Friday, December 15, 2017

WTO and Food Security: Biting the Hand that Feeds the Poor [feedly]

WTO and Food Security: Biting the Hand that Feeds the Poor
http://triplecrisis.com/wto-and-food-security-biting-the-hand-that-feeds-the-poor/

Timothy A. Wise

Since 2013, controversy has swirled around India's National Food Security Act (NFSA), the most ambitious food security initiative in the world, with its plans to buy food grains from small-scale farmers to distribute to some 840 million poor Indians, two-thirds of the country's people. The controversy came at the World Trade Organization (WTO), where the U.S. government accused India of unfairly subsidizing its farmers by paying a support price above market prices.

At the WTO biannual ministerial conference in Bali, India stood firm, questioning the subsidy calculation as an artifact of old WTO rulemaking and asserting that, in any case, such programs that are used for legitimate food security purposes should be exempt from such restrictions. The conflict nearly torpedoed the WTO's modest negotiated agreements in Bali, but a "Peace Clause" granted India and other developing countries with such programs a grace period while negotiators tried to reach a permanent solution. (See my coverage of the controversy here.)

That grace period is up now, as trade ministers from across the globe board planes for the December 10 opening of the WTO's 11th Ministerial Conference in Buenos Aires, Argentina. With no progress on the matter at the 2015 conference in Nairobi, Kenya, India and other developing countries have called for a simple exemption of such programs from WTO restrictions. U.S. negotiators, themselves under fire for "dumping" agricultural surpluses on global markets at prices below the costs of production, are demanding more restrictive measures and further concessions from developing countries.

I covered the Bali conflict, pointing out the unabashed hypocrisy of the U.S. government, which subsidizes wealthier farmers at higher rates for less compelling reasons, calling out a far poorer country for subsidizing its much poorer farmers for the purpose of feeding a large and hungry population.

As the controversy dragged on toward the Nairobi WTO meeting in late 2015, I traveled to India to see the reality of the National Food Security Act. What I found were moderate subsidies, which helped stabilize rural markets while putting urgently needed food rations into hands of poor women so they could feed their families. What I saw, in fact, was a far more ambitious version of the U.S. farm programs enacted as part of the New Deal for much the same reasons.

Feeding the hungry

I traveled to Shivpuri in the state of Madhya Pradesh, an area of the country in which 26 starvation deaths in 2001 and 2002 had shocked the nation and pushed the country's Supreme Court into intervening to insist that the government do more to ensure poor citizens' right to food.

According to the 2011 Madhya Pradesh Development Report, the state had the highest infant mortality rate in India—42 percent of children under five were stunted and 36 percent were underweight, with 18 percent qualified as severely underweight, or "wasted." As one of India's most populous states, with 75 million people, the human costs of food insecurity, even in just this one state, boggled the mind. In 2003, an estimated 160,000 children died before their fifth birthday, a child death rate of 89 per 1,000 live births.

The NFSA increased the basic food ration from 20 to 35 kilos/month (44 to 77 pounds/month) of cereals for a family, and expanded eligibility so the majority of rural Indians could qualify. Beyond the basic grains—rice and wheat—the NFSA entitled recipients to distributions of sugar, salt, and kerosene for cooking. All were given out by the Public Distribution System (PDS) through a network of thousands of village-level ration shops.

Recipients pay very low, subsidized prices; a kilo of rice that might cost 20 rupees in the market cost just 1 rupee in the ration shop—about 1 penny per pound instead of 10. A ration card was issued to qualified female heads of household, with the card stamped and registered to show compliance, a system soon to be replaced with more corruption-proof, fingerprint-based biometric systems for identifying beneficiaries and documenting distributions.

In the villages of Upsil, Benskedi, and Bineka, I met villagers who generally applauded the expansion of the program but demanded better service from the ration shops as well as the inclusion of lentils and cooking oil, key local sources of protein and fat. Children seemed poor but not desperately malnourished, though one can't know from such a visit.

