On Running Your Own Government, Or, Why Pay The Military?

I have not been talking about the insanity around the debt ceiling and debt and deficit and the efforts of Republicans to drive us all off the cliff, but I am today – and I’m going to do it by allowing you to grab ahold of this problem and see for yourself just how unbelievably bad this manufactured crisis is going to be.

You will hear a lot of conversation about the consequences from others; today, however, you are going to get the chance to be both the President and the Secretary of the Treasury, and you will get to decide for yourself exactly what bills the Federal Government should and should not pay as the cash runs out if a deal is not made by the time borrowing authority runs out.

At that point you’ll be able to see what’s coming for yourself – and once you do, you won’t need me to tell you what ugly is going to look like.

“…no state has the right to secede unless it wishes to…[and] it is the President’s duty to enforce the laws, unless somebody opposes him…”

--William H. Seward, deprecating President James Buchanan’s efforts to preserve the Union, as quoted in the book “Battle Cry of Freedom: The Civil War Era”

So before I go sending you off to take the reins of power, let’s fill you in on a few things that you’ll need to know.

If no one has explained it to you yet, the Great Big Fuss that is going on right now is set around two issues: there are those who feel that the best way to make this economy better is to ensure that the Federal Government is a smaller player in our economy and not running on a deficit; many of these folks feel the way to achieve this is to make immediate, drastic, cuts in Federal spending.

At the same time, the United States has run up against its “debt limit”. That means the US will be unable to borrow money to fund ongoing government operations, and as you’ll soon see, right now we borrow a lot of the money we need to run today’s Government.

So if you are one of those who seeks to immediately cut Federal spending, you could force that to happen by refusing to allow the Federal Government any more borrowing authority; the fear of what could happen after that is presumably going to force the opposition to accept any deal, no matter how draconian, just to obtain that borrowing authority.

Naturally, the bigger a hostage you’re holding, the more draconian of a deal you hope you can make, and holding the “Full Faith and Credit of the United States” hostage is about as big as it gets; that’s why the Republicans are pushing for everything right this very second, from the end of Medicare and Medicaid to the right to mine uranium right next door to the Grand Canyon.

So with all that in mind, let’s talk money.

In the month of August, the Federal Government is expected to take in $172.4 billion.

There will be a mess of bills that are coming due during the month; that amount totals $306.7 billion, and that means about 44% of the bills must go unpaid.

Where’s that money go?

The Big Five are interest on current debt, which must be paid to avoid a default, payments due to defense contractors, Social Security, Medicare, and Medicaid; the five of those, alone, will be just about $160 billion.

And that leaves $12.4 billion to fund everything else the Federal Government has to do.

That would include the remaining cost of supporting our several wars, the entire Federal law enforcement establishment (for example, the FBI, DEA, ATF, Immigration and Customs Enforcement, the TSA, the Border Patrol, the Federal Marshals’ Service and the Bureau of Prisons), the National Parks Service and the Forest Service, the Centers for Disease Control, the Weather Service…well, just about every single thing the Federal Government does, except the Big Five.

So that’s the situation – and now it’s time for you to become the boss and make the choices:

The fine folks at Bloomberg Government have created an interactive tool that allows you to point and click your way to figuring this stuff out.

You will find your spending choices, and you just click on what you want until you run out of money, which the handy bar on the left will manage for you. When the bar turns red…you’re out of money.

“…Each month, I put all my bill collectors’ names in a hat, reach in, and pull out a name. That’s who I pay. If you keep calling here, then your name is not going in the hat next month.”

--Steve Harvey, quoted in October 2003’s “Vibe” magazine

OK folks, so now you know where to go, and you know what to do, so let’s make something happen.

Take this tool and use it to create a conversation about just what really is at stake, and watch the look on your friends’ faces when you point out that the entire Federal Government is about to go out of business if Republicans have their way.

I’d tell you the looks on their faces would be priceless – but that’s not true.

