THE DEMOCRATS’ “A BETTER DEAL”

Congressional Democrats have announced a package of policy proposals they are calling “A Better Deal.” It’s apparently their policy platform for the 2018 Congressional elections and its focus is on re-establishing Democrats as the party that stands up for working people. It proclaims that too many American families feel that the rules of our economy are rigged against them. It notes that incomes and wages are not keeping up with the cost of living for many workers. It states that large corporations, the rich, and other special interests are avoiding paying taxes and meanwhile are spending huge sums of money to influence our elections. Democrats claim that A Better Deal will grow and strengthen the middle class and reverse the failure of so-called trickle-down economic policies (i.e., tax cuts for the wealthy) to do so.

A Better Deal has three overarching goals: [1]

Raise the wages and incomes of American workers and create millions of good-paying jobs,
Lower the costs of living for families, and
Build an economy that gives working Americans the tools to succeed in the 21^st Century.

A Better Deal calls for raising the national minimum wage to $15 an hour by 2024 and then increasing it automatically so it keeps up with inflation. A Better Deal promises that Democrats will fight the offshoring of Americans’ jobs by penalizing corporations that move jobs overseas and by cracking down on unfair trade policies of other countries, including currency manipulation. It calls for renegotiating the NAFTA trade agreement with Canada and Mexico to increase US exports and jobs, while also improving wages. Federal contractors who move jobs to foreign countries would be penalized and there would be Buy American requirements in government purchasing.

The Democrat’s plan calls for $1 trillion in federal spending on the infrastructure, such as bridges, roads, railroads, airports, and waterways, that is the transportation backbone of our economy. The plan projects that 15 million good-paying jobs would be created by these investments. It would also support job creation by prioritizing support for small businesses and entrepreneurs over benefits for large corporations. It would invest in research and innovation, as well as making high-speed Internet service available to everyone. It pledges to ensure that workers will be able to “retire with dignity,” by protecting pensions, Social Security, and Medicare.

A Better Deal calls for lowering the costs of drugs, post-secondary education, child care, cable TV and Internet service, and credit cards. It promises a crackdown on big price increases by pharmaceutical corporations as well as their practices that drive up drug costs. Medicare would be allowed to negotiate drug prices (which it is currently barred by law from doing!).

A Better Deal would curtail the monopolistic practices of large corporations that lead to higher prices and reduced consumer choice. It notes that concentrated market power leads to great political power, which has been used by big corporations to obtain beneficial policies from government. Strengthening anti-trust laws and their enforcement are identified as key strategies for achieving these goals. A Better Deal calls for eliminating unlimited and/or undisclosed spending by corporations and the wealthy in our elections, as well as reducing the power and influence of lobbyists and special interests.

A Better Deal promises paid leave for workers when they are sick or when a family situation merits taking time off. Paid leave for a new child or a family member’s illness would be covered. It notes that this will keep families healthy, both medically and financially.

In A Better Deal, Democrats commit to expanding government investment in workers’ access to the education, training, and other tools they need to succeed in the 21^st Century. In addition, employers would receive incentives to invest in their workers’ skills and knowledge. Apprenticeships would be expanded and training programs would be better coordinated with businesses’ needs for workers.

There is much in A Better Deal for workers to like. Democrats appear to be recommitting themselves to putting workers first, ahead of monied interests, reversing their mid-1990s decision to cozy up to those with big money to get the funding they needed for their campaigns. Despite its good points, there are notable weaknesses in A Better Deal and its presentation that I will outline in my next post.

[1] Schumer, C., retrieved 8/20/17, “A better deal,” U.S. Senate Democrats (https://democrats.senate.gov/abetterdeal/#.WZydEbpFzIU)

PROTECTING CONSUMERS FROM WALL STREET

The collapse of the financial corporations in 2008 was due in large part to their predatory and illegal practices in pushing unaffordable home mortgages onto gullible home buyers. Congress and President Obama enacted the Dodd-Frank Wall Street Reform and Consumer Protection Act (known as Dodd-Frank) to help protect consumers from such abusive behavior.