As it turned out, I visited these villages at one of the less needy times of year, just after food crops had been harvested. Three months earlier, I would have seen the hungry season, that paradoxical period when the fields are green with early growth but last year's stores have long run out. In regions as poor as Shivpuri, they have a different name for that season.

"We call it the season of death," said Sachin Jain of Vikas Sanvad, a member organization of the Right to Food Network in the state capital of Bhopal. Nineteen people in the region died in 2011 from malnutrition. Six died just two months before my visit.

But Sachin confirmed that things were improving with the NFSA. Thanks to the full range of court-ordered anti-hunger measures—school lunches, Integrated Child Development Services for women and young children, and the National Rural Employment Guarantee Program, in addition to NFSA—rural welfare had improved considerably. Government spending on programs for children under six years old increased twentyfold over the previous decade. The child death rate had been cut almost in half in 10 years. In Madhya Pradesh, the percentage of underweight children had dropped from 60 percent in 2006 to 43 percent in 2016.

Food better to distribute than cash

There is significant variation in how well the NFSA is being implemented across India's vast territory, but Madhya Pradesh has emerged as a leader. That was thanks in no small part to government officials like Dr. Manohar Agnani, State Commissioner for Food and Civil Supplies, the agency in charge of the Public Distribution System.

Dr. Agnani told me that Madhya Pradesh, with its high poverty levels and strong program inclusion, expects to enroll 75 percent of the state population, not just 67 percent, more than 60 million people. For reference, that is more beneficiaries than the U.S. has in its entire SNAP (food stamp) program.

He said food distributions for India were far preferable to cash benefits, which are favored by the U.S. government because they are seen as less "market-distorting." Agnani was dismissive of the new fascination with cash. "We have discrimination based on gender and caste," he said. Many male heads of household, he told me, would use cash distributions for things other than food, and for themselves rather than their families. Men would more readily control the income. "I don't believe in efficiency at the cost of effectiveness and gender equity," he went on.

Agnani, who has since moved on to a job with the national Health Ministry, said that Madhya Pradesh has proven that the NFSA can be implemented efficiently and effectively to reach the millions of Indians going hungry. But what about its procurement at subsidized prices? That was the question on the table at the WTO.

Originally published by Food Tank.


 -- via my feedly newsfeed

Game Theory and the Greater Good

Game Theory and the Greater Good

POSTED ON: December 10, 2017TOPICS: dean's note, game theory

thisweek365-deans-noteOur current political moment

Before I begin today's note, a comment on recent political events. We have just seen the Senate pass a bill that will systematically undermine previous efforts towards progressive taxation, widen income gaps, deepen challenges to social mobility, and start a process of inexorably chipping away at the Affordable Care Act, exposing millions to again being uninsured or having substandard insurance. At the same time, Congress continues to fail to reauthorize spending for the Children's Health Insurance Program, which provides low-cost health insurance coverage for families who do not qualify for Medicaid. These are all, sadly, systematic efforts to place the interests of a few—in particular, those who already have substantial advantage in this country—over the interests of the many. Early in the Trump administration, I wrote about its potential impact on the health of the public. It is deeply troubling that the worries that were then just hints on the horizon are slowly coming to fruition. To my mind, the challenges of the present are, once again, a reminder of the profound impact that politics can have on population health, and why our work must be concerned with ensuring that the values that animate public health are front and center in the national conversation. While there is little to lift the spirit in the face of some of the administration's recent actions, I continue to hope that these years will prove formative for a generation of students who are coming of age during a time of trial for the health of populations, and who will use the troubled present as inspiration for work that improves the conditions that create health in the coming decades.

