What kind of health care should be available to all Americans?

Far be it for Donald Trump to pass up an opportunity to make another mess for the political party that he now dominates. So he decides to promise the greatest of all health care plans.

He even named the three senators who he said will lead the charge in repealing and replacing the Affordable Care Act. Problem is, they all seem to be busy with other more important things – like watching grass grow.

The best and brightest in the White House apparently didn’t bother to explain to Trump that there is no Republican plan for health care, and more importantly, the party’s members in Congress won’t go near the issue with a ten foot pole.

There does seem to be some acknowledgement among Republicans that health care issues are important to a large portion of the American electorate. Losing forty seats in the House of Representatives in campaigns that highlighted things like protection for pre-existing medical conditions has certainly focused attention, even with a president who wouldn’t have a clue about what would go into a Republican health care plan.

This is all consistent for the gang that can’t shoot straight, but nonetheless, it brings attention to the importance of health care as a 2020 issue.

Democrats, of course, are all over the lot on the subject. Bernie Sanders and the Bernie-want-to-be’s, including Senators Corey Booker, Kirsten Gillibrand, Kamala Harris and Elizabeth Warren, are pushing “Medicare-for-All,” a plan that would create a federal single-payer program to cover all Americans.  Despite the arguments of some Republicans who are still trying to re-litigate the 1965 law, Medicare is not just settled law, it is chiseled in stone.  And Medicare is the most efficiently run health care coverage in the country.

If the founding fathers (because the founding mothers were not allowed to be involved in such decisions) had debated medical insurance coverage back in 1787 they might very well have come up with something like Medicare-for-All. The problem that Congress faces in 2019 is that we are not starting from a blank slate when trying to fashion a better health care system.

Medicare-for-All would essentially eliminate all private medical insurance through employers while also sweeping aside subsidized Obamacare coverage and the Medicaid system. Sanders wants the available- to-all Medicare to provide for more things than are currently covered, but the expanded coverage is not defined.  Deductibles and co-pays would go away.  Federal taxes would pay for the system.

Nobody really knows what Sanders’ plan would cost, including Sanders. Estimates run as high $32 trillion over the next ten years.

The intention is that the program would be paid for by higher –much higher – taxes but that overall costs to Americans would be less because of what they would save on insurance premiums, deductibles and co-pays compared with the increase in their taxes. Natural public suspicion, taken to its current high point in the age of Trump, will make explaining, much less convincing people to support the plan, a pipe dream.

And how would Bernie navigate the political rocks and shoals that would challenge any effort to install Medicare-for-All into law? He will lead a revolution of the people, who will rise up and tell Congress what they want.  Sort of like the tea party on steroids.  “You say you want a revolution; [w]ell, you know we all want to change the world.”

So the questions for Sanders and his followers (including some of his fellow presidential candidates) are: “Is it honest to play make believe with the public about what you are proposing? What is the value of creating an illusion when there is really no path to implementing what you propose?”

Another alternative would be to make Medicare coverage available to people under the age of 65 while maintaining private coverage for those who prefer it. This would give people options.  Congressman Brian Higgins is working on such a plan.  Public details, again, are next to none, but at least the idea is planted in the reality of the legislative process.

Then there is the possibility of tinkering with the existing Obamacare coverage, which House Speaker Nancy Pelosi seems to favor. This would include providing additional financial subsidies to the state health exchanges.  Or perhaps ending the Trump-loving option of creating health care association plans, which he sells as inexpensive health care, but which are, in reality, nothing but fake insurance.

If then politicians on the right or left, Democrat or Republican, are really interested in providing access to affordable quality health care, what do the pols do to bring about a solution?

For Democrats the strategy is a bit simpler. Pretty much every Democratic politician wants to expand the availability of health care.  The trick will be to not let the perfect get in the way of the good when it comes to health care reform.

Republicans, on the other hand, are in many cases still doing all they can to prevent people from getting quality health care.  Consider the eight year game that the party played about repealing and replacing the Affordable Care Act.  They could not pull it off, even when controlling all the levers of federal power, because they lied about having some alternative plan in their back pocket.

Trump’s Justice Department has joined with some Republican state Attorneys General in a lawsuit to declare the entire Affordable Care Act unconstitutional. Up to twenty million people would lose health coverage if that were to happen, and things like protections for those with pre-existing conditions and continued family insurance for children up to the age of 26 would be gone.

Consider also the situation occurring in red states where the voters approved referenda to expand Medicaid only to have the Republicans running those states (Utah, Missouri, Maine) working to overturn the will of the people.

What it comes down to is that Republicans come at health care from a different angle, which basically says, “I’ve got mine, good luck getting yours.” These politicians are not bothered by the fact that many people in this country must often choose between feeding their family and seeing a doctor.

There is a great deal of talk from Democrats and Republicans, including Trump, about at least doing something about the skyrocketing costs of prescription drugs. Such action could provide great benefits to pretty much everyone in this country.  Government costs could be minor by essentially letting the companies absorb more of the cost of what people now pay for their prescriptions by reducing drug company profits.  The problem is that Big Pharma is big and powerful and has many friends in Congress and in the administration.

The year 2019 will be some sort of test for the United States. Is it possible, given all the collective interest in some solution, that the powers-that-be can at least come together to handle the universally supported and politically obtainable goal of reducing and controlling drug costs?  We are already seeing the run-up to the 2020 elections, but just maybe it is possible to do one good and important thing that will help everyone before the campaign silly season takes hold.

