Reported by NPR here’s another deep dive into MAGA America from Louisiana’s Department of Health:
A group of high-level managers at the Louisiana Department of Health walked into a Nov. 14 meeting in Baton Rouge expecting to talk about outreach and community events. Instead, they were told by an assistant secretary in the department and another official that department leadership had a new policy: Advertising or otherwise promoting the COVID, influenza or mpox vaccines, an established practice there — and at most other public health entities in the U.S. — must stop.
In a statement, the Louisiana Department of Health told NPR it has been “reevaluating both the state’s public health priorities as well as our messaging around vaccine promotion, especially for COVID-19 and influenza.” The [Department of Health] described the move as a shift “away from one-size-fits-all paternalistic guidance” to a stance in which “immunization for any vaccine, along with practices like mask wearing and social distancing, are an individual’s personal choice.” [It] did not address mpox vaccinations. The statement said that the flu vaccine can reduce illness severity and therefore may help high-risk patients — but falsely claimed “the flu vaccine does not prevent one from getting the influenza virus.”
How far will they go in the months ahead in MAGA Universe? Will it go as far as the limit? – Banning vaccines altogether? Department of Health employee prayer groups dedicated to eradicating viruses? There are, apparently, no limits.
At a campaign rally yesterday in Pennsylvania, Trump tried to pander to women voters, disastrously, that he’s not a threat but will be their “protector” in abortion matters, and in general:
“I always thought women liked me. But the fake news keeps saying women don’t like me. [But] You will be protected, and I will be your protector. Women will be happy, healthy, confident and free. You will no longer be thinking about abortion.”
The president who ushered in the overturning of Roe v. Wade, bragged about sexually assaulting women, and was found liable for sexual abuse now realizes that the legacy of the Dobbs decision that his three Supreme Court nominees made possible isn’t polling well. So he’s on the reassurance grift. There is a mind-set demonstrated by his “soothing” words that shows a glaringly stupid lack of understanding of even the grade school basics of what women desire in all aspects of their lives, especially abortion.
For example, his “You will be protected, and I will be your protector”: women no longer accept (if they ever did) that their relationships with men be a “protector/protectee” paternalistic bargain, freighted with exceedingly onerous obligations. For example, Trump (of all men) telling them “Women will be happy, healthy, confident and free” indicates his belief that men (specifically himself) alone by their paternalistic largesse can make women happy, healthy, confident and free. This, from Trump, a serial sex assaulter, adulterer, adjudicated rapist, defamer, and “pussy grabber.” He and the MAGA crowd simply have no overall, historical, cultural, or conceptual understanding of feminist goals. And trying to fake it just digs them in deeper and rightly alienates millions of women, and men.
And there’s this:
More Reassurance from Ohio…
GOP Senate nominee Bernie Moreno (OH), at a town hall event last week but first reported yesterday by NBC4 in Columbus. As you’ll see, Moreno vocalizes the MAGA self-centered view that one’s vote ought to matter only when an issue DIRECTLY threatens one’sown life, not, for example, the lives of all women, including their daughters and granddaughters.
“You know, the left has a lot of single issue voters. Sadly, by the way, there’s a lot of suburban women, a lot of suburban women that are like, ‘Listen, abortion is it. If I can’t have an abortion in this country whenever I want, I will vote for anybody else.’ … OK. It’s a little crazy by the way, but — especially for women that are like past 50 — I’m thinking to myself, ‘I don’t think that’s an issue for you.'”
As for Trump’s conclusion, “[Women] will no longer be thinking about abortion,” the absurdity of that in every way spotlights his utter lack of understanding of women’s daily lives. Women walk through life with targets on their chests and backs, at all ages, placed there by men like Trump and Moreno.
A week ago, Trump took to his Truth Social safe space to make a specious claim about a problem vexing millions of diabetic Americans on Medicare, the out-of-pocket/copay cost of insulin, one of the more contentious political issues of the day, especially since Medicare beneficiaries comprise a population with higher prevalence of diabetes (33%, 22 million) than the general population (11%, 37 million). More than three million people with Medicare coverage use insulin.
So, let us ask of the man who spent much of his administration trying to repeal the Affordable Health Care Act, “What would a serious and informed policy disagreement about Medicare and insulin coverage be without Donald Trump?” Asked and answered last Saturday:
“Low INSULIN PRICING was gotten for millions of Americans by me, and the Trump Administration, not by Crooked Joe Biden. He had NOTHING to do with it. It was all done long before he so sadly entered office. All he does is try to take credit for things done by others, in this case, ME!”Truth Social, June 8, 2024
This is firstly, stupid, and secondly, nonresponsive, simultaneously both false and true, a hallmark of Trump & Company. It’s a technique that confuses those who do not follow the ins-and-outs of government policy, and many who do follow it. Trump’s Truth Social post conflates outright lying with some actual facts that, on analysis, are, indeed, truthful, but that don’t advance Trump’s argument. Given that, his argument is iconically specious, i.e., apparently good or right though lacking real merit; superficially pleasing or plausible. So, let’s dig in and deconstruct.
