When Paul Ryan first introduced his first “Path to Prosperity” budget proposal, he framed it as an attempt to build upon the “successful” welfare reform of the late 1990s. At the time, I wrote that “welfare reform” was a “catastrophic success,” because of its devastating impact on the people reform advocates claimed reform would help.

I stand by that assessment, but it turns out I got one detail wrong.

At the time I wrote that welfare reform did not reduce the number of people in need of help, but merely reduced the number of people receiving help.

I’m increasingly convinced that most of the time – whether it’s jobs, the economy, or health care – progressives and conservatives are almost never talking about the same thing. If you’re a progressive, all of the above is evidence of that conservative welfare reform was a failure and a fraud, because it didn’t leave families better off because of it. If you’re a conservative, welfare reform was a success because it reduced the number of people on welfare – and that’s all it was supposed to do. It was supposed to get people off welfare rolls. Period. After that, they were on their own.

Paul Ryan, in his WSJ op-ed, says that with his roadmap we “strengthen and improve welfare programs for those who need them, we eliminate welfare for those who don’t.” It’s curious, because it really does sound like he wants to duplicate the catastrophic success of the welfare reform of the 1990s. The “success” was getting people off welfare rolls, not necessarily improving their condition. It was about reducing the number of people receiving government assistance, not reducing the need for assistance. Simply put, it’s fewer people getting help, instead of fewer people needing help.

What makes it a success is also what makes it catastrophic; at least for the people fall from the welfare rolls. Getting people off welfare rolls isn’t a good measure of success, because it fails to ask what they fall into. If the answer is “they go to work,” the next question is whether they go to work that pays them a livable wage, and whether they go to work that gives them an opportunity to improve their economic status, rather than just barely get by. That’s success.

According to a new study, welfare reform actually did reduce the number of people needing help – by shortening their lives.

… The average number of people receiving cash benefits from Temporary Assistance for Needy Families (TANF), the name welfare has gone by since 1996, has fallen from 12.6 million that year to 4.6 million in 2011. “Caseloads declined by 54 percent. Sixty percent of mothers who left welfare found work, far surpassing predictions of experts,” President Clinton wrote in a 2006 op-ed in the New York Times. “Child poverty dropped to 16.2 percent in 2000, the lowest rate since 1979, and in 2000, the percentage of Americans on welfare reached its lowest level in four decades.”

But it’s not that simple. Indeed, the health consequences of the change, a new study suggests, are potentially quite large, and quite negative. The Health Affairs study, written by Columbia’s Peter Muennig and Zohn Rosen, along with the Wallace Foundation’s Elizabeth Ty Wilde, finds that welfare reform increases mortality among recipients, reducing life expectancy by about nine months.

Wonkblog’s Dylan Matthew’s points out that the study doesn’t look at the 1996 reform act itself, but a Florida precursor program that ran from 1994 to 1999. The study found that people in the “welfare to work” program were more likely to find employment than those in traditional welfare, but weren’t likely to have more total income. They also weren’t likely to live as long.

Of the 1,611 experiment participants in the county the study focused on, 75 died by November 2011. Of the 1,613 members of the control group, by contrast, 67 died by November 2011. That means the welfare-to-work had 16 percent higher mortality than those receiving normal cash assistance, a result that was highly statistically significant and, because of the study’s random design, can be attributed to the different welfare program. That amounts to a nine-month reduction in life expectancy between the ages of 30 and 70.

Matthews adds that, since the Florida program was even less stringent than the federal law, it wouldn’t be surprising if the same were true of the national welfare reform. The increase of households in extreme poverty after welfare reform hurt health outcomes, and would have made increases in mortality all but inevitable.

So, it looks like I was wrong. I said that welfare reform didn’t reduce the number of people in need of help, but ensured that fewer people received help. Now it appears that welfare reform did reduce the number of people in need of help, by shortening their lives. Dead people don’t need welfare, after all.

I stand corrected, but only on that one point. A policy that has the effect of shortening lives doesn’t count as a “success.” It’s still a “catastrophic success.”

Thomas Carlyle called economics “the dismal science.” Journalist A. J. Liebling called boxing “the sweet science.” To read the Internet lately you’d think they got the two professions mixed up.

Economics is becoming a battle royale, a free-for-all. It’s a melee where everybody with a fist, glove or folding chair can jump out of the audience and into the ring. It doesn’t matter how much the ref blows his whistle. There will be blood. If economists had entourages, bullets would be flying.

