Does The Public Believe That Nursing Home Operators Are Underpaid? Have We Failed to Create a Narrative to Support a Political and Media Strategy to Debunk Industry Propaganda?

By:

Dave Kingsley

    My last post laid the groundwork for ongoing blogging about and discussing the privatized, publicly funded U.S. medical care system with colleagues and anyone interested in that discussion.  I understand that it was a long post.  However, it is presented in chunks.  There is no necessity to read through the whole piece to take away the point I’m making:  the system is rigged on behalf of corporations and high net worth individuals at the expense of ordinary wage and salary workers.

    One might think that everyone knows that.  But we have no good studies of public opinion to inform us about exactly what “most” people believe.  My focus in the past few years has been increasingly on the long-term care/skilled nursing sector, i.e., nursing homes.  In addition to many dimensions of this Medicare/Medicaid funded system I have worked on – mostly financial – I have interacted with journalists on a consistent basis and have discussed what I perceive as pervasive substandard care with medical professionals and lay persons.

    I believe that a negative view of nursing home care is widespread.  Let’s face it, no one wants to end up in one.  However, I would hypothesize that a large proportion of the public is confused or ambivalent about, or even in some cases sympathetic with, the owners of facilities.  Trade associations and their lobbyists repeatedly spread a hardship narrative, claiming that corporations are operating on a razor thin margin and on the edge of bankruptcy. Major media outlets report on specific scandals and a small number of scandalous chains and their scurrilous activities.

    This industry narrative, and the political and media strategies it supports has been effective – even though it is based on falsehoods and misinformation.  Although my colleague Charlene Harrington and I have conducted an analysis 2020 financial reports submitted to the SEC by publicly listed corporations and concluded that they did quite well during COVID (Kingsley DE, Harrington C. COVID-19 had little financial impact on publicly traded nursing home companies. J Am Geriatr Soc. 2021;1–4. https://doi.org/10.1111/jgs.17288), there has been no call from any quarter for holding the industry accountable for the death of at least 140,000 patients.  Industry representatives have appeared on many major media outlets claiming that the government is at fault for not providing operators with sufficient resources.

    This is a falsehood.  But have we – advocates and scholars – failed to frame issues and develop a narrative and political/media strategy based on objective, evidence-based, information?  I think we have failed to do that.  Therefore, the public and the media are responding to a well-funded media and legislative presence of nursing home industry lobbyists such as Mark Parkinson, former governor of Kansas, and others who have been well received in legislatures and by major news sources.  The time has come for us to go on offense with our own knowledge-based narrative and legislative-media strategy.

Why Are We Putting Up With Medical-Industrial Grifters And Politicians Who Collaborate With Them?

By:

Dave Kingsley

Who Pays for Medicare, Medicaid, and the Affordable Care Act?

The answer to this subtitle, “Who Pays for Medicare, Medicaid, and the Affordable Care Act?” is “You and I do. We all do.” We pay through our income taxes, payroll taxes, sales taxes, property taxes, premiums, deductibles, and co-pays. We pay more than enough to provide all of us with first class medical care from the prenatal stage of life to the end of life. I can provide an overwhelming amount of evidence to support a claim that I will make in this and subsequent posts: we are getting far less for our money than we deserve because of greed supported by government/corporate corruption and propaganda.

Furthermore, corporations paid with taxes to underwrite our healthcare are allowed by federal and state governments to display their disdain for us with bizarre and insulting ad blitzes featuring carnival barkers like Joe Namath, Jimmie J. J. Walker, William Shatner, George Foreman, and other clownish characters with no self respect and the same amount of respect for us. You are paying for this incredible insult to your intelligence. If you are wondering why Medicare Advantage (MA) costs the Medicare program more than traditional Medicare, this is one reason.

Medicare has evolved into an incomprehensible Rube Goldberg morass of traditional and MA components incomprehensible to ordinary people. Enrolling in the program involves a lot of good luck or expert help for avoiding traps that could haunt you down the road if your health status changes. Even worse, hardly anyone knows that the MA program is an ongoing effort (facilitated by both political parties) to end traditional Medicare and rig the system in the favor of big insurance over beneficiaries. It’s succeeding with a swiftness beyond the wildest dreams of the corporate sponsors of the cleverly named Medicare Modernization Act of 2003.

How Much Are You Paying For Government-Funded Healthcare?

In considering what you pay for federal/state collaboration with corporate America for medical care – which is practically all medical care in the U.S. – let’s consider the macro level numbers first and then discuss what it costs you – the resident/citizen/beneficiary. Annual expenditures for Medicare were approaching $1 trillion per year in 2020 and will no doubt reach that milestone this year. Medicaid expended $655 billion in 2020 and premium subsidies for the Affordable Care Act totaled $55 billion, medical care for post 9/11 veterans is estimated to cost $60 billion per year, tax deductions (expenditures) for employer sponsored health insurance is the largest tax expenditure at $227 billion, household out of pocket spending reached over $406 billion. With these expenditures and hospital, drug, physician/clinical services, the U.S. expended approximately $4 trillion for medical care in 2020 (https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet).

We can only estimate total expenditures but $4 trillion is an acceptable official estimate, which would be approximately $11,700 per capita and 18% of GDP. This is double the expenditures of U.S. peer countries in Europe and Asia, which have universal, single payer systems rather the U.S. privatized model that blocks millions of our fellow citizens and residents from medical care.(https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/).

I believe however that when tax expenditures are considered, $4 trillion, or $11,700 per capita and 18% of GDP significantly underestimates the total expenditure for medical care in the U.S. corporatized, for profit system. Corporations receive significant streams of revenue through the tax codes, which burdens ordinary wage and salary earning Americans by increasing their tax burden while reducing the capital gains taxes of corporations and high net worth individuals. There has been no attempt to enumerate the total amount of benefits accorded to medical care corporations for real estate depreciation, interest on debt, executive compensation, and other forms of federal and state tax expenditures. I’ve already noted the $227 billion for employer provided health insurance and included that in the $4+ trillion total.

One Egregious Example Of Corporate Greed Among Many

It is past time that the American people were told about the excessive executive compensation, unnecessary increases in shareholder value through stock buybacks, stock splits, and other manipulation of stock prices. Taxpayers need to be clearly enlightened about how much of their money is going to medical care versus going to shareholders, executives, advertisers, and other wasteful expenditures that we can expect in a privatized public-funded medical care – technically known as the medical-loss ratio. The Centene Corporation is one of many examples of greed and corruption unquestioned by the people sent to congress to oversee our rights as taxpayers and citizens.

Centene, which derives its revenue from Medicaid – poverty medicine – paid its CEO Michael Neidorff $24 million in 2020. The total compensation for Centene executives and board members (which includes former congressman and HHS Secretary Tommy Thompson and former congressman Richard Gephardt) was slightly more than $64 million. Much of this compensation is paid in stock options and stock awards. The first $500,000 of executive compensation is tax deductible, hence tax maneuvers (tax arbitrage) through stock awards/option are beneficial to corporate earnings.