Dodd-Frank’s most notable consumer protection provision was the creation of the Consumer Financial Protection Bureau (CFPB). The CFPB’s role is to protect consumers from illegal and predatory practices, as well as discrimination, by financial corporations and to work to ensure that consumers receive the information necessary to make good financial decisions and to avoid “unsafe” financial products and services.

Since its creation, the CFPB has been hard at work punishing financial corporations that violate the law, returning almost $12 billion to over 29 million victimized consumers. In less than 8 years, it has helped consumers by responding to over 1.2 million complaints and issuing, for example, new standards for home mortgage documents that are clearer and easier to understand. At CFPB’s website you can find information on understanding your credit score and to help you make a good decision about a car or student loan.

Given that financial products and services (such as bank accounts, credit cards, and car and student loans) are essential for individuals, families, and our economy, appropriate regulation of them is necessary. Before the creation of the CFPB, financial services regulation was spread among 6 federal agencies and state regulators. None of them had consumer protection as its sole or primary role nor had the power to establish a single set of regulations for the whole financial industry. The CFPB has this power and a sole focus on consumer protection, much as the Consumer Product Safety Commission does for non-financial products. [1]

In July, the CFPB finalized a rule prohibiting financial corporations from putting mandatory arbitration clauses in their customer contracts. These clauses, which are in most agreements consumers sign when they open a bank account or get a loan or credit card, prohibit customers from suing the financial corporation in court. (They are also in many contracts or agreements for other consumers products and services, such as cell phones and cable TV, Internet, and phone services.) They require the customer to submit any complaint, even one due to illegal activity, to an arbitrator, who is usually selected by the financial corporation. They eliminate the ability of customers to band together in a class action lawsuit, and require them to pursue any grievances only through individual arbitration cases.

In addition to preventing class action lawsuits, the mandatory arbitration clauses often prohibit customers from sharing their experiences with regulatory or law enforcement agencies and the media. Corporations know that consumers will rarely spend the time and money (the typical cost to file an arbitration claim is $161) to pursue arbitration, given that the amount of money at stake is usually small. The result is that corporations evade accountability and can hide illegal or unethical behavior. [2]

The CFPB rule banning mandatory arbitration clauses was put in place after 5 years of study and development pursuant to a Congressional directive to study mandatory arbitration clauses and restrict or ban them if they harm consumers. The CFPB study found that customers win only 1 out of 11 arbitration cases and when they win they receive an average of $5,389. However, when a financial corporation makes a claim or counterclaim against a customer, it wins 93% of the time and the customer is ordered to pay, on average, $7,725 to the financial corporation! [3]

The CFPB study also found that in an average year 6,800,000 consumers get cash awards due to class action lawsuits while only 16 do so in arbitration cases. Consumers in these lawsuits receive a total of $440,000,000 (after deducting lawyers’ and courts’ fees), while consumers across all arbitration cases receive a total of $86,216.

Three recent examples of practices by Wells Fargo & Company make clear the significance and importance of banning mandatory arbitration clauses and allowing class action lawsuits by customers. (By the way, Wells Fargo is the third largest US bank and a multi-national financial corporation headquartered in San Francisco with $22 billion in annual profits.) It recently paid $185 million to settle with the CFPB and other regulators for having illegally opened and charged customers for over 2 million unauthorized checking and credit card accounts. When customers tried to sue Wells Fargo for this starting back in 2013, it forced them to make their claims in individual arbitration cases. This allowed Wells Fargo to continue its illegal behavior and theft from customers for 3 more years (5 years in total) before its behavior came to the attention of regulators.

