The basic economics of U.S. health care makes that easier said than done. Before the ACA, the U.S. stood out from the international pack on health care in two very unpleasant ways. First, it spent a far larger share of gross domestic product on health care. Second, it was the only advanced industrial nation that left vast swaths of its population uninsured. These two doleful facts remain true, although the fraction of Americans without health insurance fell from 13.3% in 2013 to 8.8% in 2017, according to Commerce Department data.
There are several ways to get more people covered. One is to adopt a system in which the government provides or pays for universal coverage—the British or Canadian model. This won’t happen soon in the U.S., not even as Medicare for All.
A second route, advocated unsuccessfully by President Clinton in 1993, is to mandate that every employer provide health insurance to its workers. This approach might seem natural in the U.S. context because so many workers already receive health insurance that way. But the employer mandate has fatal flaws. It wouldn’t cover the nonworking population, and it would impose heavy burdens on small businesses.
For these and other reasons, many economists in the Clinton administration—including me—favored an individual mandate. But that idea was dead in the water in 1993 because it had been advocated by the Heritage Foundation starting in 1989. It was therefore a “right wing” idea.
There are problems with an individual mandate, too. For one, the high cost of U.S. health insurance means that many low- and moderate-income families cannot afford to buy policies on their own. For another, if for-profit insurance companies are made to lose money by covering people with pre-existing conditions, the government must also force young healthy people, who tend to have limited medical expenses, into the insurance pool.
Fortunately, both problems are easily solved—conceptually, that is, not politically—by mandating that everyone buy a policy and providing subsidies to the needy. Massachusetts legislators understood this in 2006. They also knew they were not writing on a blank slate; many citizens received health insurance through their jobs and didn’t want to lose it. Hence the hybrid system that became known as RomneyCare.
If this short description reminds you of the ACA, it should. The two plans are not identical twins, but there is a family resemblance. In 2010 Democrats didn’t follow in the footsteps of Romney Republicans to make them look good; they designed their plan that way because under the constraints of precedent, the underlying logic practically forces you there.
Keep that in mind: If there ever is a TrumpCare, an unlikely proposition, it’s bound to resemble RomneyCare and ObamaCare—no matter what the president claims.
White House is assigning one of its lawyers to a new communications role to handle the stepped-up oversight coming from Democratic-led congressional committees, among other issues, a White House official said Thursday.
Steven Groves, now an assistant special counsel in the White House, will become a deputy press secretary under a broader realignment of duties in President Trump’s press and communications operations, the official said.
.. Mr. Groves had been working under Emmet Flood, the White House special counsel dealing with the Russia investigation.
Before coming to the White House, he worked at the Heritage Foundation and the Senate’s Permanent Subcommittee on Investigations.
“He speaks law, which will help,” the White House official said.
In a new book, Steve Kornacki looks back at the 1990s — and finds the roots of today’s polarization in the Clintons’ ascent.
.. the 1990s was until recently an invisible decade. “The holiday from history,” it was called, a “lull” where nothing much really happened, a candy-colored coma between the Berlin Wall’s fall on 11/9 and the 9/11 attacks less than a dozen years later.
.. The Red and the Blue, is a political procedural that sets out to explain how we went from giga-landslides in the ’60s, ’70s, and ’80s to Electoral College squeakers today, how Republicans disappeared from the coasts and Democrats died their final deaths in the South and Midwest.
.. it benefits from the context provided by Trump’s ascent, which has clarified that one big reason we’re seemingly reliving the 1930s today is because both the Left and Right spent the 1990s and early 2000s rehashing the culture wars of the 1960s and early ’70s.
.. Because cable and the Internet have so completely transformed American culture over the past two or three decades, it’s easy to forget (and younger people can’t even remember) just how norm-shattering Bill Clinton was, compared to the Greatest and Silent Generation leaders who came before him. To social conservatives and foreign-policy hawks, Clinton’s election was downright triggering, and deserved nothing less than full-on #Resistance. Historian Steven Gillon famously interviewed one who succinctly fumed that Clinton was “a womanizing, Elvis-loving, non-inhaling, truth-shading, draft-dodging, war-protesting, abortion-protecting, gay-promoting, gun-hating Baby Boomer!”
.. aside from Gary Hart, whose ill-fated career was recently reexamined in the Jason Reitman movie The Front Runner, America hadn’t had a youthful, truly sexualized major-party presidential nominee since JFK — until Clinton came along.
- .. The Federal Reserve’s preference for financialization and neoliberalism was at its very peak under the influence of Paul Volcker and Alan Greenspan.
- Nearly half of Americans still thought “sodomy” — never mind same-sex marriage or civil unions — should be illegal.
- And while America was pro-choice, huge percentages of voters demanded restrictions to abortion-on-demand.
The Red and the Blue gives an excellent Gen-X-plaining of just how systemically, institutionally, and culturally impossible it would have been for Democrats to move even farther leftward than they did back then — of how much damage their “too far left” brand had done to the party in the ’80s and of the disastrous political consequences of Bill Clinton’s attempts to govern from the left in 1993–94, as epitomized by Hillary’s attempt at health-care reform. He reminds his readers with his trademark aptitude for facts and figures that America in the 1990s was still very much living in what Sean Wilentz called The Age of Reagan.
.. He manages, for example, to nail the most salient point of the abusive relationship between Bill Clinton and Newt Gingrich: that it was at heart a love story, and/or a co-dependency worthy of Dr. Phil. One man could simply not have managed to stay in office without the other.
