Republicans Vote To Deny Health Care Coverage To Millions But It Is Far From Certain That Democrats Can Take Advantage Of This

The lie of the week is that the Republican-controlled Congress voted to repeal and replace Obamacare. Repeal yes, but the law they passed is too worthless to seriously be called a replacement. Republicans voted to deny health care coverage to millions, and to open the door for insurance companies to deny coverage for preexisting conditions. Doctors, insurance companies, hospitals, AARP, and many consumers groups are unified in opposing this legislation. Fortunately even some Senate Republicans realize that this is a terrible plan and want to start from scratch.

To summarize the effects of the House plan:

  • Tax cuts for the wealthy–always a Republican priority
  • Defunds Planned Parenthood for one year
  • Allows older Americans to be charged more
  • Cuts benefits to Medicaid recipients
  • Cuts school services for disabled children
  • Could weaken employer sponsored health care along with plans sold on the exchanges, including removing coverage for the essential health benefits now in Obamacare, and removing prohibition on annual limits of coverage

The House plan could return us to the days when insurance companies made their profits by taking in premiums but finding ways to avoid paying out money on claims. Only selling insurance to the healthy very well could result in lower premiums, but this defeats the purpose of having health insurance. Republicans claim to be funding high risk pools to care for those with preexisting conditions, but they are only providing funding to cover five percent of those with preexisting conditions.

Of course, this will depend upon what happens in the states, and how many red states actually do opt out of the current requirements. Scott Walker has already stated he might apply for a waiver for coverage of preexisting conditions in Wisconsin.

Democrats are excited that this will help them politically, with some saying that the GOP just doomed itself. Even those who support many of the GOP goals see this plan as being politically damaging for Republicans.

Health care should dominate politics in upcoming cycles, but Democrats cannot count on this by itself being the key to retaking control of the House. Democrats need to keep up the pressure and do a far better job of making their arguments than they did when the Affordable Care Act was initially passed. It is questionable if anything resembling the House plan will ever pass the Senate and become law. (Presumably Donald Trump will sign whatever the Republicans pass, regardless of how much it violates his campaign promises).

Democrats could have the same problem in capitalizing on this as they did in promoting Obamacare. While some might lose insurance coverage immediately, many others might feel safe, not realizing that developing a medical problem could put them at risk of losing coverage in the future. Some will even be happy as young, healthy people very likely could wind up paying less–as long as they remain young and healthy. The adverse effects of this law won’t be fully apparent in 2018.

The Democrats could also lose due to their political cowardice. During the 2016 presidential campaign, Hillary Clinton opposed Bernie Sanders’ proposal for Medicare for All. Truthout debunked Clinton’s arguments. Now Nancy Pelosi and the Democratic establishment are refusing to take this opportunity to push for a single payer plan. The Observer’s view of Pelosi and mainstream Democrats is quite close to that expressed previously by Truthout:

Their failure to support a proposal that the majority of their base wants illuminates the growing disconnect between elected officials and their constituents and the massive influence of the health insurance and pharmaceutical industries. Americans want single payer health care, and the obstacles blocking them from the system they want are special interests, which are bought and paid for Democrats in office who avoid taking principled stances on issues. Democrats like Pelosi don’t stand for anything because fighting for something like single payer health care would upset the party’s wealthy donors.

Pelosi’s and other Democrats’ arguments excuse themselves from supporting progressive policies and reaffirm the Democratic Party as a corrupt entity tied to the wealthiest 1 percent of Americans. On May 1, the Washington Post reported a poll conducted in January among Trump voters who had previously voted for Obama. When those polled were asked what the Democratic Party stands for they gave responses like, “The 1 percent,” “The status quo” and “They’re for the party. Themselves and the party.” One woman, asked whether the Democratic Party is for people like her, flatly declared, “Nope.”

As Donald Trump has learned, health care is complicated. You cannot reduce costs without reducing coverage, unless you make fundamental changes in the system. The most obvious way would be a single payer plan which both removes the huge profits of the insurance industry and places everyone in the same risk pool. In hiding from this reality, Democrats show why they tend to lose and Republicans have been winning. Republicans did not care that their ideas have been far out of the mainstream. They pushed their ideas until they won over enough people to win, even if it has been on fallacious arguments. The party which stands for something, regardless of what it stands for, has an advantage over a party which stands for nothing. Thus we have seen the Democratic losses in 2010, 2014, and now 2016.

Discussing Obamacare Replacement With A Republican Congressman

House Republicans have finally released their plan to replace Obamacare. I have a lot of concerns about the plan, such as whether the tax credits will be sufficient for low income families to afford health insurance, and their attack on Planned Parenthood.

