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katherineharron

Trump relying on government officials in final campaign stretch - CNNPolitics - 0 views

  • As President Donald Trump makes a hurried final push for reelection, he is relying not only on his campaign staff but on government officials to transmit his message to voters
  • his White House press secretary has appeared on television from campaign headquarters, identified as a campaign adviser. His top White House immigration adviser convened a campaign-organized briefing to assail Joe Biden
  • Seldom does a day go by in a battleground state where a Cabinet member from the Trump administration is not paying a visit -- often with a government announcement in tow.
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  • One Cabinet official has already run afoul of the rules, according to an independent government watchdog agency; another, Secretary of State Mike Pompeo, is now under investigation for the speech he delivered from Jerusalem to the Republican National Convention.
  • Trump is hoping officials on the government payroll can help fill the void.
  • Trump has pressed administration officials to finalize announcements in the weeks leading up to the election that could woo key voters, including a plan that would cover the cost of a potential coronavirus vaccine for Medicare and Medicaid recipients or an initiative that would help lower the prices of prescription drugs.
  • Trump's efforts have differed in their explicitly political nature.
  • His decision to host the final night of the Republican National Convention on the White House South Lawn seemed both to encapsulate his disregard for separating the two and to permit more rampant politicking by his team.
  • Trump himself is not bound by the Hatch Act. But the example he sets has clearly been adopted by other members of his administration, whose salaries are funded by taxpayers but who have nonetheless engaged in explicitly political activity over the past weeks. Trump has joked in the past that those found in violation of the Hatch Act won't face consequences, according to people who have heard the conversations.
  • White House press secretary Kayleigh McEnany has made several appearances from what appeared to be the Trump campaign headquarters studio in Arlington, Virginia
  • "We hand out masks, we encourage people to wear them, we temperature check, we provide hand sanitizer. That's what the campaign does," she said.
  • "People like Kayleigh can volunteer for the campaign, but obviously not in their government capacity or using their government authority," said Jordan Libowitz, communications director for CREW, Citizens for Responsibility and Ethics in Washington.
  • But she was not the only White House official to participate in campaign activities this week. Stephen Miller, who has orchestrated Trump's hardline immigration policy, spoke in his "personal capacity" as a "Trump campaign adviser" during a briefing with reporters on Wednesday, baselessly claiming that Biden would "incentivize child smuggling" if elected president.
  • And Ivanka Trump, ostensibly a White House senior adviser, has been on the campaign trail constantly in support of her father.
  • As Vice President Mike Pence rallied supporters in Des Moines on Thursday, Interior Secretary David Bernhardt was also in Iowa, touring the historic Surf Ballroom in the city of Clear Lake.
  • Energy Secretary Dan Brouillette has jetted to states that closely hew to Trump's political map, including Wisconsin, North Carolina, Pennsylvania and Ohio. Trump has made energy -- and in particular fracking -- a key element of his closing message against Biden.
  • Education Secretary Betsy DeVos has traveled in her official capacity to promote school reopening across the country, another item Trump touts during his campaign rallies. On Thursday, DeVos participated in a "Moms for Trump" campaign event in Detroit.
  • Cabinet officials are permitted by law to discuss the President's actions and how they affect Americans, but they are prohibited from making direct pitches to support Trump's reelection while acting in their official capacity.
katherineharron

Health care: Here are 7 Trump measures that Biden will likely overturn - CNNPolitics - 0 views

  • When it comes to health policy, President Donald Trump made it his mission to undo many measures his predecessor put in place.
  • In their four years in office, the Trump administration made sweeping changes that affected the Affordable Care Act, Medicaid, abortion and transgender rights, in many cases reversing the efforts of the Obama administration.
  • Biden's health officials will likely be active, as well, but it will take time for all their actions to take effect.
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  • "They don't have a massive eraser pen. They've got to go through the rule-making process," said Allison Orris, a former Obama administration official and counsel with Manatt Health, a professional services firm. "They are going to have to think about what comes first, second and third and be realistic about timing."
  • Plus, the Biden administration may opt to keep and continue several Trump administration efforts, including shifting to value-based care, rather than paying doctors for every visit and procedure, and increasing access to telehealth,
  • The two administrations also share common views on some measures to lower drug pricing, including basing Medicare payments on the cost of prescription medications in other countries and importing drugs from abroad. But Trump officials have not actually put these proposals in place.
  • While Trump focused on dismantling the Affordable Care Act, Biden will emphasize expanding the law and access to health coverage.
  • The Trump administration took the historic step in early 2018 of allowing states to require certain Medicaid recipients to work in order to receive benefits. Eight states have received approval, seven have pending requests and four had their waivers set aside in court, according to the Kaiser Family Foundation.
  • Biden's Health and Human Services secretary would be able to unwind the approvals, but it is a complicated task, said Joan Alker, executive director of the Center for Children and Families at Georgetown University. The secretary would have to determine whether to withdraw permission for the entire waiver or just certain features.
  • Several of these waivers included other provisions that could make it harder for low-income Americans to retain Medicaid coverage, such as lockouts for non-payment of premiums.
  • One executive order Trump repeatedly points to is expanding short-term health plans, which typically have lower premiums, but provide less comprehensive coverage and don't have to adhere to the Affordable Care Act's protections for people with pre-existing conditions.
  • "The short-term plans have important symbolic significance because they restrict coverage to people with pre-existing conditions, which was a prominent political issue in the campaign," said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation.
  • In its first year in office, the Trump administration slashed funds to promote Obamacare open enrollment and to assist consumers with selecting plans by 90% and 84%, respectively.
  • The Biden administration is expected to reverse all these measures to curtail Obamacare.
  • Biden has promised to revoke the Trump administration rule barring federally funded health care providers in the Title X family planning program from referring patients for abortions.
  • Biden has vowed to reverse the so-called Mexico City Policy, a ban on funding for foreign nonprofits that perform or promote abortions, which Trump reinstated and expanded during his tenure.
  • The Trump administration reinstated the measure -- which had previously impacted only family planning assistance -- in 2017 by presidential memorandum and extended it to all applicable US global health funding under the "Protecting Life in Global Health Assistance."
  • The Biden administration is also expected to reinstitute a directive that states cannot bar Medicaid funds from going to qualified providers that separately provide abortions, such as Planned Parenthood.
  • Trump also signed a bill in 2017 allowing states to withhold federal money from organizations that provide abortion services, including Planned Parenthood.
  • The Trump administration has been particularly hostile toward transgender Americans. Among its most criticized moves was an effort earlier this year to rollback an Obama-era regulation prohibiting discrimination in health care against patients who are transgender.
  • Biden's LGBTQ policy plan also says he will work to expand funding for mental health services for LGBTQ Americans and that his administration plans to automatically enroll low-income LGBTQ people in the public option, once it's created, if they live in rural areas in states that didn't expand Medicaid.
carolinehayter

New Zealand To Give Free Vaccines To Entire Population And Pacific Islands : Coronaviru... - 0 views

  • New Zealand has advance purchased two new coronavirus vaccines from pharmaceutical companies AstraZeneca and Novavax, giving the small island country the ability to vaccinate its 5 million residents.
  • they will go a step further and provide free doses to its population as well as neighboring nations Tokelau, Cook Islands, Niue, Samoa, Tonga, and Tuvalu, should they want them.
  • "Never before has the entire globe sought to vaccinate the entire population at the same time," Ardern said. "This will be a sustained rollout over months not weeks but our pre-purchase agreements means New Zealand is well positioned to get on with it as soon as it is proven safe to do so."
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  • The University of Oxford-AstraZeneca and Novavax vaccines will add to New Zealand's previously agreed upon purchases of vaccines from Pfizer-BioNTech and Janssen Pharmaceutica. The new agreements secures access to 7.6 million doses from AstraZeneca – enough for 3.8 million people, and 10.72 million doses from Novavax– enough for 5.36 million people, according to the government. Both vaccines require two doses.
  • If the vaccines are proven to be safe and effective, the vaccination process is expected to begin early next year with border-control personnel and later other essential workers, with the general population getting the vaccines in the second half of the year.
  • "no-one misses out, even if it means we've purchased more than we need. It's an investment worth making."
  • Ardern said New Zealand is also working with Australia to support vaccination across the wider Pacific.
  • Government officials reminded the public that the start of COVID-19 vaccines doesn't mean a quick lifting of the nation's border lockdown.
  • The Centers for Medicare & Medicaid Services in the U.S. is also taking steps to ensure all Americans have access to the COVID-19 vaccines at no cost once it becomes widely available.
Javier E