It is not uncommon these days for high paid corporate executives to have their stock awards diverted into individual and family trusts or some entity set up for tax avoidance. Having analyzed the proxy statements of several health care corporations, I’ve come to realize how fabulously wealthy many families and individuals have become in corporations earning most of their revenue from government funded medical programs.

What Should Excessive Government-Funded Medical Expenditures Mean to You?

It may escape peoples’ attention that the budget in their state is strapped because of the cost of Medicaid due to massive numbers of residents unable to obtain access to care through some form of insurance. State revenue is primarily derived from income, property, and sales taxes. In most states, consumers pay at least 4 or 5 percent sales taxes on everything they buy – including food and clothing. Some states like Texas and Florida have no income taxes and therefore have high sales taxes. The burden of sales and property taxes is inversely proportional to income and wealth. Higher income people have a lighter burden. Although poor people who have the greatest burden for taxes are funding poor peoples’ medicine while wealthy individuals benefit financially from Medicaid have a lighter tax burden. Furthermore, program beneficiaries are treated as second class citizens in the health care system. Indeed, millions of poor people can’t even qualify for Medicaid or the Affordable Care Act and are essentially uninsured.

What does it mean to anyone in a society in which some of their fellow human beings are forced to pay taxes but denied medical care or accorded only low tier medicine for no other reason than they are poor? The public’s acquiescence in and acceptance of this injustice is mind boggling and disturbing.

In addition to state and federal income taxes paid by wage and salary earners, most every worker pays nearly 3% of every paycheck for Medicare (1.45% deducted from wages/salary and 1.45% submitted by the employer). These payroll taxes fund the Medicare hospital trust fund (Part A). At age 65, citizens qualify automatically for hospital benefits but are charged a premium for physician services (Part B), which will be $170.10 per month in 2022 (deducted from Social Security). Coverage for drug benefits (Part D) will cost around $37.00 per month. In spite of these costs, a major medical catastrophe can bankrupt you.

Hundreds of billions of tax expenditures for depreciation, employer provided health insurance, and generous tax avoidance provisions too numerous to mention flow from income taxes deducted from wage and salary earners’ paychecks – labor is taxed heavier so that capital can avoid taxes.

Budget Deficit & Inflation Propaganda

The monied elites are undeservedly rewarded through privatized, government-funded (with your taxes), medical care. Consequently, these programs do add significantly to U.S. debt and deficits. However, debts and deficits don’t bother me as much as the blame heaped on programs that benefit the American people for “running up the deficit.” The power elite owns the media and controls legislators through obscene amounts of political expenditures and can perpetuate big lies for the purpose of cutting benefits and increasing their share of program expenditures.

Here is some truth: Of the total expenditures on Medicare in 2020, 57% was paid by beneficiaries through their payroll taxes, premiums, co-pays, and deductibles (See page 10, 2020 Medicare Trustees’ Report). I submit to readers that the corruption of privatization and politics accounts for the other 43%. For instance, the Medicare Modernization Act of 2003, which legislated the drug benefit into existence, prohibits negotiation of drug prices. Very little serious discussion occurs regarding excessive payouts to shareholders and executives and lack of price controls in all phases of medical care.

That budget deficits and debts – often blamed on Social Security and Medicare – are running up inflation is one of the big lies foisted on the American people through clever, highly paid, public relations firms. Not one cent of Social Security is paid out of the U.S. Treasury. All of it – 100% – is paid for by beneficiaries through taxes they pay while earning a wage or salary. As I explained above, less than half of the funds for Medicare is transferred from the U.S. Treasury. That would not be necessary if corporations, i.e. shareholders and executives, weren’t lining their pockets with your taxes.

Why Are the American People Putting Up With The Medical Industrial Complex & The Politicians Supporting Its Greed & Corruption?

We could write books about the incessant propaganda and conditioning heaped on the American public. Suffice it say at this point that “we the people” are victims of clever framing, narratives, and political strategies. The Medical-Industrial juggernaut has unlimited amounts of money to spend on lobbying, paying off legislators (both Democrats and Republicans), and grooming the media. Taxpaying citizens and residents are sitting ducks. Therefore, they have been conditioned to believe that they don’t deserve anything better and should thank their lucky stars for the kindness and beneficence of the elites for any healthcare they do have. And if they are paying taxes and have no healthcare paid for with their taxes, too bad. That’s life.

There is an answer to the sorry state of affairs in the U.S. medical care system. Citizens must become informed, organized, and force their legislators to answer for the money they are receiving from Big Pharma, the American Hospital Association, and every other big money, medical-industrial group, roaming the halls of legislatures and paying for political campaigns and other goodies for legislators.

Paid professionals as advocates need a narrative and political strategy that might be risky. Speaking truth to power necessitates exposure of powerful people such as Congressman Richard Neal, current chairman of the powerful House Ways & Means Committee and a poster child for medical-industrial graft. He holds hearings on the disgraceful nursing home situation in this country without any intention of seriously reforming the system. If you don’t believe me, just Google him.

The Tallgrass Economics Blog will be focusing on propaganda, framing, narratives, political strategies, and how citizens can fight the corruption in a government-funded medical care system they pay for. We believe that the Democratic Party, liberals, and progressives could step up their political communication skills. We also believe that the great people in nonprofits advocating for reform of tax funded medicine need to come together and call out the politicians who are helping corporations fleece the hard working, patriotic, people of America.

Capitalism, Electric Vehicles, and Nursing Homes

By:

Dave Kingsley

Why would any capitalist believe that government funded medical care is amenable to capitalist fundamentals.  It’s nonsensical, even crazy, to think that “free markets,” “competition,” “buyer-seller negotiation” (bargaining over price), and so forth are relevant to medical care.  The results of this delusion – that Medicare and Medicaid can be administered through a “free market” – are: (1) bizarre, costly, and insulting advertising blitzes during Medicare open enrollment, (2) excessive costs due to payouts to shareholders and executives, (3) corrupt politics, which is also driving up costs, (4) dearth of R&D and innovation, and (5) lack of access for many citizens and residents who pay taxes that help fund the system.  I’m amazed that the public tolerates this corrupt, inefficient, unfair, and costly system.

    For a comparison to what is happening in the medical-industrial complex, consider the merging electric vehicle industry – about which I’m thrilled – as an example of real capitalism.  The traditional auto industry failed to move quickly enough toward vehicles that reduce the kind of emissions posing a threat to the future of the human species.  Hence, companies like Tesla have disrupted the staid auto manufacturing business.  Either Ford and GM will move much faster or will shrink into oblivion.  It is exciting to see upstart companies like Rivian (recent IPO & a contract to build delivery vehicles for Amazon), Lucid, and Archimoto challenge big auto and other gas vehicle manufacturers. We have a whole new exciting industry that is designing and building electric vehicles, inducing battery technology, spawning charging station manufacturers (e.g., ChargePoint), and creating well-paying jobs.

