Friday, July 14, 2017

This Is What One-Sided Dishonesty Looks Like

by Neil H. Buchanan

Faced with the historic unpopularity of his health care bill, Senate Majority Leader Mitch McConnell responded by making it even worse -- or, as the sub-headline to a New York Times editorial put it, Senate Republicans "found a way to make a horrible bill truly hideous."

This is not surprising, I suppose, although McConnell did manage to make it worse than even I cynically predicted earlier this week.  The new window dressing is even more minimal than expected.  Moreover, he adopted a proposal offered by the much-beloved Senator Ted Cruz, who figured out how to indirectly destroy the highly popular provision in the Affordable Care Act that prevents insurance companies from denying coverage to people with preexisting conditions.

As Donald Trump might put it: mean, mean, mean.  My focus here, however, is not on the Republicans' attempt to deny health care to millions of people, as shocking as that is.  Instead, I want to put this latest truckload of Republican dishonesty into some context.

The simple fact is that Republicans -- not just Trump or McConnell -- long ago decided that they are willing to utter bald-faced lies and defend demonstrably false arguments in pursuit of their political goals.  Worse, they concluded that there was no downside to standing by those lies, nor was there any upside to keeping each other honest.

Let us begin with a classic McConnell lie about his cruel proposal to take away health care from vulnerable people: "Nothing we’ve advocated so far would cause anyone currently on Medicaid to come off of it."  Putting aside the ominous "so far," what was McConnell saying?

As the Fact Checker at The Washington Post explained, this was a classic lie wrapped in a thin tissue of misleading statistical sleight of hand.  Or, as I put it recently, this is a "careful lie," in the sense that someone like McConnell can say, "See, it's not exactly based on outright falsehoods."

Although that is a step up from Donald Trump's casual, careless lies, that is a low bar indeed.  This is like the clever kid who says, "I can tell you the score of tonight's Yankees-Red Sox game before it starts," and then says, "0-0, which is the score before it starts!"  Good one, kid.  You can be Senate Majority leader someday.

Where is the "not exactly false" part of McConnell's claim?  Because people cycle on and off of Medicaid rather quickly (and because so many of Medicaid's beneficiaries are formerly middle class retirees who have spent down their assets while living in nursing homes for a few years before they die), McConnell is saying that people "currently on Medicaid" are not going to be on Medicaid when his cuts would take effect.

Even worse, McConnell's argument is that state governments will make the ultimate choices about Medicaid spending levels.  Just because the federal government's 90% reimbursement rate to states would go away does not mean that McConnell's bill would "cause" anyone to lose Medicaid coverage.  States could make up the difference, right?  Anyone who loses coverage can simply blame their state government.

This is like arguing that locking a group of people in an overcrowded room with no food or water does not "cause" them to die, because the inevitable violence that will ensue was the free choice of the people who then desperately killed each other.  Appropriately, The Post's writers gave McConnell "three Pinocchios," although their statement that "McConnell pushed the envelope here" is puzzlingly understated.

This kind of dishonesty is now standard for Republicans.  Many commentators have noted the absurdity of Republicans' claim that their health care bills would not "cut" Medicaid, because the total number of dollars spent on the program would be higher in future years than it is this year, which ignores the growth in population and health care cost increases.

A bill that would reduce Medicaid enrollment by 15 million people is not a "cut"?  A bill that would reduce spending by $772 billion over ten years does not count as a "cut"?  Of course, this is by now a standard move by Republicans, who have for years been saying that "only in Washington" can we spend more money but call it a spending cut.

And there is also a depressingly familiar level of hypocrisy.  A few days ago, the Congressional Budget Office released a scathing analysis of the Trump budget proposal (which you can be forgiven for having forgotten even exists), which showed that the White House's forecasts of economic growth, spending, and deficits were wildly optimistic.

What did the Trump people say in response: "We are thrilled that C.B.O. confirms that the president’s proposed budget ... is the largest deficit reduction package in American history."  How does that work?