Doomsday Prep for the Super-Rich | The New Yorker - 0 views

  • as the Presidential campaign exposed increasingly toxic divisions in America, Antonio García Martínez, a forty-year-old former Facebook product manager living in San Francisco, bought five wooded acres on an island in the Pacific Northwest and brought in generators, solar panels, and thousands of rounds of ammunition. “When society loses a healthy founding myth, it descends into chaos,” he told me. The author of “Chaos Monkeys,” an acerbic Silicon Valley memoir, García Martínez wanted a refuge that would be far from cities but not entirely isolated. “All these dudes think that one guy alone could somehow withstand the roving mob,” he said. “No, you’re going to need to form a local militia. You just need so many things to actually ride out the apocalypse.” Once he started telling peers in the Bay Area about his “little island project,” they came “out of the woodwork” to describe their own preparations, he said. “I think people who are particularly attuned to the levers by which society actually works understand that we are skating on really thin cultural ice right now.”
  • In private Facebook groups, wealthy survivalists swap tips on gas masks, bunkers, and locations safe from the effects of climate change. One member, the head of an investment firm, told me, “I keep a helicopter gassed up all the time, and I have an underground bunker with an air-filtration system.” He said that his preparations probably put him at the “extreme” end among his peers. But he added, “A lot of my friends do the guns and the motorcycles and the gold coins. That’s not too rare anymore.”
  • Tim Chang, a forty-four-year-old managing director at Mayfield Fund, a venture-capital firm, told me, “There’s a bunch of us in the Valley. We meet up and have these financial-hacking dinners and talk about backup plans people are doing. It runs the gamut from a lot of people stocking up on Bitcoin and cryptocurrency, to figuring out how to get second passports if they need it, to having vacation homes in other countries that could be escape havens.” He said, “I’ll be candid: I’m stockpiling now on real estate to generate passive income but also to have havens to go to.” He and his wife, who is in technology, keep a set of bags packed for themselves and their four-year-old daughter. He told me, “I kind of have this terror scenario: ‘Oh, my God, if there is a civil war or a giant earthquake that cleaves off part of California, we want to be ready.’ ”
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  • When Marvin Liao, a former Yahoo executive who is now a partner at 500 Startups, a venture-capital firm, considered his preparations, he decided that his caches of water and food were not enough. “What if someone comes and takes this?” he asked me. To protect his wife and daughter, he said, “I don’t have guns, but I have a lot of other weaponry. I took classes in archery.”
  • Over the years, Huffman has become increasingly concerned about basic American political stability and the risk of large-scale unrest. He said, “Some sort of institutional collapse, then you just lose shipping—that sort of stuff.” (Prepper blogs call such a scenario W.R.O.L., “without rule of law.”) Huffman has come to believe that contemporary life rests on a fragile consensus. “I think, to some degree, we all collectively take it on faith that our country works, that our currency is valuable, the peaceful transfer of power—that all of these things that we hold dear work because we believe they work. While I do believe they’re quite resilient, and we’ve been through a lot, certainly we’re going to go through a lot more.”
  • Justin Kan heard the first inklings of survivalism among his peers. Kan co-founded Twitch, a gaming network that was later sold to Amazon for nearly a billion dollars. “Some of my friends were, like, ‘The breakdown of society is imminent. We should stockpile food,’ ” he said. “I tried to. But then we got a couple of bags of rice and five cans of tomatoes. We would have been dead if there was actually a real problem.” I asked Kan what his prepping friends had in common. “Lots of money and resources,” he said. “What are the other things I can worry about and prepare for? It’s like insurance.”
  • Long before the financial crisis became front-page news, early signs appeared in user comments on Reddit. “People were starting to whisper about mortgages. They were worried about student debt. They were worried about debt in general. There was a lot of, ‘This is too good to be true. This doesn’t smell right.’ ” He added, “There’s probably some false positives in there as well, but, in general, I think we’re a pretty good gauge of public sentiment. When we’re talking about a faith-based collapse, you’re going to start to see the chips in the foundation on social media first.”
  • How did a preoccupation with the apocalypse come to flourish in Silicon Valley, a place known, to the point of cliché, for unstinting confidence in its ability to change the world for the better?Those impulses are not as contradictory as they seem. Technology rewards the ability to imagine wildly different futures,
  • “When you do that, it’s pretty common that you take things ad infinitum, and that leads you to utopias and dystopias,” he said. It can inspire radical optimism—such as the cryonics movement, which calls for freezing bodies at death in the hope that science will one day revive them—or bleak scenarios.
  • In 2012, National Geographic Channel launched “Doomsday Preppers,” a reality show featuring a series of Americans bracing for what they called S.H.T.F. (when the “shit hits the fan”). The première drew more than four million viewers, and, by the end of the first season, it was the most popular show in the channel’s history.
  • A survey commissioned by National Geographic found that forty per cent of Americans believed that stocking up on supplies or building a bomb shelter was a wiser investment than a 401(k).
  • Johnson wishes that the wealthy would adopt a greater “spirit of stewardship,” an openness to policy change that could include, for instance, a more aggressive tax on inheritance. “Twenty-five hedge-fund managers make more money than all of the kindergarten teachers in America combined,” he said. “Being one of those twenty-five doesn’t feel good. I think they’ve developed a heightened sensitivity.”
  • In an e-mail, Wong told me, “Most people just assume improbable events don’t happen, but technical people tend to view risk very mathematically.” He continued, “The tech preppers do not necessarily think a collapse is likely. They consider it a remote event, but one with a very severe downside, so, given how much money they have, spending a fraction of their net worth to hedge against this . . . is a logical thing to do.”
  • I asked Hoffman to estimate what share of fellow Silicon Valley billionaires have acquired some level of “apocalypse insurance,” in the form of a hideaway in the U.S. or abroad. “I would guess fifty-plus per cent,” he said, “but that’s parallel with the decision to buy a vacation home. Human motivation is complex, and I think people can say, ‘I now have a safety blanket for this thing that scares me
  • In building Reddit, a community of thousands of discussion threads, into one of the most frequently visited sites in the world, Huffman has grown aware of the way that technology alters our relations with one another, for better and for worse. He has witnessed how social media can magnify public fear. “It’s easier for people to panic when they’re together,” he said, pointing out that “the Internet has made it easier for people to be together,” yet it also alerts people to emerging risks.
  • “I’ve heard this theme from a bunch of people,” Hoffman said. “Is the country going to turn against the wealthy? Is it going to turn against technological innovation? Is it going to turn into civil disorder?”
  • The C.E.O. of another large tech company told me, “It’s still not at the point where industry insiders would turn to each other with a straight face and ask what their plans are for some apocalyptic event.” He went on, “But, having said that, I actually think it’s logically rational and appropriately conservative.”
  • “Our food supply is dependent on G.P.S., logistics, and weather forecasting,” he said, “and those systems are generally dependent on the Internet, and the Internet is dependent on D.N.S.”—the system that manages domain names. “Go risk factor by risk factor by risk factor, acknowledging that there are many you don’t even know about, and you ask, ‘What’s the chance of this breaking in the next decade?’ Or invert it: ‘What’s the chance that nothing breaks in fifty years?’ ”
  • “Anyone who’s in this community knows people who are worried that America is heading toward something like the Russian Revolution,” he told me recently.
