MONDAY, AUGUST 5 , 2019. THE WASHINGTON POST EZ RE A
BY PRAMILA JAYAPALI
n the wake of the second Democratic
presidential debate, it is clear that
Medicare-for-all has become a defining
issue of the 2020 election. Earlier this
year, when I introduced our comprehensive,
120-page “Medicare for All Act of 2019,” I
expected attacks from Big Pharma and
for-profit insurance companies. But I did
not expect misrepresentations from Demo-
cratic presidential candidates about what
the bill is and is not.
Let’s be clear about the scale of this crisis.
The United States spends an astronomical
$3.6 trillion per year on health care —
almost double what peer countries spend —
and it is set to increase within 10 years to
$6 trillion annually. Pharmaceuticals such
as basic insulin cost up to 10 times less in
Canada for the exact same drugs. Approxi-
mately 500,000 Americans turn to bank-
ruptcy each year because they cannot afford
medical costs — and that includes people
with insurance.
With so much at stake, facts matter. So
let’s get them right.
First, it is a myth that Americans love
private insurance. The vast majority of
Americans are deeply frustrated with the
health-care system — even if they have
private insurance. Opponents and pundits
often quote polling t hat suggests support for
Medicare-for-all drops when you tell people
that their private insurance plan would go
away. But when polls accurately describe
Medicare-for-all, and explain that you can
keep your doctor or hospital, the majority
support increases. People are happy to get
rid of private insurance; they just want to
know they can keep their doctors and
hospitals, even if they switch or lose their
jobs. Medicare-for-all would let them do so.
Second, it’s wrong to assert that taxes will
rise without talking about what health care
currently costs Americans in premiums,
co-pays and deductibles. The average Ameri-
can family with employer-sponsored insur-
ance incurs more than $28,000 dollars in
health-care costs per year, of which about
$15,800, or 56 percent, is paid by employers.
And many argue that they still can’t get the
care they need. Americans are smart enough
to be asked questions like: Would you be
willing to pay more in taxes each month if
you saved more money by not paying private
insurance premiums, deductibles and co-
pays and were guaranteed high-quality
health care?
Third, it is simply false that labor unions
don’t want Medicare-for-all. Sure, they
fought hard for employer-sponsored health
insurance plans for their workers. But they,
above all others, recognize that the rising
costs of insurance premiums are directly
related to stagnating wages and, more and
more, the pressure of those costs hurts
worker power at t he bargaining table. Ta ke a
look at t he unprecedented n umber of unions
that have endorsed our bill, all of which
know Medicare-for-all is necessary.
Fourth, comparisons of Medicare-for-all
to the GOP’s p ush to “repeal and replace” t he
Affordable Care Act are simply unfounded.
Republicans are the only ones trying to take
away health care. There is absolutely no
daylight between leading on Medicare-
for-all and fighting to shore u p the ACA right
now, or stopping the GOP from stripping
care away. The Affordable Care Act made
profound improvements to our health-care
system. But it was never meant to be the end
goal, because it does not address the real
disease in our system: a profit motive that
leaves millions either without a ccess to care,
bankrupt or unable to afford medication in
the world’s richest country. We can strength-
en the ACA and work toward Medicare-
for-all at the same time. Even former presi-
dent Barack Obama agrees.
Fifth, we simply cannot expect to bring
down the costs of health care in the United
States without taking on the for-profit
insurance and pharmaceutical corpora-
tions, which are raking in billions of dollars
at the cost of American lives. Incremental
steps such as a public option might sound
appealing but would still leave more than
10 million people without coverage while
keeping in place a costly private-insurance
middleman that eats up 25 to 30 percent in
administrative waste and profits. If we want
to achieve true universal health care while
containing costs, Medicare-for-all i s the only
answer.
Finally, Democratic candidates should
stop using one-liners from industry front
groups and Republican playbooks — such as
“Medicare-for-all would shutter hospitals,”
or telling seniors that “Medicare goes away
as you know it. All the Medicare you have is
gone.” These claims — amplified by contri-
butions from the private health-care indus-
try — are designed to incite fear and sow
confusion. I’ve spoken with several hospital
CEOs who see Medicare-for-all as a lifeline
for their hospitals — particularly safety-net
and rural hospitals that are barely surviving
under the current system. And my
Medicare-for-all bill improves Medicare for
seniors by adding additional benefits such as
dental, vision, hearing and long-term care.
As the debates continue, I hope that my
fellow Democrats will take a good look at
our bill and get the facts right. The
Medicare-for-all movement has overwhelm-
ing public support, unprecedented grass-
roots organization and a serious plan that is
ready t o change our h ealth-care system right
now.
