Poll: Public Views the ACA More Favorably Than Congress’ Plan to Replace It, Though Republicans Favor the Replacement

Posted on May 31, 2017 by David Posnett

Kaiser Family Foundation

Majority Says the Senate Either Should Make Major Changes or Not Pass The House Bill At All, While About a Third Want the Senate to Pass It As Is or With Only Minor Changes

Public Grows More Pessimistic About How Repeal Will Affect Them Personally

Most (55%) of the public holds an unfavorable view of the Congressional plan that would repeal and replace the Affordable Care Act, and the same share (55%) want the Senate either to make major changes to the House-passed bill or not pass it all, finds the latest Kaiser Health Tracking Poll.

Three in 10 (31%) of the public hold favorable views of the American Health Care Act, which narrowly passed the House on May 4 and is now under consideration in the Senate. In comparison, about half (49%) of the public hold a favorable views of the Affordable Care Act.

There are large partisan divisions on these questions, with far more Republicans holding favorable views of the replacement plan (67%) than of the ACA (12%).  The opposite is true for Democrats, and among independents, more also hold favorable views of the ACA (48%) than of the replacement bill (30%).

tuesday poll.pngIn spite of these views, a majority of the public (74%) believe it is” likely” that the president and Congress will repeal and replace the ACA. At the same time, relatively few say the Senate should adapt the American Health Care Act as passed by the House (8%) or with only minor changes (24%). Most want the Senate either to make major changes (26%) or not pass it at all (29%).

Public Growing More Pessimistic About How Repeal Would Affect Them Personally

The poll also finds the public more pessimistic about the replacement bill now than they were in December after the elections but before Congress put forward specific legislation. Nearly half (45%) of the public now says the replacement bill would result in higher health care costs for their family, compared to about a quarter (28%) who said so in December. In addition, a third now expect their ability to get and keep health insurance and the quality of their health care to get worse under the pending bill, compared to about one in five that said so in December.

poll_2Tues.pngOther findings include:

  • A majority of the public (63%) continue to say that President Trump and Republicans in Congress are responsible for any problems with the Affordable Care Act moving forward, more than twice the share who say President Obama and Democrats in Congress are responsible. Those considering Republicans responsible includes most Democrats (77%) and independents (63%), and half (49%) of Republicans.
  • Few (14%) believe that the House-passed bill fulfills all or most of President Trump’s promises on health care, while three quarters (76%) say it fulfills none (35%) or some (40%) of them. Among Republicans, twice as many say it fulfills none or some of the President’s promises (59%) as say it fulfills all or most of them (30%).

The poll also includes additional questions on Medicaid, which will be released separately later this week.

Read the PollDesigned and analyzed by public opinion researchers at the Kaiser Family Foundation, the poll was conducted from May 16 – 22 among a nationally representative random digit dial telephone sample of 1,205 adults. Interviews were conducted in English and Spanish by landline (421) and cell phone (784). The margin of sampling error is plus or minus 3 percentage points for the full sample. For results based on subgroups, the margin of sampling error may be higher.

Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.

Posted in ACA, AHCA, Congress, Health Care | Comments Off on Poll: Public Views the ACA More Favorably Than Congress’ Plan to Replace It, Though Republicans Favor the Replacement

The Last Nuremberg Prosecutor Alive

Posted on May 31, 2017 by David Posnett

At 97, Ben Ferencz is the last Nuremberg prosecutor alive and he has a far-reaching message for today’s world (click to watch 60 Minutes with Leslie Stahl).

  • Twenty-two SS officers responsible for the deaths of 1M+ people would never have been brought to justice were it not for Ben Ferencz.
  • The officers were part of units called Einsatzgruppen, or action groups. Their job was to follow the German army as it invaded the Soviet Union in 1941 and kill Communists, Gypsies and Jews.
  • Ferencz believes “war makes murderers out of otherwise decent people” and has spent his life working to deter war and war crimes.  

Ben Ferencz

CBS NewsIt is not often you get the chance to meet a man who holds a place in history like Ben Ferencz.  He’s 97 years old, barely 5 feet tall, and he served as prosecutor of what’s been called the biggest murder trial ever. The courtroom was Nuremberg; the crime, genocide; the defendants, a group of German SS officers accused of committing the largest number of Nazi killings outside the concentration camps — more than a million men, women, and children shot down in their own towns and villages in cold blood.

Ferencz is the last Nuremberg prosecutor alive today. But he isn’t content just to be part of 20th century history — he believes he has something important to offer the world right now.

“If it’s naive to want peace instead of war, let ’em make sure they say I’m naive. Because I want peace instead of war.”

Lesley Stahl: You know, you– have seen the ugliest side of humanity.

Benjamin Ferencz: Yes.

Lesley Stahl: You’ve really seen evil. And look at you. You’re the sunniest man I’ve ever met. The most optimistic 27-year-old Ben Ferencz became the chief prosecutor of 22 Einsatzgruppen commanders at Nuremberg.

Benjamin Ferencz: You oughta get some more friends.

Watching Ben Ferencz during his daily swim, his gym workout and his morning push-up regimen is to realize he isn’t just the sunniest man we’ve ever met — he may also be the fittest. And that’s just the beginning.

This is Ferencz making his opening statement in the Nuremberg courtroom 70 years ago.

Ben Ferencz in court: The charges we have brought accuse the defendants of having committed crimes against humanity.

