Relevant and even prescient commentary on news, politics and the economy.

Clinton Announces When She Will Disclose Her Healthcare Insurance Improvement Plan: She’ll announce it just as soon as the Republican presidential candidates tell us theirs. [Typo in sentence referencing Max Ehrenfreund’s Wonkblog post corrected 3/2 at 2:28 p.m.]

Paul Krugman has been incessantly complaining about some Sanders supporters who accuse him and other high-profile Sanders critics, especially academics, of conflict of interest. The Sanders supporters allege all manner of self-interested reasons for the Sanders animus, much of it (including Krugman’s) expressed with vitriol.

I’m not among the Sanders supporters who subscribe to the academics-who-want-a-position-in-the-Clinton-White-House general theory.  And making that charge against Krugman is ridiculous.  But there is one virulently anti-Sanders healthcare economist who I’m betting is motivated exactly by personal ambition: Emory University’s Kenneth Thorpe.*

Thorpe, a Clinton administration healthcare official, gets his Sanders’-single-payer-critique cred because he worked on the failed Vermont single-payer plan.  Just before it was about to begin being implemented last year, the governor, a supporter of the plan, agreed to kill it because it became clear that its costs would significantly exceed former projections.

Weirdly, the failure of the Vermont plan is used, by Thorpe and others, as evidence that single-payer could not be cost-effective nationally.  As if the tiny state of Vermont has the same contractual bargaining power, regulatory power, medical training funding power, and any other relevant power as the federal government has.

Thorpe recently made big news with a report that deconstructed the Sanders plan as little more than witchcraft in its cost savings and costs overall and in its costs to this or that entity—the federal government, the states, etc.  But in a January 29 response published at Huffington Post, two healthcare economists, David Himmelstein and Steffie Woolhandler—both with credentials at least as impressive as Thorpe’s—deconstructed the Thorpe deconstruction as, well, odd in light of certain facts.  Including several that Thorpe earlier had used.

Not to worry.  Thorpe last week came up with a new headline grabber, this one likely intended to respond to us Sanders supporters who think Sanders would do better in November against Trump than Clinton would.  (Or, it now seems likely, courtesy largely of elderly and middle-aged Southern African-Americans, will.)  It is an issue that this week has become red hot now that Trump is the probable Republican nominee.  And as of this week we Sanders supporters are no longer alone in thinking that Clinton is not quite the perfect candidate to compete against Trump.  According to the NYT, the Clinton campaign itself now shares our concern.

The Washington Post Wonkblog writer Max Ehrenfreund on February 25 summarized Thorpe’s headline grabber thusly:**

Sanders estimates a middle-class family of four would pay an annual premium of $466 under his plan, with no deductible or co-pays. Less affluent households would pay less than that, or nothing at all.

But for at least 72 percent of households enrolled in Medicaid — in which someone is working — the costs of Sanders’s plan would exceed the benefits, according to an analysis by Kenneth Thorpe, a public-health expert at Emory University.

That figure includes 5.7 million households, or 14.5 million people — among them, 4.2 million Hispanic recipients and 2.5 million black recipients. The requirements for eligibility for Medicaid vary widely by state, so that group includes some households living in poverty as well as some that are modestly better off.

How? Well:

“The vast majority of low-income Medicaid workers, who are probably predominantly minority, are going to end up paying more in terms of payroll taxes, and aren’t going to receive really any financial benefits,” said Thorpe, a former Clinton administration health official.

Many lower-income people are already insured or eligible for insurance under Medicaid, at least in the states that expanded the program under President Obama’s health-care reform. Many Medicaid beneficiaries also work, and those workers’ wages would likely decline due to the additional 6.2 percent payroll tax the proposal would levy on their employers.

The lengthy blog post is titled “Study: Bernie Sanders’s health plan is actually kind of a train wreck for the poor.”

That, presumably, is because of course Sanders could not, or at least would not, tweak the plan to remove the payroll tax for people who qualify for Medicaid under current federal law.  Because although the ACA is a very complex and very lengthy statute that took a year of drafting and amending to finalize, Sanders surely has thought of every possible issue and when that one came up he simply said, “Too bad.”

Sort of like Hillary Clinton, who regularly professes plans to build on Obamacare and move toward universal coverage for all—$10,000 deductibles?  No prob.—but who never hints at what her building plans are, and, curiously, is never asked.  Not by the likes of Thorpe or Krugman.  And not by the likes of anyone else I know of.

But she’s definitely working on a plan for that move-toward-universal-coverage thing, and, as with the release of the transcripts of her highly-compensated speeches to large finance-industry and other big-corporate players, she’ll give us a hint about how she plans to do that the very minute after the Republican presidential candidates outline their plans to move toward universal healthcare coverage.

Or instead, she could refer us to Thorpe.  Since he will again be a healthcare official in the Clinton administration.

*This entire paragraph was inadvertently deleted before the post was published. So now it’s back.  And the post makes sense!

____

UPDATE:  Reader J.Goodwin and I just exchanged these comments in the Comments thread:

J.Goodwin

March 1, 2016 6:08 pm

Is there a reason we should anticipate that it would be significantly different than the Health Security Act?

I.e. larger federal subsidies and a stronger employer mandate than the ACA?

 

Me

March 1, 2016 6:54 pm

I think it wouldn’t be anything at all, J.Goodwin. I think it’s outrageous of her to keep saying generically that she wants to build on the ACA without saying what she wants to do, yet criticize Sanders for his plan.

And I think it’s outrageous of the Hillary shillary economists brigade–Thorpe, but Krugman too, and probably others–for not mentioning that she has said nothing at all about what she has in mind, yet keeps saying she has, well, something in mind.