  • “People know the only real answer is, Fix the problem,” he said. “It’s a reason most of them give a lot of money to good causes.” At the same time, though, they invest in the mechanics of escape. He recalled a dinner in New York City after 9/11 and the bursting of the dot-com bubble: “A group of centi-millionaires and a couple of billionaires were working through end-of-America scenarios and talking about what they’d do. Most said they’ll fire up their planes and take their families to Western ranches or homes in other countries.”
  • By January, 2015, Johnson was sounding the alarm: the tensions produced by acute income inequality were becoming so pronounced that some of the world’s wealthiest people were taking steps to protect themselves. At the World Economic Forum in Davos, Switzerland, Johnson told the audience, “I know hedge-fund managers all over the world who are buying airstrips and farms in places like New Zealand because they think they need a getaway.”
  • many worry that, as artificial intelligence takes away a growing share of jobs, there will be a backlash against Silicon Valley, America’s second-highest concentration of wealth.
  • The gap is widening further. In December, the National Bureau of Economic Research published a new analysis, by the economists Thomas Piketty, Emmanuel Saez, and Gabriel Zucman, which found that half of American adults have been “completely shut off from economic growth since the 1970s.” Approximately a hundred and seventeen million people earn, on average, the same income that they did in 1980, while the typical income for the top one per cent has nearly tripled.
  • r the silo and finished construction in December, 2012, at a cost of nearly twenty million dollars. He created twelve private apartments: full-floor units were advertised at three million dollars; a half-floor was half the price. He has sold every unit, except one for himself, he said
  • Johnson said, “If we had a more equal distribution of income, and much more money and energy going into public school systems, parks and recreation, the arts, and health care, it could take an awful lot of sting out of society. We’ve largely dismantled those things.”
  • “Why do people who are envied for being so powerful appear to be so afraid?” Johnson asked. “What does that really tell us about our system?” He added, “It’s a very odd thing. You’re basically seeing that the people who’ve been the best at reading the tea leaves—the ones with the most resources, because that’s how they made their money—are now the ones most preparing to pull the rip cord and jump out of the plane.”
  • The movement received another boost from the George W. Bush Administration’s mishandling of Hurricane Katrina. Neil Strauss, a former Times reporter, who chronicled his turn to prepping in his book “Emergency,” told me, “We see New Orleans, where our government knows a disaster is happening, and is powerless to save its own citizens.”
  • Tyler Allen, a real-estate developer in Lake Mary, Florida, who told me that he paid three million dollars for one of Hall’s condos. Allen said he worries that America faces a future of “social conflict” and government efforts to deceive the public. He suspects that the Ebola virus was allowed to enter the country in order to weaken the population. When I asked how friends usually respond to his ideas, he said, “The natural reaction that you get most of the time is for them to laugh, because it scares them.” But, he added, “my credibility has gone through the roof. Ten years ago, this just seemed crazy that all this was going to happen: the social unrest and the cultural divide in the country, the race-baiting and the hate-mongering.”
  • d G. Mitchell, Jr., a professor emeritus at Oregon State University, who spent twelve years studying survivalism, said, “During the Reagan era, we heard, for the first time in my life, and I’m seventy-four years old, from the highest authorities in the land that government has failed you, the collective institutional ways of solving problems and understanding society are no good. People said, ‘O.K., it’s flawed. What do I do now?’ ”
  • That gap is comparable to the gap between average incomes in the U.S. and the Democratic Republic of Congo,
  • If a silo in Kansas is not remote or private enough, there is another option. In the first seven days after Donald Trump’s election, 13,401 Americans registered with New Zealand’s immigration authorities, the first official step toward seeking residency—more than seventeen times the usual rate. The New Zealand Herald reported the surge beneath the headline “Trump Apocalypse.”
  • In fact, the influx had begun well before Trump’s victory. In the first ten months of 2016, foreigners bought nearly fourteen hundred square miles of land in New Zealand, more than quadruple what they bought in the same period the previous year
  • Much as Switzerland once drew Americans with the promise of secrecy, and Uruguay tempted them with private banks, New Zealand offers security and distance. In the past six years, nearly a thousand foreigners have acquired residency there under programs that mandate certain types of investment of at least a million dollars.
  • The difference between New Zealand and the U.S., to a large extent, is that people who disagree with each other can still talk to each other about it here. It’s a tiny little place, and there’s no anonymity. People have to actually have a degree of civility.”
  • Jack Matthews, an American who is the chairman of MediaWorks, a large New Zealand broadcaster, told me, “I think, in the back of people’s minds, frankly, is that, if the world really goes to shit, New Zealand is a First World country, completely self-sufficient, if necessary—energy, water, food. Life would deteriorate, but it would not collapse.”
  • Top to bottom, the island chain runs roughly the distance between Maine and Florida, with half the population of New York City
  • In a recent World Bank report, New Zealand had supplanted Singapore as the best country in the world to do business.
  • “Kiwis used to talk about the ‘tyranny of distance,’ ” Wall said, as we crossed town in his Mercedes convertible. “Now the tyranny of distance is our greatest asset.”
  • American clients have also sought strategic advice. “They’re asking, ‘Where in New Zealand is not going to be long-term affected by rising sea levels?’ ”
  • In particular, the attention of American survivalists has generated resentment. In a discussion about New Zealand on the Modern Survivalist, a prepper Web site, a commentator wrote, “Yanks, get this in your heads. Aotearoa NZ is not your little last resort safe haven.”
  • An American hedge-fund manager in his forties—tall, tanned, athletic—recently bought two houses in New Zealand and acquired local residency. He agreed to tell me about his thinking, if I would not publish his name. Brought up on the East Coast, he said, over coffee, that he expects America to face at least a decade of political turmoil, including racial tension, polarization, and a rapidly aging population. “The country has turned into the New York area, the California area, and then everyone else is wildly different in the middle,” he said. He worries that the economy will suffer if Washington scrambles to fund Social Security and Medicare for people who need it. “Do you default on that obligation? Or do you print more money to give to them? What does that do to the value of the dollar? It’s not a next-year problem, but it’s not fifty years away, either.”
  • He said, “This is no longer about a handful of freaks worried about the world ending.” He laughed, and added, “Unless I’m one of those freaks.”
  • Fear of disaster is healthy if it spurs action to prevent it. But élite survivalism is not a step toward prevention; it is an act of withdrawal.
  • Philanthropy in America is still three times as large, as a share of G.D.P., as philanthropy in the next closest country, the United Kingdom. But it is now accompanied by a gesture of surrender, a quiet disinvestment by some of America’s most successful and powerful people. Faced with evidence of frailty in the American project, in the institutions and norms from which they have benefitted, some are permitting themselves to imagine failure. It is a gilded despair.
  • As Huffman, of Reddit, observed, our technologies have made us more alert to risk, but have also made us more panicky; they facilitate the tribal temptation to cocoon, to seclude ourselves from opponents, and to fortify ourselves against our fears, instead of attacking the sources of them. Justin Kan, the technology investor who had made a halfhearted effort to stock up on food, recalled a recent phone call from a friend at a hedge fund. “He was telling me we should buy land in New Zealand as a backup. He’s, like, ‘What’s the percentage chance that Trump is actually a fascist dictator? Maybe it’s low, but the expected value of having an escape hatch is pretty high.’ 
  • As Americans withdraw into smaller circles of experience, we jeopardize the “larger circle of empathy,” he said, the search for solutions to shared problems. “The easy question is, How do I protect me and mine? The more interesting question is, What if civilization actually manages continuity as well as it has managed it for the past few centuries? What do we do if it just keeps on chugging?”
Javier E

