Health care and the 10 Commandments: Two monumental stories

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

Sometimes news stories are important, and sometimes they are mostly just eye-catching. It’s important for news providers to offer both if they want to stay in business. It’s important for news consumers to understand which is which, and when a story is both, and why.

This week was a good illustration.

On Tuesday, something important but not particularly eye-catching happened. Senate Majority Leader Mitch McConnell (see, I’ve bored you already) announced that the Senate health care bill doesn’t have enough support to come to the floor, so he’s delaying action.

Health care is perhaps the country’s most vexing domestic issue. The system has been on an unsustainable path for decades. What Congress decides to do about it is literally a life and death matter.

But Americans know politicians will argue and posture about this issue forever, and it’s been pretty clear for a while Republicans aren’t ready to repeal Obamacare, much less replace it. So I’m doubting McConnell’s decision was the lead topic of conversation at dinner tables and baseball fields across Arkansas.

Wednesday’s top story, on the other hand, was definitely eye-catching. The day after workers installed a controversial 10 Commandments monument at the Capitol, a mentally disturbed individual knocked it over with his Dodge Dart, leaving it broken on the ground.

That’s a heck of a visual, and it followed a long process that involved passing the legislation authorizing the monument, a commission determining its placement, hearings where satanists argued for their own statue of a goat creature named Baphomet, and a pledge by the Arkansas chapter of the American Civil Liberties Union that they would sue to take it down. After all that, it stood for less than a day.

I didn’t monitor every conversation at dinner tables and baseball fields across Arkansas, but I suspect more people were talking about this than were talking about Mitch McConnell.

But was it important?

Not as a statement in the country’s never-ending culture war, on either side. The driver is not an agent of supposed liberal intolerance, nor is this the fault of the monument’s outspoken opponents. On the other hand, he is not a hero for religious liberty or a defender of separating church and state. He instead is a seriously disturbed individual with a history of mental disorders who allegedly committed the same crime against a 10 Commandments monument in Oklahoma. A guy who has heard voices in his head telling him that he will be abducted by a UFO is not on either team.

But this part is important: We are a nation of laws.

Hours after the monument was destroyed, the sponsor of the legislation creating it, Sen. Jason Rapert, R-Conway, told reporters that the private organization that funded it, the American History & Heritage Foundation, had already ordered a replacement, possibly with some protective barriers. Money is being raised, and it’s possible the driver’s insurance will help cover the cost, he said.

That’s good news. Regardless of what you think about the 10 Commandments monument, we should all agree its fate shouldn’t be based on the whims of a disturbed individual. The proper way of deciding its future is through the courts, which will determine if it’s an appropriate historical marker or an unconstitutional government establishment of religion.

There’s also this. We live in a world where mentally ill people have easy access to very dangerous things such as assault weapons and 6,000-pound vehicles. That combination can do a lot of damage before authorities or bystanders can act.

We must prevent these people from doing great harm to themselves and others. Public policies must balance the rights of mentally imbalanced individuals with the need for society to protect itself. Meanwhile, the health care system must be part of the solution. It must provide better mental health services.

However, as we all know, it’s hard to change the health care system. Did you see where Mitch McConnell delayed a vote on the Senate health care bill? That was really important.

History and health care

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

History repeats itself, and, as we’re seeing with health care, that includes recent history.

In 1993, newly elected President Bill Clinton put the first lady in charge of fixing health care, and the next year the Republicans took over the House and Senate and gained 10 governorships. In 2009-10, newly elected President Obama and the Democrats passed the Affordable Care Act, and then Republicans gained control of government in Arkansas and virtually everywhere else except cities and the big blue states.

Now, newly elected President Trump and Republicans in Congress are trying to pass a health care bill – without any support from Democrats, who are salivating at the prospect of that issue sinking Republicans the way it previously sank them.

The latest Senate effort to repeal and replace Obamacare is called the Better Care Reconciliation Act, but you’d better believe that Democrats are calling it Trumpcare. That effort got some bad news Monday when the Congressional Budget Office said its passage would lead to an increase of 22 million uninsured Americans by 2026. That’s about the same as the American Health Care Act earlier passed by the House – the one that only 16 percent of Americans called a good idea in a recent NBC News/Wall Street Journal poll.