Then again, I don’t know why Sanders hasn’t pointed out that she’s taking a page out of the Republican playbook: just keep saying you plan to do something about the uninsured; just don’t say what that is.

Added 3/1 at 6:59 p.m.

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**Sentence edited and separated from preceding paragraph, to make sense. 3/2 at 2:19 p.m.

Gotta tell ya, Microsoft updated its Office 365 last week, and since then I’ve had nothing but big problems trying to write anything using Word.  With this post, two main parts were just missing from the post by the time I pasted it into AB’s new-post function. There was the mysteriously deleted paragraph that I reinserted last night, and there was a sentence between this now-edited one and the preceding paragraph, and they were two separate paragraphs, as they are now.

This post is not the only thing that the Word update has made very hard for me to write.  I am not happy about this, and do not look forward to calling Microsoft and having them FIX THE SETTINGS SO THAT I CAN USE WORD AGAIN.

Okay. Rant done.  Now back to trashing pols and economists.

I’m very grateful to Yves Smith for reposting this post at Naked Capitalism this morning, and I’ve now posted the following comment to the repost there:

POST SHOULD READ:

“… Not to worry.  Thorpe last week came up with a new headline grabber, this one likely intended to respond to us Sanders supporters who think Sanders would do better in November against Trump than Clinton would.  (Or, it now seems likely, courtesy largely of elderly and middle-aged Southern African-Americans, will.)  It is an issue that this week has become red hot now that Trump is the probable Republican nominee.  And as of this week we Sanders supporters are no longer alone in thinking that Clinton is not quite the perfect candidate to compete against Trump.  According to the NYT, the Clinton campaign itself now shares our concern.

“The Washington Post Wonkblog writer Max Ehrenfreund on February 25 summarized Thorpe’s headline grabber thusly:”

I just corrected the original post at Angry Bear and added a note at the bottom raging about Microsoft’s update to Office 365 that has caused big, big problems for me in drafting anything in Word.  In this case it mysteriously deleted an entire paragraph, which I reinserted last night, and also a sentence that had prefaced the one mentioning Ehrenfreund’s blog post and making clear that his post was about Thorpe’s latest attempt to take down Sanders’ healthcare plan, not about the Clinton campaign’s concerns about the strength of Trump’s candidacy and problems with her own.

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Democrats and Progressives need to accept the likelihood that their nominee will be facing Trump in November. And they need to seriously consider what that actually means. [Edited. Cringe-inducing cut-and-paste typo corrected**.]

— Clinton [at a CNN-sponsored town hall last night in South Carolina] promised to go hard after Wall Street. The former Secretary of State faced criticism in a different department: her failure to release transcripts of paid speeches given to Goldman Sachs. “Sure, I’ll do it if everybody else does,” the former Secretary demurred, circling back to a familiar refrain after being pressed by moderator Chris Cuomo. “But this is about whether I have the best plan to go after Wall Street,” she said. “Why is there one standard for me and not for everybody else?” [All boldface in original.]

— James Hohmann, the Washington Post’s PowerPost blog, today

Okay, you probably have figured out the answer to Clinton’s question all by yourselves: She, unlike, say, Marco Rubio, who wants Dodd-Frank repealed and replaced with no financial-industry regulation at all, and who wants also to eliminate the capital gains tax—completely eliminate it—is a Democrat who has proposed a detailed plan to regulate some aspects of the financial services industry but believes that nothing beyond the provisions in Dodd-Frank is necessary regarding actual banks.

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Paul Krugman Hits It Home [Updated]

And let me say that the great thing about a progressive agenda is that it doesn’t require big growth promises to make it work, because the elements of that agenda are good things in their own right. Conservatives need to promise miracles to justify policies whose direct effect is to comfort the comfortable (cutting taxes on the rich) and afflict the afflicted (slashing social insurance); progressives only need to defend themselves against the charge that doing good will somehow kill economic growth. It won’t, and that should be enough.

Realistic Growth Prospects, Paul Krugman, today

You. Go. Guy!

All is forgiven.  Eh.  Almost all.

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I finally agree with (much of) a Krugman criticism of the Sanders campaign. (And why I’m glad he made the criticism in the way he did.) [Clarification added 2/20 at 11:05 a.m.; update added 2/21 at 9:40 a.m.]

Bernie Sanders hates the Supreme Court’s decision in Citizens United v. FEC, which held that corporations have a First Amendment right to spend unlimited sums advocating for their preferred candidate. Who doesn’t? Citizens United was a deeply misguided decision that vastly underestimated the state’s compelling interest in preventing the appearance of corruption that massive corporate electioneering inevitably creates. An overwhelming supermajority of Americans despise the decision and wish to see it overturned. That includes most Democrats—which is probably why Sanders recently tweeted a guarantee that his Supreme Court nominees “will make overturning Citizens United one of their first decisions.”

Bernie Sanders Has No Idea How the Supreme Court Works, Mark Joseph Stern, Slate, Jan. 22

Okay. As an obsessive Bernie Sanders supporter, and as someone who knows that Supreme Court justices cannot make overturning Citizens United one of their first decisions simply because they want to, I cringed.  To understate it.  There are certain prerequisites to overturning Citizens United: specifically, an existing state or federal campaign-finance law that conflicts with the holding in Citizens United, and a legal challenge to the statute’s constitutionality that has been decided by a federal trial court and then by a federal appeals court, and then then a filed “cert.” petition asking the Supreme Court to agree to hear the case.

Granted, something not all that different than what that tweet proposed did happen in none other than Citizens United, but at least there was an actual statute in existence—McCain-Feingold—which they could, and most of which they did, pronounce unconstitutional.*  (In a follow-up case, they pronounced most of the rest of it unconstitutional.)

