Wednesday, February 27, 2013

Is there a displaced rational basis for blaming Obama?

Lots of smart political observers have been working hard in recent days to explain the odd phenomenon of centrist beltway types (Fournier, Ignatius, WaPo editorial staff) blaming Obama for not being able to induce Republicans to accept the kind of compromise or "balanced approach" to replacing the sequester that Obama has articulated ad infinitum and that the pundits in question themselves seek. That approach seeks a roughly equal mix of revenue increases (via tax loophole reduction) and spending cuts to replace the $1.2 trillion in automatic, across-the-board cuts in discretionary spending mandated by the sequester. Should such a balance be struck, spending cuts would still outnumber revenue hikes by about 2-to-1 in the sum of deficit reduction measures taken since 2011, not counting interest savings.

James Fallows calls the both-sides-are-to-blame schtick false equivalence.  Brendan Nyhan decries Green Lantern theory, the apparently ineradicable belief that the president can bend Congress to his will by force of rhetoric or personality or some more nebulous magical power.  Brian Beutler detects an Obama derangement syndrome -- a profound disappointment in Obama stemming from his apparent lack of power to stop the train wreck. Beutler does an excellent job demonstrating that David Ignatius in particular lambastes Obama for not making precisely the public argument in favor of a mix of tax hikes and spending cuts -- including cuts to Medicare and Social Security -- that Obama has been making nonstop for two years.

Fallows and others attribute this phenomenon to a rooted belief among establishment Beltway types that if compromise fails, both sides must be at fault. Beutler and Nyhan allude to misplaced faith -- disproved by political science research -- that the president can win a political fight by force of argument. Also, more generally, that presidential power should be able to overcome, because the president is...Father of us all?

I suspect that at least some of those who call on Obama to compromise more, or articulate better, or propose larger, "braver" entitlement cuts may be displacing anger over a disappointment in Obama that is more grounded in reality. Or perhaps I'm just speaking for myself here. Because I am angry at Obama.

Tuesday, February 26, 2013

Yes, Team of Rivals was Tony Kushner's "principal source" for Lincoln

I came to  Michael Vorenberg's Final Freedom: The Civil War, The Abolition of Slavery, and the Thirteenth Amendment (2001) via Timothy Noah, who suggested in a New Republic  "best books" listicle  that this book was likely the unacknowledged main source of the movie Lincoln,  In a Jan. 10 followup, Noah notes that "Lincoln isn't adapted in any meaningful way from its nominal source, Doris Kearns Goodwin's book, Team of Rivals, which despite its many virtues dedicates only a few pages to the film's central narrative--the passage of the 13th amendment to the Constitution" and that Final Freedom is "a book rich in narrative detail that [screenplay author Tony] Kushner surely feasted on."

I finished Final Freedom yesterday, after a slow read, noting points of convergence and divergence with the movie along the way. A week or two ago, I reread Goodwin's four pages on the House's passage of the thirteenth amendment in January 1865. And what struck me right away -- and now again as I read those pages again -- is that the film's narrative shape and thematic focus bear a much closer resemblance to Goodwin's short hero's narrative than to Vorenberg's richly detailed, polyphonic tic-toc.

Preparing to write that thought up, I went to TNR to pull Noah's article and discovered that he has gone on something of a quest to get Tony Kushner to acknowledge a debt to Vorenberg. In a followup,  Noah spoke to both Kushner and Vorenberg.  Kushner acknowledges having read Final Freedom, and praises it warmly, but denies that it was a primary source. Reading his response was for me a case of reading more or less what I was about to write. first! -- it's my blog. Then, Kushner and Vorenberg.

Sunday, February 24, 2013

About that conservative soft spot for means-testing

[reposted from 2/22]

Jonathan Cohn had some fun this afternoon with this tweet and article:
Huge scoop: White House endorses means-testing for Medicare.

--  the joke being that Obama's 2013 budget, released a year ago, proposed modest increases in the already-higher premiums that wealthy seniors pay for Medicare Parts B and D.  Legions apparently retweeted Cohn without pausing to note that the "scoop" was a year old and based on information that the White House publicized.

