Memoirs of the Addams Administration 25.

There have been four special Congressional elections since the general election of November 2016 put Donald Trump into the White House.  Democrats have fought hard to win these newly-opened seats, casting the votes as a referendum on the reality show of a Trump presidency.  To the alarm of Democrats, Republicans have won all four.[1]  In Georgia’s Sixth District the Democrats appeared to have a reasonable shot.[2]  Although the district had long given the Republican candidate 20-plus percent majorities, Trump had beaten Hillary Clinton there by only 1.5 percent and the Democratic candidate, Jon Ossoff, had almost reached the 50 percent mark in an April 2017 election amidst a crowded Democratic field.  In the run-off election between Ossoff and Republican Karen Handel, the Democrat claimed to be a centrist, while Handel portrayed herself as a mainstream Republican (rather than as a Trumpite).  Immense amounts of money ($55 million) from both sides passed through the campaigns and into the hands of local television stations and Washington consultants.  In the end, Handel triumphed by 52 to 48 percent of the vote.  That is, she did better than had Donald Trump.  Conservatives have commented that Ossoff’s “centrism” was bogus: he supports all the standard Democratic orthodoxies that have sent Southern Democrats streaming into the Republican party for decades: gun control, secular sharia, abortion-on-demand, and extensive regulation of the economy.[3]

According to Democrats, Donald Trump is in deep trouble with the law.  They point to the retention of private lawyers by Mike Pence, Jeff Sessions, and Jared Kushner as proof that the allegations of collusion made by Democrats “could be a big deal.”  However, Trump “believes that he’s the victim of a Democratic conspiracy to oust him from the White House.[4]  OK, now it’s out in the open.  Thing is, he’s probably correct.  When Green Party candidate Jill Stein challenged the vote count in a number of critical states, alleging un-specified “irregularities” and “Russian interference” with the vote count, money from aggrieved Clinton supporters poured in.  Trump foolishly[5] challenged the reports of the intelligence services on Russian hacking.  They responded with sun-burned “amour propre” by leaking secret information to embarrass the president.[6]  So far, there exists no actual evidence of collusion between the Trump campaign and the Russians.  Not even “circumstantial evidence.”  If there was no collusion, then it will be a stretch for prosecutors to prove that Trump “obstructed justice” rather than just tried to get James Comey to act the way a decent human being outside the Beltway might do.  Most of the quoted criticism comes from the New York Times, the New Yorker, and New York Magazine.  Partly, this reflects the collapse of print journalism in the rest of the United States.  Fewer points of view are represented.  Partly, it reflects the bifurcation of the United States into bi-coastal Democratic islands and “heartland” Republicans.  All the same, for a long time lots of Republicans believed that President Richard Nixon could not have broken the law.[7]  We live in an ugly political season.

[1] This includes a Montana race where the Republican won despite (because of?) body-slamming a reporter.

[2] “GOP holds seat in high-stakes Georgia election,” The Week, 30 June 2017, p. 5.

[3] As many scholars have demonstrated, race wasn’t the issue that caused Democratic decline in the South.

[4] “Trump goes on attack against special counsel,” The Week, 30 June 2017, p. 4.

[5] Being a fool is no legal bar to running in or winning a presidential election.  Look at Ted Kennedy or Jimmy Carter or George W. Bush or Mitt Romney.

[6] Good luck with that.  Embarrassing the president I mean.  Still, it is difficult to understand the American intelligence community’s leaks of information about the Manchester, Britain, bombing while President Trump was en route to meet with Prime Minister Theresa May as anything other than a jab at the president.

[7] That is, I may yet have to eat this line of reasoning.

To Europe by land and sea.

Lots of people in Sub-Saharan Africa want to go to Europe.  As of late June 2017, 72,000 immigrants have completed the journey this year.  For the most part, they are fleeing poverty above all else.  Population growth dramatically exceeds economic growth in these countries.[1]  The poverty is particularly serious in rural areas.  “We have no machinery to cultivate the land [and] no rain,” one person told a New York Times reporter.[2]  However, “fleeing poverty” has a larger meaning here.  In the absence of any social security system or local pathway to an adequate income, sons are expected to support their parents.  Often this means leaving home in search of work elsewhere.  Many are pulled to the capital city of Dakar, where there is more opportunity and lower poverty levels.  Other go to Gabon or Congo to work in mines.

