Thursday, July 20, 2017

TRUMP’S SIMPLE SOLUTION TO HEALTH CARE

By Dominique Paul Noth

For eight years, Republicans of every political stripe have made it their mantra that the ACA (Obamacare) must be repealed and replaced.  Now political realities suggest a clear fix – apologize for being wrong for eight years and move to repair the stuff both sides agree need adjustment.

Standing in the way of an apology that most Americans would welcome is a president whose whole reputation is built on non-apology. 
Photoshop gremlins had fun on Facebook melding Trump with his
doctor but actuallly there is an easy health care solution -- admit
a mistake and move on.

Donald Trump has made a career of refusing to back down from whatever nonsense escapes his speeches or tweet threads, such as forming commissions to investigate nonexistent voter fraud, or continuing to challenge Obama policies he is actually building on because they work. His ability to find grievances in every event has become legendary even as he mangles history and facts as he did for New York Times.

It’s not quite like Ted Cruz admitting the GOP would look foolish backing away from repeal and replace -- though "foolish" looks like a tiny problem in the current state of things.

Trump is now insisting it was THEIR promise, not his. In fact, he will sign ANY bill they put in front of him. 

The   repeal-replace rhetoric was absurd with Obama in office and it remains a bigger absurdity today as the ACA has taken hold and helped far more Americans than claim damage despite the drumbeat of GOP ads.

Now Trump is assuring Congress that he won’t even read what they give him to sign!  This is his last gasp. 

He doesn’t know or can’t say that 85% of the people on the health exchanges have subsidies to help them with their premiums and that most of the complaints are coming from people just on the other income side of the subsidies. The exchanges are also a miniscule part of the ACA and get better fast if insurance companies are reassured by the president that the underwriting will continue, as now it should by law.

He apparently doesn’t know that most people in the ACA rely on employee health plans where their companies are supposed to have negotiating power on premiums or that Medicaid alone pays for 49% of the babies born in this country. Some 74.5 million individuals were enrolled in Medicaid and CHIP in April -- yes, those are government programs.

Some Republicans actually seem ready to admit repeal-replace was a lousy pledge, but now a day after suggesting repeal without replace would work, Trump doubled down July 19, suggesting a simple White House meeting with “I’m the greatest deal closer” could fix both repeal and replace.

The world had changed around him.  Evidence exists that Obamacare is not failing – it is being sabotaged.  Health insurance companies simply want Trump’s promise that the ACA subsidies will continue, so success is in his small hands.

The president clearly doesn’t understand health care policy and actually wants to keep several things the Obama bill made possible – pre-existing coverage, children on parental plans until age 26, etc.  He doesn’t even understand that every version of the GOP bills he never read happily offers one form of subsidy or another (that’s actually one of the right wing’s problems).  

There’s a giant duplicity in the Republican talking points – that people don’t want to be forced to buy insurance if they feel, today at least, they don’t need it, but that’s only because they know others in society are poised to pay for their emergency room visits.

Health insurance works when the pool includes those who need it now and those who may need it in the future.  Plus there are terrific rewards from preventive care.  These are the larger universal truths about the American experience that comes through in war and peace – Work together to support each other, and recognize that sometimes we need government to help us do that.

There is a philosophical issue at work as well -- being mandated to be covered, as in everyone pays something. People understand that with state auto insurance, Social Security and income taxes, but some draw the line on health care.  It sounds so American to say citizens shouldn’t be forced into participation by government -- except it is also anti-American to not recognize there have always been exceptions.

The central dilemma in the discussion remains whether health care is a right or a privilege. The Republicans seem to be saying that anything we have to pay for is not a right, conveniently forgetting the military, the highways and even the breadth of Medicaid.  

This is also an underlying misconception on the left, which thinks terms like “single payer” or “Medicare for all” don’t carry a price tag.  They do and these systems will be much harder to set up in a nation that has built its health care system around private companies.  Obama recognized that as he moved the “right not a privilege” argument forward but maintained the private companies and their high level of employees and affiliates (one sixth of the economy) through a remarkably sturdy system of levers, sticks, sweeteners and counter-weights.

