Tim Pawlenty: “Health Care Policy All-Star?”

Former Minnesota Governor Tim Pawlenty is being featured as a “health policy all-star” by the University of Minnesota’s Humphrey School of Public Affairs. No, I’m not kidding.

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The University event is celebrating the accomplishments of a 2008 Healthcare Transformation Task Force that happened during the Pawlenty years.   Governor Pawlenty is the keynote speaker.  The invitation portrays the Pawlenty years as a time when there was less intense partisan disagreement. Again, not kidding.

Health care policy has generated intense partisan disagreement over the past 5 years. The acrimony has been a sharp departure from Minnesota’s long tradition of collaboration among Democrats and Republicans and across the business, non-profit, and public sectors.

I’m not all that familiar with the Task Force’s work, but I’m sure it made excellent health care policy contributions.  It’s very worthwhile to recognize and reflect on that work, and I applaud the University’s Humphrey School for doing that.  If you’re interested in health care policy, I’d encourage you to attend the event.

But perhaps the Humphrey School should also invite the community to reflect on some of the big picture differences between health care in Minnesota under the Pawlenty-era policies versus health care in the post-Pawlenty era.  Minnesotans should reflect on the dramatic health care improvements that have happened despite Governor Pawlenty, rather than because of him.

The Good Old Days

Ah 2008, those certainly were the good old days of Pawlenty era health care in Minnesota, back when the rate of health uninsurance was 9.0 percent. In contrast, in the post-Pawlenty era, the rate of uninsurance under Governor Dayton has declined to 4.9 percent, the lowest point in Minnesota history.

This happened largely due of the success of the ACA reforms that Governor Pawlenty persistently and bitterly opposed.  For example, in 2011 Governor Pawlenty revved up a Conservative Political Action Committee (CPAC) audience with this simplistic barn burner:

The individual mandate in ObamaCare is a page right out of the Jimmy Carter playbook. The left simply doesn’t understand. The individual mandate reflects completely backwards thinking. They, the bureaucrats, don’t tell us what to do. We, the people, tell the government what to do!

We’re blessed to live in the freest and most prosperous nation in the history of the world. Our freedom is the very air we breathe. We must repeal Obamacare!

Do you see how much less “intensely partisan” health care policy was five years ago under Governor Pawlenty?

hqdefault_jpg__480×360_Oh and then there was that super nonpartisan time when Governor Pawlenty, who was preparing to run against President Obama, enacted an executive order to ban Minnesota from accepting any Obamacare-related Medicaid funding to provide health care coverage for 35,000 of Minnesota’s most vulnerable citizens. As the Star Tribune reported at the time, even Pawlenty-friendly health industry groups reacted to the highly partisan and punitive Pawlenty ban with unified expression of strong disapproval.

In a rare and unusually sharp statement, heads of Minnesota’s most influential medical associations said Pawlenty’s step contradicts his earlier embrace of state health care legislation. “The governor’s decision just doesn’t make sense for Minnesotans,” the Minnesota Council of Health Plans, the Minnesota Hospital Association and the Minnesota Medical Association said in a joint statement late Tuesday.

The Post-Pawlenty Health Policy Era

When Governor Dayton took office, he promptly reversed this Pawlenty ban to ensure that 35,000 low-income Minnesotans could get health care coverage.  Governor Dayton took a lot of heat for that decision, but this move started the process of driving down the state’s uninsured rate, a trend that has continued throughout the Dayton era.

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In more ways than many citizens realize, Minnesota has benefited enormously from the ACA reforms that Pawlenty politicized and obstructed.  According to the federal Department of Health and Human Services:

  • 64,514 Minnesotans have gained Medicaid or CHIP coverage
  • 1,465,000 Minnesotans with private health insurance gained preventive service coverage with no cost-sharing
  • Over 2 million Minnesotans are free from worrying about lifetime limits on coverage
  • As many as 2,318,738 non-elderly Minnesotans have some type of pre-existing health condition, and no longer can have coverage denied because of that condition

Yes, those Pawlenty years, when the Governor was fighting to keep Minnesotans from enjoying all of these ACA benefits, certainly were the good old days of health care policy.  “Health care policy all-star” indeed!

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Note:  This post also was published as part of MinnPost’s weekly Blog Cabin feature.

Ten Questions You Won’t Hear Asked By Intimidated Political Reporters

With all of the horse race and insult-related content in the GOP presidential debates, there is a huge opportunity cost: A lot of substantive questions simply are going unasked.

Megyn_Kelly_bimboMaybe that’s because reporters are worried bullying candidates will give them the Megyn Kelly Treatment/Rebecca Quick Treatment. Maybe it’s because reporters don’t take the time to learn policy issues. Maybe it’s because reporters don’t respect voters’ intelligence enough to think that they will care about, or understand, policy issues

Whatever the reason, the most consequential questions simply aren’t being posed, and the result on the Republican side is the most vapid set of presidential debates of my lifetime. Here just a few of the questions that I would love to hear asked at the upcoming Republican debate:

