GOP Senate takeover is best for all

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

This is not an endorsement of Rep. Tom Cotton, but it’s best for everyone – in some ways, even President Obama – if Republicans take over the Senate. They are almost certain to maintain control of the House, so a GOP-controlled Senate is the only way our government might be able to function during the next two years.

We’ve seen what happens when one party controls the House and the other controls the Senate in the current political climate – a complete train wreck. Nobody has to take responsibility because everybody can just blame the other side. As a result, Americans have witnessed a series of avoidable fiscal crises and a government shutdown. It’s also why we’ve seen hundreds of show votes that have little purpose but to score political points, such as the Republican House’s dozens of votes to repeal or cripple Obamacare. Those bills died in the Senate, which the House members knew would happen all along.

Just as a split Congress is bad for the country, so too is one-party control. Under the Constitution, the White House and Congress are supposed to check and balance each other. But the way the system has evolved, when the president and the congressional majority are of the same party, they see themselves as members of the same team.

In contrast, the government functioned reasonably well at times from 1994-2000, when Democrats controlled the White House under President Clinton and Republicans controlled Congress. The melting pot of ideas and priorities brought both branches of government to the center. Together they reformed welfare and passed polices that enabled the government to balance the budget, sort of. On the other hand, Monica Lewinsky happened.

If Republicans win control of the Senate (and keep the House), they will have a responsibility to govern, not just oppose Obama. They will need to show the country they can accomplish something constructive so they can win again in 2016.

So there will not be dozens of votes to repeal Obamacare because if Republicans actually did that, they’d have the responsibility to replace it with something else, and they don’t know what that would be.

Instead, GOP members will pass one bill to repeal Obamacare in the House and try to pass one in the Senate to satisfy their base voters. If it somehow survived a Democratic filibuster attempt in the Senate, Obama of course would use his veto. If that were to happen, everyone on both sides would rant and rave, and then hopefully Congress would get down to business and start amending the law – for example, by passing tort reform to limit the excesses of medical malpractice lawsuits. Obama might even sign such a bill because a Republican takeover of the Senate would force (and on some issues allow) him and some congressional Democrats to move to the center.

Mike Ross, who spent 12 years in the U.S. House of Representatives, has made a similar argument in his race for governor. Republicans already are assured of a minimum of 20 of the 35 seats in the Arkansas Senate. They’ll almost certainly control the House as well.

Ross has said his election will keep one party from controlling everything. That’s true, although the Arkansas governor’s veto is far less powerful than the president’s. While a presidential veto requires a two-thirds vote to override, the state Legislature merely needs a simple majority, which is the same percentage that passed the bill in the first place. Still, the governor is the state’s chief executive – the one able to get everybody’s attention, and the one who remains in Little Rock administering state government after legislators have gone home.

So Ross is right. Voting for him will result in divided government in Little Rock, and voting for his opponent, Asa Hutchinson, will result in one-party control.

That’s not an endorsement of Ross any more than this column is endorsing Cotton. There are many other reasons to choose one candidate over the other. Besides, Little Rock is not Washington – not now, and hopefully not ever.

Remembering history on the eve of war

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

“Those who cannot remember the past are condemned to repeat it,” the philosopher and poet George Santayana wrote. They also forget the good stuff, too.

Prior to Dec. 7, 1941, Americans were divided on how to respond to the escalating global conflict. That division ended with the attack on Pearl Harbor. Congress declared war on Japan with one dissenting vote. Germany and Italy declared war on America. America declared war on Germany and Italy.

In the months that followed, Americans volunteered for service or registered for the draft. During the war years, civilians across the country participated in scrap metal drives, bought war bonds, and accepted the rationing of certain foods and household items. They could hardly buy a tire because the rubber was needed by the boys overseas. Taxes, which already were high, rose even higher to a top rate of 94 percent. No one, and I mean no one, could go about their lives pretending a war wasn’t happening.

On Wednesday night, President Obama announced that the United States is expanding its efforts against its newest enemy. As with Japan in World War II, the Islamic State, or ISIS, has been committing atrocities for a while now in Syria and Iraq, but American opinion was not galvanized until Americans were killed, visibly. In 1941, it was the bombing of Pearl Harbor. Now, it’s the beheading of two journalists.