Absent a debt ceiling deal, the price is actually going to be about $134 billion, which is the money we’re just not going to have next month, when we’re not doing things like paying for the salaries of active-duty servicemembers or food inspectors or the guards out there at the Supermax.

It should be a fun time, all the way around – unless, of course, you’re one of the 300 million or so of us who are gonna get screwed over by it all.

On My Last Weekend, Or, Wanna Save A Few Trillion On Health Care?

So I disappeared for a full week, right in the middle of what should have been a busy writing schedule, and I have to claim some “personal days” to cover the time we missed here at the blog – but it won’t be time entirely wasted.

Instead, I’m going to jump into my own personal life for today’s story, and I’m going to do it so that we can stimulate some thinking about where we really need to go to if we ever hope to make some sense out of the crazy way we deliver health care in this country.

Since this appears to be the weekend that a lot of decisions are either going to be made about the future of our “social safety net”…or they wont; we’re entirely unsure…let’s talk about how it actually works for a lot of us – and how it could work a lot better.

But the worst part of the Industrial Revolution – and the part that has never been documented – is what happened to the role of managers. The owners of factories realized they needed a layer of insulation between themselves and the people they were exploiting. They needed the type of people who were incapable of understanding the workers’ pleas for common sense, decency, and safe working conditions. The owners wisely chose managers for these roles.

--Scott Adams, from the book “Dogbert’s Top Secret Management Handbook”

So as most of you know, I am a blogger, and that means, for better or worse, that this is how I’m trying to make a living – and as a result I, along with about 50,000,000 other Americans, find myself on the DGS Health Plan (never heard of DGS? It’s the “Don’t Get Sick” Health Plan).

So what do I do? The same as a lot of you: I don’t get sick.

And up ‘til now, it’s worked out surprisingly well, even though I weigh more than I should and I have a coke addiction that can see me consuming as much as 2 liters in a single day…but by last Friday I had one of those tooth twinges building up that you know is not going to end up well.

By Friday night things were getting bad enough that I had to tell The Girlfriend that we were very likely to be going to an Emergency Room, if not that night, certainly by morning – unless things cleared up on their own, which, if you’re an optimist, could happen.

So much for optimism.

Midday Saturday we’re in downtown Seattle and I’m waiting in line to be seen by an intake clerk, then a triage nurse, and then a financial counselor, because there’s no way I can really take on a big medical bill.

I’m lucky that Washington State has a “Charity Care Law”; that law requires Washington’s hospitals to accept all comers at the Emergency Room, regardless of ability to pay – and there’s been a considerable increase in demand over the past four years.

(The Department of Health reports that $591 million in such care was provided in ’07, and in the last year for which numbers are available, ’09, the same cost had run up to $846 million; that’s a 43% jump in just two years. The odds are pretty good that the ’10 and ’11 numbers will also show an increase that’s well above the rate of inflation.)

Anyway, after that they showed me to a sort of mini-Emergency Room facility, I was examined by a Medical Student and his Instructor, and they decided that maybe a CAT scan would be a good idea, just to determine exactly how badly and how widespread this infection might be.

I rode the ride, an assessment was made, and it time to offer up my various elbows to my Medical Student, which left me with a couple of bruises that are still healing, and him with a couple of experience points.

More assessment followed the return of the lab results; as a result I was given a prescription of a rather unpleasant antibiotic that I’ll be taking for a few more days, but all in all, for me, things worked out pretty well.

That said…imagine if I lived in Canada.

First thing, I waited longer than I should have with this infection, and if I had a General Practitioner with whom I had an ongoing relationship, I would have gone there at least a day sooner.

That delay imposed a few costs: I had that CAT scan, took up ER time and a mini-ER suite; instead I could have made an office visit, and probably walked out with a prescription for the same antibiotic with a quick exam or just a blood test.