But I also knew that Bernie Sanders himself knows this, and that he was not the one who published that tweet.  Some 20-something member of his communications staff did.  I gritted my teeth and said to myself something like: “Okay, Sanders’ campaign manager, Jeff Weaver, has a law degree from Georgetown.  Sanders should order that no tweets or other communications on technical legal issues—or on legal-related things that involve legal technicalities, even his 20-something communications staff doesn’t recognize that it does–ever again be published without approval from Weaver.  Or someone else who has some actual knowledge of actual legal procedure and such.

There are, in other words, certain subjects that plainly require expertise—sometimes extensive expertise—before a statement about them is made. Supreme Court jurisdiction is one of them.  And obviously, macroeconomics is another.

Okay, well, by now y’all know about the controversy concerning a report by UMass-Amherst economist Gerald Friedman, commissioned by the Sanders campaign, that apparently is so of a mirror image of the macroeconomic claims of Arthur Laffer to Ronald Reagan, and Ronald Reagan, George W. Bush, Mitt Romney, Jeb! Bush, Marco Rubio, Ted Cruz, etc., to the public.  In this case the claim is that Sanders’ economic-policy proposals will produce something along the lines of 5.3% annual GDP growth, an unemployment rate of less than 4%, and a significant increase in the labor-participation rate (notwithstanding the aging of this country’s population).  You’ve read Krugman’s blog posts about it and you’ve read his column today. Or many one of the other excoriating commentaries about it as well.  Or maybe Krugman’s and some others’.

The growth and unemployment rates apparently are theoretically possible, so it is not quite the mirror image of Laffer economics.  But also apparently, historically it is extremely unlikely.

No one has ever accused me of being an economist, man, but I’ve read enough Paul Krugman blog posts and columns, and AB posts, over the years—including Krugman’s repeated mockery of Jeb!’s promise of 4% GDP growth annually within the last year—for Friedman’s conclusions to raise series questions of accuracy, even to this novice.  Yet Sanders’ campaign began trumpeting the report.

This creates three huge problems, perhaps the most important of which Krugman flags: that if Democrats start pushing voodoo economic theories, they give away a fundamental part of their raison d’être.  The Republicans push voodoo (or highly implausible) economic theories; the Democrats do not.

I’ve argued that a big, big reason why I think Sanders would be a stronger general-election candidate than Clinton is that there is so very much that the Dem candidate should argue against, say, Rubio or Bush or Cruz that would as a practical matter be unavailable to Hillary Clinton to actually argue, but that are at the very center of Sanders’ campaign and Sanders’ appeal. And now suddenly, there is this wrench that’s been thrown into this.

Another huge problem is how extremely easy it is to conflate this issue with the incessant claims—by Clinton, by Krugman, by the Washington Post editorial board, by the Washington Post centrist-left and centrist-right columnists, etc., etc.—that Sanders’ high-profile substantive policy proposals (e.g., Medicare-for-all; tuition-free public colleges and universities) are financially unworkable. These are entirely distinct issues.  Yet just the headlines on some of these stories, which is all that many people will read, makes this conflation very easy.  Some mainstream-media political journalists (inexplicably) are doing it in their articles or blog posts about it.

But counterintuitively, I think Krugman’s column, which identifies and explains the actual issue, will help make clear the distinction.

And then there is this: If Sanders does, as I dearly hope, become the next president, his administration’s economic success will be judged against this.  A 3.5% annual growth in GDP, for example, will be called a broken promise.

But I disagree with Krugman’s political assessment that this indicates that the Sanders campaign and maybe the candidate himself are not ready for primetime.

If not nipped in the bud—repudiated very soon by Sanders himself—his campaign success could begin unraveling; that is true enough.  But every modern presidential campaign makes mistakes, some of them major ones, and the Sanders campaign, unlike the Clinton campaign, is not well stocked with presidential-campaign veterans.  Weaver himself is a novice.

And Sanders and Weaver are navigating a 20-ring circus right now, with several campaign appearances of one sort or another every single day. They both must be exhausted.

What Sanders needs to do—seriously needs to do—is to determine the types of published things ostensibly by Sanders himself (tweets, for example) and by his communications staff are fine for them to publish on their own, and the types of things that are not. Law things, not. Macroeconomics things, not.

For law things, there needs to be a designated person with actual knowledge of law things.  For macroeconomic things, there needs to more than one.  Nothing—nothing—should be published about macroeconomics without prior review by more than one macroeconomist.

I absolutely get the Sanders campaign’s frustration with the incessant torrent of uses of the word “SOCIALIST” to misrepresent Sanders’ actual policy positions.  I share the frustration.  But the way to handle it is to do what Sanders had been doing: Pointing out the capitalist, entrepreneurial success of countries such a Canada, Denmark, Sweden, Germany and … Australia (which has universal healthcare coverage!).

And pointing out that this country’s most entrepreneurial period was the post-WWII period, with tax rates higher than anything Sanders is proposing. A period of organized-labor strength.  Of Glass-Steagall separation of traditional banking and investment banking.  And of aggressive enforcement of antitrust laws and securities laws. And, in 1967, the start of Medicare.

An addition to this torrent came earlier this week from another high-profile Friedman, New York Times columnist and aggressive-centrist Thomas Friedman, who wrote:

Bernie Sanders shows zero interest in entrepreneurship and says the Wall Street banks that provide capital to risk-takers are involved in “fraud.” …

I’d take Sanders more seriously if he would stop bleating about breaking up the big banks and instead breathed life into what really matters for jobs: nurturing more entrepreneurs and starter-uppers. I never hear Sanders talk about where employees come from. They come from employers — risk-takers, people ready to take a second mortgage to start a business. If you want more employees, you need more employers, not just government stimulus.

