At the Sanders Institute Gathering, we set out to have conversations with some exceptional people that have made studying issues like the climate crisis their life’s work. Sanders Institute founding fellow, author and climate expert Bill McKibben, author and activist Naomi Klein, Executive Director of Presente Matt Nelson, Sanders Institute founding fellow and leading economist Stephanie Kelton, and physician and former Michigan gubernatorial candidate Abdul El-Sayed, spoke in depth about the climate crisis and how it intersects with each and every issue that our progressive movement is fighting for.
Month: February 2019
Healthcare is a right. At the Sanders Institute Gathering, National Nurses United sponsored a panel called “We Can Win Medicare For All” that brought together experts in the Medicare for All movement.
Senator Nina Turner began the panel with a rallying cry – that we must fight for healthcare for all – “because only all that we love is on the line.”
The panel was introduced by Jane Kim, a member of the San Francisco Board of Supervisors.
Kelly Coogan Gehr, Assistant Director of Public Policy and Advocacy for NNU, laid the scene: an overview of the movement for healthcare for all. She also delivered remarks for Jean Ross, Nurse and Co-President of National Nurses United, speaking about the moral aspects of a Medicare for All system and why our strength not only lies with the statistics, and the economic benefits, but also in the moral imperative of healthcare as a human right.
Dr. Diane Archer, President of Just Care USA, explained why Medicare for All is the best and only option – because we cannot encourage a “middle-ground” system that would continue to include private companies that exclude patients that need care to maximize their profits while hiking up costs for everybody else.
Dr. Hosnieh Djafari-Marbini described the reverence for and popularity of the UK’s single payer system but warned of spreading privatization – an import from the American system – that is jeopardizing the popular and quality care that has been provided in the UK for over 70 years.
Jo Beardsmore, co-founder of UK uncut, convinced every person in the room that we must not only fight for healthcare for all, but that we can win!
Finally, Libby Devlin, Southern Director of NNU, showed us that nurses in each and every state in the U.S. and around the country are already leading the charge because they know – and see every day – what is at stake.
The voices of the nurses of our country are important. They care for patients in their greatest time of need. As the healing hands at the bedside, they have been the consistent witnesses to the inequality of our current health care system. They bear witness to the need for systemic change. They believe as we all do that our collective activism is the catalyst for change.
Medicare for All is possible.
It is right.
It is within our reach.
And we must reach for it… because only all that we love is on the line.
Children are not only our most precious possession but also our most fragile. This may not seem correct: we are reminded constantly of the indomitable human spirit, of children rising from great poverty and hardship to the greatest heights of success. Such examples warm our hearts and yet mislead our judgment. Countless children suffer lifetimes of difficulty as the result of early childhood poverty, and millions worldwide die each year because their families are too poor to keep them alive.
Here is a grim statistic: 5.4 million children under the age of five died in 2017, almost all of them in developing countries. Some 5.4 million children, yet without headlines, government inquiries, arrests of public officials, or any other kind of accountability. Indeed, they died with almost no public awareness at all. Hundreds of millions more children scraped by, surviving, but suffering from undernourishment, dangerous pollution, extreme stress, and with absentee parents who left the children behind as they searched for work in the cities or abroad.
The world is rich, yet countless millions of children are poor, including in Ireland and the United States, but especially in the poorest countries. In 2018, the world’s output reached $135 trillion measured at international prices, an average of about $17,500 per person on the planet. That’s enough to enable everybody on the planet to have a decent life, except for the fact that a few at the top end up with an unconscionable amount, and millions at the bottom end up with almost nothing. As Oxfam noted last month, just 26 individuals have a combined wealth of $1.5 trillion, equal to the wealth of the poorest 3.8 billion people on the planet.