Trump Administration’s Half-Baked Accomplishment
“I don’t use insulin, Should I be? Huh? I never thought about it. But I know a lot of people are very badly affected, right? Unbelievable.” Donald Trump, a nondiabetic, displaying his advanced knowledge of the subject USA Today, May 26, 2020
The above crackpot quote was served up by then President Trump at a May 26, 2020 formal White House Rose Garden speech about, among other things, an executive action reducing the copay cost of insulin to $35 for Medicare recipients. Here’s the summary excerpt from the White House (ironically named) Fact Sheet released during that Rose Garden speech:
LOWERING COST OF INSULIN FOR SENIORS: President Donald J. Trump and his Administration are lowering out-of-pocket insulin costs for Medicare’s seniors.
“Under President Trump’s leadership, the Centers for Medicare & Medicaid Services is announcing that many Medicare Part D plans and Medicare Advantage plans have applied to offer lower out-of-pocket insulin costs to seniors for the 2021 plan year.
Across the Nation, participating enhanced Part D plans will provide many seniors with Medicare access to a broad set of insulins at a maximum $35 copay for a month’s supply of each type of insulin.
And,
Lowering out-of-pocket insulin costs will provide the many Medicare beneficiaries who rely on one or more common forms of insulin with plan options that will deliver critical relief.
And,
No effort will be spared to give America’s seniors the care and support and devotion and love they have earned and that they deserve.President Donald J. Trump, March 26, 2020
In fact, rather than sparing no efforts, Trump administration’s policy spared many efforts. Unrevealed was that the cost cap would apply to only a small subsetof 3.5 million insulin-dependent Medicare beneficiaries, and they were still stuck with a yearly deductible. That’s a big “unreveal” that affected many. Nonetheless, the Fact Sheet excerpt reads as if all insulin-dependent Medicare beneficiaries would receive the new copay cost cap. So, factually, Trump’s policy did lower insulin costs, but despite being presented as a cure-all for Medicare patients, it was misleadingly presented, ergo, factual but largely false since so many on Medicare were left out.
For Trump, even this half-baked policy was something he didn’t want to establish, nor did the pharmaceutical CEOs, or insulin suppliers who colluded with him design it as anything more than a sop to the Medicare voting bloc. Trump had been suffering some blowback on the issue and needed something that he knew he could sell as a major accomplishment to his diabetic MAGA Medicare recipients (many of whom were excluded from the insulin cap). Nonetheless, at a 2020 presidential debate Trump boasted that lowered insulin prices that vials were “so cheap, it’s like water”, despite insulin prices remaining fixed at about $300 per vial. And that wasn’t misleading, that was 100% false.
The Biden Administration’s Meaningful Accomplishment
Jump forward from the Trump administration’s weak insulin copay cost policy to today. President Biden achieved much when he signed the August 2022 Inflation Reduction Act. Among those achievements was a new insulin copay cap program (effective date January 1, 2023 for Medicare Part D, and July 1, 2023 for Medicare Part B). Also, as of January 1, 2024, eligibility for the Part D Low Income Subsidy (LIS) expanded from 135 percent of the Federal Poverty Level (FPL) to 150 percent of FPL, which allows these enrollees to further reduce their out-of-pocket costs for insulin. Also, under the Inflation Reduction Act, beginning in plan year 2023 (Jan-Dec), Medicare Part D enrollees no longer may have a deductible for insulin and must have a maximum $35 monthly co-payment. These are broad and meaningful benefits, rather than – as Trump’s 2020 executive action was – a simply cynical political expedient to attempt to silence critics by, basically, confusing them. (Note, however, as always, Senate Republicans tried to block the $35 cap on price of insulin from the Inflation Reduction Act.)
KEY POINTS • The Inflation Reduction Act (IRA) caps insulin out-of-pocket spending at $35 per month’s supply of each insulin product covered under a Medicare Part D plan, with similar limits for out-of-pocket costs for insulin supplied under Part B, and reduces out-of-pocket drug spending in Medicare in other ways. . . . [Omitted — States that the study used data below based upon analysis of 2019 data] • Nationally, [during 2019, Trump administration] the average out-of-pocket cost was $58 per insulin fill, typically for a 30-day supply. The average cost per fill among people who were uninsured for the entire year was $123, more than double the national average. Patients with private insurance or Medicare paid about $63 per fill on average. • [During 2019] About 37 percent of insulin fills for Medicare enrollees (Part B and Part D) required cost-sharing exceeding $35 per fill, including 24 percent that exceeded $70 per fill. About 36 percent of insulin fills for people without insurance and 35 percent for people with private insurance had cost sharing above $35 per fill. These estimates are only for enrollees who filled an insulin prescription and do not include potential costs for patients who did not fill their insulin due to cost or other reasons. • We estimate that 1.5 million Medicare beneficiaries would have benefited from the new [Inflation Reduction Act] insulin cost-sharing limits if they had been in effect [during] 2020, [rather than Trump’s policy] with savings to those beneficiaries of about $734 million in Part D and $27 million in Part B – or approximately $500 in average annual savings per person among those benefiting from the provision. [Emphasis added]
The Trump plan lacked coverage for millions of Medicare insulin users. The Inflation Reduction Act remedied that.