There is no financial counselor in Canadian healthcare – instead, you present your Provincial insurance card, and that’s that. For those not aware, Canadian healthcare, for the most part, works like American care, except there’s only one insurance company, and that’s each Province; they also collect taxes to fund the services.

That means providers only deal with one insurer, and all of that cuts a lot of administrative expenses out of the system. It also means patients never have to worry about whether their provider will be “in the network”.

(Fun Fact: bankruptcy is now a big part of the American medical system. In 1981 8% of bankruptcies were related to medical costs, but by 2007 that number appears to have grown to 62%, all this according to the Journal of the American Medical Association. Three-quarters of that 62% had medical insurance.

Canada does not have a medical bankruptcy problem of statistical significance.)

When you add all this together, it begins to explain how it’s possible that Canada can insure all their people for about 11% of their 2009 Gross Domestic Product (GDP) when we pay about 17% of GDP and still leave a huge portion of the population either completely uninsured or unable to pay for care even if they have insurance, due to what won’t be covered when the bill comes in at the end of the month.

(Fun Fact #2: Sweden, Switzerland, France, Germany, Iceland – in fact, any country that you can name on the face of the Earth – pays less than we do for their health care.

By a lot.

When it comes to the cost of health care, the USA is #1.)

So it’s not all skittles and beer, up there in Canada. You might have to wait a while to get some types of care, and it appears that there’s an element of “rationing by waiting period”, which is a constant source of complaints up there. (The counterargument is that rationing of some sort is required in any medical insurance scheme; otherwise, you’ll have folks at the doctor’s for no reason at all, and that’ll quickly drive a system broke.)

There are co-pays, for some services, and no coverage for others, depending on your Province, (nonemergency dental and vision are often not covered) and that can lead to some out-of-pocket, but for the most part taxes cover the bills.

And just as we in the USA are struggling to pay for medical care, so is everyone else: controlling medical costs are hard, for a variety of reasons, including the cost of paying medical professionals to do work in a dangerous environment that can often be hard to automate.

Dangerous, you say?

In healthcare, back injuries, frequently caused by overexertion, occur at a very high rate. Healthcare industry workers sustain 4.5 times more overexertion injuries than any other type of worker…According to national statistics, six of the top 10 professions at greatest risk for back injury are: nurse's aides, licensed practical nurses, registered nurses, health aides, radiology technicians, and physical therapists.

So the other reason I’m having this conversation today is because I was having a talk with a very nice gentleman just about 48 hours ago who is a bit more Conservative politically than I, and he wondered how I felt about “Obamacare” (formally known as the Affordable Health Care Act).

I’m not a big fan of that plan, I’m not, and that’s because I’d much rather do something like expand Medicare to everyone, or “go all Canada”; either choice seems simpler and easier and doable at far lower administrative costs than any plan that relies on private insurers, as the Affordable Health Care Act does.

So there you go: that’s how I spent the weekend, and a couple of days after to boot, and if we were living in Canada I could have had the same problem, but it would have cost the healthcare system a whole lot less money – and when everyone gathered at the White House today, I wish that’s what they had been talking about.

Obama Wants To Attack The Middle Class? Take Congress Hostage!

By now you have heard that President Obama has chosen to throw Social Security and the Medicare and Medicaid Programs over the side of his proverbial fishing boat as bait to see if he can get Republicans to give him another really lousy compromise, much as he did last December when he gave up billions upon billions of deficit reduction in order to help Republicans preserve tax cuts for billionaires.

And it looks like the President doesn’t really lose if you or I get hurt here: in fact, it seems that, in his eyes, it’s to his advantage to fight against his own base as he seeks to be “the adult in the room” in the runup to the ’12 election.

So we’re going to have to find a way to put The Fear on this guy – and I think I’ve got a plan to force this President to listen.

And it works like this: if this President ain’t gonna be moved by our message…we do it by holding the rest of his Party hostage.