  • PAYING FOR TAX CUTS FOR WEALTHY? Which Americans’ services are you going to cut or eliminate to pay for your proposed tax cuts, which go disproportionately to the wealthiest Americans?
  • PAYING FOR PENTAGON SPENDING SPREE? You claim President Obama has destroyed the military, despite the fact military spending is at historically high levels, and is 23% higher than under President Reagan.  But if you do want to further beef up the military, which specific Pentagon spending programs will you increase, how much will that cost and what service cuts and/or tax increases will you offer to pay for that large increase in spending?
  • BUSHONOMICS AGAIN? President George W. Bush’s tax cuts on the wealthy didn’t lead to economic growth and deficit reduction, yet your tax proposal is remarkably similar to the Bushonomics that didn’t turn out so well for Americans. Why do you think that approach will lead to a booming economy if it didn’t turn out that way under the last Republican president?
  • CAP-AND-TRADE. One solution for reducing greenhouse emissions is the cap-and-trade approach. The last three Republican Presidents, including conservative icon Ronald Reagan, embraced this market-based approach. But suddenly Republicans now oppose the cap-and-trade approach to protecting the environment. Has cap-and-trade changed since President Reagan, or has the oil industry’s control of Republican leaders gotten that much stronger?
  • ELIMINATE OIL COMPANY SUBSIDIES? Given that you oppose subsidizing alternative energy sources, and government spending in general, would you support eliminating the $4.8 Billion in subsidies the petroleum industry is given every year? If not, why give an unfair competitive advantage to dirty, non-renewable, and foreign sources of energy over cleaner, renewable, American-based sources?
  • MAKING BANKS SMALL ENOUGH TO FAIL? The largest banks in America are now actually even larger than they were in 2008, when leaders judged them to be too big to fail.  Will you break up the nation’s largest financial institutions so that they are no longer “too big to fail?” If not, aren’t you leaving American taxpayers wide open to another crippling bailout?
  • DETAILS ON DEPORTATION. Explain specifically how you would deport 11.2 million undocumented immigrants, an amount roughly equivalent to the population of the State of Ohio? For example, how would you pry 11 million people away from their lives and families, and get them onto trains or buses? Would you use the military, National Guard or police? How would you pay the estimated $400-600 Billion cost of deporting 11.2 million people?
  • VETERANS VOTING RECORD. You all talk a lot about needing to honor and help military veterans. But if you all love veterans so much, why do groups like the Disabled American Veterans of America (DAV) rate your voting records so low. For instance, the DAV says Senator Rubio and Senator Cruz supported veterans 0% of the time in their most recent rating of them, while Senator Sanders supported veterans 100% of the time and Senator Clinton supported them 80% of the time.   Don’t legislative actions speak louder than your words?
  • DEFICIT SPENDING FOR WARS? Your comments on foreign policy indicate that you are inclined to send American troops to another armed conflict in the Middle East. If you do, will you increase taxes to pay for those operations, or will you fund the conflict with deficit spending, as the last Republican President did? If you’d run up the deficit with trillions of dollars of war spending, how can you claim to be a fiscal conservative?
  • AFFORDABLE CARE ACT (ACA) ALTERNATIVE? What’s your specific plan for replacing the Affordable Care Act? No, really, it’s been six years since the ACA passed, so this time you are not going to get away with dodging the question. If you still can’t name an alternative you support, isn’t it fair to assume that the claimed “repeal-and-replace” rhetoric is actually just “repeal,” which would lead to 1) about 15 million Americans losing their coverage and 2) another 65 million losing their ACA protection from discrimination due to a pre-existing condition?

Oh, and here is one over-arching question I’d like them to add. “For every tax cut or spending increase you didn’t know the cost of today, will you pledge to the American people that you will disclose the estimated fiscal impact within the next month? If not, why won’t you shoot it straight to the voters.”

There are dozens of other questions that need to be asked by reporters, but this would be a very helpful start. Yes, such questioning will cause reporters to get booed, heckled and bullied by the candidates and their cheering sections. But frankly that happens even when they ask softball questions, so what exactly do they have to lose?

The Health Reform Middle Ground Between Bernie and Hillary

Cursor_and_bernie_hillary_debate_msnbc_-_Google_SearchTo hear Senator Hillary Clinton’s campaign tell it, you would think that there is absolutely no way to transition from the Affordable Care Act (ACA) world of today to an eventual Medicare-for-All world that her opponent Senator Bernie Sanders promotes.

The Clinton campaign asserts that the ACA and Medicare-for-All are effectively mutually exclusive. That is, they claim that if you support Medicare-for-All, you must be against the ACA. For instance, former First Daughter Chelsea Clinton was put out on the stump to play Chicken Little:

“Senator Sanders wants to dismantle Obamacare, dismantle the CHIP program, dismantle Medicare, and dismantle private insurance. I worry if we give Republicans Democratic permission to do that, we’ll go back to an era — before we had the Affordable Care Act — that would strip millions and millions and millions of people off their health insurance.”

Chelsea’s mom, a bona fide health care policy expert, knows better. She knows that Senator Sanders proposes to consolidate public insurance programs to make coverage better and more efficient, not eliminate public coverage.

The Clinton campaign’s dire warnings aside, there is a potential middle ground between Senator Sanders’ Medicare-for-All Model and Secretary Clinton’s Stick With The ACA Model.  It’s a middle ground that is more politically viable than what Sanders proposes, and more progressive than what Clinton proposes.

The middle ground is this: Amend the Affordable Care Act to allow ACA exchange shoppers the option of voluntarily buying into Medicare.

This middle ground approach would effectively empower patients to decide the fate of Medicare-for-All.  Here’s how:  If over the years enough ACA exchange shoppers choose of their own free will to buy into Medicare, we will be making progress towards a public single payer system, which in numerous other western countries has proven to be a more effective and efficient model than America’s current model.