The Nuremberg trials after World War II were historic — the first international war crimes tribunals ever held. Hitler’s top lieutenants were prosecuted first. Then a series of subsequent trials were mounted against other Nazi leaders, including 22 SS officers responsible for killing more than a million people — not in concentration camps — but in towns and villages across Eastern Europe. They would never have been brought to justice were it not for Ben Ferencz.

Lesley Stahl: You look so young.

Benjamin Ferencz: I was so young.  I was 27 years old.

Lesley Stahl: Had you prosecuted trials before?

Benjamin Ferencz: Never in my life. I don’t—

Lesley Stahl: Come on.

Benjamin Ferencz: –recall if I’d ever been in a courtroom actually.

Ferencz had immigrated to the U.S. as a baby, the son of poor Jewish parents from a small town in Romania. He grew up in a tough New York City neighborhood where his father found work as a janitor.

Benjamin Ferencz: When I was taken to school at the age of seven, I couldn’t speak English– spoke Yiddish at home. And I was very small. And so they wouldn’t let me in.

Lesley Stahl: So you didn’t speak English ’til you were eight?

Benjamin Ferencz: That’s correct.

Lesley Stahl: Could you read?

Benjamin Ferencz: No, on the contrary. The silent movies always had writing on it. And I would ask my father, “Wazukas,” in Yiddish, “What does it say? What does it say?” He couldn’t read it, either.

But Ferencz learned quickly. He became the first in his family to go to college, then got a scholarship to Harvard Law School. But during his first semester, the Japanese bombed Pearl Harbor, and he, like many classmates, raced to enlist. He wanted to be a pilot, but the Army Air Corps wouldn’t take him.

Benjamin Ferencz:  They said, “No, you’re too short. Your legs won’t reach the pedals.” The Marines, they just looked at me and said, “Forget it, kid.”

So he finished at Harvard then enlisted as a private in the Army. Part of an artillery battalion, he landed on the beach at Normandy and fought in the Battle of the Bulge. Toward the end of the war, because of his legal training, he was transferred to a brand new unit in General Patton’s Third Army, created to investigate war crimes.  As U.S. forces liberated concentration camps, his job was to rush in and gather evidence. Ferencz told us he is still haunted by the things he saw. And the stories he heard in those camps.

Benjamin Ferencz: A father who, his son told me the story. The father had died just as we were entering the camp. And the father had routinely saved a piece of his bread for his son, and he kept it under his arm at… He kept it under his arm at night so the other inmates wouldn’t steal it, you know.  So you see these human stories which are not — they’re not real.  They’re not real.  But they were real.

Ferencz came home, married his childhood sweetheart and vowed never to set foot in Germany again.  But that didn’t last long. General Telford Taylor, in charge of the Nuremberg trials, asked him to direct a team of researchers in Berlin, one of whom found a cache of top-secret documents in the ruins of the German foreign ministry.

Benjamin Ferencz: He gave me a bunch of binders, four binders. And these were daily reports from the Eastern Front– which unit entered which town, how many people they killed. It was classified, so many Jews, so many gypsies, so many others–

Ferencz had stumbled upon reports sent back to headquarters by secret SS units called Einsatzgruppen, or action groups. Their job had been to follow the German army as it invaded the Soviet Union in 1941, and kill Communists, Gypsies and especially Jews.

Benjamin Ferencz: They were 3,000 SS officers trained for the purpose, and directed to kill without pity or remorse, every single Jewish man, woman, and child they could lay their hands on.

Lesley Stahl: So they went right in after the troops?

Benjamin Ferencz: That was their assignment, come in behind the troop, round up the Jews, kill ’em all.

Only one piece of film is known to exist of the Einsatzgruppen at work.  It isn’t easy viewing…

Benjamin Ferencz: Well, this is typical operation.  Well, see here, this– they rounded ’em up. They all have already tags on ’em. And they’re chasing them.

Lesley Stahl: They’re making them run to their own death?

Benjamin Ferencz: Yes. Yes. There’s the rabbi coming along there. Just put ’em in the ditch. Shoot ’em there. You know, kick ’em in.

Lesley Stahl: Oh, my God. Oh, my God.

This footage came to light years later. At the time, Ferencz just had the documents, and he started adding up the numbers.

Benjamin Ferencz: When I reached over a million people murdered that way, over a million people, that’s more people than you’ve ever seen in your life, I took a sample. I got on the next plane, flew from Berlin down to Nuremberg, and I said to Taylor, “General, we’ve gotta put on a new trial.”

But the trials were already underway, and prosecution staff was stretched thin. Taylor told Ferencz adding another trial was impossible.

Benjamin Ferencz: And I start screaming. I said, “Look. I’ve got here mass murder, mass murder on an unparalleled scale.”  And he said, “Can you do this in addition to your other work?” And I said, “Sure.” He said, “OK. So you do it.”

And that’s how 27-year-old Ben Ferencz became the chief prosecutor of 22 Einsatzgruppen commanders at trial number 9 at Nuremberg.

Judge: How do you plead to this indictment, guilty or not guilty?

Defendant: Nicht schuldig.

Benjamin Ferencz: Standard routine, nichtschuldig.  Not guilty.

Judge: Guilty or not guilty?

Defendant: Nicht schuldig.

Lesley Stahl: They all say not guilty.

Benjamin Ferencz: Same thing, not guilty.