Cohn's post was prompted by David Brooks lambasting Obama for not offering serious entitlement cuts, such as means-testing, in current negotiations to replace the sequester (see Cohn's post for links).  Which highlights a rather odd fact: means-testing Medicare and Social Security has been a Republican talking point throughout the budget wars. They use it either, I imagine, for cover -- see, we're not just about cutting benefits for the poor -- or as a stalking horse for cutting benefits for everyone else. More on that later.

The funny thing about means-testing is that it's functionally equivalent (if arguably less efficient in some cases) to raising taxes on the wealthy, which is anathema to the GOP.  Another funny thing: people don't realize the extent to which benefits for the elderly are already means-tested -- or, if I'm using that term imprecisely, more expensive for the wealthy (and in one case, available only to the poor).  A few facts, then, about our core elderly benefits:

Woodward is peddling a nonsense conclusion. Why?

For who knows what reason, Bob Woodward is blowing smoke on the sequester deal.

In an article published yesterday, he makes an allegation about the sequester and the grand bargain it was supposed to stimulate that is so absurd no one even noticed what he now says he meant:
In fact, the final deal reached between Vice President Biden and Senate Minority Leader Mitch McConnell (R-Ky.) in 2011 included an agreement that there would be no tax increases in the sequester in exchange for what the president was insisting on: an agreement that the nation’s debt ceiling would be increased for 18 months, so Obama would not have to go through another such negotiation in 2012, when he was running for reelection.

So when the president asks that a substitute for the sequester include not just spending cuts but also new revenue, he is moving the goal posts. His call for a balanced approach is reasonable, and he makes a strong case that those in the top income brackets could and should pay more. But that was not the deal he made.
There is a major sleight-of-hand embedded here. Woodward is saying, first, that the sequester includes no revenue -- which is plain fact -- but also that it was therefore understood initially that the replacement for the sequester would also include no revenue.

That is palpable nonsense, as I demonstrated yesterday: before the deal was signed, Obama said that the supercommittee would be charged with striking a deal that would include revenue.  The White House elaborated the point that most parties expected the supercommittee to consider a mix of tax hikes and spending cuts from the start.

Now Woodward is back with an email to Politico's Mike Allen spelling out his initial  point, which no one noticed because it was so absurd:

Saturday, February 23, 2013

No, Bob Woodward, the White House did not move the goalposts on the supercommittee's charge

Bob Woodward claims to have proof, in the form of statements by the principals, that the idea of using sequestration as an enforcement mechanism in the Budget Control Act of 2011 originated with the White House. That may be.*

Woodward also asserts that "the final deal reached between Vice President Biden and Senate Minority Leader Mitch McConnell (R-Ky.) in 2011 included an agreement that there would be no tax increases in the sequester." He provides no quotes in this article to back that statement up. If there was any such agreement, it was never put in writing and it is not reflected in the legislative language or in official descriptions of the deal immediately following its announcement.

A CBO statement put out on August 1, 2011, described the supercommittee's task as follows:
Create a Congressional Joint Select Committee on Deficit Reduction to propose further deficit reductions, with a stated goal of achieving at least $1.5 trillion in budgetary savings over 10 years
The BCA itself describes the supercommittee task as follows:

GOAL.—The goal of the joint committee  shall be to reduce the deficit by at least $1,500,000,000,000 over the period of fiscal years (Sect 401b, p. 52).
"Reduce the deficit" does not mean "by spending cuts only."

Publicly, from the moment the deal was announced, Republicans insisted that the supercommittee was tasked with considering cuts only, and Democrats insisted that new revenues would be part of the mix.  Announcing the deal on July 31, 2011, Obama said this of the supercommittee (my emphasis):

Friday, February 22, 2013

Breaking: U.S. senior benefits means-tested

Jonathan Cohn had some fun this afternoon with this tweet and article:
Huge scoop: White House endorses means-testing for Medicare.