Jump Forward to . . . Last Saturday & Donald Trump
Yes, this again:
“Low INSULIN PRICING was gotten for millions of Americans by me, and the Trump Administration, not by Crooked Joe Biden. He had NOTHING to do with it. It was all done long before he so sadly entered office. All he does is try to take credit for things done by others, in this case, ME!” Truth Social post, June 8, 2024
Why now, why this spirited defense? The closeness of the 2024 election, in time and in winning margin, sespite Trump’s overwhelming confidence, he may have been alerted to the fact that today’s seniors, particularly baby boomers over 64, are not majority GOP voters seniors as we’ve assumed. And Trump relies on them, and trusts them to support him, and boomers now represent 60+% of the senior vote. More conservative or radical voters have died since the 2016 and 2020 elections at a greater number than baby boomers have joined the senior voting bloc. An April 26 NYT article succinctly summed it up:
“Mr. Biden’s strength among seniors might be surprising, but the likeliest explanation is deceptively simple: At every stage earlier in their lives, many of today’s seniors voted Democratic. They just got older.”
As a 74 year-old baby boomer I unanimously agree. (I’m also a diabetic who once used insulin and now use Ozempic exclusively: O! O! O! Ozempic!) Given the millions of Medicare insulin-dependent patients, insulin costs – Trump may have learned is a salient issue in the presidential race and as the chart below suggests, the blue seniors still retain their leftie reputation:
And since the 2012 election, much has changed. Baby boomers could decide the 2024 election, although Gen Z voters appear to be trending more conservative/MAGA, older voters vote in greater percentage terms than younger ones. Therefore, if not Trump himself, then it’s likely someone in the Trump campaign alerted him that the Medicare voting bloc was at risk, not only on general issues, but on pocketbook issues like the Medicare insulin cap. It’s unlikely, however, that many approved of his outlandish June 8th tweet and the blowback that established how cynical and untrue it was. We baby boomers aren’t babies anymore and we are still predominantly hippies . . .
This post is a reprint of one I published in October 2011 entitled “The Floridation of Fluoridation: Pinellas County Commission Votes to Increase Tooth Decay.” In the midst of the MAGA anti-science/anti-regulation movement this 2011 post reminds us that this kind of retreat from rationality has suffered through many other periods, and this particular version is only twelve years past. This one, spearheaded by the Tea Party crusade, was an obvious precursor of the worse things to come with our present MAGA crowd who have taken this to an extreme, of course. They have far more political power than the Tea Party had.
In fact, a strong third party candidate, Robert Kennedy Jr., has built much of his campaign around conspiracy thinking about vaccinations. He may have enough support to materially affect the 2024 election outcome, and many political analysts believe he might draw enough votes in close battleground states to propel Trump into our lives for four more years. And, given the very limited success of the court cases against him and the weakness of our incumbent president’s popularity, there is no vaccination against a second Trump regime.
October 14, 2011
NAZIs for Tooth Decay
Teeth Are Highly Overrated. Last night, Rachel Maddow gave us a glimpse at what a Tea party Republican America might look like. It ain’t pretty. And it’s stupider than it ain’t pretty. Moreover, its collective toothy grin will be missing a tooth or two within a fairly short time. . .
On October 4th, Pinellas County Florida’s Tea Party dominated Board of County Commissioners voted 4-3 to remove fluoride from the county water supply, exempting St. Petersburg and a few other cities. Health concerns? Not so much. One could sympathize if the commissioners based their decision on serious health concerns. They didn’t. Indeed, there are no serious health concerns associated with fluoridation according to an overwhelming number of public health researchers.
Then what? One local Tea Partier put it this way, according to the October 5th St. Petersburg Times: “Fluoride is a toxic substance,” said tea party activist Tony Caso of Palm Harbor. “This is all part of an agenda that’s being pushed forth by the so-called globalists in our government and the world government to keep the people stupid so they don’t realize what’s going on.”He added: “This is the U.S. of A, not the Soviet Socialist Republic.”
Another, an actual voting member of the commission, longtime Republican John Moroni joined Norm Roche, Neil Brickfield and Nancy Bostock in voting to stop the program. . . Morroni compared the practice to the disputed federal health care reform law mandating that people buy health insurance. Ultimately, he said, public support has shifted since he and other commissioners approved the practice. “I don’t think the county government should be telling people they have to have fluoride in the water,” Morroni said. If folks want their water flavored with slime, fish heads, mercury, and petroleum, Morroni will apparently brook no governmental interference. This is a guy who, believe it or not, also serves on the county’s Health and Human Services Coordinating Council.
Pinellas County residents shrugged. In fact, a week after the vote Morroni’s emails were highly supportive. At the next commission meeting on October 11th, he stuck to his guns. Citizens spoke out as well. According to TampaBay.com: “One woman blamed fluoride in her drinking water for making her overweight, causing dentists to shrug. Another woman handed all seven commissioners a book: The Fluoride Deception. . . In a tangle [between two commissioners, one of them] even compared adding fluoride to dropping psychotropic drugs Ritalin and Prozac in the water.” Why not Viagra, I ask.
