When It Cares, the U.S. Government Is Extremely Efficient

           As the COVID-19 pandemic has made painfully clear, our healthcare system is a disaster. 12% of Americans are uninsured and 21% are underinsured. Many counties have zero or just one healthcare plan on offer through their local ACA marketplace, so there is no price competition whatsoever. Due to the lack of competition, and price gouging, by for-profit insurers, the average family of four who buys insurance through Obamacare pays a whopping $25,000 a year in premiums and deductibles—more than a third of their income after taxes.

            More than 18,000 Americans die annually due to lack of medical insurance.

            This is very sad, especially for them and their families. But nothing can be done about it. Lame as it is, the Affordable Care Act is as good as it gets. Until the Republicans get back in charge, when they will try to get rid of it again. Political dysfunction, amirite?

            When they care about something, however, the U.S. government can be incredibly efficient.

The U.S. government really cares about war.

Just two days after Russia invaded, President Biden signed a memo authorizing the transfer of $350 million of weapons to Ukraine. Within three weeks, almost all the antitank weapons, kamikaze drones and other war materiel had arrived in Ukraine. That’s less time than it takes first-class mail to get to some places within the United States.

            If you are sick and uninsured, consider a move to Kyiv. As we saw in Afghanistan, U.S. weapons have a habit of disappearing and being sold for profit in war zones. If you still have enough energy and a little luck, you might be able to pilfer one of those American-made radar systems or a few boxes of grenade launchers to finance your chemotherapy. Even if not, Ukraine offers something the United States probably never will: a universal healthcare system.

            Out-of-control college tuition costs have pushed 9 million young borrowers and their families into default on $124 billion in student loans. 80% of these young men and women came from families with total incomes under $40,000; so they’re not deadbeats, they’re poor. The burden of student loan debt hobbles America’s best and brightest just as they are starting out their adult lives. They defer or never purchase homes and cars, and are unable to save for retirement. This hurts the real estate, automobile and durable-goods businesses and turns many talented people into future welfare recipients.

            This is highly unfortunate, especially for them and their families. But nothing can be done about it. Lame as it was, President Biden’s campaign promise to cancel $10,000 in student loan debt was as good as could be hoped for. And he never followed through. Responding to pressure from Republicans and right-wing Democrats, Biden’s latest federal budget, for 2022, doesn’t contain any provisions for student loan forgiveness. They said they were too worried about the deficit.

            Republicans and right-wing Democrats, on the other hand, only worry about the deficit sometimes. Liberals, conservatives, Democrats, Republicans and every other strain of American House representative and Senator quickly approved an additional $13.6 billion in military aid to Ukraine less than a month after the first shipment of cash. There was strong bipartisan support for the measure, which was immediately signed into law by President Biden. Yay, America!

            So don’t despair if you are broke, defaulting on your student loans and unable to escape poverty because even under bankruptcy you can’t get rid of student debt. Scrape up whatever money you still have and hop a plane to Ukraine. Even for non-Ukrainian citizens, total cost of tuition, housing, food, books and other fees at colleges and universities in Ukraine rarely exceed $4000 a year — and they’re usually cheaper. Alternatively, you can try to pass yourself off as Ukrainian at Texas A&M or Hampton University in Virginia, both of which now offer free room, board and tuition to Ukrainian nationals. Americans, of course, need not apply.

            One out of six American children, 12 million total, officially live in poverty. Neither political party seems much to care, and child poverty has not been a major campaign issue in decades. So the problem continues to worsen.

            This is a total bummer, especially for the kids and their families. But nothing can be done about it. Republicans and right-wing Democrats vote against child tax credits, citing the need to balance the budget and concerns that some parents might not use the money to take care of their kids.

            But the budget doesn’t always matter. Nor is careful stewardship of public funds always a priority. When the need is great, both parties come together and overlook such trivialities. President Biden, with the support of Republicans, liberal Democrats and right-wing Democrats, just announced an additional $800 million in military aid to Ukraine, bringing the total to more than $2.5 billion. Who cares if some of that gear winds up in the hands of neo-Nazis? In $100 bills, the cash would weigh 25 tons.

            Those who criticize the United States government as inefficient couldn’t possibly be more mistaken. Congress and the White House are lightning quick and incredibly generous—when it matters.