The Republicans, after eight years of empty flailing, are only now realizing how carefully the system was built.

Since none voted for it, they conveniently forget how many Republican ideas were incorporated, inviting GOP votes that never came (here is where my memory differs from GOP Sen. Susan Collins, who thinks the Republicans weren’t asked and now  rightly wants any new system to have both parties cooperating – but so did Obama).

Even Obama’s universal lie of 2013 (if you like your plan and your doctor, you can keep them) was a poorly worded anticipation that doctors would not flee good plans and providers would fix bad ones. 

His public relations optimism did not anticipate court roadblocks, a medical community both noble in some practices but also venal and guilty in the opioid epidemic, the financial games health companies and big pharma are experts in, the refusal of half the states to participate in the health exchanges, the reluctance of so many states to expand Medicaid despite the financial incentives, and so forth. 

Only now after eight years has the American public on the left and right realized that cooperation and repair are the best path forward – not continuing to insist on a pledge that was not thought through to begin with.

The current president, who keeps trying to shame the Republicans with their stupid pledge he apparently never agreed to, has laid down the biggest blockade to improving health care.  He thinks a few words over a White House lunch will convince the Republicans.

Minnesota Democratic Sen. Amy Klobuchar disagrees, referring to the three Republican senators who have spoken out against the meanness of the GOP bill in its various forms – Lisa Murkowski, Shelley Moore Capito and Collins.

Said Klobuchar: “I don’t think a tuna salad sandwich is going to change the minds of these three strong women” – who incidentally were excluded from the original white male taskforce on the Senate bill.


About the author:  Noth has been  a professional journalist since the 1960s, first as national, international and local news copy editor at The Milwaukee Journal, then as an editor for its original Green Sheet, also  for almost two decades the paper’s film and drama critic. He also created its Friday Weekend section and ran Sunday TV Screen magazine and Lively Arts as he became the newspaper’s senior feature editor. He was tapped by the publishers of the combining Milwaukee Journal Sentinel for special projects and as first online news producer before voluntarily departing in the mid-1990s to run online news seminars and write on public affairs and Internet and consumer news. From 2002 to 2013 he ran the Milwaukee Labor Press as editor. It served as the Midwest’s largest home-delivered labor newspaper, with archives at milwaukeelabor.org.  In that role he won top awards yearly until the paper stopped publishing in 2013. His investigative pieces and extensive commentaries are now published by several news outlets as well as his culture and politics outlets known as Dom's Domain.  His award-winning theater reviews appear at urbanmilwaukee.com.



Sunday, July 16, 2017

IN CANDID BUT NEEDED DEFENSE OF TOM BARRETT

By Dominique Paul Noth

In 2017 Milwaukee Mayor Tom Barrett delivered yet another
well accepted state of the city speech
Nice guys finish last. That truism of modern politics has been heightened in the Trump era but certainly applies at crucial times to the career of Tom Barrett, whose organizational skills and personable manner have brought a lot of success in the public arena but have also at key moments worked against his elections and his reputation in office.

His personal bravery – demonstrated in a famous 2009 incident outside State Fair – has been combined in public life by a caution that some interpret as cowardice and others as a habit of reflection from a lifetime of political realities. 

Some of Barrett’s problems may be self-inflicted but much of it has to do with a growing attitude in society that progressives have to be extreme to be taken seriously.  Over the years as an opinion journalist I have taken Barrett to task on moments of what he would call political balance and I criticized as trying to please too many sides at once.  

Those moments have now led to something I think ugly and even despicable – an unfair depiction of his methods and skilled service. 

Nowhere was this clearer to me than in the recent concern about language changes in immigration policy imposed by a skittish city attorney and quietly agreed to by the Fire and Police Commission without the due process of asking the immigrant community first, particularly the outspoken advocates of Voces de la Frontera. 

It should be worth noting that while Barrett along with police chief Ed Flynn was savaged for these changes, since reversed, there was never any evidence of initiation. Barrett never wavered in his support of the immigration community and even applauded the change back in language.