Obama announced that the United States will, among other actions, lead a broad coalition against ISIS, conduct airstrikes in Iraq and Syria, and will deploy 475 additional military advisors in Iraq. He asked Congress for “additional authority and resources” to train and arm Syrian rebels. “America, our endless blessings bestow an enduring burden” of leadership, he said.

This effort will be a fraction of the federal budget, but it will not be free. There is no question the resources will be provided. The question is, from whom? Like much of what the United States has done since 1980 – including a bunch of military actions, particularly in Iraq and Afghanistan – the money likely will be borrowed. Because our blessings are not actually endless, we’ve made a habit of asking for our children and grandchildren to pay for our current needs.

Whether it involves foreign policies like the wars in Iraq, or domestic crises such as relief after Hurricane Sandy, America’s response has been consistent for decades: There’s a need, often a legitimate one, and so we meet it. Unfortunately, we tend not to count the costs, and if we do, we tend to pass them on.

I am not opposed to what the president is proposing – and unlike many, I expect he’ll do a decent enough job of carrying out his plans. But the costs of this exercise should be budgeted, and they should be offset by spending cuts elsewhere or by revenue increases. No more wars that we ask our kids to pay for.

There’s a tendency to glorify World War II. That’s a mistake, because we need to learn from actual history, not an idealized one. They had a draft back then because they couldn’t get enough volunteers. They raised taxes because they couldn’t just pass the offering plate and collect enough to pay for the war. At the end of the war, the national debt had increased to 109 percent of the gross domestic product – higher than it is now.

But Americans back then at least tried to pay their own way. They did this at a time when the entire world was in flames, when much of the available workforce was overseas, when many were grieving lost loved ones, and when the Great Depression was still a fresh memory. Everyone sacrificed – not just those who wore a uniform.

Now, like so many times in recent years, the United States is about to kill some bad people in a far-off land. Let’s hope it makes the world a safer, freer place.

If it does, it would be our world that benefits – the one we’re living in now. That means we should be the ones to pay for it, not our children and grandchildren. They already will be looking back through history at us, and, hopefully, learning from our mistakes so they don’t repeat them.

A drugstore quits cigarettes

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

CVS Pharmacy, a national drugstore chain, stopped selling cigarettes last week. This was big news because it was so unusual. And if anyone is wondering why the United States is spending far too much money paying for health care that isn’t making Americans healthier – those first two sentences should help explain it.

The chain is rebranding itself as “CVS Health” as it empties its shelves of the tobacco products that contribute to one in five American deaths, according to the Centers for Disease Control and Prevention (CDC). The company did not have a sudden epiphany that tobacco is bad for us. It’s trying to find a market niche as a health care provider. Like other pharmaceutical retailers, it also is offering basic medical services such as flu vaccines and blood pressure tests.

This is a welcome change because drugstores – which supposedly sell us products to make us well – are among the unhealthiest retailers in the country. The national chain in my area – I won’t use the name, but it’s new slogan contains the word “healthy” – sells cigarettes, candy and colas behind or near the cashier, who is located only feet from the doorway. Rows upon rows of candy, in fact, are sold in that store, along with chips and other salty snacks. It does sell cereal, and there’s a small refrigerated section that contains juice and milk, along with frozen pizza and ice cream. The gas station that changes my oil sells bananas, oranges and apples. Not so this drugstore, where virtually every grocery item is a processed food. The drugstore does sell bottled water, which, though a waste of money, is at least good for you.

You can’t really blame the drugstores for this. I guess they have every right to sell us what we have every right to buy, and Americans in general and Arkansans in particular buy a lot of tobacco, candy and processed foods. According to the CDC, an estimated 41.1 million Americans, or 18.1 percent of us, smoke cigarettes. In Arkansas, it’s 27 percent, ranking the state 49th, and not in a good way. More than one-third of Americans are obese.

The United States spends about 18 percent of its gross domestic product on health care – far more than other industrial countries. Some say it has the “best health care system in the world,” and if you judge it by one metric – the ability to treat certain serous diseases, that’s true. But it’s burdening us and future generations with unsustainable debt, and was doing so long before Obamacare was created.

The health care system itself is partly to blame. Among its biggest problems is that it rewards all the wrong behaviors. It pays medical providers far more money for treating diseases than it does for curing them and pays them almost nothing for prevention. A pharmacy selling us cigarettes and then selling us drugs (and charging the government for them) to treat the effects of those cigarettes? That’s the American way.