(Ted Rall (Twitter: @tedrall), the political cartoonist, columnist and graphic novelist, is the author of a new graphic novel about a journalist gone bad, “The Stringer.” Order one today. You can support Ted’s hard-hitting political cartoons and columns and see his work first by sponsoring his work on Patreon.)

Corporate Journalists are Blind to a Big COVID Lesson

Episode 24.5 - Literary Scandals 201 - Fax Machines, Man — The Bookstore

           One of my complaints about mainstream media is that they recruit reporters from inside the establishment—Ivy League colleges, expensive graduate journalism programs, rival outlets with similar hiring practices. Some staffs develop admirable levels of gender and racial diversity. But they all come from the same elite class. Rich kids believe in the system and they accept its basic assumptions.

            On New Year’s Day a reporter (UPenn and Oxford, of course) published a solid piece for The Washington Post about an important issue, how America’s “fractured healthcare system” hurts our response to COVID-19. Seeking to answer the question of why the pandemic is still going on after the miraculously rapid development and distribution of vaccines, the Post identified organizational shortcomings as part of the problem, citing the need for “improvements on the delivery side.” She quoted an expert who called for “increasing staffing and funding for local health departments, many of which have been running on a shoestring. Officials in some local health departments still transfer data by fax.” Both true. I’ve been asked to fax my records recently.

            But.

            Nowhere in the Post piece was there any mention of what the United States is missing that most other countries in the  world are not: a unified national healthcare system like the United Kingdom’s NHS.

            I’m not talking here about fully-socialized medicine or a single-payer Medicare For All system like the one championed by Bernie Sanders, although I strongly believe Americans need and deserve one. This isn’t about who pays for healthcare (though it should obviously be covered 100% by the government).

It’s about data integration.

In the same way that law-enforcement agencies across the country can access criminal records from other jurisdictions via the FBI’s National Data Exchange system, public-health officials need access to a real-time, constantly-updated source of every report of disease whether it’s known or novel, the visit was paid for in cash by the patient or covered by insurance, or it was diagnosed by a country doctor, walk-in urgent-care center or a giant urban hospital system.

A fully-integrated national healthcare database would be a powerful side benefit of a national healthcare system like Medicare For All. But how likely is Bernie Sanders’ pet project to cross the mind of a writer who graduated from UPenn and Oxford and has a gold health insurance plan provided by her employer, who is Jeff Bezos?

Here in America, the nation’s top epidemiologists at the Centers for Disease Control are flying blind, relying on algorithmic models that estimate what’s going on rather than providing accurate, precise situational awareness.

I tested positive for COVID-19 on December 30. I notified my doctor’s office on January 1 but due to the holiday didn’t hear back until January 3. Will New York City authorities and/or the CDC be notified about my case and, if so, when?

Several friends and friends of friends also tested positive during the Omicron surge using home tests. Many, probably most, didn’t tell their doctor. You have to assume that official numbers for Omicron have been significantly underreported.

If we had a national healthcare system instead of a medical Wild West in which the ailing are jostling against each other fighting over $24 testing kits like shoppers rushing into Best Buy on Black Friday, testing would be handled through clinics and doctor’s offices in coordination with the federal government—which would instantly compile the results.

A national healthcare database could include “visualization tools to graphically depict associations between people, places, things, and events either on a link-analysis chart or on a map. For ongoing investigations, the subscription and notification feature automatically notifies analysts if other users are searching for the same criteria or if a new record concerning their investigation is added to the system… [allowing] analysts to work with other analysts across the nation in a collaborative environment that instantly and securely shares pertinent information.”

I lifted that last quote from an FBI description of their police database. Crime, by the way, kills a small fraction of the number of Americans who die from disease.

HIPAA regulations governing patient records would need to be modified by Congress, but consider the potentially lifesaving benefits even when there is no longer a pandemic. Medical errors are the third leading cause of death in the United States.

Decentralized recordkeeping is a public-health disaster. If you live in Wyoming, there is no good reason that your healthcare records shouldn’t be accessible to first responders driving the ambulance that responds to a call that you collapsed and are unconscious at a mall in Florida. As soon as you are identified—something that could be facilitated by a national healthcare ID card that you carry in your wallet or as an app on your smartphone—EMS workers could use your patient history to identify chronic problems. They could avoid a medication to which you might be allergic or feel confident in administering one thanks to the knowledge that you are not.

