Tag: Democratic Party

The Next Healthcare Battle

Thursday 7/20/2017 – Most people are at the least relieved with the demise of the latest vicious Republican healthcare proposal cooked by old-all-white-all-male-Republican Senators. Obamacare appears to be safe for the moment. But now is the time to double down on the battle for real healthcare reform in this country.

Millions are still not covered by Obamacare; the performance of the healthcare system is appalling; it is a giant ripoff of over-priced-super-profitable prescriptions and procedures masquerading as health.

Here are the basic facts:

  • Health outcomes: the US ranks
    • 56th in infant mortality out of 225 countries;
    • 48th in maternal mortality out of 184;
    • 42nd in life expectancy at birth out of 224.1
    • all developed countries provide universal healthcare and do much better
  • Healthcare spending: the US spends more than double per capita on healthcare compared to other developed countries.

    (click for full size)

Obamacare Is Not the Solution

Obama and the Democrats never had the political will and strength to tell the pharmaceutical companies, doctors, hospitals and insurance companies that their game was over. We should be outraged that they charge exorbitantly high prices and deliver terrible results. But they live in a marketplace where they set the prices and the incentives in their marketplace urge them on to prescribe more drugs and procedures. The things that are being purchased in their marketplace are not health. We need to demand that we develop a healthcare system focused on health not profits.

The Proof Is In the Pudding

Just look at the chart from the Commonwealth Fund2 comparing performance and spending. Certainly if all of these countries (and others not included in this study) have figured out how to deliver much better healthcare at half the cost we need to demand that our government do at least as well.

 

 

  1. Current CIA The World Factbook – https://www.cia.gov/library/publications/the-world-factbook/ accessed 5/13/2017 []
  2. http://www.commonwealthfund.org/publications/fund-reports/2017/jul/mirror-mirror-international-comparisons-2017 accessed 07192017 []

Affirmative Action For Whites – began in the 1930s

As noted here in “Creating Segregated America in the 20th Century – government in action” segregated America didn’t happen by chance nor by choice of the victims. Consistent white supremacist government action supported by private institutions created the segregation that persists and flourishes in the 21st century. But there is a flip side to this. At the same time government law, regulation and policy created white affirmative programs to provide white people enormous advantages in jobs, education, housing, healthcare and more throughout this period. Columbia University professor Ira Katznelson’s When Affirmative Action Was White: an untold history of racial inequality in twentieth-century America1 lays out the history of Federal legislation, most prominently of the New Deal era, that created the booming white middle-class of the post-WWII decades while excluding African Americans. 

In June, 1965 President Johnson gave a commencement speech at Howard  University, “To Fulfill These Rights” about efforts to end segregation and poverty in the African American community. He outlined the growing disparity between white America and black America as follows:

A WIDENING GULF But for the great majority of Negro Americans-the poor, the unemployed, the uprooted, and the dispossessed–there is a much grimmer story. They still, as we meet here tonight, are another nation. Despite the court orders and the laws, despite the legislative victories and the speeches, for them the walls are rising and the gulf is widening.

Here are some of the facts of this American failure.

Thirty-five years ago the rate of unemployment for Negroes and whites was about the same. Tonight the Negro rate is twice as high.

In 1948 the 8 percent unemployment rate for Negro teenage boys was actually less than that of whites. By last year that rate had grown to 23 percent, as against 13 percent for whites unemployed.

Between 1949 and 1959, the income of Negro men relative to white men declined in every section of this country. From 1952 to 1963 the median income of Negro families compared to white actually dropped from 57 percent to 53 percent.

In the years 1955 through 1957, 22 percent of experienced Negro workers were out of work at some time during the year. In 1961 through 1963 that proportion had soared to 29 percent.

Since 1947 the number of white families living in poverty has decreased 27 percent while the number of poorer non white families decreased only 3 percent.

The infant mortality of nonwhites in 1940 was 70 percent greater than whites. Twenty-two years later it was 90 percent greater.

Moreover, the isolation of Negro from white communities is increasing, rather than decreasing as Negroes crowd into the central cities and become a city within a city.

Of course Negro Americans as well as white Americans have shared in our rising national abundance. But the harsh fact of the matter is that in the battle for true equality too many–far too many–are losing ground every day.2

Without exploring the ironies of Johnson, who was present in the Congress and Senate when much of the legislation that generated these disparities was passed with his support, now calling for a solution, this is the central set of facts that persist to this day with only a worsening in some areas in the ensuing five decades following his Great Society programs.

Katznelson recounts the central political facts of the political coalition that passed the New Deal legislation of the 1930s. Northern Democrats had to rely on the support of Southern Democrats for their majorities in both the House and Senate. The Southern Democrats were white supremacists across the board. They could effectively guarantee that every piece of legislation and the regulations that implemented it would exclude African Americans. Any Federal action that might upset the white supremacist regime in the South was foreclosed.3 Second, Southern Democrats also insisted that the administration of programs be handled at the state and local levels of government. This provided further opportunities to exclude or harass African Americans seeking to take advantage of the Federal programs. And third, Southern Democrats made sure that no anti-discrimination policies could be attached to a Federal program.