But just as it’s very hard for schools to educate students without parental support, it’s difficult for the health care system to treat patients when we don’t treat ourselves. Americans see “health care” largely as the act of taking a pill, right now, to make us feel better, right now. It’s no wonder drugstores sell cigarettes and candy. They’re drugs. One produces a nicotine high, and one produces a sugar rush.

So while we’re talking about state and national policies, we also have to talk about personal responsibility. In fact, the conversation must start there, even if it’s a little uncomfortable, just as writing this column has been. (Most are.) As Arkansas Surgeon General Dr. Joe Thompson said recently as we discussed various forms of health care reform, “If we don’t get control over our obesity and of our hypertension and our tobacco use, it doesn’t matter how much money we’re spending. We’re going to sink the boat.”

Will a drugstore clearing its shelves of America’s most harmful drug keep that boat afloat? No, but it certainly can’t hurt. It made its choice based on free market principles. Let’s hope the market rewards it, and that others freely follow its lead.

The minimum wage: Make it about work, not fairness

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

Arkansans in November will vote on whether or not to raise the minimum wage incrementally from its current $6.25 an hour to $8.50 by the beginning of 2017. There is no organized opposition, the State Commerce of Commerce doesn’t have an opinion, and polls have shown it is likely to pass.

For perspective on this Arkansas-based issue, let’s check with a self-described “zillionaire” from Seattle.

Nick Hanauer earned his billions starting and helping start more than 30 companies and was an early investor in Amazon.com. He’s written a widely shared piece for Politico magazine, “The Pitchforks Are Coming … For Us Plutocrats.” A plutocrat is a powerful, wealthy person.

Hanauer says the shrinking middle class is bad for everyone. The top 1 percent earn about 20 percent of the nation’s income while the bottom half earn just 12 percent – a gap that is widening. He points out that capitalist societies don’t survive long without a healthy middle class – the economy’s real job creator. As the middle class shrinks, consumers have less money to spend at businesses owned by rich people. Eventually, he writes, the common people get restless, and then you have problems – historically, either a revolution or a police state. As Hanauer jokingly told radio host Tavis Smiley, the super-rich have the most to gain or lose “because we’re the ones that go to the guillotine.”

Hanauer’s only specific prescription in his piece is raising the minimum wage. In Seattle, the economy has boomed even as the minimum wage has increased to $15 an hour – which would be too high for Arkansas.

Arkansas is one of only four states whose minimum wage falls below the federal level of $7.25 per hour. According to the Bureau of Labor Statistics, in 2012 there were 50,000 employees here above the age of 16 earning at or below the federal minimum wage. That’s about 6.9 percent of all workers here who, if they work 40 hours a week and never take a vacation, earn $13,000 a year before taxes.

You might say that’s not fair. If you do, Hanauer would say you’re using the wrong language. He says supporters of raising the minimum wage should stop talking about fairness and instead focus on the economic benefits that occur when work pays. People who earn a livable wage have money to spend at local businesses and don’t require government assistance, as do many fast-food and other low-wage workers now. “The fundamental law of capitalism is, when workers have more money, businesses have more customers,” Hanauer told Smiley.

The same argument is being made – and should be made more aggressively – by supporters of the private option. That’s the state program that uses Medicaid dollars to buy private insurance for low-income Arkansans. It had enrolled 163,480 people as of July 31.

One of the arguments opponents make is that it’s an expansion of government, and they are right, in one way. But remember that the private option is a benefit for “low-income Arkansans,” not “no-income Arkansans.” Recipients are engaged in some form of employment that had made them ineligible for free government health care through Medicaid. They’ve made choices to try to be self-sufficient. If the private option is repealed, the practical result will be that they will get free health care anyway because they won’t be able to afford it on their own. Moreover, the message sent to recipients will be that they are better off not working and instead should depend on the government like some of the people they know.

The wealth gap must be addressed. Without a strong middle class, both democracy and capitalism are corrupted. There’s a reason why the Wall Streeters who nearly wrecked the economy were bailed out: They make the rules. And without a strong middle class, the economy enters a death spiral where not enough people spend not enough money to support not enough businesses, which then hire not enough people.