But Ferencz knew they were guilty and could prove it. Without calling a single witness, he entered into evidence the defendants’ own reports of what they’d done. Exhibit 111: “In the last 10 weeks, we have liquidated around 55,000 Jews.”  Exhibit 179, from Kiev in 1941: “The city’s Jews were ordered to present themselves… about 34,000 reported, including women and children. After they had been made to give up their clothing and valuables, all of them were killed, which took several days.” Exhibit 84, from Einsatzgruppen D in March of 1942: Total number executed so far: 91,678. Einsatzgruppen D was the unit of Ferencz’s lead defendant Otto Ohlendorf. He didn’t deny the killings — he had the gall to claim they were done in self-defense.

Benjamin Ferencz: He was not ashamed of that. He was proud of that. He was carrying out his government’s instructions.

Lesley Stahl: How did you not hit him?

Benjamin Ferencz: There was only one time I wanted to– really. One of these– my defendants said– He gets up, and he says, “[GERMAN],” which is, “What? The Jews were shot? I hear it here for the first time.”  Boy, I felt if I’d had a bayonet I woulda jumped over the thing, and put a bayonet right through one ear, and let it come out the other. You know? You know?

Lesley Stahl: Yeah.

Benjamin Ferencz: That son of a bitch.

Lesley Stahl: And you had his name down on a piece of—

Benjamin Ferencz: And I’ve got– I’ve got his reports of how many he killed. You know? Innocent lamb.

Lesley Stahl: Did you look at the defendants’ faces?

Benjamin Ferencz: Defendants’ face were blank, all the time. Defendants– absolutely blank. They could– like, they’re waiting for a bus.

Lesley Stahl: What was going on inside of you?

Benjamin Ferencz: Of me?

Lesley Stahl: Yeah.

Benjamin Ferencz: I’m still churning.

Lesley Stahl: To this minute?

Benjamin Ferencz: I’m still churning.

All 22 defendants were found guilty, and four of them, including Ohlendorf, were hanged. Ferencz says his goal from the beginning was to affirm the rule of law and deter similar crimes from ever being committed again.

Lesley Stahl: Did you meet a lot of people who perpetrated war crimes who would otherwise in your opinion have been just a normal, upstanding citizen?

“War makes murderers out of otherwise decent people. All wars, and all decent people.”

Benjamin Ferencz: Of course, is my answer. These men would never have been murderers had it not been for the war. These were people who could quote Goethe, who loved Wagner, who were polite–

Lesley Stahl: What turns a man into a savage beast like that?

Benjamin Ferencz: He’s not a savage. He’s an intelligent, patriotic human being.

Lesley Stahl: He’s a savage when he does the murder though.

Benjamin Ferencz: No. He’s a patriotic human being acting in the interest of his country, in his mind.

Lesley Stahl: You don’t think they turn into savages even for the act?

Benjamin Ferencz: Do you think the man who dropped the nuclear bomb on Hiroshima was a savage? Now I will tell you something very profound, which I have learned after many years. War makes murderers out of otherwise decent people. All wars, and all decent people.

So Ferencz has spent the rest of his life trying to deter war and war crimes by establishing an international court – like Nuremburg. He scored a victory when the international criminal court in The Hague was created in 1998.  He delivered the closing argument in the court’s first case.

“If they tell me they want war instead of peace, I don’t say they’re naive, I say they’re stupid.”

Lesley Stahl: Now, you’ve been at this for 50 years, if not more. We’ve had genocide since then.

Benjamin Ferencz: Yes.

Lesley Stahl: In Cambodia—

Benjamin Ferencz: Going on right this minute, yes.

Lesley Stahl: Going on right this minute in Sudan.

Benjamin Ferencz: Yes.

Lesley Stahl: We’ve had Rwanda, we’ve had Bosnia. You’re not getting very far.

Benjamin Ferencz: Well, don’t say that. People get discouraged. They should remember, from me, it takes courage not to be discouraged.

Lesley Stahl: Did anybody ever say that you’re naive?

Benjamin Ferencz: Of course. Some people say I’m crazy.

Lesley Stahl: Are you naive here?

Benjamin Ferencz: Well, if it’s naive to want peace instead of war, let ’em make sure they say I’m naive. Because I want peace instead of war. If they tell me they want war instead of peace, I don’t say they’re naive, I say they’re stupid. Stupid to an incredible degree to send young people out to kill other young people they don’t even know, who never did anybody any harm, never harmed them. That is the current system. I am naive? That’s insane.

Ferencz is legendary in the world of international law, and he’s still at it. He never stops pushing his message and he’s donating his life savings to a Genocide Prevention Initiative at the Holocaust Museum. He says he’s grateful for the life he’s lived in this country, and it’s his turn to give back.

Lesley Stahl: You are such an idealist.

Benjamin Ferencz: I don’t think I’m an idealist.  I’m a realist. And I see the progress.  The progress has been remarkable. Look at the emancipation of woman in my lifetime. You’re sitting here as a female. Look what’s happened to the same-sex marriages. To tell somebody a man can become a woman, a woman can become a man, and a man can marry a man, they would have said, “You’re crazy.” But it’s a reality today. So the world is changing. And you shouldn’t– you know– be despairing because it’s never happened before. Nothing new ever happened before.

Lesley Stahl: Ben—

Benjamin Ferencz: We’re on a roll.

Lesley Stahl: I can’t—

Benjamin Ferencz: We’re marching forward.

Lesley Stahl: Ben? I’m sitting here listening to you. And you’re very wise. And you’re full of energy and passion.  And I can’t believe you’re 97 years old.

Benjamin Ferencz: Well, I’m still a young man.