Apparently he’s been reading too many Washington Post centrist-right and centrist-left columnist columns.  Or else he concluded on his own that such things as breaking up the big banks, or for that matter government stimulus, has nothing at all to do with what really matters for jobs: nurturing more entrepreneurs and starter-uppers.

He is, though, certainly right that these days, if you want more employees, you need more employers.  The large, current employers plow most of their profits into stock dividends and stock buybacks, not into hiring more employees and not into upgrades of such things as manufacturing plants.  The ones here in the States, anyway.

But about the risk-takers whom I’m betting he really has in mind—his wife’s father and uncle, who during the postwar period began one of the first shopping-mall development companies and grew it into the very largest, turning their relatively small family collectively into multibillionaires before the collapse of the shopping-mall real estate business because of online shopping (the family still is extremely wealthy, but not nearly to the extent that it was).

Sanders is in fact the most pro-entrepreneurial of the presidential candidates in either party. He combines Theodore Roosevelt’s antitrust vigor with Franklin Roosevelt’s New Deal regulation of the financial services and securities industries, and FDR’s and Dwight Eisenhower’s massive building programs, mainly in major infrastructure projects.

What the centrist crowd doesn’t understand, or pretends not to, is that just as in Teddy Roosevelt’s day, there are critical conflicts between the interests of entrepreneurs (current and would-be) and ongoing small-businesses, on the one hand, and large corporations (especially certain types of large corporations), on the other.  One of my favorite examples is what is known as the Durbin Amendment, which pitted the interests of Visa and Mastercard against small retail businesses.  The Democratic Congress pushed it through. The nature of the charges at issue made it especially difficult for small retailers to compete with large ones. Walmart lost on that one; Mom and Pop won.

As for business loans and home mortgages, Friedman, who neither has a home mortgage nor a small business, may not be aware that the very size of the megabanks makes it ever harder for small local banks of the type that surely funded his in-laws’ startup in Marshall, Iowa back in the ‘50s, to remain in business.  The megabanks, like Walmart, set market prices. And pretty much everything else.

And the collapse of antitrust enforcement has had an enormous effect not merely on direct competition but also on small manufactures in the supply chain of large ones.  The fewer the buyers of the type of part manufactured by the small manufacturer, the less bargaining power the small manufacturer has in order simply to stay in business.

Sanders and his campaign need to bring the conversation back to where it was before this Gerald Friedman debacle.

And I need to end this very long post.

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*Sentence edited slightly for clarity and precision. 2/19 at 8:57 p.m.

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CLARIFICATION: Reader EMichael and I exchanged these comments this morning in the Comments thread:

EMichael

February 20, 2016 9:25 am

Bev,

It is the unforced errors of the Sanders’ campaign that scares me. Perhaps it is simply, as you state, that there are not enough knowledgeable people working for the campaign and that those who are capable are simply exhausted. Kind of scary when there are still nine months before the election. If Sanders wins the nomination, how can the campaign pick up capable people to stop these kind of errors?

 

Me

February 20, 2016 10:08 am

EMichael, every major presidential campaign makes unforced errors, and the Sanders campaign is chock full of competent people. Clinton’s campaign has made a slew of them.

It’s just that there are some policy areas that require some real expertise in before a statement that has the potential to get a key thing wrong (e.g., the Citizens United tweet) or that requires expertise to evaluate (e.g., macroeconomics projections).

I plan to post a follow-up to this post clarifying some things and making the point that it now appears that Krugman way overblew what the Sanders campaign actually did, which was that its policy director mentioned the Friedman study and praised it as outstanding work. That was all.

But this key point I was trying to make is still valid: that while it is necessary for the Sanders campaign to refute the Sanders-will-kill-entrepreneurship-in-this-country-and-destroy-the-banking-system-and-kill-all-the-apple-trees-in-order-to-keep-Americans-from-making-apple-pie slurs, he should keep the focus of his campaign on his policy proposals and their benefits for their own sake. This macroeconomics controversy has been a big distraction, and–as I said in the post–is one that is far too easy for my comfort to conflate with the issue of the cost of his policy proposals.

The link I included in my comment is to an article on Salon by Elias Isquith, detailing what prompted the controversy and rebutting Krugman’s political argument.

Several other readers in the Comments thread supplied important links, among them: to James Galbraith’s two-page letter to Krueger, Goolsbee, Romer and Tyson deconstructing their high-profile letter that has played such a large role in the controversy; and to an article by David Dayen in the New Republic rebutting Krugman’s political argument.

On second thought I think I’ll just let this Clarification suffice rather than post a separate follow-up post.  I’m tired of this subject.

Added 2/10 at 11:05 a.m.

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UPDATE: An exchange between reader Urban Legend and me in the Comments thread this morning:

Urban Legend

February 21, 2016 2:49 am

I am strongly pro-Clinton in the primaries, but Galbraith’s letter seems absolutely unassailable. Nothing justified this assault by Krugman and the others except their feeling that their credibility is undermined because of their giggling at the Bush et al projections. Somehow, the difference between massive stimulus and increasing regressive tax policies — differences they themselves have emphasized for years — escaped them.

 

Me

February 21, 2016 9:29 am

Urban, that struck me, too, when I read the Galbraith article: Somehow, the difference between massive stimulus and increasing regressive tax policies — differences they themselves have emphasized for years — escaped them.

There is still the (I would think) obvious problem that apparently Friedman didn’t take into account: the ageing of this country’s population in considering projected increase in labor participation. And there probably are other things that he didn’t consider that should have been considered.

And the main point of my point–or at least the intended main point–holds and is important: on subjects that require some technical expertise or special knowledge, it is really important that Sanders have someone with the expertise or special knowledge screen what his campaign is about to say about it.

But Krugman and the others themselves mislead in this.

This is it for me on this subject.

