Single Payer Coming?

It looks like we might be heading in the direction of a single payer health care system, but note in the way we wanted. Aetna is seeking to buy Humana. While this would not actually be single payer, it would further decrease competition in the insurance industry. There is also speculation that UnitedHealth is interested in purchasing Cigna and Aetna. Instead of a single=payer system modeled on Medicare, we could wind up with a more monopolistic system, which should please Republicans. These purchases would be subject to anti-trust review.

Aetna purchasing Humana would also give Aetna a much larger share in the Medicare Advantage market. So much for George Bush’s plan to supposedly increase competition and choice for Medicare patients. The plan has was more designed as a reward to the insurance industry for all the contributions they have made to the Republicans.

In related news, The New York Times repeated misleading information on health care rates which I previously discussed. Only plans desiring rates over ten percent are required to submit their requests. Insurance companies have multiple plans, and are only seeking increases on some plans, leaving less expensive choices for those who take advantage of the exchange to compare plans. Plus the requests for larger rate increases will not necessarily be granted.

However, should private insurance rates still be too high, single payer remains the most cost-effective means of providing health care coverage. This could turn into a major issue in Bernie Sanders’ favor.

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Two Liberal Decisions From A Conservative Court

Rainbow White House

It has been a good week for liberal decisions form a conservative court. Yesterday, as I was certain they would, they threw out the absurd case against the Affordable Care Act. I’m not sure that this really changes anything. Conservatives will continue to complain about the law, but lack any effective way to repeal it, and certainly have no alternative.

The case made no sense and if Roberts had wanted to destroy Obamacare he would have done so when they ruled on the individual mandate. In this case it isn’t so much that the Supreme Court has become more liberal, but that the Supreme Court is not willing to go along with every ridiculous case brought by conservatives. Earlier in the week, The New York Times showed that the court has made more liberal decisions this year. Brendan Nyhan followed this up discussing a reason why the court might appear more liberal when it is not:

In a 2009 article, the political scientists Kevin T. McGuire, Georg Vanberg, Charles E. Smith Jr. and Gregory A. Caldeira proposed a theory that provides an alternate explanation to liberal drift. They predicted that conservatives would press their luck to take advantage when they had a majority on the court, appealing more cases they lost in lower courts. (Conversely, liberals would be less likely to appeal cases because they were more likely to prefer lower-court decisions and to fear creating damaging precedents.) Mr. McGuire and his co-authors then showed empirically that this process increased the number of conservative reversals of lower-court rulings but also increased the number of cases in which a more liberal ruling was affirmed because litigants guessed wrong about how far the court was willing to go.

Their prediction seems to fit nicely with recent evidence. The court has reversed lower-court decisions and decided in favor of conservatives on high-profile cases concerning issues like campaign finance and voting rights. But Justice Kennedy and/or Chief Justice Roberts have joined the liberal wing to affirm more liberal lower-court rulings in cases like today’s decisions on health care and housing.

The case also did show a degree of sanity on the court in deciding against an argument which only bat-shit crazy conservatives(such as George Will) could accept. It also demonstrated that at least one justice was persuadable as it takes four justices to accept a case, and only three stuck with this argument in the end.

The decision in favor of same-sex marriage was also predictable but is far more significant. It really does change the status quo for those living in states where same-sex marriage has remained illegal. Andrew Sullivan returned to blogging to describe what this meant to him:

We are not disordered or sick or defective or evil – at least no more than our fellow humans in this vale of tears. We are born into family; we love; we marry; we take care of our children; we die. No civil institution is related to these deep human experiences more than civil marriage and the exclusion of gay people from this institution was a statement of our core inferiority not just as citizens but as human beings. It took courage to embrace this fact the way the Supreme Court did today…

I think of the gay kids in the future who, when they figure out they are different, will never know the deep psychic wound my generation – and every one before mine – lived through: the pain of knowing they could never be fully part of their own family, never be fully a citizen of their own country. I think, more acutely, of the decades and centuries of human shame and darkness and waste and terror that defined gay people’s lives for so long. And I think of all those who supported this movement who never lived to see this day, who died in the ashes from which this phoenix of a movement emerged. This momentous achievement is their victory too – for marriage, as Kennedy argued, endures past death.

This case also shows how the Republican Party has moved to the right while the nation has become more liberal on social issues. Compare the views of the Roberts Court with this year’s presidential candidates which are summarized at BuzzFeed. In 2004 Republicans successfully used proposals to ban same sex marriage to turn out the vote in their favor. While opposition might help some candidates in Republican primaries, it will also hurt them in the general election.

