In past episodes, we've made the case that Congress isn't serving the common good -- the oath our elected representatives took when they swore to uphold the Constitution of the United States. Congress gets away with it, because our media follows the horse race and not the substance. Our fifth episode of “Another Reason to Fix Our Democracy” discusses why the majority of our national, mainstream media isn't asking the right questions of our elected representatives, and not giving citizens enough information to realize they're not being served as our Constitution intended.
Episode #5, written and recorded by Rick Hubbard during his cross country Walking to Fix Our Democracy epic journey.
NOTES:
Preamble to the U.S. Constitution. Link: https://www.uscourts.gov/about-federal-courts/educational-resources/about-educational-outreach/activity-resources/us#:~:text=%22We%20the%20People%20of%20the,for%20the%20United%20States%20of
https://fortune.com/2022/06/16/41-percent-of-employees-are-living-paycheck-to-paycheck/
Congressional Budget Office, Working Paper 2020-08, December 2020, How CBO Analyzes the Costs of Proposals for Single-Payer Health Care Systems That Are Based on Medicare’s Fee-for-Service Program Link: https://www.cbo.gov/system/files/2020-12/56811-Single-Payer.pdf
Congressional Budget Office, Working Paper 2020-08, December 2020 Exhibit 11-1, p. 121, National Health Expenditures Under Current Law and CBO’s Illustrative Single-Payer Options, 2030. Link: https://www.cbo.gov/system/files/2020-12/56811-Single-Payer.pdf
Health Affairs Blog, 2021-2-16, Doctors Adam Gaffney, David Himmelstein and Steffie Woolhandler, Congressional Budget Office Scores Medicare-For-All: Universal Coverage For Less Spending. Link: https://www.healtheaffairs.org/do/10.1377/hblog20210210.190243/full/
Health Affairs Blog, 2021-2-16, Doctors Adam Gaffney, David Himmelstein and Steffie Woolhandler, Congressional Budget Office Scores Medicare-For-All: Universal Coverage For Less Spending. Effects of Design Features Underlying All of the Options, page 13. Link: https://www.healtheaffairs.org/do/10.1377/hblog20210210.190243/full/
US Census Bureau, Health Insurance Coverage in the United States: 2021
Written by: Katherine Keisler-Starkey and Lisa N. Bunch, Report Number P60-278, Dated: September 13, 2022 Link: https://www.census.gov/library/publications/2022/demo/p60-278.html
2021-3-11 Health Affairs Blog - Medicare Advantage For All? Not So Fast, Exhibit 1: Medicare Advantage enrollment rates over time. Link: https://www.healthaffairs.org/do/10.1377/hblog20210304.136304/full/
Dr. Ana Malinow, MD Past President of Physicians for a National Health Program (PNHP) video presentation explaining Dicrect Contract Entities.
Link: https://pnhp.org/direct-contracting-entities-handing-traditional-medicare-to-wall-street
2021-9-29 Health Affairs Blog, Gilfillan and Berwick - Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 1: The Risk-Score Game, How the “MA Money Machine Works.” Link: https://www.healthaffairs.org/do/10.1377/hblog20210927.6239/full/
2021-9-30 Health Affairs Blog, Gilfillan and Berwick - Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 2:
2021-8-17 Kaiser Family Foundation - Higher and Faster Growing Spending Per Medicare Advantage Enrollee Adds to Medicare’s Solvency and Affordability Challenges. Findings-Spending per person. Link: https://www.kff.org/medicare/issue-brief/higher-and-faster-growing-spending-per-medicare-advantage-enrollee-adds-to-medicares-solvency-and-affordability-challenges/
2021-3-11 Health Affairs Blog - Medicare Advantage For All? Not So Fast, Exhibit 4: Medicare per beneficiary growth rate. Link: https://www.healthaffairs.org/do/10.1377/hblog20210304.136304/full/
2021-8-17 Kaiser Family Foundation - Higher and Faster Growing Spending Per Medicare Advantage Enrollee Adds to Medicare’s Solvency and Affordability Challenges. - Conclusion. Link: https://www.kff.org/medicare/issue-brief/higher-and-faster-growing-spending-per-medicare-advantage-enrollee-adds-to-medicares-solvency-and-affordability-challenges/
Brennan Center For Justice, 2021-11-6 - Tim Las, The Filibuster Explained, https://www.brennancenter.org/our-work/research-reports/filibuster-explained
Why Competition in the Politics Industry is Failing America, by Katherine M. Gehl and Michael E. Porter
Takeaways About Money in the Midterms, The Brennan Center for Justice
https://www.brennancenter.org/our-work/analysis-opinion/4-takeaways-about-money-midterms
Majority of Americans say they won’t donate to 2020 presidential campaigns
CNBC and Acorns Invest in Your Spending Survey.