Lesley Stahl: Clearly, clearly.

Benjamin Ferencz: And I’m still in there fighting.  And you know what keeps me going? I know I’m right.

Produced by Shari Finkelstein and Nieves Zuberbühler.

© 2017 CBS Interactive Inc. All Rights Reserved.

Lesley Stahl

One of America’s most recognized and experienced broadcast journalists, Lesley Stahl has been a 60 Minutes correspondent since 1991.

 

 

Posted in Religion & tolerance, Uncategorized, war | Tagged , , , , , | 1 Comment

Who said it: Donald Trump or Frank Underwood? Take the Guardian Quiz.

Posted on May 31, 2017 by David Posnett

The new season of House of Cards is here.  But first, the question is:

Has the Underwood White House Been Trumped?

 

https://www.theguardian.com/tv-and-radio/2017/may/29/who-said-it-donald-trump-or-frank-underwood?utm_source=esp&utm_medium=Email&utm_campaign=GU+Today+USA+-+Collections+2017&utm_term=228237&subid=21930353&CMP=GT_US_collection

Posted in Trump | Tagged , , | 1 Comment

We All Have Pre-existing Conditions

Posted on May 30, 2017 by David Posnett

If 1/7 people were turned away on medical insurance applications prior to Obamacare (before 2009), then you probably know someone in your circle of friends with a pre-existing condition, who was denied insurance in those “dark ages”.   Call or visit your congressperson and give them a piece of your mind.   D Posnett MD

Add your stories to those compiled by Elizabeth Rosenthal in her excellent OpEd.

Re-printed from the NY Times Opinion Pages.

By ELISABETH ROSENTHALMAY 29, 2017

Lisa Solod, photographed in 2013, was turned away by four insurers because she was on thyroid replacement, an asthma inhaler, and hormone replacement. Greg Kahn for The New York Times

The Republican health care plan recently passed by the House would hollow out one of the most popular provisions of the Affordable Care Act: a prohibition on charging higher prices to people with pre-existing medical conditions. States, under the plan, could waive that rule, provided they offer publicly funded alternatives for coverage.

The Republican plan raises questions, including about cost: Many experts believe the more than $100 billion earmarked for alternative programs, such as “high-risk pools,” would be inadequate. According to the Congressional Budget Office, many patients with pre-existing conditions would be priced out of the market.

But the Republican proposal also raises a more basic issue: Who will decide what constitutes a pre-existing condition?

Before the Affordable Care Act, profit-taking insurers had lowered the bar for what was considered a pre-existing condition to include nearly every malady, making it difficult for many healthy patients to get affordable insurance.

I have interviewed many such people. Renée Martin was thrown into an unaffordable high-risk pool because of an abnormal Pap smear. Lisa Solod got turned away by four insurers because she was on thyroid replacement, an asthma inhaler and hormones — a not uncommon trifecta for women in their 50s. Wanda Wickizer was priced out of having insurance because she had taken Lexapro for depression. Jesse Albert found that he and his family were uninsurable because he had once had a benign skin cancer and a bout of hepatitis C, even though his immune system had cleared the virus.

Turning away people with just a hint of illness is a reasonable business strategy. But as so often occurs in the profit-oriented health system, what is best for business is not necessarily good for patients.

When the House Committee on Energy and Commerce studied insurance denials and exclusions for pre-existing conditions by the four largest for-profit insurers in 2010, it found plentiful evidence that “each company had business plans that relied on using pre-existing conditions to limit the amount of money paid for medical claims.” In documents reviewed by the committee, one company listed “improved pre-existing exclusion processes” as an opportunity to increase growth.

The committee report found that the insurance companies turned down one out of every seven applicants with pre-existing conditions. Such denials had jumped by nearly 50 percent between 2007 and 2009, as the apparently successful financial strategy gained sway.

In the pre-Affordable Care Act era, states that ran high-risk pools generally specified pre-existing conditions that automatically qualified patients for admittance — generally serious diseases like AIDS, diabetes or epilepsy. The determination was based on health, but patients who could show they had been turned down by insurers were also generally eligible. Insurers, with different motivations, draw very different boundaries. In interviews with Dr. Hall before the A.C.A., some Kansans said that merely having hay fever or being fat were enough to be placed in the pools.

Indeed, if insurers make the call about who to exclude, almost anyone who needs insurance would seem vulnerable. I’m by all measures really healthy but I, too, once had an abnormal Pap smear, have taken Lexapro for short periods of my adult life and very occasionally use an asthma inhaler before I exercise in winter. Since an orthopedist removed the cartilage in my right knee after a soccer injury in college (an operation that has since been deemed useless or harmful), odds are that I will someday need a knee replacement. Dr. Hall told me that surgery alone could throw me into a high-risk pool, by many insurers’ standards.

And what of the much-vaunted benefits of cancer screening? With the possibility of a poorly financed high-risk pool looming, a rational person might avoid a colonoscopy. A polyp removal might prevent cancer but could mean paying higher insurance rates, because patients who get polyps are at risk for developing more polyps, which can be precursors to cancer.

We all have — or will have — some kind of a problem in our medical history.

Today, Mr. Albert, 52, is not happy with the price of his family’s high-deductible Obamacare policy: $2,000 a month. Even so, he said: “The A.C.A. was a lifesaver for us. Everyone in my family has something that could be defined as a pre-existing condition. It’s expensive but I don’t have to worry about being excluded from insurance or about bankruptcy anymore.”