Best of all is to reach Europe.  Sons who have made it to Europe and found work send home part of their earnings.  Even a share of the meager earnings of those working in Europe pay for “luxuries” in West Africa: concrete block houses instead of mud huts; iPhones and satellite dishes (and the electricity to power them); sometimes a car instead of a bicycle.[3]  Parents or spouses often encourage men with small future prospects to migrate in search of work.

For those living in West Africa, the route generally takes them east along Route 5 of the Trans-Africa Highway system.[4]  That route passes from Dakar (Senegal) through Bamako (Mali), Ouagadougou (Burkina Faso), Niamey (Niger), and Kano (Nigeria), to N’Djamene (Chad).  In its longest extent, this is a journey of about 2,700 miles.  That’s like driving from Philadelphia, Pennsylvania to Reno, Nevada.  Without the Rockies, but also without much in the way of paved roads.  From there they join Highway 3 as it runs north across the Sahara to Tripoli (Libya).  From Tripoli and other Libyan ports, they “take ship” for Italy.

Almost every leg of the journey is dangerous.  Human traffickers organize much of the migration in order to prey upon the migrants.  Travelers can find themselves extorted for further payments or abandoned en route.  Africa’s transportation infrastructure is in poor condition.  It’s one thing if you’re a rich Westerner (but I repeat myself).  Airlines connect European capitals with important cities endowed with comfortable hotels.  For ordinary people, travel is more difficult.  Some roads are unpaved dirt tracks.  Many paved roads haven’t been maintained for a long time.  The few railroads mostly haul freight, with infrequent or no passenger service.  There aren’t enough vehicles of any kind, so overloading is common-place.  So are vehicle break-downs.  The vast distances pose another challenge.

The sea passage is worst of all.  Most of the deaths come in the crossing from Libya to Italy.  Vessels starting the sea-crossing are over-loaded, under-powered, and badly crewed/captained.  In the first half of 2017, an estimated 2,100 migrants have drowned in ship-wrecks on the Mediterranean.  In April 2015, one terrible disaster killed more than 800 migrants.

Yet people—those who go and those who urge them to go—rarely understand the dangers involved.  “We only heard success stories” said the mother of two sons drowned at sea.  Death lists are sometimes published in Europe, then reported by those who made it to relatives at home.  Yet still the migrants come.

[1] According to the World Bank, almost half (47 percent) of Senegalese live in poverty.

[2] Dionne Searcy and Jaime Yaya Barry, “Leaving Home, One by One, Along “Deadliest Route” to Europe,” NYT, 23 June 2017.

[3] But not more farmland or tractors?  Well, perhaps.  Some of the emigrants sell their land to raise the money for the trip.  So, someone is buying.

[4] See: https://en.wikipedia.org/wiki/Trans-African_Highway_network

Medicaid 2.

The Republicans are willing to try to address the “entitlement tidal wave” headed toward the economy.[1]  Naturally, their first effort targets the low-hanging fruit of the poorest Americans.  Who don’t usually vote Republican.

Their first target is Medicaid.  Medicaid works as a partnership between the federal government and state governments.  Medicaid pays whatever bills are presented by care-providers.  The Republican American Health Care Act (AHCA), the intended successor to the Affordable Care Act (ACA) intends to cut the federal contribution to Medicaid.  Non-partisan experts agree that the intent of the plan is to cut federal spending on Medicaid over the long term.  States would not, in all likelihood, make up most of the cuts to federal spending by increasing state spending and—to pay for it—state taxation.

Critics of the current operation of Medicaid point out that a willingness to pay any bill that is submitted just entrenches an inefficient current system.

The much admired Congressional Budget Office (CBO) estimates that the Republican plan would cut Medicaid spending by $80 billion a year for a decade.