Health care is the top issue for voters, and
they deserve to know the truth about the
solutions we are proposing. I’m willing to
debate Medicare-for-all with anyone — but
we owe it to all Americans to stick to the
facts.Th e writer, a Democrat, represents Washington’s
7th Congressional District in the U.S. House.The factsaboutMedicare-for-allF
ederal Reserve Chair Jerome
H. Powell has not been shy
about saying what he’s trying to
do: prolong the economy’s ex-
pansion so that it creates more jobs for
those who, in the past, have often felt
left out. The Fed increasingly sees itself
as a social agency dedicated to job
creation. That — more than the effect
on stock prices — is the real story
behind the Fed’s decision last week to
cut interest rates by a quarter-point.
For years, some economists have
argued that a “hot” l abor market could
pay huge social dividends. By “hot,”
they meant a situation where the
demand for workers equals, or out-
strips, the supply. The pressures would
push up wages, which, in turn, would
cause people not in the labor force
(defined as neither having a job nor
searching for one) to look for work.
Once employed, these relatively un-
skilled workers would develop compe-
tencies and contacts that would help
them get work. Sounds simple. It
wasn’t.
There was always an i mposing o bsta-
cle: inflation. The effort to employ
society’s l east-employable people creat-
ed a general wage-price spiral that
typically forced the Fed to tighten
credit, which in turn slowed the econo-
my or led to a recession.
But this time might be different,
Powell seems to be betting. For reasons
not well understood, inflation has
remained low. In the past year, the
consumer price index has risen
1.6 percent. That’s slightly lower than
the Fed’s official target of 2 percent
using another, slightly different infla-
tion indicator.
As a result, the Fed may be in a better
position now to test the “hot economy”
theory than at any time since World
War II. Powell is hardly hiding what he
and the other members of the Federal
Open Market Committee (FOMC), the
Fed’s main decision-making body, are
doing. The following excerpt from
Powell’s news conference makes this
clear.
Q. Thank you, Mr. Chairman. Scott
Horsley for NPR. You’ve talked a num
ber of times about the people who feel
like they are just recently getting to the
punch bowl 10 years into this expan
sion. Can you elaborate a little bit on
how this rate cut is expected to help
them?
A. We are getting lots of feedback
from people who work and live in low
and moderateincome communities to
the effect that they’re now feeling the
recovery, and in fact they haven’t felt a
better labor market in anybody’s ex
perience. So this is great to hear. And I
guess my view is the best thing we can
do for those people is to sustain the
expansion, keep it going, and that’s one
of the overarching goals of this move
[the Fed’s cut in interest rates] and of
all our policy moves.
(Note: The Q&A is edited for space.
The “punch bowl” reference is to Wil-
liam McChesney Martin Jr., Fed chair-
man in the 1950s and 196 0s, who said
the Fed’s job is to take away the punch
bowl just as the party gets going.)
By law, the Fed is supposed to
achieve “maximum” employment and
price stability. With tame inflation, the
Fed arguably can concentrate on job
creation.
The Fed isn’t alone in concluding
that low unemployment (3.7 percent) is
attracting new workers. “ There’s s trong
evidence that the tight labor market is
drawing people in,” s ays Josh Bivens of
the left-leaning Economic Policy Insti-
tute. He cites increases in the labor
force participation rate for men and
women aged 25 to 54, the prime-age
workforce.
The participation rate hit a high of
84.6 percent in early 1999. The Great
Recession of 2007 to 2009 then led to
an explosion of joblessness. The partic-
ipation rate slid to 80.8 percent in
mid-2014. Since then, it has recovered
to 82 percent. These changes seem
small; they’re not. Each percentage
point is worth 1.3 million people. The
increase from the low point translates
into almost 1.5 million workers.
Labor markets have clearly grown
tighter. Since 2009, the number of
workers involuntarily in part-time
jobs has dropped by about half. And
then there’s the broadest unemploy-
ment indicator, the U-6 (regular unem-
ployment, involuntary part-time em-
ployment, plus those “marginally” at-
tached to the labor market). It’s fallen
from about 17 percent in 2009 to
7 percent.
Still, it’s too early to say Powell has
won his bet. There are cautionary
signs. For starters, two members of the
FOMC dissented from the rate cut,
apparently fearing that too much easy
credit risks higher inflation and finan-
cial speculation.
History amplifies the warnings.
Since World War II, there have been
two other long stretches of economic
expansion: one in the 1960s, then again
in the 1990s and early 2000s. Both
ended badly: The 1960s economy bred
high inflation; the tech boom and
housing booms gave way to the Great
Recession.
