TomCADem
TomCADem's JournalAtlantic - What American Healthcare Can Learn From Germany
This is what I wonder. The German healthcare system works very well, and it is probably closer to the ACA then the ACA is to single payer. So, why not make adjustments to be closer to the German healthcare system? It is not only cheaper per capita than Canada, but it is also easier to get an appointment.
https://www.theatlantic.com/health/archive/2014/04/what-american-healthcare-can-learn-from-germany/360133/
Instead, the bill was paid by the Barmer GEK sickness fund, one of about 160 such nonprofit insurance collectives in the country. Every German resident must belong to a sickness fund, and in turn the funds must insure all comers. They’re also mandated to cover a standard set of benefits, which includes most procedures and medications. Workers pay half the cost of their sickness fund insurance, and employers pay the rest. The German government foots the bill for the unemployed and for children. There are also limits on out-of-pocket expenses, so it’s rare for a German to go into debt because of medical bills.
Sound familiar?
It should, since this is very similar to the health-insurance regime that Americans are now living under, now that the Affordable Care Act is four years old and a few days past its first enrollment deadline. All Americans are now required to have health insurance or to pay a fine, and insurers cannot deny coverage to anyone, regardless of pre-existing conditions. Obamacare has also created subsidies for those who can’t afford to buy health insurance and has implemented limits on out-of-pocket costs.
There are, of course, a few key differences. Co-pays in the German system are minuscule, about 10 euros per visit. Even those for hospital stays are laughably small by American standards: Sam payed 40 euro for a three-day stay for a minor operation a few years ago. Included in that price was the cost of renting the TV remote.
North Korea/China/Russia's Joint Goal Regarding NK Missile Tests...
...is to provoke Trump into launching a limited, Syria-style cruise missile attack that would open the door to North Korea launching a roughly proportional attack on South Korea.
Why you may ask? Well, to let Trump continue to be Trump and reduce U.S. influence in the Pacific Rim. Trump is already half way there. He as already backed out of TPP. He has raised tensions with our closest allies in the region such as South Korea and Australia. He antagonized China from the get-go by recognizing Taiwan and suggesting that he would go further. Finally, he has already shown that he likes splashy military attacks such as Syria cruise missiles and dropping a huge bomb on virtually empty caves in Afgan while also showing less concern for collateral human casualties so long as they are not white.
So, North Korea is going to continue to shoot test missiles toward Japan every time Trump makes a threat of military action, while also floating the idea of a similar test launched at Guam. The Trump administration is going to continue to ratchet up their rhetoric, perhaps with Trump once again threatening to turn North Korea into a pool of slag in order to please his base and generate ratings if North Korea threatens the U.S. Meanwhile, the U.S. has been telling North Korea on the down low not to fire a test missile at Guam, because the U.S. will treat it as an attack.
Well, eventually, Trump is going to lose patience and announce then any missile test directed toward Guam will not be tolerated. He will back himself into a corner. At that time, North Korea will launch a test missile toward Guam and may or may not announce that it is a test depending on the wording of Trump's threat.
The Trump administration having seen such a test will need to either let it pass, thus forcing Trump to eat his words. Or, Trump will do something like launch cruise missiles at North Korea with the U.S. being the one that has initiated an actual military attack. With an actual military attack, North Korea will launch a limited, conventional artillery attack at South Korea designed to kill about a 1,000 people. Since the U.S. launched the first attack, China will then announce that it will stand by its original promise to defend North Korea.
China and Russia will then call for an emergency meeting of the U.N. Security Council demanding a cease fire. North Korea will point to the actions of the U.S. in actually initiating an attack, and China and Russia will concur and demand that the U.S. end its provocation. Relations with South Korea will deteriorate with South Koreans demanding an end to the U.S. presence due to the casualties resulting from a U.S. response to a test missile directed at Guam. Likewise, countries throughout the Pacific Rim will not see the U.S. as a reliable ally.