With the passage of the Social Security Act in 1935 the first national comprehensive economic security program proved not to be so comprehensive and not so national. Southern Democrats forced the final bill to exclude farm workers and maids. This excluded 65% of African Americans nationally and 70 to 80% in the South from the retirement program. To be sure these exclusions in a country that was still quite rural and agricultural also kept 40% of whites outside of Social Security. In the second portion of the bill, Aid for Dependent Children and help for elderly poor, where cost sharing between the Federal and state governments was involved, the impact of local administration was even more decisive in excluding African Americans. Three states, Texas, Kentucky and Mississippi did not participate at all. The third leg of the Social Security Act, unemployment insurance required that an unemployed person’s employer had paid into the system and that they had a history of “regular and stable employment”. Combined with the exclusions for farm workers and maids the availability of this insurance for African Americans was miserable. The net of these affirmative action programs for whites and others is that by 1950 over $100 billion had been transferred to the white population in preference to black America.4

Katznelson details how the same coalition of complicit white Northern Democrats and Southern white-supremacist Democrats crafted labor legislation and the great post-WWII GI Bill to further favor whites. All of these white affirmative action policies contributed to the increasing disparities between white and black America described by president Johnson.

Taken together, the effects of these public laws were devastating. Social Security, from which the majority of blacks were excluded until well into the 1950s, quickly became the country’s most important social legislation. The Labor Laws of the New Deal and Fair Deal created a framework of protection for tens of millions of workers who secured minimum wages, maximum hours, and the right to join industrial as well as craft unions. African Americans, who worked on the land or as domestics, the great majority, lacked these protections. When unions made inroads in the South, where most blacks lived, moreover, Congress changed the rules of the game to make organizing much more difficult. Perhaps most surprising and most important, the treatment of veterans after the war, despite universal eligibility for benefits offered by the GI Bill, perpetuated the blatant racism that had marked military affairs during the war itself.  At no other time in American history have so much money and so many resources been put at the service of the generation completing education, entering the workforce, and forming families. yet comparatively little of this largesse was available to black veterans, With these policies the Gordian knot binding race to class tightened.5

In short African Americans were excluded from the great boom of the 25 years that followed WWII.

This affirmative action for white people and persistent segregation have been the drivers of the continued disparities that mark American society. The ability of African Americans to fully participate and succeed in American life has been and continue to be severely inhibited. Since home ownership is the primary source of wealth accumulation for middle class Americans, we now see a multi-generational gap widening. The persistent segregation with its accompanying poor education, healthcare, lack of job opportunities and mobility, have produced African American incomes and wealth that areis a fraction of what would have been expected to result from the boom decades following WWII. Of course, since the mid 1970s everyone, excepting the top 10 percent, in America has suffered from stagnating incomes and a worsening of wealth accumulation. The fate of African Americans in this environment are predictably somewhat worse.

Katznelson ends his book with an examination of the affirmative action programs following President Johnson’s initiatives. The results have not been very good in terms of changing the fundamentals of income and wealth.

 

 

  1. Ira Katznelson. When Affirmative Action Was White: An Untold History of Racial Inequality in Twentieth-Century America. New York; London: W.W. Norton, 2006. []
  2. http://www.presidency.ucsb.edu/ws/?pid=27021 accessed 07162017 []
  3. This is a repeat of the failure of Northerners and their politicians to make the emancipation of slaves real when they abandoned Reconstruction in 1877. Not only did newly minted civil rights for African Americans disappear over the following years to the semi-totalitarian system called Jim Crow but the very people who had cleared the land and made it productive were left landless and forced into the new slavery of share cropping. []
  4. Katznelson p. 142 []
  5. Katznelson p. 143 []

The Democratic Party and Healthcare – Preserving Obamacare Cannot Be The End Game

While our current attention is on the Republican Party’s transfer of wealth to the rich and corporations through the charade of a healthcare reform, the Democratic Party needs to face up to its future and the future of our healthcare system in particular.

The Global Context

The chart shown here tells you everything you need to know about the outrageous amounts of money we pay versus the astonishingly poor outcomes for our health. Basically we pay twice (200% more) than almost every other developed country in the world for healthcare that is distinctly second rate.1 To put it simply we have a healthcare system that is ripping us off and laughing all the way to the golf course. It is a market system that incentivizes tests, procedures, and prescriptions, not health. It is a market system in which the providers, doctors, hospitals, insurance and pharmaceutical companies set prices as they wish.  Our healthcare system consumes just shy of 20% of our economic output. Our developed country competitors use 8%-10% of their output.

click for large size.

Preserving Obamacare is not enough to bridge these gaps.

Obamacare addresses the lack of access to healthcare in a significant but hardly comprehensive manner. It only hints at changes to the incentives and pricing that drive the unhealthy outcomes. Obamacare is not the solution. Better than nothing, but given the enormous resources being spent and the fundamental failings of the outcomes it is not sufficient.