"You've got to put the points on the board. Good effort and style aren't enough. Everyone loves the Chicago Cubs, but no one expects them to win. Be more like the New York Yankees."

--Greg Swienton, COO of Ryder Systems, advising Army NCOs at a leadership seminar, July 2009.

First things first: let me tell you how the hustle is potentially going to go down.

Republicans are going to try to force Obama to offer up 100% cuts in spending, with no new money coming in to Government at all, or they’ll let the whole “debt default” thing come crashing down, which looks like The Best Thing To The Tea Party Ever – and based on past history, this is a deal that Obama, around 11:56 PM on August 1st, will be willing to take.

The two most likely ways to cut spending and get results in the trillions of dollars are to change the connection between increases in your future Social Security benefits and the cost of living (which guarantees that you and I will forever be behind the inflation eight-ball), or to cut the payments coming out of Medicare or Medicaid, which is going to stick it, immediately, to medical service providers, the poorest of the poor, your Grandma and Grandpa (or, maybe, you), and the disabled.

It is rumored that both of these approaches have been put out as options by the President. It is also rumored that, in return, he wants some amount of revenue increases – but it’s also rumored that he went from seeking a dollar in cuts for each dollar in new revenue to something that looks more like $6 in cuts for every $1 in new revenues – with lots more time available for Republicans to play chicken and get even more.

So if the President is not going to put a stop to all this, I think we, ourselves, are going to have to step up and get it done.

What I’m going to propose is brutal, unfair to many of our friends, and vindictive to the point of risking an even worse situation than we have now…but these are desperate times, and I suspect it’s now time for desperate measures.

So here’s what I think we have to do:

Now, today, before this gets any farther, we have to call every single Democratic Member of Congress, House and Senate, friend and foe, and deliver this message:

“I don’t care what you ever did for us before, we are not going to let you do this to us now. We cannot stop Barack Obama directly – but we can do this.

We can target Congressional Democrats.

Each and every one of you, as a group.

And with that in mind, you are now on notice: if you allow this President to make a deal that includes any cuts, adjustments, alterations, or anything else, to Medicare, Medicaid, or Social Security, and you don’t get at least a dollar of new revenue for every dollar of cuts…then you are done.

We will immediately stop giving any Democratic incumbent even one dollar of donations, we will not help you win elections by volunteering – and we will vote for any candidate that’s running against you in the next primary.

Even if it’s not your fault.

That’s how serious we are, and that means you better figure out, right now, how to stop Obama from caving…because now, it’s all on you.

If Obama slips on the stairs and his pen accidentally signs the bill…it’s now your fault.

If Obama puts his pen back in the desk set upside down, and there’s an open window in the Oval Office, and an errant breeze drags the bill across the upside-down pen… it’s now your fault.

So what you better do is you better go make sure there aren’t any roller skates on the stairs at the White House, and go close the windows, and do whatever you have to do, because now, you, and every other Congressional Democrat…all of you, together…are going to be held responsible for what happens.”

And then we gotta stick to it – even if it costs us Jim McDermott and Raul Grijalva and Barney Frank, all on the same day.

We have to show that we will bring even more wrath and destruction than the Tea Party – and we have to be ready to support new Democrats who rise up to oppose the current ones.

And consider this: Labor is already making the effort to recruit and train Progressive candidates, and there are lots of opportunities to partner with unions who would presumably love to have some new partners of their own.

The next negotiating session between the President and Congressional leadership is Sunday, and that means we need to move fast if we want this to work – but Sunday is unlikely to be the last day of negotiations, and after that is when we can really crank up the pressure on Democrats.

Is this unfair to our friends?

Yup.

But that’s too bad, because we have been unfairly taking hits from our friends and Republican bullies alike for three years now - and the only thing that’s going to make it stop is if our friends fear us more a whole lot more than they fear Republicans.

