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Dear Group, Republican Leah Vukmir, a Wisconsin state senator, is challenging Tammy Baldwin (D-WI) for Baldwin’s seat in U.S. Senate. In 2009 Vukmir voted against a bill in the Wisconsin state house requiring insurance companies to cover hearing aids and cochlear implants for Wisconsin children. Vukmir was one of few who voted against the bill. Twice. The bill became law in spite of Vukmir. Recently, the mother of a child who received a cochlear implant using the coverage mandated by the law spoke out in an ad against Vukmir’s candidacy. The flap over the ad was covered on Wisconsin Public Radio. See if Vukmir’s defense sounds familiar: Vukmir’s campaign manager, Jess Ward, pushed back on the criticism, saying Vukmir opposes, “government-run, one-size-fits-all healthcare.” “As a nurse, Leah believes in providing patients with plans suited to their needs, and she opposes plans that increase costs for all patients, making health care less affordable,” Ward said. She added Vukmir believes such changes also lead to fewer options and diminished health care quality for consumers. Vukmir’s defense is familiar because it is Republican/Libertarian boilerplate (see the P.S. below). I have heard the same nonsensical talking points from every Republican who speaks on health care and health insurance, at both a state and federal level. Most certainly that includes McMorris Rodgers. Republican’s always conflate health care and health insurance.Their fundamental objection is to any government regulation of business, specifically the business of health insurance. “Leah believes in providing patients with plans suited to their needs, and she opposes plans that increase costs for all patients, making health care less affordable,” Her statement should go this way: “Leah believes health insurance companies should be able to offer hard to comprehend, sub-standard insurance policies that do not protect the consumer from medical bankruptcy. Leah believes an inexpensive insurance premium for barebones coverage equals affordable health care.” That is nonsense. Health insurance is merely a complicated vehicle, a middle man, a clearing house, for paying bills from a health care “system” that has not been a free market for more than half a century. Anyone who has ever looked at an Explanation of Benefits (EOB) knows the only thing regulating the charges posted by the health care system is public outrage, and in the case of drug prices even public outrage has limited utility. Health insurance companies actually blunt public outrage by serving as a buffer between health care charges and the patients they insure. (Note: Serving as a buffer, i.e. averaging cost over a subscriber population, is what insurance companies are expected to do.) The only way in which health insurance companies regulate health care charges is through mostly opaque business deals concerning what insurance will cover at all, what it will “allow” (i.e. pay) for a given service, and whether the provider will accept the payment offered. What the patient can pay or is willing to pay for health care is not a significant factor. This arrangement has no guard rails. This system resulted in an aggregate average health care expenditure per person of over $10,000, more than twice that of many countries that provide better average care. The spokesperson added: “…Vukmir believes such changes [changes like requiring insurance companies to provide coverage for hearing aids and cochlear implants] also lead to fewer options and diminished health care quality for consumers.” If you are able to construct a rational train of thought leading to that conclusion you are doing better than I. The Republican/Libertarian party’s acolytes keep repeating the same words over and over, They don’t stand up to inspection. Keep to the high ground, Jerry P.S. If you know Vukmir’s background it should come as no surprise she is spouting boilerplate Republican ideology. Vukmir served as the national chairwoman for the American Legislative Exchange Council (ALEC), a non-profit, 501(c)(3) “think tank” and clearing house. ALEC was set up to aid state legislators in sharing Republican legislative ideology. It provides boilerplate language for Republican bills at the state level. ALEC is heavily supported by the Koch brothers donor network as a way of dominating and homogenizing Republican ideology across the fifty states. If you are not already familiar with ALEC you should be. Read the wikipedia article for a start. Note the ALEC’s expropriation of “American,” It should be the “Republican” Legislative Exchange Council. ALEC was founded in the 1973 in response to the infamous Powell Memorandum. P.P.S. At one time I thought Republicans who spouted this “healthcare” mantra were purposefully deceitful. No longer. I now believe most of them simply lack the bandwidth and education to understand economic reality. |
Nature Roars. Does CMR hear?