In 2013 I had posted a prediction from George Clooney which is far closer to coming true:

 

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CDC Reports On Decrease In Uninsured Under Affordable Care Act

The CDC reports the percent of uninsured showed the largest drop since they began reporting data on this, consistent with other measures of the decrease in uninsured under the Affordable Care Act such as the Gallup poll.

The share of working-age people without health insurance fell by more than 4 percentage points in 2014, the biggest drop since the U.S. Centers for Disease Control and Prevention began reporting the data in 1997.

Last year, 16.3 percent of adults under age 65, or about 31.7 million people, lacked medical coverage, according to a CDC survey published Tuesday. That’s down from 20.4 percent a year earlier.

Many people are able to receive coverage due to eliminating the ability of insurance companies to deny coverage based upon pre-existing conditions. Many also are assisted by the subsidies which help them pay for the insurance premiums under Obamacare.

We are now waiting to see how the Supreme Court rules on King v. Burwell. Even if the Supreme Court accepts this fallacious argument that the law only intended to provide subsidies for those purchasing insurance on the state exchanges, and not the federal exchange, I would expect some sort of fix to enable the subsides to continue. The Republican Congress would be under tremendous pressure to cooperate in making a slight revision to the Affordable Care Act to continue the subsidies. If they did not, I bet some way would be found to make versions of the federal exchange available to the states.

Of course we cannot underestimate the possibility of Republicans to deny health care coverage, as we saw with the expanded Medicaid program:

States that expanded Medicaid through Obamacare provisions had lowers rates of uninsured, the CDC said. In states that didn’t expand Medicaid, 19.3 percent of adults under 65 were uninsured, compared with 13.3 percent in states that did.

Most people 65 and over get coverage through Medicare, the U.S. government program to cover the elderly.

Texas and Oklahoma had the highest rate of uninsured at 21.5 percent; neither state expanded Medicaid under the Affordable Care Act. Hawaii had the lowest rate, with 2.5 percent uninsured last year.

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Don’t Believe The Latest Round Of Scare Stories On Health Insurance Premiums

health care reform

There have been a number of scare stories recently predicting huge increases in health insurance premiums for 2016 due to Obamacare. This year premiums went up much less than predicted and most likely the current predictions of doom will not come about. Two recent stories from NPR’s Morning Edition and The Hill provide a more realistic outlook:

The average insurance premium under ObamaCare is probably not headed toward a double-digit hike next year, according to new data.

Premiums for silver plans on the federal insurance exchanges are slated to increase an average of 5.8 percent in the eight states where all data is available, according to an analysis by Avalere Health. For the lowest-cost silver plans, that increase will be 4.5 percent, or an average of $378 per year.

That data, which includes Maryland and Michigan, comes after a string of headlines predicting steep cost increases for health insurance plans in 2016.

“While recent public attention has focused on a subset of plans that filed for premium increases of 10 percent or more, these data reveal that most plans are proposing more modest increases,” said the group’s senior vice president, Caroline Pearson.

Health insurance companies were required to file their rate increases by June 1, though under law, most are only required to seek approval for hikes of 10 percent or more — resulting in a skewed portrait of the increases.

That is an important point that the news is coming from those plans which are requesting the largest increases while the plans which desire lower increases do not make news. Morning Edition had more to put this in perspective.

The numbers released last week came out of a June 1 deadline, under the Affordable Care Act, that requires insurance companies to tell government regulators when they’re requesting price hikes of more than 10 percent. Some officials opposed to the law, like Sen. Steve Daines, a Republican from Montana, decried the increases.

“Blue Cross Blue Shield, which is Montana’s largest insurer, is asking for an average increase of 23 percent for Montanans enrolled in individual plans,” he told colleagues from the U.S. Senate floor last week.

While that sounds scary, it turns out that Blue Cross Blue Shield in Montana is actually asking for large price hikes on just two plans it wants to offers in the state. While it’s not yet public how many they’ll offer in 2016, they currently offer 50 plans.

Caroline Pearson, vice president for health reform at the consulting firm Avalere Health, has been digging into available numbers on insurance pricing across several states. She says such price hikes are not the norm. She’s not seeing anything like a 20 percent average increase in the price of monthly premiums.

“Those are not necessarily the plans that hold the bulk of enrollment,” she says. “So, while some of those plans may be going up a lot in price, that doesn’t mean a lot of enrollees are necessarily affected.”

