Repeal, and then what?

By Steve Brawner

© 2017 by Steve Brawner Communications, Inc.

The Senate health care bill is dead. Senate Majority Leader Mitch McConnell killed it Monday after it did what President Obama couldn’t do – make Obamacare more popular – and after too many Republican senators said they’d vote against it and none expressed enthusiasm for it.

The unenthusiastic included Arkansas Sens. Tom Cotton and John Boozman, who both remained noncommittal even though Cotton was one of 13 Republican senators who wrote the bill behind closed doors.

McConnell’s new plan is to repeal Obamacare now, but it wouldn’t take effect for two years while Congress creates a replacement. In response, Cotton told conservative radio host Hugh Hewitt Tuesday that he was “pleased” with that direction. He said Congress already voted to repeal Obamacare in 2015, a move supported by all six members of Arkansas’ congressional delegation.

Of course, in 2015 everyone knew President Obama would veto the bill. This vote would actually count because President Trump would sign it.

Cotton seems to think this could happen and seems to support it, even though he told “Meet the Press” in January that any repeal vote should include a path forward and that “kicking the can down the road a year or two years is not going to make it any easier to solve.” He told Hewitt that senators who voted once to repeal Obamacare would have no choice politically but to do so again. Boozman also is on board with the idea.

Let’s hope they don’t get that chance.

Here’s the thing about businesses, including health care-related ones such as insurance companies and hospitals: Like a tree growing on the side of a cliff, they can thrive in difficult environments as long as they know the rules. They can make a profit even when taxes are too high, regulations are too onerous, and government is too big.

But it’s much harder to thrive amidst the shifting sands of uncertainty. In that environment, free market providers can’t make business decisions, so they play it safe and wait to see what happens next. If the Affordable Care Act (Obamacare) were repealed with only a vague promise from politicians of something coming later, the entire system would be thrown into disarray, leading insurers to leave markets and making health care more expensive and less available.

Besides, working off a deadline is not exactly Congress’ strong suit these days. Time and again, it’s funded the government through continuing resolutions – spending what it did last year, plus some, because it didn’t have time to do a real budget. It’s repeatedly extended the debt ceiling at the last minute, and it’s delayed important legislation because it couldn’t get its act together. One example: After the No Child Left Behind education law expired in 2007, Congress didn’t do anything about it until 2015, when it finally replaced it.

We can’t have years of limbo with health care, because people will die. If Republicans don’t have an answer seven years after Obamacare was passed, they won’t have one in two more. It’s not hard to foresee an inconclusive election in 2018, and then the two-year deadline passes with no consensus, so there’s a new deadline, and then another.

Since “repeal and replace” is dead and “repeal, then replace” is a terrible idea, what’s left? There’s “return” – just go back to the old system, where insurance companies denied coverage based on pre-existing conditions, set lifetime limits, and cut people off based on technicalities. In other words, sell you insurance as long as you don’t need it. Want to go back?

Instead of repeal, replace or return, there’s a fourth “R” – reform. Change current law  incrementally, and then change it again as needed. This would require a bipartisan approach, along with listening to health care providers and other stakeholders, which did not happen this time. It would anger some supporters and media blowhards, and it would mean accepting that you can’t get everything you want in a democracy. But the health care system would be better.

There is another option, offered by President Trump: Let Obamacare “fail,” and then create a new system.

Presumably, he still could get the health care he needs after the system “fails” and policymakers try to figure out how to pick up the pieces.

The rest of us shouldn’t have to live with such uncertainty. Let’s go with the fourth “R.”

Steve Brawner is an independent journalist in Arkansas. Email him at brawnersteve@mac.com. Follow him on Twitter at @stevebrawner.

Here’s what the world owes: $217 trillion

By Steve Brawner

© 2017 by Steve Brawner Communications, Inc.

If the $20 trillion national debt concerns you, what about $217 trillion?

That’s how much public and private debt now exists worldwide, says the Institute of International Finance, a worldwide financial industry association. That’s the equivalent of more than $29,000 for every human – and this despite 71 percent of Earth’s population living on $10 or less per day, according to the Pew Research Center.

The $217 trillion is a record, with the increase over last year driven by developing nations, including China, where the IIF says total debt now equals $33 trillion. Advanced economies actually reduced their debt in the past year by $2 trillion, but developing countries increased theirs by $3 trillion. Continue reading →

Drones, health care and the Constitution

By Steve Brawner

© 2017 by Steve Brawner Communications, Inc.

What do the emerging aerial drone industry and the health care system have in common? They both would benefit from a section of the Constitution that’s largely been ignored in recent years.

That would be the 10th Amendment, which says, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people.”

The political science term for this is “federalism.”

I’m bringing this up after reading that Arkansas’ Sen. Tom Cotton and three other senators – two of them Democrats – have introduced a bill that would let states and communities govern aerial drones flying under 200 feet of airspace.

In a co-written column in the Washington Times, Cotton and Sen. Mike Lee, R-Utah, said the nation’s drone industry has been stuck in a hover as it awaits regulations from the slow-moving Federal Aviation Administration. Meanwhile, Chinese manufacturers are beginning to dominate the developing market. Cotton and Lee argued that since it will take forever for the federal government to act, states and communities should be given control. A drone flying less than 200 feet over someone’s farm is a local issue, not a national one.

