Has U.S. Democracy Been Trumped?

[kenberg]

I guess we will see. I got to thinking about saying that I have no proof. That is true, but consider this: Recently a bill was passed by the House close to unanimously to kill the tax (not really a tax) on Cadillac health plans. So the Dems vote for killing a part of the ACA, but they don't, I gather, pursue this stuff about the tax returns. My guess, again without proof, that this divide occurs because the Dems know, or think that they know, where the votes are and aren't. So it seems that the Dems are thinking along the same lines as I am regarding the tax return dispute. That doesn't prove anyone is right, or wrong, but it does seem that my views on the tax return business are shared by the Dem leadership. Now on impeachment there is divided opinion as to where the votes lie, but again I think it's a mirage to seek votes by going after impeachment. I acknowledge I can't prove it, but of course neither can you.

[johnu]

It's a good bet that we won't agree here, but this can illustrate my point. Imo there might be fifteen voters in the US whose 2020 vote will be mildly influenced by whether the Dems do or do not pursue this issue. I will even grant that there might be twenty-five such voters. It is my very strong view that if the Dems wish to win in 2020 rather than have a satisfying explanation as to why they lost, then they need look elsewhere for issues. I suppose this could be considered cynicism, I see it as realism.

 

What is my evidence? Well, I don't have any. I still regard this as correct.

 

There will be a lot of anti-Trump voters that will be discouraged by the failure of Democrats to impeach and they may fail to vote in the 2020 elections. How many? Who knows, but if there is no impeachment the election will probably be determined by how much of the base turns out so failure to impeach will deflate their base, IMO.

 

As far as changing minds, impeachment is the only way to get the facts of the Mueller report and other impeachable offenses before the American electorate. Weeks, maybe several months of nationally televised daily impeachment hearings can't help but dominate the news cycle and get the facts out there. Seeing how there are 250 million Americans of election age (and 157 million actually registered to vote), there are probably 100+ million voters who know basically nothing about the Mueller report findings or other high crimes and misdemeanors committed by the president. Since estimate of independent voters is about 40+% of the electorate, that is the group that need to know what high crimes and misdemeanors have been committed.

 

I don't expect any/enough Republicans in the Senate to vote to convict, so Dennison won't be removed from office, but the widespread dissemination of facts will tip the electorate enough to make sure Dennison is not reelected.

[y66]

From Jonathan Bernstein at Bloomberg:

 

A new budget deal passed the House on Thursday and is expected to easily clear the Senate next week. Assuming it does (and President Donald Trump signs it), there will be no debt-limit worries for two years, no sequestration, and little chance of a government shut down. Here are a few other things we’ve learned from this episode.

 

One is that it’s no coincidence that extended government shutdowns have happened in 1995-1996, 2013, and 2018-2019. They all began with Republican majorities in the House. So did the debt-limit brinkmanship of 2011. Although Democrats bargained hard for spending they wanted in this deal, they never really threatened to disrupt the government or the economy over it. Perhaps they’re more responsible than Republicans. But Democratic majorities have also always had substantive goals that they were out to achieve in these negotiations. Republicans? Not so much. They’re after confrontation for its own sake.

 

Another takeaway was that Trump’s alleged control over the Republican Party was, as usual, shown to be illusory. Trump signed on to the budget deal, tweeted that Republicans “should support” it and then watched as they opposed it by a two-to-one margin. The dynamic among House Republicans is the same as it’s been for years: Radicals try to differentiate themselves from mainstream conservatives by opposing any compromise legislation, then mainstream conservatives, fearful of being called moderates, also vote “no.” That – and not Trump’s anger or his Twitter feed – is what they’re really afraid of. As a consequence, the party is collectively dysfunctional and its leaders lose leverage in negotiations.

 

Meanwhile, the much-anticipated “Tea Party of the left” remains AWOL. Some Democrats certainly are very liberal, even more liberal than the bulk of the caucus, which is hardly a group of moderates. But while the “Squad” and some others might be ideologically extreme, they aren’t radicals – they’re willing to compromise and to accept half-victories when they’re available. This vote, in fact, split the Squad, and despite a lot of unhappiness over high levels of military spending, most of the handful of Democratic “no” votes came from the small group of moderates.

 

One other thing: Republicans say they opposed the deal because of budget deficits. Don’t believe it. If you’re not willing to support any trade-offs to reduce the deficit, then you’re not actually concerned about it – and I didn’t hear any Republicans complaining that their leadership sold them out by accepting a larger deficit instead of lower defense spending or higher taxes. They’re not against larger federal budget deficits; they’re just against spending on programs they don’t like. In other words, this is the old Republican War on Budgeting.

[kenberg]

There will be a lot of anti-Trump voters that will be discouraged by the failure of Democrats to impeach and they may fail to vote in the 2020 elections. How many? Who knows, but if there is no impeachment the election will probably be determined by how much of the base turns out so failure to impeach will deflate their base, IMO.