In the handful of states where data is available (Connecticut, Maryland, Michigan, Oregon, Virginia, Vermont, Washington state and Washington, D.C.), Pearson says the majority of people buying health coverage on exchanges won’t face serious sticker shock.

“We have seen that about 6 percent average rate increases are expected for 2016,” Pearson says.

As Avalere looks at the less expensive plans, she says, “We’re seeing anywhere from a 5 percent increase for the lowest-cost plan available, to a 1 percent increase for the second-lowest-cost plan available. So we’re really looking at very modest increases — very consistent with what we saw from 2014 to 2015.”

With some plans planning large increases while other plans, including some from the same company, are only likely to have modest premium increases, my suspicion is that insurance companies are counting on some customers sticking with the same plan without shopping around. They will receive higher profits from those who stick with plans which jump the most in price, while consumers who take advantage of the exchange can switch to plans without huge premium increases.

Also note that these increases making the news are only requests. Another change under the Affordable Care Act is that it is possible that these larger premium increases will be denied.

As long as health care remains based upon private insurance companies we will continue to see premium increases. After all, double digit increases in premiums were extremely common before the Affordable Care Act was passed. While the ACA has expanded health care coverage and has resulted in some lower costs, the bulk of the proposed cost-containing provisions were stripped form the bill in order to achieve sixty votes to pass in the Senate. Some of the remaining provisions to lower costs are based more on long term changes in health care.

If cost control was the goal, then it would have made more sense to go for a single-payer plan as opposed to the far more modest bill which passed. Ironically Bill Kristol recently suggested, in an interview with Ezra Klein, that this is what the Democrats should have done:

Kristol’s perspective on this will be of some comfort to liberals. “I was never convinced that single-payer wouldn’t be more attractive than Obamacare,” he says. “I think there was some truth to the left-wing critique of Obamacare. You’re building this giant contraption, making people worried about disruption, but you’re helping a rather limited number of people. In a funny way, if you’re doing a middle-class entitlement, you should do a big middle-class entitlement.”

The problem is that there would have never been sixty votes to pass a single-payer plan. If ideas such as the public option and a buy-in to Medicare had to be dropped because of the opposition from Joe Lieberman and Ben Nelson, there is no way that sixty votes could have been obtained for a single-payer plan. The same article points out how Obamacare passed while Hillary Clinton’s more extensive plan from the 1990’s, which “would have upended the health insurance of most Americans” was easier for Republicans to defeat.

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Bernie Sanders Answers Questions And NBC Advises Not To Count Him Out

Bernie Sanders facebook

Bernie Sanders will be holding a rally in Vermont to kick off his campaign tonight. Sanders answered ten questions from MSNBC–almost as many questions Hillary Clinton has answered in her entire campaign to date. Some excerpts, which show that while on the left of our political spectrum, he is still not out to destroy our market system as conservatives are bound to claim.

HARWOOD: In the latter part of the 20th century, Ronald Reagan came along and there was a big pivot in our politics. It revolves around the idea that we need less government and more market forces. Do you think that basic pivot was wrong?

SANDERS: Let me answer it this way, John. I think there is obviously an enormously important role for the free market and for entrepreneurial activity. I worry how free the free market is. In sector after sector, you have a small number of companies controlling a large part of the sector.

Certainly, in my view, the major banks should be broken up. We want entrepreneurs and private businesses to create wealth. No problem. But what we’re living in now is what I would call—what Pope Francis calls—a casino-type capitalism, which is out of control, where the people on top have lost any sense of responsibility for the rest of the society. Where it’s just “It’s all me. It’s all me. And to heck with anybody else.” I want to see the result of that wealth go to the broad middle class of this country and not just to a handful of people.

HARWOOD: If the changes that you envision in tax policy, in finance, breaking up the banks, were to result in a more equitable distribution of income, but less economic growth, is that trade-off worth making?

SANDERS: Yes. If 99 percent of all the new income goes to the top 1 percent, you could triple it, it wouldn’t matter much to the average middle class person. The whole size of the economy and the GDP doesn’t matter if people continue to work longer hours for low wages and you have 45 million people living in poverty. You can’t just continue growth for the sake of growth in a world in which we are struggling with climate change and all kinds of environmental problems. All right? You don’t necessarily need a choice of 23 underarm spray deodorants or of 18 different pairs of sneakers when children are hungry in this country. I don’t think the media appreciates the kind of stress that ordinary Americans are working on. People scared to death about what happens tomorrow. Half the people in America have less than $10,000 in savings. How do you like that? That means you have an automobile accident, you have an illness, you’re broke. How do you retire if you have less than $10,000, and you don’t have much in the way of Social Security?