To return to a previous post, those with disabilities, poor mothers, and about two-thirds of those in nursing homes have their costs paid by Medicaid.  This was Medicaid before the ACA expansion of coverage.  That expansion of coverage added many poorer Americans beyond these core categories.

Reportedly, the Republican bill (AHCA) will cap payments to each person covered by Medicaid, with a controlled rise in payments over time.  However, there is no guarantee that states will make up the difference if health care costs rise faster than the Republican projection.

Critics point out that necessary medical spending varies over the years, rather than sticking to the Republican projection.  If Zika reaches the United States (never mind Ebola), then spending could spike well above the projections.

At the center of the dispute is the question of who will pay if Medicaid spending is capped or reduced.  Will spending caps force doctors to cut their rates?[2]  That is the Republican bet, just as they blame rising college costs on the growth of financial aid.  Or will spending caps lead doctors and hospitals and insurance companies to dump their least profitable patients?  One factor missed in this crude debate is that the first to be cut will be the able-bodied workers added to the Medicaid rolls by the ACA.   If that happens it may never come to cutting nursing home funding.

Again, the press provides too little information to evaluate the program on its merits.  It seems absurd that the United States is the only advanced industrial country that allows the greed of doctors to dictate medical costs.  That seems to me a “social wrong.”  It seems absurd that ne’er-do-wells should send in their medical bills to the tax-payers.  Again, a “social wrong.”  On the other hand, it seems absurd that the United States is the only advanced industrial country without universal health care.  Such access seems to me a “social right.”

To think about these issues is to confront a basic question.  What role should the state play in providing medical care to the poorest Americans?  What role should be assigned to self-reliance?

[1] Margot Sanger-Katz, “How G.O.P. Health Plan Is Really a Rollback of Medicaid,” NYT, 22 June 2017.

[2] Apparently, American doctors make 50 percent more than their comparably-skilled Western European or Japanese confreres.  Did I ever tell you about my son’s urologist whose computer screen background was a picture of a 40 foot sailboat with the text “Sail the boat”?

Medicaid.

In 1965, fresh off a Democratic thrashing of the Republicans in the 1964 elections, President Lyndon B. Johnson had the means to push through his effort to “complete” the New Deal.[1]  This included legislation to provide government-funded medical care to four groups of the “deserving poor”: children, pregnant mothers, the disabled, and geezers who needed long-term care.  So it went from 1965 to 2014, as the one-time “war on poverty” failed to end poverty in a growing population.  By 2014, 57 million Americans were covered.  Still, at that point, one in seven Americans (14.3 percent) had no health insurance.  Then the Affordable Care Act (ACA) of 2010 kicked in, “allowing” states to use Medicaid to pay for the expenses of all able-bodied adults who earned less than 138 percent of the government’s poverty level.  This added 17 million people (about 30 percent of the 2014 total) to the Medicaid rolls. By 2016 the share of Americans without medical insurance had fallen to one in twelve (8.6 percent).  However, the cost of those covered by Medicaid ran to $574 billion a year.[2]

As part of the “repeal and replace” ACA effort, House Republican proposed to reverse the ACA’s expansion of Medicaid by 2020.  That is, they sought to return Medicaid to its original mission.  This would involve dropping 14 million people—those able-bodied people added by the expanded Medicaid of the ACA.  There also is talk of imposing a work requirement on able-bodied recipients of Medicaid.

Another part of the plan is tax cuts.  The ACA imposed $875 billion in new taxes, mostly on high income earners.  The Republicans want to roll back those tax increases.

Another part of the Republican plan would reduce the future growth in Medicaid spending by $834 billion over ten years.  The federal government would provide states with fixed amounts of money, rather than just paying whatever bills come in.  This proposal tries to address an important demographic and financial problem.  Medicaid pays for home health aides and for nursing home care for those who have exhausted their own savings.  A recent report by the World Economic Forum pointed out that the United States has the biggest gap between actual retirement savings and projected needed savings.[3]  U.S. government projections suggest that 70 percent of people will need long-term care.  The vast majority of these will need a home health-care aide, while 18 percent will need nursing home care.  Given the retirement savings gap, a huge financial cost will fall on the Medicaid system.  The Republican plan tries to address that issue.  It may not do that well, but one is surprised to see it done at all.