 

As far as changing minds, impeachment is the only way to get the facts of the Mueller report and other impeachable offenses before the American electorate. Weeks, maybe several months of nationally televised daily impeachment hearings can't help but dominate the news cycle and get the facts out there. Seeing how there are 250 million Americans of election age (and 157 million actually registered to vote), there are probably 100+ million voters who know basically nothing about the Mueller report findings or other high crimes and misdemeanors committed by the president. Since estimate of independent voters is about 40+% of the electorate, that is the group that need to know what high crimes and misdemeanors have been committed.

 

I don't expect any/enough Republicans in the Senate to vote to convict, so Dennison won't be removed from office, but the widespread dissemination of facts will tip the electorate enough to make sure Dennison is not reelected.

 

Who would get discouraged by what is a legitimate issue, I think it can cut various ways. Here is a dichotomy:

 

 

1. Try to win by explaining how awful Trump is

 

2. Try to win by explaining what the Dems plan to do, why it will work, who is best placed to implement these plans and so on.

 

 

Yes, ideally we do both. In practice, probably not. The current focus is much much more toward 1. than it is toward 2. I think that this is a really good way to lose the election. I will try to elaborate on this, but right now I have some other matters to tend to.

 

But a quick quote from WaPo:

 

"Most notably, House Intelligence Committee Chairman Adam B. Schiff (D-Calif.), who elicited several of Mueller’s criticisms of Trump at the hearings, sharply played down the prospects of removing the president through impeachment.“We do need to be realistic, and that is, the only way he’s leaving office, at least at this point, is by being voted out, and I think our efforts need to be made in every respect to make sure we turn out our people,” Schiff said during an interview on CNN."

 

 

[Winstonm]

I guess we will see. I got to thinking about saying that I have no proof. That is true, but consider this: Recently a bill was passed by the House close to unanimously to kill the tax (not really a tax) on Cadillac health plans. So the Dems vote for killing a part of the ACA, but they don't, I gather, pursue this stuff about the tax returns. My guess, again without proof, that this divide occurs because the Dems know, or think that they know, where the votes are and aren't. So it seems that the Dems are thinking along the same lines as I am regarding the tax return dispute. That doesn't prove anyone is right, or wrong, but it does seem that my views on the tax return business are shared by the Dem leadership. Now on impeachment there is divided opinion as to where the votes lie, but again I think it's a mirage to seek votes by going after impeachment. I acknowledge I can't prove it, but of course neither can you.

 

I also think it is wrong to seek votes by impeachment - and that is not the object. The reason to do it is so we a have "a republic, if we can keep it."

 

The impeachment process is 3 steps: 1) judiciary committee investigation 2) referral and House vote 3) Senate trial

 

What is needed is to take step 1. Step 1 alone will compel testimony that the WH and DOJ has stonewalled because it is a valid constitutional reason that the courts will back with expedited decisions.

 

This is what this is all about: from NBC coverage of an Amash town hall

 

But of particular interest was a quote from one Republican local voter, whom NBC News spoke to after the event.

 

Cathy Garnaat, a Republican who supported Amash and the president said she was upset about Amash’s position but wanted to hear his reasoning. She said that she will definitely support Trump in 2020 but that Tuesday night was the first time she had heard that the Mueller report didn’t completely exonerate the president.

“I was surprised to hear there was anything negative in the Mueller report at all about President Trump. I hadn’t heard that before,” she said. “I’ve mainly listened to conservative news and I hadn’t heard anything negative about that report and President Trump has been exonerated.”

my emphasis

 

When you totally control the narrative, you can get away with murder; since all other norms are violated, and the DOJ is an active participant in cover-up, impeachment is the only avenue left to penetrate the Omerta.

[Winstonm]

As far as the Schiff quote, I agree totally. Impeachment inquiry is not an alternative to that notion but a supplement to it in order to find out and show the American public all those things that this administration is trying to hide, including whether or not the president is benefiting financially from his policy decisions.

 

Policy ideas - Warren, Sandsers, etc. - can be accomplished at the same time. However, nothing the House passes is now even getting to the Senate floor for votes, and there is little news coverage of what the Democrats are passing that the Senate Republicans are killing.

 

The Dems are losing the PR struggle to someone who knows a thing or two about ratings - maybe all he does know.

 

As it turns out, this WaPo article agrees with me:

 

Politico reported recently that Nadler raised the idea with House Speaker Nancy Pelosi (D-Calif.), who shot it down. But Judiciary Committee members have grown convinced that launching an inquiry is important for the pragmatic purpose of increasing Democrats’ legal leverage to overcome the Trump administration’s maximal resistance to oversight on all fronts.....

 

....The House is set to sue to make this happen, with the goal of getting a judge to rule on the administration’s claim that the White House can assert “absolute immunity” to such requests. If Democrats win that, it could compel more cooperation on other fronts.

 

But an impeachment inquiry would make that more likely to succeed. As the Times reports, Judiciary members believe a unilateral inquiry without a full House vote would accomplish that goal:

 

Doing so, they think, would strengthen their hand in the courts and potentially persuade judges to move more quickly on cases like the potential one against Mr. McGahn, while building on any momentum generated by Mr. Mueller.

my emphasis

[y66]

+ a gazillion for the quote of Adam Schiff channeling kenberg. The dudes abide.