But how we talk about the wealth gap is as important as what is done about it. Please, no more political movements encouraging us to see ourselves as victims. Hanauer is right: As society debates issues like raising the minimum wage, the focus should be on self-sufficiency, not fairness. There are many things about which Americans can’t agree, including what’s “fair,” but most of us believe this: It’s better for people to earn a real paycheck than to accept a government handout.

Here’s Hanauer’s Politico article.

Here’s Hanauer’s interview with Tavis Smiley.

Kansas independent could shake up Senate

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

Note to subscribers: This is an updated version of this column that had been released earlier today.

The race between Sen. Mark Pryor and Rep. Tom Cotton is one of the two or three most important in the country because both political parties believe it will help determine control of the Senate. But another race could be even more important – the one in Kansas, where businessman Greg Orman, a member of no party, has a real chance to win.

Orman, an independent, had polled third in a four-man race in a recent Public Policy Polling survey, but with 23 percent support, he was not far behind Sen. Pat Roberts, the unpopular incumbent Republican. Roberts was leading with only 32 percent and had an approval rating lower than President Obama’s. That same poll revealed that, were this only a two-man race between Orman and Sen. Roberts, Orman would be leading, 43-33.

The four-man race is now a three-man race. The Democrat, Chad Taylor, who was second with 25 percent, dropped out Wednesday. The other candidate is Libertarian Randy Batson.

Taylor had little chance of winning in a state that hasn’t elected a Democrat to the Senate since the Great Depression. In fact, the best he could have done was split the anti-incumbent vote and elect the Republican, which would have been a huge irony. Typically the argument against voting for independents is that it’s a “wasted vote” – you know, you must vote for the major party candidate you dislike the least, or you’ll otherwise help the other major party’s candidate win. In this case, the Democrat would have been the spoiler. His party’s leadership obviously encouraged him to drop out.

Orman says he simply does not fit into either party. He was a College Republican in 1988, became a fan of independent Ross Perot in 1992, leaned Republican for a while, and then flirted with running against Roberts as a Democrat in the 2008 race. He says he voted for President Obama in 2008 and then Mitt Romney in 2012. In 2010, he founded the Common Sense Coalition, whose purpose has been to elect centrist candidates. “Historically, I’ve tried the Republican Party, I’ve tried the Democratic Party, and I’ve just finally decided that if we’re going to change things in Washington, we’ve got to attack the two-party system and stop supporting it,” he told MSNBC.

He describes himself as “fiscally conservative and socially tolerant,” which might not play well in Arkansas right now but apparently has some appeal in Kansas. The nationwide tension between the GOP’s various factions is boiling over in that state. On Wednesday, more than 70 moderate former Republican legislators announced they were supporting Orman, not their own party’s candidate.

Why am I writing about a Kansas race? Because of what might happen if Orman wins. There are already two independents in the Senate who align themselves with the Democrats. Orman says he will caucus with whichever party will adopt more of a solutions-oriented approach. If control of the Senate in this close election comes down to which party he chooses to align with, he then becomes a powerful swing vote. He could make demands. And that could get interesting.

Then what? There would be three independents out of 100 in the Senate. Maybe Orman’s model could create a template that other independent candidates could follow. Maybe a rich businessman in a state like Arkansas might decide to run as an independent, too. Maybe if there were six or seven independents in the Senate, they could form a “coalition of the uncorrupted” who side with either party or neither depending on the issue, forcing both to behave.

Of course I’m heading toward wishful thinking territory here. Eventually, that coalition would be corrupted, too. Also, two-party domination is almost inevitable the way our system is designed. The most likely good scenario is a shakeup that makes the system work a little better for a while. That’s what happened after 1992, when Perot won 19 percent of the vote basing his campaign on balancing the budget, and then congressional Republicans and President Clinton sort of balanced the budget.

Maybe it starts this time in Kansas.

Here is one of Orman’s ads.

A tale of two Pryor ads

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

One ad explains why Sen. Mark Pryor made the toughest vote of his career. In another ad, the Pryor campaign misrepresents his opponent’s position. The first ad features the candidate speaking directly into the camera and is effective. The second uses faceless narrators and is terrible. That’s not a coincidence.