HARWOOD: It came out in disclosure forms the other day that Hillary Clinton and Bill Clinton, in the last 16 months, have made $30 million. [More on their disclosure here.] .What does that kind of money do to a politician’s perspective on the struggles you were just talking about? Does it make it difficult for recipients of that kind of income to take on the system?

SANDERS: Well, theoretically, you could be a multibillionaire and, in fact, be very concerned about the issues of working people. Theoretically, that’s true.

I think sometimes what can happen is that—it’s not just the Clintons—when you hustle money like that, you don’t sit in restaurants like this. You sit in restaurants where you’re spending—I don’t know what they spend—hundreds of dollars for dinner and so forth. That’s the world that you’re accustomed to, and that’s the world view that you adopt. You’re not worrying about a kid three blocks away from here whose mom can’t afford to feed him. So yes, I think that can isolate you—that type of wealth has the potential to isolate you from the reality of the world.

HARWOOD: I read an interview that you did about the corporate media. And you said the corporate media was reluctant to call out people for lying in public debates. You’re on corporate media right now. Who’s lying in our politics?

SANDERS: I’m the ranking member of the Budget Committee, OK? Leader of the opposition. The Republican budget does the following: It throws 27 million people off of health care by ending the Affordable Care Act and cutting Medicaid by $440 billion. Have you seen that in print? Have you seen that statement? There is a reality that goes on here. And you have many people who try to be, “Oh, I’ve got to be even-handed here and even-handed there. You got the Koch Brothers there, Bernie Sanders there.” That’s nonsense. And I think a lot of right-wing people get away with murder because the media doesn’t call them out on it.

Elsewhere at NBC, Steve Kornacki advised not to count Bernie Sanders out, although he was writing more in terms of Sanders winning enough delegates to shape the platform. That is hardly a satisfactory outcome if it still means Clinton wins the nomination. It is not as if a more liberal platform has any real bearing on what she will do if elected.

First Read has a slightly different, and more desirable, take:

For political historians out there, think of Sanders as a potential Eugene McCarthy. McCarthy’s ability to gain traction against LBJ drove LBJ out in 1968 and sparked more Dems to run. If Sanders gets enough traction to actually knock off Clinton in an early state, then Katie bar the door.

The closest political analogy would be the sitting Vice President winning on to win the nomination as Hubert Humphrey did in 1968. While Joe Biden is not my first choice, he would be far preferable to Clinton. He spent four years opposing Clinton’s more interventionist views when she was Secretary of State, and it was Biden who pushed Obama into announcing support for same-sex marriage. Knocking out Clinton could also result in other more liberal Democrats entering the race. Martin O’Malley, who will be announcing his candidacy later this week, is certainly seeing such a scenario as opening the way for him to win the nomination. I also wouldn’t rule out the chances of Sanders himself winning.

Update: Text of Sander’s speech here.

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What Bernie Sanders Believes

Bernie Sanders

Bernie Sanders has become the first to officially announce his plans to run against Hillary Clinton for the Democratic nomination. The conventional wisdom is that he has no chance to win (a type of prediction which I fear the media helps become true) but will move the conversation to the left. Unlike most politicians, Sanders’ views have remained quite consistent, making it a good bet that looking at his past statements will give a good idea of what he will be talking about while campaigning.

Common Dreams has a lengthy article on Sanders. This includes, “In December of last year, Sanders put forth what he called an Economic Agenda for America, a 12-point plan”

  1. Invest in our crumbling infrastructure with a major program to create jobs by rebuilding roads, bridges, water systems, waste water plants, airports, railroads and schools.
  2. Transform energy systems away from fossil fuels to create jobs while beginning to reverse global warming and make the planet habitable for future generations.
  3. Develop new economic models to support workers in the United States instead of giving tax breaks to corporations which ship jobs to low-wage countries overseas.
  4. Make it easier for workers to join unions and bargain for higher wages and benefits.
  5. Raise the federal minimum wage from $7.25 an hour so no one who works 40 hours a week will live in poverty.
  6. Provide equal pay for women workers who now make 78 percent of what male counterparts make.
  7. Reform trade policies that have shuttered more than 60,000 factories and cost more than 4.9 million decent-paying manufacturing jobs.
  8. Make college affordable and provide affordable child care to restore America’s competitive edge compared to other nations.
  9. Break up big banks. The six largest banks now have assets equivalent to 61 percent of our gross domestic product, over $9.8 trillion. They underwrite more than half the mortgages in the country and issue more than two-thirds of all credit cards.
  10. Join the rest of the industrialized world with a Medicare-for-all health care system that provides better care at less cost.
  11. Expand Social Security, Medicare, Medicaid and nutrition programs.
  12. Reform the tax code based on wage earners’ ability to pay and eliminate loopholes that let profitable corporations stash profits overseas and pay no U.S. federal income taxes.