To continue our engagement with this topic, on Tuesday, May 8, 2018, we will, together with the Lancet Commission on Public Policy and Health in the Trump Era, host a daylong symposium, called "The Trump Administration and the Health of the Public." The symposium will aim to catalyze data-informed discussion about how the changes we are seeing to national policy may influence public health now and in the future. Additional details will be posted online. For today—a note that explores the forces that underlie our country's political shifts, written with the goal of implementing healthier polices on the national stage, once our present moment has passed.

On game theory

Those of us who study the health of populations know that populations do not always act in their collective best interest. Americans, for example, have long been ambivalent about policies that could improve the country's health, such as federal welfare benefits and universal health care. Additionally, as Professor Jacob Bor's research shows, many of the country's unhealthiest citizens voted for Donald Trump, who has since done much to undermine the polices and programs that safeguard health in the US. What makes people act against their core interests? Journalist Thomas Frank famously tackled this question in his bookWhat's the Matter with Kansas? How Conservatives Won the Heart of America. The book looks at how Kansans went from being historically progressive to strongly conservative, electing candidates who, once in office, implemented economic policies that disadvantaged the very working-class voters who put them in power. With this in mind, today's note seeks to answer a perennial, perplexing question: Why do populations oppose measures that could improve their health?

To answer this, I will draw an example from a perhaps unexpected place: the world of game theory. It is here that we encounter the ultimatum game. The ultimatum game is an economic experiment in which two players participate. Player One is given a sum of money and the choice of how to apportion it between herself and Player Two. She may give Player Two all of the money, or none. The second player then chooses whether to accept or reject the first player's offer. If he rejects it, both players get nothing. The game depends on individual self-interest regulating itself, so that each player will benefit, however unequally. Figure 1 provides a useful visualization of the game's dynamics, when the total sum is $10.

Game-Theory-and-the-Greater-Good-fig-1

Figure 1.
Talwalkar P. The Ultimatum Game and the Hollywood Writer's Strike. Mind Your Decisions Web site. https://mindyourdecisions.com/blog/2008/01/15/game-theory-tuesdays-the-ultimatum-game-and-hollywood/ Published January 15, 2008. Accessed November 26, 2017.

Theoretically, assuming rational actions on the part of both participants, the second player would always accept whatever Player One offers, since something is always better than nothing. Yet this is not invariably the case. On average, second players tend to accept offers above 40 percent of the total sum, with about half of all second players declining offers below 30 percent. The motivation of players who decline the lower offer is not difficult to guess. If they believe that Player One is taking advantage, or benefitting unfairly from the rules of the system, it opens the door to a sense of competition, turning what should be a mutually beneficial exchange into a zero-sum game. As a consequence, the second player would rather no one benefit, than someone do so apparently at his expense.

Lessons for our work in population health

Our politics often shows how this motivation can be used to rally support for policies that do not always serve the people who vote for them, but that nevertheless speak to the anger and anxiety of these populations—to their frustration with the status quo or suspicion of certain socioeconomic groups. This can mean the creation of scapegoats, who come to embody "the unfair first player"—the individuals or groups who seem to undeservedly benefit from the advantages of a given policy. During the 2016 election, for example, then-candidate Donald Trump leveraged fear of "the job-taking immigrant" into working-class support for a movement that has, so far, done little to benefit the working class. More recently, opponents of the Affordable Care Act have argued, in effect, that healthy people should not have to subsidize the care of sick people, that those "who have done things the right way" should be rewarded, and that those who have "not" should fend for themselves.