The baseline ten-year deficit for the relevant period was $10.1 trillion (in an economy that will produce well over $200 trillion in income over that period).  Trump's people claimed that the deficit would be $5.6 trillion lower because of their budget, but CBO said the reduction would actually be $3.3 trillion.

Get it?  The debt will go up by $6.8 trillion -- pushing gross federal debt well past the "the 24 trillion . . . 23 . . . 24, that’s like a magic number, where as a country . . .  we become a large-scale version of Greece," as Trump once put it with his trademark cluelessness.  But that counts as a cut, according to his budget people, because it is a reduction against the future baseline, which is exactly what Republicans say is wrong when measuring Medicaid cuts.

Again, this dishonesty long predates the current crop of Republicans.  They describe nearly every tax increase as "the largest in history," for example, without adjusting for inflation, population, or the size of the economy.

This actually predates not only Trump and McConnell but the hyper-partisanship of the Gingrich era.  It even predates Ronald Reagan.  Back in the 1970's, I recall watching conservative icon Milton Friedman being interviewed about economic policy in a recession.  He was asked something like this: "Shouldn't we worry about high levels of unemployment?"

Friedman's response: "I'm focused on the fact that more Americans have jobs today than ever before."  Don't worry, be happy -- and do not worry your pretty little heads about the fact that of course a growing population will have more people working compared to earlier eras, making this a meaningless deflection.

Moreover, this dishonest habit of the Republican mind is not limited to using statistics in misleading ways.  They have become increasingly comfortable bulldozing through their lies, even when directly confronted with reality.  It is not "merely" climate change and voter fraud claims that Republicans refuse to let go in the face of the truth.  They have been practicing this for years.

Back in the 1988 presidential campaign, a new level of race-baiting ugliness was reached with the so-called Willie Horton attack ads, in which the first George Bush and his supporters ran commercials linking furloughed felons to Democratic nominee (and Massachusetts governor) Michael Dukakis.  Democrats quickly pointed out that the furlough program in question was in fact very similar to (and less generous than) a California program that former Governor Ronald Reagan had supported.

Did any of that matter?  Not one Republican that I am aware of ever pulled back, saying, "Well, this turns out to be a bipartisan policy -- and it is actually a good one."  The Republicans ignored reality and went back to acting as if Dukakis had personally let loose a (black) felon to prey on (white) people in the suburbs.

By 2008, when John McCain decided to inflict Sarah Palin on the world, one of her talking points had to do with the "bridge to nowhere," which was a federal appropriation to connect a sparsely populated Alaskan island to the mainland with an expensive bridge span.  Palin's stump speech included the statement that, as governor, she had said "thanks, but no thanks" to Congress's offer of such wasteful spending.

It was quickly shown that that is not at all what had happened.  In fact, "Palin advocated for the federal earmark before opposing it, only ended [it] after Congress had essentially killed it, and kept the $223 million for the appropriation after the project was killed."  Yet Palin would not drop the false claim, and Republicans did not call her out on it.

By this point, one can hear the right-wing partisans screaming: "Oh, like Democrats are so pure!"  To which the answer can only be: "Democrats are far from perfect, but they simply do not engage in this type of dishonesty."

The fact is that Democrats are still capable of being embarrassed when they are called out, which means that they are willing to back off of false statements -- and, perhaps more importantly, they are careful not to make obviously dishonest statements in the first place.

I cannot imagine, for example, that Democrats as a group would stand behind a statement about a budget or tax proposal that was based on numbers that had not been adjusted for inflation.  Even if one person were willing to do so, others would quickly run for cover by assuring reporters that the guilty party spoke only for himself.

And again, this is not just about budgeting.  For example, when the Clinton email story broke in March 2015, a Clinton spokesperson offered some simply embarrassing arguments to MSNBC's Lawrence O'Donnell.  O'Donnell, a liberal who is a former Democratic staffer in the Senate, responded with scorn.  In a blog post, I then asked: "Do Hillary Clinton's Defenders Have Any Non-Embarrassing Arguments?"

