THURSDAY, OCTOBER 17, 2019 The Boston Globe Opinion A
Warren has some explaining to do
I’m a supporter of Senator Elizabeth Warren, but my wife
and I were a little surprised by what appeared to be an eva-
sive posture when she was interviewed by a panel on CNN
following Tuesday night’s debate. I don’t think it serves her
well when she automatically slides into folksy anecdotes
about people suffering from a medical catastrophe. Anyone
half awake knows her pitch by now, sincere as it may be.
When we hear it over and over, it sounds like a script. The
result is that Warren is not answering the specific, honest
questions posed by people who are covering the issues
24-7.
I don’t think there is a living American who has not
heard of or experienced medical and financial problems re-
sulting from our inadequate health care system, although,
under the Obama administration, the Affordable Care Act
made great strides in dealing with some of the most egre-
gious inadequacies.
Warren might borrow from Robert Reich’s technique of
explaining economics in the simplest and most direct way
so that everyone can understand the difference between
Medicare for All and the more “moderate” plans of other
candidates. Specifically, how it would be funded, and how
will individuals — especially those in the middle class — see
incredible savings in the long run.
MICHEL L. SPITZER
Jamaica Plain
Yes, there is a simple answer to: How
would you pay for Medicare for All?
When Elizabeth Warren was asked during the debate Tues-
day how she would pay for Medicare for All, Bernie Sanders
gave the answer. Yes, taxes would increase, but for the mid-
dle class that would be more than offset by the elimination
of soaring out-of-pocket costs — premiums, deductibles,
and copayments. Nearly every serious analysis shows that
would be the case. Moreover, the system as a whole would
be more efficient and less inflationary because of the elimi-
nation of insurers’ profit motive and overhead costs.
DR. MARCIA ANGELL
Cambridge
The writer is a member of the faculty in the department
of global health and social medicine at Harvard Medical
School and former editor in chief of the New England Jour-
nal of Medicine.
As a longtime resident of Topsfield, I made my annual pil-
grimage to the Topsfield Fair during opening weekend. The
usual attractions were present: the giant-pumpkin contest,
the Dock Dogs, and, my favorite, the fried dough stands.
What struck me, however, was something I hadn’t seen be-
fore that was very prominent. Throughout the fairgrounds,
there were signs that said, “See Something. Say Some-
thing.” As the mother of a teenager, I was thrilled to see this
message posted. I hoped that people would be moved to
take action if they saw something suspicious or disturbing.
That is why I applaud Ana Goble for having the strength
and courage to speak up when she had concerns about a
teacher’s behavior (“On deaf ears,” Metro, Oct. 10). As
Amanda Grady Sexton, of the New Hampshire Coalition
Against Domestic and Sexual Violence, stated, “What she
did is something that many adults struggle with every day.”
Appallingly, the “adults” involved in this situation got it all
wrong. The principal astonishingly suspended Ana, then a
seventh-grader, for three days for “spreading malicious and
slanderous gossip.” By doing this, he aligned himself with
the teacher, who now, five years after Ana raised her con-
cerns, has been charged with aggravated rape and other
charges.
I would like to believe that the outcome would be differ-
ent if this situation happened today, in the wake of the
#MeToo movement. I hope that young people will emulate
Ana, and when they see something, they say something.
And I hope their words are heeded.
BRENDA SCOTT
Topsfield
After‘seesomething,saysomething,’
authoritiesneedtodosomething
Deborah Davis’s nearly $3,000 surgery bill only hints at the
scope and size of the surprise medical billing problem
(“Post-op pain: Patient hit with bill of $2,800 despite insur-
er’s assurances,” Page A1, Oct. 14). Recent research from
Stanford University finds that such blindsiding medical in-
voices hit nearly 40 percent of hospital patients.
And that does not include soaring monthly premiums
and annual deductible costs. According to the Kaiser Fami-
ly Foundation, average family premium costs for employer-
provided insurance exceeded $20,000 this year. Employees
have seen their portion of premium costs rise by 71 per-
cent, to $6,000, and their deductibles double since 2009.
Transparent prices for health care services would reduce
these inflated and surprising costs. Transparency happens
when providers, insurers, andthird-party administrators
post their secret negotiated rates and cash prices. Armed
with this information, employers and patients can shop for
price and quality, putting downward pressure on prices of
care and coverage, as in other economic sectors.