Because Democrats are an automatic no, the Senate version cannot survive if more than two Republicans vote against it. Things can change quickly in politics, but as of this writing more than two are expressing serious misgivings. Even Arkansas’ Sen. Tom Cotton, one of 13 senators who helped draft the bill in secret, hasn’t said if he’s definitely for it, and neither has Sen. John Boozman, though it’s hard to see either bucking the party in the end. If it does pass the Senate, it still has to be reconciled with the House version.

Just looking at the politics, you might wonder why elected officials don’t just ignore the issue. Unfortunately, health care is too big to do that. It’s 18 percent of the economy and growing faster than inflation. Premiums are rising, and insurers are pulling out of markets. Costs have risen so much for so long that policymakers vaguely pledge to “bend the cost curve” because it’s too much of a reach to say “spend less.”

In other words, health care is so big that elected officials must at least pretend to try to solve it, and when they do, they’re probably going to get punished for it. That’s because they cannot provide what voters expect – unlimited care for everyone with no bad outcomes at a negligible price and with no effort on our parts beyond taking a pill, which had better go down easy. Americans expect health care to be cheap if not free, but they don’t want the government to run it, and they don’t particularly like the insurance companies, either. You know the old saying, “Everybody wants to go to heaven, but nobody wants to die”? It’s just as accurate to say, “Everybody wants great health care, but nobody wants to pay for it.”

Meanwhile, the problem of exploding costs could be lessened if Americans simply made healthier choices. A recent Arkansas Center for Health Improvement study of 69,000 state and school employees found insurance plans spent far less in 2015 when employees were not obese or exercised regularly. In fact, the plans spent almost twice as much for employees who said they exercised fewer than 20 minutes per week – $6,043 each – as those who exercised moderately three times a week or vigorously once a week. Those employees cost their health plans only $3,345.

Health care won’t be “fixed” by any bill hatched in secret at the U.S. Capitol – not by Republicans, and not by Democrats. But one potential bright spot in the House and Senate bills is that they offer more flexibility to the states, which offer 50 laboratories to experiment with partial solutions. One such experiment, begun in 2013 and now called Arkansas Works, uses taxpayer dollars to buy insurance for poor people rather than enrolling them in a government program. It insures 300,000 people – more than were expected, so now Governor Asa Hutchinson is seeking to modify the program by adding a work requirement and lowering the income eligibility threshold.

Experiments like Arkansas Works should be encouraged. Good or bad, someday they will be the history others can learn from.

Extra cash for highways?

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

Arkansas does not have Tennessee’s Great Smoky Mountains, but it does have the Ozarks and the Ouachitas. It does not have Elvis’ Graceland home, but it does have the birthplace of Johnny Cash. Unlike Tennessee, it does not have $2 billion to play with, but, like Tennessee, could it also find hundreds of millions of dollars for highways?

The question is asked after the Arkansas Highway Commission voted June 7 to pursue a ballot initiative for 2018 to raise up to $400 million a year for road construction.

That was step one of about a thousand. Forgive this run-on sentence, but the Commission and supporters such as the Arkansas Good Roads Foundation would have to decide on a specific proposal, obtain the attorney general’s approval, raise money to collect 67,887 voter signatures, raise money to defend against the inevitable last-minute legal challenge, raise money for the campaign, and then win the campaign.

The Highway Commission took this step because it’s tired of waiting on the Legislature and Gov. Asa Hutchinson, who have talked some about highways but not made them a priority. Funding for highways has been mostly flat for decades as spending for other state needs has increased significantly. Arkansas voters did approve an interstate bond issue in 2011 and passed a temporary half-cent sales tax in 2012, and last year Hutchinson cobbled together $50 million in state funds to make the state eligible for $200 million in federal ones. But the Highway Commission and the state Department of Transportation say that’s not enough.

One reason for the shortfall is the primary highway funding mechanism, the motor fuels tax, has not increased at the state level since 2001 and at the federal level since 1993. While motorists are paying the same 39.9 cents per gallon that they were in 2001, road construction costs have increased. Meanwhile, cars have become more fuel efficient, which means we’re buying fewer gallons and therefore paying less in taxes.