The real history here seems that the independently elected city attorney, frightened by how Trump AG Jeff Session had been moving harshly against sanctuary cities and independent local policing, wanted to put belt and suspenders on city policy – and never understood how stridently immigration defenders would react to any change in language, a reaction I found understandable.

Barrett was victimized in the public mind as weakening on defense of immigrants, though he remained an outspoken articulate leader on immigration causes. Privately he seems to understand that, while the reaction may seem hysterical to outsiders, if you live in the immigration community and are aware of how remorseless the Trump administration can appear, a little paranoia doesn’t mean Sessions isn’t out to get you.

But no question, there is a history of Barrett talking one way but then not speaking out for the principles he subscribed to in the minds of constituencies that had supported him.  That certainly influences the reaction to current events. Much of this may be his way of operating but it has seemed to me in the past that voucher school advocates and building contractors have been pretty good at picking the mayor’s pocket whatever principles he thinks he stands for.

Some examples.  Barrett made a major error in my opinion in seeking control of Milwaukee public schools eight years ago, taking his cue from Democratic Gov. Jim Doyle without recognizing how ferociously the city felt about local citizen control -- even if the voters didn’t always turn out in big numbers for MPS board elections.

Both Doyle and Barrett, either knowingly or not, were reacting to outside privatization and business interest pressures, where Barrett often doesn’t find the right point of balance. Neither, of course, do many of his current critics.

His vacillation here, much like County Executive Abele’s more recently, speaks to a confusion about education policy that the community itself has had difficulty deciphering.  What do you do with programs that are popular with parents but may actually be hurting children’s education? 

Similarly, in 2008 when Milwaukee voters overwhelming supported a modest paid sick leave ordinance, Mayor Barrett joined the business community in opposing it, even using their argument that “voters just want free stuff” and such a law would isolate the city with higher standards than hungry business-stealing suburbs. His opposition shortly brought a state law under Gov. Scott Walker preventing any policy stronger than the state’s – while around the country, my contrary argument was winning. The city passed up the chance to be an oasis of good corporate citizenship.

When he was elected mayor in 2004, Barrett was actually riding some high regard in the black community. It traced back to his excellent service in Congress and his refusal in 2002 to primary fellow Democrat Jerry Kletzka when Milwaukee lost a congressional seat in the 2000 census.  Since Kletzka was from the whiter south side, Barrett support was vital in the black community.

Handing his district over to Kletzka was a moving ceremony in 2002 when Barrett invited his good friend, civil rights icon Rep. John Lewis, to speak at the Black Holocaust Museum and join hands with him, Kletzka and many noted local names such Marvin Pratt in a march to the Martin Luther King statue.

In 2002 newbie David Clarke was
sucking up to the Democrats.
I have memorable photos of the event including a newly appointed sheriff, David Clarke, bobbing up and down behind the famous in an effort to ingratiate himself with the Democrats – my, how times have changed!

Later that year, Barrett lost a primary bid for governor, coming in second behind Doyle and ahead of Kathleen Falk – a race he ran well but may have lost because of that lingering outside resistance in Wisconsin to anyone from Milwaukee, even anyone clearly accomplished. 

The irony of that 2002 popularity moment, when Barrett was  holding hands with Pratt on the march, became striking in 2004 when Barrett used his bigger name and war chest to defeat by eight points Pratt, the interim mayor  who used the theme “It’s Time” (in a minority dominated city) to make much of that campaign a black-white issue. The black-white fever lingers to this day.

A mustachioed Barrett campaigning for mayor at a 2003 gathering.
Pratt had some campaign finance issues as well and Barrett still had popularity within the black community, which would slowly be diminished by a curious combination of right wing money, streetcar opposition, lead pipe simplicities and extremist minority concerns about representation.

The myth that blacks are better for blacks and Latinos are better for Latinos regardless of ability dies hard. Barrett’s early support for Obama, his record of fighting for civil rights, his refusal to be cowed on immigration rights, his ability against odds to pass important legislation, all seem  to count for little.