--  the joke being that Obama's 2013 budget, released a year ago, proposed modest increases in the already-higher premiums that wealthy seniors pay for Medicare Parts B and D.  Legions apparently retweeted Cohn without pausing to note that the "scoop" was a year old and based on information that the White House publicized.

Cohn's post was prompted by David Brooks lambasting Obama for not offering serious entitlement cuts, such as means-testing, in current negotiations to replace the sequester (see Cohn's post for links).  Which highlights a rather odd fact: means-testing Medicare and Social Security has been a Republican talking point throughout the budget wars. They use it either, I imagine, for cover -- see, we're not just about cutting benefits for the poor -- or as a stalking horse for cutting benefits for everyone else. More on that later.

The funny thing about means-testing is that it's functionally equivalent (if arguably less efficient in some cases) to raising taxes on the wealthy, which is anathema to the GOP.  Another funny thing: people don't realize the extent to which benefits for the elderly are already means-tested -- or, if I'm using that term imprecisely, more expensive for the wealthy (and in one case, available only to the poor).  A few facts, then, about our core elderly benefits:

Thursday, February 21, 2013

Worse than a crime, etc.

In trying to pin the sequester on Obama, Republicans never really say exactly what they're blaming him for. Is it for actually wanting the savage cuts -- a suggestion that doesn't pass the laugh test? Or for being weak or foolish enough to let them inflict it on him and on the country? That must be it -- notwithstanding it doesn't reflect very well on them.  They're the ones insisting that the meat ax is better than a) simply calling the thing off, since no one intended to enact it, or b) replacing it with a mix of more targeted cuts and modest tax hikes.

Ruth Marcus speaks my thought exactly (and I suppose I've more or less reiterated hers):
The Obama administration is guilty of bad negotiating in pursuit of sensible policy. Congressional Republicans are guilty of exploiting the president’s bad negotiating in pursuit of terrible policy.
And yes, Obama, never willing to carry a fight to the finish, gave up his point of maximum leverage:

Tuesday, February 19, 2013

What would Simpson-Bowles 2.0 do to Medicare?

Liberals are up in arms about the new Simpson-Bowles deficit reduction framework because, in brief, it calls for about $1.4 trillion less in revenue over ten years than Simpson-Bowles 1.0  (let's call it SB 1) along with roughly another $1.8 trillion in spending cuts, counting interest savings. That's more cuts than those mandated by the looming sequester, but more back-loaded, and with $600 billion coming from Medicare and Medicaid, which the sequester doesn't touch.

The shock comes from the reduction in proposed new revenue compared to the original plan, a change that simply reflects Obama's more limited revenue goals ($1.2 trillion over ten years at last ask, compared to $2.6 in SB 1). Spending cuts remain approximately the same, making the whole package proportionately more cut-heavy.

I want to look for a moment at the $600 billion in savings SB 2 proposes for "health care reforms" -- $200 billion more than SB 1 laid out, but  no more than Obama put forward in his last "grand bargain" offer to Boehner.  Simpson and Bowles envision bending the health care curve in ways that overlap with those envisioned by Obama -- though BS 1 cuts benefits in ways that Obama would not approve, and BS 2 would presumably cut benefits still more. Their rather sketchy new framework takes an "all of the above' approach to reducing healthcare costs -- hitting providers, beneficiaries, and drug companies:
Reduce Medicare and Medicaid spending by improving provider and beneficiary incentives throughout the health care system, reducing provider payments, reforming cost-sharing, increasing premiums for higher earners, adjusting benefits to account for population aging, reducing drug costs, and getting better value for our health care dollars (Feb-Dec 2013)

Monday, February 18, 2013

The paradox of power, immigration reform edition

It's pretty amusing that Republicans are lambasting Obama for daring to stick his oar into the immigration reform process:
...Republicans quickly condemned the reports of a new administration plan, calling it “dead on arrival” and “very counterproductive”...