Finally, North Korea will then offer to de-escalate if they have assurances that the U.S. will not continue to threaten military action toward North Korea, and Russia and China will support this. Meanwhile, the U.S.'s traditional allies will be hard pressed to stand with Trump given his prior willingness to take them for granted, including Germany, Mexico and the U.S.
Of course, the huge risk is that the limited military conflict outlined above might spiral out of control into World War III. This all would not be possible without a President Trump.
The Fundamental Problem is That Republicans Are Rewarded For Failure
I think Democrats in Congress, including Nancy Pelosi and Chuck Schumer, should get credit for being able to close legislative deals achieving Democratic goals even though they are in the minority with a hostile President. However, despite their legislative skill, the fundamental problem is that Republicans are repeatedly rewarded for failure. You could call it the Ted Cruz effect.
In the Republican party, with a whole right wing propaganda apparatus in place with Fox, Brietbart, Rush, plus billionaire backers like Adelson, the Koch Brothers and the Mercers, Republican members of Congress do not need the Republican party nor do they even need to rely on donations from their constituents. They do not need to deliver results for the folks at home. Instead, thanks to the aforementioned structures, they can rely on a highly charged ideological minority to vote for them as a block. Of course, to keep the ideological minority satisfied, they have to be ideologically pure.
Of course, purity and reality do not mix. Actual governing often requires trade-offs. Ideologically pure policies often will fail spectacularly upon implementation. Kansas's tax cuts under Governor Brownback are a perfect example of the danger of actually achieving success in implementing an ideologically pure set of right wing policies. The last thing a Ted Cruz/Donald Trump Republican wants to do is actually succeed in seeing a bill that bears their name get implemented with in a manner that will cause an immediate impact. Therefore, repeal the ACA, but put-off implementation for a few years. Terminate DACA, but hold off implementation for a couple of months. Then, demand that Democrats clean up the mess that you made.
Thus, to avoid being the next Brownback, a Ted Cruz/Freedom Caucus type Republican has to repeatedly move the goal posts to the right of any actual Republican proposal. If Ryan puts it out there, you have to oppose it on the ground that it is not nearly conservative enough, because god forbid that your most extreme proposal actually get implemented. Or, perhaps let your bill pass the House, but secretly pray that the Senate kills your most recent death bill. Is this responsible governing? Hell No. Is this a cynical acceptance of the realities of Republican politics? Yes it is.
Of course, with a President Obama, you could count on him to save Republicans from the consequences of their rhetoric. Thus, repeal the ACA on a monthly basis, because you can count on the President to veto the bill.
However, Trump changes that equation because he is even more irresponsible about governing then most Republicans. Thus, he will out Ted Cruz Ted Cruz himself. Trump's budget will cut taxes a gazillion dollars, cut the State Department in half, and propose to increase the Defense budget by an obscene amount, and then he will dare Congressional Republicans to pass a proposed budget filled with their own talking points. No wonder Paul Ryan and Mitch McConnell where horrified. Even the Freedom Caucus and Ted Cruz were hard pressed to out-crazy Trump.
Which leads to why the only real game in town to get anything done is with the Democrats who for the most part campaign on trying to achieve real results. They are not ideologically homogeneous, but for the most they do not introduce poorly drafted bills with no chance for passage as a means to grand stand. Likewise, you do not have too many Ted Cruz clones on the left who owe their success to demeaning Democrats as being part of the corrupt establishment. Instead, Democrats for the most part will generally try to work with each other, rather than to throw each under the bus for even the most routine votes.
This is why when Trump actually does need to get something constructive done, like raise the debt limit, the Democrats are the only game in town. Only Nancy Pelosi and Chuck Schumer can deliver on a promise to deliver the votes. Paul Ryan can never deliver the votes, because regardless of the proposal, the Freedom Caucus/Ted Cruz wannabes will stake out a position to the right of the proposal in the name of purity. That way, they can always bitch about the bill that does pass as not being sufficiently pure.