Mind you, fluoridation has never been popular in Pinellas County. According to the St. Petersburg Times, until its 2004 debut it was, “the largest water supplier in the eastern United States that did not fluoridate its water.” This despite the wide acceptance of fluoride’s positive effect on reducing dental disease.
The Mayor of Florida speaks out
Tea Party Florida-tion of America So, surely, this reaction to fluoride is an anomaly, a local breakout treatable with Clearasil. We’d think even the Tea Party understands the importance of proven public health measures. Well, no. The Tea Party has but one interest: to end anything they consider an “interference” with their brand of “liberty,” or “freedom.” This principle does not spare public health. In effect, they don’t recognize or give credence to the word “public” in any real sense. All men (and, presumably, women) are islands. Therefore, public health measures like fluoridation and vaccinations are invasions of liberty, or, thereby, privacy (a right they do not, by the way, believe exists in the Constitution). No public health measures would be safe in Tea Party America.
For example, the Centers for Disease Control and Prevention (CDCP) rates fluoridation as one of the “Ten Great Public Health Achievements” of the 20th Century, right there with these other successes, all intermediated by federal and state governments:
“healthier mothers and babies,” (WIC, Planned Parenthood, Food Stamps, etc.)
“family planning,” (Planned Parenthood, birth control, right to choose, etc.)
“vaccination,” (everything from measles to polio to APV)
“safer and healthier foods,” (FDA, Dept. of Agriculture), and
“safer workplaces” (OSHA, Mine safety, etc.).
Note that all these are on the national Tea Party hit list. Recall the debate over funding the FDA, the controversy over the otherwise loony Rick Perry’s APV vaccination program in Texas, the attempts to defund Planned Parenthood, and, most of all, the never ending attack on abortion rights, including some forms of birth control. As you know, there are many more examples of this that affect health or safety, that, in effect, endanger public health successes from reaching the public, particularly the poor.
Of course, a Tea Partiers’ primary peeve is a general one, from which their “policies” emerge like poop from a goose: government regulation of nearly any kind. Since all regulation of individual behavior or business practices are considered by them to be an interference with liberty and freedom, regulations furthering the promotion of the “Ten Great Public Health Achievements” of the 20th Century are slated for suppression. Here’s two more:
“Motor-vehicle safety,” and
“Recognition of tobacco use as a health hazard.”
These are, after all, an interference with an individual’s liberty to kill himself/herself needlessly. Regulations, like seat belt and motorcycle helmet laws, firstly, denies the freedom to be without insurance and then, secondly, let’s them rely on health professionals’ and hospitals’ charity to regain their health. “Responsibility to society” is not, in any real sense, a phrase in the Tea Party repertoire. (Nor is “repertoire”)
In any event, the above covers eight of CDCP’s “Ten Great Public Health Achievements” of the 20th Century, all slated for serious ugly treatment by the Tea Party. That leaves two more:
“Control of infectious diseases,” and
“Decline in deaths from coronary heart disease and stroke”
There must be something wrong with these. . . How will they attack them? Well, if not directly, they plan to do so indirectly by defunding national research programs like NIH, CDCP, and others. This is already underway in the GOP-dominated Congress.
NOTE: I will be adding pre-2023 blog posts to the blog over the next six months. These are postings I made during the period 2007-2017. They’re drawn from a previous version of the They Will Say ANYTHING! blog. Each post will be preceded by this blue text block.Of course, I will continue to add new post-2023 postings as well.
December 25, 2011
“Older Americans do not intend to ruin America,but as a group, that’s what they’re about. . . Why are we in this debt fix? It’s the elderly, stupid.” Robert Samuelson, Washington Post
Robert J. Samuelson. He’s one of the more mean-spirited of a group of right wing conservative economists. His opinion piece below represents the wild imaginings and over-the-top nastiness of the group in general. . . the worst take on Medicare of 2011:
Samuelson ignores the fact that Medicare is not the problem, health care cost inflation is, especially the part of it devoted to health insurance intermediation. President Obama’s and the Democratic party plan – what the right wing calls “Obamacare” – addresses this problem by trying to contain the costs associated with providing and financing the entire system. “Solutions,” like Samuelson’s are simply a craven effort to permit those costs to rise in a laissez faire fashion, and then, over many years, decades, too gradually reduce the benefits available.
There are fixes for Medicare, but they are wide and deep. They involve curbing health care costs. President Obama’s “Affordable Care Act” is an exceptional good start.
So, here’s my nominee for Nastiest Medicare Article 2011:
“Why are we in this debt fix? It’s the elderly, stupid.By Robert J. Samuelson, Published: July 28
If leadership is the capacity to take people where they need to go — whether or not they realize it or want it — then we’ve had almost no leadership in these weeks of frustrating and maddening debate over the budget and debt ceiling. There’s been an unspoken consensus among President Obama, congressional Democrats and Republicans not to discuss the central issue underlying the standoff. We’ve heard lots about “compromise” or its absence. We’ve had dueling budgets with differing mixes of spending cuts and tax increases. But we’ve heard almost nothing of the main problem that makes the budget so intractable.