On Sunday, Representative Paul D. Ryan of Wisconsin, another Republican calling for immigration changes, said on “This Week” that the president’s efforts to develop his own legislation would undermine efforts on Capitol Hill and were taking “things in the wrong direction.” 
No one is more aware than Obama that he, as president "remains a polarizing figure," as the Times' Michael Shear and Julia Preston put it.  The last time Congress was huffing and puffing in the early stages of a Grand Bargain, almost exactly two years ago (2/15/11), over deficit reduction,  Obama explained why he had not unveiled a detailed plan:

In which Obama induces false memory in Fallows, and I name that tune

In a headnote to his annual line-by-line annotation of Obama's SOTU (noting the political imperatives driving almost every line), James Fallows elaborates on a point he's made before about Obama: "You can barely remember a word of what he says. Obama's eloquence exists almost exclusively on the macro scale..."  In a sense, Fallows suggests, he remembers less than no lines, since the one line he thought he remembered -- ""not red states, nor blue states, but the United States of America," from Obama's 2004 DNC keynote, was a  "play it again, Sam" -- never quite said.

This evening, Fallows recounts the long back story to that speech and the missing line (as told by David Bernstein in Chicago Magazine), and then segues to some thoughts I sent him, e.g.:
Re that strange absence of memorable phrases: it's not just balanced by one strength, it's book-ended between two: conceptual complexity/coherence on the macro side, and cadence on the sub-micro. At least in 2007/2008, less so now, Obama's speeches were musical, hinging on repeat phrases (yes we can) and on the simplest of rhetorical devices, various forms of parallel structure, e.g. anaphora, the repetition of beginning words (also a lot of parallel phrasings in series -- "A man touched down on the moon, a wall came down in Berlin" etc.).  It was no accident that was able to set one of his speeches to music to some effect.
That's a distillation of a post I put up in response to Obama's victory speech on election night, 2008, which illustrates the point. That was one incantatory speech.

Sunday, February 17, 2013

David Goldhill, consider our dental dystopia

David Goldhill, long an advocate of shunting all but catastrophic health care costs onto consumers (pairing super-catastrophic insurance with mandatory HSAs) offers, I must admit, a compellingly negative view of what's likely to become of cost controls embedded in the ACA or favored by the health care experts I like to read. It's a kind of mirror image of Atul Gawande's thousand flowers vision:
Through private insurance, Medicare and Medicaid, our health system relies on centralized cost control and clever adjustments to payment formulas to try to tame the beast. Traditional health experts may repackage their ideas, but they are never discouraged by past failure. So the new Accountable Care Organizations are a reinvention of H.M.O.’s. The Independent Payment Advisory Board is the new Medicare Payment Advisory Commission, or MedPAC. Bundled payments are the new Prospective Payment System.
We often see some early benefit from the introduction of new ideas, but over time such initiatives are always subjugated by our system’s nefarious economic incentives. Implement cost control reforms and watch providers circumvent new rules and guidelines. Reduce reimbursement rates for procedures, and witness providers expand the definition of required services. Convert fee-for-service reimbursements into bundled payments, and soon more severe diagnoses are given. Attempt to use government buying power, and see providers turn to lobbyists to keep prices up. We are approaching a half-century of fighting this losing battle.

It's true that power industries and interest groups are very successful at gaming new regulations. It's also true that today's reforms bear some resemblance to prior efforts.

Friday, February 15, 2013

Morning in, ah, Medicare?

Well, it's a sunny pre-holiday Friday morning, and I am cheered by Ezekiel Emanuel in today's Times heralding the bending of the healthcare cost curve, as it now seems over the past ten years. On the cost control front, perhaps the ACA will look in retrospect something like the surge in Iraq, giving a jolt of indeterminate magnitude to a st of processes already in motion.

In any case, perhaps superficially, I am riffling through my mind the hopeful signs that have emerged on the healthcare front in recent weeks. If I want to go head over heels in caffeinated optimism, I might imagine that Atul Gawande's vision of a kind of venture capital process of reform stimulated by the ACA -- dozens of simultaneous experiments, a handful of which will yield dramatic results -- may actually occur over the next ten-odd years.

