Thursday, September 14, 2017
The Genius of Bernie’s Gradualism [feedly]
http://prospect.org/article/genius-bernies-gradualism
Senator Bernie Sanders holds a press conference on his Medicare for All bill on Capitol Hill.
I'm a fervent supporter of Bernie Sanders's Medicare for All bill, which he introduced Wednesday along with 16 Senate Democrat co-sponsors—and not only because I believe health care is a right and that a universal single-payer system is the best way to ensure that right.
I also support it because it diminishes the power of capital not just in our economy but in our politics as well.
I also support it because it's aspirational—setting a long-term goal that will both motivate Democratic and progressive activists and clarify the Democrats' purpose to an electorate that at times has been understandably unsure how or whether the Democrats champion their interests.
Most important, I also support it because it's gradualist—expanding Medicare in its first tranche to cover just those Americans under 19 and over 49, then lowering the age for eligibility to 45, then 35, then making it universal, in subsequent years. The political implications of this gradualism may make it easier to assemble a congressional majority to enact this bill, and may also make it easier for progressive and centrist legislators in more conservative states or districts to support it in piecemeal fashion.
My first two supplemental reasons for backing the bill don't require extensive explanation. Pharmaceutical companies, in which many private equity firms and hedge funds invest heavily, have long played an outsized role in our legislative process. The Affordable Care Act could not have passed if those companies had not secured a guarantee that the government would not compel them to subject their drug pricing to governmental negotiation or oversight, or if private insurers had felt their interests similarly threatened. The campaign contributions and independent expenditures that these companies make to members of Congress subvert disinterested legislating and the integrity of the democratic process. Single-payer takes these obstacles to democracy out of the game.
As to its aspirational aspects, Sanders's bill does what political parties and movements need to do: set a clear goal that defines the party's or movement's purpose and can motivate adherents over the course of a long struggle. Sanders's timing in introducing the bill also couldn't be better: Coming on the heels of the victorious battle over the ACA's would-be repealers (in which Sanders himself played a significant role), the bill's unveiling comes at a time when the public's belief that health care is a right, and the public's support for government ensuring that right, are both higher than they've been in many years.
But by far the most strategically savvy aspect of the bill is its gradualism. Sanders, it's important to recognize, has not made and does not make the perfect the enemy of the good. During the Republicans' war on the ACA, he more actively defended that legislation—while at the same time making the case for going beyond it—than most of his peers, touring the country to rally the opposition to the GOP's attacks. Likewise, the bill he just introduced, composed as it is of several time-specific steps, is designed to make it progressively easier for legislators to support and progressively more difficult for such entrenched interests as the insurance and pharmaceutical industries to defeat.
Suppose, as will likely be the case, that a legislative majority for the bill's first tranche—expanding Medicare to Americans under 19 and over 49—emerges first, before there's a majority willing to enact the entire package. Politically, it's far less of a heavy lift to support a universal entitlement for children (who also incur low medical expenses) and for a slice of the population that's worked for many years and is finding it more difficult to find remunerative employment in our brave new economy. That's a debate that single-payer advocates should welcome, and that Big Pharma and the insurance companies should feel somewhat nervous about. I suspect the bill's 17 sponsors would see it as a victory if that first tranche were enacted as a separated-out piece of legislation, with the understanding that they'd keep trying to secure majorities for the other tranches.
As the scope of Medicare's clientele expands and as that of the private insurers contracts, the financial and political heft of the private insurers would contract with it. The fight to lower the age of eligibility to 45, then 35, then to make Medicare truly universal, would be one in which private insurers would have progressively fewer arrows in their quivers. An industry that provides insurance to 60 million Americans, and then 40 million Americans, has smaller profits and less clout in Congress than one that provides insurance to 150 million Americans.
It may not be Sanders's intent to disassemble his bill into age-and-time-specific pieces of legislation. But the bill's very design certainly makes that possible if it's politically necessary, and Sanders's own inclinations not to make the perfect the enemy of the good, and his understanding of the complexities of social change, suggest that he at least understands this may be the course that getting to single payer will take.
None of this is to suggest that enacting just the first tranche will be easy—it will, of course, require substantial Democratic majorities in both houses of Congress and a Democratic president. Compelling pharmaceutical companies to negotiate prices and simply expanding the populations covered by Medicare will provoke a massive opposition campaign from Big Pharma and insurance companies, and other forces that thrive under the health care status quo. But it's easier to overcome those forces when the debate centers on the right to health care of children and longtime workers than it is to win an all-or-nothing battle that some on the left have advocated.