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Dear Group, I am taking this day off from writing. For those who may have missed this piece in the very successful New York Times published September 16th. Consider my copying it as an unsolicited advertisement for the NYTimes. I have subscribed to the online version since shortly after the Trump election. Here is the article: Nature Roars. Washington Hears Nothing. The elements offer a rebuke as President Trump rolls back policies designed to address global warming. As if this past summer of merciless heat waves, droughts and megafires were not warning enough, in the past several days the elements sounded another alarm about the state of a world made warmer by the burning of fossil fuels. It came in the form of a one-two punch of wind and rainfall from Hurricane Florence, which like Hurricane Harvey a year ago, has derived much of its wallop from unusually warm ocean waters and stalled weather systems linked to climate change. “Supercharged” is the word one prominent climate scientist, Michael Mann, used to describe Florence, echoing the findings of the federal Global Change report in 2014 that, along with a rise in other extreme weather events, “hurricane intensity and rainfall are projected to increase as the climate continues to warm.” To no one’s surprise, this linkage went unacknowledged in President Trump’s Washington. Quite the contrary. On Tuesday, in a further retreat from President Barack Obama’s ambitious promises to reduce America’s emissions of the greenhouse gases deemed largely responsible for global warming, the Environmental Protection Agency proposed weakening rules aimed at reducing leaks of methane from oil and gas operations. Methane, a principal component of natural gas, is a short-lived but potent greenhouse gas that represents about 9 percent of this country’s total greenhouse gas emissions; one-third of it comes from oil and gas operations. Though the changes seem small — reducing the frequency of inspections and fixes to wells and pipelines, for instance — they may well presage an administration decision to get out of the business of regulating methane altogether. (The Interior Department, in a companion move, is soon expected to release its own proposal to roll back Obama-era rules regulating the venting and flaring of methane from drilling operations on the millions of acres under its control.) The change in the methane rule is just plain dumb. The savings to industry would be trivial, $75 million a year by the Environmental Protection Agency’s estimates, a rounding error for the powerful oil industry. The industry could in fact end up a loser, since captured methane can be sold at a profit. Moreover, leaking methane undercuts the industry’s claim that natural gas can be a bridge fuel to a cleaner energy future. Though the burning of natural gas emits only about half the carbon dioxide of coal, the leak rate — as high as 2.3 percent, according to studies organized by the Environmental Defense Fund — erodes much of that advantage. Finally, and most sadly, the change pretty much completes the demolition job on Mr. Obama’s climate strategy: the rollback of automobile fuel efficiency standards announced in August; the planned repeal, also announced last month, of Mr. Obama’s Clean Power Plan aimed at reducing emissions from coal-fired power plants; and now the methane pullback. These three programs, plus an effort to regulate climate-forcing gases used in refrigerants, formed the basis for Mr. Obama’s pledge at the 2015 climate summit in Paris to reduce America’s greenhouse gas output by 26 to 28 percent from 2005 levels by 2025. To redeem that pledge — and to reassure the other signatories of the Paris agreement that much of America still cares about climate change — was the purpose of the Global Climate Action Summit, an extraordinary gathering last week of 4,000 or so climate advocates, foreign dignitaries, investors and state and local officials. The meeting, co-hosted by Gov. Jerry Brown of California and Michael Bloomberg, the former New York mayor, was a bright spot in a week dominated by atmospheric fury in the Carolinas and political fecklessness in Washington. Unlike the Paris summit, the meeting had no power to set goals or to legally commit anyone to do anything to reduce emissions. What it did have was messaging power. And the message was one of defiance as well as concern. According to a report prepared for the conference, the states, cities and businesses that have joined the cause — what Mr. Brown and Mr. Bloomberg call the “coalition of the willing” — now represent over half the population of the United States, over half the American economy and more than a third of its nationwide greenhouse gas emissions. Thanks partly to their efforts (plus, of course, market forces, not least the declining cost of renewable energy sources and the switch in the power sector from coal generation to natural gas), the United States is almost halfway to meeting Mr. Obama’s Paris pledge. Simply honoring existing commitments and policies at the state and local level will get the country two-thirds of the way there. The tough part is the rest of the journey, and to that end, the report offers strategies that it believes state and local governments can undertake without any help from Mr. Trump. Most are familiar: tougher ordinances to encourage more energy-efficient buildings, stronger state mandates for renewable energy sources like wind and solar power, more rapid deployment of electric vehicles (as California requires) and efforts to begin phasing out the super-polluting compounds used in commercial and residential cooling systems. And, as if in direct rebuke to Mr. Trump, the group called for new and tougher state and local regulations to stop methane leaks from oil and gas wells and municipal distribution systems. Uniting these leaders is a belief that human ingenuity can lead us out of a predicament that humans have helped create and a faith in collective action that is almost impossible to find on the Potomac.