Some intrepid employers such as H.B. Global in Penn-
sylvania have already reduced their health care costs by
about 50 percent by directly contracting with price-
transparent surgical centers. This has allowed them to offer
their employees no copays, no deductibles, and cash bonus-
es from shared savings.
Imagine getting a check, not a bill, next time you have
surgery.
CYNTHIA A. FISHER
Founder and chairman
PatientRightsAdvocate.org
Newton
Imagineasituationwhereyouknew
justwhatyoursurgerywouldcost
D
uring the housing boom of the early
2000s, Massachusetts homeowners Ana
and Ismael Ramirez did what a lot of ho-
meowners did: They used a broker to refi-
nance their home.
The mortgage company set prices looking at objec-
tive measures like credit history and outstanding debt.
But the mortgage company also empowered the broker
who sold the mortgage to jack up the Ramirezes’ mort-
gage rate even more and pocket some of the difference.
The Ramirezes suspected they had been duped, and
they weren’t the only ones. They sued, arguing that this
policy violated the Fair Housing Act because it resulted
in borrowers of color being charged more than white
borrowers with similar credit profiles. Years later, the
company settled the case, providing millions to the
Ramirez family and other borrowers the mortgage com-
pany had discriminated against.
Like most companies that violate the FHA, the
Ramirezes’ mortgage company did not have an explicit
policy of discriminating against borrowers of color.
There weren’t two separate pricing sheets — one for
white homeowners and one for everyone else. But the
policy of allowing brokers to raise interest rates above
the level warranted by its own formula based on objec-
tive data had resulted in borrowers of color paying more
than white borrowers.
Our federal government’s history of housing discrim-
ination is an ugly scar on this country. For decades until
the 1960s, racist redlining blocked black and brown
families from buying homes and building wealth. Then
in the years before the 2008 financial crisis, government
regulators sat on their hands as predatory financial in-
stitutions targeted minority communities with the worst
toxic mortgages.
Now, President Trump and Housing and Urban De-
velopment Secretary Ben Carson are trying to make it
almost impossible for people like the Ramirezes to fight
back. HUD has proposed dangerous new rules to gut
these “disparate impact” claims — that is, housing dis-
crimination claims that arise from policies that appear
neutral, but still have the effect of disproportionately
hurting people based on their race, color, religion, na-
tional origin, sex, disability, or familial status.
Disparate impact cases are already hard to prove be-
cause the companies that discriminate hold most of the
evidence. HUD’s proposed rule would effectively make
these claims impossible to prove by requiring those who
bring discrimination claims to have all the evidence of
discrimination before filing suit. In other words, even
before they got to see the mortgage company’s files, the
Ramirezes would have needed to provide specific details
about how the company’s policy discriminated against
them from the outset of the case.
And it gets worse. Any business practice that is
profitable for a financial institution, insurance compa-
ny, or housing provider gets immunity under HUD’s
proposed rule. This means that the company could
point to the extra revenue it received because its bro-
kers fleeced borrowers of color with lousy mortgages as
a justification for that discrimination.
HUD’s rule also protects companies that use com-
puter models or algorithms to make decisions from lia-
bility under the FHA — ignoring the evidence that al-
gorithms can be just as discriminatory as people’s ac-
tions. These changes, if implemented, would open the
floodgates for giant companies to discriminate — at a
time when overwhelming evidence demonstrates that
housing discrimination is still alive and well.
A report last year found that in 85 metropolitan ar-
eas across the nation, prospective homeowners of color
were denied mortgages at higher rates than white pro-
spective homeowners with similar credit profiles.
Landlords and real estate agents show fewer units
to black, Latinx, and Asian-American homeseekers
compared to similarly situated white families. And the
black homeownership rate today is nearly the same as
it was when housing discrimination was legal.
The actions by Trump and Carson are shameful, but
they are not a done deal. HUD is still taking comments
from the public on the proposal until Friday. We
should all be in this fight — because this isn’t just
about housing, it’s about the kind of America we want
to live in.
Do we want to live in an America defined by a racial
wealth gap and the moral stain of racism, or an Ameri-
ca where we own up to our past and start building a
more equitable future for everyone?
Do we want to live in an America where big finan-
cial institutions, insurance companies, and housing
providers have free rein to prey on our neighbors, or an
America where every family has the legal tools avail-
able to fight back against discrimination?
Do we want an America where families are denied
homes and opportunities because of who they are or
who they love, or do we want to live in an America
where every family has equal access to an American
dream?
