Senate healthcare bill showed lots of heat, but little light

Mitch McConnell

In what has been a tumultuous week in Washington as the U.S. Senate revealed its revised version of the American Health Care Act, passed by the House several weeks earlier, amidst much protest for the cuts in Medicare affecting 24 million Americans, the Senate version differed little than the House, but received swift opposition by many of the nation’s most prestigious organizations: The American Medical Association, The American Diabetes Association, the American Heart Association,and the American Hospital Association and Federation of American Hospitals, to name but a few.

With near equanimity, they opposed the nearly $800 million dollar reduction of Medicaid, a program that benefits prenatal women, up to and including the birth of a child, children’s health care, care for the indigent and for many older Americans, both low and middle income, that the bill contained.

The American Hospital Association and Federation of American Hospitals had this to say, “In a letter to Senate Majority Leader Mitch McConnell and Minority Leader Chuck Schumer, the AMA's CEO James Madara wrote, "Medicine has long operated under the precept of Primum non nocere, or 'first, do no harm.' The draft legislation violates that standard on many levels."

"We believe that Congress should be working to increase the number of Americans with access to quality, affordable health insurance instead of pursuing policies that have the opposite effect," Madara continued.

As this blog has noted, these bill proposals by the Trump administration have in actuality been wealth transfer bills, than true health care plans, yet the ruse has worked as a cover for the GOP as they attempt to maintain the appearance of moral purity, and insisted that the Senate version would provide REAL health care that is affordable and by retuning economic power to the states, and subsequently to the people themselves; yet, as we have seen nothing could be further than the truth as the Congressional Budget Office noted with its negative rating on both proposals, which aired on Monday, and found that the bill would leave 22 million more Americans uninsured by 2026 if enacted, noted CNN.

On the day of reckoning, Senate Majority Leader, Mitch McConnell only had five reliable senators in approval as the rest peeled away their votes, under negative public reaction, as protesters across the country, were shown on televised news, in sit-ins, begging lawmakers to reconsider. And, certainly the sight of wheelchair bound activists across the country, in Denver, and in Washington, being arrested by police must have made an impact on their decision.

Now the hue and cry is for a bipartisan effort between the Republicans and the Democrats to act, in concert, something that no one has seen in recent years and that many doubt can happen. And, some far left Dems are urging, in retaliation, that the Dems not even come to the bargaining table, as they were shut out of the Senate deliberations. Yet, seasoned observers note that this helps no one achieve what the nation deserves - true and affordable health care.

As history has shown, those who try are often pilloried as socialist, communists, egoists and worse; as President Lyndon Johnson endured with Medicaid, and as First Lady Hillary Clinton was trashed in 1993, and of course, President Obama got the lion’s share with the Affordable Care Act, getting panned for putting his name on what was essentially a Republican plan, created by Mitt Romney as governor of Massachusetts.

But, a recent Marist poll found only 12 percent of Americans favoring the dead-on- arrival plan, and there are some efforts remaining to try, and try again. One option from the GOP is to retain one of the taxes on the wealthy to help stem the tide of opioid abuse.

Secondly, in a departure from precedent, they are willing to look at offering cheaper plans that are less comprehensive as long as there is one that contains the standards of the ACA, that meets consumer protection standards in the ACA, reported The New York TImes.

This would meet, while it was not in the House version, or even in the initial approach by the Senate, an opportunity to mute critics such as Republican Sen. Bob Corker, of Tennessee, who opposed the cuts, and Sen. Rob Portman.  

Yet, opposition, to even that has come from Sen. Susan Collins of Maine, and Democrat Senator Maggie Hassan who said the money for opioid treatment would be “a drop in the bucket,” with Collins wanting to distinguish between those taxes that increased premiums, versus those that didn’t, an unwelcome comment to those that want to cut deeper, and deeper, like Rand Paul and Ted Cruz.

it’s important to note that White House Economic Advisor Mick Mulvaney, in one of my earlier analysis said “The White House also needs the money from the repeal to help fund the tax overhaul and the tax code revision. In a sharp reversal from earlier statements from Trump, Mulvaney said that the president said he was going to do tax reform next, now says that has to wait. He said in an interview with Fox Business that if health care doesn’t happen “fast enough, I’ll start the taxes. But, the tax reform and the tax cuts are better if I can do health care first.”

Statements like these make it harder for those like Collins and Alaska Senator Lisa Murkowski, both with large expanses of rural areas, whose small network of federally funded providers, and many older residents facing a loss of Medicaid, revealing, once again, that this bill is not about health care, and these adjustments are mostly cosmetic adjustments to court opponents.

The rancor in the GOP has also evolved to the point that a super PAC was ready to denounce Sen Dean. Heller, of Nevada, whose vulnerability in 2018, made him low hanging fruit for an attack, but one that was repelled by his colleagues.