McMorris Rodgers carefully avoids saying in so many words that climate change is a hoax. Instead, whenever climate change/global warming is mentioned she quickly pivots to her defense of the Snake River damns and the renewable hydropower they provide. When confronted with a direct question as to her understanding of global warming she wanly notes the earth has been colder sometimes. Then last summer she and her Republican cronies in the House took time out from their busy schedule to declare in a resolution that a carbon tax would hurt the economy. McMorris Rodgers’ ideology prevents her from acknowledging the basic science of global warming. There is no amount of climate disruption sufficient to shake her conviction. It is time to vote her out. Keep to the high ground, Jerry |
Rural Hospitals, Mike Bell v. CMR’s non-analysis
Dear Group,
Mike Bell is the Democratic candidate for Washington State Representative (Position 2) against Joel Kretz in Legislative District 7, a huge rural district covering the northeast corner of Washington State and extending into the northern Spokane County.. Mike Bell is a retired Certified Public Accountant with a deep understanding of the finances of rural healthcare. He operated a CPA practice working with healthcare organizations for about 20 years with 20 employees in 14 states working “with about 100 hospitals, clinics, and nursing homes.”
I’ve heard him speak on the topic of rural hospitals twice in person. On July 20 he was interviewed by Doug Nadvornick on Spokane Public Radio. I’ve transcribed below the part of the interview in which Mike Bell speaks on the plight of rural hospitals. (You can listen to this very interesting interview here.) The closing of a rural hospital is often the beginning of a death spiral for a rural community. These hospitals are important linchpins.
BELL: Let me just say that though the biggest concern I’ve got in healthcare right now is in rural areas (I’ve worked with every one of the hospitals and clinics in the 7th District.) I was up in Republic recently talking with them and they said the most important asset they had in their community was the hospital. I explained to them that seven years ago bad debts and charity care had just about killed off all the hospitals in rural America. They were growing to the tune of 25% a year. So a million dollars in bad debts and then several years later it’s $2 million and they were out of cash. Liabilities were high. They had already tapped the community for everything they could get and a lot of them were on the brink of going under. Then all the sudden the bad debts declined. In the example, down from 2 million to 1 million and then declined again to 650,000 and suddenly they were back in the black. Their cash reserves were going back up and and that was what saved them. That was seven years ago.
NADVORNICK: Can I ask why did their debts declined so drastically?
BELL: Well, it was because of the Affordable Care Act. The Affordable Care Act required people to get insurance and expanded Medicaid, so it reduces the uncompensated care, bad debts and charity care that were causing them such financial problems. So in my opinion it is this: that if you voted against the Affordable Care Act for those folks in Republic and Chewelah and in Newport you were voting against your local hospital because the Affordable Care Act was the one thing that saved them. There was one legislator that voted 50 times against the Affordable Care Act and that was Cathy McMorris-Rodgers. So she effectively voted 50 times to close the hospital that you consider the most important asset. That to me suggests that a lot of people are uninformed about the benefits of the Affordable Care Act. The concern I’ve got now is that of the bad debts are starting to creep up again because the current administration is undermining the Affordable Care Act. The Individual Mandate is not required. Insurance companies are not getting the subsidies that they require. Insurance rates are skyrocketing and it wouldn’t surprise me at this time next year if those bad debts are back up to where they were seven years ago and were then jeopardizing the rural hospital systems.
NADVORNICK: So let me go one step deeper. How did the Affordable Care Act help those hospitals reduce their debts?