How can we avoid this "ultimatum game trap?" Game theory suggests a possible solution. Suppose each player in the game is weighing her or his options. Player One knows that she must offer Player Two something, or else Player Two has no incentive to accept. Player Two knows he can only gain by accepting whatever he is offered, as long as it is more than nothing. Each understands how adhering to this strategy benefits the other player, not to mention their own self-interest. They therefore decide not to deviate from the course of action that will lead to the best outcome for them both: Player One offers a sum, and Player Two accepts it. This solution is called the Nash Equilibrium, named after the economist John Nash. To function, it requires each player to see which course of action is most beneficial for himself and his fellow player, and then to not deviate from what is understood to be the best strategy for success. A "real-world" parallel would be obeying a law that no one has the incentive to break, even if that law were to go unenforced—obeying traffic lights, for example, when a car is driving in your direction. Or, indeed, investing in health as a public good in a country where deleterious social, economic, and environmental influences put populations at risk of injury and disease every day. Through this framework, positive outcomes occur when self-interest meets an awareness of how the needs of others need not conflict with, indeed may even complement, one's own. For populations to make choices that are more in line with their interests, they must first see how what is good for others can be good for them, and vice-versa—that the world does not have to be divided into "winners" and "losers," where someone can only thrive at another's expense.

I have written previously about the challenge of implementing measures that could improve the health of all, when some individuals or groups perceive these measures to be burdensome. I suggested that vaccines are an example of how something that was once viewed with skepticism can eventually achieve acceptance when its proven benefits become widely known. It is encouraging that this is so—that spreading awareness of a public health good can be enough to change minds and persuade populations to accept initiatives for the betterment of all. However, as we have seen, this is not always possible. Sometimes, a measure's benefits can be clear, yet it will still be opposed on the grounds that it might help the wrong people for the wrong reasons. Often, this opposition has its roots in the resentment of particular socioeconomic groups. To overcome this resentment, and apply the Nash equilibrium to population health, we must not only promote health as a collective value, we must continue to emphasize that this value is not attainable as long as our society tolerates stigma and hate. These forces have great power to mobilize and mislead, distracting populations from core health interests. For this reason, any effort to nudge the public towards a deeper understanding of the true causes of health must approach advocating for the marginalized not as an incidental goal, but as a central organizing principle. This fits with the mission of public health, and with our school's stated aim "to improve the health of local, national, and international populations, particularly the disadvantaged, underserved, and vulnerable." Our pursuit of these goals points us towards a truly broad-based movement in favor of the institutions and policies that promote health. Ultimately, it is through cooperation, rather than competition, that we can best apply the lessons of game theory to the work of public health, empowering populations to know, and do, what is in their best interests.

I hope everyone has a terrific week. Until next week.

Warm Regards,

Sandro

Sandro Galea, MD, DrPH
Dean and Robert A. Knox Professor
Boston University School of Public Health
Twitter: @sandrogalea

Acknowledgement: I am grateful to Eric DelGizzo for his contributions to this Dean's Note.

Previous Dean's Notes are archived at: http://www.bu.edu/sph/tag/deans-note/


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Wednesday, December 13, 2017

Enlighten Radio Podcasts:Resistance Radio: The Doug Jones victory -- Celebration

John Case has sent you a link to a blog:



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Post: Resistance Radio: The Doug Jones victory -- Celebration
Link: http://podcasts.enlightenradio.org/2017/12/resistance-radio-doug-jones-victory.html

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AFL-CIO Joins CWA Call for $4,000 Wage Increase for Working People [feedly]

AFL-CIO Joins CWA Call for $4,000 Wage Increase for Working People
https://aflcio.org/2017/12/12/afl-cio-joins-cwa-call-4000-wage-increase-working-people

CWA

The Donald Trump administration repeatedly has claimed that its tax bill would result in a $4,000 wage increase for working people. Today, the AFL-CIO has joined a campaign by the Communications Workers of America (CWA) to demand corporations guarantee this raise in writing. The labor federation is rallying the power of its 12.5 million members and the entire union movement to support this campaign in every industry.

AFL-CIO President Richard Trumka said:

CWA has inspired an innovative movement to demand working people get our fair share and expose the scam that is the Republican tax bill. Working people have heard the same old lies about the benefits of economic policies written by and for greedy corporations for too long. This campaign is about holding corporations and politicians accountable to their claims and getting a much-needed raise for America's workers.

