Health Care

First Night of the DNC: A TV & Twitter Review

Did you watch it last night? It was an amazing night of TV, of Twitter (that instant snark convo), and of politics. My twitter feed was full of journos saying to each other: Wow, there’s a lot of energy here! Don’t you feel more buzz than in Tampa? I thought this was supposed to be the dispirited convention, but these folks are excited. You could see that in every breakaway shot of the convention floor: Folks were cheering, nodding, yelling back in witness. Over and over again, the Dems boasted proudly about standing up for health care, equal pay, LGBT rights (including the freedom to marry), and yes, reproductive rights, without apology.

Paul Ryan Is Way More Anti-Abortion Than You Thought

(Speaker Boehner/Flickr)

Since the Todd Akin affair entered the national conversation, many commentators—myself included—have noted the extent to which Akin’s views are in line with the mainstream of the Republican Party, and nearly identical to ones held by Paul Ryan, the GOP vice presidential nominee. This video, unearthed by Buzzfeed’s Andrew Kaczynski, illustrates the point. In it, a younger Ryan denounces a women’s health provision that was included in a bill to ban “partial-birth” abortion. Exceptions to the ban, he argues, would make it “meaningless”:

Texas Says "No Thanks" to Women's Health Care

(AP Photo/San Angelo Standard-Times, Patrick Dove)

If you haven't been worn down reading about Todd Akin's bizarre and ignorant views about the female reproductive system, now turn to Texas, where women's uteruses may soon have to move out of state to find health care. Late Tuesday night, a federal court of appeals ruled that Texas can exclude Planned Parenthood from the Women's Health Program, which provides basic preventative care—like birth control and cancer screenings—for low-income women. The decision has terrifying implications in a state where women's access to health care is already poor.

Rep. Akin and Fun with Fake Facts

Honestly, some days I can’t tell real news from The Onion. Representative Todd Akin’s staggering comment on Sunday about the female body’s amazing ability to reject unwanted sperm actually made my jaw drop. If only it didn’t represent what so many people believe, as Amanda Marcotte explained so clearly here yesterday. The good news is that it flushed those beliefs out into the open. As she said, it’s not a gaffe; it’s an insight into the anti-choice movement’s distrust of women and its ignorance of science.

Five Things Government Does Better Than You Do

We know a lot less about how to manage money than we think.

(Flickr / Sheffield Tiger)

When Wisconsin Congressman Paul Ryan and other hard-line conservatives talk about cutting the government’s budget, their primary rationale is that individuals can make better decisions with their own money than the government can. As Ryan himself said to an audience at Georgetown University, “We put our trust in people, not in government. Our budget incorporates subsidiarity by returning power to individuals, to families and to communities.” It sounds reasonable—of course we want individuals to have power, and of course we want communities to take care of their neediest members. And since conservatives have done a fine job of portraying the government as full of heartless, inept bureaucrats, allowing people to make their own decisions sounds better than the alternative.

Medicare Myths, Debunked

(Flickr/Ann Lobb)

At the moment, the hot issue of the 2012 presidential campaign is Medicare, with the Obama and Romney campaigns trading charges and counter-charges over the health-insurance program for the elderly. Since we at the Prospect love clarifying the muddy and making the complex understandable, we thought we'd unpack the arguments the two sides are making and provide some context so we can all grasp this a bit better. We'll start with the campaigns' claims.


Does Mitt Romney actually want to "end Medicare as we know it"?

That's the charge Democrats are now making; here's a video the Obama campaign just released:

I Know You Are But What Am I? Medicare Edition

In the good old days, you could get political speeches on LP.

Republicans' pleasure over Mitt Romney picking Paul Ryan for his running mate is tempered by their nervousness that Democrats will use Ryan's budget to hammer them on Medicare, particularly in Florida. And yes, they will. So how are Republicans going to respond? The answer is that they'll employ the time-honored "I know you are, but what am I?" strategy.

The National Republican Congressional Committee, the House Republicans' campaign arm, is sending out memos to its members telling them to, in the title of one, "Stay on offense on Medicare." And how do you do it? You say, we're not the ones who want to destroy Medicare, the Democrats are the ones who want to destroy Medicare! We're already hearing it from Romney and Ryan, and it'll be coming from all kinds of other places as well; here's the Heritage Foundation saying "Obamacare ends Medicare as we know it." (How? Because it's all governmenty.)

This kind of muddying of the waters has worked before...

Who Said Women Can Have It All?

Remember that Anne-Marie Slaughter article in The Atlantic about a month and a half ago, whose title—"Why Women Still Can't Have It All"—drove feminists bonkers, while the substance nevertheless rang true for roughly 70 gazillion working parents in this country who are doing the impossible every single day? Rebecca Traister proposed forever retiring the phrase "having it all" here, and I chastised the magazine for the framing. But the article's core idea was right, as I wrote at the time: 

If Only the President Would Make Speeches, Everything Would Be Different

President Obama delivers a speech on health care to a joint session of Congress.

Yesterday, psychologist and political consultant Drew Westen had yet another op-ed in a major newspaper (the Washington Post this time) explaining that all of Barack Obama's troubles come from a failure of rhetoric. Don't get me wrong, I think rhetoric is important—in fact, I've spent much of the last ten years or so writing about it. But Westen once again seems to have fallen prey to the temptation to believe that everything would be different if only a politician would give the speech I've been waiting to hear. There are two problems with this belief, the first of which is that a dramatic speech almost never has a significant impact on public opinion. The second problem is that Barack Obama did in fact do exactly what Drew Westen and many other people say they wish he had done.