    Compare the Medicare-Medicaid funded, tax advantaged, nursing home industry to the rapidly emerging electric vehicle industry. The primordial roots of the industry can be dated to 1950 when the Social Security Act was amended to authorize federal funds for medical care (almshouses were state and local eleemosynary institutions and did not receive federal funds). It wasn’t long before federal lending began to boost a private, for profit, real estate industry – justified by a façade of medical care.  Medical delivery was based on the total institutional, industrial, model because efficiency and economy trumped professional medical standards. In 1965, massive amounts of federal and state dollars began to flow into the industry, which grew into a major sector of the commercial real estate industry and the medical industrial complex.

    There has been no innovation to speak of in the design of facilities and delivery of care in the nursing home industry since 1950.  The same substandard, disgraceful, care delivered in 2021 is essentially the same standard of care that has been delivered for the past 70 years. Conversely, financial innovation since the 1980s has been breathtakingly swift.  The “shareholder as supreme” theory of management and financialization throughout the economic system overtook a publicly funded nursing home system.

    What we now have is trillions of dollars funneled into the medical industrial complex – including the nursing home sector – without a correlative expectation that providers deliver a standard of care that is comparable to the money they are paid.  The nursing home industry operates in collaboration with government in a cartel like arrangement in which prices are guaranteed but labor floats in the low-wage service market.  Entry into the market is restricted and those providers privileged with a license are guaranteed an excessive return.  Owners, executives and their families are becoming fabulously rich in this system while patients suffer from low grade care without concern for professional medical standards. 

There is no disruption and innovation in a system like this.  Hence, it is not a capitalistic system at all.  It is government funded privilege accorded to select groups of shareholders. The tax codes are not incentivizing them to invest in capital and operational improvements. Rather, they have been able to arbitrage tax provisions into enhanced revenue streams without any other purpose than increasing shareholder returns.

Watch For Future Posts:

“The General Welfare Clause in the U.S. Constitution: What Should be Public and What Should be Private in a Democratic Republic with a Capitalist Economic System.”

“Taxpayers & Tax Codes: What Should Residents of the United States Expect for the Money They Spend on Medical Care?”

“Conservative Industrialists Have A Narrative and a Political Strategy. Advocates, Liberals, and Progressive Legislators Do Not.”

“Framing & Narratives Do Not Have to Be Based On Deceits, Falsehoods, and Propaganda. The Truth and Scientific, Objective Data & Information Work Well.”

Corporate Greed in an Increasingly Complex Healthcare System

By:

Dave Kingsley

Healthcare is a Cash Cow & U.S. Corporations Are Getting Better at Fleecing the Public

    I was looking at an AFL-CIO list of CEOs and their 2020 compensation – ranked from highest to lowest.  The $6 million to $20 million compensation packages for CEOs of nursing home corporations during 2020 – the year of COVID – had sort of blown my mind.  But nothing shocked me like the $199+ million 2020 compensation package awarded to the CEO of 1Life Healthcare, a rather new company.

    It is difficult to understand what 1Life does and why its needed in the healthcare system.  The company claims that it derives “net revenue from multiple stakeholders, including consumers, employers, and health networks.”  Apparently, it charges a per member fee for consulting services and care provided through its clinics and telehealth system.  The description of the company’s business model in its 10-K report to the SEC is a jumble of jargon and alphabet soup labels.

    This definition will not do justice to the business 1Life is in, but I will be elaborating on it in future posts:  the company is a layer of medical services between physicians groups, employers, and health networks for the purpose of increasing efficiency and effectiveness of publicly funded programs (I consider employer provided health insurance a publicly funded program because the government spends at least $200 billion per year in providing tax write downs for employers and employees). Like so many other services such as pharmacy benefit managers, nursing home referral services, and managed care organizations (see Centene Corporation below), this company will add excess costs, waste, and inefficiency to the U.S. healthcare system but do nothing to improve the overall health of Americans.

    Have you heard of Centene Corporation?  This St. Louis company rose from 48th to 24th on the Fortune 500 in 2020.  With revenues of $111 billion in 2020, it paid it’s CEO $24 million last year.  What does Centene do?  It derives its revenue from Medicaid by managing Medicaid programs for various states.  It is known as an MCO – another unnecessary layer of complexity in the healthcare system and an inefficient, wasteful rip off.  I will be following this company along with others in the years ahead.

Capitalism Can Only Thrive in a Robust Democracy. As Democracy Weakens, Capitalism Rots

By:

Dave Kingsley

Democracy is becoming weaker in the United States and the economic system is becoming increasingly corrupt and inefficient. 

    The primary hallmarks of a well-functioning capitalistic system are competitive free-markets, disruption of stagnant companies and industries by innovative startup companies, widespread opportunities for entrepreneurship, and a government with the political will to regulate the economy and business on behalf of the people and the general welfare.  These characteristics have been alternatively strengthened and weakened in the United States over the past 200+ years.

    Currently, the super-rich, and major corporations representing a burgeoning oligarchy have plied their increasing share of the wealth to government capture. Consequently, the U.S. government and a large proportion of the corporate world have settled into a destructive, money-driven, relationship.  Over the past few decades, the amount government largess channeled into corporations, their shareholders, and executives has accelerated. It is important to recognize this as one major underlying cause of what may be the twilight of American democracy and a free enterprise system.

We Cannot Overlook the Role of Religion in the Rise of Anti-Democratic Corruption

    I believe that a major cause of deteriorating democratic systems in this country is the money washing over elections and office holders. Our seriously corrupted political system is due in large part to dominance of the Supreme Court by a Christian-theistic-fascistic movement which has a propensity to throw its weight behind a strongman leader and a conservative, wealthy, white, elite.   For instance, Citizens United is merely a convoluted decision handed down for the purpose of legitimating the purchase of legislators by oligarchs and entire industries.

    Recent world history has taught us that major elements of modern Christianity are prone to collaboration with fascist autocrats.  Examples of Christian leadership’s deference to and support of strongmen abound.  The most recent example of course is the Christian white nationalist movement’s strong backing of the vile Donald J. Trump. The Catholic Church has a well-known history of providing comfort and aide to fascists throughout Latin America. 

    During the fascist-Nazi movement of the 1930s, the Catholic church was all too often willing to place its imprimatur on German, Italian, Spanish, (European) Nazism, and fascism.  Following the Holocaust, ratlines set up by Catholic priests helped shuttle war criminals such a Mengele and Eichmann to Latin America.

    Most Christians and Christian leaders in the United States are opposed to the vicious, vile politics of Donald Trump and today’s Republican Party.  Unfortunately, they are far too passive, unorganized, and quiet.  I say to them: “Please do not underestimate the organization, money, passion and commitment of the proto-fascist Christian white nationalists promoting Trump and Republican candidates.” 

    The Wasteful, Corrupt, U.S. Healthcare System is a Symptom of a Sick Political System

    There is a reason Americans pay two to three times per capita for healthcare than peer countries in the advanced, industrialized sphere of the global economy:  corruption.  How many ways can we document the claim that corruption is at the root of the wasteful, inefficient, U.S. healthcare system?  In so many ways that they are too numerous to mention in one blog post.  I will discuss some in this post and many more in future posts, but I first want to say as a capitalist that privatization and healthcare are not compatible.  Medical care cannot be reduced to an industrialized, free market model and at the same time optimize the health and wellbeing of the U.S. population.