Let’s start with the first ad. Pryor and his father, former Sen. David Pryor, describe Mark Pryor’s struggles with his insurance company when he was battling cancer. “No one should be fighting an insurance company while you’re fighting for your life,” Mark Pryor says in the ad. “That’s why I helped pass a law that prevents insurance companies from canceling your policy if you get sick or deny coverage for pre-existing conditions.”

That law was the Affordable Care Act, otherwise known as Obamacare. The ad has gotten some national attention because a Democratic senator in a tough re-election bid in a Republican-leaning state embraced his vote for Obamacare, even if he doesn’t actually use the name. Good for him for explaining his reasoning. That’s what campaigns are for – to give voters information so they can make decisions.

Then there’s the “Ebola” ad, which also has received national attention, but for a different reason.

You don’t hear much from Pryor in that ad, except for the legally required “I’m Mark Pryor, and I approved this message.” In that ad, not only one but two faceless narrators say Pryor’s opponent, Rep. Tom Cotton, “voted against preparing America for pandemics like Ebola. … Instead Cotton voted for tax cuts for billionaires funding his campaign rather than protecting our families.”

The vote to which the Pryor campaign is referring was to pass the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, which funded preparations for responding to a public health emergency such as a rapidly spreading disease. The bill passed 395-29 in the House on Jan. 22, 2013. As the ad correctly states, Cotton was the only Arkansas congressman to vote no.

How could Cotton vote against “protecting our families”? His spokesman, David Ray, said Cotton objected to a part of the bill enabling the federal Department of Health and Human Services to enact a mandatory deployment of public health workers, including those employed by states, during a major health crisis. Cotton believed the mandatory call-up was contrary to existing law and Supreme Court precedent. The bill did not pass as written. In March, Cotton voted for a similar bill that made the call-up of health workers a voluntary one. Pryor voted for the same bill, and that’s what funded the program.

So Cotton didn’t really vote “against preparing America for pandemics like Ebola.” He voted against an early version of a particular bill. Campaigns use votes like this to mislead voters about their opponents all the time, but this one is so over-the-top that Cotton’s campaign is now featuring it on its own website, while it’s not on Pryor’s.

On Wednesday, Pryor held a press conference defending the ad. He brought up Cotton’s votes against the farm bill and disaster aid and said this is part of a pattern where Cotton votes against appropriate government spending.

He made a better case talking in person than those two faceless narrators did reading a script on television.

In fact, the most effective campaign ads right now feature the candidates talking directly to voters. Those would be the Pryor cancer ad already mentioned, and Asa Hutchinson’s ad where he talks about his granddaughter inspiring him to support a law requiring high schools to offer a computer coding class.

Those ads work because they allow voters to see the candidates offering a positive vision, but what if candidates also spoke for themselves when they wanted to criticize their opponents? I’m betting their messages would be much more responsible and measured. In one earlier ad, Pryor himself had this to say, calmly, about Cotton regarding Medicare: “My opponent voted to withhold benefits until age 70, and I’m trying to stop that.” When candidates want to distinguish themselves from their opponents in a 30-second ad, that’s how they should do it.

Campaigns have decided it’s bad for their candidates to be seen criticizing their opponents in an ad. Actually, I would respect them more if they did it that way. My outlook is very Southern. If you can’t say something nice about someone, don’t say anything at all. But if you think something not nice needs to be said, say it yourself.

Here are the two ads.

The lieutenant governor: Change it, or get rid of it

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

For more than three years from 2003-06, your tax dollars were not spent very efficiently, and I was a beneficiary.

I was the communications director in the lieutenant governor’s office. My boss, Lt. Governor Win Rockefeller, was a very good man, but the lieutenant governorship, at least the way it is designed in Arkansas, is not a useful office.

Nothing occurs there that could not be done somewhere else. Under the Arkansas Constitution, the lieutenant governor presides over the Senate when it is in session (a ceremonial job) and serves as governor when the governor is out of state (an unnecessary responsibility in the 21st century). The other major duty, the one that really matters, is to serve as governor if the governor does not finish his or her term. Two of the past four lieutenant governors have been called upon to do that.

The office, when filled, consumes about $400,000 a year in order to employ state government’s backup quarterback and his or her staff. Currently, no one even occupies the office. With the resignation of former Lt. Governor Mark Darr, the doors have been locked and the lights off for months. As Sen. Keith Ingram, D-West Memphis, explained in an interview, “We’ve got an office that in all intents and purposes doesn’t exist right now, and there’s no clamor about some services that are not being met.”