The gradualist approach in Sanders's bill also permits Democrats and progressives to have a more flexible approach to their own elected officials and candidates. A liberal or center-left Democrat in a red state may face electoral extinction if she endorses single-payer. She may well be strengthened at the polls, however, if she backs Medicare for kids and the middle-aged. Rather than encouraging some on the left to create a single standard for candidate support—to wit, whether that candidate backs single-payer now—the Sanders bill creates a continuum that affords candidates the ability to position themselves on a sliding scale of support, depending on the politics of their state or district. Some on the left clearly want to cast elected officials who don't or politically can't support the entire package now into the eternal darkness; little Lenins at the Finland Station we certainly have with us. But Sanders himself has made no such argument, and his bill clearly invites the partial endorsement of Democrats who feel constrained from backing it in its entirety.
Besides, revolutions take time. They're a process, not an overnight transformation. Bernie understands that; so should the left.
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Race AND Class, Then and Now [feedly]
https://workingclassstudies.wordpress.com/2017/09/11/race-and-class-then-and-now/
Just a few days after white supremacists marched in Charlottesville, my husband and I went to see Kathryn Bigelow's film, Detroit. Set amid the 1967 uprising 50 years ago this summer, the film focuses primarily on the brutal torture and the murder of three black men by police officers that took place that week at the Algiers Motel. Because it so powerfully and intimately dramatizes the racial hatred and injustice that has defined far too much of this country's history, the film was a fitting end to a terrible week. In an era when police officers keep shooting young black men whom they see as threatening, and when jury after jury acquits those officers, no matter how clear the evidence that their victims posed no threat at all, Bigelow puts us inside a sustained and horrific example of police brutality and, true to history, refuses us the relief of a just verdict. To see this film after the events in Charlottesville and the President's disturbing insistence that the "alt-left" was as much to blame as the bigots bearing assault rifles, waving swastika flags, and chanting racist and anti-semitic slogans, was especially sobering. I was depressed before seeing the film. I could hardly move as the credits rolled.
We went to see Detroit in part because I had been studying fiction, poetry, and films about that city as I researched a book on deindustrialization literature. Detroit is the iconic Rust Belt city, and its deteriorating landscape and long-term economic and social struggles have drawn attention from photographers, filmmakers, advertisers, poets, and fiction writers. In many ways, stories about Detroit are typical of deindustrialization literature, centered on how people and communities continue to wrestle with the long-term effects of economic decline. But there's one crucial difference: while all Rust Belt cities have been marked by racial division and injustice, more than any other city, Detroit is defined by race. Where other deindustrialized cities trace their transformations to plant closings, in Detroit, decline is almost always linked to the uprising of 1967 and the white flight that it spurred.
Yet, as Tom Sugrue has noted, the history of racial tension in Detroit began long before the riots, and it was always entwined with economic struggle. In the opening animation sequence of Detroit, we are reminded that the Great Migration of African Americans was driven by the economic hope of factory jobs, not by – or at least not only by – a desire to escape the Southern racism. African Americans coming to the city in search of good jobs faced segregation and discrimination, patterns that Angela Flournoy captures well in her 2015 Detroit novel, The Turner House. But as Sugrue has shown, both racial divisions and economic inequality grew when Detroit's factories moved out of the city to suburbs like Warren and Livonia. The African Americans who burned buildings and looted businesses in 1967 were frustrated not only by racial prejudice but also by economic limitations, even though, as Sugrue points out, they were not "the poorest or the most marginal. It was folks who were slightly better off and slightly better educated and more tied into the city's labor market than the poorest residents." Detroit's history reminds us that conflicts over race are often also class conflicts.
Fifty years later, African Americans still lag far behind whites economically. They have higher rates of unemployment, poverty, and incarceration, less access to good health careor education, and lower rates of home ownership and less wealth. When we say that Black Lives Matter, we're not talking only about the right to be safe from police violence. We're also talking about the right to earn a living, to have access to decent health care, to get a good education, and to vote. Like the African Americans who rioted in Detroit in 1967, African Americans today – along with many other people of color – have good reason to be angry, frustrated, and doubtful about the integrity of government officials, elected or employed.