Elisabeth Rosenthal, a former New York Times correspondent, is the editor in chief of Kaiser Health News and the author of “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back.”

Posted in ACA, AHCA, American Health Care Act, GOP, Pre-existing Conditions, trumpcare, Uncategorized, Zeldin | Tagged , , , , | Comments Off on We All Have Pre-existing Conditions

A Tale of Two Tax Triggers

Posted on May 29, 2017 by David Posnett

Tax Policy Center — May 17,2017

Richard C. Auxier

 

Oklahoma is running a nearly $1 billion budget deficit. The District of Columbia (DC) is enjoying a surplus. Yet both might kill scheduled tax cuts. And, for different reasons, both show tax cut schedules are only as good as their schedulers.

According to the Center on Budget and Policy Priorities, nine states plus DC have used  “triggers” since 2002 to spread tax cuts over several years—eight are ongoing. A trigger is like a phased-in tax cut except the reduction only occurs if and when the state reaches some fiscal benchmark, such as future revenue growth.

Triggers can help states provide fiscally responsible tax relief—if designed well. They can also make it easy for lawmakers to pass large tax cuts that imperil future budgets—if executed poorly.

Oklahoma is a model of poor design and execution. Its glaring flaw: tying the tax cuts to estimated revenuerather than actual revenue. As my then-colleague Norton Francis wrote in a prescient January 2015 post, “It’s clear that lawmakers wanted the tax cut regardless of the budget implications.”

Oklahoma passed a two-step tax cut in April 2014. It scheduled a reduction in the state’s top income tax rate from 5.25 percent to 5 percent in January 2016 if the December 2014 revenue estimate for fiscal year (FY) 2016 was higher than the February 2013 estimate for FY 2014. Not only was it convoluted and impossible for voters to understand, but it was designed to effectively guarantee the rate cut under a misleading banner of fiscal responsibility.

By December 2014, oil prices and production were collapsing and the state’s economy was struggling. Oklahoma was already estimating a $300 million budget hole for fiscal 2016. But remember the trigger was not tied to the actual budget conditions, and the FY 2016 revenue estimate was still slightly higher than the FY 2014 estimate. Thus, even though the state could not afford $100 million in tax cuts, the trigger was pulled.

With a slowing economy and falling revenue, the state has faced deficits approaching $1 billion every year since 2015. The budget cuts enacted in response were so severe that 20 percent of Oklahoma school districts moved to a four-day week. Still, the legislature would not even consider bills to stop the triggers in 2015 or 2016.

But Oklahoma’s fiscal hole is now so deep that lawmakers have killed the second trigger before it could go off. If they had not changed the law, the income tax rate would have been cut to 4.85 percent in 2018 if next year’s total estimated revenue growth was greater than the estimated cost of the tax cut. Lawmakers didn’t want to risk it.

DC’s story is very different. In 2014, the District passed major tax reform. (Disclosure: I worked for the tax revision commission that developed the reforms.) The reform package was a deal, with tax changes that benefited low-income residents (EITC expansion), middle-income residents (higher standard deduction), high-income residents (increasing the estate tax threshold), and businesses (lowering the corporate income tax rate). However, the DC Council didn’t adopt all of the commission’s suggested revenue raisers, so some of the cuts were tied to triggers in future years. But unlike Oklahoma, DC’s triggers were based on actualbudgets—specifically, they went into effect when realized revenue was greater than budgeted revenue. The triggered cuts were set to begin in January 2016, and take effect over three to five years. However, DC’s revenue was so strong that all remaining cuts were pulled in February.

That windfall triggered a debate. Two DC councilmembers want to delay cuts in corporate and estate taxes, and progressive groups are lobbying to spend the excess revenue on affordable housing, transit, and to protect against possible federal budget cuts. However, business groups argue the business cuts were part of the original deal and the cuts are needed to sustain recent economic success. Further, the council chair stated, “any effort to repeal them is, in effect, raising taxes.”

You can think DC should go ahead with its tax cuts (and I do) and still appreciate the debate. In stark contrast to Oklahoma, DC set a responsible schedule for its cuts and checked the math as its fiscal situation changed. That’s what lawmakers are supposed to do, especially at a time of weak state revenue growth and unpredictable federal policies. It’s called a trigger for a reason; you can take your finger off it.

Posted in budget, Tax Reform, Trump | 1 Comment

“Assume A Can Opener” — Trump’s Can Opener Budget

Posted on May 29, 2017 by David Posnett

The Tax Policy Center

By Howard Gleckman

You know the old joke: An economist and a seaman are stranded on a desert island with only canned food to eat. But they have no way to open the containers. “What do we do,” asks the sailor. “Assume a can opener,” replies the economist.

That, in a nutshell, describes President Trump’s 2018 budget request. On its face, it claims to accomplish five major goals: It would significantly cut taxes, boost spending on the military and border control, slash spending for regulation and safety net programs for the poor, protect most of Medicare and Social Security, and balance the budget in 10 years.

But it all only hangs together thanks to that hypothetical kitchen device, a big dose of supply side economics, and a black box the size of an aircraft hanger. The President’s budget will balance in a decade only if the economy grows far faster than nearly all economists think it can. And that implausibly rapid growth, the White House argues, will happen largely thanks to huge tax cuts that it never describes in more than a few bullet points. The result: The government will collect $2.7 trillion more over the next decade than under current law. Combined with $3.5 trillion in spending cuts, the budget will be balanced.