Added 2/21 at 9:40 a.m.

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Two Must-Read Columns in the NYT Today

Nicholas Kristof’s and Linda Greenhouse’s.  They’re on different subjects but, in my opinion, part and parcel of the same thing.

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ADDENDUM: Reader Sandi and I exchanged these comments in the Comments thread here this morning:

Sandi

February 19, 2016 9:03 am

One way Kristoff didn’t mention that amasses huge fortunes is our tax laws, as pertains to inheritance.

It’s beyond obscene that not only are families like the Scaifes and Kochs able to set up trusts to pass the loot to their kids, that, are structured so that after a few years of giving the proceeds of the trust to charity, the kids then get the whole enchilada with no inheritance or gift tax consequences.

The really brilliant bit is using that generated cash to set up 501(c)(3) and 501(c)(4)s to further your political agenda, much of which is to keep the tax laws bent in your direction……………
Power is great, but anonymous power really keeps your enemies on their toes. They never know where you’ll strike from next.

 

Me

February 19, 2016 9:57 am

Sandi, it absolutely dismays me that the news media and the Republican Establishment think Rubio could beat Clinton or Sanders. The two seminal parts of Rubio’s tax plan are to end the capital gains tax and end the estate tax.

The public, of course, doesn’t yet know this, and it does not occur to the media and Republican Establishment folks that once they learn of it Rubio couldn’t defeat a monkey in the general election.

Yet they all—the pundits of all ideological stripes—keep saying that Sanders’ current strength against the Republican candidates in polls pitting them against Sanders and against Clinton don’t mean much this early, yet the polls showing Rubio’s strength do. But the key thing that supposedly makes Sanders unelectable—that he’s a SOCIALIST—is actually the thing that virtually everyone who’s heard of him knows. Yet the key thing that actually would make Rubio unelectable—his tax plan—has yet to break through to most of the public. Literally; it’s extremely likely that almost no one knows of it.

I’ll add here that it is to Paul Krugman’s tremendous credit that he keeps making that point about Rubio.

Added 1/19 at 10:14 a.m.

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Sighhhh. [Addendum added.]

Sarah Kliff has a very helpful account of Vermont’s attempt to create a state-level single-payer health care system, and why it failed. It’s a bit like the old joke about the farmer, asked for directions, who says “Well, I wouldn’t start from here.”

The point is not that single-payer is a bad idea. It is that given where the U.S. is now, achieving the kind of low costs we see in other countries would involve imposing large losses on many stakeholders, including people with generous policies, health care providers, and more — which is the point I’ve been making. The gains would almost surely be bigger than the losses, but that’s not going to make the very hard politics go away.

— Paul Krugman, Lessons From Vermont, today

I don’t have time right now to read Kliff’s piece, so I don’t know whether she, like Krugman, says that Sanders’ single-payer plan precludes the purchase by employers for their employees, or by individuals, of separate, private-insurer, supplemental policies?

Medicare-for-all means Medicare for all.  Or something close enough to it to allow separate, private-insurer, supplemental policies.  Just like real Medicare does!

As an aside, I do wish Krugman would address the candidate he champions’ campaign tactics, especially regarding healthcare insurance but also about … well … things.

Gotta run.

—-

ADDENDUM: By Noni Mausa in the Comments thread:

Noni Mausa / January 20, 2016 6:59 pm

Canada here. I had a good professional job for 20 years, which included a generous supplemental health policy. Having been retired for 15 years (!) that means that for at least 35 years public and private coverage have rolled along smoothly side by side here.

Still haven’t read the Kliff piece.  But, for the life of me, I don’t understand the basis of this claim that Sanders’ single-payer proposal precludes the availability of supplemental healthcare policies. Or precludes employers from providing them as benefits.  Or whatever these folks are saying.

It sounds like a classic canard, to me.

 

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Clinton’s Bizarre Attack on Her Husband’s 1992 Credentials to Be Elected Commander in Chief

The Clinton campaign is set to air this new, minute-long ad in Iowa and New Hampshire that has the feel of a closing argument: [picture from ad of a very solemn-faced Secretary of State Clinton standing next to Obama at the funeral of a fallen soldier or marine, and a link to the ad.]

— Greg Sargent, The Washington Post, this morning

Sargent goes on to say:

The ad makes the case that Clinton is the only Democratic candidate who has the fight, gravitas, and multi-faceted experience to handle both international crises and domestic economic challenges. The new spot has echoes of the infamous 3 A.M. ad that Clinton ran against Barack Obama in 2008, which argued that when your children are sleeping and a crisis is unfolding, the person you want in the White House is someone as experienced as Clinton.

But Clinton’s new ad is both less of an attack and also goes a bit farther. It is both an argument for Clinton’s fitness as commander in chief and an electability argument, in the sense that it suggests that only a candidate with this fleshed out a profile can win in November.

Good heavens.  This is someone whose husband was elected president in 1992 with government experience only as governor of Arkansas, against a sitting president who also attended military funerals, in his capacity as Commander in Chief, and who was a former CIA chief.

This attack is really dumb.

Clinton continues to run a really awful campaign, in my opinion—a campaign in which she’s spent the last few months adopting Republican talking points and making bald misrepresentations about Sanders’ policy positions, past and present, via strange sleights of hand or outright misstatement.

After taking a five-week hiatus from posting here at AB, I’ve posted a series of posts on the campaign in the last week, the most recent one titled “The little problem with Clinton’s message that Krugman doesn’t mention in his critique of Clinton and Sanders today: Her incessant claim that only taxes bears negatively against “incomes”.  The post was hastily written (I had only a few minutes to throw it together yesterday), and I’ve now edited it and added an addendum, which says:

Here in sum is the point: Clinton says that the only thing that matters to people’s bottom line is the amount of taxes they pay.