On the other hand, if private insurance options prove to be the most attractive, on a quality and/or price basis, the Medicare buy-in option will die off, because it will be exposed as being as inferior as Republicans claim it to be.

But with this Medicare buy-in option, patients would effectively decide Medicare-for-All’s ultimate fate, not politicians.  That’s why it’s a middle ground position.

Senator Clinton maintains that a public option lacks sufficient congressional support to pass, and that is certainly a distinct possibility. But if she proves to be correct and it gets defeated, the ACA will still be there. At that point, we would simply stay with the status quo ACA model.

But I’d like to see an aspirational President who was willing to lead a campaign to enact this middle ground approach.  Because this would be merely optional for patients, it is much more politically feasible than Sanders’ proposal to mandate Medicare-for-All.  Even if a Medicare buy-in option loses, promoting the issue now may pave the way for eventual passage in the future.   It moves the national debate forward.

I actually think a passionate, committed President would have an outside shot of passing this.  After all, there already is a great deal of support for this approach. GBA Strategies recently asked 1,500 likely 2016 voters whether they supporting giving “all Americans the choice of buying health insurance through Medicare or private insurances, which would provide competition for insurance companies and more options for consumers.”

An overwhelming 71% supported this Medicare buy-in option, including 63% of Republicans and 71% of Independents. Only 13% opposed. 

After the special interests start their multi-million distortion and lobbying campaigns, the Medicare buy-in option may well get defeated in a Congress that defeats just about everything. (In fact, any of Senator Clinton’s ideas for incrementally improving the ACA also face a steep uphill battle with a Republican-controlled House).   But this survey tells me that there is a solid foundation of support to build on. So why not lead the American people towards this place halfway between Bernie and Hillary, and at least try to make some progress.

Note:  This post was featured in MinnPost’s Blog Cabin.

Dirty Job Dayton Dusts Himself Off

Dayton_dirty_2Governor Mark Dayton is Minnesota’s political version of Mike Rowe, the star of the Discovery Channel television show “Dirty Jobs.” Rowe’s show is all about him taking on difficult, disrespected and grotesque jobs that others avoid, such as being a sewer inspector, road kill scavenger, worm dung farmer, shark repellent tester, maggot farmer, and sea lamprey exterminator.  Who knew that worm dung needed farming?

Dirty Job Dayton

Governor Mark Dayton may not be farming worm dung, but consider just a few of the filthy tasks Dirty Job Dayton has already embraced in his five year’s in office.

Taxing Most Powerful Minnesotans.  Before Dayton, non-partisan analyses were showing that the wealthiest Minnesotans were not paying their fair share of taxes.  So Dayton ran for Governor unabashedly championing tax increases on the state’s most wealthy citizens, which earned him some very powerful enemies. At the time, progressive political consultants considered advocating almost any kind of tax increase political suicide for candidates. But Dayton ran on a platform of large tax increases, won a razar thin victory at the polls, and then promptly passed the tax increases into law as promised.

Implementing Unpopular Obamacare.  Dayton wasn’t done there. One of his very first acts of Governor was to champion Obamacare, which many politicians were extremely nervous about at the time. In contrast to his fellow Governors in neighboring Wisconsin, Iowa and South Dakota, Dayton embraced Obamacare’s Medicare expansion to cover 35,000 of the most vulnerable Minnesotans.   The Governor had Obamacare protesters shouting him down in his announcement news conference, but he let them have their say and stuck to his principles without looking back.  As a result of taking on a number of controversial Obamacare implementation tasks, Minnesota now has the second best rate of health insurance coverage of any state (95%).

Resolving Vikings Stadium Quagmire.  Then there was the Vikings Stadium debate that had been festering for almost a decade before Dayton came to office. Despite polls showing that subsidizing the stadium was unpopular, Dayton provided active backing for legislation to publicly subsidize the Vikings Stadium.  While noting that he is “not one to defend the economics of the NFL,” he plugged his nose and embraced a job he didn’t welcome, but felt was necessary to keep the Vikings in Minnesota and boost a then-suffering construction sector.

Cutting Coveted Social Safety Net.  Early in Dayton’s tenure as Governor, he even made significant cuts in state safety net programs, which is one of the very worst jobs any progressive can ever get.  Faced with a large budget shortfall, he proposed cutting $950 million in planned spending, told agencies to cut their budgets by up to 10 percent, and cut the state workforce by 6 percent.  That work had to leave even Dirty Job Dayton feeing grimy.

Love these positions or hate them — and Dayton himself didn’t relish many of them — no one can accuse Dayton of political timidity.

Dirtiest Job Yet

But this winter, Dirty Job Dayton finally met his Waterloo. With no political allies in sight, he attempted to push through salary increases for state agency commissioners, who are making less than their peers in many other states.   Dayton said he “knew there would be negative reaction,” but, as is his habit, he plugged his nose and pushed forward anyway.

How did that go for him?  Well, in the last few weeks Dayton learned that attempting to raise bureaucrats’ pay makes shark repellent testing look like a walk in the park.

Fresh off that experience, one might expect that Dayton would now stick to clean, safe, and easy jobs for the remainder of his time in office.  But if you believe that, you obviously don’t know Dirty Job Dayton very well.