Barrett has been good on those issues – in statements at least.  When he ran for mayor in 2004 and even since, no one has been as persuasive on the need for unions and worker solidarity. No one has been more forceful in speaking for the inner city. Yet that has not always been matched in public perspective or mayoral decisions.  I recall criticizing some building projects for failing their full union promise. That may have been the fault of his minions, but they were his hires and the mayor is the one who has to be held responsible.

I also recall interviewing Frank Zeidler before his death. The last Milwaukee Socialist mayor emphasized that city government was an ongoing tale of a strong common council (by law) and a weaker mayor.  So reporters should be better than the public in differentiating who is responsible for what – and which camp is making the most mischief.

The best and most amusing criticism I ever heard of Barrett came years ago in an inner city church after the mayor bravely faced down critics and the Rev. Willie Brisco, leader of MICAH, took the lectern.  “I love Tom Barrett,” he said, comparing him to a “great kid” at shortstop he played pickup baseball with in his youth.  “Wonderful guy,” Brisco said, before laying down the stinger.  “But he couldn’t pick a ball.”

Brisco was describing the difference between what Barrett said and what he did.  But note he was speaking after Barrett, overriding his own advisers, openly defended his actions before a hostile audience.

This is a pattern I have seen over the years, which is why a lot of the criticism of Barrett irks me – he only cares about Downtown, they say, he doesn’t speak up on neighborhood issues or for the working class, he doesn’t care about the inner city, that streetcar is just for the rich tourists and so forth.

Barrett speaking in 2006 at labor's Mourn for the Dead
annual event at then named Zeidler Union Square Park.
Yet over the years I always run into Barrett at neighborhood events, speaking up for investments in communities like Harambee, in home improvements on the west side, in better weather installation for older Milwaukee houses, in fighting the state on foreclosures, in talking train company Talgo back into its inner city facility despite how cruelly the company was treated by Gov. Scott Walker, in explaining his ideas before audiences not willing to listen – and on and on.

The GOP delays in the streetcar have gone on for decades and have cost both the inner city and the east side the expansions planned long ago, again demonstrating how these anti-transit and anti-community forces have set Milwaukee and Wisconsin back generations.

A lot people still take the statewide Democratic losses out on Barrett. Perhaps the party should have moved more rapidly to younger standard bearers. Perhaps the electorate should have woken up harder and faster.

But even in 2002, many think in terms of administrative skill, caring nature and personality he would have made a better governor than Doyle. Who can doubt that even his multiple losses to Walker cost the state far more than it did Barrett? Who today thinks Mary Burke was a candidate improvement on Barrett?

The latest bizarre efforts to recall Barrett brought immediately to my mind the curious mixture of right wing money organizers and left-wing agitation behind the Swanigan effort against DA John Chisholm, again much of the same tired racial simplicities that have injured city politics before and clearly will again. 

Even as in Pratt’s time, there is new evidence that political critics circling City Hall are willing to make deals on the left and the right, with workers and corporations, with big suburban money and street agitators – while hypocritically  criticizing  Barrett for his compromises.

They are now engaged secretly in areas Mayor Tom was at least honest about.

About the author: Noth has been  a professional journalist since the 1960s, first as national, international and local news copy editor at The Milwaukee Journal, then as an editor for its original Green Sheet, also  for almost two decades the paper’s film and drama critic. He also created its Friday Weekend section and ran Sunday TV Screen magazine and Lively Arts as he became the newspaper’s senior feature editor. He was tapped by the publishers of the combining Milwaukee Journal Sentinel for special projects and as first online news producer before voluntarily departing in the mid-1990s to run online news seminars and write on public affairs and Internet and consumer news. From 2002 to 2013 he ran the Milwaukee Labor Press as editor. It served as the Midwest’s largest home-delivered labor newspaper, with archives at milwaukeelabor.org.  In that role he won top awards yearly until the paper stopped publishing in 2013. His investigative pieces and extensive commentaries are now published by several news outlets as well as his culture and politics outlets known as Dom's Domain.  He also reviews theater for urbanmilwaukee.com.