On Nov. 20, CWA sent a letter to its major employers, including AT&T, Verizon, General Electric Co., American Airlines and NBC Universal, calling on them to commit to that raise in writing. In joining the CWA's efforts, the AFL-CIO is encouraging all unions from all sectors to join in by reaching out to their employers and encouraging all working people to sign a petition that puts employers on notice that they will be held accountable if the Republican tax bill becomes law. 

In a powerful op-ed, CWA President Christopher Shelton laid out how the Republican tax scam would hurt working people and increase the deficit by more than $1 trillion:

Republicans are on the brink of passing a massive tax overhaul, and it's looking like the biggest con of the Trump era so far. And that's saying a lot.

The legislation being jammed through by the House and Senate Republicans is a tax giveaway to corporations and the richest 1 percent, paid for by working and middle-income families.

Across the board, working people will be hurt by this plan, whether by the new incentives to corporations to send U.S. jobs overseas, the loss of the medical expense deduction, new taxes imposed on education benefits, the inability to deduct interest on student loans, the loss of state and local tax deductions, or the forced budget cuts to Medicare, transportation, health care and other critical programs.

Despite the double-talk from Republicans anxious to sell this plan, it's not hard to figure out who Republicans really want to help. Why else would tax cuts for corporations and tax changes that benefit the wealthiest Americans—like the estate tax—be permanent, while individual tax cuts for middle-income families are only temporary?...

Working people know better than to believe the boss' promises unless they are in writing. That's why my union has asked some of our biggest employers to sign an agreement that says if the tax plan passes, working people will get their $4,000.

Kenneth Quinnell Tue, 12/12/2017 - 14:10

 -- via my feedly newsfeed

Urban Institute: How Would Spending on Children be Affected by the Proposed 2018 Budget? [feedly]

How Would Spending on Children be Affected by the Proposed 2018 Budget?
https://www.urban.org/research/publication/how-would-spending-children-be-affected-proposed-2018-budget

If the Trump administration's proposed 2018 budget were to be fully adopted, federal spending on children would be at least 9 percent lower over the 10-year budget window compared with projections under current law. The largest proportional cuts would be to spending on education programs, which would be reduced by 15 percent below baseline spending projections for 2018–27. SNAP, Medicaid, and TANF would also experience substantial cuts, and some housing and social services programs would be eliminated entirely. The brief builds off the Urban Institute's annual Kids' Share reports, which track government spending on children annually and current-law projections.

 -- via my feedly newsfeed

Summers: We are even more convinced that thousands will die prematurely if the ACA is repealed [feedly]

We are even more convinced that thousands will die prematurely if the ACA is repealed
http://larrysummers.com/2017/12/12/we-are-even-more-convinced-that-thousands-will-die-prematurely-if-the-aca-is-repealed/

On Monday, The Washington Post published an article by Casey Mulligan and Tomas Philipson attacking Lawrence Summers's statement that "thousands" of individuals would die if the Republican tax bill became law. Summers reached his estimate after carefully reviewing the literature and consulting with health economists Jonathan Gruber and Mulligan and Philipson's University of Chicago colleague Dean Kate Baicker, who has published a number of influential studies on the effect of health insurance on health.

While Summers claimed only that thousands would die, the Baicker et al. studies suggest that at least one person dies for every 1,000 people who lose health insurance. Even with very conservative assumptions about how many people will lose health insurance as a result of the repeal of the Affordable Care Act's individual mandate, this implies tens of thousands of premature deaths.

Mulligan and Philipson make errors in logic and engage in a highly selective use of evidence. After seeing the best challenge that the Trump Council of Economic Advisers can come up, we are more convinced of our initial conclusions. Five observations seem important.

The argument against the individual mandate is uncompelling.

Standard economics predicts that people are better off making choices voluntarily only when their choices have no external effects on others. This is patently not true in health-insurance markets once we have nondiscriminatory insurance pricing.  Such "community rating" is supported by the vast majority of Americans and is the most popular part of the ACA.  If insurers are required to charge the healthy the same as the sick, then when I, as a healthy person, decide not to buy insurance, it raises your rates as a sicker person.  Such a case is the classic market-based scenario where a mandate can improve welfare, as Summers pointed out more than 25 years ago in the American Economic Review.