Hopefully, Democrats resist the temptation to engage in this cynical brand of politics. Thankfully, there are only a few on the left who seem to have built their career on throwing their would be allies under the bus in the name of ideological purity.
AP: Trump's options on North Korea going from bad to worse
Trump's administration began by boasting that the Obama ear strategy of "strategic patience" was over and proudly announcing that a military options "were on the table." Then, as North Korea responded with missile tests, Trump himself escalated by announcing that North Korea "will be met with fire and fury like the world has never seen." All the while, the Trump administration has isolated itself regionally by pulling out of TPP and threatening China and South Korea.
Personally, if the U.S. wished to confront North Korea, they should have stuck with TPP, not alienate countries in the region, and not ratchet up the rhetoric with North Korea. Quite frankly, I am sure that North Korea has a dossier on Trump, and they know that he has a long history of making a lot of threats that he does not follow through. Unfortunately, Trump has already backed himself into numerous corners, thus North Korea is now just pressing the advantage to humiliate him, which might just prove enough to cause Trump to do something impulsive.
http://www.msn.com/en-us/news/politics/trumps-options-on-north-korea-going-from-bad-to-worse/ar-AArhpzk?li=BBnb7Kz
WASHINGTON — Sanctions on North Korea have been tried, and failed. Serious negotiations seem like a pipedream. And any military strike would almost surely bring mass devastation and horrific civilian casualties.
The Trump administration's options are going from bad to worse as Kim Jong Un's military marches ever closer to being able to strike the U.S. mainland with nuclear weapons. Just as President Donald Trump seeks to show global resolve after the North's most powerful nuclear test, his leverage is limited even further by new tensions he's stoked with South Korea, plus continued opposition from China and Russia.
With South Korea, the country most directly threatened, Trump has taken the unusual step of highlighting disagreements between the U.S. and its treaty ally, including by floating the possibility he could pull out of a trade deal with South Korea to protest trade imbalances. He also suggested on Twitter the two countries lacked unanimity on North Korea, faulting new South Korean President Moon Jae-in, who has been more conciliatory to the North, for his government's "talk of appeasement."
It's an inopportune time for grievances to be aired, and on Monday the two leaders sought to show they were confronting North Korea together — and with might. The White House said that in a phone call with Moon, Trump gave approval "in principle" to lifting restrictions on South Korean missile payloads and to approving "many billions" in weapons sales to South Korea. Though no details were released, the idea was to show the countries were collaborating to bolster defenses against Kim's government.
Bernie Sanders Discussing Immigration Work Authorization Programs With Lou Dobbs
Here is Bernie explaining to Lou Dobbs why he was opposed to work authorization programs. Isn't Donald Trump using the same reasoning to justify his crack down on programs like DACA?
https://www.vox.com/2016/2/12/10981234/bernie-sanders-lou-dobbs
SANDERS: Of course there is hope that we can change that. And I think there are a growing number of Americans who understand that there's something wrong when the middle class in this country continues to shrink despite a huge increase in worker productivity, poverty continues to increase. Since Bush has been president, 5 million more Americans have slipped into poverty. Six million Americans more have lost their health insurance and the gap between the rich and everybody else is growing wider.
So when President Bush tells you how great the economy is doing, what he is really saying is that the CEOs of large multinationals are doing very, very well. He's kind of ignoring the economic reality of everybody else and that gets us to the immigration issue.
If poverty is increasing and if wages are going down, I don't know why we need millions of people to be coming into this country as guest workers who will work for lower wages than American workers and drive wages down even lower than they are now.
* * *
DOBBS: Those are all industries in which wages are declining. I don't hear that discussed on the Senate floor by the proponents of this amnesty legislation.
SANDERS: That's right. They have no good response. I read something today that a lot of people coming into this country are coming in as lifeguards. I guess we can't find - that's right. We can't American workers to work as lifeguards. And the H1B program has teachers, elementary school teachers. Well, you know.