As we now know, the answer to my question turned out to be a resounding yes, and the email story will go down in history as one of the biggest media-fed lies in American history.  But the point here is that when the Clinton people made baseless, stupid, and embarrassing arguments, liberals did not say, "Yup, we'll back that up no matter what, because we're with her."

Or consider ACORN, the community organization that was destroyed by a non-scandal that had been contrived by a doctored "undercover report" about supposedly illegal activities by ACORN workers.  (Notably, ACORN was very effective at registering poor people to vote, which made it an obvious target as Republicans amped up their voter suppression efforts.)

This was in 2009, when Democrats had strong majorities in the House and Senate, and Barack Obama was in his first year as president.  Yet even though the anti-ACORN story fell apart almost immediately, Democrats headed for the exits and allowed funding to be cut to the organization, effectively killing it.

In other words, not only are Democrats not in the habit of sticking with stupid and indefensible arguments, they even abandon completely solid positions out of some bizarre sense that good arguments will still lose.

This is a surprisingly widespread attitude among Democrats.  Paul Waldman recently returned to his concept of the "audacity gap," which "makes Republicans the party of 'Yes we can,' while Democrats are the party of 'Maybe we shouldn’t.'"  He elaborated:
"Democrats are forever worried about whether they might be criticized, whether Republicans will be mean to them, whether they might look as though they’re being partisan, and whether they might be subjected to a round of stern editorials."
Even after all these years, it is still amazing to see how shamelessly Republicans lie.  In the current health care debate, as in everything else, Republicans like Mitch McConnell do not hesitate to say anything at all to support their position.  And even if this particular bill does not pass, people are going to continue to suffer because of Republicans' dishonesty.


Joe said...

Mixture of lie and b.s. (not caring about the truth).

It is a mixture of depressing, aggravating, infuriating and sad.

This too to those who buy or accept it.

David Ricardo said...

Mr. Buchanan ranges far and wide on Republican lies but actually an entire post could have been constructed just on the lies about health care, ACA and the Republican plans. To wit.

1. ACA is failing. No, it’s not and the non-partisan CBO has said so. In states where it has been supported it is doing very well.

2. Premiums under ACA are skyrocketing and health insurance is unaffordable. There have been some large premium increases requested. But even if granted the subsidies under ACA, which are tied to income, ameliorate most of any increase for most families.

3. People who lose Medicaid can shift to private insurance (Sen. Cassidy). No, they can’t. They didn’t have private insurance because they could not afford it. And the support under the Republican plan will be even less so if it passes they can not afford it even more.

4. Repealing ACA is what we were sent to Washington to do Republicans say. Really, that’s why there plan is supported by less than 20% of the population?

5. Some areas have no insurers at all. Well yes, a very few because Republicans are threatening (and actually suing) to not pay cost sharing payments mandated under ACA.

6. ACA is a failure. Gosh, that explains why almost every health care and patient advocacy group, like AMA, the American Heart Association etc are vigorously supporting ACA and opposing the GOP bills.

7. Premiums are being reduced under the Republican plan. No they are not. On an apples to apples basis premiums will skyrocket. The reduction in premiums the Republicans talk about are for plans that lack basic coverage and will have high deductibles. Yes a basic bottom of the line Kia does cost less than a Mercedes, but drive each one and then tell us they are the same!

8. The Republican plan puts patients in charge of their health care and gets government out of the decisions. Right. Those pesky private insurance companies which will now take over coverage for some people that lose Medicaid have nothing but patient welfare at heart and will not interfere in any way on limiting coverage and payments.

9. Medicaid is no better than no coverage at all and far worse than private insurance. This ridiculous claim is objectively disposed of, you know, with data, facts and logic by the great folks over at The Incidental Economist and the Kaiser Foundation studies.

While the media is doing a great job on Russia and Juniorgate they are failing miserably on ACA, probably because they do not understand health care economics. More is needed here and elsewhere.

Joe said...

I think the Russia stuff is crowding out the ACA coverage in part since the former is juicy and because the media is best focusing on one story. It's also easier to report on it -- ACA is more wonky.