In July, another class action lawsuit was filed against Wells Fargo based on illegal behavior on car loans. Apparently, Wells Fargo was requiring customers with car loans to buy car insurance they didn’t need (it was typically redundant with insurance they already had). And Wells Fargo was getting kickbacks from the company selling the insurance. The extra cost of the unneeded insurance pushed 250,000 car loan customers into default on their loan payments and resulted in 25,000 cars being repossessed. If these customers are forced into arbitration and are unable to participate in a class action lawsuit, it’s likely that most of them will not receive any compensation from Wells Fargo for its illegal and harmful behavior.

Finally, Wells Fargo is the defendant in an on-going, 8-year-old case over overdraft fees and practices. It is arguing in court that these customers’ claims must be handled in individual arbitration cases rather than a class action lawsuit, despite complaints from customers in 49 states. [4]

Despite these examples, and the fact that Congress has banned mandatory arbitration in home mortgage agreements, members of Congress have quickly introduced legislation to repeal the Consumer Financial Protection Bureau’s new rule banning mandatory arbitration clauses in financial product and service agreements. [5] Weakening or eliminating the CFPB in general, not just its ban on mandatory arbitration, has been a goal of Wall St. corporations and their friends in Congress ever since its creation by the Dodd-Frank law.

I urge you to contact your US Representative and Senators and ask them to support the Consumer Financial Protection Bureau and its ban on mandatory arbitration clauses in consumer product and service agreements.

[1] Servon, L.J., 7/17/17, “Will Trump kill the CFPB?” The American Prospect (http://prospect.org/article/will-trump-kill-cfpb)

[2] Germanos, A., 7/12/17, “Serving Wall Street predators, GOP launches swift attack on new rule protecting consumers,” Common Dreams (https://www.commondreams.org/news/2017/07/12/serving-wall-street-predators-gop-launches-swift-attack-new-rule-protecting)

[3] Shierholz, H., 8/1/17, “Correcting the record: Consumers fare better under class actions than arbitration,” Economic Policy Institute (http://www.epi.org/publication/correcting-the-record-consumers-fare-better-under-class-actions-than-arbitration/)

[4] Brumback, K., 8/25/17, “Wells Fargo wants customer suits tossed,” The Boston Globe from the Associated Press

[5] Germanos, A., 7/12/17, “Serving Wall Street predators, GOP launches swift attack on new rule protecting consumers,” Common Dreams (https://www.commondreams.org/news/2017/07/12/serving-wall-street-predators-gop-launches-swift-attack-new-rule-protecting)

PROTECTING OUR ECONOMY FROM WALL STREET SPECULATION

After the collapse of the financial corporations in 2008 due to their greed, predatory and illegal practices, and malfeasance, Congress and the President enacted legislation to try to prevent such a collapse in the future. This was the Dodd-Frank Wall Street Reform and Consumer Protection Act (known as Dodd-Frank).

The Dodd-Frank law is not as strong as many people thought it should be, because Wall St. executives, along with their lobbyists and friends in Congress, worked hard to weaken it as it was being written and passed. For example, it did not break up the “too-big-too-fail” financial corporations or limit their growth. (They are now all bigger than they were in 2008.)

A key provision of Dodd-Frank, known as the Volcker Rule, restricts banks from making certain kinds of speculative investments that do not benefit their customers and actually put customers’ deposits (and the banks and the economy) at risk if large investment losses result. Such speculative investments and big losses from them played a key role in causing the 2008 financial collapse. The Volcker Rule restricts but does not ban such investments, as many people thought it should and as had been the case from 1933 to 1999 under the Glass-Steagall Act. [1] In particular, many people believe that banks with deposits insured by the Federal Deposit Insurance Corporation (FDIC) should be prohibited from making such risky investments because these investments, which only benefit the bank’s executives and shareholders, are, in effect, insured against big losses by the FDIC, i.e., the federal government and taxpayers.

The Volcker Rule was supposed to be implemented in 2010, but continuing opposition from Wall St. and its supporters has continued to delay (and further weaken) the rule. It finally went into effect in 2015, but banks continue to be granted extensions for when they have to come into compliance with its provisions.