The brawl du jour is over the Affordable Care Act, but it’s also an argument over the tone of policy disputes, a burning “meta” question in that paradoxical world where conservative economists believe every human being on Earth is an economic actor … except other economists.

Economists are talking trash about each other. And, as crazy as it sounds, it actually matters.

The latest fracas seems to have started when Paul Krugman used the word “fraudulent” to describe Avik Roy’s assertion that Obamacare has caused “rate shock” in California. Krugman says economist Roy “knows better” and is intentionally deceiving his readers. Then Tyler Cowen of the Marginal Revolution blog, a smart and rational libertarian-conservative economist, weighed in. “I find the screeds of most but not all of Roy’s critics to be inappropriate,” Cowen wrote, “or in some cases beyond inappropriate.”

Economist Austin Frakt of The Incidental Economist posed a question: “Can polite discourse cut through the noise and, yes, BS? Or, does one have to get a bit rude?” His blog partner, Aaron Carroll, lamented the time wasted on not discussing “actual differences of opinion” and questioned the motives of aggressive writers, saying “incivility sells. It gets eyeballs and clickthroughs.”

“Be the debate you want to see,” says Carroll.

But the question isn’t which debate we’d like to see. Isn’t the real question, “Which debate leads to the best outcome?”

Most people I know would rather have a civil, intellectually-grounded debate. Here’s the problem: The economics profession has been injected with enormous sums of money – in the form of chairs, endowments, think tanks, advisory roles, consulting gigs, and God knows what else – to push it further to the right.

And the money’s worked. Mike Konczal wrote that his graduate-level macroeconomics course “was by far the most ideologically indoctrinating class I’ve ever seen,” a place where “you learn more sophisticated ways of explaining, say, revealed preferences.”

There’s a growing perception that right-wing economists are incredibly well-funded, don’t fight fair, and are engaged in a war of attrition. That they’ll use any gambit necessary to support their case and bog their opponents down in a permanent defensive crouch.

Are they acting out of economic self-interest? There’s no way of knowing. I’m sure some are sincere, others are “actors” in the economic sense, and others have simply found themselves hemmed in by events.

I have fewer dogs than usual in the Krugman/Roy fight. I agree with those who say that the ACA is in many ways a new tax, both direct and indirect. (I come at it from the left; I think we need, at a minimum, the public option plus rate controls.) I believe that the ACA’s defenders have been seriously overselling California’s lower-than-expected insurance cost results. (Although I usually agree with him, I include Krugman among the oversellers.)

And yet, looking at it as objectively as I can, I understand why Krugman called Roy’s argument “fraudulent.” As Krugman notes, Roy can be worth engaging intellectually. But when an argument seems based on deliberate distortion, is it really more high-minded to pretend otherwise?

There is a war between the young and old/a war between the men and the women
There is a war between those who think there is a war and those who think there isn’t.

– Leonard Cohen

A lot of people are suffering because of so many conservative economists’ lack of intellectual rigor, seeming disregard for facts, and apparent disinterest in fair play or honesty. Is “civility” the proper response?

Sen. Sheldon Whitehouse doesn’t think so. This week we had the extraordinary spectacle of a United States senator – Whitehouse – all but calling a conservative economist a liar during a hearing. The word he used was “meretricious,” which when used on the Senate floor is worse than anything Jay-Z or Nas ever said about each other. Among the meanings given for “meretricious” by Merriam-Webster is “having the nature of prostitution” and “tawdrily and falsely attractive.”

Color me impressed with Sen. Whitehouse’s command of language.

Was he uncivil? Arguably. But I’d say it’s even less “civil,” under multiple definitions of that word, to mislead policymakers and the public on behalf of counter-productive (and literally deadly) austerity.

As I’ve said, I prefer civility too. But sometimes people idealize their own personal preferences rather than facing the situation – and the tough battles – at hand. (See “Obama, Barack.”) The ancient Greeks understood that a virtue employed in the wrong context becomes a vice. They even invented a dramatic form to illustrate that: tragedy.

The truth is, economics is neither “dismal” nor a “science.” It’s a heated, highly ideological and frequently unscientific enterprise. True, I hate the tone of the debates sometimes. I hate my own tone sometimes. I’ll continue to struggle with it and try to improve it.

But there’s a war on. Corporate interests are killing the middle class and depriving poorer people of hope, opportunity, and basic human needs, and they’re using economics as a weapon. They say truth is the first casualty in any war, and maybe so. But can’t we give it a decent funeral, or is that too “uncivil” to mention?

(UPDATE: I see that Krugman addressed this question late Thursday, too.)