Ingram and Sen. Jimmy Hickey, R-Texarkana, are proposing abolishing the office and making the attorney general next in line to be governor. This would require a constitutional amendment approved by the voters. Were it to pass, Arkansas would join five other states that don’t have a lieutenant governor.

The proposal has been far from universally embraced. There’s a natural resistance to changing the Constitution, which is a good thing. Plus, some legislators might want to be lieutenant governor someday and are reluctant to vote to get rid of the office. It’s hard to cut the backup quarterback when you hope to be one someday.

There’s some concern about making the attorney general next in line, which no state currently does, because doing so limits that opportunity to lawyers only.

But it not the attorney general, then who? The next highest statewide position after attorney general is the secretary of state, a job that deals primarily with running elections and maintaining the Capitol – not really governor-type duties. Still, that position ascends to governor in three states that have no lieutenant governor – Arizona, Oregon and Wyoming. In New Jersey, the lieutenant governor and the secretary of state are the same officeholder. Legislators deal with many of the same issues as the governor, so the speaker of the House or the Senate president pro tempore would make sense. The objection is that neither are elected by voters statewide, but that hasn’t stopped Maine, New Hampshire, Tennessee and West Virginia from making the leader of the Senate their next in line. In fact, Tennessee and West Virginia give their Senate leaders the title of “lieutenant governor.”

We could just make the lieutenant governor a real job. At one time, Arkansas’ lieutenant governor exercised real power in the Senate by appointing committees and committee chairs. There’s no way legislators are giving up those powers now, but perhaps the lieutenant governor could be made the head of a state agency or a member of some important commissions.

Or, the governor and the lieutenant governor could be yoked together on one ticket, like the president and the vice president are, instead of running separately as occurs now. That way the governor and lieutenant governor could be a team, maybe even share staff. That would be the opposite of what the state had before Darr resigned: a Democratic governor and a Republican lieutenant governor who couldn’t work together and didn’t even like each other.

Changing anything in government is hard, particularly when there’s no deadline forcing it to happen. We don’t have a crisis. We have an office that doesn’t do much when it has an occupant and currently doesn’t even have that. Ideally, Arkansas could either make it useful or just get rid of it.

Or we could just leave things as they are. It’s only $400,000 a year. Of your money.

Here’s a KARK-TV report about this subject.

Spreading wealth and breaking down barriers

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

For several years, I published a newsletter, “The Vanguard,” for Arkansas Baptist College, a historically black college in Little Rock. The newsletter dated back a century, and I assume I was its first editor who was white. It was an honor.

The school was in the midst of a resurgence under its visionary president, Dr. Fitz Hill. It’s now facing some challenges, but this column is not about that. I attended many events there, often as the only white person in the room, or one of the few. When it came time to publish, I would email a rough draft to my contact hoping she would like it, and when she called to sweetly make corrections, I would be disappointed in myself if I made many errors. She was the one writing the check, and I wanted to please her.

The nation needs more minority business owners. It spreads the wealth the way wealth is best spread. It breaks down barriers, creates respect, and makes everybody better. It made me better. When two people are doing business together – one performing a needed service, the other providing a needed paycheck – then it’s a lot easier to get past all the terrible things that have happened the past 400 years.

According to the U.S. Census Bureau’s 2007 Survey of Business Owners, of the nation’s 27 million businesses then, 1.9 million were owned by African Americans. That’s about 7 percent in a country where 13.2 percent of the population is “black or African-American alone,” according to the Census Bureau. The 1.9 million companies employed less than 910,000 people, so most had no paid employees. But those 910,000 people had jobs because of an African American business owner.

At one time, Little Rock was home to many minority-owned businesses – 102 on West Ninth Street in 1959, according to the Mosaic Templars Center, a neat museum in the capital city. But that would soon change. Integration put those businesses in competition with larger and more resourced businesses owned by white people. (The same dynamic occurred with colleges like ABC.) The construction of Interstate 630 cut through the business district, pretty much destroying it. Today, what’s left of West Ninth Street is in decay.