Reason #5 to Fix Our Democracy - by encouraging mainstream, national media to properly cover what our elected representatives took an oath to accomplish versus what they are actually doing.
Hello. I’m Rick Hubbard and this is the fifth in a series of podcasts about our need to fix America’s dysfunctional democracy. This podcast series is titled “Reasons to Fix Our Democracy,” and each podcast will highlight “another reason to fix our democracy”.
Today’s “Another Reason to Fix Our Democracy” addresses how and why the majority of our national, main stream media can and should do a better job explaining and educating all of us about what those we have elected to represent the public good of us all are actually doing, versus the job under the constitution they took an oath to accomplish.
The media have a huge effect on how we inform and educate ourselves on all kinds of topics. We, the public, make our decisions based on the quality and quantity of information we get to process. Therefore, it’s important that we receive ccurate, in depth information that is relevant to all kinds of important issues, and that our media properly maintain high professional standards when delivering it.
Most of us have heard the phrase: “garbage in, garbage out.” There’s very little positive benefit from that.
Much of our commercial and social media today is heavily influenced by their profit seeking business model. It prioritizes whatever coverage they feel will best engage and further involve their audience so they can earn the most advertising dollars. That has little to do with delivering us the kind of content we might need to know as citizens trying to evaluate how well those we’ve elected are doing to properly represent our public good.
I regularly listen to National Public Radio, (NPR) whose stated mission is “to create a more informed citizenry, providing listeners with a deeper understanding of events, ideas, and cultures.”
That all sounds good, but as we continue this podcast, ask yourself: how well does NPR measure up when covering the topics we’ll discuss today.
When we elect representatives both to Congress and to our state legislatures, they take an oath to follow either our federal constitution or their individual state constitutions.
The preamble to our federal constitution describes their job to “establish justice, ensure domestic tranquility, provide for our common defense, and promote the general welfare”. ,
They further agree to do this “freely, without any mental reservation or purpose of evasion” and to “well and faithfully discharge” their duties as a member of Congress.
State constitutions vary in wording, but generally have similar objectives.
So, let’s examine how mainstream, national media provides content covering three areas, among many more, where our representatives in Congress should serve the public good of all 330+ million of us in America: #1 - capitalism and our economy; #2 - our healthcare system, and #3 - the way we structure and finance our political system.
As we do, please ask yourself: are they properly informing and educating me about these issues?
Balancing Capitalism to broadly serve us all
Our nation has embraced capitalism. It’s very efficient, even ruthless, at generating economic growth. It also has nasty side effects.
The responsibility of those we’ve elected to represent us is to balance, the advantages and side effects of capitalism to broadly benefit all of us.
If not properly balanced by those who represent us, over time capitalism will create economic gains, but the majority of these gains will be funneled ever upwards to an increasingly smaller number of increasingly more wealthy individuals. The economic gains for these few, come from the rest of us in the form of low wages, abnormally higher prices, lack of competition, and more.
Another bad side effect of capitalism is that, left unbalanced, capitalism will drive wages as low as they will go, as long as someone will show up for work. A majority of our representatives at both the state and federal level have failed to balance this negative side effect for several decades now.
Our national mainstream media regularly report in great detail about our economy and capitalism. But how often do you hear them compare and contrast these details with the job our elected representatives are doing to balance capitalism and our economy to broadly benefit us all?
Healthcare
The responsibility of those who represent us, is to establish and support a health care system (whether best delivered privately or publicly) that provides high quality healthcare to all 330+ million of us at the lowest, system wide total cost, in a manner that is financially and socially sustainable into the future.
Are you aware that our elected representatives in Congress currently have available two studies that, when combined, show Congress and our Executive branch could provide high quality Medicare for almost all 330+ million of us at the highest i.e., most expensive, level, and save we the people $500 billion a year in 2030 when compared to continuing with our present system?
Our present system costs we the people much more money, leaves over 27 million of us without any health insurance, tens of millions more without adequate insurance, is the biggest cause of personal bankruptcy in America, and is funneling profits from providing us with healthcare to an ever-smaller number of the increasingly wealthiest amongst us?
The first study, done by the Congressional Budget Office and released about three years ago, concludes we can provide nearly all 330+ million of us with good quality health care at an added cost in the federal budget in 2030 of some $290 billion a year. That’s an increase of about 4 percent in our federal budget’s expenditures for national health care.