Opinion | Vaccine Hesitancy Is About Trust and Class - The New York Times - 0 views

  • The world needs to address the root causes of vaccine hesitancy. We can’t go on believing that the issue can be solved simply by flooding skeptical communities with public service announcements or hectoring people to “believe in science.”
  • For the past five years, we’ve conducted surveys and focus groups abroad and interviewed residents of the Bronx to better understand vaccine avoidance.
  • We’ve found that people who reject vaccines are not necessarily less scientifically literate or less well-informed than those who don’t. Instead, hesitancy reflects a transformation of our core beliefs about what we owe one another.
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  • Over the past four decades, governments have slashed budgets and privatized basic services. This has two important consequences for public health
  • First, people are unlikely to trust institutions that do little for them.
  • second, public health is no longer viewed as a collective endeavor, based on the principle of social solidarity and mutual obligation. People are conditioned to believe they’re on their own and responsible only for themselves.
  • an important source of vaccine hesitancy is the erosion of the idea of a common good.
  • “People are thinking, ‘If the government isn’t going to do anything for us,’” said Elden, “‘then why should we participate in vaccines?’”
  • Since the spring, when most American adults became eligible for Covid vaccines, the racial gap in vaccination rates between Black and white people has been halved. In September, a national survey found that vaccination rates among Black and white Americans were almost identical.
  • Other surveys have determined that a much more significant factor was college attendance: Those without a college degree were the most likely to go unvaccinated.
  • Education is a reliable predictor of socioeconomic status, and other studies have similarly found a link between income and vaccination.
  • It turns out that the real vaccination divide is class.
  • compared with white Americans, communities of color do experience the American health care system differently. But a closer look at the data reveals a more complicated picture.
  • during the 1950s polio campaigns, for example, most people saw vaccination as a civic duty.
  • But as the public purse shrunk in the 1980s, politicians insisted that it’s no longer the government’s job to ensure people’s well-being; instead, Americans were to be responsible only for themselves and their own bodies
  • Entire industries, such as self-help and health foods, have sprung up on the principle that the key to good health lies in individuals making the right choices.
  • Without an idea of the common good, health is often discussed using the language of “choice.”
  • there are problems with reducing public health to a matter of choice. It gives the impression that individuals are wholly responsible for their own health.
  • This is despite growing evidence that health is deeply influenced by factors outside our control; public health experts now talk about the “social determinants of health,” the idea that personal health is never simply just a reflection of individual lifestyle choices, but also the class people are born into, the neighborhood they grew up in and the race they belong to.
  • food deserts and squalor are not easy problems to solve — certainly not by individuals or charities — and they require substantial government action.
  • Many medical schools teach “motivational interviewing,”
  • the deeper problem:
  • Being healthy is not cheap. Studies indicate that energy-dense foods with less nutritious value are more affordable, and low-cost diets are linked to obesity and insulin resistance.
  • This isn’t surprising, since we shop for doctors and insurance plans the way we do all other goods and services
  • Another problem with reducing well-being to personal choice is that this treats health as a commodity.
  • mothers devoted many hours to “researching” vaccines, soaking up parental advice books and quizzing doctors. In other words, they act like savvy consumers
  • When thinking as a consumer, people tend to downplay social obligations in favor of a narrow pursuit of self-interest. As one parent told Reich, “I’m not going to put my child at risk to save another child.”
  • Such risk-benefit assessments for vaccines are an essential part of parents’ consumer research.
  • Vaccine uptake is so high among wealthy people because Covid is one of the gravest threats they face. In some wealthy Manhattan neighborhoods, for example, vaccination rates run north of 90 percent.
  • For poorer and working-class people, though, the calculus is different: Covid-19 is only one of multiple grave threats.
  • When viewed in the context of the other threats they face, Covid no longer seems uniquely scary.
  • Most of the people we interviewed in the Bronx say they are skeptical of the institutions that claim to serve the poor but in fact have abandoned them.
  • he and his friends find reason to view the government’s sudden interest in their well-being with suspicion. “They are over here shoving money at us,” a woman told us, referring to a New York City offer to pay a $500 bonus to municipal workers to get vaccinated. “And I’m asking, why are you so eager, when you don’t give us money for anything else?”
  • These views reinforce the work of social scientists who find a link between a lack of trust and inequality. And without trust, there is no mutual obligation, no sense of a common good.
  • The experience of the 1960s suggests that when people feel supported through social programs, they’re more likely to trust institutions and believe they have a stake in society’s health.
  • Research shows that private systems not only tend to produce worse health outcomes than public ones, but privatization creates what public health experts call “segregated care,” which can undermine the feelings of social solidarity that are critical for successful vaccination drives
  • In one Syrian city, for example, the health care system now consists of one public hospital so underfunded that it is notorious for poor care, a few private hospitals offering high-quality care that are unaffordable to most of the population, and many unlicensed and unregulated private clinics — some even without medical doctors — known to offer misguided health advice. Under such conditions, conspiracy theories can flourish; many of the city’s residents believe Covid vaccines are a foreign plot.
  • In many developing nations, international aid organizations are stepping in to offer vaccines. These institutions are sometimes more equitable than governments, but they are often oriented to donor priorities, not community needs.
  • “We have starvation and women die in childbirth.” one tribal elder told us, “Why do they care so much about polio? What do they really want?”
  • In America, anti-vaccine movements are as old as vaccines themselves; efforts to immunize people against smallpox prompted bitter opposition in the turn of the last century. But after World War II, these attitudes disappeared. In the 1950s, demand for the polio vaccine often outstripped supply, and by the late 1970s, nearly every state had laws mandating vaccinations for school with hardly any public opposition.
  • What changed? This was the era of large, ambitious government programs like Medicare and Medicaid.
  • The anti-measles policy, for example, was an outgrowth of President Lyndon Johnson’s Great Society and War on Poverty initiatives.
  • While the reasons vary by country, the underlying causes are the same: a deep mistrust in local and international institutions, in a context in which governments worldwide have cut social services.
  • Only then do the ideas of social solidarity and mutual obligation begin to make sense.
  • The types of social programs that best promote this way of thinking are universal ones, like Social Security and universal health care.
  • If the world is going to beat the pandemic, countries need policies that promote a basic, but increasingly forgotten, idea: that our individual flourishing is bound up in collective well-being.
Javier E

Opinion | Liz Truss in the Libertarian Wilderness - The New York Times - 0 views

  • the British economist Simon Wren-Lewis argues persuasively that financial markets were responding in large part to increased uncertainty, which was in turn largely a reflection of political uncertainty. The Truss economic plan was obviously unsustainable politically, but it wasn’t clear what would come next.
  • the political point is clear. Truss staked out a political position that, to a first approximation, has no public support either in Britain or in the United States. So failure was inevitable.
  • A 2017 paper by the political scientist Lee Drutman mapped out the distribution of U.S. voters on these axes; it’s unlikely to have changed much since. (And the distribution of British voters seems similar.) His picture looked like this:
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  • the quadrant representing a combination of social liberalism and economic conservatism — what you might call the libertarian position — is largely empty.
  • you can see that most voters like government benefits, a lot. Opposition to social spending comes mainly from voters who believe that spending goes to the wrong people — people who don’t look like them.
  • even as we marvel at Truss’s political obtuseness, we should ask what it is about the United States that prevents the emergence of anyone catering to a large bloc of voters who want the nastiness of MAGA without the right-wing economics.
  • In America, the positions of the two parties are clear. Democrats are in the southwest quadrant, both socially and economically liberal, while Republicans are socially and economically conservative.
  • There are, however, many voters who are economically relatively liberal and socially illiberal — who hate wokeness and fear immigrants but want to maintain and even expand Social Security and Medicare, at least for people they see as “real” Americans. Such voters do have political champions in other countries: France’s National Rally, formerly the National Front
  • Liz Truss is squarely in the libertarian box. She didn’t make appeals to anti-immigrant, anti-woke sentiment; she did advocate what one analysis assessed as the most conservative economic position of any party in the developed world. So she placed herself in the political wilderness, a barren quadrant where few voters may be found.
  • Politics in the modern West tends to be more or less two-dimensional. One dimension is the left-right divide in economic policy, between those who favor high taxes on the rich and large social benefits and those who want low taxes and small government
  • The other dimension is the divide over social issues, between those who favor policies promoting racial equality and gay rights and those who bitterly oppose anything they consider “woke.”
Javier E