    As dark money as well as money right out in the open began to flood into the political system, the American people were conditioned to believe that traditional government programs on behalf of the general welfare were necessarily wasteful and inefficient.  We were sold the myth that private enterprise is more competent than government bureaucracy.

    Actual practice – for instance in the case of the military, infrastructure, Social Security and Medicare – belie this deceit.  Nevertheless, practically every facet of the public domain supported by taxpayers has been handed over to private corporations.  That includes the publicly funded healthcare system.  The mind-boggling amount of capital that has flowed from the pockets of ordinary, non-wealthy, Americans into the holdings of the 1% is so excessive that it will be difficult for those hardworking, every day, Americans to grasp.

    Officially, healthcare accounts for $5 trillion or 20% of the U.S. economy.  I think it is more than that due to the generous tax reductions gifted to corporations, boards of directors and executives in the healthcare industry.  In my view, practically all revenue streaming into corporations providing medical services is coming from government sources – taxpayers – such as Medicare, Medicaid, the VA, and Obamacare.  At the same time, lobbying and campaign contributions keep costs spiraling up while care deteriorates and shareholders, boards, and executives pocket immense amounts of dividends, stock-growth, and compensation.

    The Finance-Insurance-Real Estate (FIRE) lobby, Big Pharma, device manufacturers, physician associations, the nursing home industry, and other powerful representatives of industries benefitting from corruption and excessive payouts can see the limitless government largesse available to them and have their representatives crawling all over our Nation’s capitol and the legislatures of the 50 states.  Legislators of both major political parties have become dependent on campaign contributions from the medical-industrial complex.

    In future blog posts, we will be documenting the inordinate corruption overtaking the government funded U.S. healthcare system.  See the coming post regarding 1Health Healthcare and the Centene Corporation.  Two of a very large number of scandalous and yet typical cases of healthcare rip offs at the expense of “we the people.”

The Dysfunctional U.S. Political System: We Didn’t Get Here Overnight

By:

The Editors

As the American people stand before the precipice of disaster on a scale they cannot imagine, a minority of elected officials in Congress are bending the Nation’s legislative will toward special financial interests with no regard for the public interest and future generations. One party, the Republican Party, has become totally debauched, decadent, and beholden to a tiny wealthy elite and white supremacists.  The other party, the Democratic Party, has within its ranks a few so-called “moderates” who are catering to the financiers and believers in the myth that the U.S. – the wealthiest Nation on the planet and in the history of humankind – cannot afford to care for its poorest citizens on a scale befitting an enlightened, advanced, society.

The “Blue Dog Democrats” blocking President Biden’s attempt to pass a budget designed to ameliorate economic injustice and forestall an environmental apocalypse are anything but moderate.  They are in fact reactionaries who refuse – along with the Republicans – to recognize this country’s racist past and are failing to support programs for rectifying four centuries of brutality perpetrated on African Americans.

Furthermore, Senators Manchin and Sinema and Blue Dogs in the House such as Abigail Spanberger and Kathleen Rice are looking away from the increasing discrimination and investor exploitation of programs for the less abled (elderly and physically less abled) in so-called nursing homes. They seem to be insensitive to the lack of access to health care for 30 million of their fellow citizens. They are turning a blind eye to the need for solar, wind, and other energy alternatives to fossil fuels before catastrophic failure of the environment makes the planet unlivable.  They appear to place interests of the greedy over the public interest.

We did not arrive at these crossroads of democracy versus autocracy, interest of the greedy few versus the public interests, and enlightenment versus dystopia overnight.  As distinguished Professor Max Skidmore writes in his post today, the Republican Party has been evolving toward its almost unbelievable state of debauchery for some time.  This is a chapter in a coming book, which will be one of many written by Professor Skidmore – a highly admired presidential historian.

The Democratic Party Blue Dogs now selling out their fellow Democrats are also the result of decades of political propaganda propelled into dominance by Ronald Reagan and Margaret Thatcher.  The belief that privatizing publicly funded programs in the public interest would lead to a better society was foisted on the American people and reinforced by inordinate amounts of cash from financiers.  A propaganda machine was cranked up for the purpose of conditioning the public to believe that poor people – especially African American poor people – are untrustworthy and lazy.  We’ve been put upon by propagandistic institutions with unlimited money for convincing us that government is bad and corporations are good. 

If we fail to correct decades of misinformation and disinformation and what they have wrought, the Blue Dogs will be long-remembered – but not fondly.

The Relationship Between Donald J. Trump and the Republican Party: Less Sudden than it May Appear

By:

Max Skidmore

It may appear as if Trump, a demagogic and bombastic outsider and political newcomer, suddenly seized one of America’s two major political parties, shaped it according to his whims, then dominated it entirely. The reality, however, is less dramatic. The Republican Party for years had implicitly been seeking such a figure as Trump.

Republican Senator Barry Goldwater’s 1964 presidential candidacy led to one of the greatest defeats in American history. Nevertheless, his support for “extremism” (which, Goldwater said, was not a vice) led to an increasingly hard-right party. His campaign, and the highly public support it received from a former film actor, Ronald Reagan, laid the foundation for the corruption and deterioration that today is so obvious.

In 1968, only four years after the Republican disaster, the party’s candidate, Richard Nixon, won the presidency. That year also saw the openly racist campaign of Alabama governor George Wallace, who was running for president as a minor-party candidate. Wallace’s racist appeals, both overt and coded, were lessons for Republicans, and added considerably to their repertoire. Wallace, of course, was not and had never been a Republican, but his mainstreaming of open bigotry provided inspiration for Richard Nixon’s “Southern Strategy.” That Nixonian strategy, continuing as it did¾even intensifying¾with Reagan, successfully re-oriented the Republican Party away from its civil rights heritage and toward the prejudices of the racially segregated south. Decades later, Donald Trump (another actor, of sorts, from reality television) was merely the culmination of the increasing “southernization” of the Republican Party.

Although the party might have been expected to heal over time as its message and preferences came to be more inconsistent with the changing views of an increasingly educated America, it did not. Instead, its deterioration intensified, increasing until it created a vacuum within itself that only the least principled and most unrestrained power seeker could fill.

In stepped Donald J. Trump. Whatever it seemed, it was assuredly not Trump capturing and corrupting a party; rather, it was a shameful party offering itself without reservation to the shameless Trump. Ultimately the party’s outrageous choice led to an actual insurrection¾completely Trump instigated¾that attempted to overturn the election that overwhelmingly turned him out of office. The rest is history; it also was tragedy as Trump and the bulk of the Republican Party unhesitatingly overturned America’s great tradition of peaceful regime change that dated back more than two centuries to John Adams who relinquished the office to Thomas Jefferson, honoring the result of the 1800 election.