[johnu]

But a quick quote from WaPo:

 

"Most notably, House Intelligence Committee Chairman Adam B. Schiff (D-Calif.), who elicited several of Mueller’s criticisms of Trump at the hearings, sharply played down the prospects of removing the president through impeachment.“We do need to be realistic, and that is, the only way he’s leaving office, at least at this point, is by being voted out, and I think our efforts need to be made in every respect to make sure we turn out our people,” Schiff said during an interview on CNN."

 

Before the Mueller hearings, chances that enough Republican senators would vote to convict were slim to none. There are 53 Republican senators. At least 20 of them would have to vote to convict, assuming 100% of the Democrats and independents also voted to convict. There are zero Republican senators that have shown any inclination to vote to remove Dennison. Without getting responsive answers from Mueller during the hearings, there was probably some movement in the court of public opinion, but not anything close to a tidal wave that would cause 20+ Republican senators to feel political pressure to change their positions.

 

Thus Schiff is just stating a fact that at the present time, there isn't a realistic chance that Dennison will be convicted and removed in an impeachment process.

 

Removing isn't the same as impeaching, so I still believe the House will impeach Dennison this year.

[cherdano]

Who would get discouraged by what is a legitimate issue, I think it can cut various ways. Here is a dichotomy:

 

 

1. Try to win by explaining how awful Trump is

 

2. Try to win by explaining what the Dems plan to do, why it will work, who is best placed to implement these plans and so on.

 

I don't think Hillary lost because she didn't have enough plans, or was too hesitant to talk about her plans... And it's easy to forget, but Hillary did win all the debates.

 

Obviously Democrats need to explain that they have policies that improve people's live. As Ken Berg and Ilhan Omar say:

It is not enough to condemn the corruption and self-dealing of this administration. We must support policies that unmistakably improve working people’s lives

 

But I think you also must convince at least some voters that Trump isn't on their side. That while he plays the guy who'd pick their side in a fight, in fact he didn't. Instead of improving healthcare access, he tried to take away healthcare from millions of Americans like you many times. He stood quietly as all Republicans blocked a long-needed raise of the minimum wage. Which side did he pick? The side of the billionaires who funnel millions of dollars into his account via his hotels and Mar-a-Lago memberships, who in return got the biggest tax cut for billionaires and foreign corporations in the history of the planet. And you know what, we don't even know who is paying him. When Ken Berg earns some extra money working helping a business friend on the weekends, he has to get approval from his College. President Trump could be getting millions of dollars from foreign oligarchs, and you, the voters who put him into office, and for whom he is supposed to work, aren't even allowed to know about it. The craziest bit? He directly told his Treasury Secretary to break the law and not provide his tax returns to Congress, as he is supposed to. President Trump, what do you have to hide? The American People want to know who is paying you. You have made excuse after excuse - the dog ate my tax returns, sory the IRS is auditing me, but last March your administration started breaking the law, plain and simple, to hide who is paying you.

THe day I come into office, our government will stop working for billionaires shilling out millions for Mar-a-Lago memberships. No, I will work for you, I will fight for you, to [into standard 2 min pitch on what X wants to do on minimum wage, healthcare, sensible immigration, ...]

[y66]

From Karl Smith at Bloomberg:

 

There was good news and bad news in Friday’s report on U.S. economic growth, but the bad outweighed the good. If President Donald Trump wants to improve conditions — both in the economy and for his re-election — then he might start by ending his trade war with China.

 

First the good news. Growth for the second quarter was 2.1%, much better than expected. Year-over-year growth had reached a low of 1.3% in the second quarter of 2016, in the midst of a global slowdown and a crash in oil prices. The rebound was stronger than originally thought. With an added boost from the 2017 tax cuts, year-over-year GDP growth hit a peak of 3.2% in the second quarter of 2018.

 

Which brings us to the bad news: Ever since then, growth has been slowing. It’s now lower than it was in the second quarter of 2015. If growth continues to fall, then on Election Day 2020 growth could be as low as it was in 2015.

 

There are reasons to think growth will keep falling. While most of the economy is consumer spending, the business cycle is primarily driven by investment, either in the business sector itself or in residential housing. Neither look good.

 

A major revision of past figures shows that business-sector investment is weaker than previously thought. Business investment recovered strongly from the 2015 slowdown, but not as well as previously estimated. Like overall GDP, business investment peaked in early 2018 and has been headed down ever since. That’s precisely when Trump began to ramp up his trade war.

 

Since then, business investment has fallen far more than expected and looks to be headed toward recessionary territory soon. That doesn’t necessarily mean that the whole economy will experience a recession; in 2016, for example, the business sector went into recession, but the rest of the economy held up.

 

Unfortunately, the other major driver of cyclical demand — housing — is not doing nearly as well today. The sector was going strong in 2015, but has itself been in recessionary territory since the beginning of last year. Combined with the decline in business investment, this suggests that the economy may be on an even weaker footing than it was before a mini-recession in 2015.