Efforts to block Inflation Reduction Act programs ramp up - The Washington Post - 0 views

  • The nation’s largest companies and lobbying groups spent a combined $2.3 billion in 2022 to shape or scuttle key components of the emerging law, according to a review of federal ethics disclosures and data compiled by the money-in-politics watchdog OpenSecrets.
  • Among the fiercest critics was the pharmaceutical industry, which spent more than $375 million to lobby over that period, the records show. Many tried and failed to block Congress from granting the government new powers to negotiate the price of selected prescription drugs under Medicare.
  • The work to implement that program is underway: The Biden administration is supposed to identify the first 10 drugs it is targeting for negotiation by September, continue the formal process into 2024 and see the prices implemented in 2026, with more drugs to follow in future years. Drug manufacturers that refuse to comply would face steep financial penalties.
Javier E

America Is Growing Apart, Possibly for Good - The Atlantic - 0 views

  • Michael Podhorzer, a longtime political strategist for labor unions and the chair of the Analyst Institute
  • Podhorzer recently laid out a detailed case for thinking of the two blocs as fundamentally different nations uneasily sharing the same geographic space.
  • in truth, we have never been one nation. We are more like a federated republic of two nations: Blue Nation and Red Nation. This is not a metaphor; it is a geographic and historical reality.”
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  • the growing divisions between red and blue states represent a reversion to the lines of separation through much of the nation’s history.
  • “very similar, both geographically and culturally, to the divides between the Union and the Confederacy. And those dividing lines were largely set at the nation’s founding, when slave states and free states forged an uneasy alliance to become ‘one nation.’”
  • he’s warning that the pressure on the country’s fundamental cohesion is likely to continue ratcheting up in the 2020s
  • the “MAGA movement”—as the U.S. equivalent to the authoritarian parties in places such as Hungary and Venezuela. It is a multipronged, fundamentally antidemocratic movement that has built a solidifying base of institutional support through conservative media networks, evangelical churches, wealthy Republican donors, GOP elected officials, paramilitary white-nationalist groups, and a mass public following
  • Virginia has voted like a blue state at the presidential level, and Arizona and Georgia have moved from red to purple. With these three states shifted into those categories, the two “nations” are almost equal in eligible voting-age population, and the blue advantage in GDP roughly doubles, with the blue section contributing 48 percent and the red just 35 percent.)
  • This divergence itself creates enormous strain on the country’s cohesion, but more and more even that looks like only a way station
  • the underlying political question of the 2020s remains whether majority rule—and democracy as we’ve known it—can survive this offensive.
  • Podhorzer defines modern red and blue America as the states in which each party has usually held unified control of the governorship and state legislature in recent years.
  • By that yardstick, there are 25 red states, 17 blue states, and eight purple states
  • the red nation houses slightly more of the country’s eligible voting population (45 percent versus 39 percent), but the blue nation contributes more of the total U.S. gross national product: 46 percent versus 40 percent
  • it is determined to impose its policy and social vision on the entire country—with or without majority support
  • The hardening difference between red and blue, Podhorzer maintains, “empowers” the 10 purple states (if you include Arizona and Georgia) to “decide which of the two superpower nations’ values, Blue or Red, will prevail” in presidential and congressional elections
  • that leaves the country perpetually teetering on a knife’s edge: The combined vote margin for either party across those purple states has been no greater than two percentage points in any of the past three presidential elections
  • That’s a reversal from the middle decades of the 20th century, when the basic trend was toward greater convergence.
  • One element of that convergence came through what legal scholars call the “rights revolution.” That was the succession of actions from Congress and the Supreme Court, mostly beginning in the 1960s, that strengthened the floor of nationwide rights and reduced the ability of states to curtail those rights.
  • Key moments in that revolution included the passage of the Civil Rights and Voting Rights Acts and the Supreme Court decisions striking down state bans on contraception, interracial marriage, abortion, and, much later, prohibitions against same-sex intimate relations and marriage.)
  • Simultaneously, the regional differences were moderated by waves of national investment, including the New Deal spending on rural electrification, the Tennessee Valley Authority, agricultural price supports, and Social Security during the 1930s, and the Great Society programs that provided federal aid for K–12 schools and higher education, as well as Medicare and Medicaid.
  • The impact of these investments (as well as massive defense spending across both periods) on states that had historically spent little on public services and economic development helped steadily narrow the gap in per capita income between the states of the old Confederacy and the rest of the country from the 1930s until about 1980.
  • Since about 2008, Podhorzer calculates, the southern states at the heart of the red nation have again fallen further behind the blue nation in per capita income.
  • red states, as a group, are falling behind blue states on a broad range of economic and social outcomes—including economic productivity, family income, life expectancy, and “deaths of despair” from the opioid crisis and alcoholism.
  • other measures that show those places in a more favorable light
  • Housing is often more affordable in red states; partly for that reason, homelessness has become endemic in many big blue cities. Red-state taxes are generally lower than their blue counterparts. Many red states have experienced robust job growth
  • The gross domestic product per person and the median household income are now both more than 25 percent greater in the blue section than in the red,
  • blue states are benefiting more as the nation transitions into a high-productivity, 21st-century information economy
  • red states (apart from their major metropolitan centers participating in that economy) are suffering as the powerhouse industries of the 20th century—agriculture, manufacturing, and fossil-fuel extraction—decline.
  • And red states across the Sun Belt rank among the nation’s fastest growing in population.
  • The share of kids in poverty is more than 20 percent lower in the blue section than red, and the share of working households with incomes below the poverty line is nearly 40 percent lower.
  • Gun deaths are almost twice as high per capita in the red places as in the blue, as is the maternal mortality rate.
  • Per capita spending on elementary and secondary education is almost 50 percent higher in the blue states compared with red
  • All of the blue states have expanded access to Medicaid under the Affordable Care Act, while about 60 percent of the total red-nation population lives in states that have refused to do so.
  • All of the blue states have set a minimum wage higher than the federal level of $7.25, while only about one-third of the red-state residents live in places that have done so.
  • Right-to-work laws are common in the red states and nonexistent in the blue, with the result that the latter have a much higher share of unionized workers than the former
  • No state in the blue section has a law on the books banning abortion before fetal viability, while almost all of the red states are poised to restrict abortion rights
  • Almost all of the red states have also passed “stand your ground” laws backed by the National Rifle Association, which provide a legal defense for those who use weapons against a perceived threat, while none of the blue states have done so.
  • During the seven decades of legal Jim Crow segregation from the 1890s through the 1960s, the principal goal of the southern states at the core of red America was defensive: They worked tirelessly to prevent federal interference with state-sponsored segregation but did not seek to impose it on states outside the region.
  • Jim Crow segregation offers an important reference point for understanding how far red states might take this movement to roll back civil rights and liberties—not that they literally would seek to restore segregation, but that they are comfortable with “a time when states” had laws so “entirely different” that they created a form of domestic apartheid.
  • bedrock differences dating back to the country’s founding are resurfacing. And one crucial element of that, he argues, is the return of what he calls “one-party rule in the red nation.”
  • he documents a return to historical patterns from the Jim Crow era in which the dominant party (segregationist Democrats then, conservative Republicans now) has skewed the playing field to achieve a level of political dominance in the red nation far beyond its level of popular support
  • Undergirding that advantage, he argues, are laws that make registering or voting in many of the red states more difficult, and severe gerrymanders that have allowed Republicans to virtually lock in indefinite control of many state legislatures
  • how the United States will function with two sections that are moving so far apart.
  • History, in my view, offers two models
  • The flurry of socially conservative laws that red states have passed since 2021, on issues such as abortion; classroom discussions of race, gender, and sexual orientation; and LGBTQ rights, is widening this split. No Democratic-controlled state has passed any of those measures.
  • in the last years before the Civil War, the South’s political orientation was offensive: Through the courts (the 1857 Dred Scott decision) and in Congress (the Kansas-Nebraska Act in 1854), its principal aim was to authorize the expansion of slavery into more territories and states
  • Podhorzer, like Mason and Grumbach, believes that the MAGA movement’s long-term goal is to tilt the electoral rules in enough states to make winning Congress or the White House almost impossible for Democrats
  • Then, with support from the GOP-appointed majority on the Supreme Court, Republicans could impose red-state values and programs nationwide, even if most Americans oppose them. The “MAGA movement is not stopping at the borders of the states it already controls,” Podhorzer writes. “It seeks to conquer as much territory as possible by any means possible.”
  • The Trump model, in other words, is more the South in 1850 than the South in 1950, more John Calhoun than Richard Russell
  • it does mean that the 2020s may bring the greatest threats to the country’s basic stability since those dark and tumultuous years.
mimiterranova