This is only one part of Westen's piece, but I want to focus on it because it's said so often, and is so absurd. This is what Westen says about the battle over the Affordable Care Act:

In keeping with the most baffling habit of one of our most rhetorically gifted presidents, Obama and his team just didn't bother explaining what they were doing and why. To them, their actions were self-evident. But nothing is self-evident when your opponents are spending millions of dollars to defeat you. Instead, the White House blundered around with memorable phrases such as "bending the cost curve," which didn't speak to the values underlying the need for health-care reform.

My god, do people ever have short memories

Your Guide to "Ending Medicare As We Know It"

Paul Ryan is very sincere.

Yesterday, President Obama went to Florida and told seniors that Mitt Romney wants to end Medicare as we know it, and it appears that this argument (and some related ones) will be a central feature of the Obama campaign's message in the coming days. It's entirely possible, as Jonathan Chait has suggested, that all the Obama campaign's attacks on Romney's finances and record at Bain Capital are the first stage of a two-stage strategy that culminates with an attack on the Ryan budget. Since we'll be talking about this a lot soon, I thought it might be worthwhile to refresh our memories on what this is all about, particularly with regard to Medicare, and how it relates to the current campaign.

First: Is it fair to tar Mitt Romney with the Ryan plan? No question.

Political Procrastination

Republican legislators keep pushing back plans to create health-care exchanges, and the HHS contemplates fudging the deadline.

For nearly two years, Republicans have railed against the Affordable Care Act (ACA), with many a state-level politician going so far as to call for nullification. But even after the Supreme Court voted to uphold the ACA on June 29, state legislatures and governors in states from Florida to Wisconsin are refusing to implement the law's health-care exchange provisions, while other states are running far behind schedule.

A Test of Ideology

Flickr/Gage Skidmore

Texas has a higher proportion of its population living without health insurance than any other state. But like many other states with lots of poor people, it has the misfortune of being governed by Republicans, which explains why yesterday, Governor Rick Perry announced that the state will refuse to accept the money the federal government is offering to expand Medicaid eligibility to everyone who makes up to 133 percent of the federal poverty level. Perry says that this expansion of Medicaid, which is almost entirely paid for by the federal government, will nevertheless bankrupt the state and put the oppressive boot on the necks of Texans. So he's happy to keep 25 percent of his population uninsured.

In case you're wondering, Texas currently sets eligibility for Medicaid at 26 percent of the federal poverty level, which means that if you earn more than $6,000 a year for a family of four, you're not eligible. That's not a typo. Six thousand dollars a year for a family of four is what the state of Texas considers too rich to get on Medicaid. Look down the list of eligibility levels, and you find that only Alabama, Arkansas, Indiana, and Louisiana set their eligibility lower. It is just so weird how those poor Southern states are the stingiest with health care benefits, isn't it?

It's possible that eventually, Texas and the other states will come around to the expansion of Medicaid. Sarah Kliff explains how this happened with Medicaid's enactment in the 1960s and the Children's Health Insurance Program (CHIP) in the 1990s; conservatives initially resisted, but the money and the opportunity to insure their population eventually became irresistable. One of the key factors then and now is the presence of organized, influential interest groups—particularly the hospitals that have to deliver uncompensated care to the uninsured, costing them billions—that can exert their influence on the government's decisions.

But the Republicans who resisted and then gave in were different from the Republicans of today, and this will be a test of just how far they'll go to make a statement about their hatred of the federal government in general and their hatred of Barack Obama in particular. Today's Republicans are the ones who would turn down a deal offering ten dollars of spending cuts for one dollar of tax increases. But that was a hypothetical question, and this question is very real. There are actual human beings whose lives are at stake. I'd love to hear someone ask Rick Perry this question: Which do you think is worse, someone living without health insurance, or someone getting health insurance through a government program? I'm not sure what he'd say, but his actions say quite clearly that he'd prefer that the person have no health insurance. Of course, we're not talking about him personally, or his kids, or anybody he knows having to go without insurance. We're talking about poor people. So screw them.

When Is Judicial Behavior Political?

(Flickr / s_falkow)

The debates about Chief Justice Roberts’s motivations for his health-care opinion rage on with new leaks appearing almost every day. Randy Barnett responds to Jonathan Adler’s attempt at showing that Roberts’s opinion is quite consistent with his past judgments:

But this does not [make] his bending himself into a pretzel to uphold a law when the screws were put to him any less political. [..] 8 justices acted on principle:  4 on good principles and 4 on bad principles.

Should Liberals Be Mad at Kagan and Breyer?

WikiMedia Commons

While the Supreme Court's decision to uphold most of the Affordable Care Act in NFIB v. Sebelius was generally good news, the decision did have one unfortunate side effect. The Court limited the use of federal spending power with respect to Medicaid, permitting Congress to withhold new grants but not existing Medicaid funds from states if they failed to adopt Obamacare. In other words, governors can reject new federal funds to implement the health-care law without losing the rest of their Medicaid money.

Starve a Cold, and Your Taxes

(Flickr / Gage Skidmore)

It's a well-known rule in journalism that when you don't want to write the story your editor assigned you, you suggest a new one—an equally good, if not better, alternative.