I didn’t go to UPenn and Oxford. As an independent writer, I pay my own health insurance. I am reminded of America’s crappy healthcare system every time I pay my ACA bill and every time I cough up a co-pay. Newspapers like the Post may or may not need me. But they definitely need people like me if they want to relate to the readers they’re trying to serve.

(Ted Rall (Twitter: @tedrall), the political cartoonist, columnist and graphic novelist, is the author of a new graphic novel about a journalist gone bad, “The Stringer.” Order one today. You can support Ted’s hard-hitting political cartoons and columns and see his work first by sponsoring his work on Patreon.)

 

The Difference between Democrats and Republicans Equals Zero

Democrats often ask progressives: how can you say that there’s no difference between Democrats and the Republican party? While there are differences of tone, on the most important issues there is little to no difference in policy. And Congressional votes reflect that.

Everyone Hates Obamacare. So It’s Working.

The Affordable Care Act has achieved a dubious distinction: it has brought Americans together. Conservatives are convinced that it is a bolshevik government takeover of private enterprise. Progressives view it as a sell out to big health insurance companies.

Can’t Vote/Why Vote?

Republicans are obsessively trying to prevent Democrats, particularly blacks, from voting. Meanwhile, Democrats collect those votes but don’t work hard to represent their constituents on the issues that they care about.

Hold Them Accountable in 2040

Once again, Democrats are selling out their progressive voters. This time, Joe Biden says he’s not going to bother trying for a public option on the Affordable Care Act and there’s no sign of any attempt to increase the minimum wage. What will progressive voters do about it? If history serves, probably nothing.

At Least Trump is Gone

Biden’s response to the insanely low minimum wage, the ongoing healthcare crisis and the millions of people and businesses destroyed by the COVID-19 recession has been anemic; his defenders insist Trump was worse. But we can’t say “Trump was worse” when the rent is due.

How You Can Survive on $1400

A $1.9 trillion stimulus bill sounds like a lot of money, and it is, but a single payment of $1400 isn’t going to go very far for the 40 million people who lost their jobs over the last year and the millions of people who are facing eviction or foreclosure. Maybe all they need to survive is a little imagination.

Biden Offers Moderate Solutions to Radical Problems

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“Radical problems require radical solutions,” I wrote in my 2010 book “The Anti-American Manifesto,” a polemic that calls upon us to save ourselves from imminent social, economic and political collapse by overthrowing the system and rebuilding society from the ground up. We currently face several radical problems. But we’re not likely to rise to the challenge, because the Biden Administration’s adherence to the Democratic Party’s cult of militant moderation ensures that their proposed solutions will mitigate these grave issues—at best—with zero chance of avoiding disaster.

There is a time and a place for tweaks and minor adjustments. You don’t amputate a leg to cure a sprained ankle. Extreme situations require going big; if your oncologist suggests removing half your tumor and then waiting to see how it goes, fire her.

Our planet has cancer. Exponentially increasing temperatures have killed most of the world’s reefs and threaten widespread food shortages and thus political stability. Garbage, toxins and other pollutants are clogging the oceans and poisoning the air. We can debate the specifics but when studies predict the possible collapse of human civilization within 30 years and “a ghastly future of mass extinction,” environmental degradation has obviously become a radical problem.

Despite calling climate change “the number one issue facing humanity,” Joe Biden clearly doesn’t grasp the seriousness of the situation. His plan aims to achieve net-zero carbon emissions by 2050, the same year his plan calls for the elimination of fossil fuels. Grant him this: his plan is achievable. If human civilization vanishes, who in the hellscape will be left to burn fossil fuels?

Biden’s approach to the climate change crisis recalls my metaphorical oncologist, the one who counsels half-measures. Ban fracking on federal lands though most oil and gas comes from elsewhere. Improving fuel economy standards; Detroit is moving quickly to an all-electric car future anyway. Seal off leaking oil and gas wells. It’s good stuff. It moves in the right direction. But it’s like taking out half the tumor. Half of it is still inside you, multiplying.

You’re still going to die.

You could even argue that Biden is making things worse. Democrats are breathing a sigh of relief that Trump, a science denialist who wants to mine coal even though energy companies do not, has been replaced by a president who acknowledges the issue. But Biden’s half-measures are no likelier to fix the problem of rising temperatures fueled by greenhouse gas emissions than Trump’s overt sabotage. Catastrophe is inevitable either way.