If this donnybrook can produce anything meaningful, and helpful, for the country, it remains to be seen, with these secret meetings, shutting out senior lawmakers from the deliberations, such as Collins, and then producing mean retributive measures like the attack on Heller. Can hope spring eternal?

Feds up interest rates for the third time in 6 months

As predicted by most economists, and government observers, the Federal Open Market Committee of the Federal Reserve Board approved on Thursday a rate hike of 25 basis points from 1 percent to 1.5 percent, in a move that Fed Chair Janet Yellen attributed to growing confidence in the U.S. economy. And, an outlook for the GDP of 2.2 percent, far less than the one President Trump has as a target, with his budget proposal.

With many saying that this was on target, it is also expected to offer a bit of a bump to consumer debt in the form of, adjusted rate mortgages, and revolving credit card debt, and home equity loans.

Traditionally, the prime rate will also increase for baseline interest rates, following this rate increase.

The Committee noted in their statement that “Information received since the Federal Open Market Committee met in May indicates that the labor market has continued to strengthen and that economic activity has been rising moderately so far this year. Job gains have moderated but have been solid, on average, since the beginning of the year, and the unemployment rate has declined. Household spending has picked up in recent months, and business fixed investment has continued to expand. On a 12-month basis, inflation has declined recently and, like the measure excluding food and energy prices, is running somewhat below 2 percent.”

In a prudent, and cautious vein, characteristic under Yellen’s rein,  they felt “In view of realized and expected labor market conditions and inflation, the Committee decided to raise the target range for the federal funds rate to 1 to 1-¼ percent. The stance of monetary policy remains accommodative, thereby supporting some further strengthening in labor market conditions and a sustained return to 2 percent inflation.”

As has been often noted the Fed mandate is to reach the goals of maximum employment and price stability, a feat that in the last few years had proven to be difficult, and Yellen herself has chosen the prudent course. But, the sentiment of the FOMC does represent a slight departure from the traditional notion of an inflation target of 2 percent, they were, in fact, and were willing to look at one that was just below 2 percent; a change that may reflect a nod to an economy that has not always been on a predictable path, even among Keynesians.

Then there is the psychological beliefs of consumers, as Chris Gaffney, the president of EverBank World Markets noted: "You may start to see it weigh on consumer confidence in that they believe interest rates would continue to increase, which would make their [borrowing] more expensive.”

In a view not always held by other, he also said that "If we continue to not see any inflation, we could start to perhaps see it impacting their rate decisions going forward."

The Consumer Price Index was one blot on another wise rosy report, was weaker than expected, and caused some to side with Gaffney that this might be the last raise this year. In short the fault lay with weaker gas prices, and also costs for shelter, clothes and, vehicles. Personal consumption was only at 1.7 percent.

The job growth touted by the FOMC was moderate and added 100,000 jobs, but still reflected low labor force participations, just under 63 percent, and wages at 2.5 percent, hardly a cause for rejoicing, but one that seemed steady enough after the Great Recession,and okay for the Feds, as was the 4.3 percent unemployment.

But, the real news was the spin off of the heavily held balance sheet of market based securities and Treasury bonds, that many in Congress, especially GOP lawmakers objected to. While no deadline, was given, the Feds noted that they would start on a timetable that would begin to unwind, without reinvestment in the securities that they hold.

As Business Insider described it: “To shrink its nearly $5 trillion balance sheet, the Fed plans to gradually allow a fixed amount of the assets it owns to roll off, meaning it won't reinvest them. The Fed amassed bonds after the financial crisis to help keep interest rates low. Initially, up to $6 billion in Treasurys and $4 billion in mortgage-backed securities will be allowed to roll off monthly.

These caps will be raised every three months until they hit $30 billion for Treasurys and $20 billion for mortgage-backed securities. There was no indication of when this process would begin.

Comey testimony reveals credibility and patriotism

In his much anticipated testimony before the Senate Intelligence Committee, former FBI Director, James Comey, on Thursday, showed that he was a credible and competent patriot that told the truth, unvarnished, and with a folksy, patriotic air that made the most of an unenviable moment in American political history.

The 56 year old Yonkers, NY native gave a detailed testimony, in a mostly unhesitant manner, without notes, and with great candor, the detail of his meetings and dealings with President Donald Trump before his unexpected firing.

The most revelatory questions came early on, as ranking members of the SIC began their questioning. Perhaps the most startling came from Comey, in response to a question from the committee's Democratic co-chair, Sen. Mark Warner, of Virginia, who queried why he had taken the time to write memoranda of the meetings with the president.

