’s blog, 7/13/17

July 14, 2017

There was one post yesterday, “Takers and Fakers:”

While we wait to see exactly what’s in the latest version of the Senate health bill, a reminder: throughout the whole campaign against Obamacare, Republicans have been lying about their intentions.

Believe it or not, conservatives actually do have a more or less coherent vision of health care. It’s basically pure Ayn Rand: if you’re sick or poor, you’re on your own, and those who are more fortunate have no obligation to help. In fact, it’s immoral to demand that they help.

Specifically:

1.Health care, even the most essential care, is a privilege, not a right. If you can’t get insurance because you have a preexisting condition, because your income isn’t high enough, or both, too bad.

2.People who manage to get insurance through government aid, whether Medicaid, subsidies, or regulation and mandates that force healthy people to buy into a common risk pool, are “takers” exploiting the wealth creators, aka the rich.

3.Even for those who have insurance, it covers too much. Deductibles and copays should be much higher, to give people “skin in the game” and make them cost-conscious (even if they’re, um, unconscious.)

4.All of this applies to seniors as well as younger people. Medicare as we know it should be abolished, replaced with a voucher system that can be used to help pay for private policies – and funding will be steadily cut below currently projected levels, pushing people into high-deductible-and-copay private policies.

This is a coherent doctrine; it’s what conservative health care “experts” say when they aren’t running for public office, or closely connected to anyone who is. I think it’s a terrible doctrine – both cruel and wrong in practice, because buying health care isn’t and can’t be like buying furniture. Still, if Republicans had run on this platform and won, we’d have to admit that the public agrees.

But think of how Republicans have actually run against Obamacare. They’ve lambasted the law for not covering everyone, even though their fundamental philosophy is NOT to cover everyone, or accept any responsibility for the uninsured. They’ve denied that their massive cuts to Medicaid are actually cuts, pretending to care about the people they not-so-privately consider moochers. They’ve denounced Obamacare policies for having excessively high deductibles, when higher deductibles are at the core of their ideas about cost control. And they’ve accused Obamacare of raiding Medicare, a program they’ve been trying to kill since 1995.

In other words, their whole political strategy has been based on lies – not shading the truth, not spinning, but pretending to want exactly the opposite of what they actually want.

And this strategy was wildly successful, right up to the moment when Republicans finally got a chance to put their money – or actually your money – where their mouths were. The trouble they’re having therefore has nothing to do with tactics, or for that matter with Trump. It’s what happens when many years of complete fraudulence come up against reality.

 

Krugman, solo

July 14, 2017

In “The Cruelty and Fraudulence of Mitch McConnell’s Health Bill” Prof. Krugman says the latest Trumpcare bill still takes from the poor to give to the rich; it just does so with extra stealth.  Here he is:

A few days ago the tweeter in chief demanded that Congress enact “a beautiful new HealthCare bill” before it goes into recess. But now we’ve seen Mitch McConnell’s latest version of health “reform,” and “beautiful” is hardly the word for it. In fact, it’s surpassingly ugly, intellectually and morally. Previous iterations of Trumpcare were terrible, but this one is, incredibly, even worse.

Before I get to what makes it worse, let’s talk about the one piece of thenew bill that may sound like a step in the right direction, and why it’s largely a scam.

The original Senate bill got a lot of justified bad press for slashing Medicaid while offering big tax cuts for the rich. So this version rolls back some though by no means all of those tax cuts, which sounds like a concession to moderates.

At the same time, however, the bill would allow people to use tax-favored health savings accounts to pay insurance premiums. This effectively creates a big new tax shelter that mostly helps people with high incomes who (a) can afford to put a lot of money into such accounts and (b) face high marginal tax rates, and hence get big tax savings.

So this is still a bill that takes from the poor to give to the rich; it just does so with extra stealth.

Still, this tax shuffle does give McConnell a bit more money to play with. So how does he address the two big problems with the original bill — savage cuts to Medicaid and soaring premiums for older, less affluent workers? He doesn’t.