PBS Newshour has this information on his views, including additional links:

Campaign finance: Limit corporate and interest-group spending in campaigns.

Sanders proposes a Constitutional amendment that would effectively reverse the Supreme Court’s Citizen United ruling and ban corporations and nonprofits from unlimited campaign expenditures. The independent senator would also require disclosure of any organizations spending $10,000 or more on an election-related campaign.

Climate change: Charge companies for carbon emissions

Considered to be a “climate change hawk” and use some of the money raised to boost renewable energy technology.

Education: Two years free tuition at state colleges. Reform student loans.

Sanders would provide $18 billion to state governments to allow them to cut tuition at state colleges by 55 percent. And he would allow anyone paying off a student loan currently to refinance at a lower rate.

Federal Reserve and banks: Break up big banks. Open up the Fed.

Sanders would divide large banks into smaller entities and charge a new fee for high-risk investment practices, including credit default swaps. In addition, he believes the Federal Reserve is an opaque organization which gives too much support to large corporations. His pushed for a 2011 audit of the Fed and he would use the Fed to force banks into loaning more money to small businesses. Finally, he would ban financial industry executives from serving on the 12 regional boards of directors.

Guns: A mixed approach. No federal handgun waiting period. Some protection for gun manufacturers. Ban assault weapons.

In the House of Representatives, Sanders voted against the pro-gun-control Brady Bill, writing that he believes states, not the federal government, can handle waiting periods for handguns. Soon after, he voted yes for the 1994 Violent Crime Control and Law Enforcement Act that included an assault weapons ban. He has voted to ban some lawsuits against gun manufacturers and for the Manchin-Toomey legislation expanding federal background checks.

Health care: Change to single-payer government-provided health care

Sanders voted for the Affordable Care Act, but believes that the new health care law did not go far enough. Instead, he espouses a single-payer system in which the federal and state governments would provide health care to all Americans. Participating states would be required to set up their own single-payer system and a national oversight board would establish an overall budget.

Immigration: Offer path to citizenship. Waive some deportations now.

Sanders generally agrees with President Obama that most of the undocumented immigrants in the country now should be given a path to citizenship. He voted for the senate immigration bill in 2013, which would have increased border security and issued a provisional immigrant status to millions of undocumented residents once some significant security metrics had been met. In addition, Sanders has supported President Obama’s use of executive orders to waive deportation for some groups of immigrants, including those who were brought to the United States as children.

Taxes: Raise some taxes on the wealthy. Cut taxes for middle class.

The current ranking minority member on the Senate Budget Committee, Sanders would nearly double taxes on capital gains and dividends for the wealthiest two percent of Americans. In addition, this year Sanders asked President Obama to use executive action to close six tax deductions benefitting corporations and hedge funds. The Vermont senator would use some of the revenue gained from higher taxes on the rich to lower taxes for middle and lower class Americans.

Iraq, Islamic State and Afghanistan: Opposed the Iraq war. Calls for troop withdrawal as soon as possible.

A longtime anti-war activist, Sanders voted against the Iraq war resolution in 2002. He has regularly called for the U.S. to withdraw troops from Afghanistan and Iraq as soon as possible. Regarding the Islamic State, Sanders has said the U.S. should not lead the fight. In general, he believes the U.S. should focus less on international conflict and more on the domestic needs of the middle class.

Iran and Israel: Supports current talks with Iran. Critical of Israeli Prime Minister Benjamin Netanyahu.

In an interview with ABC News Sanders called the Clinton Foundation money, along with money from conservative sources, a very serious problem:

Sen. Bernie Sanders, I-Vermont, said he is concerned by the millions of dollars flowing into the Clinton Foundation at a time when he thinks money plays too strong a role in politics.

“It tells me what is a very serious problem,” Sanders said in an interview with ABC News’ Chief White House Correspondent Jonathan Karl. “It’s not just about Hillary Clinton or Bill Clinton. It is about a political system today that is dominated by big money. It’s about the Koch brothers being prepared to spend $900 million dollars in the coming election.