BELL: Well, the Affordable Care Act…actually the bad debts and charity care were primarily caused by uninsured patients and of course the rural hospitals accept one and all regardless of ability to pay. The Affordable Care Act expanded Medicaid which covered, I think, 700,000 people here in Washington. It also required individuals to buy insurance, and some of them, many of them, were subsidized so they could afford it. It required employers to provide insurance so the uninsured rates declined significantly and of course the inverse of that is that bad debts and charity care also declined. But now we’re seeing that trend reverse, and it concerns me a lot. I worked very hard for 25 years to make sure those hospitals stayed open, and we didn’t lose any during my time, but I’m afraid that we’re on the verge of seeing a significant change in rural healthcare and that bothers me. It appears that a lot of people are voting against their own interest.
NADVORNICK: So as the state legislator what would you do in Olympia because you don’t have authority over the Affordable Care Act. The Affordable Care Act could be nullified, reversed by Congress. What do you do in Olympia to counteract that?
BELL: I think in Olympia what we have to do is is take a look at the rural hospital systems and if the federal government is not going to step in and make sure that they have the resources they need then I think the state needs to step in and take its place. So what I can do is make sure that people are aware of the danger. We don’t want to wait until after hospitals are closing because once they close they don’t open up again very easily. The professionals in the community move out. Frankly, if I have rural hospitals close that community probably will probably shrink dramatically. For every hospital job that’s lost there’s one or two or maybe even three jobs lost in the community because employers don’t want to move into a community that does not have a hospital. Retired people don’t want to live in a community without a hospital. It could be catastrophic for rural Washington and other rural places around the country. I can be the voice of those rural communities and make sure they get the attention they need.
I have no reason to doubt Mike Bell’s analysis of the situation with rural hospitals. I think sending such a man to Olympia to replace the incumbent is a great idea. (Along with Karen Hardy and Randy Michaelis the other two Democratic District 7 candidates.)
How does McMorris Rodgers assess the plight of rural hospitals? She tried to tackle the question in Green Bluff on May 29. I detailed and critiqued her answer in a post entitled CMR’s Non-Solution to the Health Care Dilemma, but I offer her words below to contrast with Mike Bell’s understanding. She does not grasp the economic difference between the cost to provide a medical service and the grossly distorted and inflated amount that is typically charged for the service in our bizarre health care system. Read and see if you agree:
One thing about Medicare and Medicaid. The government doesn’t pay the full cost of actually providing Medicare and Medicaid. So…ah…any provider, any doctor, any hospital, any physical therapist…anybody who takes Medicare or Medicaid will lose money every time someone comes in with their Medicare card or a Medicaid card. Medicaid is..I believe, 30, 35% of the actual cost and Medicare is 60, 70% of the actual cost…so the providers…how do the providers actually…how do the hospitals stay in business? How does a doctor stay in business? They’re making….so they charge the private health insurance higher so that they can keep their doors open. So…so that’s where we need to be honest about the actual cost…and I believe that the government needs…I have supported for our rural communities…so we’re losing our hospitals in rural areas right now because 70, 80% of their patients are on Medicare or Medicaid and they’re losing so much money every time somebody comes in with Medicare/Medicaid….They can’t keep their doors open! So…. We’re not being honest about actual cost of, of a what the…way it currently works.. And that’s where I think Medicare is an important program and I, I believe we’ve got to make sure it is secure but it is on a path…right now it is not on a stable path and we’re signing up twenty thousand people a day.
Summary of CMR’s argument: Rural health care providers are in danger of going out of business because Medicare and Medicaid don’t pay enough. This is like the blind man examining an elephant. Holding firmly to the tip of the tail she declares her understanding of the essence of the elephant. Let’s elect a Representative with the bandwidth to perceive the whole animal.
Keep to the high ground,
Jerry
The Blizzard and How to Fight It
Dear Group,
I have made a concerted effort to pay attention to the news in eastern Washington and, to a lesser degree, national and international news, especially over the last two years.
The stream of information is like a blizzard. Without a conscious and concerted effort one’s opinions may be formed by snippets from the haphazard media encounters. As the blizzard blows by, certain snippets catch and stick, some by chance, some because of each potential recipient’s momentary mindset, some because the snippet is particularly dramatic, horrifying, or poignant.
There are two examples from this week. My canvassing partner and I on Monday encountered a woman and her daughter who had grasped a snippet of intentional misinformation, that Lisa Brown “didn’t want sex offenders to be registered.” As is often the case, she couldn’t quite remember where she had heard this factoid, although it pretty clearly floated out of the television from the “predator” commercial McMorris Rodgers authorized and paid for. It stuck with this recipient in particular because someone in her family had been abused. Propagandists understand this.