It could be deja vu all over again.ROBERT J. SAMUELSONThe real story
behind the
Fe d’s interest
rate cut
BY JULIETTE KAYYEMT
here are no lone wolves. A
mass shooting at a Walmart
in El Paso on Saturday was,
according to police, allegedly
perpetrated by a young, white male
who appears to have posted a racist,
anti-immigrant manifesto online
minutes before the attack, declaring
the need to fight the “Hispanic inva-
sion of Texas.” Such white-
supremacist hatred isn’t just a poi-
sonous belief held by isolated indi-
viduals. It is a group phenomenon
that is, according to the FBI, the
greatest terrorist threat to America.
The El Paso shooting, which left
20 dead and more than two dozen
wounded, was followed hours later
by a mass shooting in Dayton, Ohio,
that killed nine. The shooter also
died, and on Sunday, p olice were still
unsure of his motive.
If the El Paso massacre turns out
to have been the hate crime that
police suspect, it will be one more
example why viewing what is hap-
pening in America today as anything
short of an ideological conflict —
with one side heavily armed, the
other side shopping for school sup-
plies at a Walmart — is to disengage
each individual incident from the
terrorist rhetoric that breeds it.
White-supremacist terror is root-
ed in a pack, a community. And its
violent strand today is being fed by
three distinct, but complementary,
creeds. The community has essen-
tially found a mission, kinship and
acceptance.
First, the mission. Young white
men today are the last generation of
Americans born when white births
outnumbered those of nonwhites.
Seven years ago, the Census Bureau
reported that minorities, particular-
ly Hispanics, were the majority of
newborns in the United States, a
trend that will continue. The devel-
opment can be viewed as natural for
a nation of immigrants or, in the
white-supremacist interpretation, a“white genocide” c ontrolled by Jews.
In o ther words, this strain of white
supremacy doesn’t s imply dislike the
“other”; it views the other’s very
existence as part of a zero-sum game.
The sense of “the great replacement”
seeps beyond the bounds of their
in-group, finding a voice even among
politicians who may inadvertently
bolster that view, as when Sen. John
Cornyn (R-Tex.) in June tweeted,
without providing a comment or
context, an article from the Te xas
Tribune with the headline: “Texas
gained almost nine Hispanic resi-
dents for every additional white resi-
dent last year.”
Second, the kinship. White-
supremacist terrorism has what
amounts to a dating app online,
putting like-minded individuals
together both through mainstream
social media platforms and more
remote venues, such as 8chan, that
exist to foster rage. It i s online, much
like Islamist terrorism, that white
supremacy finds its friends, col-
leagues who both validate and am-
plify the rage. When one of them puts
the violent rhetoric into action in the
real world, the killer is often call a
“lone wolf,” but they are not alone at
all. They gain strength and solace
from like-minded individuals. No
one would have said an individual
Klansman attending a Klan meeting
in the woods was a lone wolf; 8chan
and other venues are similar meet-
ing spaces in the digital wild.
Finally, the acceptance. It is too
simplistic to blame President Trump
and his inflammatory rhetoric for
the rise of white-supremacist vio-
lence. But that doesn’t mean his
language isn’t a contributing factor.
Historically, racist ideologies don’t
die; Nazism survived World War II,
after all. They just get publicly
shamed. Communities evolve to iso-
late once acceptable racism or xeno-
phobia. But they can also devolve
back to hate.
The similarities between Trump’s
language about Hispanics, immi-grants and African Americans marks
them as the “other” and is mimicked
by white supremacists. He fails to
shame them. His rhetoric winks and
nods, curries favor, embraces both
sides and, while not promoting vio-
lence specifically, certainly does not
condemn it (until after it occurs).
Public speech that may incite vio-
lence, even without that specific in-
tent, has been given a name: stochas-
tic terrorism, for a pattern that can’t
be predicted precisely but can be
analyzed statistically. It is the de-
monization of groups through mass
media and other propaganda that
can result in a violent act because
listeners interpret it as promoting
targeted violence — terrorism. And
the language is vague enough that it
leaves room for plausible deniability
and outraged, how-could-you-say-
that attacks on critics of the rhetoric.
Trump fails to shame white su-
premacy. That is all anyone needs to
know. And a responsible president —
one who was appalled that his lan-
guage might have been miscon-
strued and was contributing to the
greatest terror threat in the United
States today — would surely change
his rhetoric. The failure to do so
doesn’t mean Trump welcomes the
violence; it does mean that he isn’t
shaming its adherents.
After the white-nationalist vio-
lence in Charlottesville in 2017,
Trump uttered his now infamous
remark that there were “very fine
people on both sides.” No wonder
those young white men, rallying for
their hatred and brought together by
online organizing, were parading
their anger in broad daylight. There
was a time when they might have
worn hoods not only to terrorize but
also to hide their identity.