Next Up:  Slinging Asphalt

After the salary increase shellacking Dayton endured, he has already found a new thankless task to champion – fixing Minnesota’s deteriorating roads and bridges.  While Republicans want a modest short-term fix funded out of the current budget surplus, that would be much too easy for Dirty Job Dayton. Dayton is attempting to put in place an ambitious decade-long $11 billion solution. Such a long-term fix necessitates a 16 cent per gallon (at current prices) increase in the gas tax. Not surprisingly, the polls are looking a little rough at the moment.

But Dirty Job Dayton doesn’t care. Like Mike Rowe, if the assignment stinks, scares, or stings, he’s in!

Americans Support An Actual “Government Takeover of Health Care,” And I Don’t Mean Obamacare

Government_takeover_of_health_careOn the heels of the closing of the second year of open enrollment for Obamacare coverage, expect to hear a lot of “government takeover of health care” ranting from conservatives.

That phrase is heavily used by anti-Obamacare zealots, and that is no accident.  In 2009, Republican political consultant and celebrated wordsmith Frank Luntz advised his conservative clients to portray the proposed Affordable Care Act, also known as Obamacare, as “a government takeover of health care.”

Conservatives did as they were told. If you Google those words, you’ll see that the usage of that phrase, and close variations, has been widespread among conservatives ever since.

In a 28-page strategy memo, Luntz explained why stressing a Washington “takeover” was so important:

“Takeovers are like coups.  They both lead to dictators and a loss of freedom.”

In other words, the Affordable Care Act shouldn’t be talked about as it were a legislative proposal in a representative democracy.  Instead, it should be talked about as if it were a Stalin-esque freedom grab.

There are two problems with conservatives parroting the Luntz-recommended phrase “government takeover of health care” to make Americans fearful about health care reform: First, It’s demonstrably false.  Second, It doesn’t scare most Americans.

False.  I’m not going to go into detail about why it is false, because it’s pretty self-evident.  But suffice it to say that ‘government takeover of health care” as a descriptor for the Affordable Care Act was named by the non-partisan editors of Politifact as their 2010 “Lie of the Year.”   In a lie-intensive election year, “government takeover of healthcare” was named by both editors and readers as the Pants on Fire of all Pants’s on Fire.  Politifact notes the obvious:

“It is inaccurate to call the plan a government takeover because it relies largely on the existing system of health coverage provided by employers.

It’s true that the law does significantly increase government regulation of health insurers. But it is, at its heart, a system that relies on private companies and the free market.”

Not Scary.  But beyond being false, the more surprising thing to me is that “government takeover of health care” is not all that scary to a  majority of Americans.

While Obamacare is not remotely close to a government takeover of health care, putting Americans into the government-run Medicare program would be exactly that.  And you know what? Most Americans are just fine with even that level of government takeover of health care.

Medicare_for_All

A January 2015 GBA Strategies survey asked Americans if they support enactment of “a national health plan in which all Americans would get their insurance through an expanded, universal form of Medicare.” By a 15-point margin, a majority of Americans (51% support, 36% oppose) supported that kind of government takeover of health care.

The same survey then asked Americans about giving people the option of having government take over their health care.   Specifically, the survey asked if respondents would support giving “all Americans the choice of buying health insurance through Medicare or private insurers, which would provide competition for insurance companies and more options for consumers.” An amazing 71% of Americans support having the option of a government takeover their health care, including 63% of Republican respondents.

So it turns out that, after six years of intensive Luntz-led vilification of “government takeover of health care,” backed by hundreds of millions of dollars of political advertising and public relations efforts, there are very few issues in America today with as much public support as there is for the federal government taking over American health care.

– Loveland

Note:  This post was republished on MinnPost.

Reporters Let McFadden Have It Both Ways On Health Reform

You can’t simultaneously support deism and atheism, or capitalism and communism.  Embracing one makes it logically impossible to simultaneously embrace the other.  They are mutually exclusive.  If a candidate came out and claimed to be for both of those ideological constructs at the same time, in an attempt to win support from supporters of each idea, they would be the laughing stock of American politics.

If you doubt that, imagine if you saw these headlines in today’s news:

Dayton Tells Congregation “I Support Atheistic Christianity”

McFadden Tells Business Group He Embraces “Capitalistic Communism”

The candidates would be laughed out of the race for taking such absurd positions.

I submit that the same should be true of simultaneously advocating to 1) outlaw denial of health coverage due to a pre-existing health condition and 2) make health insurance coverage optional.  It’s defensible to embrace either of those two positions.  But it’s not defensible to embrace those two approaches simultaneously.

Here’s why:  If you outlaw the insurance companies’ enormously unpopular ability to deny coverage due to pre-existing conditions, but simultaneously make purchasing health insurance optional, millions of people would stay out of the insurance market until the moment they got sick or hurt.  After all, why would anyone choose to pay high premiums for years to protect themselves against the expenses associated with treating an illness or injury when they know that the insurance company will be forced to pay the treatment expenses after they suffer from the ailment? And if millions of people refused to pay premiums until the moment they need insurance benefits, the insurance industry would very quickly need to dramatically jack up premiums, or go bankrupt.

There is broad consensus about this.  The Georgetown University Center on Health Insurance, the Manhattan Institute, America’s Health Insurance Plans (AHIP), the Pacific Research Institute, the Manhattan Institute, The Concord Coalition, the Center on Budget and Policy Priorities, Families USA and many others have all said that a coverage mandate and preexisting condition reform have to be paired in order for the finances of health reform to work.

