Blog 128 – Solving fake Medicare opt-out problem2w


Solving the fake Medicare opt-out problem:   For a fair health care system 2w

The debate about letting the healthy and the wealthy opt-out in Medicare is a fake debate. Each part has a pretty simple and feasible answer. The real debate is only as to the profits of insurance companies.

All the issues raised by the question of whether patients should be allowed to opt out of paying the Medicare tax if they buy their own private insurance can be fairly handled, with a little effort. Raising the issue is a booby-trap laid by insurance companies wanting to sell their policies and maximizing their profits.

The response requires designing and implementing a system that is morally and socially just as well economically efficient. And It can be done. The basic principle is that it is both morally and socially just and economically sound that the healthy share in covering the health care needs of the ill, the wealthy helping with the needs of the less-well off– principles that are well accepted in many of our governmental policies, from social security to the setting of progressive tax rates.

The basic answer is that in a fundamentally fair economy all should share in the ability to have good quality health care, regardless of their wealth or health. And all should have the same options. Further, the obscene level of paper work and rules and regulations about coverage should be eliminated. The need to worry about coverage, co-pays, prior conditions, time limits, source of coverage, overlapping policies is unnecessary, produces nothing, and is not cost-effective. Having a single payer or Medicare for All, or Universal Coverage, system (beware— “Medicare” means different things to different people). Economically Medicare gives greater strength to taxpayers as against medical suppliers, when users can bargain collectively in setting rates with providers, preventing pharmaceutical companies and medical providers from taking advantage of their near monopoly position to fix rates.

A class system of medical care, in which the rich get better care than the less-well-off, can be handled by not permitting providers to refuse treatment to patients on the ground of the source patients use for covering their bills, Medicare vs. private insurance. The medical profession as a whole should join in fixing fair reimbursement rates for all providers, bearing in mind a good faith obligation of fairness both to providers and patients. Care can be provided by providers of the user’s choice, not only to the healthy and the wealthy, who are likely to get favorable retreatment from insurance companies and providers if they can pay more for treatment. Options should be equal for all. This is a democracy, and fairness is a core value.

(Elizabeth Warren’s plan recognizes all of the above. On the cost side, see: https://prospect.org/health/warrens-medicare-for-all-plan-includes-no-new-taxes-on-the-middle-class/)

Blog 127 – Donald Trump the Great Negotiator


Blog #127 Donald Trump the Great Negotiator:

     The Secret of his Model

     Phase One. Have your staff in secret negotiate a meeting with your negotiating opposite number. Select an occasion and a setting that is photogenic.Meet your opposition there, shake hands, and become buddy-buddy with him or her. Tell the world how well you get along together, praise him or her effusively, Make a photo op out of it.

Phase Two. In a private meeting ideally just one to one, find out what your opposite most wants in the negotiations by asking your opposite directly. Tell your opposite that what is wanted is feasible, and promise it will be considered. Tell your opposite a few things you want that are likely easiest for your opposite to give. Forget about it, and move on.

Phase Three. Arrange a cordial handshake while arranging for further negotiations by staff. Announce publicly a complete private agreement with a promise that almost everything your opposite wanted is feasible and will be considered, holding back just enough and fudging key points so it won’t be seen as a complete surrender. In return, get a promise that everything you want is feasible, and a promise it will be considered. Proclaim a success for the negotiations, with a final embrace and warm words towards your opposite, and arrange a suitable photo op.

Phase Four.

Forget about it, and move on. Consider firing anyone in the cabinet or head of a major federal agency who is publicly taking the results of the foregoing negotiations seriously. Or expressing doubts that they should be implemented.

Phase Five.

If further delay becomes politically embarrassing, find something minor but concrete that you and your opposite can do to demonstrate progress, with a written firm commitment to implement if found feasible in detail. Example:  a freeze on any negative changes by either side for a stated time. Announce it publicly, with appropriate photo op.

