News & Comment

There’s a lot we don’t know about what Mitt Romney would do if he won. He refuses to say which tax loopholes he would close to make up for $5 trillion in tax cuts; his economic “plan” is an empty shell. But one thing is clear: If he wins, Medicaid — which now covers more than 50 million Americans, and which President Obama would expand further as part of his health reform — will face savage cuts. Estimates suggest that a Romney victory would deny health insurance to about 45 million people who would have coverage if he lost, with two-thirds of that difference due to the assault on Medicaid. So this election is, to an important degree, really about Medicaid. And this, in turn, means that you need to know something more about the program. read more »

There are two tough questions facing the folks who want to remake Medicare into a premium support (or voucher) program. The first is that, despite decades of attempts, we don’t have a single good example of a competitive health insurance market driving down prices in a big way. Now some people think that perhaps it can work, and these efforts just got it wrong, somehow. I actually count myself in that camp, at least somewhat. But so far, the fact is that it just hasn’t worked. The second is that we do have evidence that a major way insurers compete is through trying to figure out who’s healthy and who’s sick and insuring the healthy people and turning away (or pricing out, or underserving) the sick people. And that’s a kind of competition we don’t much want. read more »

We all know that the United States is the most unequal of the rich nations of the world.  Only relatively poor countries like Malaysia and Mexico have levels of inequality similar to those in the United States.  All of the rich countries of western Europe and east Asia have much lower levels of inequality than we do. The real situation, however, is worse than the income data would suggest.  Data on income inequality only tell half the story.  The differences in the ways people live are only partly determined by income.  They’re also determined by the levels of government services provided to everyone. This is most obvious when it comes to healthcare.  In the rest of the developed world, everyone has health insurance.  Depending how you count, about a quarter of working-age Americans don’t.  Real inequalities in health coverage are even greater, since the richest Americans tend to have the best insurance. read more »

Following President Obama’s strong performance in Tuesday’s debate, Republicans, including Mitt Romney, have seized on a new line of attack: the president isn’t being specific enough about his second term agenda. Non-partisan analysts are making the same claim, namely that Obama must provide more details about what he would do in his next four years to win. They’re wrong. Even though he’s not talking about these ideas much on the campaign trail, it’s likely Obama would push for immigration and energy reform and a long-term budget deficit reduction deal in a second term. But perhaps the most important goal of an Obama second term, one he has nodded at himself at times, is preserving the accomplishments of his first term. read more »

Under the influence of the painkiller Dilaudid, and dog-tired after another day of fighting for my life with my private health insurance company, I glimpsed Mitt Romney and his running-mate, Paul Ryan, entering my Los Angeles hospital room dressed in surgical gowns with scalpels in their hands ready to fatally operate on me. It was a drug-induced hallucination, of course. But the mirage made me sit bolt upright in bed and, fully awake, start to rethink my previous, bitterly dissenting view of Barack Obama. I have written bitterly attacking Obama's serial betrayals. He's no street-scrapper, our Barack. Prior to falling sick, I pined for a third-party candidate, and seriously thought about not voting. But a drug-induced vision of a Romney/Ryan medical hell changed my mind. On 6 November, I'm pulling the lever for Obama: my arrogant, self-sabotaging, drone-happy, compromise-addicted war president. read more »

Since August, when Mitt Romney chose Paul Ryan as his running mate, the two campaigns have fought a fierce battle over who is the most stalwart protector of Medicare. The irony is that—in the short term, at least—Medicare will stay unchanged, regardless of who wins the election. Seniors are among the most mobilized voters in the electorate, and there’s too much political risk involved in making big, immediate changes to Medicare. For that reason, Medicare reform plans on both sides are backloaded and will take time to unfold. The same isn’t true of Medicaid, the other major federal health-care program. The primary constituency for Medicaid—poor and working-class families—lacks the clout and influence of seniors. And while  the Obama administration expanded the program in the Affordable Care Act, it has also made Medicaid a ripe target for conservative cuts to social insurance. read more »

Mitt Romney doesn’t see dead people. But that’s only because he doesn’t want to see them; if he did, he’d have to acknowledge the ugly reality of what will happen if he and Paul Ryan get their way on health care. Last week, speaking to The Columbus Dispatch, Mr. Romney declared that nobody in America dies because he or she is uninsured: “We don’t have people that become ill, who die in their apartment because they don’t have insurance.” This followed on an earlier remark by Mr. Romney — echoing an infamous statement by none other than George W. Bush — in which he insisted that emergency rooms provide essential health care to the uninsured. These are remarkable statements. They clearly demonstrate that Mr. Romney has no idea what life (and death) are like for those less fortunate than himself. read more »

Once again, Mitt says everybody in America has hunky dory health care even if they don't have insurance: read more »

I'll give it to Mitt Romney. During the debate he looked and sounded pretty “presidential”: good haircut, power tie, in command (total control, really) of the debate. Romney’s performance had the intended effect. Virtually every poll across the nation had his numbers soaring in the past week. Many show him leading Obama both in the popular vote and in critical swing states. Presumably, that means many American are now ”looking at Romney in a new light.” While his running mate Paul Ryan didn't do as well, for those who were swayed by Romney's performance, it might be prudent to think past his style or what positions he chose to take that night. Based on Romney’s record—as well as the agendas of his party, his running mate and the Super PACs to which he would owe his victory—let’s take a moment to envision what life would be like under a Romney presidency. read more »

Abortion was discussed only briefly during Thursday night’s vice presidential debate, but the exchange about it was, I think, an important moment, because it drove home the likelihood than a Republican victory in November will mean the end of Roe v. Wade. During the vice-presidential debate, many pro-choice observers were irritated by the way moderator Martha Raddatz framed her lone question about abortion in terms of the candidates’ Catholicism. Nevertheless, the question worked perfectly for Joe Biden. In general, Americans are ambivalent about abortion, but they don’t want to make it illegal. By speaking in religious terms, Biden was able to combine his personal opposition to abortion with a strongly pro-choice stance. Ryan, by contrast, reminded the country that he opposes abortion in all circumstances, and that Romney intends to severely restrict it. read more »