Which apparently is largely true for the wealthy, but is hardly true for the middle class and so-called working class–whose financial bottom line, financial security and standard of living is impacted tremendously by such things as healthcare insurance premiums, whether paid to the government or instead to a private company, and out-of-pocket payments to hospitals, medical labs and physicians.

That’s was so enrages me. Clinton claims by that soundbite of hers that all that matters is “income,” not income minus such things as private-healthcare-insurance premiums and out-of-pocket payments for health care.

That post was a follow-up to this one posted on Monday, titled “Why Do So Many Wealthy Democrats Think The Only Money That Matters To The Hoi Polloi Is The Money They Must Pay To The Government?

Which itself was in part a follow-up to one I posted on Sunday shortly before the debate, titled “Pre-Debate Contest: Guess which one of Sanders’ past or present policy positions or legislation he supported that Clinton will misrepresent most outlandishly tonight.

You get the idea.

Clinton certainly is qualified to become Commander in Chief. And as someone who is slightly more hawkish than Bernie Sanders, whose candidate I support obsessively, I think she would make a good one.  But I also think Bernie Sanders would make a good one.  Just as I think Bill Clinton made a good one.

The problem with Clinton’s campaign in part concerns the substance of her proposals vis-à-vis the substance of most of Sanders’, but she certainly is entitled to make her arguments on those, as long as she does not use Republican slogans to make them, and as long as she does not misstate Sanders’ past and present policy proposals.  Least of all, habitually.  And she does both of these things habitually; they’re mainstays of her campaign.

I’ve covered these points in the posts I link to, and I don’t have time right now to further elaborate anyway.  But if Clinton becomes the nominee, I dearly hope will somehow learn of my posts here at AB and take to heart what they say, because they will be pertinent to general election campaign, just as they are to her primary campaign.

Hey, maybe she’ll ditch her campaign consultants and replace them with … me!  I’d be wayyy better.  And I’m much cheaper.

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The little problem with Clinton’s message that Krugman doesn’t mention in his critique of Clinton and Sanders today: Her incessant claim that only taxes bears negatively against “incomes”. [Edited and typo-corrected. 1/20 at 11:34 a.m. Addendum added 1/20 at 11:50 a.m.]

[T]there are serious questions about how we’re going to pay for what we want to see our country do. And, I’m the only candidate standing here tonight who has said I will not raise taxes on the middle class. I want to raise incomes, not taxes, and I’m going to do everything I can to make sure that the wealthy pay for debt free tuition, for child care, for paid family leave. To help us bring down student debt we’re going to refinance that student debt, saving kids thousands of dollars.

Yeah, and that will also come out of the — some of the pockets of people in the financial services industry…

— Hillary Clinton, during Sunday night’s debate

Yep.  She wants to raise incomes, not taxes.  Because all that matters to the financial bottom line of ordinary folk is taxes.  Or so ordinary folk think, cuz they can’t do simple math computations and don’t own calculators that do that.

Or so wealthy Democrats like Clinton, her army of campaign consultants, and Paul Krugman think.

In a blog post this morning critiquing Clinton politically strategically and Sanders substantively, Paul Krugman diagnoses Clinton’s main political problem as against Sanders this way:

[Clinton’s] biggest vice, from my point of view, is listening too much to consultants who want to make cheap shots, like the claim that the Sanders plan would kill Medicaid, when her real strength comes when she lets her inner wonk and fundamental toughness shine through.

Krugman hits Sanders as dishonest for making claims of massive savings in healthcare expenditures in his single-payer plan.  Fair enough—and I dearly wish Sanders would read this post of mine from this morning on healthcare expenditure issues.  (Yes.  My post on this subject.  It’s a good post.  Really.  It mentions Uwe Reinhart!  Who now will post something somewhere on the Supreme Court, in retaliation.*)

But does he think Clinton will actually be able to pay for what she proposes by taxing only the wealthy?  Just wonderin’.

Far more important, though, does he actually think it’s a terrific idea for Clinton to use as a campaign mantra that raising incomes for the non-wealthy and raising taxes on the non-wealthy are mutually exclusive, thus defining “incomes” in a remarkably crimped way?

Why does he think Clinton should claim that, say, healthcare premiums and out-of-pocket healthcare expenditures don’t effect “income” in any but the narrowest sense if those payments are made not to the federal government (horrors!) but instead to UnitedHealthcare, Anthem Blue Cross, hospitals, medical labs, and physicians?

Depends on what the meaning of “incomes” is.  Y’know?

Krugman is exactly right that Clinton is listening too much to consultants who want to make cheap shots, like the claim that the Sanders plan would kill Medicaid.  Actually, though, she should stop listening to political consultants at all.  It doesn’t instill confidence in her abilities as a candidate or officeholder that she mouths imbecilic and easily-verifiably false soundbites proposed by these political consultants.

Or did she actually expect that voters would assume she was correct that Denmark is not a capitalist country and that it has low levels of innovation and a low standard of living?  And that Bernie Sanders wants to remove healthcare coverage from huge swaths of people—or from anyone, for that matter, because universal healthcare coverage means universal for almost no one.

Depends on what the meaning of “universal” is, I guess.  According to Clinton, her daughter, and her campaign, anyway.

It also depends on the meaning of weird. This falls comfortably within that definition.** But a campaign consultant said this was a terrific way to counteract Sanders.  Because …. um …. who knows? Reason enough for Clinton to run with it.

Same with the Republican-governors-could-kill-single-payer-so-I’m-supporting-Obamacare-whose-marketplaces-provision-works-vis-à-vis-the-states-exactly-like-the-2013-Sanders-bill-would.  Nothing—no issue, no matter—is too important for Clinton to profoundly mislead about it. She isn’t paying all those consultants those huge fees for nothin’, you know. She’s gonna get her money’s worth.

