The candidate of plans needs a really good one right now.
On Sunday, Elizabeth Warren said that she would soon release a plan explaining how she intends to pay for “Medicare for all.” Like many policy wonks, I’ll be waiting with bated breath; this could be a make or break moment for her campaign, and possibly for the 2020 election.
There are three things you need to know about Medicare for all, which in the current debate has come to mean a pure single-payer health insurance system, in which the government provides all coverage, with no role for private insurers.
First, single-payer has a lot to recommend it as a way to achieve universal health care. It’s not the only route — every major advanced country besides the United States achieves universal coverage, but many of them get there via regulations and subsidies rather than by relying solely on public insurance. Still, single-payer is clean and simple, and many health economists would support it if we were starting from scratch.
But we aren’t starting from scratch, which is the second thing you need to know. More than half of Americans are covered by private health insurance, mainly through employers.
Not many people love their insurance companies, but that doesn’t mean that they’re eager to trade the coverage they know for a new system they don’t. Most people probably would end up better off under single-payer, but convincing them of that would be a hard sell; polls show much less support for Medicare for all than for a “public option” plan in which people could retain private insurance if they chose to.
Which brings me to the third point: In reality, single-payer won’t happen any time soon. Even if Democrats win in a landslide in 2020, taking control of the Senate as well as the White House, it’s very unlikely that they will have the votes to eliminate private insurance.
Warren, who has made policy seriousness a key part of her political persona — “Warren has a plan for that” — surely knows all of this. And early this year she seemed to recognize the problems with a purist single-payer approach, saying that she was open to different paths toward universal coverage.
Since then, however, she seems to have gone all in for the elimination of private insurance.
I have no inside information about what led her to take that plunge, but my guess is that she was trying to protect her left flank — to avoid alienating supporters of Bernie Sanders, who have made single-payer a kind of purity test one must pass to be considered a true progressive. And I’m not going to criticize her for engaging in a bit of political realism; after all, the case against Medicare for all is itself basically political.
At this point, however, it’s looking as if Warren may have painted herself into a corner.
Part, but only part, of the issue involves cost.
Journalists have been badgering Warren to get specific about how much taxes would have to go up to pay for Medicare for all. She has, with considerable justice, insisted that this is a bad way to frame the discussion, since any additional taxes would be offset by savings on the huge premiums workers and their employers now pay for private insurance — on average, more than $20,000 a year for a family plan.
The right question is whether the overall costs facing U.S. families would go up or down. Warren has been claiming that for most families, they would go down, but she hasn’t offered specifics. And this vagueness, which has started to seem like evasiveness, is more of a problem for her than it might be for other politicians. As I said, Warren has made policy seriousness a key aspect of her political persona, so her fogginess on health care really stands out.
The plan in the works will presumably try to dispel that fog, but doing so will be tricky. An independent estimate from the Urban Institute (which is, for what it’s worth, left-leaning) suggests that a highly comprehensive Medicare-for-all plan, similar to what Sanders is proposing, would substantially increase overall health spending, although a more modest plan wouldn’t.
But cost isn’t the only issue — in fact, I’m not sure how important it really is, given that full abolition of private insurance remains unlikely in practice. Also, let’s get real: If Warren gets the Democratic nomination, the outcome of the general election isn’t going to hinge on dueling think tank estimates.
The election might, however, hinge on the support of people who have good private coverage and would be nervous about making a leap into the unknown, no matter how many facts and figures Warren deploys.
So what I’ll want to see is whether Warren gives herself and her party enough flexibility to assuage these concerns. I’m not sure what form that flexibility might take. Maybe something like an extended transition period, with greatly enhanced Obamacare (which might actually be politically doable) in the interim?
Whatever Warren comes up with, this is a crucial moment. There are many excellent things in her overall policy agenda; but she won’t get a chance to do those things unless she can extricate herself from what looks like a health policy trap.
Trump doesn’t have the integrity to be a mob boss
Many people have compared Donald Trump to a mob boss. But I’m starting to think that the comparison is unfair — to mob bosses.
After all, you can’t build an empire, even a criminal empire, unless people believe that your word is worth something. They have to believe both that you’ll honor your promises and that you’ll make good on your threats. The first few times you renege on agreements it may look as if you’re being smart and other people are being suckers; but soon they’ll take your measure, and realize that you’re actually the guy who can be rolled.
I’ve been thinking about this reality over the past few days, as we’ve watched two separate Trump administration debacles unfold.