Yet the system is rigged for the richest of the rich. My country, the US, and Ireland are part of the rigged system. Think of the free ride that the world’s largest company, Apple, received from both the US and Ireland. For many years, the company paid almost no taxes on its European profits, channelling the profits through an Irish subsidiary. The European Commission charged Ireland with violating state aid by giving Apple a sweetheart tax deal; the Irish Government is defending itself by arguing that the deal was open not just to Apple but to other companies as well. Either way, though, the outcome is the same: the world’s income is pouring into the accounts of the world’s richest companies and individuals, and out of reach of the world’s poorest children.
Here’s the hard truth of what we’ve learned about human resilience. Children are highly fragile to early deprivation and the related stress that accompanies poverty: violence, absentee parents, repeated bouts of illness, undernutrition, air and water pollution, and more. These early deprivations affect the development of the brain and body in ways that can be debilitating for an entire lifetime. The brain is in a critical stage of development in the first years, and the failures of early brain development due to poverty and stress may prove to be permanent.
The stress (cortisol) pathway is especially notable. When individuals are subjected to stress, the brain and body react by releasing cortisol into the bloodstream. When the stress is persistent, the high levels of cortisol adversely affect the developing brain, leading to damage to critical areas of the brain that involve memory, learning and future reactions to stress. The result is known as “toxic stress”.
On the positive side, psychologists, neuroscientists, social workers and educators have learned about the huge benefits of high-quality early childhood development (ECD), the idea that special attention to young children through loving care, good nutrition, low stress and early cognitive stimulation can lead to a lifetime of positive benefits. In the US schemes such Head Start have proven to benefit children not only through a boost of school readiness but also through a long-term strengthening of their “pro-sociality”, that is, the ability to live harmoniously and productively with others.
The Sustainable Development Goals are a global agenda to take care of our children and take care of the planet. Have a look at them. They call on us to end extreme poverty (goal 1), end hunger (goal 2), ensure health for all (goal 3), education for all, including ECD (goal 4), and equal treatment for girls and boys, women and men (goal 5). They point us to how we can pay for these outcomes, by reducing the great gulf of wealth and income between the rich and the poor (goal 10). And the goals keep our attention on a basic point: we must stop runaway climate change (goal 13), the destruction of the oceans (goal 14) and the land (goal 15), and protect our freshwater (goal 6), to avoid further desperation and poverty.
Ireland is a natural leader of the goals and the fight against child poverty. At a recent gathering in Dublin, Ireland’s remarkable Minister for Children and Youth Affairs, Katherine Zappone, mobilised caring groups and NGOs across Ireland to focus renewed attention on Ireland’s children in need and the world’s children in need. About 8.8 per cent of Ireland’s children live in consistent poverty, according to the official statistics.
The solutions involve a combination of actions: ECD for all children, social support for poor families and achieving the goals in all countries, rich and poor. The poorest nations need to be helped through increased official development assistance.
Most importantly, these proven methods require adequate public revenues to provide vital public services (health, education) and income transfers to the poor (both direct payments and as affordable housing, public transport and other services). The countries with the lowest poverty rates among the rich world are the social democracies of northern Europe, which collect government revenue of more than 45 per cent of national income in order to fund the social services. According to International Monetary Fund data, US revenues are currently about 31 per cent of GDP and Ireland’s are about 26 per cent of GDP.
The rich, in short, will have to pay more. Corporate taxes will need to be reformed collectively by the entire rich world, so that companies no long play off one country against another. With top wealth at unconscionable levels and our children’s needs more evident than ever, it’s time to forge a society that works for all, especially for all of our children.
Donald Trump says his State of the Union address on Tuesday evening will be about “unification”. But Trump discussing the state of the union is like a pyromaniac discussing lighter fluids. His goal is, and has always been, disunion.
The man thrives on divisiveness. It’s how he keeps himself the center of attention, fuels his base and ensures that no matter what facts are revealed, his followers will stick by him.
There’s another reason Trump aims to divide – and why he pours salt into the nation’s deepest wounds over ethnicity, immigration, race and gender.
He wants to distract attention from the biggest and most threatening divide of all: the widening imbalance of wealth and power between the vast majority, who have little or none, and a tiny minority who are accumulating just about all.