Pandemic Has Worsened U.S. Child Mental Health Crisis : Shots - Health News : NPR - 1 views

  • Lindsey is one of almost 3 million children in the U.S. who have been diagnosed with a serious emotional or behavioral health condition. When the pandemic forced schools and doctors' offices closed last spring, it also cut children off from the trained teachers and therapists who understand their needs.
  • In the first few months of the pandemic, between March and May 2020, children on Medicaid received 44% fewer outpatient mental health services — including therapy and in-home support — compared to the same time period in 2019, according to the Centers for Medicare & Medicaid Services. That's even after accounting for increased telehealth appointments.
  • Roughly 6% of U.S. children, ages 6 through 17, are living with serious emotional or behavioral difficulties, including children with autism, severe anxiety, depression and trauma-related mental health conditions.
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  • As a result, many, like Lindsey, spiraled into emergency rooms and even police custody. Federal data show a nationwide surge of kids in mental health crisis during the pandemic — a surge that's further taxing an already overstretched safety net.
  • The Centers for Disease Control and Prevention found that, from April to October 2020, hospitals across the U.S. saw a 24% increase in the proportion of mental health emergency visits for children ages 5 to 11, and a 31% increase for children ages 12 to 17.
  • When states and communities fail to provide children the services they need to live at home, kids can deteriorate and even wind up in jail, like Lindsey. At that point, Glawe says, the cost and level of care required will be even higher, whether that's hospitalization or long stays in residential treatment facilities.
  • But given that many states have seen their revenues drop due to the pandemic, there's a concern services will instead get cut — at a time when the need has never been greater.
Javier E