Moreover, a focus of recent research has been on inconsistencies in individual decision-making in health-insurance markets, which further strengthen his original argument. Many studies document the problems that individuals have in making appropriate decisions about their health-insurance plans.  Perhaps most compelling is a recent study that showed that the majority of employees at a company chose "dominated" health-insurance plans, where their total costs would certainly have been lower if they had chosen other options offered.

Changes to the rules of the game, therefore, can have significant negative effects on consumers. A particularly telling case is what happened during welfare reform in 1996. It changed the rules so that legal immigrants who had been in the United States less than five years could no longer qualify for Medicaid.  This rule caused a large decline in insurance coverage among immigrants who had been here for more than five years. That is, even though the coverage was valuable and free, individuals who were entitled to keep the coverage dropped it because they didn't understand the rules.

The authors turn to what they regard as empirical evidence and are simply wrong.

They completely misinterpret the evidence from the RAND Health Insurance experiment of the 1970s.  This experiment did not test whether insurance mattered (everyone in the experiment was insured), but rather whether the generosity of insurance coverage mattered (it didn't). They wrongly cite a review paper by David Meltzer and Helen Levy that concluded that the evidence on health insurance and health outcomes is uncertain. And they ignore the bulk of the evidence in the 15 years since the Meltzer and Levy review that shows that health-insurance coverage does matter for health.

In particular, numerous studies over the past 15 years using strong research designs have found that expanding health-insurance coverage improves health care. Mulligan and Philipson instead choose to focus on the one article that does not show significant effects on physical health, without highlighting that (a) that same study found massive improvements in mental health, (b) that study had a short follow-up period and (c) that study's results are sufficiently imprecise that they can't rule out the mortality effects cited in Summers's earlier article.  Indeed, Summers's article used a highly conservative interpretation of some of the best work of the past 15 years.  And Mulligan and Philipson accuse Summers of cherry-picking!

They attack the Congressional Budget Office's predicted premium hike as "speculative."

In doing so, Mulligan and Philipson ignore that CBO's prediction of premiums in the exchanges was amazingly accurate — as of the 2017 rate increases, premiums were almost exactly where CBO predicted they would be. It is true that predicting effects on market premiums is hard — but the 10 percent estimate by CBO is as likely to be low as it is to be high.

They claim that expanding insurance coverage will worsen the opioid crisis.

Exactly the opposite is true. As Gruber and Angela Kilby recently showed, the expansion of Medicaid has led to much more intensive use of cost-effective treatment for opioid addiction. By cutting back on insurance coverage, we deny addicts treatments that can save their lives.

They argue that the tax bill will save lives by promoting economic growth.

This is perhaps the most disingenuous part of their argument. In a recent survey of renowned economists from across the political spectrum sponsored by the University of Chicago, only one said the bill would substantially increase economic growth, and he later recognized that he had misread the question. Moreover, there is no evidence in the modern U.S. economy that faster growth reduces mortality. Indeed, the best research in this area shows that downturns in the economy lower mortality, although that refers only to cyclical fluctuations and not long-term growth.

But there is universal consensus that these tax cuts will cause a massive increase in the nation's deficit — which ultimately will lead to offsetting tax increases, or, more likely, spending cuts. These cuts in spending will probably be focused on the very programs that save  lives and provide valuable financial protection to our nation's poorest and oldest.  It seems implausible to argue that a tax break where 60 percent of the benefits go to the 1 percent of Americans, paid for by broad cuts to public spending focused on the needy, will improve public health.