The pack today feels no shame.Th e writer is a former assistant secretary
at the Department of Homeland Security
and faculty chair of the homeland
security program at Harvard University’s
Kennedy School of Government.There are no lone wolves
MICHAEL ROBINSON CHAVEZ/THE WASHINGTON POST
Flowers adorn a makeshift memorial near the scene of a mass shooting at a shopping complex in El Paso.W
hen one side proposes ways
that human beings might be-
gin to solve a deadly problem
while the other side leaves it
up to God, you k now which s ide is right.
When one side proposes solution after
solution to contain gun violence — and
offers compromise after compromise to
get something d one — while t he other side
blocks action e very time, you know which
side is right.
When the president of the United
States and his most incendiary media
allies fuel hatred of those who are not
white while his opponents say we should
stand in solidarity with one another, you
know which s ide is right.
When one side brushes aside the dan-
gers of racist and white nationalist terror-
ism while the other side says w e need t o be
vigilant against all f orms of terrorism, you
know which s ide is right.
And when A mericans are gunned d own
in incident after incident, when we are
numbed by repeating the same sorrowful
words every time, when we move w ithin a
news cycle from “something must be
done” to “the Senate will block action” or
“the politics are too complicated,” you
know America’s democracy is failing and
its m oral compass is broken.
Our rancid political culture is, quite
literally, killing our nation. And the prob-
lem is not caused by some abstraction
called “polarization” or by “the failure of
both sides to understand each other.”
Those are the alibis of timid souls so
intent on sounding “balanced” that they
turn their eyes from t he t ruth.
What is that truth? When it comes to
gun violence and the need to confront
white nationalism, one side is right and
one s ide is w rong.
Until we face this, even two mass s hoot-
ings within 24 hours will do nothing to
galvanize action. In El Paso, 20 peoplewere killed at a shopping center on S atur-
day and 26 were wounded by a gunman
who, according to police, appears to have
posted an anti-immigrant screed online
before the shooting. Then at 1 a.m. on
Sunday in Dayton, Ohio, another mass
shooter left nine dead and 27 injured in
area known for its lively nightlife that is
heavily patrolled by police. The shooter
was k illed in less than a minute.“Think about that minute,” s aid Dayton
Mayor Nan Whaley. “ The shooter w as able
to kill nine people and injure 26 in less
than a minute.” The gun-permissiveness
crowd wants us not to think about that
minute. It puts the lie to the gun lobby’s
claim that having armed people nearby
when a mass killer s trikes is all we need t o
keep u s safe.
The wrong side in this debate does not
want us to come together. On the c ontrary,
its goal after every mass shooting is to
deflect and divide. Here’s what Te xas
Gov. Greg Abbott said when asked by
reporters what we should do about gun
violence. “Listen, there are bodies that
have not yet been recovered,” Abbott re-
plied. “I think we need to focus more on
memorials b efore we start the politics.”
No, Abbott, reading from the NRA’s
script, started “the politics” right at that
moment, and it is an insidious form of
politics. Simultaneously, he deflected by
pretending it’s impolite to answer sub-stantive questions and divided by saying
that those who raise them disrespect the
dead.
Nothing disrespects those who are
slaughtered more than the political
paralysis Abbott and those like him are
encouraging.
Invoking God and calling for prayer
should never seem obscene. But it is al-
ways obscene to use the Almighty to es-
cape our own r esponsibility.
“God bless the people of El Paso Te xas.
God bless the people of Dayton, Ohio,”
President Trump said in a Sunday morn-
ing tweet from his New Jersey golf club.
Yes, may God bless them. But may God
also judge Trump for a political strategy
whose s uccess depends o n sowing racism,
reaction and division. May God judge him
for stoking false and incendiary fears
about an immigrant “invasion,” the very
word echoed by the manifesto that police
suspect was the El Paso shooter’s. May
God judge the president for cutting pro-
grams to fight white extremism at t he very
moment when the F BI is telling us that w e
are more at risk from white-nationalist
terrorists than Islamist terrorists.
In p ursuit of a mythical m iddle g round,
the f aint-hearted will c ounsel against call-
ing out t he m oral culpability of t hose w ho
divide, deflect and evade. Meanwhile, the
rationalizers of violence will continue to
claim that only troubled individuals, not
our genuinely insane gun policies, are
responsible for waves of domestic terror-
ism that bring shame on our country
before the world.
But sane gun laws are the middle
ground, and most gun owners support
them. Opposing the political exploitation
of racism is a moral imperative. And
refusing to acknowledge that only one
side in this debate seeks intentionally to
paralyze us i s the path o f cowardice.
Twitter: @EJDionneE.J. DIONNE JR.On gun violence, only one side is right
Nothing disrespects those
who are slaughtered more
than the political paralysis
that some are encouraging.