DOBBS: And that H1B program, we got to watch Senator Ted Kennedy watch there with the sole witness being one Bill Gates, the world's richest man, telling him he wanted unlimited H1B visas, obviously uninformed to the fact that seven out of 10 visas under the H1B program goes to Indian corporations that are outsourcing those positions to American corporations in this country and that four out of five of those jobs that are supposed to be high-skilled jobs are actually category one jobs which is low skill.
SANDERS: Well, you raise a good point, in that this whole immigration guest worker program is the other side of the trade issue. On one hand you have large multinationals trying to shut down plants in the America, move to China and on the other hand you have the service industry bringing in low wage workers from abroad. The result is the same — middle class gets shrunken and wages go down.
After North Korea Nuclear Test, Trump Saves Harshest Words for South Korea
Source: NY Times
WASHINGTON — President Trump on Sunday called North Korea’s biggest nuclear test to date “very hostile and dangerous,” but his most significant rhetorical escalation was against South Korea, a close United States ally, which he accused of talking about “appeasement.”
Mr. Trump expressed his frustration in three sternly worded tweets early Sunday that were more muted than the previous taunts and threats he has directed at North Korea’s young leader, Kim Jong-un.
“North Korea has conducted a major Nuclear Test. Their words and actions continue to be very hostile and dangerous to the United States,” he wrote at 7:30 a.m., about 10 hours after reports of a huge explosion, measured by the American authorities at a magnitude of 6.3, was detected in the area of a nuclear test site in the North. As he has done in the past, Mr. Trump placed responsibility for responding to the crisis on North Korea’s closest neighbors, China and South Korea.
But he took a notably harsh line on Twitter against the new liberal government of President Moon Jae-in of South Korea, amid an escalating dispute over trade that threatens to weaken a central partnership in the region as North Korea races to develop a nuclear warhead capable of striking the continental United States.
Read more: https://www.nytimes.com/2017/09/03/us/trump-north-south-korea-nuclear.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0
Withdrawing from trade agreements, alienating allies, and ratcheting up tensions with enemies. Trump seems hellbent on making the U.S. a pariah. Then again, a lot of Trump's base, and perhaps even some on the left, support Trump's anti-trade and anti-immigration positions.
Vox: Its the citys third 500-year flood in the past three years.
Were the models regarding the frequency of flooding in various areas wrong from the get-go. Or, have the goal posts been moved due to circumstances such as, I don't know, climate change? Otherwise, Houston must be snake bit to experience several 500 year floods, which should only happen about once in a 500 year period.
https://www.vox.com/science-and-health/2017/8/28/16211392/100-500-year-flood-meaning
It’s difficult to comprehend the scale of the flooding and devastation that Hurricane Harvey and its aftermath are wreaking on the Houston area. Weather experts call the storm unprecedented, and note that it’s gone beyond even the most pessimistic forecasts. In the final reckoning, it’s certain that Harvey will be classified a 500-year flood — and maybe even a 1,000-year flood.
But those terms can be a bit misleading — especially when high-profile people, like the president of the United States, confuse the issue by calling Harvey “a once in 500 year flood.”
In theory, a 500-year flood is something that has a 1-in-500 shot of happening in any given year — in other words, the sort of event that’s so rare that it might not make sense to plan around the possibility of it happening. The problem is that 500-year floods are happening more often than probability predicts — especially in Houston. And, especially in Houston, prevention planning hasn’t evolved to acknowledge that a “500-year” flood isn’t really a 1-in-500 chance anymore.
* * *
Either Houston is incredibly unlucky or the risk of severe flooding is a lot more serious than the FEMA modeling has predicted — and the odds of a flood as bad as the ones Houston has seen for the past few years are actually much higher than 1 in 500.
It Is Understandable That Trump Would Push a Herbert Hoover Type of Trade Policy...