A critique of the impact on African Americans of using the chained CPI to limit the cost-of-living adjustment on Social Security benefits and my criticism of President Obama’s jobs proposals were among the highlights of a one-hour discussion Sunday led by Maya Rockeymoore, the host of We Act Radio’s “Pivot Point” and a leading progressive voice on the economy and health care.

Click here to view the video on YouTube.

The full hour is worth your attention because it touches particularly effectively on three critical issues for progressives. One is whether President Obama has undercut the very economic causes that got him elected, and thrown the constituencies who believed in his promises under the bus, by continuing to pursue a “grand bargain” that includes cuts to Social Security benefits and at least a partial surrender to the conservative austerity agenda.

Another, raised by guest Dr. Margaret Flowers, a Maryland pediatrician who represents Physicians for a National Health Plan and is a board member of Healthcare NOW!, is whether the president’s signature accomplishment, the Affordable Care Act, has so from the same propensity of the president to compromise with the opponents of progressive reform that it should be counted as an accomplishment at all. Flowers remains a passionate advocate for replacing Obamacare with a single-payer health care system.

AFL-CIO economist William Spriggs appears later on the program, and during his segment he pointedly argues that one of the most devastating consequences of the economic policies in place since 2000 is how far behind they place people under 30. He notes that record numbers of young people are outside the workforce, and that will have long-term consequences for the economic health of the country.

When Spriggs laid out the numbers, I point out that this is the most devastating debt that is being imposed on future generations. It’s not the federal deficit; it is diminished future economic opportunity because of our failure today to invest in jobs, education and financial supports for those struggling to get onto the economic ladder.

With Brendan Fischer

In a victory for working families, New York is poised to become the largest U.S. city to require businesses offer paid days to workers. Community activists and labor leaders struck a deal with City Council Speaker Christine Quinn to allow a vote on a paid sick leave ordinance that would cover almost 1 million people. But workers in more than 700 other large American cities must choose between spreading their illness and getting paid.

Advocates have helped pass paid sick day laws in cities like San Francisco, Washington, Seattle and Portland, but big business has been pushing back. Corporate-backed bills have passed at the state level in Wisconsin, Louisiana, and Mississippi that would preempt (or as one GOP operative put it, “deliver the kill shot” to) local paid sick leave laws. Similar bills are on the legislative docket in Florida, Arizona, Indiana, Michigan, Oklahoma, and Washington. This paid sick leave preemption effort can be traced back to Wisconsin Governor Scott Walker and the American Legislative Exchange Council (ALEC).

Paid Sick Days Help Keep America Healthy

Workers who do not have access to paid sick days are one-and-a-half times more likely to go to work sick with a contagious illness, putting their co-workers and customers at risk, and costing an estimated $160 billion each year in lost productivity. Children are more likely to go to school sick when their parents can’t get off work to care for them, causing illness to spread. Delaying treatment for illness can cause conditions to worsen, leading to more emergency room visits and increased costs for public health insurance programs.

An estimated 40 million workers, or 40 percent of the workforce, cannot take sick days without losing wages or possibly their jobs, according to the Bureau of Labor Statistics. The Family Medical Leave Act (FMLA) only provides for unpaid leave, and only applies to employers with more than 50 employees. Approximately 40 percent of workers do not qualify for the FMLA and those who do often don’t take leave for financial reasons.

Seventy-nine percent of food industry workers – who are especially likely to spread illness if they go to work sick — don’t get paid sick leave, according to a Food Chain Workers Alliance study. A recent Centers for Disease Control study found that more than half of all norovirus outbreaks can be traced back to sick food service workers.

In response to this public health and economic issue, cities and counties have proposed ordinances that require employers allow workers to call-in sick without losing their jobs or wages. And corporate interests are pushing back. In New York City, the business lobbyists managed to get City Council Speaker and mayoral hopeful Christine Quinn to block the legislation for three years, before a long-term campaign by worker’s advocates put her in the hot seat and made it politically untenable to continue blocking the bill.

Big business has also lobbied the statehouses, in many cases successfully, to disregard “local control” and nullify and permanently preempt paid sick leave ordinances passed at the local level. And the legislation appears to have spread thanks to a bill promoted and passed by Wisconsin Governor Scott Walker, and shared at an ALEC meeting in 2011.

Walker’s Anti-Paid Sick Day Law in Wisconsin Brought to ALEC

In May of 2011, Governor Walker pushed Senate Bill 23 to override a Milwaukee ordinance providing for paid sick leave. It appeared to be the first paid-sick-leave preemption bill passed in the country.