The easiest way to increase highway funding is to raise fuel taxes, or at least index them to inflation, but polls have shown Arkansans oppose much of an increase, and those polls are backed up by what legislators hear personally from their constituents. Aware of public opinion, legislators said no this year to a proposal that would have asked voters to approve a wholesale sales tax increase on fuel. Meanwhile, efforts in previous years to direct various auto-related revenues to highways, such as sales taxes on car purchases, failed because of opposition from other interests who depend on those revenues.

Would voters be OK with higher fuel taxes if they received a tax cut elsewhere? That’s what happened this year in Tennessee, where the Legislature and Gov. Bill Haslam raised $350 million for highways primarily through a six-cent gasoline tax increase and a 10-cent diesel tax increase. At the same time, $410 million in other taxes were cut, including that state’s food tax by 20 percent.

The combination means Tennesseans will pay less in taxes while spending more on roads. Also, Arkansans will help pay for those roads when they drive in Tennessee and stop for gas.

Could Arkansas do the same? Unfortunately, not so easily. Tennessee has nearly $2 billion in surplus funds this year, while Arkansas had to cut its budget to bring it into balance. Meanwhile, Arkansas would need much higher taxes. To raise $400 million here, fuel taxes would have to increase 28.4 cents a gallon.

So unlike Tennessee, Arkansas probably could spend significantly more on highways only through increasing total taxes or cutting spending elsewhere, or a combination thereof. That’s politically very challenging, which is why elected officials haven’t done it. A legislative task force is combing through the tax code trying to make it simpler, potentially creating room for tax cuts by ending some deductions. In the process, it might find more money for highways. But its recommendations won’t be considered by the full Legislature until 2019, and there’s no guarantee any will become law.

About half the states have increased fuel taxes in the past five years, including five this year. States know they can’t wait for money for Uncle Sam, who has his own problems. Will Arkansas join them, or find other ways to fund highways? It could happen, but it won’t be easy in a state that’s home to Johnny Cash but not much extra cash.

How do you make a person or country change? Generally not through nagging

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

How do you make a person or a country change?

One option is to use overwhelming force so they have no choice but to bend to your will and eventually maybe even embrace it. It can work but is often unavailable and comes at great cost – for example, when West Germany and Japan became free market democracies after World War II under American occupation. On the other hand, if it fails, it fails big.

A second option is using less than overwhelming force – diplomacy, nagging, the silent treatment. It often results in only partial, pacifying change.

A third option is using influence and persuasion so effectively that the other chooses to change, often while in a state of crisis or transition. It’s the most effective option, but it requires patience, confidence, and the acceptance that others may adopt only some of your suggestions.

Which brings us to Cuba.

There, overwhelming force has never been an option for American policymakers for various reasons, most notably that it could have led to World War III. So instead, for half a century the United States chose option number two – ending diplomatic relations, condemning the Cuban Castro regime, and enforcing a trade embargo.

It didn’t work. Ninety miles from the planet’s wealthiest and most powerful nation, Cuba remained a hardline communist country even as most of the rest of the world rejected Soviet-style communism, including the Soviets.

So near the end of the Obama administration, the United States finally tried the third option, the one based on influence and persuasion, by re-establishing diplomatic relations and easing travel and trade restrictions. The change cracked open the door to American products, visitors and ideas. Meanwhile, it drew enthusiastic support from Arkansas’ agricultural interests, who see Cuba as a nearby and readymade market for Arkansas rice and poultry.

It’s far too early to gauge that policy’s success, but if Cuba is to change, this could be the time. Its longtime leader, Fidel Castro, died last year, while his successor brother, Raul, is 86 years old. Gov. Asa Hutchinson, who traveled to Cuba in 2015, said last year that Castro’s death was “the moment that I believe needs to be seized.”

Last week, President Trump rolled back the Obama policy – though not completely – by announcing new restrictions on travel and by prohibiting commerce with businesses that are owned by the Cuban military. Perhaps more important than the policy changes was the adoption of a much more aggressive, Cold War-era tone.