It’s the elderly, stupid.
By now, it’s obvious that we need to rewrite the social contract that, over the past half-century, has transformed the federal government’s main task into transferring income from workers to retirees. In 1960, national defense was the government’s main job; it constituted 52 percent of federal outlays. In 2011 — even with two wars — it is 20 percent and falling. Meanwhile, Social Security, Medicare, Medicaid and other retiree programs constitute roughly half of non-interest federal spending.
These transfers have become so huge that, unless checked, they will sabotage America’s future. The facts are known: By 2035, the 65-and-over population will nearly double, and health costs remain uncontrolled; the combination automatically expands federal spending (as a share of the economy) by about one-third from 2005 levels. This tidal wave of spending means one or all of the following: (a) much higher taxes; (b) the gutting of other government services, from the Weather Service to medical research; (c) a partial and dangerous disarmament; (d) large and unstable deficits.
Older Americans do not intend to ruin America, but as a group, that’s what they’re about. On average, the federal government supports each American 65 and over by about $26,000 a year (about $14,000 through Social Security, $12,000 through Medicare). At 65, the average American will live almost 20 more years. Should these sizable annual subsidies begin later and be less for some? It’s hard to discuss the budget realistically if you ignore most of what the budget does.
That’s been our course. Obama poses as one brave guy for even broaching “entitlement reform” with fellow Democrats. What he hasn’t done is to ask — in language that is clear and comprehensible to ordinary people — whether many healthy, reasonably well-off seniors deserve all the subsidies they receive. That would be leadership. Obama is having none of it. But the shunning is bipartisan. Tea Party advocates broadly deplore government spending without acknowledging that most of it goes for popular Social Security and Medicare.
I have written about these issues for years. But facts are no match for the self-interest of about 50 million Social Security and Medicare recipients and a natural sympathy for older people and for people who eagerly look forward to retirement. Public opinion becomes contradictory. While 70 percent of respondents in a Pew Research Center poll judged budget deficits a “major problem,” 64 percent rejected higher Medicare premiums and 58 percent opposed gradual increases in Social Security’s retirement age.
What sustains these contradictions is a mythology holding that, once people hit 65, most become poor. This justifies political dogma among Democrats that resists Social Security or Medicare cuts of even one dollar.
But the premise is wrong. True, some elderly live hand-to-mouth; many more are comfortable, and some are wealthy. The Kaiser Family Foundation reports the following for Medicare beneficiaries in 2010: 25 percent had savings and retirement accounts averaging $207,000 or more; among homeowners (four-fifths of those 65 and older), three-quarters had equity in their houses averaging $132,000; about 25 percent had incomes exceeding $47,000 (that’s for individuals, and couples would be higher).
The essential budget question is how much we allow federal spending on the elderly to crowd out other national priorities. All else is subordinate. Yet, our “leaders” don’t debate this question with candor or intelligence. We have a generation of politicians cowed and controlled by AARP. We need to ask how much today’s programs constitute a genuine “safety net” to protect the vulnerable (which is good) and how much they simply subsidize retirees’ private pleasures.
Our politicians make perfunctory bows to entitlement reform and consider that they’ve discharged their duty, even if nothing changes. We need to recognize that federal retiree programs often represent middle-class welfare. Past taxes were never “saved” to pay future benefits. We need to ask the hard questions: Who deserves help and who doesn’t? Because Social Security and Medicare are so intertwined in our social fabric, changing them could never be easy. But the fact that we’ve evaded the choices for so long is why the present budget impasse has been so tortuous and why, if we continue our avoidance, there will be others.”
Give Gramma a call. Don’t let her get away with this!!!
It’s cold today on Lake Superior’s Isle Royale, the Michigan island home of the Cardiac Life Extension Sandwich Association (CLESA). Since an unexpected warm spell last weekend, the group, some 125 strong, has conducted a surprisingly grueling period of sandwich testing, nutrition monitoring, and competition judging. In their “day jobs,” these doctors, scientists, bioengineers, and entrepreneurs, create, test, and market life-saving products. The CLESA has a three pronged mission based upon (1) “the constitutional right of all Americans to consume whatever sandwiches they desire,” and (2) “the constitutional right of all American food industry participants to provide whatever sandwiches they desire,” and (3) “the constitutional right of all Americans to have access to electronic devices to remedy the cardiovascular destruction due to (1) and (2).”
Therefore, CLESA is a think tank that provides research and product testing and development to enable the distribution of cardio-friendly devices like pacemakers and cardiac monitors directly to consumers. In addition, they provide manual and automated defibrillators that fast food industry merchants can place in their outlets for those times when customers need what they call “a heart jolt” to finish their sandwiches.
These recent advances in sandwich cardiology and basic research, particularly innutrition science, have made meaningful contributions to an increasingly good “report card” of national heart health. CLESA applauds this, as we all do. To piggy-back this sandwich-related national cardiovascular health effort, they have today released the results of their first of what will be an annual competition, the year’s “Best New Sandwich.” This honored sandwich must best combine all the nutrition, taste, and health criteria that “best represents the interests of CLESA constituents in expanding the number of fast food sandwiches that they may consume without worry about cardiovascular issues and engage in their right to pursue happiness.”