The response: “Circumstances, first, I was alone with the President of the United States, or the president-elect, soon to be president. The subject matter I was talking about matters that touch on the FBI's core responsibility, and that relate to the president, president-elect personally, and then the nature of the person. I was honestly concerned he might lie about the nature of our meeting so I thought it important to document. That combination of things I had never experienced before, but had led me to believe I got to write it down and write it down in a very detailed way.”

Just in case anyone was in doubt the former FBI head said that he took notes, with the implication, that due to Trump’s personality, he was deemed to be a liar. Tough and strong words, from a no-nonsense, or, what was known to a previous generation, a “straight shooter.” Or, as women from that same generation would have acknowledged “a man’s man.” And, at 6 feet, 8 inches tall, he looked the part, and far from Trump’s characterization of him as “crazy, a real nut job.”

That set the tone of the testimony, early on, and made even the most somnolent of watchers, wake up and take notice. Perhaps,not since Watergate, has a controversy embracing an American president, been so compelling, to watch.

At issue, also, was that Comey felt that the president was attempting to instigate, rather, “build a personal relationship,” in order to manipulate him into dropping the investigation into former National Security Advisor, Mike Flynn, because it was a “cloud” over his administration, with the words, ”I hope you can see your way clear to letting this go, to letting Flynn go. He is a good guy. I hope you can let this go.”

For most listening, or watching, this was political theater at its best, but it also showed a deep level of patriotism, and an understanding of the American political process, and made Comey unassailable in his testimony.

With a total of nine meetings, on the whole, Comey, further elaborated, again when questioned by Warner, on the need to keep the memos. He said, “ I knew there might come a day when I would need a record of what had happened, not just to defend myself, but to defend the FBI and our integrity as an institution and the Independence of our investigative function. That's what made this so difficult is it was a combination of circumstances, subject matter and the particular person.”

With a bit of pressure, perhaps, Trump, at the infamous dinner a deux, in the Green Room of the White House, felt compelled to give the implication, that his job depended on a quid pro quo - maybe by dropping the Flynn investigation, something that confused Comey, “so I'm sitting there thinking wait a minute three times we've already met, you've already asked me to stay or talked about me staying. My common sense, again I could be wrong but my common sense told me what's going on here is, he's looking to get something in exchange for granting my request to stay in the job.”

Taking it one step further and educating those watching, Comey went on to explain, that “The reason that Congress created a 10-year term is so that the director is not feeling as if they're serving at, with political loyalty owed to any particular person. The statue of justice has a blindfolds on. You're not supposed to peek out to see there your patron was pleased with what you're doing. That's why I became FBI director to be in of that position. That's why I was uneasy.”

This does not bode well for Trump and it also says much of his ignorance of the political process and the branches of the government, and how they work, and interact. With a myriad of opportunities for interaction, a president that can’t, or refuses, to grasp the process, suggest that the future is ripe for abuse.

Comey, on several occasions, citing confidentiality, could not comment, in an open forum, but these were genuine responses, showing respect for the FBI, and not simply evasions.

Questioned by Sen, DIanne Feinstein, of California, why he didn’t simply tell the president  that his line of questioning was wrong, he replied, simply, and with true humility, “Maybe if I were stronger, I would have. I was so stunned by the conversation that I just took in. The only thing I could think to say, because I was playing in my mind -- because I could remember every word he said -- I was playing in my mind, what should my response be? That's why I carefully chose the words. Look, I've seen the tweet about tapes. Lordy, I hope there are tapes. I remember saying, “I agree he is a good guy,” as a way of saying, I'm not agreeing with what you asked me to do. Again, maybe other people would be stronger in that circumstance.”

As most would understand, who have lived in Washington, for any length of time this candor is rare, indeed, some would say non-existent.” Even when faced with the decision on what to do when Trump called him to seal the deal, he felt compelled to protect his team, as he noted, “Our primary concern was, we can't infect the investigative team. We don't want the agents and analysts working on this to know the president of the United States has asked, and when it comes from the president, I took it as a direction, to get rid of this investigation because we're not going to follow that request. So we decided, we have to keep it away from our troops.”

Reaction from the White House has been a mixed bag: no tweets from POTUS, an unusual occurrence,(some are saying Ivanka had a hand in this) and Sarah Sanders, a spokesperson, said, defensively, “The President is not a liar.”

Meanwhile the president's attorney, Marc Kasowitz has stated, in a written statement, saying in part, “In attacking Comey's testimony — as Trump surrogates did throughout the day — the ex-director "admitted that he unilaterally and surreptitiously made unauthorized disclosures to the press of privileged communications with the president."

The right-leaning USA Today reported that the president said, “we are under siege,” but “We will come out larger, and better and stronger than ever.”

If there is any damage to the White House, from implosion, then the Comey statements tell us, once again, that we need to fear, as a nation, the things from within rather than without.