I am going to wait until I have a chance to look at the details of the plan to discuss it in depth, but for other reasons I have found it a good day to blog about health care. Hours prior to the release of the plan, I met with my conservative Republican Congressman, Bill Huizenga, along with a few colleagues, to discuss health care. I figured it would be futile to change the mindset of a conservative Republican, but when I received the invitation I also thought I should make the attempt to try to explain how health care really works. After all, there is zero chance of changing anyone’s mind if no attempt is made to persuade them. I was also appreciative that he was willing to meet with a group which strongly disagreed with him on the issue, while many Republicans around the country are reportedly hiding from their constituents.

The first time I spoke today I made a point of explaining how I am self-employed and have purchased health care on the individual market for my entire life. Therefore I could definitely state that high premiums and high out of pocket expenses, often cited as a failing of the Affordable Care Act by Republican, have always been a characteristic of the individual market–and are not something created by Obamacare.

Discussion got bogged down for quite a while over philosophical issues, especially when someone referred to health care as a right. Congressman Huizenga disagreed. While I managed to get out most of what I wanted to say today, in a conversation with multiple people present, sometimes the topic changed before I got a chance to speak. I didn’t get a chance until after the meeting while speaking to a colleague that I can understand a Republican’s position in not seeing health care as a Constitutional right in the same way as civil liberties specifically expressed in the First Amendment. After all, the Founding Fathers would have never conceived of health care being as expansive, and expensive, as it is now. However, regardless of whether you want to call it a right, access to affordable health care is both highly desirable, and something which is expected in a modern, advanced, industrialized society such as the United States. We should do it regardless of whether you want to label it a right.

The limited nature of assured coverage in the United States, compared to the rest of the world, was an underlying thought in many of our comments. It did come up that 1) the sick can show up to the Emergency Room and will not be turned away and 2) a significant portion of the Medicare population consists of the disabled. In typical Republican dodging of the issue, the Congressman at one point tried to claim that this does provide some form of basic health care as people can go to the Emergency Room. I pointed out that it is one thing to receive coverage in the Emergency Room, but this does not mean that people will receive necessary follow up medical care, especially for the types of chronic medical conditions I typically treat, such as diabetes, heart failure, and emphysema. Initial stabilization in an Emergency Room is both costly and not adequate health care. Plus an Emergency Room physician present pointed out that being seen does not mean patients do not receive large bills, which could be well beyond their ability to pay.

Congressman Huizenga responded that the disabled can receive coverage on Medicare, but I pointed out that people with chronic medical problems are not necessarily disabled, especially if they receive adequate medical treatment. Someone with diabetes, for example, can live and work for many years with the condition. However, without adequate care, twenty years down the road they are far more likely to develop problems such as heart attacks, strokes, and renal failure.

The Congressman’s philosophy on limited government (which, like most Republicans, is terribly selective, ignoring everything from infringements on reproductive rights to today’s revised anti-Muslim travel ban), also influenced his responses. Before his arrival I had discussed with others how market solutions have not worked well, with insurance companies having developed a business strategy based upon collecting premiums and then finding ways to deny care. Congressman Huizenga brought up irrelevant matters such as restrictions on choice present in Canada and other countries which Americans might not tolerate. The typical Republican scare stories. My response was simply that we do not have to adopt the restrictions which he mentioned, regardless of what other countries have done. One point I did not manage to get in was that in the United States, private insurance plans are often far more restrictive on the choices which patients and physicians can make than the government Medicare program is.

The physicians present generally saw Obamacare as an improvement over the previous system, but not going far enough, with Medicare for All being seen as a preferable solution. As a couple of us discussed afterwards, this is a far easier sell for physicians, who see first hand the amount of time and money wasted in having to deal with multiple different insurance companies, with  multiple different sets of rules. Plus this has the huge advantage of taking the astronomical profits received by the insurance industry, and using that money to actually provide health care. (Medicare for All was promoted by Bernie Sanders in the 2016 nomination battle, leading to politically-based opposition from Hillary Clinton.)

If Medicare for All is too hard a sell immediately, I, and others, suggested phasing it in. I also mentioned ideas such as the public option and the Medicare buy-in which were considered when the ACA was being written, but died when the two most conservative Senators voting with the Democrats (Joe Lieberman and Ben Nelson) opposed the ideas. Either would help with the high costs on the individual market.

The  higher cost for caring for older individuals, with some of that cost spread to the premiums of younger purchasers, is a major problem in health care coverage.  I doubt insurance companies even want to cover their older customers, who are responsible for the bulk of their costs. Either outright lower the Medicare age (even if gradually, such as initially to 50 or 55, and ultimately to around 40) or allow a Medicare buy-in.