The fiscal plan projects that economic growth will ramp up rapidly from 2.3 percent this year to a sustained 3.0 percent rate by 2021. That’s vastly higher than the Congressional Budget Office forecast, which projects 1.6 percent growth for the next few years, rising to an average of 1.9 percent from 2021 to 2027. The Federal Reserve projects roughly 1.8 percent growth over the period.

The administration, though, is banking on powerful supply-side effects of what the President says will be historic tax cuts: As soon as fiscal year 2021, the budget asserts, his fiscal policy will generate more tax revenue than current law. By 2027, the Trump tax plan will produce revenue equal to 18.4 percent of the economy, the same as CBO’s current law projection. But because the economy will be so much bigger, Trump’s fiscal plan will generate $600 billion in additional revenue.

There are two problems with this rosy scenario, to borrow an old phrase. The first is that it very likely overstates the effect of any tax cuts on economic growth. The second is that it vastly overstates the positive effects of a Trump-like tax cut on growth. Indeed, if the President’s proposal looks anything like what he offered during the campaign, its medium-term effects on the economy would be modest at best, and its long-term effects would be negative.

To take the first problem first, while tax policy can affect the economy on the margins, the biggest drivers are labor force growth and productivity. Trump can’t do much to boost the number of US workers short of, say, raising the age of Social Security eligibility or opening the borders to immigrants (neither idea is in his budget). And productivity growth is largely a result of new technology and businesses processes, which are notoriously hard to predict and mostly immune from tax policy.

Without an explosion of workers or new tech, it is hard to see how Trump could get the economy growing at a sustainable rate of 3 percent even with the best of policy choices. But Trump’s tax policy, at least as he has described it so far, falls far short of ideal.

The budget promises that the president’s unspecified tax cuts would increase revenues by $2.7 trillion over 10 years. But last October, the Tax Policy Center, in partnership with the Wharton School at the University of Pennsylvania, estimated that Trump’s last campaign plan would reduce federal revenue by $6.2 trillion over the same period.

Are these the same proposals? It is impossible to know since most specifics are either undecided or hidden in that black box. Trump’s one-page outline in April described some changes to his campaign plan, but it is roughly the same proposal and its revenue effects are likely to be similar.

The budget document itself includes a revenue estimate for exactly one significant tax policy change—a   proposal to make it harder for some immigrants to claim the Earned Income Tax Credit and the Child Tax Credit. Beyond that, it merely restates that one-page summary but without specific revenue estimates.

The lack of detail? Another can opener, according to Budget Director Mick Mulvaney. He told reporters yesterday, “We do assume in this budget that that plan is deficit-neutral, just because it was, in all honesty, the most efficient way to look at it.”

But wait, you may be saying, isn’t Trump offsetting his tax plan with spending cuts? The problem is the president can’t use the same spending reductions to pay for new military and border security initiatives, finance big tax cuts, and balance the budget.  At least he can’t without the help of that handy can-opener.

 

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Tax Break Under the AHCA — The Middle Class Gets on Average $300

Posted on May 29, 2017 by David Posnett

New CBO AHCA Score Confirms What We Already Knew

Tax Policy Center

by Mark J. Mazur

Meet the new estimate of the American Health Care Act (AHCA).  It looks a lot like the old one.

On May 24, the Congressional Budget Office (CBO) released its estimate of the revised AHCA, which the House of Representatives passed on May 7.  The revised AHCA allows states to opt out of ACA requirements establishing essential health benefits and permits states establishing high-risk pools to allow insurers to set premiums based on health status.  The modified bill sets aside $8 billion to help subsidize these pools.

Like its predecessor, the revised AHCA has four distinct major components.

  1. One would cut taxes paid by high-income individuals (lower taxes on capital gains, divided, and interest income for households with annual income over $250,000) and by companies in specific industries: health insurance, medical devices, prescription drugs, and indoor tanning salons.
  2. The second is a grab bag of tax reductions, such as loosened rules for flexible spending accounts and health savings accounts, repeal of the tax on individuals who can afford but don’t buy adequate health coverage, and a further delay of the excise tax on high-cost health plans (the so-called “Cadillac Tax”).
  3. The third restructures the tax credits that subsidize health care coverage, moving from existing income-related tax credits for purchasing health insurance on the ACA Marketplaces to age-related tax credits to purchase health insurance.
  4. And the fourth cuts Medicaid spending reducing coverage and essentially paying for the tax cuts.

The chart below shows the tax changes (the first two major components mentioned) go almost entirely to the highest earning households, while providing little or no benefit to the bottom 80 percent of the income distribution.  In fact, TPC estimates that a $37,000 average annual tax cut will go to the 1 percent of the population with the highest earnings (annual income of over $772,000).  The top 0.1 percent of the income distribution would receive an annual tax cut of over $200,000 (annual income over $3.9 million).  (Note that this chart shows the estimates for 2022, but incorporates the tax law changes for 2023 as the AHCA phases in some of the tax changes).

The bottom line: CBO estimates confirm the AHCA is largely a tax bill paired up with Medicaid cuts to offset the costs. And, as in the earlier version of the bill, almost all the benefits go to the highest income households in the country.

Posted in AHCA, American Health Care Act, Health Care, Tax Reform, trumpcare | 1 Comment

Statement of ABA President Re: The budget proposal released by the White House

Posted on May 28, 2017 by David Posnett

 

WASHINGTON, May 23, 2017 — Steep budget cuts proposed today by the White House would severely undermine the fairness of the legal system and deny access to justice for some of society’s most vulnerable individuals. These include children, veterans, the elderly, people with disabilities, people in poverty, families suffering after natural disasters, survivors of domestic violence and victims of other crimes. America must not compromise on the principles that justice is accessible to all and all are equal under the law.