While racism clearly exacerbates class struggles for African Americans, we also need to understand how class and race work together in shaping the ideology of white supremacism. Most working-class white people are not neo-Nazis, or do they identify with the alt-right. But it seems likely that many of those who claim that whites are the most frequent victims of discrimination, that immigrants are taking "our jobs," and that Black Lives Matter is a terrorist organization are motivated in part by a sense of economic vulnerability. As Bryce Covert wrote in The New Republic, the "ethno-nationalist agenda" is, to a large extent, "about protecting white jobs and white people." That some of the alt-right's violence, blame, and bigotry comes as response to the economic shifts of the past fifty years, which have undermined the economic stability of so many working- and middle-class people, does not excuse it. But economic anxiety plays a role here, and just as with the economic and social struggles of people of color, some of that anxiety (though clearly not all) reflects real changes. Wages have stagnated, job security is hard to come by, home foreclosures continue, and pension plans have defaulted. These struggles affect not only people displaced from industrial jobs, but also many in the middle class. Indeed, like the African Americans who rose up in Detroit in 1967, many in the alt-right are employed and educated, and these groups are actively recruiting on college campuses.
Unfortunately, that the alt-right and many of its targets share class interests doesn't offer much reason to hope. Don't expect a multicultural working-class revolution any time soon. Instead, as Keri Leigh Merritt pointed out in a piece on the Moyers & Company blog recently, the elite are once again using divisions of race and ethnicity to foment conflict within the working class and distract us from their machinations. In his infamous interview with the American Prospect's Robert Kuttner, Steve Bannon sneered that he had manipulated the left into staying "focused on race and identity," allowing conservatives to claim ownership of the economic agenda. Washington Post columnist E.J. Dionne, Jr., suggests that this may explain Trump's refusal to indict the alt-right: "dividing Americans along racial lines while fueling a fight on the left over identity vs. class politics will leave him a winner." The pattern is reinforced not only by Trump's nationalist economic rhetoric but also by the narrative, too often supported by those on the left, that blames the white working class for Trump's election. And it is echoed in the insistence of some progressive commentators that the sole explanation for Trump's popularity is racism.
To call commentaries that emphasize the role of economic anxiety "equivocating" or a simple refusal to "face the blatant racism that fueled [Trump's] popularity," as Roxane Gaydoes in a New York Times column, suggests that we must choose between race and class. Did racism play a role in Trump's success? Absolutely. Is it the only cause? Of course not.
Some seem to think that progressives cannot do more than one thing at a time. If we're organizing against racism and bigotry, presumably, we can't also advocate for economic justice. If we focus on the economy, we must not care about racism. But to create real change, we need to push for solid strategies for economic justice AND stand up against hatred and for a more inclusive, more equal America. Can we do both at once? As Obama told us, yes, we can. We must.
Sherry Linkon
A version of this piece appeared last month on the American Prospect blog.
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Economic Security and Key Family Economic Issues Top Priorities for Black, Hispanic Women, New Poll Shows
RELEASE: Economic Security and Key Family Economic Issues Top Priorities for Black, Hispanic Women, New Poll Shows
With unprecedented influence over an election, black and Hispanic women say economic security on par with key race and gender issues
Washington, D.C. – In many key battleground states, black and Hispanic women will be the deciding factor in the November elections, making issues facing their families key focuses for all candidates. Latino Decisions interviewed 1,600 black and Hispanic women in four of these states—Colorado, Florida, Nevada, and Virginia—on behalf of the Center for American Progress and found that economic issues, often together with barriers related to race and ethnicity, are front and center as black and Hispanic women think about the coming elections. An overwhelming majority would like to see the next president focus on improving the nation's economic well-being, and view the well-being of working families as a top priority, underscoring that a range of issues will be important in engaging with these communities this year.
"Black and Hispanic women don't live in the issue silos they are often relegated to by pundits and political campaigns," said Angela Maria Kelley. "Not only are these women and their families looking for candidates to have concrete plans to address their economic challenges, but it is also their families that are disproportionately affected by the failure to act up to this point. That is why we are seeing such overwhelming support for issues such as equal pay and affordable child care: These communities see the impact these policies would have on their lives."
The survey also finds that working black and Hispanic women report facing significant amounts of work-related hardship, experiencing racism and sexism, and supporting policies that would address these and the economic challenges they face.
Key data points include the following:
- 87 percent of black women and 88 percent of Hispanic women see improving the economic well-being of working families as the "top most important priority" or "one of a few important priorities" for the new president.
- 42 percent of black women and 53 percent of Hispanic women are worried that they or someone in their household might lose their job in the next year.
- 36 percent of black women and 45 percent of Hispanic women report difficulty at work as a result of a lack of reliable child care. In fact, a majority of both black women and Hispanic women report that "reliable child care when you need it;" "high-quality, in-home child care;" "high-quality child care centers in your neighborhood or near work;" and "affordable child care" are "out of reach" for them.
- Low pay is an obstacle confronting a large majority of black women—63 percent—and Hispanic women—61 percent.