“This award is dedicated to CLESA scientist Dr. Herbert Joneston, renowned cardiologist, who was revived from sudden cardiac arrest while consuming the prize-winning sandwich, pictured below, available at a Cardiac Garden restaurant near you.”
Yesterday, I wrote about a provision in the House version of HR 3630, the payroll tax holiday and unemployment insurance extension proposal now battling it out with the Senate version of the bill. The provision, labeled “Ending Supplemental Nutrition Assistance Program Benefits for Millionaires,” was a poorly cast joke, a poorly thought-out proposal, or both. No matter. It’s clearly not a serious proposal and I wondered, if passed into law, to whom would it apply? Millionaires denied food assistance! Here’s how it might appear in the mirror image reincarnation of Mr. Dickens . . . and his new novel about a young wastrel, Donald Twist . . .
Paul Ryan has lately taken to defending his plan to, for all intents and purposes, end Medicare. Last night, Rachel Maddow discssed this in some detail. I agree with her, this raising the kill Medicare policy back into public discussion is great for Democrats who have lately been gaining ground on the GOP. In addition, the GOP presidential primary debates will now have to address this, and punches aimed by Romney at Gingo are already flying, and connecting.
In response to this, I thought it time to visually simplify the Ryan plan. Here’s a single image that I hope does just that. Let’s look ahead and visualize a United States within which people like Ryan are actually elected and re-elected. Imagine Ayn Randyism running wild. It’s nightmarish, but let’s try.
Imagine it’s 2018, with President Ron Paul and Vice President Paul Ryan in their second term. The Ryan plan is now the Paul Ryan Medicare Responsibility Act of 2014 and has been the law of the land for four years. Its short phase-in period is complete and the PRMRA is in full effect.
So, here’s the GOP’s hallmark achievement and now the financial backbone of American health care assistance to the elderly: the health insurance voucher, available to seniors from their local U.S. Responsible Workfare office after successfully passing a series of drug and pregnancy tests. Now available only for those older than 70 (the new eligibility age), this just might be our future . . . Wake up now. . . I heard you screaming. . .
Unless we want this to happen to ourselves, our children, grandchildren, and on and on, we need to work hard to re-elect President Obama, re-take the House, and appreciably extend our lead in the Senate. Although somewhat tardily, President Obama has awakened to the very real threat posed by the horribly radicalized GOP and their supporters, unfortunately, around one-quarter of our own citizens. It’s now our turn to get radical, radically progressive, like the brave and feisty Occupiers everywhere.
Senator John Kyl (R-AZ), who adamantly opposes tax hikes, has found one he really wants to help inflate. How? By not extending the 2011 payroll tax holiday, he – and the GOP – would raise the tax by about 50%. And note, most American households pay less in income taxes than they do in payroll taxes dedicated to Social Security, so the reduction from 6.2% to 4.2% of this tax was a healthy boost to this year’s pay. Also, it exclusively benefited the working poor and what’s left of the middle class since, due to a longstanding wage cap on FICA Social Security taxes, it applies only to those earning less than a very middle classy $106,800 in 2011. Employers, by the way, match employee FICA taxes, and notably, the payroll tax holiday does not extend tothem; they pay an excise tax of 6.2% on wages paid (as well as 1.45% that is dedicated to Medicare, which also was not reduced for employees during the holiday). . .
Finally, although a controversial subject, the looming “social security crisis” being chicken-litt nearly everywhere is primarily based on inaccurate understanding of the trust fund and on ideological grounds. Relatively easy fixes exist, short of raising the retirement age or radically slashing benefits, to remedy any crisis that might ever emerge. The trust fund has a still growing $2.4 trillion surplus, and that money is dedicated by law to pay benefits. If there is a crisis, it’s in the Medicare Trust Funds and in high health cost inflation, but, for this article, let’s assume a Social Security “crisis” scenario is valid, paramount, and impending, as Kyl, most of the GOP, and some Democrats believe.
With that in mind, two simple declarative sentences during Senator Kyl’s FOX N*ws interview the other day made the news: “The payroll tax holiday has not stimulated job creation. We do not think that is a great way to do it.” With this, the senator may have unwittingly opened a door for Democrats and progressives to, in one package, lower taxes on most Americans and small businesses, ensure the viability of Social Security, and increase taxes on more highly paid wage earners. How?
Let’s Regress for a Moment. All the above can be accomplished by remaking the FICA tax, moving it from a regressive (or flat tax) system to a progressive system, and doing so in a way that puts the GOP in a policy knot. To mix metaphors as if with a blender, the GOP can be hoist on its own ideological petard.
O.K. then, Senator Job Creation, has not the 2011 FICA holiday put a great deal of money into the pockets of the middle class and working poor? Of course it has. The payroll tax on wage earners was reduced from 6.2% to 4.2%, adding more than $40 billion to working families’ pockets. Although a demand side argument, that $40 billion does have some effect on the country’s producers (“job creators”), does it not, if only to preclude more
layoffs? Moreover, with the FICA taxes on employers for wages paid not reduced for 2011, it stands at 6.2%. A reduction in that rate would have encouraged more “job creation” this year, and would also have been a truly supply side remedy, a GOP favorite. Wha’ happened?