“Divide and conquer” is one of the oldest strategies in the demagogic playbook: keep the public angry at each other so they don’t unite against those who are running off with the goods.
Over the last four decades, the median wage has barely budged. But the incomes of the richest 0.1% have soared by more than 300% and the incomes of the top 0.001% (the 2,300 richest Americans), by more than 600%. The net worth of the wealthiest 0.1% of Americans almost equals that of the bottom 90% combined.
This grotesque imbalance is undermining American democracy.
“The preferences of the average American appear to have only a minuscule, near-zero, statistically non-significant impact upon public policy,” Martin Gilens of Princeton and Benjamin Page of Northwestern concluded a few years ago, after analyzing 1,799 policy issues that came before Congress. Lawmakers respond to the demands of wealthy individuals and moneyed business interests.
No secret here. In fact, Trump campaigned as a populist – exploiting the public’s justifiable sense that the game is rigged against them. But he never attacked the American oligarchy and his divide-and-conquer strategy as president has disguised his efforts to make it even stronger.
His tax cuts, his evisceration of labor laws, his filling his cabinet and sub-cabinet with corporate shills, his rollbacks of health, safety, environmental and financial regulations: all have made the super-rich far richer, at the expense of average Americans.
Meanwhile, he and his fellow Republicans continue to suppress votes. Last week, the Senate Republican leader, Mitch McConnell, denounced Democratic proposals to increase turnout, even calling the idea of making election day a federal holiday “a power grab”. Of course, it was a power grab – for the people.
Sitting behind Trump’s left shoulder on Tuesday night when he delivers his State of the Union will be a Democratic speaker of the House, Nancy Pelosi, who refused to blink when Trump closed the government in an attempt to fund his wall at the Mexican border.
Has Trump met his match? The real question is whether, and to what extent, Pelosi and other Democrats will also unblinkingly take on America’s increasing concentration of wealth and power.
In recent weeks, senators Elizabeth Warren and Bernie Sanders, both eyeing the White House, have with 29-year-old freshman congresswoman Alexandria Ocasio-Cortez called for sharp increases in taxes on the super-rich. Democratic presidential hopefuls are also proposing to expand access to health insurance by creating Medicare for all.
Polls show strong public support but the corporate Democrats who bankroll much of the party are not happy with this drift to the putative “left”.
Michael Bloomberg, the billionaire former New York mayor now considering a presidential run as a Democrat, warns that when you try to redistribute wealth, you get “Venezuela”. Howard Schultz, the billionaire former Starbucks chief executive who is considering an independent bid, calls Warren’s plan “ridiculous.”
Trump, along with the Republicans and perhaps some corporate Democrats, would rather opponents focus on the ethnic, racial and gender differences he uses to divide and conquer.
But Democratic leaders and candidates appear to understand that the largest threat to the state of the union – one that trumps all others, rendering it all but impossible to address anything else – is the deepening divide of wealth and power between the many and the few.
The 2016 elections — all of them — were painful. Democrats failed to take back the House and Senate and lost the presidency to a bigoted fraudster. I don’t intend to relitigate the whole thing here, but those losses, as well as key defeats in local and state races across the country, have caused real harm to legions of everyday Americans.
Some people blame the losses on Russia — and that’s ridiculous. Others make it out like the hacking and interference had no impact at all — and that’s ridiculous too. The Democrats lost for dozens of reasons, but the hacking and interference was damn sure one of them. It was a major distraction during the campaign. My fear was that it would also be such a distraction for the Democratic Party moving forward that the party would ignore all of the substantive changes it needed to address.
Don’t get me wrong, I think election interference is a huge deal. The safety and integrity of our elections is no small thing, but since the losses of 2016, Democrats have needed to find a way to walk and chew gum at the same time. There’s good news here: I see four things happening right now that makes me cautiously optimistic about the future of the Democratic Party.