.. It was Clinton hatred on the social right that gave us Gingrich, and it was Gingrich’s surefire ability to trigger the libs that protected Clinton year in and year out. “Do you want him – or me?” became the basic campaign pitch of both men.
.. his Officer Friendly approach to the media is just too naïve by half, especially for someone who is a cable-news host with considerable experience in online journalism. In Kornacki’s telling, reporters merely report, offering just the facts or serving as quickie Greek choruses and footnote sources. This might work for a tenth-grade term paper, but for a book that seeks to illuminate the decade that saw the rise of the Internet, the birth of Fox News, unprecedented media consolidation, and what Eric Alterman called “the punditocracy” at the height of its influence, it’s entirely inadequate.From highly influential anti-Great Society “Atari Democrats” like
- Michael Kinsley,
- Joe Klein,
- Sidney Blumenthal, and
- Robert Samuelson and proudly un-PC pundits like
- Camille Paglia,
- Ben Wattenberg,
- Bill Maher, and
- Andrew Sullivan to donor-funded think tanks like
- Heritage and
- Cato, an entire intellectual infrastructure was shaping the national narrative for what became Third Way Clintonism well before the Clinton era began. Yet most of these people and institutions do not even appear in Kornacki’s index, or if they do, they’re curtly dispensed with in one or two lines.
.. It’s possible that with Donald Trump’s attacks on the press (and with some people using criticism of “the media” as an anti-Semitic dog whistle), Kornacki didn’t want to even go there.
.. But a book on 1990s polarization that omits Steve Jobs, Roger Ailes, and Bill Gates from its index? One that effectively ignores the O.J. trial, Maureen Dowd’s gendered, campy, sexist (certainly by today’s standards), Pulitzer-winning coverage of Monicagate, and Clarence Thomas vs. Anita Hill?
.. writers as far apart as Ann Coulter and Eric Alterman blamed Al Gore’s loss in 2000 on the media’s hatred of him (and his hatred of them)?
.. Limbaugh’s pioneering tactic (soon perfected by Gingrich, Coulter, and Karl Rove) of branding anyone whose politics were even slightly to the left of, say, Sandra Day O’Connor or Dianne Feinstein, as a Loony Liberal, Radical Leftist, or Femi-Nazi. From Clinton and Dubya well into the Obama years, red-meat conservatives intentionally fuzzed the line between corporate social-liberals and the true hard left of Michael Moore, Pacifica Radio, and Thomas Frank, and Kornacki captures their strategy perfectly... Aside from the Obamas themselves, no other politician would even remotely disrupt or challenge Clintonistas’ hold on the Democratic party for another ten or 15 years. But Clintonism could only continue as long as the true far-left remained repressed, and as long as the economy kept humming... When a fist-shaking socialist senator from Vermont lined up an army of Millennials in formation behind him eight years after the dawn of the Great Recession caused in no small part by Clinton-era financial policy, it became crystal clear that Newt Gingrich had won the war... When they exited the White House, the Clintons left behind a Democratic party that working class, rural, and/or religious whites had become almost allergic to, one more dependent on African-American and Latino voters than ever... Donald Trump cruised to triumph in 2016 using all of the dog whistles and wedge issues that Gingrich, Rove, Buchanan, and Ross Perot had refined to perfection... And just as education-conscious, socially liberal white professionals reacted against Gingrich’s and Buchanan’s reactionary rhetoric in the late ’90s, Trump’s Republican party has now been effectively evicted from places as once-synonymous with the GOP as Long Island, Maine, New Jersey, San Diego, and Orange County.
the 54 senators who voted to elevate Judge Gorsuch had received around 54 million votes, and the 45 senators who opposed him got more than 73 million. That’s 58 percent to 42 percent.
.. And if the Senate confirms Brett Kavanaugh soon, the vote is likely to fall along similar lines, meaning that we will soon have two Supreme Court justices who deserve to be called “minority-majority”: justices who are part of a five-vote majority on the bench but who were nominated and confirmed by a president and a Senate who represent the will of a minority of the American people.
.. Two more current members of the dominant conservative bloc, while nominated by presidents who did win the popular vote, were confirmed by senators who collectively won fewer popular votes than the senators who voted against them.
.. Clarence Thomas, who was confirmed in 1991 by 52 senators who won just 48 percent of the popular vote, and Samuel Alito, confirmed in 2006 by 58 senators who garnered, again, 48 percent of the vote.
.. If fate were to hand President Trump one more opportunity to put a justice on the court before 2021, it would almost certainly again be a bitterly contested and close vote, and it would probably leave us with a majority of Supreme Court justices, five, who were confirmed by senators who received a minority share of the vote.
.. no Democratic president has ever taken office after losing the popular vote. And second, justices nominated by Democrats have never been confirmed by such narrow margins. Of the four liberals currently on the court, all received 63 votes or more, from senators winning and representing clear majorities of their voters.
.. we’re on the verge of having a five-member majority who figure to radically rewrite our nation’s laws. And four of them will have been narrowly approved by senators representing minority will.
.. Bill Clinton and Barack Obama did not nominate jurists who had left paper trails of judicial extremism or dropped other hints that their jurisprudence would be radical.
.. outsourced the judicial-selection process to right-wing groups like the Federalist Society and the Heritage Foundation and twice nominated judges with an eye cast largely toward how happy they would make conservative evangelicals.
.. Republicans are doing to the Supreme Court what they have already accomplished in Congress. There, through aggressive gerrymandering, they’ve muscled their way to a majority even as their candidates have sometimes received collectively fewer votes than Democrats. And now they’re doing it to the court, by breaking the rules (Merrick Garland) and advancing nominees who are confirmed by legislators representing minority support.