Opinion | The Question of Joe Biden - The New York Times - 0 views

  • The more I covered Biden, the more I came to feel affection and respect for him. Then, as now, he could be a tough boss, occasionally angry and hard on his staff. But throughout his life, Biden has usually been on the side of the underdog. I’ve rarely met a politician so rooted in the unpretentious middle-class ethos of the neighborhood he grew up in. He has a seemingly instinctive ability to bond with those who are hurting.
  • He has his faults — the tendency to talk too much, the chip on his shoulder about those who think they are smarter than he is, the gaffes, that episode of plagiarism and the moments of confusion — but I’ve always thought: Give me a leader who identifies with those who feel looked down upon. Give me a leader whose moral compass generally sends him in the right direction.
  • But I’ve also come to fear and loathe Donald Trump. I cannot fathom what damage that increasingly deranged man might do to this country if given a second term. And the fact is that as the polls and the mood of the electorate stand today, Trump has a decent chance of beating Biden in November of next year and regaining power in 2025.
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  • Biden’s approval ratings are stubbornly low. In a recent ABC poll, only 30 percent of voters approve of his handling of the economy and only 23 percent approve of his handling of immigration at the southern border. Roughly three-quarters of American voters say that Biden, at 80, is too old to seek a second term. There have been a string of polls showing that large majorities in his own party don’t want him to run again. In one survey from 2022, an astounding 94 percent of Democrats under 30 said they wanted a different nominee.
  • I thought Biden’s favorability ratings would climb as economic growth has remained relatively strong and as inflation has come down. But it just hasn’t happened.
  • don’t find this passive fatalism compelling. The party’s elected officials are basically urging rank-and-file Democrats not to be anxious about a situation that is genuinely anxiety-inducing. Last month Gov. Phil Murphy of New Jersey told The Times, “This is only a matter of time until the broad party, and broadly speaking, Americans, converge with the opinions of folks like myself.” Really? Surely if there’s a lesson we should have learned from the last decade, it’s that we should all be listening harder to what the electorate is trying to say.
  • The Republicans who portray him as a doddering old man based on highly selective YouTube clips are wrong. In my interviews with him, he’s like a pitcher who used to throw 94 miles an hour who now throws 87. He is clearly still an effective pitcher.
  • People who work with him allow that he does tire more easily, but they say that he is very much the dynamic force driving this administration
  • In fact, I’ve noticed some improvements in his communication style as he’s aged. He used to try to cram every fact in the known universe into every answer; now he’s more disciplined. When he’s describing some national problem, he is more crisp and focused than he used to be, clearer on what is the essential point here — more confidence-inspiring, not less.
  • What about four or five years from now, at the end of a second term? Will he still be competent enough to lead? Biden is fit, does not smoke or drink alcohol, exercises frequently and has no serious health conditions, according to the White House
  • A study in The Journal on Active Aging of Biden’s and Trump’s health records from before the 2020 elections found that both men could qualify as “super-agers” — the demographic that maintains physical and mental functioning beyond age 80.
  • if the president I see in interviews and at speeches is out campaigning next year against an overweight man roughly his own age, then my guess is that public anxieties on this front will diminish.
  • To me, age isn’t Biden’s key weakness. Inflation is. I agree with what Michael Tomasky wrote in The New Republic: Biden’s domestic legislative accomplishments are as impressive as any other president’s in my adult life. Exactly as he should have, he has directed huge amounts of resources to the people and the places that have been left behind by the global economy. By one Treasury Department estimate, more than 80 percent of the investments sparked by the Inflation Reduction Act are going to counties with below-average college graduation rates and nearly 90 percent are being made in counties with below-average wages. That was the medicine a riven country needed.
  • it is also true that Biden’s team overlearned the lessons of the Obama years. If Barack Obama didn’t stimulate the economy enough during the Great Recession, Biden stimulated it too much, contributing to inflation and the sticker shock people are feeling.
  • Anger about inflation is ripping across the world, and has no doubt helped lower the approval ratings of leaders left, right and center. Biden’s 40 percent approval rating may look bad, but in Canada, Justin Trudeau’s approval rating is 36; in Germany Olaf Scholz is at 29; in Britain Rishi Sunak is at 28; in France Emmanuel Macron is at 23; and in Japan Fumio Kishida is also at 23. This is a global phenomenon
  • “Inflation is the reason Biden could not deliver on his core promise to return the country to normal and the main reason his poll numbers are bad.”
  • voters are looking back and retroactively elevating their opinion of Trump’s presidency. When he left office only 38 percent of Americans approved of his performance as president. Today, 48 percent do, his high-water mark.
  • Bitterness, cynicism and distrust pervade the body politic. People perceive reality through negative lenses, seeing everything as much worse than it is. At 3.8 percent, America’s unemployment rate is objectively low, but 57 percent of voters say that the unemployment rate is “not so good” or “poor.”
  • The nation’s bitter state of mind is a self-perpetuating negativity machine. Younger people feel dismissed; the older generations are hogging power. Faith in major institutions is nearing record lows. The country is hungry for some kind of change but is unclear about what that might look like. As the incumbent, Biden will be tasked with trying to tell a good news story of American revival, which is just a tough story to sell in this environment. And Biden is not out there selling it convincingly.
  • The bracing reality is that Trump’s cynicism and fury match the national mood more than Biden’s faithful optimism.
  • “They seem hell bent on nominating the one Democrat who would lose to Donald Trump,” Karl Rove told me recently. “They’ve got a lot of talent on their side, let’s not kid ourselves,” he continued, pointing to younger Democrats like Gretchen Whitmer, Mitch Landrieu, Gavin Newsom and Cory Booker.
  • A lot of the dump-Biden conversations are based on a false premise: that the Democratic Party brand and agenda are somehow strong and popular enough that any number of younger candidates could win the White House in 2024, and that if Biden were just to retire, all sorts of obstacles and troubles would go with him.
  • But Biden is not the sole or even primary problem here. To the extent that these things are separable, it’s the Democratic Party as a whole that’s ailing. The generic congressional ballot is a broad measure of the strength of the congressional party. Democrats are now behind. According to a Morning Consult poll, Americans rate the Democratic Party as a whole as the more ideologically extreme party by a nine-point margin.
  • When pollsters ask which party is best positioned to address your concerns, here too, Democrats are trailing. In a recent Gallup poll 53 percent of Americans say Republicans will do a better job of keeping America prosperous over the short term while only 39 percent thought that of the Democrats.
  • Fifty-seven percent of Americans said that the Republicans would do a better job keeping America safe, while only 35 percent favor the Democrats. These are historically high Republican advantages.
  • Here are the hard, unpleasant facts: The Republicans have a likely nominee who is facing 91 charges. The Republicans in Congress are so controlled by a group of performative narcissists, the whole House has been reduced to chaos. And yet they are still leading the Democrats in these sorts of polling measures
  • There is no other potential nominee who is so credibly steeped in knowing what life is like for working- and middle-class people, just as there was no other potential nominee in 2020. After watching him for a quarter-century, I think he is genuinely most comfortable when he is hanging around the kinds of people he grew up with. He doesn’t send out any off-putting faculty lounge vibes. On cultural matters he is most defined by what he doesn’t do — needlessly offend people with overly academic verbiage and virtue signaling. That is why I worry when he talks too stridently about people on the right, when he name-calls and denounces wide swaths of people as MAGA.
  • Over the last half-century, the Democrats have become increasingly the party of the well-educated metropolitan class.
  • This is about something deeper than Joe Biden’s age. More and more people are telling pollsters that the Republicans, not the Democrats, care about people like me.
  • But Democrats are losing something arguably more important than a reliable base of supporters. The party is in danger of letting go of an ethos, a heritage, a tradition. The working-class heart and soul the Democrats cultivated through the Roosevelt, Truman and Kennedy years rooted Democratic progressivism in a set of values that emphasized hard work, neighborhood, faith, family and flag. Being connected to Americans’ everyday experiences kept the party pinioned to the mainstream.
  • . It grew prone to taking flights of fancy in policy and rhetoric, be it Medicare for All or “defund the police,” going to places where middle-of-the-road voters would not follow. It became more vulnerable to the insular outlooks of its most privileged and educated members.
  • And that is the fact I keep returning to. Biden is not what ails the party. As things stand, he is the Democrats’ best shot at curing what ails the party.
  • today, the party is bleeding working-class voters of all varieties. As John B. Judis and Ruy Teixeira point out in their forthcoming book, “Where Have All the Democrats Gone?” Democrats have been losing ground among Hispanics for the last few years. In 2012, Barack Obama carried nonwhite voters without a college degree by a 67-point margin. In 2020, Biden carried this group with a 48-point margin. Today, the Democratic ticket leads among this group by a paltry 16 points
  • These cultural and spiritual roots give him not just a style but a governing agenda. He has used the presidency to direct resources to those who live in the parts of the country where wages are lower, where education levels are lower, where opportunities are skimpier. Biden’s ethos harks back to the ethos of the New Deal Democratic Party, but it also harks forward to something — to a form of center-left politics that is culturally moderate and economically aggressive
  • Something almost spiritual is at play here, not just about whether the Democrats can win in 2024, but who the Democrats are.
  • I also find myself arriving foursquare at the conclusion that rejecting the president now would be, in the first place, a mistake. He offers the most plausible route toward winning the working- and middle-class groups the Democrats need, the most plausible route toward building a broad-based majority party
  • But it would be worse than a mistake. It would be a renunciation of the living stream of people, ideas and values that flow at the living depths of the party, a stream that propelled its past glories and still points toward future ones.
Javier E

Opinion | The Economic Mistake Democrats Are Finally Confronting - The New York Times - 0 views

  • This is the driving theory of most of the progressive policy agenda, most of the time: give people money or a moneylike voucher they can use to buy something they need or even just want.
  • The problem is that if you subsidize the cost of something that there isn’t enough of, you’ll raise prices or force rationing. You can see the poisoned fruit of those mistakes in higher education and housing. But it also misses the opportunity to pull the technologies of the future progressives want into the present they inhabit.
  • The first problem is explored in “Cost Disease Socialism,” a new paper by the center-right Niskanen Center. “We are in an era of spiraling costs for core social goods — health care, housing, education, child care — which has made proposals to socialize those costs enormously compelling for many on the progressive left,”
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  • That requires a movement that takes innovation as seriously as it takes affordability.
  • There are sharp limits on supply in all of these sectors because regulators make it hard to increase supply (zoning laws make it difficult to build housing), training and hiring workers is expensive (adding classrooms means adding teachers and teacher aides, and expanding health insurance requires more doctors and nurses) or both. “This can result in a vicious cycle in which subsidies for supply-constrained goods or services merely push up prices, necessitating greater subsidies, which then push up prices, ad infinitum,” they write.
  • the authors urge conservatives to tackle costs directly. Too often, Republican proposals to cut government spending are just shell games that shift costs onto individuals. The conservative enthusiasm for moving Medicare beneficiaries onto (often more expensive!) private plans “risks being little more than an accounting trick — a purely nominal change in ‘who pays’ that would do little to address the underlying sources of cost growth.”
  • For now, though, it’s Democrats who are starting to take supply-side concerns seriously.
  • A problem of our era is there’s too little utopian thinking, but one worthy exception is Aaron Bastani’s “Fully Automated Luxury Communism,” a leftist tract that puts the technologies in development right now — artificial intelligence, renewable energy, asteroid mining, plant- and cell-based meats, and genetic editing — at the center of a postwork, postscarcity vision.
  • “What if everything could change?” he asks. “What if, more than simply meeting the great challenges of our time — from climate change to inequality and aging — we went far beyond them, putting today’s problems behind us like we did before with large predators and, for the most part, illness? What if, rather than having no sense of a different future, we decided history hadn’t actually begun?”
  • what Bastani sees clearly is that the world we should want requires more than redistribution. It requires inventions and advances that render old problems obsolete and new possibilities manifold.
  • Climate change is the most pressing example
  • In a world where two-thirds of emissions now come from middle-income countries like China and India, the only way for humanity to both address climate change and poverty is to invent our way to clean energy that is plentiful and cheap and then spend enough to rapidly deploy it.
  • It is true that European countries free-ride off the high cost we pay for drugs, because it’s the U.S. market that drives innovation. But that doesn’t mean we’d be better off paying their prices, if that meant new drug development slowed. We don’t just want everyone to have health insurance in the future. We want them to be healthier, freed from diseases and pain that even the best health insurance today cannot cure or ease.
  • It’s ludicrous to say that the pharmaceutical system we have now is oriented toward innovation. It’s oriented toward profit; sometimes that intersects with innovation and sometimes it doesn’t.
  • We should combine price controls with new policies to encourage drug development. That could include everything from more funding of basic research to huge prizes for discovering drugs that treat particular conditions to more public funding for drug trials.
  • Years ago, Bernie Sanders had an interesting proposal for creating a system of pharmaceutical prizes in which companies could make millions or billions for inventing drugs that cured certain conditions, and those drugs would be immediately released without exclusive patent protections. Focusing on the need to make new drugs affordable while ignoring the need to make more of them exist is like trimming a garden you’ve stopped watering.
  • this is a lesson progressives are, increasingly, learning. This is clearest on climate. Much of the spending in the Biden agenda is dedicated to increasing the supply of renewable energy and advanced batteries while building the supply of carbon-neutral transportation options.
  • In a blog post, Jared Bernstein, a member of President Biden’s Council of Economic Advisers, and Ernie Tedeschi, a senior policy economist for the council, framed the Biden agenda as “an antidote for inflationary pressure” because much of it expands the long-term supply of the economy.
  • Progressives have long known to look for problems on the demand side of the economy — to ask whether there are goods and services people need that they cannot afford. That will make today fairer, but to ensure tomorrow is radically better, we need to look for the choke points in the future we imagine, the places where the economy can’t or won’t supply the things we need. And then we need to fix them.
  • look closely and you can see something new and overdue emerging in American politics: supply-side progressivism.
Javier E