And if you don’t think this can work…well, guess what? The LBGT community got “Don’t Ask, Don’t Tell” repeal passed when Republicans said they would never let it get through Congress – and then the LBGT community told Democrats that if repeal didn’t pass…the gAyTM was gonna be forever closed.

And then, mirabile dictu, repeal passed, in a lame-duck Congress, even when virtually all observers had said it had no chance.

That is the power of The Fear, and if we want to win this fight, we need to be the ones putting The Fear on our Democratic friends, not the other way around.

So get up, grab the phone, and start reminding the nearest Democrat that unemployment, in this economy, really, really, sucks – and there’s no reason in the world why they can’t be just as unemployed as anyone else.

It’s time for hardball, folks – and in this fight, we need to be the ones with the hardest balls.

Because if we’re not…the terrorists win.

On Killing Medicare, Or, You Stand Up, They Run Scared

Oh, my, has there been a lot of news since we spoke last about the Potential Impending Death Of Medicare: obviously we’re going to have to talk about the implications of Osama Bin Laden’s death (but we’ll do that another day), President Obama very publicly congratulated Donald Trump for having the leadership skills to know that Gary Busey was the one who needed to be fired after the way he ran the men’s cooking team on “The Apprentice”, and, of course, there was that “extreme ironing incident” on the M1 near London’s Mill Hill.

But what you may not have noticed is that in the past two weeks the Grim Weeper himself, Speaker of the House John Boehner, has gone from saying “I fully support Paul Ryan’s budget, including on Medicare” to saying that the Paul Ryan “Let’s Kill Medicare” plan is “an idea … worthy of consideration”—and when that happens that quickly you know somebody applied what we might politely describe as being at least “an equal and opposite force”.

And what I’m here to suggest today is that the opposite force in question…is you.

When I left for college, I was determined never to be a victim again. I would take my lead from the Hollywood tough guys I had always looked up to: Charles Bronson, Clint Eastwood, Ned Beatty. So on Day One of my freshman year at Dartmouth, I walked into class and punched the first person I saw—my Ethics professor, Dr. Buneta.

--From the book “I Am America (And So Can You!)”, by Stephen Colbert

So as we said, it just a couple of weeks ago that we were talking about the then-underway Congressional Recess and killing Medicare and how you could go make yourself well understood by your local member of Congress; people did exactly that, and all of a sudden the backpedaling was under way.

As we mentioned, back then it was full speed ahead for the Ryan budget plan—but two weeks of facing the voters later, Michelle Bachmann, the Chair of Congress’ Tea Party Caucus and the Woman Who Would Usurp Sarah Palin, says that:

I supported that budget blueprint, though I’ve expressed caution about how we approach the issue of Medicare. We must keep our promises to those who receive Medicare benefits, and those who are nearing the age of Medicare eligibility. Our challenge is to reduce the soaring amounts that government spends on health care, without burdening those who are most vulnerable.

And it’s not just her: virtually no legislation moves through the House unless it first clears the Ways and Means Committee, and Chairman Dave Camp says this about the Ryan plan…

“I am not interested in laying down more markers. I am interested in solutions.”

…and that is his way of saying Ryan’s proposal is toast.

Beyond that, it looks like the Republicans’ most immediate “tactical” effort, tying big cuts in the program to an expansion of the Federal Government’s “debt ceiling”, is also coming apart at the seams; to that end we have the Republican House leadership now suggesting that they understand the urgency of passing the debt ceiling even if the Medicare “reforms” are not in that agreement.

(There is, however, an element of uncertainty still extant: Speaker Weeper spoke to the Economic Club of New York Monday; he told them he’s going to attach lots of conditions to that debt ceiling extension, after which he went off to a private spa to be dipped in whatever orange liquid they use to obtain his peculiar hue.)

Republican Representative Joe Walsh, of Illinois’ 8th, says that he would like to see the Party continue to push the Ryan plan as an issue in the ’12 campaign. That might work well in certain Congressional races, but it would seem to be a problem for any Republican Presidential candidate—and we should note that Walsh himself was elected in ’10 with a very narrow margin of victory.