The Republican Party of the United States had emerged in 1854, during the furor over slavery. That furor had led to the effective dissolution of the short-lived Whig Party, and of assorted minor parties. The founding principle of the new party was opposition to the spread of human enslavement into the territories. With astonishing speed, the new party became one of the two major political parties in the United States, electing a president, Abraham Lincoln, only six years after its founding. From then on, the Republican and Democratic Parties were the bases of America’s two-party system. In the 1880s, the term “Grand Old Party,” or GOP, referencing the Republican Party, began to appear in print. It was another century before the term took on the irony it carries today.

The Democratic Party¾then, for a time, often called simply “The Democracy”¾pre-dated the Republican Party for two decades or so, and had become the other major party. It had emerged from the presidency of Andrew Jackson. Although ostensibly devoted to the interests of workers and recently-enfranchised groups, and although there certainly were anti-slavery Democrats, (and pro-slavery Whigs) the party as such was the party of slavery. To a large extent, it was committed to southern interests, and thus became almost a sectional party during the Civil War, only to expand across the country, still generally supportive of southern segregation, in the decades to follow.

The early Republicans tended to be devoted to human rights, as reflected in Lincoln’s statement that they favored both the man and the dollar, but for the man over the dollar in cases of conflict. It was no accident that the Republican Party, during the Civil War, adopted the first income tax in US history, nor that it favored widespread education, conservation, and popular land ownership (the latter, to be sure, to the detriment of Native populations). Quickly, however, the party also was to become aligned with financial interests, after which it came to reject Lincoln’s preference for human over property rights.

Although the Republican Party developed an energetic progressive movement in the early 20th century, it could not maintain its progressive orientation. The 1920s saw the party become identified almost completely as the party of business, and the wealthy. When the Democratic New Deal under Franklin D. Roosevelt absorbed progressive elements in the 1930s and on the whole adopted progressive programs, Republicans tended to become even more devoted to what Americans call “conservative” policies: exaggerated patriotism and nationalism, isolationism, limited government, favor toward business, extreme protection of property, hostility toward programs crafted to benefit the people or anything they could describe as “socialism,” minimal economic regulation, and minimal taxation of wealth (this American version related only tangentially, if at all, to classic European “conservatism”). At the same time, Republicans became authoritarian: favorable toward the regulation of social conduct, despite their adoption of individualist, libertarian, rhetoric. The “individualism” that came to characterize Republicans, tended to be limited to economic matters; the freedom to accumulate wealth, and to use it with little or no restriction.

Following World War II, when Democratic President Harry Truman advocated fair housing, de-segregated the military by executive order, and proposed a national health service Republicans became more oriented toward policies of the south. This was the height of irony, in view of the anti-slavery commitment that had motivated the party’s founding. The two parties then shifted orientations fully after Lyndon Johnson worked for, and signed, the Civil Rights Act of 1964, and the Voting Rights Act of 1965.

Outraged by attacks on their “way of life,” southerners, as LBJ had predicted, shifted their politics. The “Solid South” no longer was solidly (or at all) Democratic. Bigoted southern Democrats en masse became bigoted southern Republicans. The Democrats had become the party of civil rights and human rights¾insofar as one existed in American politics¾and the Republicans had become ideological “conservatives.” As they did so, they came more and more to operate on a cult of personality that motivated so many autocracies in the world, summed up by Hitler’s Nazis as the Führerprinzip. Over and over, after Reagan’s presidency, Republicans who sought their party’s presidential nomination, claimed to be “more like Ronald Reagan,” than their opponents. Reagan worship continued undiluted until the advent of Trump as a Republican absorbed all the oxygen from the Republican room, so to speak, and superseded¾and far surpassed¾Reagan as the cult figure to dominate all things Republican.

By the 1960s, the Democratic Party had come to reject the explicit racism and the policies of white nationalism that until the early 20th century had been at its core.  The party then accepted the civil rights movement that sought to end racial discrimination and segregation. This caused the Republican Party to embrace the least humane principles of American politics, those that dominated the south, and most often (especially until after the Wilson administration, 1913-1921) had been associated with the Democratic Party.

Both parties, nevertheless¾after the Democrats’ defeat in the 1860s when they pursued the policies of secession and treason that brought about the Civil War¾were parties devoted to the “rules of the game,” and both generally supported the idea of self-government based on generally understood principles of democracy. They worked to ensure the most effective functioning of the legal system that the Constitution demanded, and that the political system enacted; even if a party had opposed a given law, its members generally cooperated with the other to make it work for the good of the whole.

As the latter part of the 20th century dawned and Republicans began to take away from the Democrats their most unsavory motivations, though, they also began to become less committed to democratic norms and to the “good of the whole;” even less committed to any political party’s most vital function: the very act of governing; this should have been expected.

 Republicans recognized that they were in trouble because of their devotion to the wealthy, to property as opposed to human rights, and because of their harsh disregard for the country, for democracy, and for the bulk of its people. Their orientation had progressively less appeal to those people. Nevertheless, they stood firm in their rejection of what at one time they had professed to accept as democratic values.

Instead of modifying their goals to make them more appealing to the people, they became more strident and more open in their “conservative” policies.  Following the example set by their post-Reconstruction ancestors, the architects of Jim Crow, they set about crafting ways to prevent majority interests from taking control. Ultimately, they discarded any guiding principle other than pursuit of power. This led them away from their previous professions of patriotism, and toward violence, dictatorial rule, and even subservience to foreign meddling if they saw it as aiding their cause. For elaboration, and documentation, see my Common Sense Manifesto.[1] Descriptions of a few of the outrageous Republican actions follow.

An initial break with standards of acceptable conduct came with the Nixon administration. Although this appears to have been largely forgotten, President Nixon, primarily through his henchman, Vice President Agnew, launched a campaign against the press. Nixon had long been known for his attacks on reporting that failed to support his actions, but his attacks became more strident, and more telling, when he weaponized his vice president.  Effectively blunting accurate reporting, Republicans began a mantra of “the liberal media.” So successful was this theme, that ever since, the term “liberal media” in public discourse¾untrue though it was¾became commonplace; much like “damnyankee” once was in the south. The culmination of decades of repetition was the even more powerful attack on accurate reporting by Trump, who popularized the term “fake news” to describe any coverage that failed to praise him adequately. Trump regularly blasted the news media as¾note the rhetoric borrowed from totalitarian tyrants¾“enemies of the people.” Both Nixon and Trump, one should remember, were haters, and both maintained “enemies lists.” Only the more simple-minded Trump, though, appeared to be in awe of totalitarians, and of totalitarianism itself. Nixon was too intelligent, and—although this is not a word that springs to mind when thinking of “Tricky Dick”—had too much decency compared to Trump, to be similarly taken in by foreign dictators.