They’re right. Drones will be a growing part of our lives in the coming years. States and communities will have different uses and different levels of comfort with a technology that is both beneficial and invasive, so local solutions are preferable to a one-size-fits-all approach dictated by Washington.

Cotton also had a hand in a bigger piece of legislation, the Senate health care reform bill. He was one of 13 senators who crafted it behind closed doors but still hasn’t said if he supports the final product.

That’s because the bill is a mess and will never pass. After seven years of demanding Obamacare be repealed, Republicans are being forced to admit they never had a plan to replace it or fix its problems – and no, we can’t go back to the “old system,” either.

Health care is hard. Public policies result in allocating resources, but with health care, what do we want to limit, and for whom? Do we want more government involvement, which means more government control, or do we want health care decisions to be driven by the profit motive? Should health care be refused to people who refuse to work, or should they be treated in emergency rooms, or just given health care for free? As President Trump said earlier this year, “Nobody knew that health care could be so complicated.”

Thankfully, the United States has a valuable feature: its united states. The Senate health care bill does give states some flexibility – just as the Affordable Care Act that created Obamacare did – but maybe this is one issue requiring truly massive experimentation in 50 separate laboratories. Recently, California legislators seriously considered a statewide single payer system where the state government would pay everyone’s health care bills. They couldn’t make the numbers add up, but it’s good that we live in a country where widely varying alternatives can be considered – alternatives such as Arkansas Works, where the government buys insurance for poor people. Through experimentation, maybe an affordable health care system will arise that reflects American values but doesn’t cost 18 percent of the gross domestic product. We must try something, because what we’ve been doing the past few decades isn’t sustainable.

It’s not just drones and health care where a re-emphasis on federalism would be good for the country. As the United States has become more polarized, congressional gridlock is no longer a temporary problem but a permanent reality, meaning long-term problems can’t be solved or often seriously debated. The situation is leaving too much power in the hands of the one official who can act unilaterally, the president, and in the federal bureaucracy. In America, we’re supposed to address issues through deliberative legislative consensus. And that process still happens in state governments.

America’s diversity is one of its strengths. Let states like Arkansas and California try to address more problems on their own, learn from each other, offer lessons for the federal government, and in the end, still be a little different.

It’s OK. We don’t all have to be exactly the same. It’s in the Constitution, after all – about a third of the way through the amendments.

Psst: We’re winning

By Steve Brawner

© 2017 by Steve Brawner Communications, Inc.

Amidst the unsettling news coming from North Korea and the hysteria over whatever is President Trump’s latest tweet, you may not have noticed this tidbit: In the fight against ISIS, the good guys are winning.

The Islamic State, as we all know, is the group attempting to establish a caliphate in Iraq and Syria using shockingly barbaric tactics. For a while, ISIS was dominating the news. Lately, it has reappeared in the public consciousness through periodic acts of terror, including three London attacks in the past few months.

Those kinds of events make the front-page headlines, as well as they should. But the bigger picture is this: Iraqi forces supported by Americans and allied forces have all but defeated the Islamic State in Mosul, its last remaining stronghold in that country. As of this writing, a few hundred ISIS fighters control only a small part of the city, and the jihadists were reduced in recent days to dispatching women as suicide bombers. Meanwhile, in Syria, Kurdish-led forces – also supported by Americans and other allies – have surrounded ISIS in its self-proclaimed capital of Raqqa.

ISIS – along with the belief system it tries to spread – remains a threat, and it may be impossible ever to declare victory over it because it will reappear in other forms. Still, the momentum is clearly moving in a positive direction. It controls very little land now, numerous leaders have been killed, and the tone of its propaganda has shifted from arrogance to desperation. Remember Mohammed Emzawi, the black-clad British citizen who coldly beheaded his captives while taunting the West in online videos? He met his Maker in November 2015 thanks to American and British drone strikes.

Given this latest news, Americans should at least acknowledge the success that’s occurring through efforts undertaken under both Republican and Democratic presidents. While the end of World War II was marked by jubilation, there also were moments of nationwide encouragement during the war, such as the raising of the flag at Iwo Jima. These days, good news doesn’t enter the public conversation, and when ISIS is finally squashed, it seems likely we’ll have already moved on to the next crisis, real or imagined. The poet Carl Sandburg once wrote, “Sometime they’ll give a war and nobody will come.” These days, it might be said, “Sometime they’ll win a war and nobody will notice.”

It’s not just the war against ISIS. It seems rarer and rarer for Americans these days to acknowledge anything positive happening anywhere. This obliviousness to good news ignores the facts and insults those who have sacrificed themselves for noble causes. Worse, by creating an unhealthy contempt for our democratic institutions, it threatens our way of life more than ISIS ever has.