Hopeful signs include the fact that, for all the GOP's caterwauling about "bureaucrat-controlled" and "government-controlled" healthcare, beneath the radar some Republicans are looking at cost control measures that are indeed government-imposed, and likely to be effective.  For example, as I noted recently, two long-term "doc fix" bills are currently circulating in Congress, one bipartisan (but mainly Democrat), one Republican. While the GOP bill accords far more input to healthcare providers, both purport to either end or radically curtail fee-for-service payments.

A second sign of some nonideological thinking on the Republican side emanates from a bipartisan initiative, the Partnership for the Future of Medicare, co-chaired by former CBO head Douglas Holtz-Eakin and Ken Thorpe, a professor at Emory. The pair this week distilled a  PFM report in a post on the Health Affairs blog. I think of Holtz-Eakin, former economic adviser to the McCain campaign, as an intensely partisan critic of Obamanomics and the ACA, an impression gleaned mainly from quotes in news articles.  I was therefore somewhat surprised to learn that he is preaching the futility of simple cuts to benefit formulas, and calling for more systemic reform that does not simply rely on the Competition Fairy:

Tuesday, February 12, 2013

Obama's passionate pragmatism

Obama has always presented himself as both pragmatist and idealist, projecting faith that if we "uphold our ideals through the hard, often frustrating, but absolutely necessary work of self-government" we will make incremental progress toward audacious goals: a new age of broadly shared prosperity, plentiful sustainable energy, affordable health care, nuclear weapons reduction (and ultimately eradication), an end to global poverty, arrested global warming.  In tonight's SOTU, he wedded the pragmatism and the idealism powerfully, reasoning with understated passion, shouting less than in his inaugural but building to a powerful climax of moral exhortation as he invoked Newtown, recapturing also the balanced cadences and grammatical parallelism that marked his speeches in 2008.

Obama's repeated plea to the nation tonight was to face reality: his tone was relentless reasonability. He spoke with a distilled fluency of a man who has been articulating the same values and proposing essentially the same policies (excepting gun control)* for six years on the national stage and now speaks with the knowledge that through several permutations and waves of oppositional hysteria he has still has (or has regained) a majority with him on the big stuff.  And so he argued, not only as if he were himself convinced but convinced that we are convinced: Deficit reduction has to be balanced. Undocumented immigrants have to be offered a path to citizenship as part of comprehensive immigration reform. The nation has to invest in the pillars of shared prosperity: alternative energy, education, infrastructure. Climate change is real and wreaking havoc.  The level of gun violence we live with is insane. Everyone has a right to vote without standing in line for five, six, seven hours. As he said with respect to immigration reform: "we know what needs to be done."

Here are a few of the reality checks -- arguments delivered with a "who can dispute it?" mien:

Monday, February 11, 2013


Phil Bronstein debriefed the Navy SEAL who shot bin Laden at length. Part of the anonymous shooter's narrative:
The group discussed what would happen if they were surrounded by Pakistani troops. We would surrender. The original plan was to have Vice-President Biden fly to Islamabad and negotiate our release with Pakistan's president.

This is hearsay, but I understand Obama said, Hell no. My guys are not surrendering. What do we need to rain hell on the Pakistani military? That was the one time in my life I was thinking, I am fucking voting for this guy. I had a picture of him lying in bed at night, thinking, You're not fucking with my guys. Like, he's thinking about us.

We got word that we'd be scrambling jets on the border to back us up.
Well yes, hearsay. But was Obama really ready to start lethal firefight with Pakistan after invading its airspace and landing a combat team unannounced, thereby, at a minimum, completely destroying the chance of even a minimal level of cooperation with regard to Afghanistan or terrorist and Taliban safe havens in Pakistan's tribal regions?

Sunday, February 10, 2013

Some thoughts about drone strikes and detention

It is high time I sorted out my thinking (and feeling) about U.S. drone killings and other targeted killings of those deemed to be terrorists. It's a duty to myself if no one else. The charge that liberals who were up in arms about Bush's torture and detention policies are unjustifiably silent about Obama's secret and unaccountable killings has some merit in my case, though I have on occasion expressed unease or disapproval of various aspects of Obama's conduct of the ongoing covert war. This will be an essay in the original sense, in that I am figuring out what I think (and recalling what I have thought at various stages) as I go along. The questions: what policies are effective (or likely to cause blowback), what policies are legal (or pose a lasting danger to our civil liberties), what policies are ethical (or likely to save more lives than they take).