Milwaukee’s ordinance specified that paid sick days could be used if a worker is ill or needs to care for a sick child, and passed via referendum with over 70 percent of the popular vote in 2008. The 2011 state law not only steamrolled local democratic will by overriding a law passed overwhelmingly in a popular vote, but also repealed the rights of working people to get medical treatment they need, care for their children, and help safeguard the health of their families, coworkers and customers.

A few months later, at ALEC’s August 2011 Annual Meeting in New Orleans, the bill was brought to the Labor and Business Regulation Subcommittee of the ALEC Commerce, Insurance and Economic Development Task Force.

Meeting attendees were given complete copies of Wisconsin’s 2011 Senate Bill 23 (now Wisconsin Act 16) as a model for state override. ALEC’s Labor and Business Regulation Subcommittee at the time was co-chaired by YUM! Brands, Inc., which owns Kentucky Fried Chicken, Pizza Hut and Taco Bell.

Legislators attending the Labor and Business Regulation Subcommittee meeting were also handed a target list and map of state and local paid sick leave policies prepared by ALEC member the National Restaurant Association.

In Wisconsin, the state chapter of the National Restaurant Association lobbied for Senate Bill 23 to repeal Milwaukee’s sick leave ordinance, as did the local branch of the U.S. Chamber of Commerce, an ALEC member.

And a similar pattern of opposition has emerged across the country: as cities like Seattle, Portland, and Philadelphia have taken up paid sick days, the state and local chapters of ALEC members the National Restaurant Association and U.S. Chamber of Commerce have lined up against it. Other consistent paid sick leave opponents include the National Federation of Independent Business (NFIB), an ALEC member that presents itself as “the voice of small business” but lobbies primarily for big corporate interests, as the Center for Media and Democracy has described at NFIBexposed.org. Restaurant giant Darden (parent company of Red Lobster, Olive Garden, Capital Grille and others) has also emerged as a major paid sick days foe. Darden is an ALEC member and has had a representative on ALEC’s corporate board.

Paid sick leave opponents also regularly cite a “study” from a corporate front group called the Employment Policies Institute purporting to show that employers in Connecticut cut jobs and benefits after a paid sick day law took effect. The front group is one of many formed by super-lobbyist Rick Berman — who has also formed groups like the Center for Consumer Freedom, a front for the fast food, alcohol and tobacco industries — and has received $2.8 million between 2009 and 2011 from the Milwaukee-based Bradley Foundation, which is also a major ALEC funder.

These same big business interests have backed proposed state laws to thwart local sick leave ordinances that reflect the Milwaukee legislation. Sick leave preemption bills have spread across the country since the August 2011 ALEC meeting where Wisconsin’s bill was shared. In 2012, a sick leave preemption bill was introduced in Tennessee and became law in Louisiana, and in 2013, similar bills have been introduced in Florida, Washington, Mississippi, Michigan, Arizona, Indiana, and Oklahoma.

ALEC Politician Works to “Deliver the Kill Shot” in Florida

The battle might be most heated in Florida.

Orange County is following in Milwaukee’s footsteps, with advocates gathering more than 50,000 signatures last year to place a sick-time measure on the ballot. The referendum was kept off the November 2012 ballot because of a delaying campaign coordinated by Orange County commissioners working with big business, including ALEC member Darden Restaurants, the Florida Chamber of Commerce, Disney and others. In February, a court found the County had violated “the plain meaning of its charter” by refusing to put paid sick leave in front of voters.

Text messages released through open records requests indicate the delaying tactics were part of a strategy to kill the initiative entirely.

In early September, Orange County GOP Chair Lew Oliver texted Commissioner Ted Edwards saying he wants “at least one good faith straight face test reason to at least delay it long enough to keep it off the ballot in November. After that, the Legislature can deliver the kill shot.”

The “kill shot” would come from Florida legislators duplicating the anti-democratic tactics of Wisconsin’s governor.

House Majority Leader Steve Precourt (R), an ALEC member, recently introduced a sweeping paid sick days preemption bill that tracks Wisconsin’s Senate Bill 23 and would thwart the Orange County effort. The bill would effectively keep Orange County residents from voting on the county’s first citizen-led ballot initiative.

Precourt’s proposal actually goes further than Wisconsin’s bill by incorporating ALEC model legislation that would preempt local living wage requirements as well. (ALEC’s slate of bills promoting a race to the bottom in wages and working conditions for America’s workforce was recently detailed in a report by the National Employment Law Project.)