But there are huge cost savings in areas of administration and overhead when all money for providing health care is centralized and paid through the federal government. In addition, there will be enormous savings for each of our 50 states when they transfer to our federal government all costs they currently pay for health insurance for their public employees, other health programs, plus the state share of Medicaid.
Those saving have been added up by three doctors from PNHP - Physicians for a National Healthcare Plan with decades of experience studying the economics of health care. These experts conclude that the transfer of healthcare costs from all 50 state budgets over to the federal government for payment, “would bring state and local governments’ total savings from single payer to about $800 billion in 2030 alone.”
You might say “do all that, cover everyone, and still save $500 billion in 2030? Why isn’t Congress more actively considering this?
Instead, a majority of those who represent us in Congress have set us on a different, more expensive, and more damaging healthcare path. One that actually undermines the health and savings of we the people.
Here’s how.
Buried deep in Obamacare, the Affordable Care Act of 2010, Congress established a new Innovation department, also known as “CMMI,” the Center for Medicare and Medicaid Innovation, and charged it to develop and test new healthcare payment and service delivery models like Medicare Advantage and ACO Reach.
Congress further authorized CMMI to then roll out these new programs to the entire US population without further authorization by Congress, although Congress could, if it chose, provide oversight.
The bottom line? Each new program costs MORE money per average person than is paid for those of us enrolled in traditional Medicare with a supplement program.
That’s right. More money per person.
And this current path has the full backing of both our current administration in Washington, as well as the previous one.
That extra money paid by the Center for Medicare Services to these new private entities is paid by us. We are the ones who first paid it to our government in our taxes and healthcare payments.
But when our national mainstream media regularly report in great detail about our present healthcare system, or Medicare Advantage, or about ACO REACH programs, how often do your hear them compare and contrast these details with the job our elected representatives are supposed to do to provide all Americans with good quality care at the least, total system-wide cost?
And how often do you hear them explain why what’s being done differs so much from what should be done?
Now let’s look at our third area.
Structuring our political system so it will provide us with proper representation
We the people benefit when our process is fair, impartial, inclusive, competitive, and responsive to our common good.
Our representatives each took an oath to accomplish this on our behalf.
Yet today, our two major political parties and their candidates are much more focused on winning and staying in power than on governing.
They act like two warring Super Bowl teams, each doing everything they can to win.
There’s a big problem with this.
In football, the goal is to win.
But in politics, the job of those who win, is to govern well on behalf of us all.
This has not been happening properly, and we the people know it.
Doing their job properly requires both the media and each of our representatives to speak out about how the structure and financing of our current political system is poorly serving the very people it is designed to serve.
It also requires each of our representatives to speak out about the best ways to reform it, even when it’s against their own personal re-election interests and those of their political party.
For we know that unless the media and our politiciansa repeatedly say why the structure and financing of our political process works against the common good of we the people, our will to fix it will grow more slowly.
And amplifying these problems and discussing reforms is essential for most people to begin to hear, think about, and decide how our political system’s many broken parts might best be fixed.
Now, let’s talk about these political labels
I’m sure we’ve all noticed how the media regularly labels actions by politicians as conservative, moderate, liberal, progressive, and more. But is this accurate and helpful?
Question. When one of our elected representatives supports, providing healthcare to all Americans and cites the two reports we discussed above that justify it, is he or she acting as a conservative, moderate, liberal or progressive? Or are they simply a Congressperson doing their job?
In this situation as well as in many others, these labels are not helpful. In fact the opposite. They simply misinform and misdirect us, the audience, about the issue and about whether we the people are being provided with proper representation.
Moreover, when our mainstream national media skip over the job our elected representative are supposed to do, and only cover the horserace, and what each party is doing in relation to each other, they make us think that what’s happening is normal, routine, and what we should expect. This does not serve their audience, since it gives them less information and incentive to demand improvements.
We’d all be better off, and better informed, if our media simply ditched these labels and focused on whether, on each issue, we are being properly represented.
Looking Forward
So there you have it. There’s lots of noise out there that can prevent us from making optimum decisions.
Our mainstream, national media can, and should, step up their game to best meet their own goals to inform and educate their audience. If they do this, we’ll all benefit.
So friends, it’s time to DO something about this. Ask your elected representatives to chuck the labels and speak out, loudly and repeatedly, about how the current structure and financing of our political system inhibits them from properly representing us, and to support reform. Ask the media you rely on to also chuck the political labels and when reporting on public policy issues, compare the job our elected representatives are supposed to do, versus what they actually are doing.