This week’s Republican media burst around Lisa Brown’s thirty year old dissertation is based on a different principle, buzzwords. “Communism, socialism, anarchy” blare from the titles. Never mind those words have nothing to do with the dissertation. The intent is to shock, to associate the reader’s ingrained negative images around these words with the persona of the candidate. The propagandist counts on the receptivity of the reader and the conviction the reader will not have the interest, time, or energy to actually examine the evidence. After all, “it’s in the newspaper, it must be true.” Do you remember “swiftboating,” the well-funded Republican lies that helped sink John Kerry’s campaign for President in 2004? Same method.
In this media blizzard, whether a person votes at all and for whom they vote if they do is often determined by the last snippet heard…or by a general disgust with the whole perplexing blizzard of contradictory evidence that induces paralysis.
The people who will determine the result of the election on November 6, just fifty-four days from now, are likely not the people who will watch the debate next Wednesday. Overwhelmingly, those folks have already made up their minds. The people who will make the difference are the folks I meet every time I go door knocking, people who admit they “don’t follow politics,” people who, like the woman and her daughter, who would vote but are stuck on one nasty, inaccurate snippet of information, people who are disgusted with the current state of affairs who just need a friendly person to make the effort, knock on their door, smile, listen, and encourage. Humans are built to respond to face-to-face encounters. The election can be won if enough of us get out and make those encounters. Make a difference. It is too depressing to just stay home, read, and watch the pundits on TV try to convince us they know what will happen. They don’t know.
Keep to the high ground,
Jerry
The Dissertation v. CMR
Dear Group,
Lisa Brown earned a Bachelor of Arts in sociology and economics from the University of Illinois in 1978 at the age of twenty-two, and a Masters in economics from the University of Colorado in 1981. In 1986, at the age of thirty, Lisa Brown submitted her doctoral dissertation “in partial fulfillment of the requirements for the degree of Doctor of Philosophy” in the Department of Economics at the University of Colorado, Boulder. Submitting a doctoral dissertation is a remarkable achievement. Writing one requires months of preparative reading, critical thought, organization, and consideration of the chosen topic from all angles. Once written and submitted the doctoral candidate must demonstrate a command of the topic in an oral “defense,” a exercise in thinking on one’s feet. A dissertation grows out of years of academic preparation.
Lisa Brown’s dissertation is entitled “Science and Ideology: Neoclassical Economics and Women’s Labor Supply.” It is one hundred and seventy-three typewritten pages long followed by twelve pages of bibliography. It is not easy reading for someone not immersed in the study of economics, but the gist is clear after a little study. Brown lays out the underlying gender assumptions (ideology) of “neoclassical economics” and presents a reasoned critique of those assumptions in light of gender work roles. The dissertation shines some light on where then current economic models might fall short on account of the unconsciously embedded point of view of economists who constructed the models.
I know too little about the state of economic modeling today, thirty years later, to know if Lisa Brown’s dissertation is often cited in the economics literature. An internet search for the title yields only one hit, a pair of apparent Spokanites discussing it briefly on Reddit in the context of the current election. Like many theses and dissertations, Lisa Brown’s work serves largely as a demonstration of the intelligence and diligence necessary to deeply understand a topic, analyze it, and draw reasoned conclusions, certainly the sort of ability I want my Representative to possess.
Kip Hill wrote an article for the Spokesman on September 6 entitled (in the on line version), “Lisa Brown thesis from 1986 prompts new GOP attacks.” In it, Mr. Hill links to an article in the Washington Examiner (a right-leaning mostly internet newspaper in D.C.) entitled, “Democrat running against Cathy McMorris Rodgers inspired by socialists, communists, anarchists.” The article posts the dissertation in its entirety (apparently disregarding fact it has a copyright, but never mind…) I doubt the Washington Examiner writer, Katelyn Caralle, (previously associated with the Heritage Foundations and the Washington Free Beacon) bothered to read the dissertation and she certainly did not expect anyone else would either. The best condemnation she could come up with was based on one sentence in the acknowledgements that mentions inspiration from (among others) two women activists of the late 19th and early 20th centuries, Elizabeth Gurley Flynn and Emma Goldman, both feminist thinkers with lengthy bibliographies, both of whom were dead before Lisa Brown was ten years old. Caralle’s breathless piece cherrypicks the juiciest bits of the lives of these two woman to come up with the smear buzzwords, “socialists, communists, anarchists.” For any thinking person this should be a stretch too far.
