One Issue

A lot of ink is being spilled - finally - about abortion becoming a driving force among "liberal or left-leaning" voters.

Of course, all that "liberal and left-leaning" stuff is a mischaracterization when 75-80% of all Americans are Pro-Choice, but I can let that Press Poodle crap slide for a minute, and concentrate on the revelation that enormous numbers of voters are telling the polling pimps that abortion has turned them into One-Issue Voters.

I'll acknowledge that I'm among those one-issue voters on abortion. And that's been a pretty consistent thing for me since Bill Weld stood up at the GOP convention in 1992 and said it's OK to be a Pro-Choice Republican, and practically got booed out of the building.

Over the last few decades, my One-Issue-ness has been widening, to the point where I'm not going to vote for anybody who (eg) uses "entitlements" as either a derogatory term meant to imply I'm some kinda moocher because I rely on Social Security and Medicare here in my life's twilight.

(Guess what, skeezix - I worked my ass off for 50 fuckin' years for those benefits. Keep your grubby hands off my shit, or learn to live with a coupla bloody stumps)

So anyway, I'm a One-Issue Voter with quite a few one-issue items on my one-issue list:

• Abortion
• Social Security
• Medicare
• Public Schools
• Fair Taxation
• Livable Wage
• Climate Change
• Universal Pre-K
• Universal Healthcare Coverage
• Guns

And I'm sure dog-ass Republicans will go on delivering more items for me to put on my list as they dig deeper into that Daddy State black hole.

Selling Us Out

There's no good reason the problems with Social Security and Medicare can't be fixed.

Bad Reason For Good News

Shitty-Attitude Mike wants to say thanks to a whole big bunch of dumbass rubes who gave up the ghost because they were convinced to put more stock in their political fantasies than they did in what real-world clinicians with real-world expertise told them.

Not-Such-An-Asshole Mike regrets being unable to convince people not to fuck around.

Understanding the Red State Death Trip - Paul Krugman

Last Friday the Medicare trustees released their latest report on the system’s finances, and it contained some unexpected good news: Expenditures are running below projections, and the Hospital Insurance Trust Fund won’t be exhausted as soon as previously predicted.

But one important reason for this financial improvement was grisly: Covid killed a substantial number of Medicare beneficiaries. And the victims were disproportionately seniors already suffering from severe — and expensive — health problems. “As a result, the surviving population had spending that was lower than average.”

Now, Covid killed a lot of people around the world, so wasn’t this just an act of God? Not exactly. You see, America experienced a bigger decline in life expectancy when Covid struck than any other wealthy country. Furthermore, while life expectancy recovered in many countries in 2021, here it continued to fall.

And America’s dismal Covid performance was part of a larger story. I don’t know how many Americans are aware that over the past four decades, our life expectancy has been lagging ever further that of other advanced nations — even nations whose economic performance has been poor by conventional measures. Italy, for example, has experienced a generation of economic stagnation, with basically no growth in real G.D.P. per capita since 2000, compared with a 29 percent rise here. Yet Italians can expect to live about five years longer than Americans, a gap that has widened even as the Italian economy flounders.

What explains the American way of death? A large part of the answer seems to be political.

One important clue is that the problem of premature death isn’t evenly distributed across the country. Life expectancy is hugely unequal across U.S. regions, with major coastal cities not looking much worse than Europe but the South and the eastern heartland doing far worse.

But wasn’t it always thus? No. Geographic health disparities have surged in recent decades. According to the U.S. mortality database, as recently as 1990, Ohio had slightly higher life expectancy than New York. Since then, New York’s life expectancy has risen rapidly, nearly converging with that of other rich countries, while Ohio’s has hardly risen at all and is now four years less than New York’s.

There has been considerable research into the causes of these growing disparities. A 2021 paper published in The Journal of Economic Perspectives examined various possible causes, like the increasing concentration of highly educated Americans (who tend to be healthier than those with less education) in states that are already highly educated and the widening per capita income gaps among states. The authors found that these factors can’t explain more than a small fraction of the growing mortality gap.

Instead, they argued, the best explanation lay in policy: “The most promising explanation for our findings involve efforts by high-income states to adopt specific health-improving policies and behaviors since at least the early 1990s. Over time, these efforts reduced mortality in high-income states more rapidly than in low-income states, leading to widening spatial disparities in health.”

That sounds right. But did high-income states adopt health-improving policies because they were rich and could afford to? Or was it because in 21st-century America, high-income states tend to be politically progressive and politics, rather than money per se, account for the difference?