Nonetheless, a fight over extending the wage earner FICA holiday, and its further rate reduction to 3.2%, will become the battle du jour in Congress quite soon, perhaps today in the Senate. Democrats propose funding the 2012 FICA shortfall through a 3.25% surtax on incomes over $1 million. That, of course, with GOP control of the House, and near control of the Senate, will create a battle royal. This might be good for Democrats, though, if, for now, they move off the 3.25% surtax, as worthy as it is, and hide much of it in a FICA tax overhaul proposal that may isolate the GOP in dangerous territory. The appearance of “backing down” again to the GOP on millionaires’ taxes would be mostly sanitized inside a hugely popular Social Security program proposal. In the end, that can put the GOP on the policy defensive, and, if successful, collect increased tax revenue from the upper 10% via a reformed FICA tax system.
Let’s Progress Progressively. The positive effect on personal income of this year’s 2% break was large, especially since the payroll tax is presently regressive (at least at the time it is paid, if not in benefits received later). Therefore, prior to 2011, when the social security tax was 6.2% it more negatively affected lower wage earners than higher wage earners due to the percentage of income that certain goods and services drain from family budgets at differing income
levels. Poor families, for instance, spend a larger percentage of their income on transportation to and from work than do higher income families, even if the dollar value of their subway ticket is the same $40 per week. Known generally as Engel’s law, the same effect, in general, is true for many other items like food, shelter, health care, renters insurance, etc.
Regardless of the helpful economic effect of the 2011 holiday, though, the resulting 2011 FICA tax (4.2%) remained a flat tax, and, as we saw above, flat taxes like FICA are not an “equalizer” as nearly all Congressional Republicans, Herman Cain, Rick Perry, and some Democrats ardently believe. Their FICA arithmetic is linear, however, the distribution of flat taxes and their family budget consequences among families of different incomes is not linear. Engel curves are mostly nonlinear.
Here’s a counter-example of the flat tax that presents it in a different, friendlier light. Overall, the income gain from this year’s payroll tax holiday averaged approximately $1,200 per worker, but that is regressive in the best way, i.e. it boosts lower earner incomes for the basic needs of life (food, shelter, health care, etc.) on a percentage of income basis, and that helps the households in the lower 20% more than those at the $106,800 FICA taxable wage earner ceiling. As a result, lower income earners who receive a $500 FICA break can do more to meet basic needs (and perhaps have some discretionary funds) than a $1,200 FICA holiday for those better off who have already easily met their basic needs. That group, in fact, may actually buy things just for the joy of it, like televisions, row boats, tires, and funny costumes.
Yet, in the end, a flat tax does more proportionate damage than not. As we’ve seen, it especially hurts lower income households’ living standards, and regrettably, that group of working poor has experienced virtually no net income growth for decades. Finally, though mildly debated by economists, the employer portion of the FICA tax system is differentially passed on to employees through wage reductions, benefit cuts, etc. So, as a consequence, where employees experience this they are potentially being assessed up to double their own FICA tax.
Senator Kyl’s inapt – but as you’ll see, helpful – framing of the issue as a “job creation” issue is, of course, the GOP mantra of this era. In effect, that religious belief translates, in practical terms, to five policies: less taxes, lower taxes, no taxes, decapitate business regulation, and “Let’s hang Ben Bernanke.” Kyl’s “job creation” argument against extending the lower payroll tax through 2011 arises out of supply side economics, the granite hard foundation of GOP tax policy. Supply side policies typically stress tax reductions primarily to benefit “job creators,” those well-known 1 to 10%ers. But that’s not all, Republicans, particularly the new crop of Tea Partiers everyone fears, rail around the clock against taxes on anyone for anything at any time.
So, inexplicably, here’s a tax cut – extending the payroll tax holiday – that is disliked by Senator Kyl, an exemplary supply sider. Michele Bachmann and others have this extension in their sights as well. Generally, the GOP loves this tax increase. What are they smoking? Certainly, one would think, unleashing the dollars on a recession-prone economy that would normally go to FICA would help spur production, and thereby create jobs, is the very supply side goal sought by Republicans. Though they deny that jobs are created by a payroll tax reduction, this belief violates their foundational principle that all tax reductions “pay for themselves” by spurring economic growth. To Republicans, all tax reductions, therefore, are supply side in nature. So, what’s the problem here? Why on earth oppose this one?