After the Congressman left, his Legislative Director remained for a brief time and suggested that Americans would not go for expanding a government program such as Medicare. While a typical Republican thought, it does not hold up. I pointed out that we all do wind up on a government program, with most people going on Medicare at age 65. Not only are Americans failing to rebel at the though of going on Medicare at age 65, many look forward to the opportunity. Remember all those tea party protests with signs like “Keep Government Out Of My Medicare.”

My parting comment to Congressman Huizenga before he left was that Republicans must move beyond their anti-Obama rhetoric and actually address the problem. I related how for the past eight years I have often heard patients blame Obama for anything wrong with the health care system, even if it was over matters not even related to the Affordable Care Act. However, in early January, before Donald Trump even took office, I started to hear patients blame Trump for their healthcare problems. Republicans now “own” healthcare and must deliver.

I have my doubts as to whether the plan released today does deliver, but I do want to take a look at the details beyond what is in the initial news stories I have read.

Republicans Might Lack Votes In Senate To Repeal Obamacare

As I discussed earlier in the week, it was far easier for Republicans to vote to repeal Obamacare when it would be blocked by a filibuster or veto. Republicans might not have the votes in the Senate for repeal. The plan was to repeal the Affordable Care Act through budget reconciliation, where only a simple majority is necessary, with promises to replace it with something else in the future. The absurdity of that is obvious to pretty much everyone who is not a Republican.

The Republicans might not be able to achieve even a simple majority to repeal Obamacare. Now four Republicans, Rand Paul, Bob Corker, Tom Cotton, and Susan Collins are now showing skepticism towards the plan. Susan Collins also opposes the plans to defund Planned Parenthood.

Bloomberg reports that it is unclear how this will play out:

Only one of the senators — Rand Paul of Kentucky — has so far said he plans to vote against the procedural gambit that sets up Obamacare repeal, citing unrelated budget concerns. Paul and three others are concerned that Republicans haven’t said yet how they would replace the health insurance scheme after repeal, with one of them also opposing the plan to defund Planned Parenthood as part of the repeal.

The skeptics could end up yielding to pressure from their colleagues to support the plan when it reaches the Senate floor, but Republicans can only afford to lose two senators. If they lose a third, the effort would stall, and they’d be forced to return to the drawing board. Such a delay would be an embarrassing setback for Republicans, given the intense pressure from conservatives and the Trump team to speed this through.

One problem faced by the Affordable Care Act is that, with lack of Republican cooperation, it was rarely possible to pass further legislation to make adjustments, which a program this massive would normally receive. The ideal situation would be if Republicans fail to defund Obamacare and are forced to take ownership of health care policy, leading them to work in a bipartisan manner with Democrats to pass an improved plan. Unfortunately we cannot count on the Republicans acting in such a reasonable manner.

Accusations Of Lying Dominate Republican Debate

It was a difficult week in debates for the truth. I already discussed the dishonesty from Hillary Clinton at the PBS Democratic Debate. At the CBS Republican debate in South Carolina (transcript here) there were accusations during the debate of candidates telling lies nineteen times. This doesn’t include any lies which fact checkers  have found.

Donald Trump was in the rare position of being the one telling the truth when he pointed out that George W. Bush got us into the Iraq war based upon lies:

“Obviously, the war in Iraq was a big, fat mistake, all right?” Trump thundered when asked about his call for then-President George W. Bush to be impeached. “They lied. They said there were weapons of mass destruction. There were none, and they knew there were none.”

Trump added, “George Bush made the mistake. We can make mistakes, but that one was a beauty.”

Trump later pointed out that Jeb was wrong about his brother keeping us safe:

“The World Trade Center came down during the reign of George Bush. He kept us safe? That is not safe. That is not safe, Marco. That is not safe,” he continued. “The world Trade Center came down because Bill Clinton [didn’t] kill Osama bin Laden when he had the chance to kill him. And George Bush– by the way, George Bush had the chance, also, and he didn’t listen to the advice of his C.I.A.”

“How did he keep us safe when the World Trade Center…excuse me, I lost hundreds of friends!” Trump said as the crowd booed loudly.

On the other hand, I’m not sure how Bill Clinton could be blamed when the Republican Congress obstructed his attempts to fight al Qaeda, and they certainly did not give any credit to the president who did kill bin Laden.

Trump called Ted Cruz the biggest liar, probably a position he holds due to being his most serious challenger at the moment:

TRUMP: You probably are worse than Jeb Bush. You are single biggest liar. This guys lied – let me just tell you, this guy lied about Ben Carson when he took votes away from Ben Carson in Iowa and he just continues. Today, we had robo-calls saying. “Donald Trump is not going to run in South Carolina,” — where I’m leading by a lot.”