Live by the sleight-of-hand, die by the sleight-of-hand.  Or at least because of the sleight-of-hand: you’re own.  At least if your opponent is now, finally, getting real media attention and has a zillion followers.  Who use social media!

But Krugman makes another big mistake that Clinton and her campaign also make: He conflates Clinton’s toughness in defending herself against Republican attacks with toughness in deconstructing, for the public, Republican memes and specific legislative proposals.

Clinton, Professor Krugman, is not Elizabeth Warren.  Warren never conflates herself as an individual with her skill as a policymaker and as a communicator on policy, hers and theirs.  Clinton incessantly does.

Click Krugman’s link, above, to “fundamental toughness”, and up pops a picture of Clinton at … surprise! … the Benghazi hearing last October!  Seriously.

Seriously?

Sorry, Professor Krugman, but I-want-to-raise-incomes-not-taxes is the very antithesis of toughness against Republicans. It’s unnerving that Clinton doesn’t recognize that.

This matters. A lot.

What Krugman gets right in his post today is his reiteration—he’s said this before—that Sanders really, really needs to make clear that he recognizes the abiding importance of regulating the shadow finance industry.  He needs to retain a real expert in this to formulate a specific, detailed proposal to address this.

Please, Sen. Sanders.  Please do this.

But Clinton needs at least as much to ditch the I-want-to-raise-incomes-not-taxes slogan, and to recognize, belatedly, that the price of some cutesy soundbites can be high.

As an alternative, she can switch parties.  Or could if it weren’t too late.

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ADDENDUM: Here in sum is the point: Clinton says that the only thing that matters to people’s bottom line is the amount of taxes they pay.

Which apparently is largely true for the wealthy, but is hardly true for the middle class and so-called working class–whose financial bottom line, financial security and standard of living is impacted tremendously by such things as healthcare insurance premiums, whether paid to the government or instead to a private company, and out-of-pocket payments to hospitals, medical labs and physicians.

That’s was so enrages me. Clinton claims by that soundbite of hers that all that matters is “income,” not income minus such things as private-healthcare-insurance premiums and out-of-pocket payments for health care. Added 1/20 at 11:50 a.m.

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*For those who don’t read Angry Bear regularly, the Supreme Court is my area of expertise; healthcare economics is definitely not.  So that sentence was intended as a joke.

** Sentence rewritten to make sense. Paragraph corrected also to change “know” to “knows.” Post (obviously) written hurriedly yesterday (I had only a few minutes to write it) and posted in anger.  Rather than deleting it, since there are comments posted to it, I edited it somewhat.  The post’s sentiment remains intact. 1/20 at 11:34 a.m.

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Why Do So Many Wealthy Democrats Think The Only Money That Matters To The Hoi Polloi Is The Money They Must Pay To The Government? [with update]

Second, single-payer would require a lot of additional tax revenue — and we would be talking about taxes on the middle class, not just the wealthy. It’s true that higher taxes would be offset by a sharp reduction or even elimination of private insurance premiums, but it would be difficult to make that case to the broad public, especially given the chorus of misinformation you know would dominate the airwaves.

Finally, and I suspect most important, switching to single-payer would impose a lot of disruption on tens of millions of families who currently have good coverage through their employers. You might say that they would end up just as well off, and it might well be true for most people — although not those with especially good policies. But getting voters to believe that would be a very steep climb.

Health Reform Realities, Paul Krugman arguing today in his New York Times column against attempts to enact single-payer, Medicare-for-all healthcare insurance

Good grace.  Where to begin.

Maybe by quoting myself with this excerpt from my post from yesterday, posted before the debate began:

Having no healthcare insurance is not the same as having healthcare insurance.  Unless of course the medical care you need is not covered by the insurance you have, because the deductibles and co-pays under your employer-provided insurance or under the policy you bought through a state marketplace under Obamacare for a premium low enough that your employer or you could afford it, means (unlike more comprehensive plans that others have but you do not) that you must pay those medical bills yourself.

Apparently, Chelsea Clinton doesn’t get out much these days.*

But then, neither, it appears, does her mother, who has claimed repeatedly, including in comments in defense of her daughter’s odd statements about Sanders’ single-payer concept, that the only expenses—the only money people pay—that actually matters to them is money paid to the government.

No other expenses count as money—as loss of income or as other expenditure that actually effects your and your family’s financial bottom line and therefore standard of living.  Money paid to UnitedHealthcare or Anthem Blue Cross in premiums, and to hospitals, physicians and medical labs in co-pays and deductibles, don’t count.  That’s not money paid to the government, see.  So it’s wayyy better to pay more for less-comprehensive coverage to private insurance companies, and still be financially insecure about medical expenses, than to pay less money in healthcare costs to the government and be financially secure about medical expenses.  Because, y’know … the government.

Which—I wish Sanders would point out—is exactly what Clinton says.  Again and again. Just like the Republicans do.

Hillary Clinton should get out more, too.

Sanders did almost exactly that in the debate last night.  But I hope, especially in light of Krugman’s column today, that he points out that the Democratic politicians and commentators who say the public thinks that the only money that matters to their financial bottom line, the only expenses that effect their standard of living, is taxes. Or that the math involved to understand that that is not so is too complicated for most folks to perform.

Calculators are cheap these days.  Even the hoi polloi can afford one.

Sanders got it right last night.  This is the Republican mantra.  And it’s no longer selling so well.