 

The upshot of all this? Although the economy is growing well now, its fundamentals are weaker than economists thought. Absent a change in policy, overall growth is likely to slow substantially in the coming year.

 

I’ve argued before that Trump is in danger of recreating the economic conditions that doomed Democratic chances in 2016. That looks even more probable now.

 

What can be done to restore growth? The Fed is widely expected to cut rates when it meets later next week, and that will help. More important, the data suggest that investment and overall growth turned south just as Trump ramped up the trade war. Bringing that war to an end — and quickly — may be his best hope for re-election.

[johnu]

Once again I'm disappointed in Lying Mitch the Hypocrite McConnell but not for the usual reasons.

 

Mitch McConnell Received Donations from Voting Machine Lobbyists Before Blocking Election Security Bills

 

Sure I'm disappointed that Lying Mitch would sell out the USA and allow the Russians to interfere with our elections, but what's astonishing is how little in bribes political contributions it took to buy him lock, stock, and barrel.

 

Sludge found that Brownstein Hyatt Farber Schreck lobbyist David Cohen, who has worked on behalf of Dominion Voting Systems this year, donated $2,000 to McConnell during this time. Brian Wild, who works with Cohen and has also lobbied Dominion, gave McConnell $1,000.

 

Around the same time, on February 19 and March 4 Emily Kirlin and Jen Olson, who have lobbied on behalf of Election Systems & Software over the last year donated $1,000 to McConnell each.

McConnell's actions seemed even more out of balance with his party, as the Senate Intelligence Committee⁠—led by Republicans⁠—released a report later on Thursday claiming Russians have targeted voting systems in all 50 states in 2016. Though there was no evidence votes were changed, in Illinois "Russian cyberactors were in a position to delete or change voter data."

How is selling out the country not worth a couple of million dollars in corporate contributions (thank you Citizens United)? We're in serious trouble in this country if you can buy US Senators for just a few thousand dollars B-)

[kenberg]

I will explain where I think Dems have a problem that they need to deal with.

 

In post number 13192 Y66 cites a NYT article that itself cites some sources on the Cadillac Tax, in particular an article by Sarah Kliff Let's think a bit about this, going back to the claim "If you like the insurance you have, you can keep it." I don't think that there is any real doubt that this promise was part of the advertising for passing the ACA.

 

Of course there would be a caveat. You can keep it if your employer continues to offer it. Ok, fair enough, so far. But if we take the ACA as a whole, then the statement should have been

:

"If you like the insurance you have, you can keep it, providing that your employer continues to offer it and we are going to be doing everything that we can, including a 40% penalty, to get your employer to stop offering it"

 

Ok, politicians in general are very good at explaining why words that seem to have a clear meaning of course really, when properly re-interpreted by them, have an entirely different meaning. Here the meaning is that of the person happens to be working for an employer who is so generous ort so dumb. or maybe bound at least for a while by a union contract that s/he will continue to offer this health plan despite the best efforts of everyone in the administration get them to drop it, well the you can keep it. Quoting Ms. Kliff "The whole point of the Cadillac tax was to push employers in the opposite direction, and offer their workers less robust benefit packages."

So here, as I understand it, is where this gets us. These very generous plans push the cost of medical care upward, the Cadillac tax was designed to deal with that, the Cadillac tax is so unpopular there is no chance it will every actually be implemented. All predictable.

 

The main point: The ordinary person, one who does not spend a lot of time thinking about the long term effect of the ACA, is very aware of being told first that he can keep his plan and then finding that he has to fight like hell to keep it. This does not inspire trust.

 

I regard myself as an ordinary guy, or close to it. This means that I am not an expert on health care, not an expert on immigration, not an expert on a lot of things, but I can tell when "If you like the insurance you have, you can keep it." is not really a correct description of what is going on.

Here is a shorter version: When I get a bad result at bridge, I start by looking at my own choices to see what I might have done better. The Dems had a very bad result in the last presidential election. I strongly suggest that they try looking at the errors that they made. For one thing, correcting one's own errors is much more likely to be within the power of a person than getting others to act in your interests.

[awm]

Here is a shorter version: When I get a bad result at bridge, I start by looking at my own choices to see what I might have done better. The Dems had a very bad result in the last presidential election. I strongly suggest that they try looking at the errors that they made. For one thing, correcting one's own errors is much more likely to be within the power of a [/size]person than getting others to act in your interests.

 

One has to be careful with the conclusions from the last presidential election. Keep in mind that Hillary Clinton got 3 million more votes than Trump did. This was also an election that saw a great deal of interference by Russian agents, and where the head of the FBI took the unprecedented step of reopening an investigation into the Democratic candidate mere days before the vote. Turnout was relatively low, both candidates were extremely unpopular, and it was decided by less than a hundred thousand votes total in a few states.

 

Looking at all this (and the trouncing Republicans in the house received in 2018) suggests that "Democrats need a massive change of strategy" is probably an overreaction. Trump has never been above the low 40s in popularity polls and more than 50% of registered voters claim that they will definitely not vote for him. It's hard to imagine what could change before the election that would cause Trump to become much more popular than he has ever been (both his supporters and his opponents are pretty entrenched and events rarely seem to move the number much in either direction).