There is, in fact, a strong correlation between how much a state’s life expectancy rose from 1990 to 2019 and its political lean, as measured by Joe Biden’s margin over Donald Trump in the 2020 election — a correlation slightly stronger, by my estimates, than the correlation with income.

There are several reasons to believe that America’s death trip is largely political rather than economic. One is the comparison with European nations, which have had much better health trends even when, as in Italy, their economies have performed badly.

Another is the fact that some of the poorest states in America, with the lowest life expectancy, are still refusing to expand Medicaid, even though the federal government would cover the bulk of the cost (and the failure to expand Medicaid is killing many hospitals). This suggests that they’re failing to improve health because they don’t want to, not because they can’t afford to.

Finally, since Covid struck, residents of Republican-leaning counties have been far less likely to get vaccinated and far more likely to die of it than residents of Democratic-leaning counties — even though vaccines are free.

All of this seems relevant to our current era of culture war, with many Republican politicians praising rural and red-state values while denigrating those of coastal elites. Gov. Ron DeSantis of Florida, for example, claims that although he grew up around Tampa Bay, he’s culturally a product of western Pennsylvania and northeastern Ohio. It’s worth noting, then, that the culture these politicians want all of America to emulate seems to have a problem with one of society’s most important functions: keeping people from dying early.

On Social Security & Medicare

To preface this, I think it's pretty safe to assume a few things.

1. I don't know what to do about all this - I'm not an economist, and I'm not a tax accountant, and I'm not trying to pretend I know how to fix it
2. Somebody does know how to fix it - in a fair, even-handed way
3. Anything we do to fix it will involve the tax code 

And everything we try to do will be picked apart and shat upon by all manner of armchair experts and keyboard commandos. This is likely going to get even messier than it's been for the last 90 years.

WASHINGTON — President Biden scored an early political point this month in his fight with congressional Republicans over taxes, spending and raising the federal debt limit: He forced Republican leaders to profess, repeatedly, that they will not seek cuts to Social Security and Medicare.

In the process, Mr. Biden has effectively steered a debate about fiscal responsibility away from two cherished safety-net programs for seniors, just as those plans are poised for a decade of rapid spending growth.

New forecasts from the nonpartisan Congressional Budget Office, set to be released on Wednesday, are expected to show Medicare and Social Security spending growth rapidly outpacing the growth in federal tax revenues over the next 10 years. That is the product of a wave of baby boomers reaching retirement age and beginning to tap the programs, which provide guaranteed income and health insurance from the time benefits are claimed until death.

Those retirees are an electoral force. In refusing to touch so-called entitlement programs, Mr. Biden was appealing to seniors, along with generations of future retirees, when he used his State of the Union address and subsequent speeches this month to amplify attacks on Republican plans to reduce future spending on Social Security and Medicare or potentially sunset the programs entirely.

“They’re more than government programs,” Mr. Biden told a Florida audience last week. “They’re a promise — a promise we made: Work hard and contribute, and when the time has come for you to retire, you’ll be there — we’ll be there for you to help you out. It’s been a sacred trust, the rock-solid guarantee generations of Americans have counted on, and it works.”

In his 2020 campaign, Mr. Biden proposed shoring up Social Security’s finances and increasing benefits for some retirees by raising taxes on high earners. Social Security is primarily funded through payroll taxes on workers’ incomes of up to $160,200. Mr. Biden has suggested eliminating the cap for incomes above $400,000 a year, subjecting them to payroll taxes.

Influential Republicans have proposed a variety of changes to make both programs more fiscally sustainable, including spending cuts and gradually raising the retirement age from 67 to keep up with longer life expectancy.

Republican leaders in Congress have stressed in recent days that, despite the calls from some conservatives to link safety net spending and the debt limit, they will not seek those changes as part of an agreement to raise the nation’s borrowing cap.

House Republicans have threatened not to increase the current $31.4 trillion limit, which the United States technically hit on Jan. 19, unless Mr. Biden agrees to unspecified demands to reduce government spending and debt. If the cap is not raised and the government is unable to pay all its bills at once, some retirees might not get their Social Security checks as scheduled. But leaders say their demands to raise the cap will ultimately leave Social Security and Medicare intact.