When campaigning for president during 1928, Republican Herbert Hoover's promise to help domestic industries from being undercut by cheaper foreign goods by increasing tariffs. He won, and was successful in increasing tariffs on many competing European goods, which help drive Europe into a depression. This depression helped plant the seeds for extremism.
I can see why Trump would would push a xenophobic, isolationist trade and immigration policy. It does resonate well with the fears of many Americans by scapegoating the "other" while ignoring the obvious targets of oppression, which are elites at home who enjoy low taxes and whose industries might also benefit from a competitive advantage relative to foreign competitors. Indeed, Brexit showed that trade and immigration were nice code words for demonizing non-white immigrants with the UK suddenly trying to maintain its trade agreements even as it heightens barriers to immigration. Populist rhetoric is about scapegoats and racism disguised as concern for American workers.
This is why people of color need to hold the left and Democrats accountable. Sadly, they too are starting to adopt and echo Trump's anti-trade and anti-immigration rhetoric. It is too easy to scapegoat foreigners for domestic ills resulting from a system that is tilted against American workers.
https://www.britannica.com/topic/Smoot-Hawley-Tariff-Act
Smoot-Hawley Tariff Act, formally United States Tariff Act of 1930, also called Hawley-Smoot Tariff Act, U.S. legislation (June 17, 1930) that raised import duties to protect American businesses and farmers, adding considerable strain to the international economic climate of the Great Depression. The act takes its name from its chief sponsors, Senator Reed Smoot of Utah, chairman of the Senate Finance Committee, and Representative Willis Hawley of Oregon, chairman of the House Ways and Means Committee. It was the last legislation under which the U.S. Congress set actual tariff rates.
The Smoot-Hawley Tariff Act raised the United States’s already high tariff rates. In 1922 Congress had enacted the Fordney-McCumber Act, which was among the most punitive protectionist tariffs passed in the country’s history, raising the average import tax to some 40 percent. The Fordney-McCumber tariff prompted retaliation from European governments but did little to dampen U.S. prosperity. Throughout the 1920s, however, as European farmers recovered from World War I and their American counterparts faced intense competition and declining prices because of overproduction, U.S. agricultural interests lobbied the federal government for protection against agricultural imports. In his 1928 campaign for the presidency, Republican candidate Herbert Hoover promised to increase tariffs on agricultural goods, but after he took office lobbyists from other economic sectors encouraged him to support a broader increase. Although an increase in tariffs was supported by most Republicans, an effort to raise import duties failed in 1929, largely because of opposition from centrist Republicans in the U.S. Senate. In response to the stock market crash of 1929, however, protectionism gained strength, and, though the tariff legislation subsequently passed only by a narrow margin (44–42) in the Senate, it passed easily in the House of Representatives. Despite a petition from more than 1,000 economists urging him to veto the legislation, Hoover signed the bill into law on June 17, 1930.
Smoot-Hawley contributed to the early loss of confidence on Wall Street and signaled U.S. isolationism. By raising the average tariff by some 20 percent, it also prompted retaliation from foreign governments, and many overseas banks began to fail. (Because the legislation set both specific and ad valorem tariff rates [i.e., rates based on the value of the product], determining the precise percentage increase in tariff levels is difficult and a subject of debate among economists.) Within two years some two dozen countries adopted similar “beggar-thy-neighbour” duties, making worse an already beleaguered world economy and reducing global trade. U.S. imports from and exports to Europe fell by some two-thirds between 1929 and 1932, while overall global trade declined by similar levels in the four years that the legislation was in effect.
In 1934 President Franklin D. Roosevelt signed the Reciprocal Trade Agreements Act, reducing tariff levels and promoting trade liberalization and cooperation with foreign governments. Some observers have argued that by deepening the Great Depression the tariff may have contributed to the rise of political extremism, enabling leaders such as Adolf Hitler to improve their political strength and gain power.