“So do I have concerns about the Clinton Foundation and that money? I do,” he added. “But I am concerned about Sheldon Adelson and his billions. I’m concerned about the Koch Brothers and their billions. We’re looking at a system where our democracy is being owned by a handful of billionaires.”

The issues in the above lists are primarily, but not exclusively, based on economic views. Sanders, as opposed to Clinton, also has a strong record of support for liberal positions on foreign policy and social issues. While it is inevitable that economic issues will dominate the campaign this year, I hope that during the course of the campaign more is said about both Clinton’s hawkish foreign policy views, along with her conservative cultural views.

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Good News In Polls On Obamacare, Obama, And The Economy

Kaiser Health Tracking Poll April 2015

There is some favorable news in a couple polls out today. A Kaiser Health Tracking Poll shows that the number who view the Affordable Care Act favorably or unfavorably is now evenly split, with 43 percent having a favorable view and 42 percent unfavorable. This remains within the margin of error and, while still lower than it should be considering how well the law has worked, is an improvement over previous polls. Last month 43 percent viewed the law unfavorably and 41 percent favorably. A year ag0 46 percent viewed Obamacare unfavorably compared to 38 percent favorably. As expected, there was a large partisan difference in these findings. The poll also showed that few people realize that implementation of the Affordable Care Act has cost less than originally estimated.

A CNN/ORC poll shows an improved approval rating for President Obama, along with increased optimism about the economy:

For the first time since May of 2013, more Americans polled say they have a positive impression of how Obama is handling the presidency than a negative one: 48% approve of the way Obama is handling his job, while 47% disapprove…

Obama’s numbers are on the rise at the same time the public gives the economy the highest ratings of his presidency.

The poll finds 52% describe the U.S. economy as very or somewhat good, while 48% call it very or somewhat poor. That marks the first time since Obama took office that significantly more people describe the economy as “good” than “poor,” and only the second time since then that a majority has described the nation’s economy as “good.”

…Likewise, the public’s outlook for the country’s economic future is remarkably positive. Sixty percent say they expect the economy to be in good shape a year from now, while just 38% say they think it will be in poor shape. That’s the most positive outlook since the height of the 2012 election campaign. Such campaigns typically boost optimism about the economy as people on both sides of the ideological divide believe their candidate will win and ultimately turn things around.

But outside of that campaign, the last time optimism about the economy reached 60% was in April 2009, about three months into Obama’s time in office.

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Marijuana, Needle Exchange Programs, And Clinton’s Cultural Conservatism

Clinton Marijuana

Following recent posts about Lincoln Chafee talking about running for the Democratic nomination I began looking to see if there are any other issues where the two have major differences besides Clinton’s support for the Iraq war, which he has been attacking Hillary Clinton on. which he has been attacking Hillary Clinton on. I was pleased to see that back in 2011 Chaffee called for a reclassification of medical marijuana from a Schedule I controlled substances, which puts states which have legalized medical marijuana at odds with federal laws.

Three years later, Martin O’Malley took this a step even further, signing a bill decriminalizing marijuana, while opposing outright legalization. Hillary Clinton, as would be expected from her overall cultural conservatism, has lagged behind the country, and the Democratic Party, on both legalization of marijuana and medical marijuana.

On a related issue, Clinton’s opposition to needle exchange programs, while certainly not a major issue, was also an early issue in the 2008 nomination battle which differentiated the political philosophies of Clinton from the more liberal Barack Obama. Martin O’Malley, who is also moving well to the left on economic issues, signed a bill allowing needle exchange in Maryland. Clinton and Obama also differed in 2008 on reforming sentencing for violation of drug laws. While Obama’s record on the drug war has certainly been mixed, I would hate to see a move further to the right under Clinton.

Clinton’s cultural conservatism and promotion of conservative causes has often been traced to her membership in The Fellowship while in the Senate. From Mother Jones in 2007:

Through all of her years in Washington, Clinton has been an active participant in conservative Bible study and prayer circles that are part of a secretive Capitol Hill group known as the Fellowship. Her collaborations with right-wingers such as Senator Sam Brownback (R-Kan.) and former Senator Rick Santorum (R-Pa.) grow in part from that connection…

That’s how it works: The Fellowship isn’t out to turn liberals into conservatives; rather, it convinces politicians they can transcend left and right with an ecumenical faith that rises above politics. Only the faith is always evangelical, and the politics always move rightward…These days, Clinton has graduated from the political wives’ group into what may be Coe’s most elite cell, the weekly Senate Prayer Breakfast. Though weighted Republican, the breakfast—regularly attended by about 40 members—is a bipartisan opportunity for politicians to burnish their reputations, giving Clinton the chance to profess her faith with men such as Brownback as well as the twin terrors of Oklahoma, James Inhofe and Tom Coburn, and, until recently, former Senator George Allen (R-Va.). Democrats in the group include Arkansas Senator Mark Pryor, who told us that the separation of church and state has gone too far; Joe Lieberman (I-Conn.) is also a regular.