The biggest debacle, the one that has many of us feeling a bit ashamed to be Americans, is, of course, the betrayal of the Kurds. We don’t really know why Trump so casually abandoned allies who have fought and died on our behalf, but one thing is clear: Turkey’s President Recep Erdogan took Trump’s measure, decided that his threats to retaliate against Turkey’s effective invasion of Kurdish territory were empty, and seized the moment.
But there was another, lower-key debacle involving China. Trump has, of course, made a trade war with China the centerpiece of his economic policy, inflicting substantial harm on both economies along the way. Last week, however — perhaps realizing the weakness of his domestic position as the march to impeachment gathers momentum — he seemingly decided to declare victory and retreat, proclaiming that he had a deal with China that, even by his own officials’ description, sounded like getting nothing China hasn’t been offering all along.
But it was actually worse than that. Acute observers quickly pointed out that all we had was a unilateral announcement by U.S. officials that there was a deal, which should be treated with skepticism until and unless we got an explicit joint statement of what had been agreed.
And sure enough, yesterday the Chinese basically said, “Oh, that deal? Well, we’re thinking about it. Let’s talk some more.”
In other words, like Turkey’s Erdogan — and, actually, North Korea’s Kim Jong Un a while back — they’ve taken Trump’s measure and decided that he can be rolled.
The point is that Trump’s actual art of the deal, which involves making promises you intend to break whenever it seems convenient, only works if you can keep finding fresh suckers to cheat. If there are people you have to deal with repeatedly, like the leaders of other nations, they eventually figure out both that you can’t be trusted and that you needn’t be feared: your promises are empty, but so are your threats.
All of this has vastly weakened America. We used to be a country of great power but even greater influence, because we had principles other nations could count on us to follow. Now we have a leader whom other leaders see as malleable — an unprincipled and ill-informed guy who can be flattered, bribed or simply fooled into giving them what they want.
Making America great again, indeed.
Here Comes the Trump Slump
And he has only himself to blame.
When he isn’t raving about how the deep state is conspiring against him, Donald Trump loves to boast about the economy, claiming to have achieved unprecedented things. As it happens, none of his claims are true. While both G.D.P. and employment have registered solid growth, the Trump economy simply seems to have continued a long expansion that began under Barack Obama. In fact, someone who looked only at the past 10 years of data would never guess that an election had taken place.But now it’s starting to look as if Trump really will achieve something unique: He may well be the first president of modern times to preside over a slump that can be directly attributed to his own policies, rather than bad luck.
There has always been a deep unfairness about the relationship between economics and politics: Presidents get both credit and blame for events that usually have little to do with their actions.
- Jimmy Carter didn’t cause the stagflation that put Ronald Reagan in the White House;
- George H.W. Bush didn’t cause the economic weakness that elected Bill Clinton; even
- George W. Bush bears at most tangential responsibility for the 2008 financial crisis.
More recently, the “mini-recession” of 2015-16, a slump in manufacturing that may have tipped the scale to Trump, was caused mainly by a plunge in energy prices rather than any of Barack Obama’s policies.
But unlike previous presidents, who were just unlucky to preside over slumps, Trump has done this to himself, largely by choosing to wage a trade war he insisted would be “good, and easy to win.”
The link between the trade war and agriculture’s woes is obvious: America’s farmers are deeply dependent on export markets, China in particular. So they’re hurting badly, despite a huge financial bailout that is already more than twice as big as the Obama administration’s auto bailout. (Part of the problem may be that the bailout money is flowing disproportionately to the biggest, richest farms.)
Shipping may also seem an obvious victim when tariffs reduce international trade, although it’s not just an international issue; domestic trucking is also in recession.
The manufacturing slump is more surprising. After all, America runs a large trade deficit in manufactured goods, so you might expect that tariffs, by forcing buyers to turn to domestic suppliers, would be good for the sector. That’s surely what Trump and his advisers thought would happen.
But that’s not how it has worked out. Instead, the trade war has clearly hurt U.S. manufacturing. Indeed, it has done considerably more damage than even Trump critics like yours truly expected.
The Trumpist trade warriors, it turns out, missed two key points. First, many U.S. manufacturers depend heavily on imported parts and other inputs; the trade war is disrupting their supply chains. Second, Trump’s trade policy isn’t just protectionist, it’s erratic, creating vast uncertainty for businesses both here and abroad. And businesses are responding to that uncertainty by putting plans for investment and job creation on hold.
So the tweeter in chief has bungled his way into a Trump slump, even if it isn’t a full-blown recession, at least so far. It’s clearly going to hurt him politically, notably because of the contrast between his big talk and not-so-great reality. Also, the pain in manufacturing seems to be falling especially hard on those swing states Trump took by tiny margins in 2016, giving him the Electoral College despite losing the popular vote.
