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Medicare for All Cometh

Senator Bernie Sanders of Vermont has introduced his much-touted Medicare-for-All bill with a good slate of cosponsors joining the effort. And it sets the opposition out to pick at the draft with calls of calamity.

There are those opposed on principle, but the most common criticism seems to have to do with cost, which is interesting in itself. Basically, if you aren’t opposed to the idea that everybody be covered, and be covered through a Medicare-style system, then all you have left is to say that we need to work out the details (or maintain, farcically, that no iteration can work).

Arguing that a Medicare system isn’t workable, period, doesn’t fly. Medicare itself is strong evidence that it is workable. Other countries have their own systems, too. Universal healthcare is entirely achievable.

Cost is the main target now. How to fund it, and are the benefits correct?

The benefits are possibly too generous, but not by a lot. They would be adjusted down in any serious negotiation to pass this bill. That would lower the costs, at least a little. But serious costs, the bulk, would remain.

To pay for this bill, or one like it, will require new revenues. Primarily, there will be new taxes imposed on some combination of employment and income. The tax increases will be offset by the reduction or elimination of individual and corporate costs for healthcare. There is a reasonable expectation that the tax burden will be less than the current burden of paying for healthcare, as there is widespread agreement that healthcare costs are artificially high.

People don’t want to pay taxes. That’s mostly a function of an anti-American narrative built by the right wing. ‘Taxation is theft,’ and other such nonsense. Taxation is debt. It is owed, not taken. Norquist doesn’t say to the restaurateur after his meal, ‘I want you to sign this pledge saying you’ll never adjust the cost of your food.’

More importantly, within the range of contemplatable taxes (i.e., up to the actual revenue needed to fund government), tax isn’t a problem. It’s a distortion in the minds of the wealthy that has led to such fear of taxes, even to the point where they are happy to overspend on a necessity like healthcare to avoid a lesser tax. That sort of distortion begs correction.

Given the inability of the Republican party to offer an alternative proposal that could even pretend to be universal, Medicare for All or some other system will happen. Taxes will be raised to pay for it. If the Republicans don’t like that, their only possible move is to formulate a state-level plan that ensures universal coverage. They will have to fight like hell, and with haste, to get it enacted in all 50 states before the Democrats have a chance to set up a national healthcare system. They will need to solve portability between states, too.

But they have run the clock out on not moving the nation to universal coverage.

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Hurricane Thoughts, 9 September 2017

Superfund and Climate Change

Apologies to federal officials that have had their brains altered so as not to be able to read the words “climate change.” The political correctness on the right has gone too far.

Now, with Hurricane Harvey’s impact on the Texas coast and in Houston, we have renewed insight to the vulnerability of toxic sites being impacted by natural disasters. We surely need to have the EPA prioritize cleanup of coastal sites, of which there are many given the economic gravity of the coastline in deciding where to live and work. As seas rise and as storm surges and tidal flooding become more common, we will see more disturbances of cleanup sites.

Self-Driving Evacuations

As self-driving cars are soon to become reality, and as the electric fleet model will likely dominate the space soon thereafter, there is a need to understand how evacuations and pricing and (battery) charging events will interact. That is, if the normal demand of a city is one car per six people, during an evacuation scenario it will need to become one per three, or whatever the ramp-up is.

In all likelihood, phased evacuations will be needed, with limited ranges and limited charge capacity on the grid. Ground-zero evacuees will be shuttled up to zone-one, and one-to-two, etc. Meanwhile, a flow of excess vehicles from surrounding states will be flowing in to continue moving individuals away from the disaster.

All of this needs to happen as orderly as possible, and it needs to be lotterial, so all in risk areas have equal chance if the number of seats is too low to accommodate demand. In the near-term, pop-up traffic lights could be deployed as drones with some of the existing vehicle-vision technologies to places without existing lights.

The delivery-first commerce model will require other adjustments for the delivery of water and other preparedness items prior to a storm for those not being evacuated.

Social Rescue Communications

One of the stories that kept appearing during and after Harvey was the use of various social platforms to report and organize rescue needs. There needs to be more integration of social sites, or some better way for rescuers and dispatchers to cover the whole spread of such sites, to ensure that signals aren’t getting lost because of fragmentation in that space. Nobody should be left unrescued simply because they didn’t use the right social media platform.

The key issue there is likely portability across platforms. The ability to easily take a post from one site and relay it to the dispatcher or rescuer on another service with full information and return-contact ability needs to happen. Included in that would also be some requirement that sites not block unregistered or off-platform access (while maybe not requiring they specifically accommodate it). If you don’t have a smartphone, but have a laptop, and there’s important information on a smartphone-only service, that could be a real bummer. Sites need to recognize those situations.

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Flood Insurance Shouldn’t Be Political

There are a number of government-sponsored enterprises, government-chartered corporations, and government-owned corporations, such as Fannie Mae, the Corporation for Public Broadcasting, and the Tennessee Valley Authority.

The flood insurance program should be arranged as either a government-sponsored enterprise or a government-chartered corporation. The updating of maps and the adjustment of premiums should not be subject to political whims, as there is a proven record of moral hazard in failing to adjust the risk ratings to what exists in the real world.