Mike_McFadden_scissors_obamacareYet when GOP politicians endorse those two mutually exclusive positions, almost no political reporters note the absurdity of it.  When reporters allow politicians to get away with simultaneously endorsing the part of Obamacare that outlaws pre-existing condition denials and opposing the part of Obamacare that mandates insurance coverage, they effectively allow those politicians to say something every bit as absurd as “I’m for capitalism, but I also support communism.”

For example Minnesota U.S. Senate candidate, and millionaire investment banker, Mike McFadden (R-Sunfish Lake) says:

Before we can make the kind of changes Americans deserve, we need to repeal the “Unaffordable Care Act” (which would repeal the coverage mandates)

…when we repeal and replace Obamacare, we need to make sure that those with pre-existing conditions actually have access to affordable insurance plans that cover their illnesses.

Any actuary will tell you that if McFadden and other GOP pols simultaneously enacted those two policies it would lead to a complete and utter meltdown of the nation’s health care finance system.  But almost no political reporters will.

– Loveland

Note:  This post was also featured on MinnPost’s Blog Cabin.

McFadden’s New Ad Proposes Scissoring Health Care System’s Unhealed Wounds

McFadden_Stiches_AdFollowing his sophmoric campaign ad about getting hit by a child in his, tee hee, senatorial privates, Minnesota U.S. Senate candidate Mike McFadden has a new metaphoric television ad about the harm he wants to inflict on Obamacare.

The ad opens with Mr. McFadden establishing his bona fides as a Common Man, just like us.  Sitting in a plush leather chair in a well polished den, the son of the CEO candidate — who is worth between $15 million and $57 million dollars — tells viewers about the McFaddens’ hardscrabble existence:

Conor McFadden (son of the candidate): “My dad, Mike McFadden? He’s cheap.”

Mike McFadden (candidate): “With six kids, it’s called a budget.”

In Romneyesque fashion, the “with six kids” and “budget” references are intended to imply that Millionaire Mike is struggling from paycheck-to-paycheck, just like a dang minimum wage worker.  This is as close to an obligatory “Honest Abe was raised in a primitive log cabin out on the wild frontier” yarn as Team McFadden can muster.   (Of course, the $2,000 hockey table on display next to junior doesn’t exactly support the Frugal Mike image.  But, hey, he didn’t get the kids the $3,000 table, now did he?)

Then comes the metaphoric meat of the ad:

Conor: “When I was 10 and had to get stitches out after a hockey injury, the nurse said it would cost one-hundred bucks. Dad was so horrified he grabbed the scissors and took them out himself.”

Mike: “You lived.”

Conor: “Trust me, nothing will stop Dad from trying to take out Obamacare.”

Mike: “Send me to Washington and give me some scissors. I’ll put ‘em to work.”

Mike_McFadden_stern_daddyNote the tough, no-nonsense daddy image that McFadden’s political consultants are constructing.  Linguist George Lakoff has documented how GOP candidates very consciously frame themselves as “strict fathers” of the  family — “you lived” — while portraying Democrats as the overly permissive mommies.

Wait until daddy comes home!  Daddy will stop mommy and and the children from spending irresponsibly. There is a lot of that patriarchal “father knows best” vibe here.

So, to recap the ad narrative,  strict daddy on a budget is so darn frugal he will remove son’s stitches with his own scissors to save money, and he will do that with Obamacare too!

There are at least a couple of major substantive problems with the mac daddy’s metaphor:

Problem #1:  America’s health care system is far from a healed wound.  In fact, America’s health care system is an open, festering wound.  According to the non-partisan Commonwealth Fund, the United States has the worst health care system in the developed world.  After Mr. McFadden “takes out” the ACA stitches in this gaping wound, what is he going to do about the bleeding:

  • The 99,643 Minnesotans newly enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) who would be uninsured again.
  • The 2,318,738  Minnesotans with some type of pre-existing health condition who would once again be denied insurance without ACA protection.
  • The 35,000 Minnesota young adults who, thanks to the ACA, are currently insured under their parents plans until age 26 but would be uninsured again without ACA.
  • The 2,043,000 Minnesotans who, thanks to the ACA, are free from worrying about lifetime limits on coverage, but would face such dangerous limits again.

Are we really prepared to let McFadden re-open that wound?

Problem #2:  “Taking out” Obamacare stitches with McFadden’s scissors doesn’t save money. In fact, it would cost a lot of money.  According to the non-partisan Congressional Budget Office (CBO) and Joint Committee on Taxation (JTC), eliminating Obamacare would:

“…cause a net increase in federal budget deficits of $109 billion over the 2013–2022 period.”

In other words, McFadden may be cutting, but he is certainly not saving.  That’s an important little $109 billion detail to keep in mind.

Also, McFadden has made it clear that he wouldn’t use his scissors on fellow CEOs at private insurance companies.  McFadden opponent Senator Al Franken successfully authored an ACA measure that, for the first time, requires private health plan CEOs to spend at least 80 to 85 percent of the premiums they collect to pay for actual health care, instead of corporate overhead, salaries, bonuses, marketing and profits.  In 2012, Franken’s “medical loss ratio” provision led to the average Minnesota family with private insurance receiving a rebate of $303.