I’m not going to vote for Ted Cruz. This is the same thing he did to Ben Carson. This guy will say anything, nasty guy. Now I know why he doesn’t have one endorsement from any of his colleagues.

CRUZ: Don, I need to go on…

TRUMP: He’s a nasty guy.

CRUZ: I will say, it is fairly remarkable to see Donald defending Ben after he called, “pathological,” and compared him to a child molester. Both of which were offensive and wrong.

Cruz counterattacked with an attack on Donald Trump for supporting funding of Planned Parenthood. Trump then defended Planned Parenthood despite his current (but not past) opposition to abortion rights:

CRUZ: You said, “Planned Parenthood does wonderful things and we should not defund it.”

TRUMP: It does do wonderful things but not as it relates to abortion.

CRUZ: So I’ll tell you what…

TRUMP: Excuse me. Excuse me, there are wonderful things having to do with women’s health.

CRUZ: You see you and I…

TRUMP: But not when it comes to abortion.

In yet another exchange which came down to honesty, Marco Rubio made this accusation against Ted Cruz:

I don’t know how he knows what I said on Univision because he doesn’t speak Spanish.

Cruz then responded in Spanish.

Head Of Organization Spreading False Claims About Planned Parenthood Indicted By Texas Grand Jury

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There was an unexpected turn of events in a grand jury investigation in Texas regarding the bogus charges against Planned Parenthood. The grand jury not only declared there was no wrong doing on the part of Planned Parenthood, but indicted the director of the group which spread the debunked claims that Planned Parenthood was selling fetal tissue.  The Washington Post reports:

Harris County District Attorney Devon Anderson said David Daleiden, the director of the Center for Medical Progress, faces a felony charge of tampering with a governmental record and a misdemeanor count related to buying human tissue.

Sandra Merritt, one of Daleiden’s employees, was also indicted on a charge of tampering with a governmental record.

The grand jury cleared Planned Parenthood Gulf Coast of any wrongdoing.

“We were called upon to investigate allegations of criminal conduct by Planned Parenthood Gulf Coast,” Anderson said in a statement. “As I stated at the outset of this investigation, we must go where the evidence leads us. All the evidence uncovered in the course of this investigation was presented to the grand jury. I respect their decision on this difficult case.”

Republican candidates were not happy. Think Progress quotes some of them.

Support For Abortion Rights Increases As Republicans Enact More Restrictions

Pro-Choice rally

The Republican Party remains out of sync with the views of the American people on abortion rights. An Associated Press-GfK poll reported:

Support for legal abortion in the U.S. has edged up to its highest level in the past two years, with an Associated Press-GfK poll showing an apparent increase in support among Democrats and Republicans alike over the last year.

Nearly six in 10 Americans — 58 percent — now think abortion should be legal in most or all cases, up from 51 percent who said so at the beginning of the year, according to the AP-GfK survey. It was conducted after three people were killed last month in a shooting at a Planned Parenthood clinic in Colorado.

While support for legal abortion edged up to 40 percent among Republicans in this month’s poll, from 35 percent in January, the survey found that the GOP remains deeply divided on the issue: Seven in 10 conservative Republicans said they want abortion to be illegal in most or all cases; six in 10 moderate and liberal Republicans said the opposite.

Besides trying to defund Planned Parenthood based on bogus attacks, the Republicans have been restricting access to abortion in many states. Vox has a series of maps showing where the new restrictions are. The article began:

States have enacted an unprecedented number of anti-abortion laws in the past five years, and 2015 continued that trend. According to a new report from the Center for Reproductive Rights, state lawmakers proposed nearly 400 bills restricting abortion in 2015, and 47 of those bills were enacted. Some of those 47 bills contained more than one restriction, and the Guttmacher Institute estimates that a total of 57 new abortion restrictions became law. Arkansas passed six new anti-abortion laws, the most of any state in 2015.

Vox broke down the new restrictions to include waiting periods and mandatory biased counseling, bans and restrictions on certain abortion procedures, and other types of restrictions. The maps show the new restrictions to be primarily, but not exclusively, in red states. Some of the new restrictions have been overruled in the courts, and if not for this would probably be even more widespread in the more conservative parts of the country.