But Sanders also should question why it is that the Clintons and now Krugman, and surely other wealthy Democrats, think (or claim to think) that large and annually increasing healthcare premiums and co-pays and deductibles don’t matter to middle class and so-called working class folk because they’re paid to private insurance companies and private hospitals, physicians and medical labs. Sanders’ next ad should feature one of those folk saying that his or her family’s healthcare insurance premiums and the four-figure medical bills they are paying for a short hospital stay are actual money.  Honestly and truly.

Another ad should show a small-business owner discussing the amount the business pays in premiums for private insurance for its employees and that paying less to the government in additional taxes than the amount it is paying for private insurance could be paid instead in increased salaries and wages.

And there should be a third ad, maybe featuring that very same small-business owner, explaining that the business has a few employees who are seniors and receive, um, Medicare—and that the business pays for their excellent Medicare supplement insurance.  Not complicated.  And not very costly, given that Medicare is—yes, really—itself good insurance. So … voila! Hard feelings by those employees because they aren’t part of the awesome UnitedHealthcare plan that the younger-than-65 employees have and love.

Okay, look.  Only people who are, like the Clintons and Krugman, financially way-more-than-comfortable would actually think that people who aren’t don’t care how much they pay in healthcare premiums and out-of-pocket medical expenses because the checks are made out not to the federal government but instead to private entities and parties.  And that only the most sophisticated among the rest of us will understand that Medicare combined with platinum plated supplemental policies paid by their employer will give them the same awesome benefits that they receive now.  Maybe even better.  Even though it will cost the employer less money.  (Less real money.  Really!)

The Clinton claims and Krugman arguments are profoundly elitist.  They’re spades that should be called, by Sanders, what they are: spades.

Krugman, too, should get out more.

*Chelsea Clinton said last week that she doesn’t “want to live in a country that has an unequal health care system again.”  As I said in my post yesterday, she apparently wants to move to France.  Or Canada.  Or Scandinavia, or Germany, or Thailand.  Or one of the many other Western-style democracies that has an equal health care system.

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UPDATE: Reader Lee Russ has posted this comment to the Comments thread:

Krugman’s assessment leaves out one extremely important reality and understates a second.

He left out the reality that his approach is a surrender to the power of the health insurance industry that, as he says, “played a major part in killing health reform in the early 1990s.” As he also says, Obamacare was specifically designed to rely on private insurance to keep those insurers from killing it. Now Krugman recommends walking away from a national healthcare system that even he acknowledges is both better and less expensive than Obamacare, again in deference to the insurance industry’s desires. Allowing the insurance industry to control our lives and our health is not practicality, it is an abandonment of our
rights in a democracy and it is a very big mistake.

Krugman also understates the problems that Obamacare is causing out here in “reality.” Expanding Medicaid has helped the poorest of us get some care, but that program’s low reimbursement rates mean that many doctors decline to treat Medicaid patients. The doctors who do take Medicaid are swamped by the newly Medicaid eligible, and may lose money treating them.

For many people who buy insurance policies through the exchange, massive deductibles must be paid before the insurer pays anything. Doctors across the country have noted the increase in the number of “insured” patients who are having serious problems figuring out how to both eat and pay their deductibles. Krugman wrongly says that “access to health insurance for all Americans” has been the goal. It’s access to health care—not to insurance—that matters. Obamacare too often fails to achieve it.

Exactly.

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Did Clinton Really Agree That Denmark Is an Inspiring Example for Democrats to Cite?

Denmark isn’t a middle-class, capitalist, entrepreneurial country?  Because it has universal healthcare, free college, free day care, and guaranteed family and medical leave?  Really, Secretary Clinton?  Really?

— Me, here, Oct. 14

No doubt surprising many of the people watching the Democratic presidential debate, Bernie Sanders cited Denmark as a role model for how to help working people. Hillary Clinton demurred slightly, declaring that “we are not Denmark,” but agreed that Denmark is an inspiring example.

Paul Krugman, Something Not Rotten in Denmark, today  OCT. 19, 2015 Paul Krugman

The subject of both of those quotes is, of course, Clinton’s already-famous statement about Denmark in last week’s debate:

We are not Denmark — I love Denmark — we are the United States of America.  We would be making a grave mistake to turn our backs on what built the greatest middle class in the history of the world.

I love Paul Krugman and I think his column today about the specifics of Denmark’s social democratic system and also its recent monetary and fiscal policies is terrific.  As is the fact that these things are, this week, very hot topics.  Thanks to last week’s debate.

But as I said in one of four posts I’ve written here at AB that mention that comment by Clinton — the first of my posts on this is here — I don’t see how those two consecutive sentences can be interpreted to mean anything but a preplanned sleight of hand intended to suggest that Denmark is not a capitalist country and has a weak middle class, and that Sanders’ proposed policies would destroy the middle class.

As I said in that post, we turned our backs on the greatest middle class in the history of the world when we elected Ronald Reagan and then spent most of the next three decades enforcing and expanding upon his ideological vision.  But agree or not with that assessment, what seems to me indisputable is that Clinton’s two-sentence comment is a statement that universal healthcare, free college, free day care, and guaranteed family and medical leave would amount to turning our backs of the American middle class.

My point here is not to beat the horse that I think I killed in those earlier four posts; in the last of the four I promised not to write another one bashing her, at least for a while.  It is instead to again express the hope that Clinton stops running the kind of campaign she’s running, and run one that is far less reliant on focus-group-tested soundbites, slogans and sleights of hand that one or another member of her army of consultants suggested to her .  After all, a big part of Joe Biden’s appeal and also Bernie Sanders’s is that they talk like ordinary people in ordinary conversations, not like Chatty Cathy dolls.

My point also is to publicly wonder why Krugman thinks Clinton agreed that Denmark is an inspiring example for Democrats to cite.  Because I think she indicated the opposite.

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Post edited slightly for clarity. 10-19-15 at 9:32 p.m.

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