- More than 40 percent of both black and Hispanic women are unable to take time off if they or a family member gets sick and go unpaid if they decide to have a child or if their child gets sick.
While issues such as equal pay, paid sick leave, and affordable child care receive broad support among many groups, black and Hispanic women overwhelmingly see how these policies would help them and their families. These issues would be key in addressing many of the economic security challenges facing these women and their families, and include the following:
- An overwhelming majority favor up to seven paid sick days per year—77 percent of black women and 74 percent of Hispanic women.
- On paid family leave, 79 percent of black women and 75 percent of Hispanic women favored some amount, up to 12 weeks, for a new child, serious illness, or serious illness in the family.
- On pay equity, the support is also overwhelmingly strong for gender equity—83 percent of black women and 77 percent of Hispanic women—and for racial equity—82 percent and 74 percent respectively.
- Support is also very strong, if slightly lower, for the right to request a flexible, fair, and predictable work schedule—72 percent for black women and 65 percent for Hispanic women—for a universal public preschool program—73 percent for black women and 67 percent for Hispanic women—and for help to lower the costs of child care for lower- and middle-income families—75 percent for black women and 71 percent for Hispanic women.
"These audiences are the strongest supporters of family economic policies that help their own, and all working American families, thrive," said Sylvia Manzano. "In a more acute way, black and Hispanic women see how their families would benefit from policies that address economic challenges they face and are looking to candidates for solutions on a range of policies that will help close the opportunity gap, from immigration and civil rights to equal pay and affordable child care. These voters will decide this year's elections and many to come, and candidates should not treat them as one-issue voters."
Read the poll memo and full results.
Harpers Ferry, WV
Harvey, Irma and the TBTF implicit subsidy problem [feedly]
http://jaredbernsteinblog.com/harvey-irma-and-the-tbtf-implicit-subsidy-problem/
On my way in this AM, I heard an interesting interview by the great Bloomberg Surveillanceteam of Tom Keene and David Gura (and I'm not just saying that because they occasionally invite me on; those guys get good guests and give them the time to answer good questions). They were talking to an insightful guy from the re-insurance industry about the costs to the industry of Harvey and Irma. To be clear, what follows abstracts from the human costs of these disasters, which I take extremely seriously. In fact, both the implicit subsidy point I stress below and the more elaborate argument I make here are intended to link the economics to the too-often tragic human outcomes.
Their discussion emphasized the large share of residential and commercial real estate vulnerable to flooding but without flood insurance (I think they put this share at 50% in South FL.). Moreover, as I stressed in the WaPo piece linked above, the federal flood insurance program has long underpriced the risks against which they insure, leading to subsidy #1.
Subsidy #2, though, is the one currently in play in DC, and discussed in the interview: those who build in harm's way can trust that there's an implicit subsidy as the gov't (mostly federal) will pony up serious money for their relief and rebuild efforts. That is as it should be. When Americans are laid low by natural disasters, we pitch in, whether as taxpayers or as revealed by the behavior of many good people in TX. And when we're talking about "black swans"–very low probability events with very high, unforeseen costs–the federal sector, which can borrow at favorable rates and run deficits long-term, is uniquely positioned to help.
And yet, there are problems with this model. Subsidy #2 is one of those implicit subsidies, not unlike the one tapped by some of the big banks or Fannie and Freddie after the financial crash. The bailouts that saved these firms were of course premised on "too big to fail" (TBTF), in that their collapse would generate nationwide damage. To the extent that this is true, there's a huge moral hazard problem, which will, and has, led to systemically underpriced risk.
I understand that mapping these observations onto big places like Houston and South Florida is tricky. These are big chunks of America and American commerce and thus they too are legitimately classified as TBTF. But that doesn't mean we ignore the inherent problems this creates, anymore than we ignored the financial crisis, which I assure you as a former insider was a huge motivator for the Obama administration, leading ultimately to the Dodd-Frank reforms.
Instead, we must work to both mitigate and adapt to the impacts of climate change, particularly the intensity of storms and flood surges. We must update our priors around alleged 500-year floods that appear to be showing up a lot more frequently than that. And we must generate more accurate price signals, particularly in the face of implicit TBTF subsidies.
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CONVERSABLE ECONOMIST:Health Insurance Coverage in the US
Blog: CONVERSABLE ECONOMIST
Post: Health Insurance Coverage in the US
Link: http://conversableeconomist.blogspot.com/2017/09/health-insurance-coverage-in-us.html
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Can We Pay for Single Payer? [feedly]
http://cepr.net/publications/
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