Aside from a few tweaks, those brutal Medicaid cuts are still part of the plan — and yes, they are cuts, despite desperate Republican attempts to pretend that they aren’t. The subsidy cuts that would send premiums soaring for millions are also still there.

The good stuff, such as it is, involves some new money for the opioid crisis, some (but not nearly enough) money for patients at especially high risk, and some additional aid for insurers — you know, the same thing Republicans denounced as outrageous corporate welfare when Democrats did it.

The most important change in the bill, however, is the way it would effectively gut protection for people with pre-existing medical conditions. The Affordable Care Act put minimum standards on the kinds of policies insurers were allowed to offer; the new Senate bill gives in to demands by Ted Cruz that insurers be allowed to offer skimpy plans that cover very little, with very high deductibles that would make them useless to most people.

The effects of this change would be disastrous. Don’t take my word for it: It’s what the insurers themselves say. In a special memo, AHIP, the insurance industry trade group, warned against adopting the Cruz proposal, which would “fracture and segment insurance markets into separate risk pools,” leading to “unstable health insurance markets” in which people with pre-existing conditions would lose coverage or have plans that were “far more expensive” than under Obamacare.

Or to put it another way, this bill would send insurance markets into a classic death spiral. Republicans have been predicting such a spiral for years, but keep being wrong: All indications are that Obamacare, despite having some real problems, is stabilizing, and doing pretty well in states that support it. But this bill would effectively sabotage all that progress.

And let’s be clear: Many of the victims of this sabotage would be members of the white working class, people who voted for Donald Trump in the belief that he really meant it when he promised that there would be no cuts to Medicaid and that everyone would get better, cheaper insurance. So why are Republican leaders pushing this? Why is there even a chance that it might become law?

The main answer, I’d argue, is that what would happen if this bill passes — a big decline in the number of Americans with health insurance, a sharp reduction in the quality of coverage for those who keep it — is what Republicans have wanted all along.

During the eight-year jihad against the Affordable Care Act, of course, the G.O.P. pretended otherwise: denouncing Obamacare for failing to cover everyone, attacking the high out-of-pocket expenses associated with many of its policies, and so on. But conservative ideology always denied the proposition that people are entitled to health care; the Republican elite considered and still considers people on Medicaid, in particular, “takers” who are effectively stealing from the deserving rich.

And the conservative view has always been that Americans have health insurance that is too good, that they should pay more in deductibles and co-pays, giving them “skin in the game,” and thus an incentive to control costs.

So what we’re seeing here is supposed to be the last act in a long con, the moment when the fraudsters cash in, and their victims discover how completely they’ve been fooled. The only question is whether they’ll really get away with it. We’ll find out very soon.

Krugman’s blog, 7/12/17

July 13, 2017

There was one post yesterday, “We Don’t Need No Education:”

A few days ago Pew reported that Republicans, who were already much less positive than Democrats about higher education, have turned very negative on the role of colleges in America. True to form, this worries some liberal commentators, who are calling for outreach – universities should examine their implicit biases, make an effort to hire more conservative faculty, etc..

And you can see the point. After all, among college professors 59 percent identify as Democrats versus only 13 percent as Republicans; senior faculty were even more liberal, with very few identifying themselves as conservatives.

Oh, wait – that wasn’t a survey of college professors; it was a 2004 survey of the military, and the 59-13 comparison was of Republicans versus Democrats. Support for Republicans in the military has eroded since then, but the officer corps is still far more conservative than the country at large. Strange to say, however, I haven’t seen a lot of op-eds demanding that the military change its recruiting practices and practice what amounts to affirmative action on behalf of liberals.