Supreme Court To Decide On Texas Anti-Abortion Law

Planned Parenthood

Republican efforts in recent years to restrict access to abortion have generally been at the state level (along with debunked attacks on Planned Parenthood), but now the Texas law will have national significance with the Supreme Court deciding to hear the case. The New York Times reports:

The Supreme Court on Friday agreed to hear its first major abortion case since 2007, one that has the potential to affect millions of women and to revise the constitutional principles governing abortion rights…

The case is a challenge to a Texas law that would leave the state with about 10 abortion clinics, down from more than 40. Such a change, the abortion providers who are plaintiffs in the case told the justices, would have a vast practical impact.

“Texas is the second-most-populous state in the nation — home to 5.4 million women of reproductive age,” they wrote in their brief urging the court to hear the case. “More than 60,000 of those women choose to have an abortion each year.”

The case concerns two parts of a state law that imposes strict requirements on abortion providers. It was passed by the Republican-dominated Texas Legislature and signed into law in July 2013 by Rick Perry, the governor at the time.

One part of the law requires all clinics in the state to meet the standards for “ambulatory surgical centers,” including regulations concerning buildings, equipment and staffing. The other requires doctors performing abortions to have admitting privileges at a nearby hospital.

Officials in Texas said that the contested provisions were needed to protect women’s health. Abortion providers responded that the regulations were expensive, unnecessary and intended to put many of them out of business.

Think Progress has debunked claims of supporters of this law that the strict requirements are reasonable:

Yet, while these may seem like health regulations at first glance, they do little, if anything, to actually advance women’s health. As the Texas Hospital Association explains, for example, “thousands of physicians operate clinics and provide services in those clinics but do not have hospital admitting privileges.” Hospitals provide care to women who experience complications during an abortion — complications, it should be noted, that are extraordinarily rare — regardless of whether the physician who performed the abortion has admitting privileges or not. Similarly, the ambulatory surgical center requirement applies even in abortion clinics that do not perform surgeries — many abortions are induced by medication alone. The laws, in other words, impose burdensome and expensive restrictions on abortion clinics even when those restrictions bear no relationship whatsoever to advancing women’s health.

There is little doubt that these restrictions were written by opponents of the right of a woman to control her own body, with the goal of making it harder for women to obtain an abortion by causing multiple clinics which provide abortions to shut down. Opponents of the law expect that those clinics which do remain will be limited to the metropolitan areas of Austin, Dallas-Fort Worth, Houston and San Antonio. This will leave many women in Texas without a nearby site to obtain abortions.

The Second Republican Debate: Faux Controversies, Lies, And One Candidate Was Even Right Twice

CNN Republican Debate

The second Republican debate (transcript here), this time hosted by CNN, didn’t raise as much controversy as the first. Donald Trump was still a dominant force, but whenever the talk got to policy, Trump didn’t know what to say and was quieter. CNN did try to liven things up with having the candidates respond to comments about them from other candidates. This included both comments during the debates and often insults made to the media before the debates. While at times it was a good idea to have the candidates interact, often it was over matters far to trivial to really belong in the debate.

This did allow Carly Fiorina to have one of the better moments of the debate, and she was obviously ready to comment on this insult from Donald Trump:

TRAPPER: In an interview last week in Rolling Stone magazine, Donald Trump said the following about you. Quote, “Look at that face. Would anyone vote for that? Can you imagine that, the face of our next president?” Mr. Trump later said he was talking about your persona, not your appearance. Please feel free to respond what you think about his persona.

FIORINA: You know, it’s interesting to me, Mr. Trump said that he heard Mr. Bush very clearly and what Mr. Bush said. I think women all over this country heard very clearly what Mr. Trump said.

While candidates often exceeded their time, Fiorina responded perfectly with this brief comment.

It was overall a good night for Fiorina, who might have done more than anyone else to improve her position in the GOP race with her debate performance. Unfortunately doing well in a Republican race does not require telling the truth. She repeated previously debunked claims about her record at HP. While she sounded more forceful than Donald Trump in saying how she would deal with Russia and Syria, Ezra Klein pointed out how she got the facts wrong. Klein, along with Sarah Kliff also pointed out how she was wrong about the Planned Parenthood tapes. There was no scene such as the one she described:

FIORINA: I dare Hillary Clinton, Barack Obama to watch these tapes. Watch a fully formed fetus on the table, its heart beating, its legs kicking while someone says we have to keep it alive to harvest its brain.

Of course most, if not all, of the candidates were also lying about Planned Parenthood during the debate. Even if they didn’t make a claim as blatantly false as Fiorina did, they repeated the debunked claims that Planned Parenthood was selling fetal tissue.

The biggest whopper came from Jeb Bush when he responded to criticism of his brother from Donald Trump:

TRUMP: Your brother — and your brother’s administration gave us Barack Obama, because it was such a disaster, those last three months, that Abraham Lincoln couldn’t have been elected.