Among the more egregious cuts to the Constitution’s promise of a fair legal process are:

Legal Services Corporation: This program provides funding for civil legal aid to those who cannot afford it, serving people in every congressional district. The Legal Services Corporation promotes fair and efficient operation of our nation’s courts, giving low-income people representation in custody disputes, wrongful evictions, denial of benefits cases and other matters. What makes the cuts more outrageous is that more than 30 cost-benefit analyses all show that Legal Services Corporation delivers far more in benefits than it costs. Equal access to justice is the cornerstone of our American justice system and without the LSC, courthouse doors all over the country would slam closed for millions of Americans.

Public Service Loan Forgiveness: The Public Service Loan Forgiveness program encourages people to work in lower-paying but critically needed jobs that serve the public good. Without loan forgiveness, fewer people would be able to dedicate their lives to public service as prosecutors, public defenders, legal aid lawyers and other justice-related fields, especially in underserved rural areas. While these and other programs affecting access to justice have been targeted for harsh reductions, many other parts of the proposed budget would also do severe damage to the most vulnerable people in our society by cutting access to food assistance, medical care, housing and the other necessities of life.

As the budget process moves forward, the American Bar Association urges Congress to reinstate adequate funding for these important and valuable programs. In order to “establish justice,” as our Constitution calls on us to do, these programs must be preserved.

Posted in budget, Trump | 3 Comments

Take The KHF AHCA Quiz

Posted on May 27, 2017 by David Posnett

http://kaiserf.am/2s8pLAT

Posted in AHCA, American Health Care Act, Uncategorized | Tagged , , , | 1 Comment

Trump’s Brain Function?

Posted on May 27, 2017 by David Posnett

“there is no collusion between certainly myself and my campaign, but I can always speak for myself — and the Russians, zero.”

Experts in neurolinguistics and cognitive assessment, as well as psychologists and psychiatrists, weigh in: a decade of deterioration of his speech.

Fascinating article:

State of (Trump’s) Mind

Trump wasn’t always so linguistically challenged. What could explain the change?

By Sharon Begley,  May 23, 2017

It was the kind of utterance that makes professional transcribers question their career choice:

“ … there is no collusion between certainly myself and my campaign, but I can always speak for myself — and the Russians, zero.”

When President Trump offered that response to a question at a press conference last week, it was the latest example of his tortured syntax, mid-thought changes of subject, and apparent trouble formulating complete sentences, let alone a coherent paragraph, in an unscripted speech. He was not always so linguistically challenged.

STAT reviewed decades of Trump’s on-air interviews and compared them to Q&A sessions since his inauguration. The differences are striking and unmistakable.

Research has shown that changes in speaking style can result from cognitive decline. STAT, therefore, asked experts in neurolinguistics and cognitive assessment, as well as psychologists and psychiatrists, to compare Trump’s speech from decades ago to that in 2017; they all agreed there had been a deterioration, and some said it could reflect changes in the health of Trump’s brain.

In interviews Trump gave in the 1980s and 1990s (with Tom Brokaw, David Letterman, Oprah Winfrey, Charlie Rose, and others), he spoke articulately, used sophisticated vocabulary, inserted dependent clauses into his sentences without losing his train of thought, and strung together sentences into a polished paragraph, which — and this is no mean feat — would have scanned just fine in print. This was so even when reporters asked tough questions about, for instance, his divorce, his brush with bankruptcy, and why he doesn’t build housing for working-class Americans.

In an interview from 1987, Donald Trump talks about poverty and homelessness in the US.  Trump fluently peppered his answers with words and phrases such as “subsided,” “inclination,” “discredited,” “sparring session,” and “a certain innate intelligence.” He tossed off well-turned sentences such as, “It could have been a contentious route,” and, “These are the only casinos in the United States that are so rated.” He even offered thoughtful, articulate aphorisms: “If you get into what’s missing, you don’t appreciate what you have,” and, “Adversity is a very funny thing.”

Now, Trump’s vocabulary is simpler. He repeats himself over and over, and lurches from one subject to an unrelated one, as in this answer during an interview with the Associated Press last month:

“People want the border wall. My base definitely wants the border wall, my base really wants it — you’ve been to many of the rallies. OK, the thing they want more than anything is the wall. My base, which is a big base; I think my base is 45 percent. You know, it’s funny. The Democrats, they have a big advantage in the Electoral College. Big, big, big advantage. … The Electoral College is very difficult for a Republican to win, and I will tell you, the people want to see it. They want to see the wall.”

For decades, studies have found that deterioration in the fluency, complexity, and vocabulary level of spontaneous speech can indicate slipping brain function due to normal aging or neurodegenerative disease. STAT and the experts, therefore, considered only unscripted utterances, not planned speeches and statements, since only the former tap the neural networks that offer a window into brain function.

The experts noted clear changes from Trump’s unscripted answers 30 years ago to those in 2017, in some cases stark enough to raise questions about his brain health. They noted, however, that the same sort of linguistic decline can also reflect stress, frustration, anger, or just plain fatigue.