Senator Mitch McConnell of Kentucky, the minority leader, told reporters on Tuesday that “there is no agenda on the part of Senate Republicans to revisit Medicare or Social Security, period,” adding, “I’ve noticed that the speaker of the House has said the same thing.”

note: This does not mean McConnell is "on our side". It could just as easily mean, "We won't do anything to fix the problem, knowing the thing will eventually implode (because our tax-cut strategy is working according to plan), and then we can make our move to kill it altogether."

If both sides hold their positions, the fiscal debate will narrow to Mr. Biden’s proposals to raise taxes on corporations and high earners — which Republicans have roundly rejected — and Republican proposals to cut the growth of a much smaller slice of federal programs.

Mr. Biden plans to address the deficit in remarks on Wednesday in which he will criticize Republican proposals that he says would add $3 trillion to the debt. That includes repealing tax increases Mr. Biden signed into law in 2022, which would increase federal revenues, as well as making permanent several Republican tax cuts that are set to expire at the end of 2025.

That debate will exclude the primary spending-side drivers of future federal debt and deficits. Both Social Security’s and Medicare’s trust funds are currently spending more than they take in from payroll taxes and other revenue sources, a growing gap that is included in how the government accounts for the total size of its budget deficit.

In its last wave of forecasts, in May, the budget office predicted Social Security spending would grow by two-thirds over the coming decade. That’s more than double the expected growth rate for spending on the military and on domestic programs like education and environmental protection. High inflation could further accelerate that growth; Social Security enacted an 8.7 percent cost-of-living increase this year, its largest in decades.

By 2033, the May forecasts suggest, the federal government will be spending nearly as much on Social Security alone as it does on all discretionary spending — military and otherwise — combined.

Medicare is a smaller program but poised to grow even faster, at three times the rate of military and other discretionary spending over the next decade, according to the May forecasts. The new projections are likely to show its growth will be restrained somewhat by a law Mr. Biden signed last summer that is expected to reduce the program’s spending on prescription drugs for seniors.

Lawmakers could stabilize the programs by raising taxes, reducing spending or simply continuing to borrow money to keep paying full benefits. A group of liberal lawmakers led by Senator Bernie Sanders, independent of Vermont, has a proposal to expand Social Security benefits and extend its solvency for 75 years through a variety of new taxes on investment and business income, along with earnings for Americans making $250,000 or more.

The conservative Republican Study Committee in the House has a plan that would raise the retirement age for both programs and reduce Social Security benefits for some higher-earning retirees.

Fiscal hawks in Washington, including think tank officials and some Senate Republicans, have said lawmakers must move now to find bipartisan agreement on plans to better balance the programs’ spending with tax revenues in the years to come. More than a decade ago, President Barack Obama, a Democrat, issued similar warnings.

“To put us on solid ground, we should also find a bipartisan solution to strengthen Social Security for future generations,” Mr. Obama said in his 2011 State of the Union address. “We must do it without putting at risk current retirees, the most vulnerable or people with disabilities; without slashing benefits for future generations; and without subjecting Americans’ guaranteed retirement income to the whims of the stock market.”

Some were dismayed that Mr. Biden — and Republican lawmakers — did not follow a similar path at his own State of the Union this month. “The sober warnings from the experts is quite a contrast to the gleeful cheers from bipartisan policymakers at the State of the Union for doing nothing,” said Maya MacGuineas, president of the Committee for a Responsible Federal Budget, which advocates federal debt reduction.

In his State of the Union address, Mr. Biden, who was Mr. Obama’s vice president, ripped Republicans for plans to cut safety net programs. Republicans in the audience booed him vigorously. After some back-and-forth with his critics, Mr. Biden declared victory.

“So folks, as we all apparently agree, Social Security, Medicare is off the books now, right? All right. We’ve got unanimity,” he said.

BTW, let's not pretend the problems haven't already started.

Asking For Help At 80 - America's New Face Of Hunger

PBS NewsHour

And also too:

The Forgotten History of the Radical ‘Elders of the Tribe’

The Gray Panthers staged rowdy protests against ageism and found common cause with young activists on everything from health care to racial justice. What can they teach us today?

By the mid-1970s, she was a national celebrity. She had speaking engagements all over the country; she traveled 100,000 miles annually, giving at least 200 talks a year. She was all over the TV: “The Phil Donahue Show,” the “Today” show and “The Tonight Show” with Johnny Carson, multiple times. Media monikers for her included “ball of fire,” “dynamo” and the now-problematic “feisty.” In 1978, the World Almanac named her one of the 25 most influential women in the United States. Shortly before she died in 1995, ABC News profiled her as its “Person of the Week.”