BUSH: You know what? As it relates to my brother, there’s one thing I know for sure. He kept us safe.

Both Trump and Jeb Bush were wrong about Obama and George Bush in the above exchange, but it is Jeb’s comments which were the most absurd. The most destructive terrorist attack on the United States occurred on George Bush’s watch, with Bush ignoring intelligence reports which might have enabled the United States to prevent the attack. Bush then followed up the attack by foolishly getting us into the quagmire in Iraq.

Rand Paul is one of the candidates who was nearly forgotten. Donald Trump, who insulted so many of the other candidates that I thought he was preparing to fire one, even said:

TRUMP: Well, first of all, Rand Paul shouldn’t even be on this stage. He’s number 11, he’s got 1 percent in the polls, and how he got up here, there’s far too many people anyway.

While Paul is certainly wrong on many, many things, I noted he was right on two points during the debate.  For this group, just being right twice makes him stand out.

First he pointed out that military intervention is not always the best idea:

PAUL: I think this gets to the point of wisdom on when to intervene and when we shouldn’t. Had we bombed Assad at the time, like President Obama wanted, and like Hillary Clinton wanted and many Republicans wanted, I think ISIS would be in Damascus today. I think ISIS would be in charge of Syria had we bombed Assad.

Sometimes both sides of the civil war are evil, and sometimes intervention sometimes makes us less safe. This is real the debate we have to have in the Middle East.

Every time we have toppled a secular dictator, we have gotten chaos, the rise of radical Islam, and we’re more at risk. So, I think we need to think before we act, and know most interventions, if not a lot of them in the Middle East, have actually backfired on us.

Paul missed the point Obama successfully stepped back from the brink, but his overall point is correct about thinking before engaging in senseless military intervention.

Paul also also criticized the drug war during the debate:

TAPPER: Many people on social media wanted us to ask about marijuana legalization. Senator Paul, Governor Christie recently said, quote, “if you’re getting high in Colorado today,” where marijuana has been legalized, “enjoy it until January 2017, because I will enforce the federal laws against marijuana.” Will you?

PAUL: I think one of the great problems, and what American people don’t like about politics, is hypocrisy. People have one standard for others and not for them — for themselves.

There is at least one prominent example on the stage of someone who says they smoked pot in high school, and yet the people going to — to jail for this are poor people, often African-Americans and often Hispanics, and yet the rich kids who use drugs aren’t.

I personally think that this is a crime for which the only victim is the individual, and I think that America has to take a different attitude. I would like to see more rehabilitation and less incarceration. I’m a fan of the drug courts which try to direct you back towards work and less time in jail.

But the bottom line is the states. We say we like the 10th Amendment, until we start talking about this. And I think the federal government has gone too far, I think that the war on drugs has had a racial outcome, and really has been something that has really damaged our inner cities.

Not only do the drugs damage them, we damage them again by incarcerating them and then preventing them from getting employment over time.

So I don’t think that the federal government should override the states. I believe in the 10th Amendment and I really will say that the states are left to themselves.

Paul was generally right on two points, but neither are going to help him in a Republican primary battle. It is also rather sad that the Democratic front-runner has been wrong on both issues, with Clinton supporting both greater military intervention and being a hard-liner on drug laws.

Paul was more mixed on vaccines. He didn’t go along with Donald Trump’s claims about a connection between vaccines and autism, but also wasn’t consistent with the science:

TAPPER: Mr. Trump, as president, you would be in charge of the Centers for Disease Control and the National Institutes of Health, both of which say you are wrong. How would you handle this as president?

TRUMP: Autism has become an epidemic. Twenty-five years ago, 35 years ago, you look at the statistics, not even close. It has gotten totally out of control.

I am totally in favor of vaccines. But I want smaller doses over a longer period of time. Because you take a baby in — and I’ve seen it — and I’ve seen it, and I had my children taken care of over a long period of time, over a two or three year period of time.

Same exact amount, but you take this little beautiful baby, and you pump — I mean, it looks just like it’s meant for a horse, not for a child, and we’ve had so many instances, people that work for me.

Just the other day, two years old, two and a half years old, a child, a beautiful child went to have the vaccine, and came back, and a week later got a tremendous fever, got very, very sick, now is autistic.

Paul later responded:

One of the greatest — one of the greatest medical discoveries of all times was — were the vaccines, particularly for smallpox. And if you want to read a story, it’s called The Speckled Monster, it’s an amazing story, it was all done voluntary.

But people came in by the droves. George Washington wouldn’t let his wife visit until she got vaccinated. So I’m all for vaccines. But I’m also for freedom.