The first known political maneuver in modern American politics suggesting that even overt treason might not be a deterrent foreshadowed ominously the direction the Republican Party might take in years to come. Candidate Nixon’s henchmen at his direction sabotaged the 1968 Paris peace talks in a deliberate effort to prolong the war in Vietnam. The purpose was to avoid an “October surprise” of peace that might swing voter support to Democrats, and their candidate, the sitting vice president, Hubert Humphrey. This was known earlier, but not finally verified, until 2016,[2] and was a clear indication that at least some powerful Republicans were willing to continue bloodshed and death in order to advance their own political fortunes.

There is considerable evidence that the Reagan campaign did something similar during the 1980 race for the presidency, when his henchmen dealt with Iranian officials, promising them arms and the like, if they would not release the American hostages during the campaign. Reagan and his campaign feared release would boost President Carter’s chances of being re-elected. The hostages were indeed held longer, and were not freed until the very instant of Reagan’s inauguration. The “Iran-Contra Scandal” included this, as well as other actions that also were virtually treasonous. To be sure, the deal to delay the hostage release has not been completely verified. Republicans saw to that by blocking funding for the investigation. There is full verification, though, that the Reagan administration did supply arms to Iranian terrorists who then did turn those arms against Americans. Reagan’s successor, George H. W. Bush (who had been Reagan’s vice president), subsequently pardoned Iran-Contra figures, making it impossible ever to secure their testimony.

During the administration of the younger Bush, the office of Vice President Cheney, leaked the name of Valerie Plame Wilson, an undercover CIA agent working in the Middle East, to conservative columnist, Robert Novak. This put her at risk, although she made it home safely. Her vital work on nuclear proliferation, however, was destroyed, her contacts disappeared (almost assuredly, executed), and her career was ended. This destruction of American interests, and its overt betrayal of America’s friends, took place because of outrage at her husband, Ambassador Joseph Wilson, who had demonstrated that Saddam Hussein had not secured nuclear materials from Africa, as the Bush administration had charged. It now has been verified that the G.W. Bush administration, and that of the Bush ally, British prime minister Tony Blair, presented false information to justify the Iraq War. Even worse, both administrations knew that they were committing their countries to war based on lies.[3] The resulting legacy has been tragic.

Uniquely among American presidents, Donald Trump always had refused to commit himself to abiding by election results. Even in the 2016 election, he said clearly that he would accept the results¾if he were to win. Even winning, he openly resented the greater number of popular votes that went to his opponent, Hillary Clinton. He considered an election to be fair and valid only if he won, but even that was not sufficient; he judged an election to be valid not merely if he won, but only if he were to have won by a huge majority.

There were legitimate concerns in 2020, that Trump would refuse to accept any other result. Of course, a losing candidate is not required to concede a loss, and the winning candidate wins, despite what the losing candidate says, or does. Trump, though, set about attempting to undermine public confidence in elections, which meant confidence in the entire process of political selection. That was profoundly undemocratic, profoundly subversive, and profoundly threatening to the continued existence of the United States as a democratic republic.

While still holding office, the “lame duck” president (one whose term had not yet ended, despite having lost in his efforts to achieve re-election), frantically sought to reverse the results of clear and fair elections. Trump and his henchmen brought numerous lawsuits attempting to use the legal system to achieve what he failed to do electorally: win the election. Time and again, these baseless lawsuits failed. Trump called repeatedly for violence, alleging that real Americans needed to “stop the steal.” Finally, Twitter and other social media banned him because of his flagrant lies, thus effectively shutting off the only way he knew how to communicate widely. Nor did he cease when he left office. As of late September, 2021, when this was being written, he still, nearly a year after the election was settled, continued to pressure some state election officials to reverse their certification of his loss. He seemed to harbor the deluded notion that he still might somehow be reinstated; an impossibility under the Constitution.

Ultimately, while he still had his platform, Trump urged his supporters¾fanatically committed, yet decidedly in the minority¾to march on the Capitol in Washington and “fight like hell,” to intimidate members of Congress and prevent them from counting the electoral votes, a process that had been set for January 6th. Thousands did so. They stormed the Capitol, threatening members, fighting with Capitol Police, and retreating only when the District of Columbia Metropolitan Police joined the battle with the threat of troops from National Guard Units. For the first time since the Civil War, America witnessed a violent insurrection, explicitly designed to reject the votes of the majority¾and even the electoral college¾and install the loser. That the coup failed does not minimize its threat to the country’s foundations. No democratic republic can survive as such if enough of its people seek to undermine it, and Trump did everything possible to undermine the very system that had installed him, a system that even ignored the majority’s vote, and installed him as a minority-vote president.

Right-wing extremists attempted another potentially violent demonstration on 18 September in Washington, D.C., but the effort failed, and was even anti-climactic; so few came that they were outnumbered by law enforcement officials.  The purpose of the demonstration was ostensibly to demonstrate support for the “patriots” who had been indicted for participating in the coup attempt in January. Trump, of course, expressed his support for the “political prisoners”—demonstrating how little he cares for the foundations of the United States as a democratic republic.

This was another in a long succession of Republican failures. It would seem as though Republicans might have to expect failure has a matter of course. Consider that Trump lost his re-election bid, and that the popular vote against him was enormous. Democrats retained control of the House, and gained control of the Senate. Consider also, the tragic record of Covid deaths when Trump was in office and his disclaimer of any responsibility for national health policy. At the state level, the same dynamics play out causing the huge death tolls in Florida, Texas, and other states where there are Republican governors and legislatures.  As a rule, there will be stubborn, ignorant, and vicious refusals to mandate protections against viral spread.

In 2021 alone, not only did the January insurrection and its September sequel fail, but so did the Republican effort to recall California’s governor, Gavin Newsom. There was a massive vote in the election on September 14 to retain Newsom as governor. In Arizona, there was a group of Republican state senators that forced a new “audit” of the 2020 vote in the state’s large Maricopa County. The effort was a fiasco, leading one of the Republican senators who had supported it to express his regrets, saying it made them look like idiots. Indeed.

Nevertheless, Republicans around the country thought the Arizonans had a good idea. In several other states, they announced plans to conducts their own “audits” of their states’ votes in 2020. In Pennsylvania, Republican state senators demanded complete information of all voters, including partial Social Security numbers. The state’s attorney general said “no.” In Texas, hours after Trump sent a letter to Governor Abbott demanding that Texas conduct its own audit of Democratic counties, the governor, of course, meekly ordered such “audits.” This, even though Trump had carried Texas, and could have gained absolutely nothing from such an effort.

The Arizona “auditors” had taken seriously the preposterous suspicion that Arizona ballots had been routed to, or corrupted by ballots from—of all places—China. Betraying their racism, they examined the ballots for “bamboo fibers,” assuming that anything from China had to contain bamboo, and apparently assuming that bamboo existed only in China. They found none.

They did, however, for some strange reason, take ballots out of the state, reportedly hiding them in an isolated location, hundreds of miles distant, in Montana. Regardless, after months of delay, on the 24th of September, they issued their final report.

Contrary to Republican beliefs, the voting machines had performed as intended. Moreover, their own report indicated that Trump did, indeed, lose legitimately. It said even that Trump’s loss, in fact, was somewhat greater than the official count had shown.