It is possible to see two distinct moral perspectives in the struggle over Medicaid.  Medicaid is but one front in a fight that involves Medicare, Social Security, defense, education, and taxes.  Broadly, they all touch on different conceptions of social reform and the best society.

Democrats would argue that the national government has a moral duty to its citizens.  It must break down the barriers to individual success.  Where those barriers can’t or can’t yet be destroyed, then the winners from current systems need to compensate the losers.

Republican would argue that such government action corrodes individual responsibility and creates dependency.  It harms the very people it seeks to help.  Government has a moral duty to create the conditions for individual success by fostering a dynamic economy.

It’s wishy-washy to say so, but both could be true.

[1] Julian Zelizer, The Fierce Urgency of Now: Lyndon Johnson, Congress, and the Battle for the Great Society (2015).  Really good book.

[2] “The battle over Medicaid,” The Week, 23 June 2017, p. 11.

[3] See: https://waroftheworldblog.com/2017/06/20/memoirs-of-the-addams-administration-24/

Memoirs of the Addams Administration 24.

Republicans struggled forward with the effort to make the Obama administration go away.  In 2010, the Democrats passed the so-called Dodd-Frank Act.  That legislation led to the imposition of about 28,000 new regulations on banks and credit unions, greatly increasing compliance costs.  As a result, many small institutions have been absorbed into larger institutions with deeper pockets.  The Dodd-Frank Bill created an Orderly Liquidation Authority for banks that do fail.  It created a Consumer Financial Protection Bureau.[1]  All of these were wildly unpopular with Republicans.  House Republicans passed the Financial Choice Act.   It exempts banks from many of the Dodd-Frank restriction in return for a requirement that they maintain large cash reserves.  The bill now goes to the Senate.  There it is likely to be subjected to a substantial re-write.[2]  Meanwhile, Republican senators have been trying to create a less-horrible version of the American Health Care Act (ACHA) previously passed by Republican representatives.[3]  The Senate plan postpones cuts to Medicaid for seven years[4] and maintains—at a lower level—the subsidies to low-income earners.[5]

Elsewhere, the World Economic Forum[6] (the folks who bring you Davos) reported that many Western countries—but the United States most of all—are suffering from a huge gap between the savings needed for retirement and actual savings for retirement.[7]  The American gap amounted to $28 trillion in 2015 and is projected to reach $137 trillion in 2050.  Cat food-salad sandwiches and living in an ElderCommune being unlikely to appeal as the “golden years,” one might anticipate a fight among Baby Boomers as the lower 80 percent seek to draw on the savings of the upper 20 percent.[8]

All of these were important developments for good or ill.  However, Americans seem to have focused more tightly on the controversies surrounding President Donald Trump.  To begin with, former FBI director James Comey told the Senate Intelligence Committee (which has been investigating possible collusion between the Russians and the Trump campaign) that the president made him uncomfortable in several private conversations, that he had made detailed notes of these conversations, and that he had arranged for these notes to be leaked to the press after his dismissal in hopes to triggering the appointment of a special prosecutor to investigate the man who had fired him.  Next came Attorney General Jeff Sessions and his porous memory.  Sessions told generally hostile former colleagues that he fired Comey for reasons unrelated to the FBI’s investigation of the “collusion” investigation.[9]   To round-out the week in suitable fashion, New York City’s “Shakespeare in the Park” series ran a version of “Julius Caesar” with a Trump look-alike in the title role.  Back in 2013 a square-state theater company used “Caesar” to imagine Barack Obama slain by right-wingers.  Now a right-winger is portrayed as meeting his death at the hands of women and minorities.[10]

[1] Just for fun, let’s imagine a Consumer Information Protection Bureau with its own “fiduciary  rule” requiring newspapers and other print media and television networks to “act in the best interests of their clients.”

[2] “Issue of the week: Dodd-Frank under fire,” The Week, 23 June 2017, p. 34.