Saturday, February 09, 2013

The white paper defines "imminent" correctly. Now what?

It's been widely noted that the Justice Dept. white paper purporting to set forth a legal framework "for considering when the US government could use lethal force in a foreign country" to kill a U.S. citizen vastly expands the killing zone in space and time. "The battlefield" is potentially everywhere, and the "imminence" of the threat of violent attack to be legitimately defended against is continuous.

Regarding physical space, the paper pretty much gives the government carte blanche to target anyone deemed a "senior operational leader of al-Qa'ida" in any country in the world, since an attack is deemed "consistent with international legal principles if it were conducted, for example, with the consent of the host nation's government or after a determination that the host nation is unable or unwilling to suppress the threat posted by the individual targeted" (p.5). For example indeed. That "example" covers every imaginable circumstance. I'm no expert in international law, but I doubt it sanctions governments to kill perceived enemies as defined herein wherever they find them.

The white paper has been most widely excoriated for its definition, or alleged defining away, of "imminent." One of three conditions that must be fulfilled for a lethal attack on a U.S. citizen to be justified is "the condition that an operational leader present an "imminent" threat of violent attack against the United States" -- which, according to the paper, "does not require the United States to have clear evidence that a specific attack on U.S. persons and interests will take place in the immediate future" (p.7).

Friday, February 08, 2013

Another cliff, another cave?

Greg Sargent exhorts the Democrats not to fall for the GOP's sequester bluff:
Democrats are going to have to do a better job of spelling out precisely what the consequences of the sequester would be, so the public understands precisely what Republicans are willing to allow happen in to force the spending cuts they want.

The White House is starting to do that today, circulating a fact sheet that lays out in specific terms exactly what the sequester would do. A few examples: 2,100 fewer food inspections could occur. Seventy thousand kids kicked off Head Start. Ten thousand teacher jobs put at risk. Hundreds of thousands of seriously mentally ill adults could go untreated. Over $500 million in cuts to small business loan guarantees. Cuts to unemployment benefits — further harming the economy — and child nutrition. Etc.

I must confess, this fans an anger that's been brewing in me -- and I take that anger as evidence of a weakness in the Dem position. Obama and the Dems co-negotiated the sequester. Say if you like that they never intended for it to go into effect -- but they put themselves in a position to let it happen. Put another way, Obama and Biden, through the deal they cut at year's end in a last-minute override of Harry Reid, have let the leverage they had on Dec. 31 be reversed. More broadly, Obama has put us in this position through his serial unwillingness to force a confrontation -- in December 2010, in August 2011, and in Dec/Jan 2011-12. 

Thursday, February 07, 2013

Will the 'doc fix' revolutionize U.S. healthcare?

I'm new to this, and so lack important context, but it looks to me as if a pending 'doc fix' -- a long-term replacement for the failed Medicare reimbursement formula (part of the Balanced Budget Act of 1997) that Congress patches up every year --could transform our healthcare delivery system at least as sweepingly as the Affordable Care Act.

Modern Healthcare's Rich Daly reports that two rival bills have been introduced. A bipartisan bill all but phases out fee-for-service, while a GOP bill preserves but modifies it. The first,  introduced by Rep Allyson Schwartz (D-Pa) and co-sponsored by Rep. Joe Heck (R-Nev.), an osteopath, is summarized by Daly as follows:
Schwartz's bill (PDF) would mostly unravel the fee-for-service system by requiring physicians to adopt one of several replacement models that the CMS would test and approve over five years. Physicians who did not do so would face successive payment cuts, although a small number of physicians could remain in a modified fee-for-service system if they met certain quality benchmarks or were near retirement.