The United States is facing a crisis of confidence in our academic institutions, and in the role of facts in general in important public policy debates. Ad hominem and poorly researched attacks on credible and thoughtful policy analysis only feed that crisis. We urge our colleagues to draw conclusions from a broad reading of the best available evidence. Doing so makes it obvious that this is a piece of legislation that will be bad for public health.

By Lawrence H. Summers and Jonathan Gruber

 


 -- via my feedly newsfeed

The Utterly Terrible GOP Tax "Reform" Scam [feedly]

The Utterly Terrible GOP Tax "Reform" Scam
http://ataxingmatter.blogs.com/tax/2017/12/the-utterly-terrible-gop-tax-reform-scam.html

The Republicans in the House and Senate continue on their downhill rush to pass their so-called "tax reform" plan before the holiday break.  It's a mad rush to nowhere, a corrupt process of "please the oligarch" that will cause a huge deficit increase (on the scale of $1 to $1.5 TRILLION over ten years) and be used by the Ryan, McConnell and Trump cadre of liars to justify a domino effect of Medicare, Medicaid, and Social Security cuts.

Almost all the provisions in the bill are designed to be generous to the ultra wealthy and stingy to the middle class and poor. 

Corporations and their owners and managers--among the wealthiest people in the country--get the only permanent tax breaks.  It's done in the name of competitiveness, but that's bunk.  It essentially encourages corporations to continue to move profits out of the US because foreign profits are taxed at zero while US profits are taxed at 20%.  It pretends that the multiple tax breaks for big corporations are necessary (under disproven trickle-down and supply-side theories) to lead to more investment in business in the US and to more jobs and higher pay for workers.  But in fact corporations are enjoying record profits under current law and they aren't using those record profits to pay their workers more or to create more jobs or even necessarily to invest in the US.  Mostly they are just doing share buybacks for shareholders (ie, owners/managers and other shareholders) that include the  wealthiest people who own the most corporate stock.  That's because it is demand, not capital, that determines what business expansion is needed and results in labor shortages that give workers leverage to demand more pay.  Tax cuts for corporations just add to the already existing capital glut.

The estate tax cut (elimination in the House bill; doubling the exemption to levels that only the very few multi-billionaires will pay any at all in the Senate) ensures that the wealthy will pay almost no tax at all.  They borrow against their wealth while alive.  Their estates pay no tax on the accumulated wealth when they die.  Their children inherit with a "step up" in basis so they get a huge windfall.  And their children can pay off the parents' debt by selling a few items (because of the basis step-up, with no taxes either) and live on their windfall without ever lifting a finger to do any real work.

Individual workers really lose out in these bills.  Under the House bill, the rate on the lowest wage earners is INCREASED 20%--from 10% to 12%.  And all of the 'tax cuts' for ordinary taxpayers sunset after a few years, while the corporate cuts are permanent.  Shows where the GOP loyalties lie--not to the worker base that put them in office, but to the wealthy oligarchs like the Koch Brothers who donate to the GOP political campaign chests.

The pass-through provisions (a 23% "deduction" from income before tax is one version)--along with the ability of businesses but not individuals to deduct state and local taxes--are a great boon for wealthy owners of real estate partnership interests, like the Trump family.  But they make no sense at all.  The more different kinds of income categories that are created with different rates, the more you empower the wealthy to gamesmanship with the tax system.  That's what this legislation does in spades.

And after the American people spoke up in Town Hall after Town Hall that they wanted the Affordable Care Act health insurance system protected, the Senate's version of the so-called "tax reform" bill (developed in utter secrecy by Republicans bargaining with Republicans as though nobody else counts) eliminates the individual health insurance mandate (and accompanying penalty).  Without that, the entire idea of affordable insurance through government-operated exchanges fails, because the only people on those exchanges will be those who are sick enough or old enough or vulnerable enough to realize that they will need health insurance soon.  Insurance works by diversification of risk--that's why the Republican insurance plan in Massachusetts, the model for Obamacare, called for an individual mandate and penalty.  Without that core feature, the exchanges can't work because the risk isn't sufficiently diversified.  The Republicans who are trying to gut Obamacare know that, and apparently they don't care that this particular "tax cut" will in fact cost more than 8 million Americans the possibility of having affordable health care, likely leading to early deaths for a large number of that group.  They don't care, I guess, because "those people" are less likely to be wealthy and less likely to vote Republican.  If you are so blinded by partisan fealty that you no longer care about legislating for the good of the nation, you descend to the garbage dump level of this Republican tax bill.