Embracing Progressive Ideas
A few years ago, if you supported “Medicare for All,” you were probably either a hippie, a Bernie supporter, or both. Today, polls show that 70 percent of Americans like it, and mainstream Democrats are finally embracing it publicly. When Rep. Alexandria Ocasio-Cortez began talking about how essential it is that the United States embrace a “Green New Deal,” on Day 1 her idea only had support from a few of her closest allies in government. In just a few weeks’ time, you’d now struggle to find a Democrat who doesn’t support it. Speaking of Ocasio-Cortez, she’s got the entire country talking about finally making the ultrarich pay their fair share of taxes. And a few years ago, I struggled to find a single mainstream Democrat talking about ending cash bail or decriminalizing weed — now those are basic talking points for presidential candidates.
I’m glad about all of this, but here’s why I’m cautiously optimistic. It’s easy as hell to talk about your bold policy choices when your party doesn’t have the power to enact them. I just want to make sure the Democrats don’t lose their nerve when it matters most.
Candidates Hiring Diverse Staff
One key reason why presidential candidates are so often tone deaf on issues of race and class is because their senior staffs are often primarily made up of white men. Democrats have completely changed this for the upcoming primaries. Julián Castro hired an amazing black woman, a highly skilled organizer named Maya Rupert, as his campaign manager. Kamala Harris announced that her campaign manager will be Juan Rodriguez, who also ran her Senate race in 2016. In Kirsten Gillibrand’s new staff, she announced six new hires — four of them are women. Of those six, two are African-American and one is Latina. This is a big deal. These early candidates are not just setting the tone for the candidates who will follow them, they are building teams that will actually be able to skillfully advise them on how to reach the entire nation.
Race Barriers Fall in Senate
I have long railed against the lack of diversity of Senate Democrats’ senior staffs. It’s still a serious problem, but it’s getting so much better. When Alabama’s Doug Jones was elected, he appointed the Senate’s first African-American chief of staff, Dana Gresham. Of course it’s embarrassing we had to wait this long. Thankfully, Sen. Elizabeth Warren just hired Anne Reid as her new chief of staff; an Obama administration alum, Reid became the first black woman to serve in this role for any Senate Democrat. She wasn’t the only black woman in that role for long. Gillibrand just hired Joi Chaney to serve in the same role for her office. Yes, I am celebrating the fact that we went from zero African-American chiefs of staff for Democrats to three — because it’s trending upward.
Competitive and Healthy Primaries
The 2016 Democratic presidential primaries were weird. A dozen serious candidates should’ve jumped in there to run, but they were either flagged off or chose not to, in order to make room for Hillary Clinton. I ultimately think that that was actually bad for Clinton. In the end, two people who nobody thought stood a chance, Bernie Sanders and Martin O’Malley, ignored the chatter and ran anyway. Sanders shocked the world and won 22 states, but a robust, competitive nationwide primary — with a normal number of candidates — would’ve been better for the winner. In 2008, Barack Obama beat out a who’s who of Democrats to win the nomination and went into the general with a ton of momentum. In some ways, that’s what Donald Trump actually did on the Republican side in 2016.
The upcoming Democratic primaries are going to be altogether different from the previous ones. Clearly, it appears that we will have a healthy number of candidates running. Already, with Warren, Harris, and Tulsi Gabbard in the race, it appears that the primary will set a record for the number of women running. Not only that, but this cross-section of candidates is already on pace to be the most ethnically diverse ever as well. These candidates look more like America. And with Pete Buttigieg, mayor of South Bend, Indiana, now in the race, we have the first openly gay Democratic candidate to run for president. Whoever wins is going to have to fight in all 50 states to do so. And again, that’s going to be good for their chances at defeating Trump in 2020.
I have a request for the pundits, editorial boards, and especially politicians, seemingly sympathetic to Medicare for All, but who dwell on its supposed infeasibility and limitations: please take a time out.
When it comes to seeking universal healthcare in the U.S. since the 1940’s (decades behind Germany even then), we have literally tried everything except what is popular and works: Medicare for All.