Phase Six

Forget about it, and move on.  Consider firing anyone in the cabinet or head of major federal agency or acting as an advisor who is publicly taking the results of the foregoing negotiations seriously.

Phase Seven.

When the time for the freeze, for example, runs out, arrange for a further high-level meeting. Find something concrete that you and your opposite can do to demonstrate progress, and put in writing as a commitment, such as establishment for a permanent joint consulting committee between you and your  opposite to work on details. Arrange for a celebratory photo op. Announce the result as a great deal, perhaps one of the greatest deals ever made. In North Korean negotiations, the well developed model, Trump: “the encounter “historic” and “very legendary.” Forget about it, and move on

Phase Eight, Phase Nine, Phase Ten.

Forget about it, and move on. We have good relations. There are other priorities. Any criticism in partisan.

Blog 126 -Reading the Green New Deal


Vision, Measuring Stick, and Organizational Impetus

Blog 126 – Reading the Green New Deal

A Vision, a Measuring Stick, an Organizational Impetus.

A “Green New Deal Resolution” has just been introduced in Congress. It was drafted by Alexandra Ocasio-Cortez and supported by some of the  most socially concerned elements on the mainstream political stage today. It has been, I believe, widely misunderstood, intentionally by conservatives, haltingly defended by many who  agree with its emphasis on the urgency of environmental issues but are less sure of its effectiveness as a political statement.

I believe it is a mistake to read the Green New Deal Resolution as if it were the working schedule that a group of legislators had adopted as a detailed formal step by step agenda and time-table for legislative activities for the next session of Congress. It is much too early for that, for some new and some experienced Congress-people and social activists to assemble or present as specific thought-out and carefully formulated set of draft measures ready for immediate vote by a deliberative body, particularly by a Congress with its own ways of working and getting things done, in a somewhat rule-ridden assembly.

 That’s not how the proposed Green New Deal should be read. It is somewhere between a vision and a rallying -cry, and is important as both.. It has three aspects, which together make a real contribution to the signers’ objectives: 1) setting forth what goals they have set for themselves and how they are connected to each other[1], 2) how they or others might gauge their progress to those goals, and, implicitly, 3) a possible way to use their effort organizationally and politically. The signers presumably hope to lure many others to join them in developing and implementing their jointly developed goals through realistic programs and legislation that will pass political muster and work. The New Green Deal Resolution is not a set of draft legislative measures or the platform for an organization, though it could well be steps to both.

As a vision, I would read its text as written to be useful towards presenting a unified view of what its authors are about: putting together quite a variety of ideas on a variety of subjects, paying attention to what academics call their intersectionality, what their children might call how the head bones are connected to the arm bones are connected to shoulder bones are connected to leg bones.  It is intended to avoid being a grab-bag of sweets it would be nice to have, and rather to present a coherent vision of a goal and a future, a destination for the group’s efforts, a platform on which the edifice of a green New Deal and a coalition for its effectuation could be built. It can help fix priorities across a wide band of topics, with a comprehensive logic tying them together, a reasoned way of establishing the goals for their individual terms of office, an argument for others to join in.

But the statement can have a further very concrete and useful function: as a measuring-stick against which to judge what is underway by what is actually needed, to tell how far progress has been made, what exactly has been accomplished and what remains to be done. It can be used  as a tentative report card, a measuring stick by which the doer is willing to be judged, a way of telling, as time goes on, what is likely to be pie in the sky, what in each period is forgettable red  fodder, what is digestible blue meat, and what is hoped for as dessert. One might fantasize about a non-partisan panel of experts, political and civic leaders, and activists, meeting annually to follow through in the directions that the Green New Deal’s authors have proposed, but that would really be pie in the sky.