I’m also a little concerned about how they’re bunched up. My kids had all of their vaccines, and even if the science doesn’t say bunching them up is a problem, I ought to have the right to spread out my vaccines out a little bit at the very least.

The debate will probably not change the race very much but it is a good thing that the candidates were provided this opportunity to present their views to a national audience on a repeated basis. If only the Democratic National Committee would do the same this year and allow more than six debates total.

Update: The New York Times reviewed  Crazy Talk at the Republican Debate with Paul Krugman adding additional Fantasies and Fictions at G.O.P. Debate

Planned Parenthood Fighting Back Against Republicans

Planned Parenthood is fighting back–launching ads such as the one above against vulnerable Republicans. They are targeting Senator Kelly Ayotte (R-N.H.), Rob Portman (R-Ohio), Ron Johnson (R-Wis.) and Pat Toomey (R-Pa.) who are expected to be in tough reelection races next year. The ads concentrate on the problems which might be created if there is a government shutdown over funding Planned Parenthood, as some Republicans have threatened:

“First Pat Toomey voted to defund Planned Parenthood — risking healthcare for millions of women,” the Pennsylvania ad says. “Now Republicans want to shut down the government — to block funding for Planned Parenthood. What would a shutdown mean for Pennsylvania?”

The ad then shows a veteran wondering about getting benefits and a senior worrying about Social Security checks.

“Tell Senator Toomey: Stand up for Planned Parenthood healthcare — not a government shutdown,” the ad ends.

The threats to defund Planned Parenthood arose from false attacks on Planned Parenthood, claiming they were selling fetal tissue. The videos spread by anti-abortion groups actually showed negotiations over reimbursement for costs. Payments for collection, preservation, and transportation of biological specimens are customary and legal, and are quite different from selling specimens. The fetal tissue is donated for valuable research which can save lives, as opposed to discarding the tissue.

Defunding Planned Parenthood would also be counterproductive for opponents of abortion as this would lead to a greater number of abortions if women did not have access to contraception and counseling from Planned Parenthood. Both men and women also receive other services, such as cancer screening, from Planned Parenthood.

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Fox Republican Debate Dominated By The Donald

Fox Debate August 2015

Fox brought in a record 24 million viewers for the first Republican debate on Thursday night , and nobody doubts it was because of Donald Trump. CNN explained what this number means:

For perspective, the first GOP primary debate four years ago, also on Fox, attracted 3.2 million viewers.

The most-watched primary debate that year, broadcast by ABC, reached 7.6 million.

Thursday’s debate audience more than tripled that one.

The audience easily exceeded pretty much everything that’s been on American television this year, from the finale of “The Walking Dead” to the final episode of David Letterman’s “Late Show.”

The debate was bigger than all of this year’s NBA Finals and MLB World Series games, and most of the year’s NFL match-ups.

It also trumped Jon Stewart’s Thursday night’s sign-off from “The Daily Show,” which averaged 3.5 million viewers.

Trump is a known ratings magnet. His reality show “The Celebrity Apprentice” used to reach 20 million viewers a week. But it has slipped over the years, averaging 6 to 8 million viewers for recent seasons.

The debate, as well as most of the talk afterwards, was about Donald Trump. They might as well have named it Presidential Apprentice. By the end, many viewers might have been expecting to go to the boardroom to see who Trump would fire. Hint–it might not have been one of the candidates considering what he has been saying about Megyn Kelley and the other Fox correspondents. Among the most crude:

Trump was the center of attention from the start when the very first question was a show of hands  as to “who is unwilling tonight to pledge your support to the eventual nominee of the Republican party and pledge to not run an independent campaign against that person.” Only Donald Trump raised his hand. (Full transcript of the debate can be found here).

Donald Trump did make a great case for campaign finance reform:

I will tell you that our system is broken. I gave to many people, before this, before two months ago, I was a businessman. I give to everybody. When they call, I give.

And do you know what?

When I need something from them two years later, three years later, I call them, they are there for me.

QUESTION: So what did you get?

TRUMP: And that’s a broken system.

QUESTION: What did you get from Hillary Clinton and Nancy Pelosi?

TRUMP: Well, I’ll tell you what, with Hillary Clinton, I said be at my wedding and she came to my wedding.

You know why?

She didn’t have a choice because I gave. I gave to a foundation that, frankly, that foundation is supposed to do good. I didn’t know her money would be used on private jets going all over the world. It was.

Trump also restated his opposition to the Iraq war but flip-flopped on his previous support for a single payer system. Trump could have been the best candidate in the room if he hadn’t turned into a Tea Party clown.