But Mr. McFadden has made it clear that he opposes Franken’s scissoring of private insurance companies’ overhead, salaries, bonuses, marketing and profits.   Instead, McFadden prefers to take his scissors to millions of Minnesotans benefiting from Obamacare.

So, McFadden wants to scissors an unhealed wound even though it will cost billions and cause massive bleeding.  Why?  Because the Minnesota GOP’s rabidly Tea Party base demands red-faced Obama-hating, and McFadden will say anything to curry their favor.  As McFadden’s son promises them, “Trust me, nothing will stop Dad from trying to take out Obamacare.”

– Loveland

Minnesota Senate Candidate McFadden Releases New Humorous Ad

Mike_McFadden_groin_hilaritySaint Paul, Minn. — Minnesota U.S. Senate candidate Mike McFadden (R-Sunfish Lake) followed an earlier campaign television ad that ended with a child-inflicted injury to his groin with a new  television ad that uses thinly veiled flatulence-based humor to further make his case for election to the U.S. Senate.

“We’re just trying to have some good clean fun, while making a very serious point about Al Franken’s big government, job-killing stuff,” said McFadden.

The ad opens with a fog rolling over a grainy black-and-white photo of a frowning Senator Al Franken. Ominous music drones throughout the spot, and two 10-year old boys on a playground chime in in a sign-songy tone.

Male adult announcer: “Something is very, very rotten in Washington.”

Male child actor #1: “Al Franken says the Iraq War and Great Recesssion  are not his fault. But he who smelt it, dealt it.” (giggle)

Announcer: “Death panels.  IRSgate. Benghazi. Al Franken wants to keep it silent. But we all know, they’re silent but DEADLY.”

Male child actor #2: “Whoever rebuts it, cuts it.” (giggle)

Mike McFadden: (Giggling and holding his nose ) “I’m Mike McFadden, and I declare it, so Al can no longer blare it.”

(McFadden then sits on whoopee cushion. McFadden and kids giggle in unison.)

Mike McFadden:  “Oh no, not again, Al!”

The ad began running across Minnesota today. Like the groin ad, it was created by Washington-based Sophmoric Productions.

– Loveland

Note:  This post is satire and the featured ad doesn’t exist, for now.

Minneapolis Stepping On It’s Applause Line

Betsy_Hodges_begs_for_applauseSo Minneapolis Mayor Betsy Hodges is directing Minneapolitan social media mavens to tweet on over to #bragmpls to brag about Minneapolis, and run down other cities.

 “When you go to their cities,” she joked, “talk about how disappointing they are compared to Minneapolis.”

I can hear it now.

“Yeah, New York City is nice and all, but frankly Central Park is a little disappointing compared to The Yard.”

“Chicago? I hate to be mean, but I was a little disappointed that the architecture was all so old, kind of like Minneapolis had before we had the good sense to demolish it, and replace with a fresh 1970s look.”

“San Francisco, meh. I looked everywhere to find a Culver’s, but was sooooo disappointed to learn that they haven’t arrived there yet. I couldn’t wait to get home.”

Okay, I acknowledge Mayor Hodges was making a joke when she talked about expressing disappointment in other cities.  Still, the hashtag cheerleading campaign is no joke to Mayor Hodges and her public relations team.   And to me, her public begging for hashtags is a wee bit #pathetic.

Of all of the contrived things about contemporary professional sports stage management, nothing is more inauthentic than the Jumbotron exhortations for fans to “Make Some Noise!” The piped-in artificial rhythmic clapping and the mind-numbingly chirpy D.J. Casper song “Everybody Clap Your Hands” fall into the same category.   Inevitably these perky little pick-me-ups come when the bats are silent, the defense is porous, and the hometown ownership is starting to worry about meeting its beer sales targets.

But here’s the thing: Minneapolis’s bats are not silent.

rainbow_all_star_gameIn fact, Minneapolis is kicking some serious ass right now. Two new mega-expensive LRT lines are flowing through Minneapolis, and a third appears to be on the way. An iconic billion dollar football palace is rising out of the ground to replace the embarrassing  Metrodome. The metro area has the lowest unemployment of any metro area in the nation. Minnesota has the second lowest uninsured rate in the nation. The city’s population is growing, driven by a remarkable residential housing boom in the downtown area.  The Super Bowl, the most visible sporting event in America, is coming.  And baseball fans from around the world are watching professional baseball’s All Star Game in one of the best ballparks in the world, with a rainbow framing it, right here in our Minnie Apple.

The applause is happening organically. So turning on the flashing “Applause!” sign and publicly waving the mayoral pom poms in the midst of genuine, unprompted applause constitutes stepping on your own applause line.   Methinks we’re trying just a little too hard.

– Loveland

Note:  This post was also featured on MinnPost’s Blog Cabin.

Billionaire Purchases Naming Rights To Uninsured South Dakotans

Sioux Falls, South Dakota — South Dakota billionaire banker and philanthropist T. Denny Sanford announced today that he will fund free health coverage for 48,000 uninsured, low-income South Dakotans.  The announcement comes in the wake of Republican Governor Dennis Daugaard’s continued refusal to accept $224 million in federal funding to cover the same group of citizens.

In recent years, Sanford has been lauded for donating large amounts of money to South Dakota health facilities, sports complexes, and other popular projects.   The high interest banker often has his projects named after him, such as Sanford Health™, Sanford Children’s™, Sanford Heart™,  Sanford Medical School™, Sanford Pentagon™, Sanford Sports Complex™, and Denny Sanford Premier Center™.