It is, to be a bit partisan, the mirror-perfect opposite of Donald Trump’s way of proceeding, of the way in which he and his organization have approached their responsibilities as the governing body of a great and complex nation} with no stated over-all goals, no assessing accomplishments and failures by any set of standards, no perspective on what the ultimate outcome is hoped to be. Perhaps as an alternative to the Trump, the  backers of the Green New Deal, who are after all politically progressive Democrats, with the  support of multiple  grass-roots and socially activist organizations, a diverse group  of some of the most socially concerned elements on the mainstream political stage today, including hose in the Democratic Party’s progressive wing, such as Alexandra Casio-Cortez, a principal author of the Green New Deal Resolution – perhaps such a group can become the nucleus of a larger permanently organization that  can show in practice what the vision of an environmentally sound, humane, democratic vision, an alternative to Donald Trump’s chaotic non-vision night be, and what steps are needed to move towards that vision  systematically and together. [ A full list of Individuals (and Organizations) supporting the Green New Deal resolution is at https://en.wikipedia.org/wiki/Green NewDeal#Individuals.

Best wishes to its authors


[1] Compare it to how the Pentagon goes about laying out its horrendous Overmatch policy formulation of U.S. global objectives, in which the word “peace” hardly appears and no vision of its ultimate consequences is even attempted.  Michael Klare, “Why ‘Overmatch’ Is Overkill,’” The Nation Jan. 14, 2019.[

Blog #125 – Rent Control and California Prop 10


submitted to LA Times October 31, 2018 Likely only of interest to Californians.

To the Editor, Los Angeles Times

Proposition 10 can be confusing. It does NOT establish rent controls anywhere. The Costa-Hawkins law, which Prop 10 repeals, is a state law that simply takes away the decision-making from local communities on whether or not there should be specific forms of rent regulation on specific types of housing units and established its prohibitions state-wide, overruling local decisions. Proposition 10 repeals that law, leaving decision-making on rent regulations in the hands of local communities, where almost all other land use decisions, e.g. zoning and land use planning regulations are now lodged.

Proposition 10 is essentially a home rule proposition. A YES vote restores local control of key housing decisions. If it passes, it will then be up to local voters to decide what kind of regulations of rents they want, if any, want, if any. They can then consider Gary Painter’s compelling arguments for adopting rent controls to spur more building (LA Times, Op-Ed, October 31), and it will be their decision.

Peter Marcuse
Professor Emeritus of Urban Planning
Columbia University
Home address:
3775 Modoc Road
Santa Barbara, Calif. 93105
Phone: 805 879 7714
Pm35@columbia.edu

Blog #124 – Dear Artificial Intelligence


Dear Artificial Intelligence.
On reading economics, thinking Artificial Intelligence might help.
But recalling Faust on self-doubt and Bernie Sanders on winners and losers

Here I sit, a PhD. a retired legal technician,
I’ve had to study the latest economics as if on a mission
I’ve spent hours on the web and can do no more.
Yet here I sit, poor fool, and am no wiser than before,

Maybe artificial intelligence will solve all those problems
I won’t have to go back and read all those volumes
JI can just lie back and let it all sink in
And I will know who will lose and who will win.

Yet if I think about it just as bit more
I’ll realize I actually knew the answer to that before.

To wit the answer is:

The winners will be those that were rich and have all the money,
Whose words were all so persuasive, all dripping with honey
Who only do what their lawyer says the law will allow,
Who sometimes acted quickly and sometime acted slow.
But whether the markets are frozen or runny
Whether the forecasts are cloudy or sunny
The rich always turn out to be winners. Wow isn’t that funny?

And I had to read economics to learn that?
Working hard while others grew fat?
And still not have the power to change it at all?
Maybe Artificial Intelligence will help where the natural fails?
And is better than just flipping a coin and calling heads or tails?

But that doesn’t mean Artificial Intelligence can’t have any good use
Only that what it’s taken to be doing can be seriously misleading
By ignoring whose hand and whose interest is doing its feeding.
Not disclosing who owns its product can lead to dangerous abuse.
Pretending that if something is the result of A.I.,
Without disclosing who’s asking the questions
What stake they have in what the answers are,
Against such practices there should be a bar.