The point is that your political orientation isn’t something handed to you, like your race or ethnicity. It’s a choice, reflecting your values – and those same values are likely to influence your choice of profession, and possibly how well you perform in that profession. Is there discrimination against would-be academics who express conservative beliefs? I’m sure it happens, but it’s not the main reason conservatives are less likely than liberals to join the academy, just as discrimination against would-be officers with liberal views probably isn’t the main reason the military trends conservative.

But hasn’t the anti-conservative lean of academics gotten more pronounced over time? Yes – but surely that has a lot to do with the changing nature of what it means to be a conservative. When denial of climate change, and for that matter the theory of evolution, become tribal markers, you shouldn’t be surprised to find academics, very much including those in the hard sciences, decline to be identified as members of the tribe.

Which brings me to the abrupt decline in Republican views of colleges? What’s that about? Did the colleges get a lot more liberal? I doubt it.

But Republicans have changed in the age of Trump: what was already a strong strain of anti-intellectualism has become completely dominant. The notion that there was a golden age of conservative intellectuals is basically a myth. But there used to be at least some pretense of taking facts and hard thinking seriously. Now anyone pointing out awkward facts – immigrants haven’t brought a reign of terror, coal jobs can’t be brought back, Trump lost the popular vote – is the enemy. In fact, I’d argue that anti-intellectualism was, in its own way, as big a factor in the election as racism.

What this means for the future is grim. America basically invented the modern, educated society, leading the way on universal K-12 education, building the world’s finest and most comprehensive higher education system; this in turn was an important factor in how we became leader of the free world. Now a powerful political movement basically wants to make America ignorant again.

And oh, boy, howdy are they ever succeeding.

Krugman’s blog, 7/10/17

July 11, 2017

There was one post yesterday, “Formerly True Theories (Wonkish and Self-Indulgent)”:

Taking a break from health care, treason, and all that to read David Glasner on the price-specie-flow mechanism. The exposition of this mechanism by David Hume in his 1752 “Of the balance of trade“, was a landmark in the development of economics — arguably the first real economic model, making sense of the real world (and giving important policy guidance) via a simplified thought experiment, basically a model despite the absence of explicit math. Glasner argues, however, that it had ceased to be a good model by the 19th century due to the rise of fractional reserve banking and central bank discretion.

I think this critique may go both too far and not far enough. In systems where bank reserves still took the form of specie — and bank notes were backed by specie, as in the United States — a lot of the specie-flow mechanism remained in place for most of the 19th century. On the other hand, the simple link between trade balances and specie flows was broken by the rise of widespread capital mobility: when British investors were buying lots of US railroad bonds, we were no longer in Hume’s world.

But that doesn’t mean that Hume was wrong about *his* world. And reading Glasner made me think of a category of economic ideas that’s crucial, I’d argue, in making sense of part of the history of economic thought — the category of “formerly true” ideas. That is, ideas that were either good descriptions of the world the classical economists lived in, or had been good descriptions of the world just before the classicals wrote.

Pride of place here surely goes to Malthusian economics. You still see people saying flatly that Malthus was wrong. But over the roughly 60 centuries that have passed since civilization emerged in Mesopotamia, the Malthusian proposition — population pressure swallows up any gains in productivity, so that most people live on the edge of subsistence — was true for 58. It just so happens that the two centuries for which the proposition didn’t hold were the two centuries after Malthus wrote.

Actually, of course, this wasn’t an accident. Malthus didn’t kill Malthusian economics; but the rise of intellectual curiosity, of systematic hard thinking, of the scientific attitude, gave rise both to people like Malthus — who tried to approach economics in a recognizably modern manner — and to the dramatic acceleration of technological progress that took us out of the 58-century Malthusian trap.

Similarly, I don’t think there can be any doubt that something like Hume’s specie-flow mechanism did indeed operate through all of history from the first introduction of metallic money to sometime in the late 18th or early 19th century. How did Spanish silver end up fueling a rise in prices all across Europe? As Hume himself said, because silver raised Spanish prices, leading to trade deficits, and the silver flowed out to Spain’s trading partners.