A free society depends on truth, and the truth is that some of the news these days is encouraging. Just a few examples: In late 2015, the World Bank forecasted that less than 10 percent of people worldwide were living in extreme poverty, defined as subsisting on less than $1.90 a day. In the past few decades, hundreds of millions of people have escaped destitution. Meanwhile, technological advances and cleaner fuels have allowed the United States to approach energy independence after decades of relying on undemocratic, untrustworthy countries. Nationwide, the overall violent crime rate has dropped significantly, from 747 cases per 100,000 individuals in 1993 to 373 in 2015, according to FBI statistics reported by the Pew Research Center. Violent crimes, particularly murders, increased from 2014 to 2015, but the rate is still lower than it was. Property crimes are down long-term, too. Meanwhile, the unemployment rate in Arkansas is at a historically low 3.4 percent. Granted, those numbers do not take into account people who have left the workforce. Still, the economy is certainly better than it was during the Great Recession.

The comedian Louis C.K. put it this way in a 2008 interview with Conan O’Brien while talking about the technological wonders of modern life: “Everything is amazing right now, and nobody’s happy.”

In the bigger picture, maybe everything’s not amazing, but it’s better than terrible.

Anyway, it could be much worse. We could be a civilian in Mosul or Raqqa. Or we could be a member of ISIS, surrounded or perhaps having already met our Maker.

 

State’s top Democrat: Stop ‘screaming about Trump’

Rep. Michael John Gray, D-Augusta, says Arkansas Democrats must focus on core issues such as health care, poverty and roads.

By Steve Brawner
© 2017 by Steve Brawner Communications, Inc.

Michael John Gray can trace his family’s farming heritage in Woodruff County to the year after the Civil War ended. This being Arkansas, it’s a fair assumption that all those generations before him were Democrats. But then, the rest of the state back then was, too.

Gray, D-Augusta, finds himself part of a vanishing breed in the Legislature – rural, white Democrats, which describes somewhere between eight and a dozen of the 135 legislators, depending on how you define “rural.” It wasn’t long ago that it described virtually the entire Legislature, but now Democrats mostly represent the state’s urban areas and those with high minority populations. Overall, Democrats compose only 24 of the 100 members in the House of Representatives and only nine of the 35 senators.

Gray is trying to reverse his party’s fortune as its newly elected state chairman, but he said it’s challenging when the national party is focusing on the wrong things: special elections and “the absurdity of the presidency.” Since President Trump’s election, Democrats nationally have lost four special elections, all in traditionally Republican districts. Democrats poured $25 million into the campaign of Jon Ossof, who was trying to swipe a Republican seat in a Georgia district that almost voted for Hillary Clinton last year. It was the most expensive House election in American history. In the end, Ossof did worse than she had done.

Gray said Democrats created unreasonable expectations in districts they traditionally have lost. The story could have been how they almost beat the Republicans on their home fields. Instead, it was that the Democrats lost again.

“Drop $30 million in Arkansas, and I have a fair shot at changing the face of the Legislature,” he said.

If Democrats are to change their party’s recent trajectory, they’ll have to learn lessons from places like Gray’s district, which voted for President Obama in 2012 and for the Democrats’ Senate candidate, Conner Eldridge, in 2016. But it also voted for Trump rather than Clinton.

Gray said the presidential election showed there’s a disconnect between working class Americans and the party’s base. Meanwhile, he said Democrats are “screaming about Trump” when they should be talking about crumbling roads, children going to bed hungry, and senior citizens who “have to choose between eating pet food or paying their light bill.”

And of course, there’s health care, which national Republicans are struggling mightily to change with a bill polls show is unpopular. In Arkansas, Democratic Gov. Mike Beebe’s administration implemented the private option, the program now called Arkansas Works that provides health insurance for 300,000 Arkansans. It happened in part thanks to young, creative Republican legislators. But Gray said it was made possible by Obamacare, a fact Democrats haven’t communicated well.

Those kinds of issues are important, and Arkansas Democrats like Gray are comfortable talking about them. First, however, they have to get people to listen, which can be difficult when hot-button social issues grab so much attention. Recently, Democratic National Committee Chairman Tom Perez said being pro-choice on abortion is “not negotiable,” a hardline position that brought objections from even liberal leaders including Rep. Nancy Pelosi and Sen. Bernie Sanders.

Gray disagrees, too, saying abortion should not be a litmus test. Meanwhile, he said Democrats should argue their policies will lead to fewer abortions by helping the poor and increasing access to birth control, rather than the Legislature passing abortion limitations that later are ruled unconstitutional.

Meanwhile, things happen like the guy knocking down the Ten Commandments monument at the Capitol. Gray said he “immediately cringed” when he heard the news – first, because it’s a terrible act, and second because he knew some would blame the actions of the disturbed driver on “the intolerant left.”

“We’ve got to find a way to quit feeding that story a little bit,” he said.

Can Democrats change minds, or at least move the conversation away from the issues that hurt them in a religiously conservative state to the issues that might resonate in a poor one? Gray said it won’t be easy and it will take time. But clearly, screaming about President Trump isn’t working.

“Nothing that’s been good has been built by tearing something else down,” he said. “It has been from building on what you have, and I think that’s what we’ve got to refocus on a little bit.”