So let’s do what everybody benefits from, on behalf of everybody. It’s literally true, and why it scares the elite so much: universal healthcare is… wait for it… universal!
The non-universal character of our present healthcare industry may be the biggest barrier to achieving an improved and expanded version of Medicare, the most efficient, cheapest, and provider-friendly—but not perfect—part of what could be a health system that promotes health, saves lives, and creates a sense of social solidarity.
Many of the nation’s insured still feel real health insecurity?. As examples: 29 percent of those with insurance in 2016 didn’t get some type of care due to cost and 40 million US residents are classified as under-insured. According to a new survey from the International Foundation of Employee Benefit Plans, cited by Benefit News, even the 160 million workers with employer-sponsored insurance are subject to increasing costs—an average deductible of $1,491 for individual coverage and $2,788 for family coverage.
Employer-based insurance, by the way, is far from guaranteed. As policy analyst Matt Bruenig put it over the weekend:
…if you like your employer insurance, I have some really bad news about what happens to it when you change jobs and when your employer finds a cheaper insurer to use…
— Matt Bruenig (@MattBruenig) February 2, 2019
In addition, the unsubsidized insurance premiums the worker must pay for a family are not subject to any cost-sharing limits. Thirty-six percent of Americans are in high-deductible plans with an average deductible of $4,347 or higher. Co-pays vary, and a few exceptional employer plans have no or little out of pocket expenses, typical of executive benefits and those in well-established public sector bargaining units who have foregone raises and successfully fought to maintain benefits.
Medicaid was designed to be a safety net but has instead become a lifeline for those who need long-term care, assistance with daily living, services for the disabled, rehab, and children with special needs. Yet because it provides services to the politically disadvantaged, providers receive inadequate reimbursement, states privatize coverage, and the program constantly faces budget constraints. As the pro-industry ideologues in the Trump Administration impose work requirements on Medicaid recipients (75% of whom already work), healthcare is being taken from tens of thousands of people who need it most.
No wonder with so many workers on the edge—literally making choices over getting a broken bone cast or medications for a sore throat, instead of groceries or the water bill—healthcare feels to many Americans like something only other people get. The high cost of healthcare is the central economic fact for most workers, revealed by the comparison between the cost of a “simple” ER visit or insurance deductible and the reality that 40% of Americans do not have $1000 in the bank for an emergency.
Imagine if everyone felt secure that they and their families would get the healthcare they need. We would not need $5 to see a doctor. Imagine not having to hassle with an insurance company to get an MRI, or the daily struggle to get services for a sick or struggling child in the shifting terrain of plans, coverage, public eligibility, and never-ending complexity. Even hospital CFOs are losing confidence they can adapt to new business models.
We do not have to organize our policy choices around the resentment toward those who only seem to have better benefits, and desperation to hang onto whatever plan we have fought to keep (even though 30% of employers switch health plans every year). We would no longer be riven by the disparities that plague healthcare, which are primarily financial and result in unnecessary deaths, complications, and economic hardship that seep into all areas of our lives. Instead, we would all have a stake and reason to support a healthcare program that isn’t vastly better for some than most, and isn’t based on ability to pay.
In contrast to the current for-profit system, Medicare for All guarantees healthcare based on patient need determined by the professional judgment of doctors, nurses and other caregivers. This is an improved and expanded version of the traditional Medicare model of public financing and administration in a mostly privately-delivered healthcare system. Medicare for All would consolidate the program into one part, replace Parts B and D, mimic the expansive benefits of Medicare Advantage, eliminate all existing co-pays for seniors (and for everyone else), eliminate all commercial insurance premiums paid by employers and individuals. Comprehensive benefits—all medically necessary treatments, including mental health needs, approved by a participating provider and complete choice of any participating provider—would come with a prohibition on balance billing. And while maximizing the ability to control costs, the intention is to include all residents of the United States so that nobody is excluded from receiving the care they need when they need it.
Instead of only the healthcare we can afford—leaving tens of millions out and uncertain—let’s guarantee we all get the healthcare we need.