Unlikely partnerships have become a Clinton trademark. Some are symbolic, such as her support for a ban on flag burning with Senator Bob Bennett (R-Utah) and funding for research on the dangers of video games with Brownback and Santorum. But Clinton has also joined the gop on legislation that redefines social justice issues in terms of conservative morality, such as an anti-human-trafficking law that withheld funding from groups working on the sex trade if they didn’t condemn prostitution in the proper terms. With Santorum, Clinton co-sponsored the Workplace Religious Freedom Act; she didn’t back off even after Republican senators such as Pennsylvania’s Arlen Specter pulled their names from the bill citing concerns that the measure would protect those refusing to perform key aspects of their jobs—say, pharmacists who won’t fill birth control prescriptions, or police officers who won’t guard abortion clinics.

Clinton has championed federal funding of faith-based social services, which she embraced years before George W. Bush did; Marci Hamilton, author of God vs. the Gavel, says that the Clintons’ approach to faith-based initiatives “set the stage for Bush.” Clinton has also long supported the Defense of Marriage Act, a measure that has become a purity test for any candidate wishing to avoid war with the Christian right…

The libertarian Cato Institute recently observed that Clinton is “adding the paternalistic agenda of the religious right to her old-fashioned liberal paternalism.” Clinton suggests as much herself in her 1996 book, It Takes a Village, where she writes approvingly of religious groups’ access to schools, lessons in Scripture, and “virtue” making a return to the classroom.

As noted in the above excerpt, Clinton’s affiliation with the religious right was seen in her support for the Workplace Religious Freedom Act , a bill introduced by Rick Santorum and opposed by the American Civil Liberties Union for promoting discrimination and reducing access to health care, along with her promotion of restrictions on video games and her introduction of a bill making flag burning a felony. Her social conservatism is also seen in her weak record on abortion rights, such as supporting parental notification laws and stigmatizing women who have abortions with the manner in which she calls for abortion to be “safe, legal and rare.”

(Links to additional material added on April 19)

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Hillary Clinton Begins Campaign Hiding From Press & Marco Rubio Jumps In

Clinton Announcement Video Screen Grab

Hillary Clinton has started her campaign, and is already hiding from the press. From The Los Angeles Times:

Hillary Rodham Clinton shocked nobody in the media when she announced that she was running for president on Sunday – but her next move took reporters by surprise.

Clinton didn’t get on a campaign plane and head to Iowa. Instead, she and a small group of staff piled into what the candidate calls the Scooby van. They are road-tripping it to Iowa. The press was not invited.

Peter Beinart at The Atlantic was far more impressed with Clinton’s video announcing her campaign than I was, but his article might not be doing her any favors. Beinart reminded readers of all the conservative imagery in previous Clinton announcements and her long history of cultural conservatism:

Here are some of the phrases that appeared in Hillary’s 2000 senate announcement: “voluntary uniform rating system for movies and films,” “welfare,” “more police on the streets,” “teacher testing in the face of boycotts,” “I don’t believe government is the solution to all our problems” and “parents, all parents, must be responsible.” The message was pure Clintonism, as developed when Bill ran the Democratic Leadership Council in the early 1990s: To deserve government help, people must be morally responsible. And it came naturally to a senate candidate who, although caricatured as a sixties radical, was better described, by a former White House aide, as “a very judgmental Methodist from the Midwest.”

In 1993, Hillary had declared herself “not comfortable” with distributing condoms in schools. In 1994, she had endorsed “three strikes and you’re out” laws that expanded prison sentences.

In 1996, she had backed Bill’s decision to sign the anti-gay Defense of Marriage Act. And in the 2000 senate campaign, she supported parental notification laws for children seeking abortions, a position that placed her to the right of her initial Republican challenger, Rudy Giuliani.

I agree with Beinart that this year’s video displayed more liberal imagery, but it was just imagery. Nothing was said about actual political positions or plans upon taking office. Until she shows evidence otherwise, and there is a long way to go, this video is not enough to believe that she has really changed. In many ways Hillary Clinton has remained the same Goldwater Girl she was in the 1960’s (except that Barry Goldwater was more socially liberal than Clinton, and not much more hawkish).