 

I don't think this next election will be a low turnout affair, regardless of whether Democrats run on how awful Trump is or what they plan to do to make things better. I'd be more worried that Republicans do something massively illegal to retain power (like cancel the elections, or sending ICE to round up Latino citizens trying to vote and imprison them until the day after the election) than I would be that Democrats will choose the wrong nominee or strategy.

[kenberg]

One has to be careful with the conclusions from the last presidential election. Keep in mind that Hillary Clinton got 3 million more votes than Trump did. This was also an election that saw a great deal of interference by Russian agents, and where the head of the FBI took the unprecedented step of reopening an investigation into the Democratic candidate mere days before the vote. Turnout was relatively low, both candidates were extremely unpopular, and it was decided by less than a hundred thousand votes total in a few states.

 

Looking at all this (and the trouncing Republicans in the house received in 2018) suggests that "Democrats need a massive change of strategy" is probably an overreaction. Trump has never been above the low 40s in popularity polls and more than 50% of registered voters claim that they will definitely not vote for him. It's hard to imagine what could change before the election that would cause Trump to become much more popular than he has ever been (both his supporters and his opponents are pretty entrenched and events rarely seem to move the number much in either direction).

 

I don't think this next election will be a low turnout affair, regardless of whether Democrats run on how awful Trump is or what they plan to do to make things better. I'd be more worried that Republicans do something massively illegal to retain power (like cancel the elections, or sending ICE to round up Latino citizens trying to vote and imprison them until the day after the election) than I would be that Democrats will choose the wrong nominee or strategy.

 

I don't see myself as suggestion a massive change in strategy. Or at least I hope that the things I am suggesting would not seem to the leadership to be a massive change in strategy. I am hoping that the Dems can build trust with a large portion of the electorate, and I suggest that to do that they need to look at some of the reasons that some voters are skeptical.. I like to think that I am suggestion realism. For example, yes Clinton got a good many more votes than Trump did on 2016. That fact should be set against the fact that the path to the presidency will still run through the electoral college in 2020.Whatever one thinks of that fact, it is still a fact.

 

 

The penalty on Cadillac Health plans was one example of many I might have listed where I would hope that the Dems would look and say "Oh, yeah, I can see how that might have cost us some votes from people who once would have surely voted Dem". And, just for a moment, let's look at the name "Cadillac Tax". I would be willing to bet that of the people who have such a plan, more of them drive Chevrolets than drive Cadillacs. So what? Well, I think when you write off such people you are writing off quite a few. Also, it's not really a tax, it's a penalty. The purpose of a tax is to raise revenue. But the acknowledged purpose of this charge is to kill off those plans. It's much like a fine for speeding in a school zone. Yes, the money from the fine goes into the coffers, but the purpose is to get people to slow down. It's a success if nobody speeds, even though then there is no revenue, and the "Cadillac Tax" would be judged a success if the plans die out, even thought then there would be no revenue from it. It's a penalty designed to change behavior, not a tax designed to raise revenue. Of course getting cute with words is standard for politicians, and the name is hardly a great issue, but claiming that you can keep a plan that you like while putting in a penalty designed to kill a plan that a person likes is a big deal. Or, as Biden put it, a big ****** deal.

 

I am suggesting that Dems give some thought as to why Clinton lost, and I am suggesting that if the only reasons that they can think of all come down to it being someone else's fault then I am suggesting that they think a little harder. This should not be seen as a massive change in strategy. I sure hope not.

[johnu]

The penalty on Cadillac Health plans was one example of many I might have listed where I would hope that the Dems would look and say "Oh, yeah, I can see how that might have cost us some votes from people who once would have surely voted Dem". And, just for a moment, let's look at the name "Cadillac Tax". I would be willing to bet that of the people who have such a plan, more of them drive Chevrolets than drive Cadillacs. So what? Well, I think when you write off such people you are writing off quite a few. Also, it's not really a tax, it's a penalty. The purpose of a tax is to raise revenue. But the acknowledged purpose of this charge is to kill off those plans. It's much like a fine for speeding in a school zone. Yes, the money from the fine goes into the coffers, but the purpose is to get people to slow down. It's a success if nobody speeds, even though then there is no revenue, and the "Cadillac Tax" would be judged a success if the plans die out, even thought then there would be no revenue from it. It's a penalty designed to change behavior, not a tax designed to raise revenue. Of course getting cute with words is standard for politicians, and the name is hardly a great issue, but claiming that you can keep a plan that you like while putting in a penalty designed to kill a plan that a person likes is a big deal. Or, as Biden put it, a big ****** deal.

 

In case you didn't notice, Democrats in the House have already voted to repeal this tax.

 

House votes to repeal Obamacare's ‘Cadillac tax'

 

The 367 co-sponsors of the bill by Rep. Joe Courtney (D-Conn.) included members of the progressive wing of the Democratic Party like Reps. Pramila Jayapal (D-Wash.) and Ro Khanna (D-Calif.)—who have championed replacing the employer-based system through Medicare for All—as well as conservative Republicans.