So that’s all good news, but it’s probably not the end of the story…and if you ask me, the next battle is going to look more like no battle at all.

Here’s what I mean:

A great way to negotiate a deal is to start out with a crazy demand, and then, when that idea falls off the table, come back with something slightly less crazy that looks good enough to the other side to be acceptable.

Another variation on this theme is to start out with an extreme demand, and then you “meet somewhere in the middle”, which ends up moving the entire negotiation farther in your direction than you might have ever achieved by “normal means”.

You would think Democrats would be smart enough to not go along with such a strategy—but with Osama dead, and the “Democrats are soft on defense” argument getting tougher to make all the time, there is going to be a ton of effort going into the ’12 campaign to show that Democrats are “soft on the deficit”, and there is a real possibility that this Administration and certain Democrats in Congress will be susceptible to some of that pressure.

This will begin to play itself out, I suspect, as the effort to reconcile the budget visions offered from the House, Senate, and Administration continues through the summer—and if you want to get a sense of how that battle might look, check out today’s hearing (“Perspectives on Deficit Reduction: Social Security”) before the Senate Finance Committee.

Senate Finance is Max Baucus’ Committee (Orrin Hatch is Ranking Member), so this is a Blue Dog Chairman; he’s also one of those who might be happy to make compromises to “lower the deficit” that we won’t like—including supporting cuts to Social Security or raiding the Social Security Trust Funds.

One way that could be done…very quietly…would be to put a cap on all Federal spending, and then lower that cap by some amount each year, ignoring the fact that Social Security has its own funding source and is in no way connected to the deficit—and they tell me that’s what Nancy Altman, the co-chair of Strengthen Social Security, is going to be saying to the assembled Senators today:

“Social Security lacks the legal authority to deficit-spend, and so, cannot run a deficit. Because it cannot run a deficit, it cannot add to the federal deficit…

Some policymakers are proposing a so-called universal cap as a mechanism to control federal spending. It is important to understand that unlike the general fund, Social Security already has an automatic spending cap. If Social Security were ever to lack sufficient revenue to cover the cost of scheduled benefits, the law provides that those benefits be reduced automatically

To include Social Security in deficit legislation, even with the explanation that the inclusion has nothing to do with deficit reduction, risks reinforcing the widespread belief that Congress is raiding the trust fund…”

(Full Disclosure: I’m associated with the Campaign for America’s Future, and they’re part of Strengthen Social Security.)

It’s a short story this time, so let’s wrap it up here: we’ve had great success this past couple of weeks convincing pretty much every politician in the United States of America that Social Security and Medicare/Medicaid matter to us, and that getting crazy with these programs really is political suicide—but these programs have been under assault since the very day they were born by people with their own agendas and more or less all the money in the world to fund an endless series of fights…and you can kill a popular program in subtle ways that most voters might not even notice until it’s too late; with all that in mind, this one very big victory is not a war finally won.

The shape of the next fight is going to be made more visible today, and I would encourage you to swing by C-SPAN to see how it went

Even more importantly, I want y’all to think about what this past couple of weeks really meant: we went out in force, and we scared the hell out of the politicians who thought they would slam through some major changes that we’d just somehow…accept.

Democrats and Republicans alike need a bit of direction as this electoral season gets underway, and the messages we send out there obviously have the power to turn an entire discussion, so look at what you did, let it give you a bit of confidence that you can have an impact…even in this seemingly impossible year…and then let’s get ready for the next fight, which is going to be just as rough, and just as high-stakes—but this time much of the action will be subtle and deliberately “obfuscated”, and we’ll have to be even more alert if we want to see the scam before it gets set into stone.

And of course, we’ve got to keep showing up for those “Town Halls”, eh?

FULL DISCLOSURE: This post was written with the support of the CAF State Blogger's Network Project.