At Salon, (better known in the blogosphere as just Digby) warned about the Dangers of a Hillary Clinton campaign: The disastrous centrism she desperately needs to avoid.

Barack Obama says that he and Hillary are friends (she is likable enough after all) but he won’t automatically endorse her. After all, “there are other people who are friends of of the president” who still might run. This must make the Draft Biden movement happy. Joe Biden has never been my top choice for president, but I sure wouldn’t mind seeing him get into the race against Clinton. Biden spent the first four years of the Obama administration opposing Clinton’s hawkish views, and I would like to see this explored during the campaign. Plus Biden gets points for the manner in which he pushed Obama to “evolve” on gay marriage, and for coming to the rescue in the vice presidential debate in 2012 after Obama bombed in the first debate.

In addition to the conservatives already in the race from both major parties, another has joined them. The best thing about Marco Rubio entering the race is that he cannot run for reelection in Florida, increasing the chances the Democrats can pick up the seat. He is gambling everything on winning the presidency, and he might be optimistic over only trailing Clinton by three points in the latest Public Policy Polling survey.

Brian Beutler says that Marco Rubio Is the Most Disingenuous Republican Running for President. Considering who he is up against, that is quite an accomplishment. Rubio claims Hillary Clinton’s Ideas ‘Will Not Help Everyday Americans’. That can be debated, once Clinton says what her positions are, but it is a safe bet that at least Clinton’s ideas won’t screw everyday Americans as Rubio’s ideas would.

If the Republicans plan to continue to run against Obamacare, they got more bad news. Gallup has found that the uninsured rate has continued to drop since the Affordable Care Act was passed, now down to 11.9 percent. If you got insurance thanks to Obamacare, don’t forget to turn out to vote for whoever wins the Democratic nomination.

Many more candidates will still be entering the race. Bill Kristol asks, If They Get To Nominate Hillary Clinton, Why Don’t We Get To Nominate Dick Cheney? Ok Bill, go ahead and nominate Dick Cheney, and see how the Republicans do with that.

There are many more elections besides the presidential elections in 2016. A group of liberal donors is stepping up to counter all the money the Koch Brothers and other conservatives have been spending to help Republicans win in statehouses.

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Affordable Care Act Contributed To Saving Around 50,000 Lives

Washington Post Fact Checker Glenn Kessler is often very quick to give out those Pinocchios, often hitting Obama when statements have exceptions which go beyond what would be expected to be included in a political speech. Therefore I was pleased to see that he gave a rare Geppetto Checkmark for Obama’s statement on the 5th anniversary of The Affordable Care Act that the ACE is “a major reason why we’ve seen 50,000 fewer preventable patient deaths in hospitals.”

I agree with Kessler’s overall view that The Affordable Care act has contributed to a decrease in preventable deaths from factors such as drug reactions and pressure ulcers and that other factors, some pre-dating the ACA, were also important. As Kessler wrote:

But officials say there is also little question that the half-billion dollars in ACA funding sparked significantly greater cooperation among thousands of hospitals. On pressure ulcers and adverse drug reactions, “we already had practices that we knew had worked,” another official said, but the Partnership for Patients took it to the next level by involving thousands of hospitals in a concerted effort to promote those practices. The law also created the CMS Innovation Center, which tests new ideas at participating hospitals for delivering better service without increasing costs.

HHS reports say more than 70 percent of general acute care hospitals in the United States, representing over 80 percent of admissions, were part of the networks in 2012-2013. The study showed year after year gains in preventing patient deaths, with 35,000 coming in 2013 alone. (One caveat: The figure for 2013 is considered an “interim number,” with the final figure not available until June, 2015.)

The upward trajectory suggests tens of thousands in additional patient lives may have been saved since 2013.

The president’s statement could have been a bit more precisely worded to reflect some of the uncertainty in the estimate: “likely a major reason why we’ve seen an estimated 50,000 fewer preventable patient deaths in hospitals.”

But that’s a relatively minor quibble. The numbers might seem large, but the research seems solid, according to experts we consulted, and it is based on a review of an extensive database. The results likely reflect work that predated the ACA but at the same time the ACA has spurred even greater cooperation among hospitals. Since the president is using a figure more than a year old, it is likely understated — unless, of course, the interim number for 2013 turns out to be overstated. We will keep a watch on that.

But in the meantime, the president’s claim appears worthy of the elusive Geppetto Checkmark.

Plus these numbers don’t include lives saved due to people who would otherwise be uninsured now receiving insurance.

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