Sanford’s latest donation comes in the midst of a bitter political debate that has been intensifying in South Dakota for several years.

As part of the federal Affordable Care Act (ACA), sometimes called Obamacare, about 48,000 low income South Dakotans are eligible for Medicaid coverage.  By the year 2020, South Dakota was to have received a massive influx of $224 million due to this expansion of coverage.

Medicaid_ExpansionHowever Governor Daugaard has refused the $224 million to cover uninsured poor people, citing his  personal opposition to Obamacare and the cost of the expansion that would be paid by South Dakota.  The federal government is paying 100 percent of the total costs through 2016, and 90 percent after that.

The neighboring states of Iowa, North Dakota, and Minnesota are all expanding Medicaid coverage to uninsured citizens, while Nebraska, Montana and Wyoming are not.  States that are opting out of the program will leave over 5 million of the poorest Americans without basic health benefits, or shifting their health care costs to other citizens.

Under pressure from South Dakota physicians and 63% of South Dakotans who support the Medicaid expansion, Daugaard recently asked the federal government to cover a little over half of the eligible citizens, but deny coverage to the rest of eligible citizens. The federal government rejected Daugaard’s proposal, leaving all 48,000 South Dakotans without coverage.  The Legislature  refused to allow the Medicaid expansion question to be posed to South Dakota voters at the ballot box.

But Sanford stepped into the fray today, announcing that he is creating a new Medicaid-like health plan, which he is calling SanfordCare™.  Any South Dakota citizen who would have been eligible for the Obamacare expansion would be eligible for the free SandfordCare™ coverage, provided they agree to legally change their surnames to Sanford™.  Any children born while under the health coverage would also have to adopt the first name Denny™ or Denita™.

Note:  This post is, to the best of our knowledge, satire.  There is no SanfordCare proposal, but there are 48,000 South Dakotans being denied health coverage.

Franken Opponent McFadden Refuses To Confirm Own Existence

invisible_manSaint Paul, Minnesota — Minnesota U.S.  Senate candidate Mike McFadden held a news conference today to announce that he would be announcing nothing.

“Minnesota is great, and I’ll do lots of great stuff in the Senate to make it even greater,” said McFadden, to roaring applause from his supporters.  “Beyond that, I promise that I will not do wasteful ungreat things that keep Minnesota from becoming greater.”

Under questioning from reporters, the wealthy businessman running to replace U.S. Senator Al Franken refused to provide positions  on the national policy issues that are debated in the U.S. Senate.   For example, McFadden declined to state his position on the minimum wage, the Paycheck Fairness Act and a “personhood” anti-birth control measure.

MinnPost reporter Eric Black recently attempted to profile the stealth Senate candidate, but struggled to find anything to profile beyond the over $2 million the former businessman has raised from enthusiastic conservative donors.  Black characterized the McFadden record like this:

I’m not sure what the record is for seeking a seat in the U.S. Senate without disclosing issue positions, but McFadden, who declared his candidacy nine months ago, may be giving it a run.

There is no “issues” section on his campaign website. He skipped the first three opportunities to debate his Republican opponents for the nomination.  On Monday, he appeared at the fourth debate, but that one was closed to the press and public.

The McFadden campaign maintains that the candidate has taken many position stands, such as his desire to “name way more awesome things after Ronald Reagan” and “repeal and replace” the federal Affordable Care Act (ACA).

When pressed for details about what he would replace the ACA with, McFadden said that announcement would need to wait until he begins his six-year term in office.

“We will help, not hurt Americans,” McFadden  explained.

The campaign did release a 12-page single spaced list of things McFadden would rename after Ronald Reagan.

When asked to name political role models McFadden listed Ronald Reagan, several Reagan impersonators and Chauncey Gardiner.

“By standing for no one, and Mike is appealing to everyone,” said Saul Loes, a conservative political consultant advising the McFadden campaign. “He just might be the most brilliant politician of our generation, if he exists, which we are neither confirming nor denying.”

Note:  This post is satire.

MN Congressional Candidates Take Note: 6 of 10 Americans Want To Keep Obamacare

The reporting on Obamacare public opinion research has been consistently shallow, as I’ve noted for years.  Despite the many simplistic “Public Opposes Obamacare” stories and punditifications, a deeper dive into the polls shows that an overwhelming majority of Americans want to either keep the Affordable Care Act (ACA) as is, or improve it.

The latest Kaiser Family Health Foundation Tracking Poll, which was fielded prior to this week’s positive publicity about ACA insurance exchanges targets being met, finds that this trend is continuing.  Even after a pre-deadline deluge of anti-Obamacare advertising, Americans still oppose repealing the Affordable Care Act, by a huge 29% to 59% margin.  Independent voters, who will be so important in the upcoming mid-term elections, also overwhelmingly oppose the GOP’s repeal calls, by a 32% to 52% margin.

Survey__59_pct_want_to_keep_acaSo, nervous DFL congressional candidates, improvements to the ACA — a better exhange website, a more robust exchange call center, more exchange “navigators,” stronger enrollment incentives for young adults,  and/or a public insurance option — would be welcomed by voters.  But let your Republican opponents blather on about “repeal and replace” all they want, because it simply is not selling.

– Loveland

Note:  This post was featured in Politics in Minnesota’s Best of the Blogs.