 

I don't know all the positions of Democratic presidential candidates but assuming the Senate gets around to passing a repeal bill, there won't be much to discuss in 2020.

[johnu]

The buck stops over there .....

 

Trump blames Obama administration for bad White House air conditioning

 

President Trump has blamed predecessor Barack Obama for a litany of issues, from the Iran nuclear deal to the crisis at the border, and on Friday he added the alleged poor state of air conditioning in the White House to that list.

Nothing like manning up and blaming the guy behind the tree instead of taking responsibility for anything B-)

 

You would think a guy who forced Mexico to pay for a border wall, won a global trade war and made China pay for tariffs, made North Korea and Iran give up nuclear ambitions, and solved the border crisis could have hired some A/C contractors to get the air conditioning working like he wanted. Apparently that's too lofty a plan to implement. B-)

[kenberg]

In case you didn't notice, Democrats in the House have already voted to repeal this tax.

 

House votes to repeal Obamacare's 'Cadillac tax'

 

 

 

I don't know all the positions of Democratic presidential candidates but assuming the Senate gets around to passing a repeal bill, there won't be much to discuss in 2020.

 

Yes, I very much did notice. I think there were 6 no votes, or something of that order of magnitude. I see this as belated realization that the penalty/tax was, at least politically, a very bad idea.

 

I accept that these high end plans do indeed increase medical costs by encouraging perhaps overly generous use of medical treatment but it's a real problem as to how to address it. In the last ten years I am sure I have used far more medical treatment than I had in all of the previous seventy, and I see myself as still basically healthy. Medicare is good, I have supplemental insurance, I pay a not entirely trivial amount for each of these but nowhere near what is paid out. I doubt it qualifies as a Cadillac plan but it's more than a Chevrolet plan or a Pontiac, maybe a Buick plan or an Oldsmobile plan. Anyway, I like it, but I do see how I might sometimes be getting stuff I could do without. Once I had a rash and the dermatologist was going to prescribe some lotion that would cost around 50 bucks, but then he checked my prescription plan and changed it to something that cost 200. Medicare paid 80% but the doc gave me a coupon for a 40 dollar rebate, So Medicare paid for 160 on the 200, and the rebate took care of the rest. That's nice. For me. Or, here's an item illustrating a problem much in the news: A year or so ago I had a severe tooth problem, the dentist took good care of it on an emergency basis and wanted me back the next Monday. He also wanted to give me a prescription for some opioid for the pain. I refused, he really could not understand this refusal, he got a bit hard sell. Maybe he gets paid off, maybe he is stupid, I now see a different dentist. So there are problems. I think the solution has to involve most all medical plans, even though I don't know exactly how that solution would work.

[Winstonm]

Yes, I very much did notice. I think there were 6 no votes, or something of that order of magnitude. I see this as belated realization that the penalty/tax was, at least politically, a very bad idea.

 

I accept that these high end plans do indeed increase medical costs by encouraging perhaps overly generous use of medical treatment but it's a real problem as to how to address it. In the last ten years I am sure I have used far more medical treatment than I had in all of the previous seventy, and I see myself as still basically healthy. Medicare is good, I have supplemental insurance, I pay a not entirely trivial amount for each of these but nowhere near what is paid out. I doubt it qualifies as a Cadillac plan but it's more than a Chevrolet plan or a Pontiac, maybe a Buick plan or an Oldsmobile plan. Anyway, I like it, but I do see how I might sometimes be getting stuff I could do without. Once I had a rash and the dermatologist was going to prescribe some lotion that would cost around 50 bucks, but then he checked my prescription plan and changed it to something that cost 200. Medicare paid 80% but the doc gave me a coupon for a 40 dollar rebate, So Medicare paid for 160 on the 200, and the rebate took care of the rest. That's nice. For me. Or, here's an item illustrating a problem much in the news: A year or so ago I had a severe tooth problem, the dentist took good care of it on an emergency basis and wanted me back the next Monday. He also wanted to give me a prescription for some opioid for the pain. I refused, he really could not understand this refusal, he got a bit hard sell. Maybe he gets paid off, maybe he is stupid, I now see a different dentist. So there are problems. I think the solution has to involve most all medical plans, even though I don't know exactly how that solution would work.

 

Here is a significant problem with controlling U.S. healthcare costs and patient outcomes:

 

There are two prevalent pay systems for physicians in the US—fee-for-service and volume-based reimbursement, where health care entities, and doctors through them, get paid a fixed amount per person based on a patient’s health and pre-existing conditions. Both are problematic. While fee-for-service incentivizes unnecessary or expensive treatment, volume-based-reimbursement schemes provide the opposite. By ordering fewer services for patients in the latter context, doctors directly and indirectly, make more money per patient.

 

“Fee-for-service or volume-based reimbursement, which by one estimate determines payments for nearly 90% of US physicians, provides incentives for physicians to order more and different services than those that match patient need,” write Loewenstein and Larkin. They suggest that if doctors were paid salaries, they’d be more inclined to practice medicine that meets patient needs, and could also be happier in the profession, which typically experiences high burnout rates.