I know which America I want to live in: a place
where everyone has the opportunity for a safe, decent,
and affordable place to live. And I’ll keep fighting to
make that a reality.
Elizabeth Warren is a US senator from Massachusetts
and a Democratic candidate for president of the United
States.
Housing rule would
make it harder to fight
discrimination
B
rrrr. The frost is not just on
the pumpkin. It’s on Elizabeth
Warren as she prepares to pull
away from Joe Biden for good
and win the Democratic presi-
dential nomination.
Attacked by rivals in the Democratic
presidential debate Tuesday, the senator
from Massachusetts officially cemented her
status as the Democrat to beat. For most of
the night, she ducked or swatted away
questions raised by South Bend, Ind., May-
or Pete Buttigieg and Senator Amy Klobu-
char of Minnesota, among others, about
taxes and Medicare for All and her obses-
sive love of plans.
But the way she handled Biden at the
end of the debate — like a cocky first-year
law student who must be put in his place —
showed her strength and weakness as a
candidate. The former vice president was
arguing, with Biden bluster, that he’s “the
only one on this stage who’s gotten any-
thing really big done.” He accused Warren
and Senator Bernie Sanders of Vermont of
offering up “vague” ideas. In response,
Warren talked about how she came up with
the idea for the Consumer Financial Pro-
tection Bureau, and then made it happen
in Congress.
“I went on the floor and I got votes for
that bill, I convinced people to vote for
that,” said Biden. “Let’s get that straight.”
To which Warren mirthlessly replied, “I
am deeply grateful to President Obama,
who fought so hard to make sure that agen-
cy was passed into law.”
Warren won the moment on Twitter,
with women especially finding Biden con-
descending and overbearing for trying to
take credit for her accomplishment. But I
wonder how many people in the non-
tweeting audience winced a bit at her cold
takedown of him. That’s assuming anyone
other than pundits and politicos actually
made it to the end of the third hour of a
very long debate.
What if she had just smiled and thanked
him?
Biden had already experienced a medio-
cre-to-bad night. He flubbed the one ques-
tion he should have been able to hit out of
the park, about his son’s work for an ener-
gy company in Ukraine. “My son’s state-
ment speaks for itself,” he said about the
interview Hunter Biden gave to ABC News
about his overseas work. Pressed on the
matter, Biden said, “My son made a judg-
ment. I’m proud of the judgment he made.”
That was confusing, since Hunter Biden
now calls his decision to join the board of
the Ukrainian energy company a mistake.
The former vice president also stumbled
around on other questions and wasn’t real-
ly a factor in the debate until the end —
when he raised the vagueness issue with
Warren and she iced him.
Can you imagine Warren taking apart
President Trump with the same cold surgi-
cal skill? I can. Does that make her the best
Democrat to take him on, even if he’s
wounded by impeachment? I don’t know.
Think of her starting nearly every answer
with “So,” and then launching into a lec-
ture on bankruptcy, an attack on billion-
aires, and the need for a wealth tax to pay
for universal health care and tuition-free
college. Think of her reprising the “you
didn’t build that” claim, because, after all,
all of us, together, pay for schools, roads,
and bridges. Talk about an assertion that is
absolutely guaranteed to rile up the other
side.
Warren also refused to answer a key
question: Will her Medicare for All propos-
al increase taxes on the middle class? She
answered by saying total costs would go
down, and refused to acknowledge what
Sanders admits about his Medicare for All
plan: Yes, taxes will go up.
“I will not sign a bill into law that does
not lower costs for middle-class families,”
said Warren. But as Buttigieg rightly point-
ed out, she ducked a “yes or no question.”
And, according to Klobuchar, she is pre-
senting a “pipe dream.” If fellow Democrats
are saying that now, imagine Trump’s fiery
attacks.
Warren can freeze out Biden. But she
can’t freeze out all the questions about her
health care plan — or her ability to unite
the country and defeat Trump.
Joan Vennochi can be reached at
[email protected]. Follow her on Twitter
@Joan_Vennochi.
JOANVENNOCHI
Frosty Liz takes down tepid Joe
JOHN MINCHILLO/AP
Joe Biden and Elizabeth Warren
By Elizabeth Warren
Ourfederalgovernment’shistoryofhousingdiscrimination
isanuglyscaronthiscountry.
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Warren feels the heat
in health care debate
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