States should have a role in funding the program that covers their state, with a choice between property taxes, real estate sales tax, a rake on mortgage payments, or other mechanisms.

Under the current regime, the program gives a false sense of security. Many at-risk properties without coverage, many more that aren’t paying according to their real risks. Without truthful premium costs, the market gets a distorted risk signal, knowing the federal government will pay for municipalities’ and states’ messes. Sound familiar?

The political environment makes risk adjustment difficult. Nobody wants to pay more, but they want flood protection. If the program is private, the owners want to ensure they are keeping liabilities in check, so they will keep premiums rising with risks. Specifically, if the lenders are on the hook for underinsured properties that are damaged, they will demand proper insurance.

Similar moves should be made for other issues that should be outside of political tampering, such as the gas tax and vehicle efficiency standards, drug price negotiations for public healthcare programs, and other similar budgetary matters. If these various measures require a waiver process, that’s fine, but generally firms and individuals should pay what’s required for the efficient operation of the system as designed.

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Please Leave Enough Time to Override a Veto

The debt ceiling and the continuing resolution votes coming up should be passed with at least 11 days to spare. In the past, these votes have been done at the last minute, but Congress should leave nothing to chance here.

Under the Constitution, the president could sit on a bill for at least 11 days (ten, but they excepted Sundays) before issuing a veto (any longer and it automatically becomes law). While the president would probably sign either bill at the last minute, if McConnell and Ryan give him the chance, he might just screw it up.

The debt ceiling is the bigger deal here, though both matter. But in both cases, what should have been handled well before hand has been put off to the last minute. In both cases, there are efforts to try to leverage political gains out of what should be the most basic, no-nonsense acts of government.

But, worse, we have a president who appears unstable enough to stick a pinky on the corner of his mouth and fire guns at the feet of the legislature, telling them to dance and build his wall and whatever other villain cliches might be on hand at the time.

If the legislature puts the debt bill on the president’s desk in time, and he fails to sign it, causing any default, he would be impeached and likely removed for it. But the damage would be done. The fiscal reputation of the country would be harmed in a way that is not easily repaired.

It’s an easy call to make. Pass the bill early. If President Trump doesn’t sign it, override his veto. It’s the least the government can do for its people.

The continuing resolution to fund the government and keep it open is a similar story, though thankfully the only people directly harmed by a shutdown would be millions of workers and not the very fabric of the international financial order. So, no big deal, right? Just get the bill done. No gimmicks. Clean bill, with a plan to override any veto.

There is about a month left to get both done. If you want to do tax reform, then get these out of the way quickly.

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The Civil War Memorials That Matter

Instead of worrying about a bunch of sculptures, we should focus on preserving these living memorials, enshrined in law, and on fulfilling the necessities of our government with respect to them. That includes protection of civil rights, the cultivation of the franchise, and the voting out of any legislator or executive that acts contrary to those ends.

Article of Amendment 13, ratified 18 December 1865.

Section 1. Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction.

Section 2. Congress shall have power to enforce this article by appropriate legislation.

Article of Amendment 14, ratified 9 July 1868.

Section 1. All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

Section 2. Representatives shall be apportioned among the several States according to their respective numbers, counting the whole number of persons in each State, excluding Indians not taxed. But when the right to vote at any election for the choice of electors for President and Vice President of the United States, Representatives in Congress, the Executive and Judicial officers of a State, or the members of the Legislature thereof, is denied to any of the male inhabitants of such State, being twenty-one years of age, and citizens of the United States, or in any way abridged, except for participation in rebellion, or other crime, the basis of representation therein shall be reduced in the proportion which the number of such male citizens shall bear to the whole number of male citizens twenty-one years of age in such State.

Section 3. No person shall be a Senator or Representative in Congress, or elector of President and Vice President, or hold any office, civil or military, under the United States, or under any State, who, having previously taken an oath, as a member of Congress, or as an officer of the United States, or as a member of any State legislature, or as an executive or judicial officer of any State, to support the Constitution of the United States, shall have engaged in insurrection or rebellion against the same, or given aid or comfort to the enemies thereof. But Congress may, by a vote of two-thirds of each House, remove such disability.

Section 4. The validity of the public debt of the United States, authorized by law, including debts incurred for payment of pensions and bounties for services in suppressing insurrection or rebellion, shall not be questioned. But neither the United States nor any State shall assume or pay any debt or obligation incurred in aid of insurrection or rebellion against the United States, or any claim for the loss or emancipation of any slave; but all such debts, obligations and claims shall be held illegal and void.

Section 5. The Congress shall have power to enforce, by appropriate legislation, the provisions of this article.

Article of Amendment 15, ratified 3 February 1870.

Section 1. The right of citizens of the United States to vote shall not be denied or abridged by the United States or by any State on account of race, color, or previous condition of servitude.

Section 2. The Congress shall have power to enforce this article by appropriate legislation.

Article of Amendment 24, ratified 23 January 1964.

Section 1. The right of citizens of the United States to vote in any primary or other election for President or Vice President, for electors for President or Vice President, or for Senator or Representative in Congress, shall not be denied or abridged by the United States or any State by reason of failure to pay any poll tax or other tax.

Section 2. The Congress shall have power to enforce this article by appropriate legislation.