In the serious insurrection attempt on the 6th of January, not only had the Trump-inspired seditionists sought Democratic Speaker Pelosi to assassinate, but they had set up a gallows on the Capitol lawn, and chanted their desire to find and hang even Republican Vice President Pence. His offense was that he had not followed Trump’s demand to steal electoral votes and thus overturn the recent election. Happily, their thirst for vengeance remained unslaked.

Immediately after the riot, even Republicans, still frightened and in shock, condemned the insurrection. A number even blamed Trump, himself, for his obvious instigating role¾remember his shouted urging of the mob to march on the Capitol and “fight like hell.” Within a few days, though, most Republicans denied that they had ever been in danger, that anyone else had, and that there had even been an insurrection. This after the entire world had seen the violent assault on the Capitol and its police guard. Rather, there had been merely a “peaceful tourist” assembly in the (vandalized) Capitol building, some said absurdly.

These acts of malfeasance and many other Republican actions of the last few decades, would have been sufficient throughout American history to bring down administrations, and to destroy political careers. So degraded has the party become, however, and so outrageous were Trump’s actions, that no revelation, and no verification, seems sufficient any longer to shame Republicans. They readily deny painfully obvious facts, or even to recognize them, but to say, “so what”?

The Trumpist Republican Party now has thrown all pretense of “conservatism” aside, along with any attempt to be consistent. Actions a Democrat does, however benign, they will condemn; the same action, or even a violent and treasonous one, by a Republican¾especially Trump¾they will applaud. The frenzied, out of control, insurrection had put all members of Congress in danger, even Republicans. Still, though, they closed their eyes (and minds) to reality.

The Party, as indicated, no longer even pretends to devote itself to conservatism. An examination of Republican policies demonstrates that the party now operates in pursuit of a few basic principles, most of which simply are cynical efforts to please their “base;” some examples are:

The GOP opposes all measures to regulate or reduce the proliferation of firearms. When a mass murder takes place, as one does frequently, they are likely to say, “now is not the time to politicize the issue.” Instead of policy, they rely on “thoughts and prayers” for the victims. They were never content to rely on “thoughts and prayers” to keep out of the country those they opposed; rather they sought a huge, expensive, and futile wall.

The party seeks to eliminate all abortion. Republicans often are equally hostile to contraception. Thus, despite professing to favor limited government, and “freedom,” they would empower government to take full control of all women, or girls of childbearing age. Ultimately, this presupposes required regular medical exams to ascertain whether or not they are pregnant. Republicans ignore the fact that a government has to be powerful to forbid abortion, and that a government sufficiently powerful to forbid abortion will also be powerful enough to require it, or if they so choose, to require pregnancies. The result of an effective prohibition of abortion is the enslavement of women, subjecting them to government dictates regarding their own bodies. Quite clearly, the motivating factor is misogyny. The Texas approach that other authoritarian states are admiring is to empower citizens to spy on one another, and to reward them if they follow the demands of the state. A police state is just around the corner, if the anti-abortion fundamentalists continue to have their way.

The party elevates a warped version of “religious freedom,” to overwhelm personal privacy. It seeks to ensure “religious freedom” for corporations to regulate the conduct of their employees. All this presupposes that the religion in question is one that possesses official approval. The party actually has two components: one that consists of Christian fundamental evangelicals, and the other that is relatively secular. The former openly seeks a theocracy that is rigidly authoritarian¾even totalitarian. The latter would be content with a secular dictatorship that maintains them in power, but it cooperates gleefully with the religious fanatics. The two groups use one another for the purpose of securing and maintaining power. The characteristics of the resulting government otherwise are of less concern to them.

Republicans seek to have a minimum of immigration, and no influx of refugees.

They favor opinion over fact, and deny the role of scientific findings in public policy, even in the face of mass death from a pandemic.

There is little indication that the party actually cares about the substance of these issues. Republican leaders seek solely to secure and maintain the support of their hard core voters. What gets serious and sincere Republican attention, is an effort to subvert majority will. Republicans generally recognize that their actual policies have no broad public appeal. Instead of pursuing support, however, they seek to diminish, or even to eliminate, votes that would turn them out of office. At the same time, they attempt to hide their real intentions. As they make it more and more difficult to vote, they lie in state after state that they are making it easier to vote, merely making it harder to commit fraud (which they know is virtually nonexistent in modern America).

Republicans go to extreme efforts to draw district boundaries so that they maintain power, regardless of their minority status. They also make voting as difficult as possible in areas in which they have less than majority support. These usually are districts with voters who reflect the interests of people of color. This has led to the greatest suppression of votes since post Reconstruction days when Jim Crow policies became solidified.

Worst of all, Republicans have succeeded in controlling governments in numerous states. There, they are adopting measures designed to empower them to overturn the results of elections when they dislike the outcomes. They are avidly developing mechanisms to permit them to disregard and overrule the will of the voters. At the same time, they charge “liberals” with being “elitists.” The clear Republican intent here is to make it impossible for them to lose elections, regardless of how large Democratic majorities may be. In other words, they are openly plotting to end even the possibility of rule by the people.

This, then, is the relationship between Trump and the Republican Party. The Party reflects his will, and supports his whims. Regardless, it is not the case that he corrupted the Party. Rather, the corruption was endemic, and of long duration; it prepared the party for one such as Trump. Sadly for the country, and the world, such a person was available, and eager to fill the pernicious role that the Republican Party had been crafting for him.

No one can say with certainty what ultimately will happen. One thing, though, is certain. Things as they currently exist cannot continue. No democratic republic based on a two-party system can long survive if one of its major parties refuses to honor and abide by accepted principles of restraint, popular government, and peaceful changes of political power. The current court system has been systematically corrupted by stolen seats, and decades of ideological appointments by right-wing Republicans. The Senate retains its archaic rules that permit the minority to thwart majority rule.

Thus, there are two major reforms needed urgently. The Senate must change its procedures, including elimination of the filibuster, which empowers and encourages a minority to thwart the will of the majority. Also, the Supreme Court must be expanded by four seats, to enable it to counteract rulings protecting the extreme right.

Examples of such rulings are those protecting virtually unlimited financing of politics by the wealthy; those that sacrifice public health and create physical dangers by giving preference to a narrow and extreme version of “religious liberty”; yet others that permit states virtually to outlaw abortion, thus reducing women to the status of slaves, in what would seem to be a clear violation of the Thirteenth Amendment.  Ultimately, the worst of the rulings suggests that the Court accepts Republican measures to make it impossible for them to lose elections, regardless of what the majority of the voting population desires.

Finally, if the Republican Party does not truly cast off its current extremism and accept restraints on its conduct, it must fade from importance¾even existence¾and be replaced by another party that will conduct itself within democratic norms. As things stand, unless it reforms itself dramatically, either the Republican Party will vanish, or the United States as a democratic republic will do so.


[1] The Common Sense Manifesto (With a Nod to Thomas Paine, Not Karl Marx), Washington: Westphalia Press, 2020.