 

One remedy offered would be to pay physicians a salary, which could be the case if all physicians were hired by the government, for example.

 

I once spoke to an American physician who was licensed a practiced in Canada, and he was quite happy with Canada's care system for just that reason - the physicians were in charge of the care.

[kenberg]

Here is a significant problem with controlling U.S. healthcare costs and patient outcomes:

 

 

 

One remedy offered would be to pay physicians a salary, which could be the case if all physicians were hired by the government, for example.

 

I once spoke to an American physician who was licensed a practiced in Canada, and he was quite happy with Canada's care system for just that reason - the physicians were in charge of the care.

 

We are not going to do this. We just aren't, and I doubt anyone thinks that we are. The authors describe it as a simple solution. I suppose that depends on what "simple" means.

[Winstonm]

We are not going to do this. We just aren't, and I doubt anyone thinks that we are. The authors describe it as a simple solution. I suppose that depends on what "simple" means.

 

Yippee-ki-yay isn't much of an argument but it our argument and we love it. So tell me, America, do you feel lucky? :)

 

I agree that this won't get done - at least not quickly - but if it is an answer, or the answer, why are we so quick to dismiss it as "impossible" instead of moving toward it or at least talking about it? There is a fine line between pragmatic and stodgy.

[y66]

Guest post from David Leonhardt at NYT:

 

In last year’s midterm elections, Democrats won 31 congressional districts that President Trump had carried in 2016 — including in the suburbs of Atlanta, Chicago, Des Moines, Detroit, Oklahoma City, Phoenix, Pittsburgh and Richmond, Va., as well as in more rural parts of Maine, Minnesota, New Mexico and Wisconsin.

 

How did the Democrats do it? By running a smart, populist campaign that focused above all on pocketbook issues like affordable health care and good jobs. The Democrats who won in these swing districts didn’t talk much about Trump, the Russia scandals, immigration or progressive dreams like single-payer health care. They focused on issues that affect most voters’ daily lives.

 

Theda Skocpol — the Harvard social scientist who has studied the Tea Party and the anti-Trump resistance, among many other things — has a new op-ed in USA Today that argues that the 2020 Democratic presidential candidates are ignoring the lesson of 2018. By doing so, Skocpol says, they are increasing the chances that Trump will win re-election. As Democrats prepare for their second round of debates this week, I think Skocpol’s message is worth hearing.

 

“The first 2020 primary debates were a case in point,” she writes. “Thrilling as it was to see female contenders do well, the debates were chaotic and dominated by simplistic questions about topics of little concern to most Americans. The ostensible winners embraced ultra-left issue stands — like calls to abolish private insurance and give free health care to migrants — that would sink them in the general election.”

 

These stances may help Democrats run up even larger margins in blue states like California and New York. But the presidency isn’t decided by the popular vote. And two of the smartest election analysts — Nate Cohn of The Times and Dave Wasserman of the Cook Political Report — have both written pieces recently that explain how Trump could lose the popular vote by an even wider margin than he did in 2016, and still win re-election.

 

Skocpol writes: “U.S. politics is not a national contest. Victories in Congress, state politics and the Electoral College all depend on winning majorities or hefty pluralities in heartland states and areas that are not big cities. Hillary Clinton lost in 2016 mainly because she was whomped in non-urban areas where Obama had lost by far smaller margins.”

 

A final point she makes is that Republicans — like the Koch brothers and their network — are more ruthlessly disciplined about advancing their interests and more focused on winning state and local campaigns. Too many Democrats, by contrast, give in to wishful thinking, imagining that they can control government policy by running campaigns that mostly excite people who live in deep blue areas.

 

The 2018 midterms showed a clear playbook for Democratic victory. The question is whether the party will follow it.

[y66]

From Jonathan Bernstein at Bloomberg:

 

One of the few qualified, well-respected and scandal-free members of President Donald Trump’s administration is on his way out. Dan Coats plans to resign next month as director of national intelligence, apparently to be replaced by a House member who has few obvious qualifications for the job – unless we count strong partisanship and loyalty to Trump.

 

Trump has been feuding on and off with U.S. intelligence agencies since his presidency began, and we’re told that Representative John Ratcliffe, his proposed replacement for Coats, is going to “clean house,” which presumably means rooting out those more interested in getting the intelligence right than in demonstrating fealty to the president.

 

Perhaps the Senate will insist on someone with more experience in these matters than Ratcliffe. But it’s a good reminder that Republican senators have flubbed this process from the get-go. They could’ve used their power of confirmation to insist that Trump run a professional White House and executive branch. They’ve largely chosen otherwise.

 

To be sure, Trump has had an unusually high number of failed nominations. Republican senators have been willing to block some of his poor choices; that’s why Herman Cain and Stephen Moore aren’t on the Federal Reserve Board of Governors and why Judy Shelton, who still hasn’t been formally nominated, may not wind up there either. The Senate is able to block choices when it collectively chooses to, usually by convincing the president to withdraw a nominee before a hearing is held or even before he makes the nomination. But if anything, the process of finding, selecting, and vetting executive-branch nominees seems to be getting worse, considering that it took about seven months and two selections to find a secretary of defense and there’s still no nominee for secretary of homeland security more than three months after the position was vacated.