The Trump Administration, through the five agencies that regulate the financial industry, is currently working to rewrite and further weaken the Volcker Rule. They are moving to loosen the restrictions on risky investments, even though they were a major cause of the 2008 financial collapse. [2]

The Dodd-Frank law in general, not just its Volcker Rule, has been a target for weakening and delaying tactics ever since its original drafting and passage, as well as at every step in its implementation. The US House recently passed the so-called Financial Choice Act that would significantly weaken Dodd-Frank’s regulation of the financial industry.

I urge you to contact your US Representative and Senators and ask them to:

Oppose efforts to weaken the Volcker Rule and to support an outright ban on speculative investment activity by banks that have customer deposits and FDIC insurance, and
Oppose efforts to weaken the Dodd-Frank law in general and its regulations that reduce the likelihood of another financial industry collapse.

[1] Wikipedia, retrieved 8/15/17, “Volcker Rule,” (https://en.wikipedia.org/wiki/Volcker_Rule)

[2] Bain, B., & Hamilton, J., 8/1/17, “Wall Street regulators are set to rewrite the Volcker Rule,” Bloomberg News (https://www.bloomberg.com/news/articles/2017-08-01/volcker-rewrite-is-said-to-start-as-trump-regulators-grab-reins)

THE CASE FOR SINGLE-PAYER HEALTH INSURANCE

Our private health insurance system is not working. As I outlined in my previous post, there are three core problems with our private health insurance system:

By fragmenting the pool of insured people and allowing some to opt out, the basic theory and efficiency of insurance is undermined.
Private insurers have no financial incentive to maintain the long-term health of their customers because customers change insurers frequently.
Private insurers spend a large portion of their health insurance premiums on overhead, i.e., non-medical expenses (roughly 25%, which adds up to hundreds of billions of dollars each year).

An alternative that would address these major problems with the U.S. health insurance system is a Medicare-for-All, single-payer system. This type of a system is supported by a growing majority of Americans (62%), most Democrats in Congress, many doctors, and a growing number of public figures, such as former President Jimmy Carter [1] and former Vice President Al Gore. [2] Physicians for a National Health Program is one of a number of groups advocating for a single-payer system. An interview with its President, Dr. Carol Paris, on why the group supports single-payer health insurance is here. (She joins the newscast at 17 minutes 25 seconds into this 28-minute segment. The link starts 14.5 minutes into the newscast, when the topic turns to health care.)

A universal, single-payer system provides the most efficient health insurance for multiple reasons. First, it maintains a single, large pool of insurees who have differentiated risks and health care needs. A large, differentiated pool of insurees is what the basic theory and efficiency of insurance is predicated on.

Second, a single-payer insurance system has people as customers for life, thereby providing a strong incentive to invest in preventive care and the long-term health of its customers. A focus on preventive care and wellness produces the best health outcomes and does so at the lowest cost.

Third, switching to a single-payer, Medicare-for-All type health insurance system would save about $500 billion per year by eliminating the administrative overhead of our health insurance corporations. [3] In addition, health care providers would have only one set of forms, procedures, and paperwork to deal with, greatly simplifying the processing of billing the insurer for their services and reducing their costs and frustrations in doing so. [4]

A single-payer system is the only way to both improve quality and control costs, as Don Berwick (a doctor and former head of the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees those public health insurance programs) has stated. An example he cites to illustrate this point is an action he took when he was the head of CMS. Data was showing that senior care facilities were using drugs to sedate patients whose behavior was challenging at times, rather than taking the time and energy to handle their behavior more appropriately. Given that Medicare and Medicaid pay for much of the care these facilities provide, he had the leverage to tell the facilities’ managers that they should address this problem or that he would develop regulations to deal with it. The result was that the facility managers reduced drug use and costs, and also provided better care to their patients. Berwick could do this because he had leverage as the primary payer (although not quite the only or single payer) for these services. [5]

Bills have been introduced in Congress to create a single-payer, Medicare-for-All health insurance system. Over half of the Democrats in the House, over 100 Representatives, have endorsed H.R. 676, The Expanded and Improved Medicare for All Act, sponsored by Rep. Conyers. Senator Bernie Sanders will introduce a similar bill in the Senate.