[2] See John A. Farrell, Richard Nixon: The Life,New York: Doubleday, 2017, quoted in Skidmore, Common Sense Manifesto, pp. 4-7.

[3] See Marcia and Thomas Mitchell, The Spy Who Tried to Stop a War, Sausalito, CA: PoliPoint Press, 2008; see also Skidmore, Common Sense Manifesto, p.25.

“Means testing” Is Originally a Racist Idea: Senators Manchin & Sinema May Not Know That

By

Dave Kingsley

“Means Testing” is a unique U.S. Idea

Like the uniquely barbaric U.S. slavery system and its Jim Crow aftermath, means tested medical care is a unique and racist idea designed to keep African Americans from accessing government funded medical care. President Johnson could not move Medicare through congress without support of segregationist Southern Democrats in the Senate and House. Their concern was that Medicare alone would be expanded to cover younger ages over time and transformed into a universal, single payer.

By forcing Johnson to add means tested, poor peoples medicine, administered by states, former slave states with a residual planter economy and subhuman wages for black workers, could make qualification for eligibility so onerous that African Americans could be kept in subhuman conditions without medical care. State control and the right to opt into the program allowed for arbitrary, racist, administration of the program. Bureaucrats could put obstacles in the path of applicants who would be required to prove they were poor enough and of high enough character to qualify for medical care.

That is the way it works to this very day – especially in states with large African American populations. To qualify for Medicaid in many states, poor people are required to prove they are so poor that even most low wage workers cannot qualify. Due to a glitch in Obamacare (actually due to a Supreme Court decision), people not poor enough to qualify for Medicaid are often too poor to qualify for Obamacare.

As opposed to our enlightened peer countries with advanced economic systems, medical care is not a right in the U.S. Given the horrific medical ethics that implies, one would think that the medical profession would be up in arms and fighting with vigor and intensity to move the U.S. medical system into the 21st Century. But it was the medical profession that originally teamed up with Southern Democrats to kill Harry Truman’s universal, single payer health care system. Overall, the professional medical system hasn’t changed much in that regard.

Conservatives – both Republican and Democrat conservatives – insist on making people prove they are too poor to buy medical care. Rather than provide medical care to people for no other reason than they need medical care, sick people or people who fear that they will not have care if they are sick are put through humiliating rituals and are constantly under threat of being kicked off the program. The subtext of the conservative narrative in that regard is that ordinary, wage earning, taxpaying citizens can’t be trusted – that they want something for nothing from the government or that they are lazy cheats. This stigmatization of poor people for medical purposes doesn’t apply to wealthy executives and investors who really are ripping off the system (see my last post).

I wish media outlets such as MSNBC and CNN would quit referring to Democrats insisting on means testing as “moderates.” The indignities of poor peoples medicine as a special category of care is an extremely conservative, backward, idea that has the foul odor of history.

Liberals & Democrats Need to Change the Conversation: Too Much of Our Federal Medical Care Funding is Flowing to the Wealthy

By:

Dave Kingsley

Rogue Corporations Scamming the System

You may have never heard of Centene Corporation. But we need to talk about this company which derives most of its revenue from Medicaid – medical care for the poor. With revenue of $111 billion in 2020, it is 24th on the Fortune 500 ranking of corporations (by size of revenues). CEO Michael Neidorff earned $25 million last year – among the five or six highest paid executives in corporate America. Not bad for “welfare medicine.”

Compensation for the top four Centene executives and the board of directors totaled $64 million in 2020. The board includes former congressmen Tommy Thompson (also former head of HHS) and Richard Gephardt. Two very powerful former members of congress.

So, what exactly does this company do for Medicaid? It is known as a “managed care organization” or MCO. The idea underlying the MCO concept is that private, for-profit corporations can do a better and more economical job of managing government funded medical care than government employees. Evidence overwhelmingly points in the other direction but the myth nevertheless persists.

Humana, Cigna, and other corporations have jumped into the MCO business. Let’s face it, the $600 billion+ Medicaid budget has opened opportunities for corporations to rake off untold billions for wealthy investors, executives, and board members, while poor people in states that have expanded Medicaid are humiliated through character tests such as proof they aren’t taking drugs, or too lazy to look for a job. Poor people in Arkansas for instance are facing administrative road blocks and state bureaucracies that see their role as keeping people from receiving benefits.

I’m certain that wealthy executives and investors are enjoying their concierge medicine while poor people can’t get treatment for an abscessed tooth, screening for cancer, diabetes, or medical care that most of us take for granted. This is what the Democrats and liberals need to be screaming about – not means testing and making people prove they are worthy of medicine taken for granted by every citizen in most affluent countries. No doubt, progressives in the U.S. House of Representatives are doing just that. However, silence on this issue from most senators and congresspersons on the Democratic side of aisle is deafening. Forget the now cruel Republican Party. There is no hope there.

This is Not the Democratic Party’s Finest Hour

By:

Dave Kingsley

Democrats Have Both House of Congress & A President’s Proposed Budget We Badly Need: And They Are Blowing It!

Last night I heard an interview with Texas Congressman Henry Cuellar – a Democrat – in which he said that he’s insisting on “means testing” for eligibility in President Biden’s proposed medical care and other programs benefitting ordinary Americans. I’ve heard Senators Manchin and Sinema say the same thing. In other words, people needing child care, medical care, and home based care must prove they are worthy of receiving government assistance to see a doctor, have a place for their child while they work, or need assistance to stay in their home and out of a nursing home.

If past is prologue, this means that American citizens in many states badly needing these humane programs must suffer the humiliation of proving that they are not taking drugs, looking for work if they are unemployed, and too poor to buy these services on their own. This is an anti-worker, anti-people attitude that Democrats need to lose.

As someone who spends a lot of my waking hours researching finances of corporations benefitting from privatized, taxpayer funded, medical programs, I can say with certainty that corporate executives and investors are becoming fabulously wealthy by diverting an excessive amount of Medicare and Medicaid revenue into family and individual trusts for the purpose of avoiding taxes. They undergo no universal character test and yet fraud committed by low and middle income people pales in comparison to what clever CPAs are able scam out of the system on behalf of their high net worth clients.

It is interesting that so many Democrats think that spending a piddly few trillion on its non-rich citizens is excessive in a nation with a $25 trillion economy and a federal budget providing trillions in tax benefits to its wealthiest citizens. In a government funded, privatized health care system, corporations and wealthy investors and their families are able to capture trillions they don’t deserve through dark money and an ability to fund political campaigns.

If conservative Democrats think that catering to the wealthy and demeaning the wage/salary workers of this country is a formula for success, they are delusional. Furthermore, they are weakening a president with a program crucial for staving off crises the likes of which we can’t imagine. This country, this economy, this planet cannot sustain the perverse, toxic, corrupt form of economics and politics exhibited by medical care, agriculture, finance, real estate, energy, and other industrial sectors – it is not capitalism, rather it is a corrupt, debauched economic system in which government and businesses collude at the expense of the public.