Of course, the elimination of the individual tax cuts, the expansion of the real-estate-industry favorable tax cuts, the inclusion of what can only be called a 'mock' provision to deal with carried interest (it doesn't), the elimination of the medical expense deduction (in the House bill) that will leave the disabled, the injured, and the elderly in dire straits, the decimation of the casualty loss provision that helps ordinary people recover from natural disasters, the huge cutback to the state and local tax deduction for individuals (while continuing to allow it for all businesses)--all these provisions prove that Republicans don't care a fig about ordinary people.  We won't be spending money on basic scientific research (needed to be competitive in a global marketplace and needed to save lives from cancer and other diseases).  We won't be spending money on infrastructure (needed to have safe roads, trains, airports. etc).  We won't be spending money on  education (other than Betsy DeVos's favored religious charter schools that teach falsehoods on a daily basis).  We won't be creating a sustainable economy that serves all of our citizens.

Oh, but we will be decimating the environment, as Trump's lineup of industry trolls continues to reduce wilderness areas, as Lisa Murkowski sells her tax and healthcare vote to get to open pristine and irreplaceable Arctic wildlife refuge to the oil and gas fossils that have grown obese off 200 years of government subsidies, as Zinke reduces FOR THE FIRST TIME EVER national monuments set aside by other presidents so that those obese coal and oil and gas guys can get even wealthier, as Pruitt ensures that nobody at the EPA does anything to protect the air, water and land from industry pollution.....

The passage of a tax bill that will create an additional one-to one-point-five trillion-dollar deficit is proof that the Republicans don't care if they destroy this country in their effort to return to the Gilded Age of the past (or, in Roy Moore's definition of the time that America was great, the slavery era when (white) families stayed together and were able to sell black babies away from their black mothers (or half white babies away from their raped black mothers)).

What is the Republican response to the deficit and mal-distribution problems created by such a huge tax cut for the already wealthy?

1) The tax cut will pay for itself.  This is trickle-down gobbledy-gook.  The vast majority of economists and tax experts are quite clear that this is simply not a supportable claim.  It's pie-in-the-sky ideology with no basis in fact when there have been a number of attempts to find such a basis.  It wasn't true for Reagan, back in an economy for which tax cuts held much more promise of economic stimulus than they do for our current situation.  The Kansas experiment shows this trickle-down reasoning is without foundation.  But the Treasury secretary put out a one-page analysis--compared to the careful, extensive, fact-based analyses usually prepared to support well-researched tax proposals--saying that the GOP plan would produce record growth and that growth would pay for the tax cuts.  It's pure fiction.

2) Medicare, Social Security, Medicaid (the "entitlement" programs) will have to be cut to make up for any deficits.  That, of course, is the underlying plan.  Create a deficit and use it to 'starve the government' to justify cutting any programs that don't serve the oligarchs.  Most of that minority of people who voted Trump into the presidency (assuming there wasn't a good bit of ballot falsification, which I think went on in Detroit to not count everyone's ballot) will suffer from this--they depend on Social Security when they retire and on Medicaid when they become incapacitated in their old age and need nursing home or assisted living care.  Under the Republicans, we'll return to the "good old days" of the Great Depression when old folks became homeless and the government didn't have to bother with caring about the vulnerable.

We all should be hitting the phones and telling every GOP member of Congress that they are not there to protect their wealthy donors: they are there to protect us and ensure that the economy is sustainable and viable for all of us.

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