From geoengineering to synthetic trees that absorb carbon dioxide more efficiently to whitening the surface area of the earth to reflect the sun’s rays to actively promoting algae blooms, science offers a number of Hail Mary passes that might stave off environmental apocalypse. Many sound wacky. They might be counterproductive. But at least they’re radical. Which means that, unlike tweaking MPGs, they might work.

The COVID-19 pandemic reiterated what anyone who ever gets sick has long known: America’s healthcare system is hobbled by rapacious for-profit insurance companies. I have a “silver plan” (Anthem BlueCross BlueShield) purchased via New York State’s Affordable Care Act marketplace. When I arrived at the hospital two weeks ago for a hernia repair operation that I definitely needed—I was losing feeling in my upper legs—I was informed hours before surgery that I would have to cough up $6500 between the deductible and the co-pay. I am due for a colonoscopy but now I can’t afford one. And I’m relatively lucky; I’m not one of the one out of four Americans who routinely skip seeing a doctor because they are too poor.

As with climate change, healthcare in the United States is a radical problem in need of a radical solution. Studies consistently show that Americans rank last or close to last among industrialized nations in terms of access to medical care, quality of care and cost. Average life expectancy in the United States has been falling over the last three years — a radical reversal of 20th century trends that recalls Russia after the collapse of the Soviet Union. Nothing Biden has in mind would put us where we belong: number one.

Biden’s moderate sales pitch famously defeated Bernie Sanders, for whom a major platform plank was Medicare for All. During the campaign Biden repeated Obama’s 2008 pledge to add “a public option” to Obamacare (Obama reneged). But the scheme recently unveiled by the White House downplays the public option and would allow Americans to spend up to 8.5% of their annual income on healthcare.

The new president is inheriting big, long-neglected problems that require big dramatic solutions.

The average young college graduate leaves with over $32,000 in student loan debt. Default rates hover around 10%; even bankruptcy doesn’t allow people to discharge these debts. Hobbling our best and brightest minds shrinks the consumer economy and discourages entrepreneurship. Yet Biden only wants to forgive up to $10,000 — and it doesn’t seem to be a top legislative priority. Even if he gets what he wants, the problem will remain extreme.

According to the Economic Policy Institute, the U.S. labor market is 9.9 million jobs smaller than pre-pandemic levels. New York City alone lost 1 million jobs to the COVID-19 lockdown. Millions of families face destitution, eviction or foreclosure. By any measure, this is a huge problem that could slow recovery for a long time. Biden’s solution is a one-time payment of $1400. Better than nothing but a rounding error compared to what would be required to keep people in their homes while they’re waiting for employment opportunities to return.

As Democrats bask in the glow of impeaching Donald Trump for a second time with some bipartisan support, they may want to consider how he got elected. Desperate workers in flyover country suffered from deindustrialization for years. It was a radical disruption. But Democrats ignored them, exacerbated the problem with poorly-written free trade agreements or satisfied themselves with half-measures.

Here we go again.

(Ted Rall (Twitter: @tedrall), the political cartoonist, columnist and graphic novelist, is the author of “Political Suicide: The Fight for the Soul of the Democratic Party.” You can support Ted’s hard-hitting political cartoons and columns and see his work first by sponsoring his work on Patreon.)

 

It’s Not That Biden Is Too Slow. It’s That He’s Going Too Small.

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           In the intraparty Democratic war between progressive leftists and corporate centrists, each side speaks a different language. The two factions’ takes on Joe Biden’s first weeks as president starkly demonstrate that inability to communicate.

            Biden’s base is his centrist supporters, those who backed him against Bernie Sanders during the primaries on the grounds that his moderate demeanor and years of wheeling and dealing would allow him to find common ground with Republicans who would probably continue to control the Senate. Centrists’ response to criticism of Biden is that Donald Trump’s mishandling of the coronavirus crisis, the shattered economy and the deep wound to our national psyche caused and embodied by the January 6th Capitol insurrection will require a long time to fix. Impatience, they say, is unrealistic and unfair.

The same principle applies to Biden’s response to longer-standing policy issues that predate Trump, like climate change and the healthcare system. They say, he just moved into the White House. Chill.

But progressives aren’t complaining that Biden is too slow—although they obviously feel a sense of urgency. They are complaining that his policy prescriptions are too small.