Political musical chairs

Politics and Other Stuff reported last Friday on the impending decision of Erie County Legislature Chairman Peter Savage to decline the nominating petitions that were filed on his behalf for the 3rd District Erie County Legislature seat. Savage made that action official on Monday.

So the race – actually more like a one hundred yard dash – is on for the Democratic Party to substitute a new candidate in the 3rd District. The decision will be made on April 11.

When petitions were filed last week two other candidates had also filed for the nomination, Cindi McEachon and David Amoia. Of the two, McEachon would appear to have done more of the homework necessary to actually be an active candidate.

Last Friday’s Politics and Other Stuff post also mentioned Town of Tonawanda Councilmember Lisa Chimera and former State Senate candidate Amber Small as the possible party endorsed substitute candidate. Chimera is a teacher as well as a councilmember. Small is attending law school and has been a leader of the Parkside Community Association. County Democratic Chairman Jeremy Zellner told the Buffalo News that those two are in the running for the party designation but that he will entertain other candidates as well.

Chimera could have the inside track on the designation, but assuming their petitions hold up, McEachon and Amoia will also contest for the nomination in the June primary. So what might have been a somewhat easy opportunity for Savage to be re-elected has turned into potentially a real contest for the seat. There is a Republican candidate, Juan Rivera, but the district is more than three-to-one Democratic by affiliation.

So far, so good. But here is the rest of the story.

Savage confirmed on Monday that he had declined his nominating petitions for the Legislature and instead will seek an appointment to the City Court bench. Chief Judge Tom Amodeo is retiring around the end of April.

The Chief Judge position is an elected office. But since the time for petitioning which would have opened up an opportunity for a June primary for the office has passed, whoever is designated by the Democratic Executive Committee will be the candidate. The Republicans will either endorse the same candidate or come up with a name for the ballot who doesn’t have much of a chance in November.

Look for current Buffalo City Court Judge Craig Hannah to be appointed interim Chief Judge by Mayor Byron Brown. Hannah will then likely receive the Democratic designation for Chief Judge in the November election. Peter Savage will then at some point be appointed to the City Court seat that Hannah will leave. Savage will not need to worry about a Democratic primary either, since the time for petitioning to create a primary election has passed.

See Through NY lists the 2018 salaries of Judges Amodeo and Hannah at $194,407. City Court judges have ten-year terms. Savage has been making $52,588 as Chairman of the Legislature, with a two-year term.

Then there is the issue of who will replace Savage as Chairman of the County Legislature. Here things get a bit more complicated.

Assuming Savage leaves the Chairmanship sometime in the next few months, a majority of the remaining Democrats in the Legislature will appoint his successor as legislator. The entire Legislature will elect a new Chairman from among the Democratic Caucus. Here’s where the complication comes in.

The Democratic members of that Caucus are or would be:

  • Savage’s replacement – a rookie
  • April Baskin, current Majority Leader who is a freshman in only her 16th month as a legislator. Baskin has a primary coming up in June.
  • John Bruso, who is also a freshman in only his 16th month as a legislator.
  • Tim Meyers, a recent appointee who took Pat Burke’s place in December.
  • Barbara Miller-Williams, who is leaving the Legislature as she runs for Buffalo Comptroller.
  • Tom Loughran, who is retiring from the Legislature at the end of this term.
  • Kevin Hardwick, who is still technically a Republican.

So from that line-up will emerge the new Chairman of the Erie County Legislature.

One more thing. If Lisa Chimera is appointed to Savage’s vacant legislative seat the Tonawanda Town Board will need to appoint her replacement.

Ain’t politics grand?

Enrollment and revenues are down. Where is ECC heading?

Finding time in their busy legislative calendars, highlighted recently by consideration of the “Feline (Cat) Adoption Promotion Act of 2019,” the Erie County Legislature recently received a presentation concerning the status of Erie Community College. The felines (cats) look like they will be getting some serious attention from the Legislature. The Kats (the ECC mascot) or the taxpayers who help fund their education – not so much. Continue reading

Regardless of what the Barr Report claims, there are plenty of reasons to hold Trump accountable

“A man hears what he wants to hear, and disregards the rest…” Simon and Garfunkel

So it’s finally out. The Mueller Report, that is. Followed just 48 hours later by the long awaited Barr Report.

Working overtime during the past weekend, Attorney General William Barr and his gang of Republican-appointed attorneys digested twenty-two months of work by the Office of Special Counsel and wrapped it all up in a concise four-page political summary. Continue reading

When the Republican Party claimed to be fiscal conservatives and constitutionalists; Roger (Stone) and me

You don’t need to think too far back to remember a time when the Republican Party touted the idea that they were the party of fiscal responsibility. They also said they were constitutionalists or originalists.

This is not to say that the Republicans were always pure about such subjects. They took great joy in quickly turning the Clinton budget surpluses into deficits with the Bush tax cuts of 2001. Continue reading

Will Sanders crowd out the other progressive senators? And a couple footnotes on the Erie County Executive race

Welcome to Sunshine Week. Politics and Other Stuff does its part by writing about public institutions that need some sunlight. Sometimes it’s necessary to comfort the afflicted and to afflict the comfortable.

I haven’t watched American Idol or Survivor in a long time, but it seems like we are living in the political version of those TV reality shows at the moment. The Democratic presidential sweepstakes has people coming in; dropping out; trying to decide what to do – it seems like nearly every day.

I’m sure it is just a coincidence, but why did all the “progressive” senator Democratic presidential candidates all seem to enter the 2020 race in a bunch? And now there may be the march of the moderates – some governors, plus former Vice President Joe Biden. Is Beto O’Rourke in this bunch too? Continue reading