Dear A.I., the problems economics describes seem intractable to me,
The answers, A.I. or no, seem to me nowhere in sight.
I’m not even sure I know which ones are harmful, which ones right.
So A.I., if you’re so smart, please tell me what I should do,
And I’ll go do it, and if it goes wrong, blame the results on you.
Of course if it succeeds, I’ll take the credit for having seen the light.

So remember, Dear Artificial Intelligence,
You may think you’re so smart
But– you and we know you don’t have a heart,
You can’t tell the good from the bad
You don’t know if you’re being used honorably or being had
You may know moral values by their name,
And you may even refer to them without shame
But letting feelings influence your work is for you are a no-no
People are just numbers in some algorithm you have developed.
You can’t tell whether the level of happiness produced is high or is low.
All most of your clients seem to care about is the dough.

Blog #123 – The Funny Hearings, Seriously


THE FUNNY HEARINGS, SERIOUSLY

The Kavanaugh senate hearing was efficient and conclusive.
It gave Kavanaugh a chance to show how abusive
A Supreme Court Judge-in-Waiting could be without ever saying “sorry.”
It simply had to make it sure that her story would end up as his story
Its conclusions were firm without time wasted on thinking and worry.
.
So what really happened in that really irrelevant past?
(We all know youthful characteristics don’t last)
She knows, but don’t believe her, just a teen, and he’s now a very honorable judge,
You can believe she’d have dreams, but such an honorable man wouldn’t fudge.

If only we knew who from behind pushed her in,
We’d know if he committed the original sin.
Maybe it was an immigrant hiding in that hall
Oh, if only they’d let us build up that wall!
After all, maybe it was only a prank,
Just blame it on one too many he drank
And he never got her clothes off and went all the way,
So just tell him how much he has to pay
That satisfied each of the others Trump had had
And they never complained or showed they were sad.
After all, didn’t the man drive his daughter to her classes?
So what if he took a little time out to make a few passes.
And “nothing really happened,” said our worldly Rep, boys will be boys,
And if a future Supreme Court judge doesn’t want to answer questions,
Why upset him by asking for confessions.
And girls should be pleased that they could be their toys.
If everyone knows, a the end of the line,
What the result will be, we’re just wasting our time.
His concern for justice can wait till he’s on the bench,
By then we’ll have forgotten there was a bit of a stench.
It’s time to stop this demeaning charade
And get on with his inaugural parade.
Donald Trump has told us whom to believe in these cases.
With his personal experience he knows what a man such as this faces.
Don’t call in the over-burdened FBI
Why expect them to tell the truth from a lie.
Our leaders can do that much better themselves, they tell us,
And get the job done without anymore fuss.

We’ve spent too much time on this already. Not a single day more.
After all, finding the truth would just be a bore.
—————
Now they’ve got to wait a whole week for a “limited” FBI report
Which won’t have a firm conclusion of any useful sort
Then they’ll draw their own conclusions, from this fact or that fact ,
And move on, greatly relieved, as it’s in their sole power to do, to act
Never mind if the facts show they were right or were wrong,
They’ll do as they’ve wanted to do all along.

And then the voters will finally have their say,
And we’ll thank the strong women who’ve shown us the way!

Blog 122c -Non-Causes of Poverty, Jobs, Welfare Responses


Blog #122c – Non-Causes of Poverty, Jobs, Welfare Responses

Why is there poverty in the United States today?[1] Most anti-poverty policies rely on one or more of four theories about the causes of poverty: the lack of jobs, the shiftlessness of the poor, the changing technological composition of production, or the scarcity of resources to provide for all. None of the four holds up.

We don’t have enough jobs. Not so. “Unless we create more jobs, there will be unemployed and thus poverty,” many believe. But unemployment is low, whatever the weaknesses of its measure, and most poor people are already employed. They already have “jobs,” or at least work, and very often hard work, often part- time, insecure, without benefits, almost always devalued. It is the substandard quality of the jobs we have that undergirds poverty.[2]  Killer jobs, not job killers, are the real problem.