I don’t understand why Democrats in Congress haven’t been making more of a push for a single-payer health insurance as an alternative to the Affordable Care Act repeal-and-replace legislation that the Republicans have been promoting. [6] I am disappointed that our mainstream, corporate media haven’t provided more coverage of this as an option, although at some level I’m not surprised as it would make significant changes for the health insurers and drug companies that provide them significant advertising income. [7]

I urge you to contact your US Representative and Senators to ask them to support a single-payer, Medicare-for-All health insurance system. Every other economically advanced country has a universal, single-payer health service system that covers everyone at far lower costs than our current privatized system and produces better health outcomes with longer lifespans. [8]

There has been a concerted effort in the U.S. to discredit other countries’ universal, single-payer health care systems, particularly Canada’s, often with inaccurate information. An excerpt from a recent Congressional hearing where a Canadian doctor very effectively rebuts attacks on the Canadian health care system can be viewed here. (It’s just under 7 minutes.) Or you can watch or listen to a Canadian businessman rebut attacks on the Canadian health care system here (a short, less than 3-minute YouTube video).

I encourage you to engage, however you can, in the movement to make universal, single-payer health insurance a reality in the U.S. We need to pressure our elected officials to adopt this solution to our failing health insurance system. If you need further convincing that this is the way we need to go, please watch or listen to the interview with Dr. Carol Paris referenced above. (She joins the newscast at 17 minutes 25 seconds into this 28-minute segment. The link starts 14.5 minutes into the newscast, when the topic turns to health care.)

[1] Nichols, J., 7/27/17, “Jimmy Carter calls for single payer,” The Nation (https://www.thenation.com/article/jimmy-carter-calls-for-single-payer/)

[2] Johnson, J., 7/21/17, “Message to Democrats: Get on board with Medicare for All or go home,” Common Dreams (https://www.commondreams.org/news/2017/07/21/message-democrats-get-board-medicare-all-or-go-home)

[3] Goodman, A., & Moynihan, D., 6/30/17, “Medicare for All: It’s a matter of life and death,” Common Dreams (https://www.commondreams.org/views/2017/06/30/medicare-all-its-matter-life-and-death)

[4] Ready, T., 9/20/16, “Donald Berwick calls for ‘moral’ approach to healthcare,” Health Leaders Media (http://www.healthleadersmedia.com/quality/qa-donald-berwick-calls-moral-approach-healthcare) See in particular page 2 of the article.

[5] Ready, T., 9/20/16, see above. See in particular page 3 of the article.

[6] Cho, J., 6/30/17, “The cynical opposition of some Democrats to universal health care,” Common Dreams (https://www.commondreams.org/views/2017/06/30/cynical-opposition-some-democrats-universal-health-care)

[7] Goodman, A., & Moynihan, D., 6/30/17, see above

[8] Cho, J., 6/30/17, see above

WHY PRIVATE HEALTH INSURANCE DOESN’T WORK

The health insurance system in the U.S. has been getting a lot of attention lately, focused primarily on Republicans’ efforts to repeal and replace the Affordable Care Act, often referred to as Obama Care. The policy alternatives that have been presented would increase the number of people without health insurance and increase costs or reduce coverage for consumers with health insurance. They would, however, reduce the government’s costs.

Little attention has been given to ways to improve our health care system by decreasing the number of people without health insurance, improving the quality of services and outcomes, and reducing overall costs. From an international perspective, among countries with similar advanced economies, the U.S. health care system is the most expensive on a per person basis, has far more people without health insurance, and produces worse outcomes. [1] Clearly, our private sector health insurance system has failed to provide affordable health insurance for all Americans and fails to provide good health outcomes despite spending huge amounts of money. There are three core problems with our private health insurance system.