Traditionally, many small businesses owned by African Americans have served mostly African American people – funeral homes, hair stylists, etc. While that’s not necessarily a bad thing in itself, it is bad if it stops at that. According to the Pew Research Center, median incomes for African Americans in 2013 were 59.2 percent of whites, and the wealth gap between members of those two races was growing. One way to address that is to circulate dollars throughout the entire American community. The best way to make that happen is for more African Americans to own the means of production.

When I told my wife I was thinking about writing this column, she asked, “So what’s your solution?” Unfortunately, I don’t have a good one. I’m not sure if any more laws need to be passed. I think affirmative action in government contracts and scholarships is helpful, though it should be based on class and background, not race.

Undoubtedly, progress is being made in race relations, which should increase opportunities for African American business owners. Regardless of what you think about President Obama, his election was a ceiling-breaking event unimaginable not long ago. Young people are not color blind, but they are color blurry, which is good, because they’ll have to be. While the Census Bureau considered only 2.4 percent of us to be “two or more races” in 2013, that number will grow in the coming years. In 2010, 10 percent of opposite sex married couple households were interracial or interethnic – an increase from 7 percent in 2000. A 2013 Gallup poll found 87 percent of Americans approved of marriages between white and black people. In 1958, just 4 percent did.

Please keep all this in mind as we watch the unfolding events in Ferguson, Missouri. Certainly a scab has been ripped off an old wound there. I’m not sure what to think about all of it, except this: An officer shooting an unarmed man is bad, and rioting is also bad.

But honest commerce – that’s really good. Many things must still happen on this long march to justice. One is more diverse people doing business with each other. After all – and I usually hate this expression – but in business, the only color that matters is green.

Arkansas’ other health care reform

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

Let’s play a word association game. I write “health care reform.” What comes to mind?

Probably “Obamacare,” and probably, if you live in Arkansas, not in a positive light. You might next think, “private option,” the state program that uses federal dollars under Obamacare to buy private insurance for lower-income Arkansans.

Meanwhile, there’s another important health care reform effort underway. While Obamacare and the private option are mostly about expanding health coverage, the Arkansas Payment Improvement Initiative is meant to address the biggest problems with the health care system today – costs and incentives.

The United States spends 18 percent of its gross domestic product on health care, far more than the rest of the industrialized world, and gets no better overall results. Too much of the care provided really doesn’t help the patients. These high costs and inefficient process occur largely because the system is based on what policymakers call “perverse incentives.” Medical providers are paid by the procedure, not the outcome – not for making us well and certainly not for keeping us from ever getting sick.

They don’t try to make us sick, of course, but the system’s incentives do influence their focus – how much effort they expend on preventive care, for example. As CHI – St. Vincent CEO Peter Banko told me, “Until you change how we’re being paid, you’re not going to see changes in the system.”

So Arkansas is changing the way they’re being paid.

As part of the Arkansas Payment Improvement Initiative, state agencies, insurance providers Blue Cross and Qualchoice, the Arkansas Hospital Association, and the Arkansas Medical Society collaborated to try to determine appropriate practices and acceptable ranges of costs for various “episodes of care.” They started with five situations: pregnancies; total hip/knee replacements; outpatient upper respiratory infections; congestive heart failures; and attention hyperactivity disorder.

For each of those episodes, a principal accountable provider now serves as the “quarterback,” meaning he or she is the main decision-maker responsible for coordinating all providers who are delivering care. That’s unlike a typical health care episode, where no one is in charge and patients are just handed off from provider to provider – each of whom runs their own tests for which they charge insurance companies and taxpayers. For hip and knee replacements, the quarterback is the orthopedic surgeon, who is responsible not only for the procedure but also for the 30 days prior and the 90 days afterwards.

After 12 months, the quarterbacks’ total insurance and Medicaid claims are totaled. Those whose costs are below “commendable” levels receive a bonus payment, and those whose costs are above “acceptable” levels pay back part of the excess cost.

Early results are promising. According to the Arkansas Center for Health Improvement, providers are performing more preventive tests for diabetes, HIV and other conditions in pregnant women. That makes sense, because they’ll be penalized if they don’t catch these health issues and costs rise later. Unnecessary antibiotic prescriptions for unspecified upper respiratory infections have dropped 19 percent. That’s important because antibiotics have no effect on, say, a cold virus, but the overuse of them leads to harmful effects, such as creating drug-resistant bacteria.