The move drew criticism from two members of Arkansas’ all-Republican congressional delegation, Rep. Rick Crawford of the 1st District and Sen. John Boozman. Crawford’s district produces half the nation’s rice, a product Cuba currently purchases from Vietnam, a slow boat ride away from the other side of the world. In a statement from his office, Crawford called America’s decades-long policy toward Cuba “failed, outdated, and isolationist” and said returning to it could open the door to increased influence from Iran, Russia, North Korea and China. Boozman released a statement arguing that the Cold War policy didn’t work and that a more open relationship allowed for not only trading goods but also trading ideas. Days earlier, the two had jointly published an opinion piece in the Wall Street Journal that called for allowing Cubans to buy American-grown food on credit instead of requiring cash transactions, a policy Crawford has long championed and tried to pass through Congress.

The other members of Arkansas’ congressional delegation didn’t release statements. They’re generally reluctant to criticize Trump, who remains popular in Arkansas, and to varying degrees some agree with him on Cuba. Sen. Tom Cotton strongly condemned Obama’s opening with Cuba when it happened, saying it was wrong to do business with the oppressive Castro regime.

We’ll have to see how serious and long-lasting this latest American policy is, or if it’s just temporary politics that changes nothing, and never would have.

After the shooting, a question

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

Many are asking if politics made the shooter crazy. That’s an important question. Another is, what is it doing to the rest of us?

Here’s what we know, as of Thursday morning. A man had lived a relatively normal life, even serving as a foster parent. There had been a few acts of violence and minor run-ins with the law, including one scary episode where he allegedly punched a woman in the face, pointed a gun at a neighbor and then hit him with the stock, but there’s plenty of evidence that he was sane. In recent years he’d become increasingly political and agitated, angrily obsessing over the injustices of a system he could not change. He posted political rants in Facebook’s echo chamber and joined a page pushing to “terminate” the Republican Party. He’d once practiced shooting his rifle outside his home, prompting a neighbor to call the sheriff. He moved to the Washington, D.C., area a few months ago, lived in a van, and frequented a bar where he would sit and drink beer with a creepy smile on his face. Then, on Wednesday, he took his rifle to a congressional baseball practice, calmly asked a congressman which party was practicing, thanked him for his answer, and then started shooting.

I started to write that he “snapped,” until my wife corrected me. No, she said. He made choice after choice after choice to fuel his anger until he’d crossed a line and there was no going back.

Most of us are not going to cross that line, or tiptoe anywhere near it. But we are making many of the same choices the shooter did. We obsess over societal forces we can’t change, that we don’t really understand, and that we’re not objective enough to define. We let our frustrations over these things bleed over into the parts of our lives that we can control, affecting our relationships with the people who matter. We seek shelter in our tribes and then adopt language that dehumanizes the outsiders, turning them first into caricatures and then, naturally, enemies. Political opponents are to be impeached, or locked up, or terminated.

The shooter and many of the rest of us are all marinating in those juices. We differ from him in that almost none of us are going to start shooting other people. But, like him, we can stop seeing them as human.

The American experiment is now almost a quarter of a millennium old. Its founding document, the Declaration of Independence, states that government exists to secure unalienable rights that include life, liberty, and the pursuit of happiness.

Unfortunately, American democracy has evolved to the point that it often more deters happiness than defends it. A spirit of anger hangs over the air, unleashing the monster in one man and turning many of the rest of us into angry jerks.

Solutions? I wouldn’t have space to write them even if I knew what they were. But here are two that might help.

The first comes also from my wife, who’s taking somewhat of a news break after spending too much time worrying about the election last year, like many of the rest of us. She’s trying to refocus on real life and on the things she can influence. In a recent conversation, she said Americans should judge President Trump’s individual actions one at a time, rather than declaring him completely right or dismissing him as completely wrong, and that same standard should apply to all other elected officials as well.

That’s true. There are times to judge the totality of an elected official’s performance. They’re called elections, and there will be another one soon enough next May. Until then, let’s try to regain some objectivity – for our own sakes, if nothing else.

The other comes from Proverbs 22:24, which states, “Make no friendship with an angry man; and with a furious man thou shalt not go.”

That verse has two meanings. The obvious one is to avoid angry people.

The second is less obvious but just as important: Don’t be that angry friend. It’s the first bad choice from which a lot of worse ones can follow.