OTOH, there has been various reporters on the ACA beat who have spelled out such things. For instance, I read a recent report on how the Trump Administration okayed a fix in Alaska. This shows ACA is workable.

The general impression I get from the coverage is that the Republican replacement plans are problematic and unpopular. The details are out there. This includes discussion of such things like CBO scores etc. That the process they are using is secretive. The public likes many parts of ACA & there is basically a sense that it is now the "established" norm really, not some new thing. People, including in red states, like Medicaid.

And so forth. I am not sure how horrible they are doing. I'm sure some critique can be provided. But, consider -- the Republicans have been demonizing ACA for years now. Yes, it being a major part of their message, them being in full control now would suggest they have a mandate to end it. But, of course, they have been liars and b.s. artists and "Obamacare" is the alleged problem. The voters actually like a lot of what is in the actual law. Still, they do control the government.

But, unlike appointing conservative trolls to the Supreme Court, it hasn't gone easy for them here. If the media was "failing miserably," I'd think it might be a tad easier. It is complicated. It's harder for the media et. al. to do that. It can do better but I think it deserves more credit.

As to here, this is a legal blog covering many topics. One regular here is the tax expert and even there health care economics is only part of things. I don't know how much more we can expect here. As to elsewhere, it has been covered various places.

Shag from Brookline said...

I feel that the media are doing a good job on both Trumpcare and TrumpTowerJr.Gate. Some pretty good timelines have been noted on both, particularly those of the Trump campaign and Administration. Paul Krugman's NYTimes Blog post of 7/14/17 "Climate of Treason" ties both together and the role of Republicans.

For some reason, when the Donald, Jr. revelations were in a state of change daily, I thought back in my career when I had to address antitrust matters and the concept of "conscious parallelism" and price fixing. Peter Baker at the NYTimes developed a timeline that suggested that The Donald may have been aware of the meeting on a timely basis because of a major speech he proposed to give against Clinton in a few days but never did. Perhaps there was "unconscious parallelism" involved?

And Jennifer Rubin is back on deck at WaPo with her dual attacks on Trump and today's Republicans. And even Chuck K at WaPo seems to know collusion when he sees it.

But then there are the Revengelicals with their hands on The Donald - rather than vice versa.

This is all faster than Watergate.

And The Donald has hired yet another lawyer, named Ty Cobb. I wonder if Cobb is sharpening his legal spikes for those standing in the way of The Donald. Who knows, full employment for the legal profession may get economic growth to 3%.

I wonder if Vegas is giving odds on whom The Donald will throw under the bus in an effort to resolve the Russia Connection. The question has been raised whether VP Pence may have had Russia-connected meetings.

David Ricardo said...

The WSJ has a front page story of how two major health insurance organizations, America’s Health Insurance Plans and the Blue Cross Blue Shield Association, have written a letter to Senate leadership that says the Cruz plan to segment the health insurance market

“is simply unworkable in any form and would undermine protections for those with pre-existing medical conditions, increase premiums and lead to widespread terminations of coverage for people currently enrolled in the individual market.”

In effect, everything that Cruz has said about his segmentation plan is not true.

Okay, so the WSJ has this as a story. But don't look for any of the print media, the TV journalism shows or any major Forums to publicize a communication that would, in a normal world, doom the Cruz idiocy and thus doom the Republican bill. Details of health care economics and principles of insurance are just not as interesting as what Melania wore while she was in Paris or who attended meetings in the Juniorgate scandal.

Unknown said...

I fear for the country I love. There is, in my estimation, so much ignorance (of policy, of history, of the plain inescapable truth) rampaging throughout the country, particularly among the seething Republican electorate that I tremble when I consider the possibility of that low-information cadre violently lashing back against a federal republic struggling to survive the onslaught of ignorance (and, if I'm honest, stupidity) that John Adams warned us against more than two centuries ago. You cannot keep a republic when a plurality of its citizens do not understand their role in maintaining it.