Biden came out of the gate fast with dozens of executive orders. But policy-obsessed progressive populists weren’t impressed by their close-to-nonexistent impact.

            On January 22nd the president issued a mandate that federal workers become subject to a $15-an-hour minimum wage. Given that the “Fight for $15” movement began in 2012, satisfying that progressive demand would require $17 after adjusting for inflation. More vexing is that Biden’s order doesn’t do anything. According to the U.S. Office of Personnel Management fewer than 20,000 of the nation’s 2.1 million federal government employees—fewer than one percent—currently earn less than $15 an hour. The administration made a splash but 99% of federal workers won’t see an extra penny.

Biden claims that he wants to reform American prisons, an idea for which progressives have been fighting and where common ground with Republicans may be achievable. But his executive order, which tells the Department of Justice not to renew contracts with privately-operated, for-profit prisons, affects only 14,000 out of nearly 152,000 federal inmates currently incarcerated, or fewer than 10% of federal prisoners. There were 1.8 million people in American prisons as of the middle of last year. Biden’s executive order will lead to the transfers of fewer than 1% of the total prison population.

“When it comes to private prisons, the impact of this order is going to be slight to none,” Fordham law professor John Pfaff tells NBC News. Because it fools us into believing in a nonexistent improvement it might even make things worse. “The symbolism carries the very real risk of making us blind to the nearly identical incentives of the public prison sector, and the public side is so much vaster in scope,” Pfaff warns.

One Biden order promises to replace the federal government fleet of 645,000 vehicles with electric ones. The catch is, he doesn’t say when. Unless it happens before 2035 and no future administration issues another executive order reversing this one, companies like General Motors will render the issue moot. The automaker has announced that it will stop making gas-powered passenger cars and SUVs that year.

I was pleasantly surprised by Biden’s decision to push his $1.9 trillion COVID-19 stimulus package through Congress using the budget reconciliation process, which only requires 50 votes rather than a 60-vote supermajority in the Senate. Democrats finally seem to be waking up to the reality that Republicans really, really hate them and aren’t going to cooperate with their initiatives. But here’s the thing: neither the one-time $1400 per person payout nor the $15/hour minimum wage can lift us out of the deep coronavirus depression. The American workforce has lost at least 10 million jobs over the last year. Millions of people face eviction or foreclosure. There is widespread consensus among economists that Biden’s plan, assuming it passes intact, is insufficient and will fail to provide long-lasting relief.

If Biden has big plans in mind, now—while Democrats control the Senate and he enjoys high approval ratings—is the time to tee them up.

First, the president should communicate to the public that sizable coronavirus relief packages will be an ongoing part of fiscal policy until the pandemic is over, recovery is at hand and the rising tide has already begun to lift most boats. The current ad hoc approach inherited from Trump is woefully inadequate and creates unnecessary anxiety among individuals and in the securities markets. Stimulus in fits and starts doesn’t work. We need a Universal Basic Income.

Second is the environment. Long neglected by both major parties, the climate change crisis represents both an enormous opportunity as well as an existential threat to humanity. Auto manufacturers that are rapidly moving toward electric vehicles and big energy companies that already understand the future lies outside fossil fuels prove that the marketplace is ahead of government when it comes to the Green New Deal. Biden deserves credit for talking about the problem but he wants to do way too little way too late.

He should work to push through a comprehensive plan to radically reduce the emission of greenhouse gases within the next few months.

There are, of course, a myriad of other policy challenges ahead—militarism, immigration, an increasingly authoritarian Silicon Valley—but if I were Biden I would tackle racism and particularly racist policing quickly. American police are vicious, stupid and predatory. They make communities more dangerous, not safer. Cops should get out of the revenue enhancement business. Protecting the public must take priority over protecting themselves. Harassing people based on ethnicity and other demographic profiles must end. Biden can use the threat of withholding federal funding to force states and cities to reinvent policing from the ground up.

We want Biden to be fast. More than that, though, we want him to be bold.

(Ted Rall (Twitter: @tedrall), the political cartoonist, columnist and graphic novelist, is the author of “Political Suicide: The Fight for the Soul of the Democratic Party.” You can support Ted’s hard-hitting political cartoons and columns and see his work first by sponsoring his work on Patreon.)

 

 

 

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