 

The underlying problem is that Senate Republicans just haven’t given the president a forceful nudge. The need has been obvious since Trump welcomed Steve Bannon to the White House in a senior position and picked Reince Priebus, who had no governing experience, as chief of staff. Senate Republicans should’ve staged an intervention immediately and threatened to leave other executive-branch picks in limbo until Trump hired someone to run the White House who had a chance to be effective. If not then, they should’ve stepped in when he started the predictable string of failed nominees. Insisting that he run the administration professionally would’ve spared them a lot of trouble in the long run.

 

It’s true that Trump came in as an outsider, and he had earned some latitude for the individuals he wanted to choose. Yet most of his problems haven’t really come from outsiders. Some of his least successful picks have been Republican members of the House.

 

At any rate, Republican senators – many of whom were willing to publicly take on Trump when he attacked the intelligence community – should make sure that the new nominee isn’t intent on dismantling things that are actually working.

[kenberg]

Yippee-ki-yay isn't much of an argument but it our argument and we love it. So tell me, America, do you feel lucky? :)

 

I agree that this won't get done - at least not quickly - but if it is an answer, or the answer, why are we so quick to dismiss it as "impossible" instead of moving toward it or at least talking about it? There is a fine line between pragmatic and stodgy.

 

Well, it would be a lot of work! Here is something I don;t know: There are doctors at a hospital who treat patients coming in on an emergency basis. Let's say, as happened a few years back, I am admitted to the emergency room where things are of course hectic, but then I am put into a room where I stay for two or three days. A hospital doc is in charge of what happens to me. Is that doc on a salary? Whatever his form of payment was, I hope to never be under his care again.

 

But trying to look carefully at all of this would require a lot of time and effort and I it seems so unlikely to happen that I am reluctant to put in the effort. I also probably would not be in favor of it, but as of now I cannot say that with certainty.

[PassedOut]

Doctors at the Mayo Clinic are salaried and I've been very happy with the medical care my family has received there. The whole operation is well-organized, including the timing and accuracy of the appointment schedules.

 

When my middle son was a freshman in college, he developed painful kidney stones and was determined by a local doctor there to have a problem with one of his parathyroid glands. The doctor recommended immediate surgery -- which he would do -- and pulling our son out of college for the rest of the semester for recovery.

 

Of course, Constance and I said "Hold your horses until we get back to you." On the phone immediately to Mayo, we learned that immediate surgery was not required and that Mayo had a minimally invasive technique available to remove the defective gland that would require only a couple of days to recover. We scheduled the procedure for his winter break, and everything went like clockwork, as is usual with Mayo. But, even more telling, from my viewpoint, was that the staff there knew that we would be returning to Michigan's Upper Peninsula on the day after the procedure, and that winter driving in the dark could be problematic. To help us out, Mayo offered to have the discharge doctor come in to work an hour early to meet with us so that we could get an early start on our drive. We welcomed that and the doctor did meet with us early and we did get home before the sun went down.

 

And it's not just us who like Mayo. Mayo generally has a fine reputation, both in the US and internationally. So the idea of doctors receiving (very good) salaries and working in a well-organized setting does not seem a farfetched notion to me. It's the other structures that seem ridiculous.

[kenberg]

Doctors at the Mayo Clinic are salaried and I've been very happy with the medical care my family has received there. The whole operation is well-organized, including the timing and accuracy of the appointment schedules.

 

When my middle son was a freshman in college, he developed painful kidney stones and was determined by a local doctor there to have a problem with one of his parathyroid glands. The doctor recommended immediate surgery -- which he would do -- and pulling our son out of college for the rest of the semester for recovery.

 

Of course, Constance and I said "Hold your horses until we get back to you." On the phone immediately to Mayo, we learned that immediate surgery was not required and that Mayo had a minimally invasive technique available to remove the defective gland that would require only a couple of days to recover. We scheduled the procedure for his winter break, and everything went like clockwork, as is usual with Mayo. But, even more telling, from my viewpoint, was that the staff there knew that we would be returning to Michigan's Upper Peninsula on the day after the procedure, and that winter driving in the dark could be problematic. To help us out, Mayo offered to have the discharge doctor come in to work an hour early to meet with us so that we could get an early start on our drive. We welcomed that and the doctor did meet with us early and we did get home before the sun went down.

 

And it's not just us who like Mayo. Mayo generally has a fine reputation, both in the US and internationally. So the idea of doctors receiving (very good) salaries and working in a well-organized setting does not seem a farfetched notion to me. It's the other structures that seem ridiculous.

 

Great story, thanks. I have never been to the Mayo but growing up in Minnesota I always understood it to be a great place.

 

They are salaried? That's interesting. I am guessing that at The NIH this is also true, I think it probably is not the case at Johns Hopkins (two major places near me) but I don't really know in either case.