Here’s where it gets tricky. Understanding the nature of their supply side about face here is a clear path to attacking the GOP on its flank, and subject them to an unwanted limelight for a while, perhaps until the morning of November 7, 2012. The Kyl-GOP position on ending the payroll tax holiday is akin to shooting themselves in the philosophical foot., i.e. effectively taking billions out of consumers’ wallets and giving them back to the federal government’s “entitlement” programs, which they also adamantly oppose. This is a real political bind for them. Certainly, the resulting income transfer to government will affect their 1%ers’ bottom lines, dividends, and incomes adversely when the majority’s discretionary income declines. Without a FICA break, they’ll be paying 2% more salary to Uncle. So, for the GOP to take such a pro tax hike stance over a 2012 FICA holiday is a mystery. And does not Grover Norquist oppose any rescinding of a tax cut or tax expenditure once it’s enacted. And, for Gosh sake, as Romney said about another more personal issue related to the politics of lawn maintenance, “It’s an election year!” Why would the anti-tax, anti-government, anti-“entitlements” pro Social Security privatization party want to be seen pushing a tax increase in an election year? Well, with a reform proposal, the Democrats can ask that on a daily basis. Betcha’ Boehner sheds tears.
And here’s yet another GOP hot spot: Social Security itself. It’s solvency. They’re frightfully concerned about that. They do their arithmetic and discover that Social Security will run out of money any day now. What shall we do? Their preferred choice, privatizing it via the equity markets, given the recent track record of the financial industry, is a non-starter. And that’s really all they have. So, now, how do we shore up the program, this mammoth “Ponzi scheme,” they ask? Well, they suggest raising the retirement age (not so good if you work in the trades where muscles are involved), they suggest cutting benefits (not so good if you’re already destined to live on dog food in emergency rooms), and they suggest everything short of deporting the elderly to Finland (Finnish is a hard language to learn). In Social Security reform, Americans view them like a Republican in a punch bowl. Democrats can keep that pleasant image in the forefront by actively battling them over a FICA tax overhaul that, through its progressive tax basis, and no income cut-off, they will find it hard to respond to in a way that does not make them even more unpopular, particularly, I believe, among independents.
Now Progress to the Proposal. Senator Kyl, by tying the question to supply side economics through his use of the term “job creation,” may has invited an effective Democratic progressive flanking movement along these tactical lines: Democrat/Progressives might say,“Yes, Senator, we share your concern about the payroll tax holiday. But let’s also discuss the demand side, which is opposite the supply side on the macroeconomic coin. Low demand leads to less private sector revenue, less cash flow, less employment, and other things we all can agree need fixing. And, as you say, right now!”
Remember, the average American pays more payroll taxes than income taxes. And, as mentioned above, here’s the most important factor: payroll taxes are regressive, like Herman Cain’s 9-9-9. For just one more example, a poor family pays a higher percentage of its income on food than a middle-class family, even though the middle-class family spends more dollars on food. That’s regressive. Let’s ask Kyl and the GOP, “Can we both admit that such a regressive effect is a bad thing?” Publicly, where it matters, if framed in terms that appeal to the Democratic base and to independents, I’d dare Republicans to disagree without negative polling consequences.
Next, Democrats agree with the GOP (as they always seem to do on this) that Social Security “desperately needs fixing.” Push the GOP regularly with their own beliefs that extending the payroll tax, a tax cut, would be a helpful macroeconomic remedy to move our stagnant economy forward and always mention that you too believe the Republican mantra that “tax cuts create jobs.”
Caught like this, however, in a snit for the Democrats’ attempt to hoist them on their own supply side petard, the GOP will suddenly care about Social Security in its present form, something rarely show-boated. This is where Democrats and progressives can tie them into knots. “Well, yes, we too, as you well know, fear for Social Security’s future. And we support your proposed payroll tax hike, and we applaud your courage in going counter to your tax-free economics. But we, just as you have said over and over, we do not condone tax hikes on the middle class and poor alone, especially in a time of weak economic recovery while others in the top 10% of earners suffer little, if at all.” Spring the trap, and continue: “So, we propose solving both the payroll tax regressivity problem and the Social Security viability problem in one big bipartisan package. We’ll start with your excellent idea of ending the payroll tax holiday as of January 1, 2012. We’ll both frame it as a ‘big solution for some big problems,’ giving you, the GOP, ample accolades for the original concept.”
Then, roll up their flank, and uncover the proposals:
1. To assure Social Security viability for a century or more, we will erase the present payroll tax cutoff point. FICA will now be collected on all wage earners required to pay the tax regardless of income.
2. In addition, we will transform the payroll tax from a regressive flat tax to a progressive tax with lowest rates for the lowest income wage earners, with proportionately higher rates for higher earners;
3. With a progressive FICA system and the wage cut-off point removed, we will make employer FICA taxes on wages paid a progressive tax as well. Progressivity, in turn, greatly benefits small business owners with few employees.
All these things could follow, both arising from demand and supply side features of the FICA overhaul:
a marked decrease in FICA taxes on most of the American public, three quarters of whom pay more in FICA taxes than in income taxes,
a similar decrease in FICA taxes owed by small businesses, freeing up money to invest, thus driving expansion and job growth, and
a mechanism that will sustain Social Security for the long term.
And it is those constituencies who deliver GDP growth and, thereby, happily for all, increase incomes, private sector revenue, corporate profits, and, consequently, add to the wealth of the upper 10%, producing legal ecstasy for Republicans. By golly, it’ll trickle up! Exxxcellent!
If someone runs with this, how can the GOP resist it without alienating more voters than they already have?