Eventually, however, people — especially the Scots! — developed modern banking and learned to invest capital across borders. These commercial innovations were part of a general spirit of inquiry and innovation that produced, among other things, David Hume and Adam Smith.

Are there other examples? The self-correcting economy — in which unemployment leads to deflation, which increases the real money supply, and thus restores full employment — is another thing that probably did work for most of history, but began to fall apart as agrarian economies gave way to industrialized economies with less flexible prices. David Ricardo’s rejection of the possibility of demand shortfalls eventually turned out to be very wrong — and was surely already wrong in Britain by 1817 — but had been true in the past.

Is there a moral to this story? Maybe it is that things economic do change. By and large they change more slowly than many people think; understanding the 1930s was still immensely valuable to understanding the world after 2008. But economic “laws” — I generally hate that term — aren’t immutable, and good economists can be both right about the past and wrong for today.

I now return you to our regularly scheduled Trump coverage.

 

Krugman’s blog, 7/9/17

July 10, 2017

There was one post yesterday, “When Was The Golden Age Of Conservative Intellectuals?”:

A few days late, but a few thoughts on Bret Stephens’s columnabout the intellectual decline of conservatism. As you might guess, I agree completely with his take on the modern degeneracy of the movement. But Stephens harks back to a golden age of deep thought; and my question is, when was this age, exactly?

William F. Buckley is a problematic icon. Surely one needs to mention his spirited defense of white supremacy in the South, and National Review’s weird infatuation with Generalissimo Francisco Franco. I’d also note that while God and Man at Yale castigated my alma mater for its downgrading of religion, he seemed equally dismayed by the fact that it was teaching Keynesian economics — you know, the stuff that has been so thoroughly vindicated these past few years.

But leave that aside. When did conservatives have good ideas, and when did they stop? Let’s talk about four areas I know pretty well: macroeconomics, environment, health care, and inequality.

In macroeconomics, there’s no question that Milton Friedman and, initially, Robert Lucas performed a useful service by challenging the case for policy activism, especially fiscal activism. Circa 1976 the track record of Chicago macroeconomics was impressive indeed.

But then it all fell apart. Lucas-type models failed the test of eventsin the 1980s, while updated Keynesianism held up. Rather than admitting that they had overreached, however, conservative macroeconomists just dug themselves deeper into the rabbit hole — effectively turning their back on Friedman-style monetarism as well as Keynesianism. Vigorous monetary expansion to fight a deep slump, originally a conservative idea, became anathema on the right even as it was welcomed on the left. What was once a good conservative idea was incorporated by liberals while rejected by the right.

On environment, a similar turn took place a bit later. The use of markets and price incentives to fight pollution was, initially, a conservative idea condemned by some on the left. But liberals eventually took it on board — while cap-and-trade became a dirty word on the right. Crude slogans –Government bad! — plus subservience to corporate interests trumped analysis.

On health care, ObamaRomneycare — relying on mandates, regulation, and subsidies rather than a single-payer system — was, famously, a conservative idea developed at the Heritage Foundation. But liberals took it on board — pretty quickly, actually — while conservatives began denouncing their own side’s clever idea as evil incarnate.

Finally, on inequality, conservative intellectuals were terrible from the very beginning. I wrote a long piece in 1992 detailing their evasions and distortions, many of which remain unchanged to this day. It wasn’t just that they were wrong; as I wrote at the time,

the combination of mendacity and sheer incompetence displayed by the Wall Street Journal, the U.S. Treasury Department, and a number of supposed economic experts demonstrates something else: the extent of the moral and intellectual decline of American conservatism.

Remember, this was a quarter-century ago.

So when was the golden age of conservative intellectuals? Actually, there never was one. Certainly, the supposed era in which only conservatives had all the interesting ideas while liberals rehashed tired dogma never happened in any field I know well. That said, there was a period when conservatives contributed some useful stuff to the discourse. But that era ended a long, long time ago.