And that so many jobs are substandard is not by accident. Simple economics dictates that employers will always push wages as low as they can: wages to workers are income to employees, but expenses for employers.  Matthew Desmond’s trenchant article[3] provides the figures, and lays out the consequences, in well reasoned and human terms. What’s needed are good jobs, paying living wages, secure over time, organized so as to be manageable along with meeting all the other obligations of complicated lives

They are poor because they are lazy. Not so. “They don’t want to work, or they drink, or are addicted, or mentally ill,” some argue. But, as noted above, most poor are in fact working, but at jobs with less than living wages or unsustainable working conditions Blaming the victims for their poverty will not work

Technological change requires workers with skills the poor don’t have. Yes but. A high school education may be increasingly needed to get a good job, but lack of a high school education is not voluntary for most without it. Getting a good education is not so simple for many, and especially for those that begin poor. Lack of good schools, of health care, of transportation, of housing, of physical security, of social encouragement, all play large roles. There is no evidence that, given the opportunity, poor people are not able to handle work that requires a post-high-school education. The poor may indeed have less education than those better off, but not because they are stupid.

Technological advances should in fact increasingly be able to provide enough for all, so that there would be no such thing as poverty, if they were appropriately socially organized.

There will always be winners and losers. The poor are simply the losers. No longer so. “The poor will always be with us is an old argument. It is increasingly wrong. Our societies are able to produce enough so that no one needs to live without adequate housing, food, clothing, rest, security, or the other things a decent standard of living in a technologically advanced society can produce. The statistics on inequality are clear. Even a modest redistribution from the top 1% would mean that all of the other 99% could live well above poverty levels.

 If none of these four explanations accounts for the widespread existence of poverty today, what does?

Two factors basically explain the existence of poverty today.

First, major real conflicts of material interest underlie poverty.  As pointed out above, simple economics dictates that for-profit businesses will always push wages as low as they can: wages to workers are income to workers, but expenses for for-profit businesses. Thus, poverty benefits powerful economic and political interests, powerful both in establishing economic relations, and in politically establishing governmental policies that further business interests opposing the steps necessary to eliminate poverty.  And,

Second, the necessity of dealing with immediate and critical human problems detracts from confronting these real conflicts, creating an incentive to downplay the existence of these conflicts politically as well as ideologically, even among well-meaning advocates of policies challenging the underlying causes of the conditions whose consequences they seek to ameliorate, so-called anti-poverty and social welfare programs.

So what is to be done to reduce and ultimately eliminate poverty from rich societies such as ours?

 Immediate actions. We have some limited but moderately effective social-mobility programs: minimum wage laws, restrictions on hours of labor and unhealthy working conditions, subsidized health care, unemployment benefits, public financing of elementary education. They need to be adequately and securely funded.[4] They should be championed, expanded, and stripped of any draconian and counterproductive work requirements. But more is needed.

Ultimate goals must be kept on the agenda as ultimately needed, goals such as a real right to housing, to free medical care, to free public education through college, an adequate income should be considered, and seen as obvious governmental functions, just as are police or fire services or streets and highways or sanitation or environmental controls or providing for holding democratic elections or public parks or clean water. So one might consider adopting as ultimate asocial goals for social action the elimination of poverty entirely and the provision of a right to a comfortable standard of living commensurate with what society is already in a position to provide, given a commitment to use it so that its wealth is distributed equitably among all individuals and groups in the society, commensurate with individual and group needs and desires. The even broader goal might be expressed as the just and democratic control of the economy as a whole and in its parts.