Ben Michaelis, a psychologist in New York City, performed cognitive assessments at the behest of the New York Supreme Court and criminal courts and taught the technique at a hospital and university. “There are clearly some changes in Trump as a speaker” since the 1980s, said Michaelis, who does not support Trump, including a “clear reduction in linguistic sophistication over time,” with “simpler word choices and sentence structure. … In fairness to Trump, he’s 70, so some decline in his cognitive functioning over time would be expected.”

Some sentences, or partial sentences, would, if written, make a second-grade teacher despair. “We’ll do some questions, unless you have enough questions,” Trump told a February press conference. And last week, he told NBC’s Lester Holt, “When I did this now I said, I probably, maybe will confuse people, maybe I’ll expand that, you know, lengthen the time because it should be over with, in my opinion, should have been over with a long time ago.”

In an interview conducted earlier this month, President Trump explains the timing of James Comey’s firing. Via YouTube

Other sentences are missing words. Again, from the AP: “If they don’t treat fairly, I am terminating NAFTA,” and, “I don’t support or unsupport” — leaving out a “me” in the first and an “it” (or more specific noun) in the second. Other sentences simply don’t track: “From the time I took office til now, you know, it’s a very exact thing. It’s not like generalities.”

There are numerous contrasting examples from decades ago, including this — with sophisticated grammar and syntax, and a coherent paragraph-length chain of thought — from a 1992 Charlie Rose interview: “Ross Perot, he made some monumental mistakes. Had he not dropped out of the election, had he not made the gaffes about the watch dogs and the guard dogs, if he didn’t have three or four bad days — and they were real bad days — he could have conceivably won this crazy election.”

The change in linguistic facility could be strategic; maybe Trump thinks his supporters like to hear him speak simply and with more passion than proper syntax. “He may be using it as a strategy to appeal to certain types of people,” said Michaelis. But linguistic decline is also obvious in two interviews with David Letterman, in 1988 and 2013, presumably with much the same kind of audience. In the first, Trump threw around words such as “aesthetically” and “precarious,” and used long, complex sentences. In the second, he used simpler speech patterns, few polysyllabic words, and noticeably more fillers such as “uh” and “I mean.”

Donald Trump shares his take on Ross Perot’s 1992 presidential campaign. Via YouTube

The reason linguistic and cognitive decline often go hand in hand, studies show, is that fluency reflects the performance of the brain’s prefrontal cortex, the seat of higher-order cognitive functions such as working memory, judgment, understanding, and planning, as well as the temporal lobe, which searches for and retrieves the right words from memory. Neurologists therefore use tests of verbal fluency, and especially how it has changed over time, to assess cognitive status.

Those tests ask, for instance, how many words beginning with W a patient can list, and how many breeds of dogs he can name, rather than have patients speak spontaneously. The latter “is too hard to score,” said neuropsychologist Sterling Johnson, of the University of Wisconsin, who studies brain function in Alzheimer’s disease. “But everyday speech is definitely a way of measuring cognitive decline. If people are noticing [a change in Trump’s language agility], that’s meaningful.”

Although neither Johnson nor other experts STAT consulted said the apparent loss of linguistic fluency was unambiguous evidence of mental decline, most thought something was going on.

John Montgomery, a psychologist in New York City and adjunct professor at New York University, said “it’s hard to say definitively without rigorous testing” of Trump’s speaking patterns, “but I think it’s pretty safe to say that Trump has had significant cognitive decline over the years.”

No one observing Trump from afar, though, can tell whether that’s “an indication of dementia, of normal cognitive decline that many people experience as they age, or whether it’s due to other factors” such as stress and emotional upheaval, said Montgomery, who is not a Trump supporter.

Even a Trump supporter saw and heard striking differences between interviews from the 1980s and 1990s and those of 2017, however. “I can see what people are responding to,” said Dr. Robert Pyles, a psychiatrist in suburban Boston. He heard “a difference in tone and pace. … What I did not detect was any gaps in mentation or meaning. I don’t see any clear evidence of neurological or cognitive dysfunction.”

Johnson cautioned that language can deteriorate for other reasons. “His language difficulties could be due to the immense pressure he’s under, or to annoyance that things aren’t going right and that there are all these scandals,” he said. “It could also be due to a neurodegenerative disease or the normal cognitive decline that comes with aging.” Trump will be 71 next month.

Northwestern University psychology professor Dan McAdams, a critic of Trump who has inferred his psychological makeup from his public behavior, said any cognitive decline in the president might reflect normal aging and not dementia. “Research shows that virtually nobody is as sharp at age 70 as they were at age 40,” he said. “A wide range of cognitive functions, including verbal fluency, begin to decline long before we hit retirement age. So, no surprise here.”

Researchers have used neurolinguistics analysis of past presidents to detect, retrospectively, early Alzheimer’s disease. In a famous 2015 study, scientists at Arizona State University evaluated how Presidents Ronald Reagan and George H.W. Bush spoke at their news conferences. Reagan’s speech was riddled with indefinite nouns (something, anything), “low imageability” verbs (have, go, get), incomplete sentences, limited vocabulary, simple grammar, and fillers (well, basically, um, ah, so) — all characteristic of cognitive problems. That suggested Reagan’s brain was slipping just a few years into his 1981-1989 tenure; that decline continued. He was diagnosed with Alzheimer’s disease in 1994. Bush showed no linguistic deterioration; he remained mentally sharp throughout his 1989-1993 tenure and beyond.

Sharon Begley answered reader questions about this article on Facebook. Read the conversation here.

 

 

 

Posted in State of (Trump’s) Mind, Trump, Uncategorized | Tagged , , , , | 1 Comment