First, a central problem with our private health insurance system is that it undermines the basic theory of insurance, which is to have a large group (i.e., pool) of people with different risks and different (and unknown) future events. Then, when someone experiences an adverse event that requires payment under the insurance plan, the pooled insurance can cover their loss or expenses. With many private health insurers and many different insurance plans, the insurance pool is split into multiple small groups of people. In addition, our private market approach lets people who don’t believe they have much risk or who can’t afford it to opt out of having insurance. These characteristics of private health insurance undermine the basic theory and efficiency of insurance.

When multiple (and often for-profit) health insurers are allowed to split up the pool of people, they have a strong incentive to avoid people who are or are likely to become unhealthy and to attract customers who are and are likely to remain healthy. This reduces their costs and increases their profits. They do this by refusing to cover people with pre-existing conditions. They also tend to make it difficult for people they cover who develop health problems to access the services they want or to receive the insurance payments they are due. These people, therefore, have an incentive to leave this insurance company and go to another one.

When the insurer of last resort is a public program such as Medicaid or the public version of Medicare, the result is that the private insurers take the healthiest and least costly customers and dump the least healthy and most costly patients into the public programs. They also work to attract the healthiest customers up-front with advertising and targeted benefits, such as providing reimbursement for the cost of joining a fitness center. Once again, the basic theory of insurance – having a large and randomly differentiated pool of insurees – is undermined. [2]

Without universal participation in health insurance, those without health insurance undermine the insurance system and are what are referred to as “free riders.” They know that in an emergency they will get health care. However, because they haven’t paid for insurance, they get care for free or at low cost and the rest of us, through insurance premiums or tax dollars, pick up the tab.

If everyone is required to have insurance, costs are more equitably shared. In addition, with more people in the insurance pool to share the overall costs of the health care system, the cost to each individual is, on average, less. If we only buy insurance when we get sick, get injured, or have an accident, or as we get older and are more likely to need health care, the cost of insurance will be higher than if everyone participates in the health insurance system and the costs are spread more broadly.

Second, long-term incentives to keep people healthy are, unfortunately, not present in a fragmented, private health insurance system. If a health insurer knows they are going to have you as a customer for a long time (or even for your whole life), then it has an incentive to pay for programs that will maintain and promote your long-term health. It has a reason to spend time and energy to encourage you, for example, to exercise and eat healthy foods, to avoid smoking and excessive use of alcohol, and to regularly take drugs for chronic health conditions such as diabetes, high blood pressure, or asthma.

Because customers tend to change health insurers every couple of years, the insurers have no financial incentive to focus on long-term health maintenance. Due to the fragmented health insurance market, we change insurers frequently, such as when we change jobs, when our employer switches health insurance company offerings to save money, or when we change insurers to save money or access a different set of providers or benefits. Therefore, insurers have little or no incentive to invest in their customers’ long-term health; their goal as a private business is to minimize payments for their customers’ health care and maximize profits.

Finally, a large portion of private health insurance premiums go to non-medical expenses, i.e., overhead. Private insurers tend to spend about three-quarters (75%) of the money they receive in premiums on customers’ medical expenses. The rest goes to advertising, profits for shareholders, and administrative processing due to the complexity of the multiple plans they usually offer, each with its own different co-pays, drug payment schedules, and negotiated rates for providers. (By way of comparison, about 95% of Medicare and Medicaid spending, the two biggest public health insurance programs, is for medical expenses.) Furthermore, doctors, hospitals, and other service providers spend lots of time and money dealing with the multitude of variations in paperwork and procedures that are unique to billing each insurance company and plan for their services.

My next post will present a solution to these problems with our private health insurance system.

[1] Goodman, A., & Moynihan, D., 6/30/17, “Medicare for All: It’s a matter of life and death,” Common Dreams (https://www.commondreams.org/views/2017/06/30/medicare-all-its-matter-life-and-death)