There were some other moments when Republican candidates deserved credit. This includes Rand Paul criticizing both his fellow Republican candidates and Hillary Clinton for their policies which on sending more arms to middle east:

I’ve been fighting amidst a lot of opposition from both Hillary Clinton, as well as some Republicans who wanted to send arms to the allies of ISIS. ISIS rides around in a billion dollars worth of U.S. Humvees. It’s a disgrace. We’ve got to stop — we shouldn’t fund our enemies, for goodness sakes.

This was followed by John Kasich defending taking funds for the Medicaid expansion under Obamacare:

First of all, Megyn, you should know that — that President Reagan expanded Medicaid three or four times.

Secondly, I had an opportunity to bring resources back to Ohio to do what?

To treat the mentally ill. Ten thousand of them sit in our prisons. It costs $22,500 a year to keep them in prison. I’d rather get them their medication so they could lead a decent life.

Rand Paul made a another good point when he argued with Chris Christie over NSA surveillance:

The Fourth Amendment was what we fought the Revolution over! John Adams said it was the spark that led to our war for independence, and I’m proud of standing for the Bill of Rights, and I will continue to stand for the Bill of Rights.

Beyond this, we primarily learned from the debates that Republicans hate Barack Obama, Hillary Clinton, Obamacare, and Planned Parenthood.

I am looking forward to seeing Bernie Sanders debate Hillary Clinton on foreign military intervention and suppression of civil liberties. Clinton’s record on these topics does fit well in the GOP mainstream.

I am hesitant to write about winners because we have learned that the winner of a debate is not based upon the debate itself, but the perception of the candidates after people have listened to the talking heads in the days following the debate. This is further complicated with the Republican Party as most of their voters receive their thoughts from Fox. Criticism from the Fox commentators could make Donald Trump look like a loser, but so far he has managed to survive better than the pundits have predicted, and it is not looking like Fox will be successful against him.

From my perspective, which could be quite different from that of Fox, the winners were John Kasich and Marco Rubio. Kasich barely squeaked into the prime time debate, and the two debates did show that Kasich really did deserve to be there more than Rick Perry, who was excluded, possibly by fudging the results of the polls. Kasich and Jeb Bush looked the most stable in the group. Bush already has his position as top contender after Trump, but now Kasich might replace Scott Walker as the leading challenger to Bush and move into the top tier.

I also downgraded Bush for his discussion of his brother’s policies. It wasn’t faulty intelligence which got us in Iraq as he claimed, but his brother twisting the intelligence to justify the war he wanted to start. Jeb! also seemed oblivious to the fact that ISIS and the other problems now occurring in Iraq are due to his brother destabilizing the region. They all seemed oblivious, when talking about the deficit, to the fact that the deficit is a consequence of George W. Bush both fighting the war on credit and cutting taxes on the wealthy.

The other Republican who looked good, if you ignore his actual views, was Marco Rubio. He could make a good candidate in a television-based campaign. The entry of Trump into the race made it hard for candidates like Rubio to get attention, but he did get a shot at being noticed Thursday.

On the other hand, it seemed a battle throughout the evening between Mike Huckabee and Ted Cruz to be the most bat-shit candidate on stage, which was impressive considering that Donald Trump was on the same stage. I was edging towards awarding this to Huckabee, with lines such as, “The purpose of the military is kill people and break things,” until Cruz gave his closing statement, and clinched the title:

If I’m elected president, let me tell you about my first day in office. The first thing I intend to do is to rescind every illegal and unconstitutional executive action taken by Barack Obama.

The next thing I intend to do is instruct the Department of Justice to open an investigation into these videos and to prosecute Planned Parenthood for any criminal violations.

The next thing I intend to do is instruct the Department of Justice and the IRS to start (sic) persecuting religious liberty, and then intend to cancel the Iran deal, and finally move the U.S. embassy in Israel to Jerusalem.

I will keep my word. My father fled Cuba, and I will fight to defend liberty because my family knows what it’s like to lose it.

In contrast, Huckabee went for the laugh as opposed to Cruz’s tirade:

It seems like this election has been a whole lot about a person who’s very high in the polls, that doesn’t have a clue about how to govern.

A person who has been filled with scandals, and who could not lead, and, of course, I’m talking about Hillary Clinton.

So, in conclusion, Trump wins for continuing to totally dominate the discussion, Kasich and Rubio had smaller victories which might improve their position if the race should return to be about the more conventional candidates, and Cruz edged Huckabee for the scariest Republican in the room. Hillary Clinton and Bernie Sanders must really have felt happy seeing this debate and the caliber of candidate they might come up against in the general election.