I want a Representative who is intelligent, reads voraciously, listens, and is able to command detailed material. Lisa Brown’s thesis, written more than thirty years ago, (as well as all her subsequent legislative work) well demonstrates those abilities.
Where are the writings actually authored by McMorris Rodgers? What is her command of economics beyond her thin talking points? What is her intellectual depth? There are clues in statements on climate change and healthcare economics,
Keep to the high ground,
Jerry
P.S. A very similar story to the one that appeared in the Washington Examiner appeared Thursday, September 12 in the Washington Free Beacon another right biased conservative website with the title “Dem Congressional Candidate Repeated Her Admiration for Radical Labor Leader in 2017.” No surprise there, considering the link with the other author and the conservative media ecosystem. Expect to hear more of this from their echo chamber.
Why We Canvass
Dear Group,
The General Election that closes this November 6 will not be a cakewalk. There will be no landslide. Every vote will count. The stakes are high.
Monday evening my canvassing partner and I were out knocking on doors for Lisa Brown on the north side as part of the wholly volunteer effort put together by one of the Indivisible groups (the one whose canvasses are often advertised in the text box above this message). I had just left a flyer at a door. We were standing on the sidewalk in front of the same home checking our papers when a woman in her forties and her twenty-something daughter turned their car into the driveway, parked, and got out. We smiled and waved, sporting our stickers, name-tags, and clipboards. Seizing the opportunity, my partner asked, “May we have a few minutes of your time?” The woman smiled back but waved us off, indicating she was in a hurry to get inside. We smiled back and slowly walked on.
We were one house away when the same woman, with her daughter in tow, came across her lawn, hailing us, “If you have a minute, I do have a question…”
We stopped and smiled, “Sure, what is it?
“Is Lisa against registering sex offenders?” she asked. “We heard she is and if that’s true we can’t vote for her. You know, fifty percent of woman are abused some time in their lives…”
We quietly assured her that was misinformation, actually a lie, probably fostered by the nasty attack ad McMorris Rodgers had sponsored about a month ago. I recounted the letter signed by hundreds of health professional professionals published in the Spokesman denouncing that ad and calling on McMorris Rodgers to retract it.
“I’m really glad to hear that,” she said. “We don’t like what McMorris Rodgers is doing, but we just couldn’t vote for someone who was against registering sex offenders.”
We didn’t think to ask, but I’m willing to bet these two women did not vote in the Primary. I’m pretty sure they will vote for Lisa in November, all because we had a pleasant face-to-face conversation with them on the sidewalk. The same evening we had meaningful conversations with people who had just moved to town and didn’t know exactly how to change their voting address, people whom we helped register to vote, and people who started out saying they mostly “don’t follow politics” who sounded moderately inspired to vote after our conversation.
I have written letters and talked with friends, but I have never knocked on doors for any candidate or any initiative before November 2016. Although by now I have gone out many times I still have to push myself to get started…and every time it is a rewarding experience, in part because of the contacts themselves and in part because of social interaction with and the enthusiasm of the other canvassers.
The General Election this fall could be the most consequential election of my lifetime. The future of our democracy hangs in a balance to be swayed by all the little actions of all the people of good will knocking on doors and talking with other people all over the country in the next fifty-six days.
It is time to come out and make good on that check mark you made months ago that indicated your willingness to volunteer. All it requires is your time, a little gumption, your smile, and your sincerity…and it’s fun, interesting, and educational.
This Saturday, September 15th come on down to Riverside Place, 1110 W Riverside Ave,, (the old Masonic Temple) at 11:30 to 12 for pizza, 12-1:15 Campaign Update, Motivation and Persuasion Training, meet Lisa, and then go out door knocking with a partner! The time is now. You can do this!
Keep to the high ground,
Jerry
Paul Ryan’s PAC?
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