[3] “Trumpcare: The GOPs secret plan,” The Week, 23 June 2017, p. 17.

[4] Actually, this is pretty clever.  Seven years from 2017 would be 2024.  Given the way that the parties alternate in the White House, a Democrat would be walking in the front door just as the Medicaid cuts took effect.

[5] One federal court has held that those subsidies are illegal because the original Affordable Care Act (ACA) made no provision for appropriating the money to pay for the subsidies.  The Obama administration appealed this decision.  The case has not yet reached the Supreme Court.  When/if it does, that will be the end of all subsidies and the whole system of “mandated” insurance for poor people who don’t have employer-supplied medical insurance will collapse in a heart-beat.   Republicans hope to use this as leverage.  Democrats have been blaming the “uncertainty” caused by the Republican repeal-and-replace effort among insurers for the collapse of the health-care market-places.

[6] See: https://en.wikipedia.org/wiki/World_Economic_Forum

[7] “Retirement: Will Boomers work forever?” The Week, 23 June 2017, p. 32.

[8] See Richard Reeves “America’s hidden class system,” The Week, 23 June 2017, p. 12.

[9] “Comey: did he damage Trump?” The Week, 23 June 2017, p. 6; “Sessions denies collusion as Trump eyes Mueller,” The Week, 23 June 2017, p. 4.

[10] “Julius Caesar: Assassinating Trump on stage,” The Week, 23 June 2017, p. 17.

The Middle Kingdom.

China has emerged from backwardness and isolation with astonishing suddenness.  The death of Mao Zedong, followed by the overthrow of his immediate successors, brought to power Deng Xiaoping.  While opening China to foreign trade, investment, and learning, Deng counseled modesty.  “Hide your brightness, bide your time.”  Now that time has come.  China has begun to exert its power in ways unprecedented in modern times.

The Romans built roads to hold their empire together, then they built a lot of other things to increase its value.  Alarm has begun to spread at a new “One Belt, One Road” enterprise launched by ChiComCo.[1]  The “Belt” is an overland transportation system (roads, railroads, bridges and tunnels) and its attendant support systems (power generation and transmission, a regulated version of the Internet).  The “Road”[2] is the complementary sea-route to Europe, along with all the logistical support (like ports).[3]

Chinese companies can count on the lion’s share of construction contracts.  For example, Chinese construction companies have built “95 deep-water ports, 10 airports, 152 bridges, and 2,080 railroad” segments in countries along the routes of the Belt and Road.  As it is completed, the Belt and Road facilitates Chinese trade.

Recognizing the rising economic power of China, the United States sought to counter this with the “Trans-Pacific Partnership” (TPP) trade treaty.[4]  However, American politics suddenly shifted against an open world economy.  Not only Donald Trump, but Bernie Sanders and then Hillary Clinton declared the TPP a bad deal for Americans.  While the leaders of many countries likely to be touched by China’s great plan attended a “Belt and Road” conference in May 2017, the United States sent only a delegate.  Some of the negative commentary about China’s investments abroad is couched in humanitarian, rather than economic or strategic, terms.  China founded its pursuit of prosperity on seizing land for economic development projects and then shoving huge numbers of people off the land.[5]  (One counter to this is that countries like Pakistan or Cambodia act in similar ways—without greatly improving the economic lives of their citizens.)  The Chinese investment may have a long-term effect of putting the critical infrastructure of developing countries under Chinese control.  Hence, many people see the United States as ceding global leadership to China.[6]

It’s difficult to know what to make of this charge.  On the one hand, George W. Bush in his second term and Barack Obama in both his terms sought to limit American engagement abroad in the interest of strengthening a redoubled country at home.  The Trump Administration’s “America First” rhetoric and policies falls in line with these earlier efforts.  Thus the national impulse seems to be running toward dealing with domestic problems.  It is hard to deny that America has pressing domestic problems that will not be easily resolved.

On the other hand, China’s strengths are many and real.  It would be foolish to think that these will not reshape the global order.  So, where is the sweet spot?

[1] “China’s plan to run the world,” The Week, 16 June 2017, p. 11.