Health Not Profits

In order to create a world class healthcare system we need to focus it on health not profits. Every other developed country long ago recognized that a market based system would not work because health is not a commodity like corn, cars, or cell phones. It is complex, multi-dimensional, and emotional. It requires a system capable of a holistic approach to people and the society they live in. Each of the countries with universal healthcare approaches implementation very differently in the details, but all have some sort of national/regional health budget that is negotiated with the various constituents. This amounts to a lump sum per person with which the health system operates to deliver health outcomes. The proof that it works is in the chart above. 

Outrage and Political Will – Stop Taking Big Money from the Rich and Corporations

The Democratic Party must absorb the reality of our situation. We need to develop and express some outrage at the current healthcare providers. It will not be a simple task to bring a sector of the economy that consumes nearly a fifth of economic output to understand that we cannot allow this to continue. We need them to evolve to a system that consumes a tenth while vastly improving healthcare for the entire population. A basic truth here is that we as a society cannot and should not allow one sector to consume so many resources, so inequitably, for such poor outcomes. In the global context this is not sustainable and makes us less competitive and less flexible to meet the changes. 

None of this will happen as long as Democrats are taking money from the rich and corporations. If there is a single lesson from the Bernie Sanders campaign it is that with messages and programs that reflect the needs of the vast majority of Americans, you can raise enough money to fight off the Republican Party and its wealthy and corporate sponsors. Time to start now.

  1. The US ranks 56th in infant mortality out of 225 countries; 48th in maternal mortality out of 184; and 42nd in life expectancy at birth out of 224. – source Current CIA The World Factbook – https://www.cia.gov/library/publications/the-world-factbook/ accessed 5/13/2017 []

Vicious Republicans Not Trump Are The Problem

With today’s release of the Senate’s version of the Republican healthcare bill we see clearly that the Republican Party is a vicious, immoral pack of angry white people – mostly men it would appear from the faces representing the party in the media (see below). No matter how you slice up this legislation it says clearly that Republicans want to punish poor and middle class people for their slovenly, lazy, unhealthy lifestyles, and reward the wealthy with a large tax holiday. The healthcare industry gets to continue charging outrageously high prices while providing last in the pack healthcare outcomes. 

Trump is a side-show

The problem is the Republican Party bought and sold by the wealthy and corporations. The Republicans are busy destroying families through their attacks on healthcare, education, family income, and government protections. The Republicans are busy mouthing talk about job creation while doing nothing to create jobs, just more rhetoric about job creators and government regulations. The Republicans are busy doing nothing to assure that a person working a full-time job can achieve a livable standard of living. The Republicans are busy destroying the environment through their actions internationally and at the EPA. The Republicans are busy destroying women’s lives through their attacks on reproductive rights and women’s healthcare. The Republicans are busy encouraging white supremacists and racists in general through their endless pandering about immigration and Muslims. The Republicans are busy destroying the very fabric of our society by completely failing to maintain our infrastructure and decrying any action by government at any level to invest in our common future and protect us from the attacks by corporations on our health and well-being.

Meanwhile the Democratic Party is still dominated by the same old people and the same old rhetoric. They need to declare war on the ruling class and its Republican Party. There should be no more talk about pleasant bipartisan legislative efforts.

Forget about Trump!

We need to defeat the Republican Party and take back the country from the wealthy and corporations.

The Future of the Women’s March

There is much ongoing discussion about steps needed to turn the enormous one day action of the global Women’s March in to a sustained movement to achieve better outcomes for the vast majority of Americans.1 To focus on just one strategic element, the movement needs to move beyond identity politics to embrace class warfare. The rich and corporations have carried out a sustained and successful class war for more than 40 years. They control the government and the economy. Donald Trump is just a symptom of the underlying issues. We need to break this hammerlock and shift the rules of politics and the economy back towards us, the 90% who are living off the remainders, the scraps from their feast.

  1. The energy of this action is illustrated locally by the fact that over a 1,000 people marched in Hudson NY, a town of 7,000 in a county of 68,000. Video here of this event []

Next Steps for Progressives

The Trump election debacle demonstrates the bankruptcy of the current leadership of the Democratic Party. Faced with a foe who has engaged in serial bankruptcy as a business strategy, is a notorious know-nothing bully with a very sensitive ego, and is best known as the red-faced guy on reality TV who says “You’re fired”, they could not come up with a candidate and story to retain their core voters in the old rust-belt states.

Election Results: The Next Ten Years

img_1844– The Morning After –

The election of Trump and the continued Republican control of both Congress and Senate guarantee that the rich will continue to get richer at the expense of the shrinking middle class and further aggravate conditions for the poor. Trickle down economics and tax subsidies will flow for the rich and corporations. The financial sector will buy its way out of the weak regulations of Dodd/Frank and lurch towards new adventures in gambling; a financial disaster will once again require the socialization of their risk at taxpayer expense.