Sunday, June 25, 2017

The Tipping Point of Cruelty

Update 6/27: Senate Republican leadership withdrew their Kill Obamacare and the People It Serves bill from immediately going to the floor for debate and a vote when it became clear that not enough Rs supported this first step.  The next opportunity comes in two weeks, after negotiations with key Senators may result in a revised bill.  The nail in the coffin of this bill appears to be the Congressional Budget Office estimate that 22 million Americans would lose coverage.  Meanwhile opposition is growing, both from healthcare related organizations, including the American Medical Association, and voters, who may have the opportunity to move their demonstrations from Senate offices to the home districts during the Fourth of July break.  Laurence O'Donnell and guests on his show suggest that the bill actually had the support of from 5 to 20 or 30 Republicans, which would seem to make getting to 50 an uphill climb.

This piece of video is amazing, one of the best sequences I've ever seen on Rachel Maddow.  It starts as a mundane story about the upcoming Fourth of July weekend, and what happened in Denver in 1978 on a similar weekend, with the 4th on a Tuesday.  It then becomes a story of a successful social justice campaign, that over a scandalously long time, won rights for the disabled--providing them the liberty of free movement on public transportation.

Then it comes up against the current Senate Kill Obamacare and the People It Serves bill, specifically the draconian cuts in Medicaid which will devastate the lives of a large proportion of the disabled.

The climax of this piece is a bit of video of disabled demonstrators outside the offices of Senator McConnell that is heartbreaking and haunting.  The woman being dragged away while pleading "Don't touch Medicaid!" is very powerful video.

This segment illustrates and suggests why this bill is the tipping point of cruelty.  If it passes, it will change America more than any single act of this regime, and tips the future into a very ugly place.

Medicaid is the insurer for a third of disabled adults and 60% of disabled children (and 40% of all children.)  Medicaid insures nearly half the births in America.  Medicaid is by far the largest health insurance provider in the United States--75 million Americans--much bigger than Medicare.

And here's what Republicans are trying to do:

Washington Post:
"Congressional budget analysts plan to issue their projections as early as Monday on the legislation’s impact on the federal deficit and the number of Americans with insurance coverage. Already, proponents and critics alike are predicting that the Senate proposal would lead to greater reductions through the Medicaid changes than the estimated $834 billion estimated for a similar bill passed by House Republicans last month."

This is almost incredible, as most observers assumed the Senate bill will moderate the crude brutality of the House bill.  But this one is worse, particularly on Medicaid.

 Medicaid is not only enormously important, it is also popular with the American public.  The Post again:

"Part of the pressure the moderates now face is that Medicaid consistently draws widespread support in surveys. A poll released Friday by the Kaiser Family Foundation found that three-fourths of the public, including 6 in 10 Republicans, said they have a positive view of the program. Just a third of those polled said they supported the idea of reducing federal funding for the expansion or limiting how much money a state receives for all beneficiaries.

Even among Republicans, the foundation found, only about half favor reversing the federal money for Medicaid expansion."

The money that the federal government won't pay into Medicaid goes directly to a tax cut for the wealthy.

America's first social programs may not have been purely or even largely motivated by compassion.  In the 1930s, even the bankers worried about revolution.  But FDR's programs, including Social Security, put social justice on the agenda, and gave permission to politicians to act decently.

When Michael Harrington published his landmark book on poverty in the early 60s, he estimated that a fourth of the population was below the poverty line.  Dwight McDonald, in his review of the book in the New Yorker, suggested that in practical terms it was more.

Harrington's book caught the attention of President Kennedy, who had already proposed the program that became Medicare.  Kennedy identified poverty as the domestic issue he would emphasize in his reelection campaign in 1964.  Following his lead and using his memory to get it passed, President Johnson got enacted the programs that made up his War on Poverty.

For awhile, poverty did decrease. But with the additions and subtractions of programs and especially the rapid changes in the economy affecting jobs and incomes, poverty--especially child poverty--has increased, and many Americans are living so close to the edge that nearly 40% could not sustain an emergency costing just $400.

The expansion of Medicaid under Obamacare was the single most important social justice effort in decades, as it provided medical care for the most vulnerable, especially poor and disabled Americans.  The Senate bill erases the expansion, and limits Medicaid in ways certain to decrease coverage and increase harm.  Here's a pretty good summary from, of all places, Cosmopolitan.

The Senate version, should it become law, will directly threaten the independence and the very lives of the disabled and the elderly requiring care beyond Medicare.  Many more will be hurt.  In the long run it will increase poverty in America.

Harrington's book is called The Other America. Poverty in the 50s and 60s was hidden outside the mainstream, in urban ghettos among people of color, and in isolated rural areas--in Appalachia for instance--where poverty was often white.  (Even today most welfare and Medicaid beneficiaries are white.)

Today there is homelessness everywhere that would have been a scandal in the 50s but which has become invisible except as nuisance or threat.  Major parts of cities like Detroit look like the bombed out streets of European countries after World War II.  And rural poverty is widespread again, if it ever abated.

But as two new books from Princeton U. Press (reviewed here and in the June 22 issue of New York Review of Books) describe the greater extent of economic vulnerability.  Because of volatility in jobs and incomes, fully a third of all Americans are living below the poverty line for at least one month of the year. Costs of necessities have risen enormously in just the past decade.  Social programs are generally not flexible enough to respond.  They need to be improved, not destroyed.

Social justice movements made injustices painfully visible.  With this Senate bill it may be happening again.

If this bill passes, it will pave the way for more self-defeating cruelty in the proposed Republican budget.  But more immediately, this Senate bill will devastate not only the lives of the most vulnerable, but the American soul.

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