(1) Republicans Get Angry When You Do the Right Thing - 0 views

  • We are living in, as George F. Will recently put it, “the most dangerous U.S. moment since World War II, more menacing than the October 1962 Cuban missile crisis”—because then the country was dealing with just one reckless nuclear power, and today it is dealing with three (China, Iran, Russia). Our national debt is dangerously high. Any serious discussion of the viability of Medicare and Social Security is sidelined indefinitely, even as the tidal wave of Baby Boomers reaches retirement age. The Southern border is indeed in crisis. Emerging technologies such as AI threaten to, at a minimum, have a significant economic impact.
  • Such a time requires clarity, forward thinking, and moral leadership. But it is abundantly clear that Republicans are not up these challenges—which was not lost on Buck. “It is impossible for the Republican party to confront our problems and offer a course correction for the future while being fixated on retribution and vengeance for contrived injustices of the past.” Indeed, those issues decided the speakership election. They are the raison d’être of the party’s prohibitive nominee for president.
Javier E

A Conservative Blueprint for Universal Healthcare | MedPage Today - 0 views

  • In 1989, a policy analyst at a leading conservative Washington, D.C. think tank described a workable planopens in a new tab or window in which private insurers, just as in Germany, provide universal coverage. This plan would:Change the current tax treatment of health insurance (which largely benefits people with employer-based coverage at the expense of lower income Americans)Declare that families face the responsibility of having adequate insuranceOffer government assistance to families unable to afford health coverage on their ownReform the Medicare program
  • The middle planks of this conservative plan ultimately became the Affordable Care Act's (ACA) Marketplacesopens in a new tab or window, where families could purchase health insurance in a new, nationally regulated market with financial subsidies to cover costs for those with incomes below 400% of the federal poverty level (about $92,120opens in a new tab or window for a family of three).
  • President Barack Obama signed the ACA into law 13 years ago today, transforming a patchwork system of individual health insurance markets into one that today could form a national framework for universal healthcare
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  • an "ACA for All" system would prevent government from operating health insurance while allowing it to regulate and finance health insurance for most Americans. The ACA for All would not be "socialized medicine" -- where government not only finances healthcare but supplies it through public hospitals, clinics, and the direct employment of clinicians. ACA for All would continue to rely on private industry (private doctors and private hospitals) and personal responsibility, and would limit the government's role in healthcare delivery.
  • A Republican plan for universal healthcare would offer those with non-employer-based coverage an adequately sized tax deduction, big enough to cover the cost of a family health insurance plan. And, for the first time since the 1940s, individuals would pay taxes on the value of employer-based health insurance above a certain threshold (based on the average costopens in a new tab or window of a family health insurance plan).
Javier E

Opinion | The Mystery of White Rural Rage - The New York Times - 0 views

  • Business types and some economists may talk glowingly about the virtues of “creative destruction,” but the process can be devastating, economically and socially, for those who find themselves on the destruction side of the equation. This is especially true when technological change undermines not just individual workers but also whole communities.
  • It’s a big part of what has happened to rural America.
  • This process and its effects are laid out in devastating, terrifying and baffling detail in “White Rural Rage: The Threat to American Democracy,” a new book by Tom Schaller and Paul Waldman
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  • “devastating” because the hardship of rural Americans is real, “terrifying” because the political backlash to this hardship poses a clear and present danger to our democracy, and “baffling” because at some level I still don’t get the politics.
  • Technology is the main driver of rural decline, Schaller and Waldman argue. Indeed, American farms produce more than five times as much as they did 75 years ago, but the agricultural work force declined by about two-thirds over the same period, thanks to machinery, improved seeds, fertilizers and pesticides
  • Coal production has been falling recently, but thanks partly to technologies like mountaintop removal, coal mining as a way of life largely disappeared long ago, with the number of miners falling 80 percent even as production roughly doubled.
  • The decline of small-town manufacturing is a more complicated story, and imports play a role, but it’s also mainly about technological change that favors metropolitan areas with large numbers of highly educated workers.
  • Technology, then, has made America as a whole richer, but it has reduced economic opportunities in rural areas. So why don’t rural workers go where the jobs are? Some have
  • But some cities have become unaffordable, in part because of restrictive zoning — one thing blue states get wrong — while many workers are also reluctant to leave their families and communities.
  • So shouldn’t we aid these communities? We do. Federal programs — Social Security, Medicare, Medicaid and more — are available to all Americans, but are disproportionately financed from taxes paid by affluent urban areas. As a result there are huge de facto transfers of money from rich, urban states like New Jersey to poor, relatively rural states like West Virginia.
  • While these transfers somewhat mitigate the hardship facing rural America, they don’t restore the sense of dignity that has been lost along with rural jobs.
  • And maybe that loss of dignity explains both white rural rage and why that rage is so misdirected — why it’s pretty clear that this November a majority of rural white Americans will again vote against Joe Biden, who as president has been trying to bring jobs to their communities, and for Donald Trump, a huckster from Queens who offers little other than validation for their resentment.
  • This feeling of a loss of dignity may be worsened because some rural Americans have long seen themselves as more industrious, more patriotic and maybe even morally superior to the denizens of big cities — an attitude still expressed in cultural artifacts like Jason Al
  • In the crudest sense, rural and small-town America is supposed to be filled with hard-working people who adhere to traditional values, not like those degenerate urbanites on welfare, but the economic and social reality doesn’t match this self-image.
  • Prime working-age men outside metropolitan areas are substantially less likely than their metropolitan counterparts to be employed — not because they’re lazy, but because the jobs just aren’t there.
  • Quite a few rural states also have high rates of homicide, suicide and births to single mothers — again, not because rural Americans are bad people, but because social disorder is, as the sociologist William Julius Wilson argued long ago about urban problems, what happens when work disappears.
  • Draw attention to some of these realities and you’ll be accused of being a snooty urban elitist
  • The result — which at some level I still find hard to understand — is that many white rural voters support politicians who tell them lies they want to hear. It helps explain why the MAGA narrative casts relatively safe cities like New York as crime-ridden hellscapes while rural America is the victim not of technology but of illegal immigrants, wokeness and the deep state.
  • while white rural rage is arguably the single greatest threat facing American democracy, I have no good ideas about how to fight it.
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