Transformational Measures. But to achieve such goals, shorter-term steps also need to be pursued, measures that move in these directions but that do not promise more than are immediately political feasible yet can contribute to meeting long-term goals.. [5] We should not neglect the importance of the poverty fixes we already have. Safety-net programs that help families confront food insecurity, housing unaffordability and unemployment spells lift tens of millions of people above the poverty line each year. By itself, SNAP annually pulls over eight million people out of poverty. According to a 2015 study, without federal tax benefits and transfers, the number of Americans living in deep poverty (half below the poverty threshold) would jump from 5 percent to almost 19 percent.[6]

  1. Improving minimum wage laws. Moving towards the ultimate goal of stablishing a standard of living for all that guarantees not only the necessities of life but at a level consistent with a comfortable and secure standard of living and a level commensurate with the productive capacity of society, appropriately organized to fullfill social needs and enforced well enough to prevent destructive competition- among businesses based on how little they pay their workers.
  2. Strengthening workers’ rights, moving in the direction of fair wages for all, including strengthening requirements for fair labor standards in the work place. Encouraging self- organization workers and poor households along diverse lines needing publii representation..
  3. Expanding the public and non-profits sectors, in the direction of recognizing the benefits of using social contribution as the motivation of provision of goods and services, rather than profit to be made by furnishing them, e.g. in housing, health care, education, recreation, transportation, environmental amenities, creative arts.
  4. Terminating public expenditures whose motivation is economic development and growth for their own sake, and focusing them on their contribution to meeting social goals, including provision of socially desired levels of goods and services. Publicly subsidized job creation as part of and motivated by economic development interests will simply benefit employers unless coupled with living wage and decent working condition requirements. Adding a work requirement to the receipt of social benefits is likewise a painfully ironic was of reducing such benefits to their recipients in a system in which if they do not produce profits for an employer, over and above their wages they will not be hired.[7]
  5. Making the tax system strongly progressive, lower at the bottom, higher at the top, moving towards the broad reduction of inequality and targeting them to the encouragement of socially desirable activities.
  6. Weighing the advantages and disadvantages of imaginatively recasting budget priorities, specifically reducing the military budget, funding anew climate -change-centered civilian conservation corps, increasing foreign aid aimed at alleviating conditions that lead to emigration etc.
  7. Recasting the public thinking about the meaning and values of work, the causes of poverty, the values implicit in alternative approaches to inequality and injustice. [8]

In Matthew Desmond’s eloquent words, “We need a new language for talking about poverty. ‘Nobody who works should be poor,’ we say. That’s not good enough. Nobody in America should be poor, period.”  He’s right.[9]

[1] The official poverty rate is 12.7 percent, based on the U.S. Census Bureau’s 2016 estimates. That year, an estimated 43.1 million Americans lived in poverty

 [3] Matthew Desmond, “Americans Want to Believe Jobs Are the Solution to Poverty. They’re Not,” concludes simply: “the able-bodied, poor and idle adult remains a rare creature “Why Work Doesn’t Work Any More,” The New York Times  Magazine, p. 36ff. Available at                             https://www.nytimes.com/2018/09/11/magazine/americans-jobs-poverty-homeless.html

[4]

[5] For a further discussion of the concept of transformative measures, see pmarcuse .wordpress.com, blogs 81a-81e, 97, and 99, Towards Transformative Approaches to Unjust Inequality.

[6] Mathew Desmond, op. cit., p. 49.

[7] Mathew Desmond in a factual, tightly argued, and very persuasive article effectively demonstrates the futility of work requirements attached to the receipt of social benefits. Today, 41.7 million laborers — nearly a third of the American work force — earn less than $12 an hour. the New York Times Magazine of September 11, 2018,

[8] Matthew Desmond, op. cit., writes ”No single mother struggling to raise children on her own; no formerly incarcerated man who has served his time; no young heroin user struggling with addiction and pain; no retired bus driver whose pension was squandered; nobody. And if we respect hard work, then we should reward it, instead of deploying this value to shame the poor and justify our unconscionable and growing inequality.”  And Joanna Scuffs, in a rich and provocative article , writes of ”the slipperiness of the term ”work”, from work  as a daily grind into work as “life’s work “oeuvre, art,  the reason you’re here on earth.” The’Linguistic Chamelion” of Work,In These Times, April  2018, [[. 65ff.

[9] Op. cit., p. 9.