Vox: How Trump both stokes and obscures his supporters racial resentment
Recently, Bernie Sanders again tried to discuss Trump in relatively race neutral terms by stating that Trump broke promise to ‘stand with the working people." In so doing, Bernie is attempting to grab Trump's base by trying to validate their reasons for voting for Trump as being based on economic concerns. However, in refusing to call out Trump's racism, Bernie's efforts to grab Trump's base are doomed to fail.
Both Martin Luther King and Lyndon Johnson noted how the powerful often used racism as a means to oppress whites by giving them a scapegoat. Rather than focus on the rich, powerful and elite, Trump lets them focus on their minorities and women that work side by side with them.
Progressives cannot ignore Trump's sexism and racism in an effort to focus on the economic well-being of the middle class. Instead, you have to call this out to show that Trump is using racism and sexism to oppress the working class and distract them from focusing on how Billionaires like himself benefit from the tax cuts that are paid for with the cuts in benefits to the working class.
Otherwise, when Bernie says that Trump has broke his promise to stand with the working people, working class whites will think, "No, he hasn't because look at how he has deported and cracked down on all of those minorities and immigrants that I compete with." Put another way, by attacking women, LGBT, minorities, immigrants, etc., Trump's supporters may believe that Trump is keeping his promise to stand with working (white) people.
https://www.vox.com/policy-and-politics/2017/8/31/16226488/trump-identity-politics-racism
Over the past month, President Donald Trump has taken a series of steps that, at first glance, may not seem related: He characterized white supremacists who caused chaos and violence in Charlottesville and counterprotesters as equally violent. He pardoned the former Arizona sheriff, Joe Arpaio. He moved to give police greater access to military weapons. He’s considering revoking a program that shields undocumented immigrants from deportation.
But there’s a common thread linking all of these moves together. “It’s identity politics,” Paul Frymer, director of the Program in Law and Public Affairs at Princeton University, told me. “[Trump]’s playing to a group of voters who feel disaffected as whites. It’s not their only identity, but it’s an identity that they identify with and that he’s targeting and exploiting.”
* * *
To understand what Trump is doing, it’s important to first understand how many conservative white Americans feel about the state of US politics. The best description of that comes from sociologist Arlie Hochschild’s book, Strangers in Their Own Land: Anger and Mourning on the American Right.
Hochschild spent years with Tea Party members in Louisiana. Out of that experience, she came up with a theory to explain how many of them feel: As they see it, they are all in this line toward a hill with prosperity at the top. But over the past few years, globalization and income stagnation have caused the line to stop moving. And from their perspective, other groups — black and brown Americans, women — are now cutting in the line, because they’re getting new (and more equal) opportunities through various government services, new anti-discrimination laws, and policies like affirmative action. All of that builds resentment.
Trump Weighs Cuts to Coast Guard, T.S.A. and FEMA to Bolster Border Plan (March 2017)
With Trump's controversial moves and Hurricane Harvey, no one is mentioning that Trump was proposing to gut FEMA to build his wall.
https://www.nytimes.com/2017/03/09/us/politics/trump-budget-coast-guard.html
WASHINGTON — The Trump administration is considering deep cuts in the budgets of the Coast Guard, the Transportation Security Administration and the Federal Emergency Management Agency as it looks for money to ratchet up security along the southern border, according to a person familiar with the administration’s draft budget request.
The goal is to shift about $5 billion toward hiring scores of additional agents for Customs and Border Protection and Immigration and Customs Enforcement, as well as toward infrastructure to support a crackdown on illegal immigration at the border. A significant portion of the money would go toward erecting a wall along the border with Mexico, one of President Trump’s signature campaign promises.
To fund those efforts, though, the plan would seek significant reductions in other areas, including a 14 percent cut to the Coast Guard’s $9.1 billion budget and 11 percent cuts to both the T.S.A. and FEMA. The three agencies have played high-profile roles in the Department of Homeland Security’s post-Sept. 11 security architecture.
All told, the plan would increase the department’s budget by 6.4 percent, to $43.8 billion, for the 2018 fiscal year, also using savings from other executive branch departments to fund it.
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