SD Senate Challenger Shows How Obama Should Have Led On Health Care Reform

rick_weiland_head_shot-2President Obama and his supporters have struggled mightily to market the byzantine Affordable Care Act (ACA) reforms to the public.  But by uttering three simple words – “Medicare for all” –  U.S. Senate candidate Rick Weiland in neighboring South Dakota is showing President Obama how it should have been done way back in 2008.

The “Medicare For All” approach that Weiland proposed last week is much easier to sell than the ACA.  The Associated Press reports:

Weiland has proposed that citizens of any age be allowed to buy into Medicare, which now is generally open only to people 65 and older, as an alternative to private health insurance plans.

“People understand Medicare,” Weiland told The Argus Leader. “It works, it’s efficient, and all this other stuff that they’re having now to focus on is extremely complicated, and they don’t understand it.”

Clear.  Concise.  Compelling.  The same can’t be said about most ACA-related rhetoric.

Obama Framed Up The Wrong Comparison

In the book Predictably Irrational,  Dan Ariely, a psychology and behavioral economics professor, examines how we make choices.  One of the phenomena Ariely describes is research showing that humans tend to judge their environment in relation to things that are comparable.

For instance, let’s say you give newlyweds the choice of three honeymoon options – Paris with free breakfast included, Rome with free breakfast included, and Rome with no breakfast included.  Because the two Rome options are comparable, most will gravitate away from the single Paris option.  We are attracted to comparability.

The Comparability Obama Offered.  With that research in mind, consider what President Obama and congressional Democrats did on health reform in 2008.  He believed that Americans needed to have a system that was comparable with what they were familiar with, our American system of private insurers and private health care providers.  So, from 2008 to 2010, Obama framed the health care reform debate as the choice of two comparable things:

Private-centered status quo model.  The pre-2010 status quo system of private insurers and private health care providers.

vs.

Private-centered model, coupled with reforms..  The status quo system of private insurers and health care providers coupled with complicated reforms.

Affordable_Care_Act_infographic-2The ACA reforms were enormously complex, mostly because the underlying pre-2010 status quo health care system was so decentralized and entangled.  Obama’s reforms were narrowly enacted in 2010, primarily because the status quo was so overwhelmingly unpopular.

The Comparability Obama Should Have Offered.  But what if Obama had framed up  a different kind of comparable choice for the American people?  While it’s true that Americans are familiar with private health insurance, they are also familiar with Medicare.  So why didn’t Obama frame the debate up as a choice between these two comparable things:

Medicare for some.  A status quo system where Medicare is available only to seniors.

vs.

Medicare for all.  A new system where Medicare is available to everyone who wants it.

The Political Advantages of Medicare for All

Obama didn’t go with Medicare For All, presumably because he was afraid that Republicans would castigate it as “government run health care” and “socialism.”

As it turned out, the Republican spin machine was determined to characterize anything Obama proposed as “government run health care” and “socialism.” After all, it uses those terms to describe the ACA, which is  absurd, because the ACA relies on private insurers and private caregivers without permitting a single government-run option in the mix.

President Obama was never going to avoid this “government run health care” political attack , so there was no good reason to allow it to shape the proposal.

Moreover, Medicare happens to be “government run health care” that Americans really like.  About 56 percent of Medicare recipients give it a rating of 9 or 10 on a 0-10 scale, while only about 40 percent of Americans enrolled in private health insurance gave their plans such a high rating. An amazing 70% of Medicare recipients say they always get access to needed health care, while only 51% of people with private insurance say that.

A 2007 Associated Press/Yahoo survey showed that about two-thirds of Americans (65%) agreed that “the United States should adopt a universal health insurance program in which everyone is covered under a program like Medicare that is run by the government and financed by taxpayers.”

So demonizing the specific (“Medicare”) would have been much more politically difficult for Republicans than demonizing the abstract (“government run health care” or “socialism”).

Could Obama have passed a “Medicare For All” bill?  Expanding the nation’s most popular health plan was certainly possible.   After all, knowing that two-thirds of Americans support Medicare for All, what politician of either party would want to take to the stump arguing:

“For your parents, grandparents, neighbors, and friends, Medicare is terrific.   I’ll fight to the death to protect it for them.  But for the rest of you,  I am blocking you from accessing  Medicare.  Medicare for YOU would be radical socialism that would lead to horrific health problems.”

Huh?  That would be a head-spinning political argument to sell.

Still, because the insurance lobby is so strong, maybe Congress would have rejected Medicare for All, against the wishes of two-thirds of their constituents.  But if Obama had made  Medicare for All the starting point for the debate, the compromise at the end of the process may have been more progressive, such as a private-dominated marketplace with a Medicare-like public option impacting market competition.

Incumbents who voted for the ACA in 2010 need to defend that confusing law in the 2014 mid-term elections, and the ACA is certainly a vast improvement over the pre-ACA status quo that Republicans have effectively embraced by not offering alternatives for reducing the rate of uninsurance and outlawing preexisting condition bans.  The ACA, for all its warts, is the most significant health care reform since the creation of Medicare.

But even in a neon red state like South Dakota, challengers like Mr. Weiland are wise to adopt the clear, concise and compelling “Medicare for All” rallying call, just as Obama and congressional Democrats should have done back in  2008.

Loveland

Note:  This post was featured in MinnPost’s Blog Cabin.