Again, incentives are the key. As Arkansas Surgeon General Dr. Joe Thompson, a pediatrician, explained, “It was easier for me to write the prescription for the mom whose kid had a cold than it was for me to spend the 10 minutes telling her why she really didn’t need the antibiotic.” Now that doctors face a financial penalty for prescribing a useless drug, they’re more likely to give that explanation.

One obvious concern is that providers will cut corners in order to shave costs, but that’s not been the intent. Providers still have plenty of incentives to provide effective care, including of course, their desire to serve patients. Keep in mind that more care is not necessarily better care and can be much worse for the patient. CHI – St. Vincent is participating in a similar pilot program through Medicare where the hospital and doctors are paid a set amount for joint replacement procedures and must control costs to make a profit. The result? Hospital readmissions have been reduced by two-thirds.

I asked Banko why the hospital and doctors didn’t make those changes beforehand. He replied, very forthrightly, “There was no financial incentive to.”

Who knows if all this is going to work, but it seems promising. What America needs isn’t more health care – but better and more affordable care. That will only happen when the incentives change.

Impeach us all

By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

Impeaching the president would be bad for the country in many ways. It should not happen, and it will not happen.

But we columnists like to use this kind of thing to make a point, so here goes.

If the U.S. House of Representatives somehow were to vote for impeachment, there would be no point in asking whether or not the Senate would remove the president from office. Conviction requires a two-thirds vote in that chamber, and no Democrat there would vote for that.

Instead, a better question would be, if we’re going to start stripping constitutional duties, why stop with the president? Maybe we all should be replaced.

The president has failed to provide leadership on the most important long-term issue facing the federal government, one that will really matter long after the Benghazi and IRS scandals are long forgotten. The national debt was $17.68 trillion on Aug. 11 – more than $5 billion more than it was the day before and more than $11 trillion more than it was in 2000. The $500 billion that will be added to the national debt this year will be the best fiscal year the nation has had since President Obama took office. The debt is now equal to about $56,000 for every American man, woman and child. It’s still rising, and it will continue to rise unless something in Washington changes.

The country must have a serious conversation about its wants, needs and expectations, because it’s clearly living beyond its means. The president started that conversation by appointing the bipartisan National Commission on Fiscal Responsibility and Reform in 2010 to make recommendations for addressing the problem. At the time, he seemed interested in the subject. But no one in the White House is talking about fiscal responsibility and reform now.

The president sets the tone, but Article 1 of the Constitution gives Congress the responsibility for taxing, spending, and paying off debts. Clearly, Congress has been failing to fulfill those responsibilities for a long time. For the past few years, it has lurched from fiscal crisis to fiscal crisis, jeopardizing the full faith and credit of the United States and blunting the country’s economic recovery. Like a college freshman who parties all semester and then crams during finals week, it rarely acts anymore without an absolute deadline.

And yet despite the fact that, according to Gallup, only 13 percent of Americans approve of the job Congress is doing, being a member is a secure job. According to the Center for Responsive Politics, 90 percent of House incumbents and 91 percent of Senate incumbents running for re-election were sent back to Washington in 2012. Voters did not care that, during the fiscal year leading up to that election, the federal government had spent almost $1.3 trillion more than it had collected. In fact, they rewarded that behavior.

Ultimately, the White House and Congress reflect the will of the people, and the will of the people is to borrow and spend. Polls have made it clear that Americans are at least aware that the national debt is a problem, but they also oppose meaningfully cutting spending or raising taxes. In a survey last year by the Pew Research Center, respondents were presented 19 areas where spending could be cut. None were favored by a majority. Members of Congress and the president know this.

The Constitution reserves impeachment for “treason, bribery, and other high crimes and misdemeanors.” Americans today – the president, the Congress, and the voters – together have made the decision to steal trillions of dollars from our children and grandchildren. Stealing is a crime – in this case, a high crime. We’re committing treason against the future country they will inherit.

So maybe it’s time to stop talking about impeaching just a particular president and start talking about impeaching us all. We voters have proven unable or unwilling to perform our duties, and so perhaps those duties should be stripped from us and entrusted to the next in line – every American currently under 18. Put kids in the White House and in Congress. If we won’t make their future a priority, maybe they will.

I’m kidding, I guess. But at least my 12-year-old and nine-year-old know that stealing is wrong.