And while many presidents have found themselves confronting politically damaging economic adversity, Trump is, as I said, unique in that he really did this to himself.
Of course, that doesn’t mean that he will accept responsibility for his mistakes. For the past few months he has been trying to portray the Federal Reserve as the root of all economic evil, even though current interest rates are well below those his own officials predicted in their triumphalist economic projections.
My guess, however, is that Fed-bashing will prove ineffective as a political strategy, not least because most Americans probably have at best a vague idea of what the Fed is and what it does.
So what will come next? Trump being Trump, it’s a good bet that he’ll soon be denouncing troubling economic data as fake news; I wouldn’t be surprised to see political pressure on the statistical agencies to report better numbers. Hey, if it can happen to the National Weather Service, why not the Bureau of Economic Analysis (which reports, by the way, to Wilbur Ross)?
And somehow or other this will turn out to be another deep-state conspiracy, probably orchestrated by George Soros.The scary thing is that around 35 percent of Americans will probably believe whatever excuses Trump comes up with. But that won’t be enough to save him.
Republicans Don’t Believe in Democracy
Do Democrats understand what they’re facing?
Item: Last week Republicans in the North Carolina House used the occasion of 9/11 to call a surprise vote, passing a budget bill with a supermajority to override the Democratic governor’s veto. They were able to do this only because most Democrats were absent, some of them attending commemorative events; the Democratic leader had advised members that they didn’t need to be present because, he says, he was assured there would be no votes that morning.
Item: Also last week, Representative Adam Schiff, the Democratic chairman of the House Intelligence Committee, issued a subpoena to the acting director of national intelligence, who has refused to turn over a whistle-blower complaint that the intelligence community’s inspector general found credible and of “urgent concern.” We don’t know what the whistle-blower was warning about, but we do know that the law is clear: Such complaints must be referred to Congress, no exceptions allowed.
On the surface, these stories may seem to be about very different things. The fight in North Carolina is basically about the G.O.P.’s determination to deny health care to low-income Americans; the governor had threatened to veto any budget that didn’t expand Medicaid. The whistle-blower affair probably involves malfeasance by high government officials, quite possibly President Trump, that in some way threatens national security.
What the stories have in common, however, is that they illustrate contempt for democracy and constitutional government. Elections are supposed to have consequences, conveying power to the winners. But when Democrats win an election, the modern G.O.P. does its best to negate the results, flouting norms and, if necessary, the law to carry on as if the voters hadn’t spoken.
Similarly, last year America’s voters chose to give Democrats control of the House of Representatives. This still leaves Democrats without the ability to pass legislation, since Republicans control the Senate and the White House. But the House, by law, has important additional powers — the right to be informed of what’s going on in the executive branch, such as complaints by whistle-blowers, and the right to issue subpoenas demanding information relevant to governing.
The Trump administration, however, has evidently decided that none of that matters. So what if Democrats demand information they’re legally entitled to? So what if they issue subpoenas? After all, law enforcement has to be carried out by the Justice Department — and under William Barr, Justice has effectively become just another arm of the G.O.P.
This is the context in which you want to think about the latest round of revelations about Brett Kavanaugh.
First of all, we now know that the F.B.I., essentially at Republican direction, severely limited its investigation into Kavanaugh’s past. So Kavanaugh was appointed to a powerful, lifetime position without a true vetting.
Second, both Kavanaugh’s background and the circumstances of his appointment suggest that Mitch McConnell went to unprecedented lengths to create a Republican bloc on the Supreme Court that will thwart anything and everything Democrats try to accomplish, even if they do manage to take both Congress and the White House. In particular, as The Washington Post’s Greg Sargent notes, it seems extremely likely that this court will block any meaningful action on climate change.
What can Democrats do about this situation? They need to win elections, but all too often that won’t be sufficient, because they confront a Republican Party that at a basic level doesn’t accept their right to govern, never mind what the voters say. So winning isn’t enough; they also have to be prepared for that confrontation.And surely the first step is recognizing the problem exists. Which brings me to the Democratic presidential primary race.
The leading candidates for the Democratic nomination differ considerably in both their personalities and their policy proposals, but these pale beside their differences from Donald Trump and his party. All of them are decent human beings; all would, if given the chance, move America in a notably more progressive direction.
The real chasm between the candidates is, instead, in the extent to which they get it — that is, the extent to which they understand what they’re facing in the modern G.O.P.
The big problem with Joe Biden, still the front-runner, is that he obviously doesn’t get it. He’s made it clear on many occasions that he considers Trump an aberration and believes that he could have productive, amicable relations with Republicans once Trump is gone.
Which raises the question: Even if Biden can win, is he too oblivious to govern effectively?