The Health Care Cul-de-Sac

What are the biggest threats to the American Dream right now, to our unity and prosperity, our happiness and civic health?

First, an economic stagnation that we are only just now, eight years into an economic recovery, beginning to escape — a stagnation that has left median incomes roughly flat for almost a generation, encouraged populism on the left and right, and made every kind of polarization that much worse.

First, an economic stagnation that we are only just now, eight years into an economic recovery, beginning to escape — a stagnation that has left median incomes roughly flat for almost a generation, encouraged populism on the left and right, and made every kind of polarization that much worse.

.. And if the Democrats, having blown up the insurance system once to implement Obamacare, really rallied around a Bernie Sanders-style proposal to do it all over again but on a bigger scale? Then not only would 2020 be a health care election, but if the Democrat won, the next two years would be consumed by outlandish single-payer expectations.

Where would that leave our two big problems, stagnation and the social crisis?

.. But when your main challenges involve men who aren’t working, wages that aren’t rising, families that aren’t forming and communities that are collapsing, constantly overhauling health insurance is at best an indirect response, at worst a non sequitur.

.. Democrats, meanwhile, could let single-payer dreams wait (or just die) and think instead about spending that supports work and family directly. They could look at proposals for a larger earned-income tax credit, a family allowance, and let the “job guarantee” and “guaranteed basic income”factions fight things out. If they want to go big in 2020, they could run on wage subsidies and public works, not another disruptive health care vision.

.. The country has bigger problems than its insurance system. It’s time for both parties to act like it.

Trump’s budget takes aim at illegal immigrants by limiting tax credits

Trump’s budget would limit eligibility for the Earned Income Tax Credit and the Child Tax Credit to recipients “who are authorized to work in the U.S.”

.. Together, changes to those two programs alone are estimated to save about $40 billion over a decade.

.. The program — commonly known as food stamps — would see a $193 billion cut under Trump’s proposal.

.. Mulvaney said the EITC and child credit would not be available to those without a Social Security number.

What Would It Take to Replace the Pay Working-Class Americans Have Lost?

Put another way, as long as you’re cutting taxes by $6 trillion (that is the high-end direct cost estimate of Mr. Trump’s plan from the Tax Foundation), carving out $1 trillion for workers who haven’t seen large raises in years may just pay some dividends.

.. Gross domestic product for each person in the United States was 78 percent higher in 2015 than in 1979. But the average income for those households at the 20th percentile of the income distribution rose only 6.9 percent in that span.

.. In its current form, for example, a married couple with two children that makes $30,000 a year receives a tax credit of $4,201.

.. The first step was to design a tax credit expansion that would raise the income of the bottom 20 percent of families to where they would be if they shared equally in the gains since 1979. That meant figuring out a tax change that would put an extra $2,889 in the pockets of a family of three that in 2013 made $20,420.

.. a family of four making $40,000 would receive about $6,000 a year in this expanded E.I.T.C., compared with the $2,142 they get now.

.. The Tax Policy Center crunched the numbers: The policy would deplete federal coffers by $1.02 trillion over a decade.

The Banality of Change

..Trump speaks to this man’s situation and makes him feel heard. But when you think practically about which candidate could improve his life, it’s clear that Clinton is the bigger change agent.

.. To create political change, you have to work within groups and organize groups of groups.

.. Now, if you wanted to design a personality type perfectly ill suited to be a change agent in government, you would come up with Donald Trump: solipsistic, impatient, combative, unsubtle and ignorant.

.. None of us should be under any illusions. Wherever Clinton walks, the whiff of scandal is always by her side. The Clintons seem to have decided that they are righteous and good, and therefore anything that enriches, empowers or makes them feel good must always be righteous and good. They surround themselves with some amazing people but also some human hand grenades who inevitably blow up in their faces.

Passing legislation next year is going to be hard, but if Clinton can be dull and pragmatic, and operate at a level below the cable TV ideology wars, it’s possible to imagine her gathering majorities behind laws that would help people like that guy in Idaho:

  • an infrastructure push, criminal justice reform,
  • a college tuition program,
  • an apprenticeship and skills program,
  • an expanded earned-income tax credit
  • and a bill to secure the border
  • and shift from low-skill to high-skill immigration.