She was Maggie Kuhn, the woman who, 50 years ago, founded the Gray Panthers, a movement to encourage activism — sometimes radical activism — among the country’s older people. Today, both Kuhn and her movement have been all but forgotten. But their mission is worth remembering, commemorating and perhaps even resurrecting, especially in the present moment.

Then, as now, was a time of intense activism. Inspired by demonstrations on behalf of racial and gender equality, and against the Vietnam War, Kuhn insisted it was time that the issues facing older people be included in any social reform agenda. Her passion was to shatter every stereotype she could about older people and, as a lifelong feminist, especially older women.

- more -

On Medicare Improvement

In today's thrilling episode of "Why Won't The Democrats Do Anything?", we see the ever-earnest Chuck Schumer having to go begging hat in hand to get the dastardly Joe Manchin to consider not being such an asshole all the fucking time.

Axios:

Dems try again on drug prices

Democrats are trying again to enact government price negotiations for prescription drugs, with a revised plan that would be wrapped into a broader reconciliation bill.

State of play:

• Senate Majority Leader Chuck Schumer on Wednesday released updated drug pricing language for review by the chamber’s rules referee, with a goal of passing it through the partisan reconciliation process, which wouldn't need any Republican votes.Schumer has been engaged in talks with Sen. Joe Manchin (D-W.Va.) on a package that would let Medicare negotiate directly with drugmakers over the price of prescription drugs
• While there's no agreement on other components in the package, Schumer has told Senate Democrats that if a deal can be reached, a bill could reach the Senate floor before August recess, per a source familiar.

The big picture:

The specifics of the new plan "appear ever so slightly more favorable to industry," said Raymond James analyst Chris Meekins.

Details:

• According to a summary of drug pricing provisions obtained by Axios, negotiations would begin next year. The new negotiated prices would take effect in 2026.The deal would overhaul Medicare's Part D drug benefit starting in 2025 and cap annual premium growth at 6% through 2029.
• Drug companies would have to rebate back the difference if they raise Medicare Part D prices higher than inflation, starting in October.

The revised draft would require Medicare to use its new negotiating power for as many drugs as possible — a change from earlier drafts, which gave the department some flexibility to back off. Price negotiations for biological drugs, however, could be delayed up to two years if a functionally equivalent biosimilar is likely to hit the market before the negotiated price takes effect.

The latest language doesn't specifically address price negotiations for insulin.

What they're saying:

"This reform would help make sure when companies profit they do it because they are innovating and serving their customers, not hiring the best lawyers and lobbyists," said Frederick Isasi, executive director of Families USA.

The other side:

• Drugmakers decried the plan as misguided.
• "The prescription drug bill released today went from bad to worse for patients," said Debra DeShong of PhRMA, the big Washington drug lobby. "Democrats weakened protections for patient costs included in previous versions, while doubling down on sweeping government price-setting policies that will threaten patient access and future innovations."
• "As we've previously warned, 'negotiation' is simply a euphemism for a government takeover of a sector that, on its own, has been historically successful in saving millions of lives," said Michelle McMurry-Heath, CEO of the Biotechnology Innovation Organization.

The intrigue:

Democrats are eager to show voters they've acted to lower drug prices before the November midterms, and progressive groups are prodding them to use all the legislative and administrative tools they can to do so.But taking on pharma could exhaust a lot of political capital, and opponents say the substance of the proposal could have a chilling effect on innovation.

What we're watching:

Manchin's involvement doesn't ensure a smooth ride for the rest of the reconciliation package, and the parliamentarian could still decide some of the drug pricing provisions don't comply with Senate rules.

M4A

John Oliver - On Medicare For All

Ryan's Medicare "Plan"

Repub spokesnut goes on and on about how people over 55 right now shouldn't even be part of the discussion, because Ryan's plan doesn't affect us at all.  It's all about how Repubs give younger people a choice in their coverage plans, and gee golly, isn't having a choice a wonderful thing? Wait just a fuckin' minute - if having a choice is the be all and end all, how come I don't get a choice, asshole?



And then, she lurches into the "un-elected 15-member panel that gets to decide whether or not her dad gets a particular procedure"...? What the fuck was that? Are we trying to dog-whistle the Death Panels again?

Well, It's About Time

In keeping with the spirit of bi-partisanship, Congress and the White House have just announced a compromise aimed at resolving the main differences between The Ryan Plan and ObamaCare.

As usual, we're not sure the American public actually had a Senior Death Match in mind, but hey - at least we're making a little progress (?)  Oy.