Go to my website, FixOurDemocracy.us to sign up, and to find supporting state groups. Participate in parades. Carry signs to “Fix Our Democracy.” The road is long, but we can and must fix our representative democracy.
NOTES:
Preamble to the U.S. Constitution. Link: https://www.uscourts.gov/about-federal-courts/educational-resources/about-educational-outreach/activity-resources/us#:~:text=%22We%20the%20People%20of%20the,for%20the%20United%20States%20of
https://fortune.com/2022/06/16/41-percent-of-employees-are-living-paycheck-to-paycheck/
Congressional Budget Office, Working Paper 2020-08, December 2020, How CBO Analyzes the Costs of Proposals for Single-Payer Health Care Systems That Are Based on Medicare’s Fee-for-Service Program Link: https://www.cbo.gov/system/files/2020-12/56811-Single-Payer.pdf
Congressional Budget Office, Working Paper 2020-08, December 2020 Exhibit 11-1, p. 121, National Health Expenditures Under Current Law and CBO’s Illustrative Single-Payer Options, 2030. Link: https://www.cbo.gov/system/files/2020-12/56811-Single-Payer.pdf
Health Affairs Blog, 2021-2-16, Doctors Adam Gaffney, David Himmelstein and Steffie Woolhandler, Congressional Budget Office Scores Medicare-For-All: Universal Coverage For Less Spending. Link: https://www.healtheaffairs.org/do/10.1377/hblog20210210.190243/full/
Health Affairs Blog, 2021-2-16, Doctors Adam Gaffney, David Himmelstein and Steffie Woolhandler, Congressional Budget Office Scores Medicare-For-All: Universal Coverage For Less Spending. Effects of Design Features Underlying All of the Options, page 13. Link: https://www.healtheaffairs.org/do/10.1377/hblog20210210.190243/full/
US Census Bureau, Health Insurance Coverage in the United States: 2021
Written by: Katherine Keisler-Starkey and Lisa N. Bunch, Report Number P60-278, Dated: September 13, 2022 Link: https://www.census.gov/library/publications/2022/demo/p60-278.html
2021-3-11 Health Affairs Blog - Medicare Advantage For All? Not So Fast, Exhibit 1: Medicare Advantage enrollment rates over time. Link: https://www.healthaffairs.org/do/10.1377/hblog20210304.136304/full/
Dr. Ana Malinow, MD Past President of Physicians for a National Health Program (PNHP) video presentation explaining Dicrect Contract Entities.
Link: https://pnhp.org/direct-contracting-entities-handing-traditional-medicare-to-wall-street
2021-9-29 Health Affairs Blog, Gilfillan and Berwick - Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 1: The Risk-Score Game, How the “MA Money Machine Works.” Link: https://www.healthaffairs.org/do/10.1377/hblog20210927.6239/full/
2021-9-30 Health Affairs Blog, Gilfillan and Berwick - Medicare Advantage, Direct Contracting, And The Medicare ‘Money Machine,’ Part 2:
2021-8-17 Kaiser Family Foundation - Higher and Faster Growing Spending Per Medicare Advantage Enrollee Adds to Medicare’s Solvency and Affordability Challenges. Findings-Spending per person. Link: https://www.kff.org/medicare/issue-brief/higher-and-faster-growing-spending-per-medicare-advantage-enrollee-adds-to-medicares-solvency-and-affordability-challenges/
2021-3-11 Health Affairs Blog - Medicare Advantage For All? Not So Fast, Exhibit 4: Medicare per beneficiary growth rate. Link: https://www.healthaffairs.org/do/10.1377/hblog20210304.136304/full/
2021-8-17 Kaiser Family Foundation - Higher and Faster Growing Spending Per Medicare Advantage Enrollee Adds to Medicare’s Solvency and Affordability Challenges. - Conclusion. Link: https://www.kff.org/medicare/issue-brief/higher-and-faster-growing-spending-per-medicare-advantage-enrollee-adds-to-medicares-solvency-and-affordability-challenges/
Brennan Center For Justice, 2021-11-6 - Tim Las, The Filibuster Explained, https://www.brennancenter.org/our-work/research-reports/filibuster-explained
Why Competition in the Politics Industry is Failing America, by Katherine M. Gehl and Michael E. Porter
Takeaways About Money in the Midterms, The Brennan Center for Justice
https://www.brennancenter.org/our-work/analysis-opinion/4-takeaways-about-money-midterms
Majority of Americans say they won’t donate to 2020 presidential campaigns
CNBC and Acorns Invest in Your Spending Survey.