Wednesday, February 06, 2013

The xpostfactoid service employee mandate

I confess to be swayed back and forth a bit by an online debate. I more or less assented to Timothy Noah's brief against Pret-a-Manger, a counter food chain that takes training its employees to be friendly and engaging to perhaps new extremes:
Pret keeps its sales clerks in a state of enforced rapture through policies vaguely reminiscent of the old East German Stasi. A "mystery shopper" visits every Pret outlet once a week. If the employee who rings up the sale is appropriately ebullient, then everyone in the shop gets a bonus. If not, nobody does. This system turns peers into enthusiasm cops, further constricting any space for a reserved and private self. And these cops require literal stroking. In other workplaces, touching a co-worker may get you fired, but at Pret you have to worry about not touching co-workers enough. "The first thing I look at," Chief Executive Clive Schlee told The Telegraph last March, "is whether staff are touching each other . . . I can almost predict sales on body language alone...

Tuesday, February 05, 2013

Obama and further deficit reduction

In response to Obama's reiteration during a pre-Super Bowl interview that he's seeking new revenue by curbing tax deductions for the wealthy, Andrew Sullivan reverts to favorite (though somewhat modified) mantras:
I’d love those loopholes to be closed. But that’s not real, serious revenue-raising tax reform. It’s old-school class demagoguery, not 2008 Obama honesty. If we are to control future debt, and to do so in part through ending tax deductions, we simply have to include the mortgage deduction, the state tax deduction, and the charity deduction – or find a way to cap those deductions past a certain income level. Nothing else comes close to making a difference. And yes, that means the middle class will get hurt a little. That’s what “additional revenue” in the amount required entails.

So less about the Cayman Islands and more about the sacrifices we need to make, please. I really hope the ACA reduces healthcare costs, but I don’t think it’s fiscally responsible to rely on experiments that may well yet fail. Baiting the super-rich is easy. Reducing the deficit responsibly is extremely hard – unless this president is prepared to be blunter and clearer than he was in this interview. And this, recall, is at the beginning of his second term, with maximal leverage at his disposal.

In the two years since Obama's 2011 SOTU, when Andrew called on Obama to make a crusade of deficit reduction, he has come a long way toward a liberal perspective on the budget -- acknowledging that the Tory austerity program in the UK has been a failure and at least partially recognizing, as here, that controlling healthcare costs is basically the whole of the U.S.'s long-term budget challenge.  But Sullivan still can't quite shake the notion that long-term budget planning calls for "sacrifice,", as if deficit reduction were some kind of war effort rather than a component of seeking the greatest prosperity for the greatest number.  And he misreads Obama more than one way here.

Friday, February 01, 2013

a second microblog post

So, based on the economic fundamentals in 2011-12 as we now know them, if Romney and Obama had been sock puppets the election results would have been about the same. But see also the first micropost.

Last year's contraceptive compromise completed: Federal government will pick up tab for contraceptive coverage at religious nonprofits with self-funded insurance plans

Today, HHS answers a question that arose last February when the administration announced its compromise regarding insurance coverage for contraception at faith-based nonprofits that objected to the coverage on moral grounds (places of worship do not have to provide contraceptive coverage at all). Here is the question as I framed it last February: 
Under the  compromise,
  • Religious organizations will not be required to subsidize the cost of contraception.
  • Contraception coverage will be offered to women by their employers’ insurance companies directly [and free of charge], with no role for religious employers who oppose contraception.
Question: more than half of Americans who get their health coverage from their employers are in self-funded plans -- that is, plans in which the employer sets aside funds to cover the cost of health care, usually hiring a third party administrator (TPA) to handle the claims process, as well as a stop-loss insurer to cover costs above a certain level.  So: who will "provide contraception coverage" in self-funded plans?   If it's the self-funded entity, then the employer is paying for it. Would the TPA somehow absorb the cost -- or a stop-loss insurer under some special rider? If so, surely either would find a way to pass the cost back? 
And lo, here is the answer, published today by HHS:

A microblog post

Obama won reelection because he managed to restrain GOP economic sabotage just enough to keep growth sputtering along