[2] Obviously, the planners hadn’t been reading Cormac McCarthy.  See: https://en.wikipedia.org/wiki/The_Road

[3] For the historical antecedents, see: https://en.wikipedia.org/wiki/Zheng_He

[4] The treaty was highly favorable to Americans.  It created a free trade zone encompassing 40 percent of the world’s trade, while creating safeguards for American interests through labor and environmental standards.

[5] Along the way, China moved  86 percent of its people out of extreme poverty.  Many of them moved into lives of middle-class abundance—and stress.

[6] American announcement that the country would withdraw from the Paris Climate Control agreement is offered as a further example of American abdication.

Donner, party of ten! No, eight.

Western lands appealed to many Americans during the 18th and 19th Centuries.  Mexican Texas, Mexican California, and Oregon exerted a magnetic attraction on malcontents of the Mississippi Valley watershed during the 1830s and 1840s.[1]  Real estate speculators and promoters have been talking up America’s “wonders” since John Smith touted the 17th Century Chesapeake.  In 1845 one of Smith’s successors described—accurately enough—the charms of California: “a paradise” of “perpetual spring” with fertile lands and a healthy climate.  With visions like that dancing before their eyes, it’s not surprising that some of the migrants skimmed over the bits about what lay between the point of departure (Independence, Missouri) and the destination.  For example, migrants were warned to leave Independence by 1 May at the latest and to get a move on.  While California might be a land of “perpetual spring,” things were rather different in the Sierra Nevada mountains, where the snow storms could block the passes.

George and Jacob Donner, and James Reed headed a party of 74 people in 19 wagons.[2]  The Donner Party suffered a minor, but spectacular, disaster.  In mid-April 1846 the pilgrims headed west from Springfield, Illinois; a month later they departed Independence.  Having left late, the party then dawdled along the way, failing to catch up with a larger wagon train.  Starting to feel a certain urgency, they consulted their guidebook.  It mentioned a newly-discovered short-cut.  Great!  Problem solved.  Then they encountered a grizzled old trapper heading east.  He didn’t think much of the supposed short-cut.  What to do?  Ignore his inconvenient opinion.  Great!  Problem solved.

Unfortunately, the short-cut took them through the Wasatch Range and over a long stretch of arid salt flats.  Many of the draft animals died there.  Further slowed by these losses, the party reached the Sierra Nevada well behind the recommended dead-line.  Heading into the mountains, they found themselves snowed-in by November 1846.  They could neither go forward nor go back.  They had too little food to last out the winter.  Eventually, in December 1846, they sent out a couple of messengers to try to bring back help.  The pass was snowbound on both ends, so it was February 1847 before help finally reached them.  Only 48 people survived the winter, and nine of them died while being moved west into California.  Many of those who did live had engaged in cannibalism.[3]

Of the 34 who died in the winter camps, 25 were men and 9 were women.  Why was that?  People who study this sort of stuff figure that age, sex, and the size of the family group played the largest role in deciding who survived.  People under the age of 35 had a better chance of surviving than did older people, although most children under 6 died.  Two thirds of men between 20 and 39 died.  Nutritionists tell us that men metabolize protein faster than women, and women do not require as high a caloric intake. Women store more body fat (although you shouldn’t mention this in conversation if you want your genetic line to continue).  This can delay the physical decline caused by starvation and overwork. Men also tend to do more dangerous and physically demanding work.  Men wore down faster than did women.  Then, bachelor males survived at lower rates than did those who were those traveling with family members.  Maybe families were more ready to share neighbors with family than family with neighbors?

[1] Ray Allen Billington, The Far Western Frontier, 1830-1860 (1956).  Still a hell of a book.

[2] Michael Wallis, The Best Land Under Heaven: The Donner Party in the Age of Manifest Destiny (2017).  Reviewed by David Price, WSJ, 6 June 2017.

[3] Although not in murder.  People who died of natural causes were consumed by the survivors.   For an analogous case, see Nathaniel Philbrick, In the Heart of the Sea: The Tragedy of the Whaleship Essex (2000).