Precourt attended the 2011 ALEC meeting where legislators were handed complete copies of Wisconsin’s 2011 Senate Bill 23. He reported receiving $487.38 from the corporate-funded “scholarship fund” to attend the 2011 ALEC meeting. According to documents released from the ALEC State Chair for Florida, Rep. Jimmy Patronis, Florida lawmakers’ attendance at ALEC’s 2011 annual conference in New Orleans was “one of the strongest delegations in years.”

Also at that 2011 ALEC meeting, Precourt and sixteen other Florida legislators attended a “State Night” dinner at Antoine’s Restaurant, where lawmakers sat down with corporate lobbyists for meals that averaged around $120. But Florida legislators were not asked to pay a dime for their expensive night out: their tab was picked up by the corporate-funded ALEC “scholarship fund.”

ALEC Legislator Has Ethics Concerns

Under current Florida law those ALEC “scholarships” are banned. In 2006, Florida enacted some of the strictest ethics laws in the country, and legislators are now prohibited from accepting most gifts from lobbyists or their employers. But, legislators can still use ALEC “scholarship” funds collected prior to the law taking effect. “The organization has significant funds that were collected prior to the effective date of the law and which, when collected, even those from lobbyists and principals were entirely lawful,” reads a House legal opinion sanctioning the use of already-raised scholarship funds. Despite these “scholarships” being grandfathered in, the appearance of impropriety remains the same.

And ethical concerns about Precourt don’t end there. In 2008, he formed a consulting firm whose founding documents indicate it intends to provide “engineering and lobbying services” – with lobbying being a questionable activity for a sitting legislator. In 2011, the Orlando Sentinel reported that Rep. Precourt was gunning for an appointment to direct Central Florida’s toll-road agency, despite a significant conflict of interest: his engineering firm, Dyer, Riddle Mills and Precourt (DRMP), had received $10.5 million in contracts in recent years and stood to make millions more from new contracts. Precourt had worked at the firm for 20 years, and though he said he resigned as a principal a few years after becoming an elected official, he retained a financial relationship with the company.

DRMP also has a financial relationship with some of the major opponents of Orange County’s proposed Earned Sick Time ordinance. It has major contracts with Disney, for example, which lobbied against the sick leave initiative in Orange County.

Precourt’s bill passed out of committee and is up for a final vote in the House on April 4.

Proposed State, Federal Bills to Require Paid Sick Days

Legislation has also been proposed on the federal and state levels to require paid sick days.

In Congress, the Healthy Families Act has been introduced several times since 2004, and would allow workers to earn up to seven days of paid sick leave (or one hour for every 30 hours worked) for use when an individual is ill or needs to care for a sick family member. States like Maryland, Massachusetts, Vermont, and Washington State are also considering bills to guarantee state-wide paid sick leave.

But the campaign against paid sick days is growing increasingly intense and coordinated, particularly as local governments take matters into their own hands. Keep an eye out for an ALEC legislator introducing a “kill shot” preemption bill in your state legislature.

*****

The Center for Media and Democracy is the publisher of the award winning “ALEC Exposed” project. Learn more at ALECexposed.org and follow us @ALECexposed.

Jared Bernstein has posted some very important information that one can only hope both the White House and the Democrats are aware of and prepared to change direction because of.  It shows that our runaway medical costs are actually slowing down and he posits that there’s good reason to believe that it’s permanent rather than transitory:

My colleague Paul Van de Water recently noted that CBO’s 10-year forecasts for the growth of Medicare and Medicaid have come down by $500 billion relative to those from a few years ago. We don’t yet know whether any of this will last—whether we’re looking at another “whoops” moment. But because the initiatives ticked off above are targeted at changing highly inefficient incentives embedded in the delivery system, using technology to improve productivity (which typically lowers costs), and providing better oversight, they certainly have the potential to be lasting. And remember, while the recession is surely playing some role in recent cost savings, that role is surely less pronounced in Medicare and hospital readmissions.

So my guess is there’s something lasting going on here, and that means the doctor has just prescribed a very large chill pill for those who want to whack away at Medicare and Medicaid and CHIP because “they’re going bankrupt…bankrupt I tell you!” They’re not, and our energies would be much better spent on careful research on the factors behind these recent cost trends and how we can build on them. The goal is not to diminish these extremely valuable programs. It’s to enhance their efficiency so as to ensure that they remain a solid part of American social policy.

Read the whole thing for the details.But the upshot is that we have just enacted a bunch of reforms to the system that are having an impact. Who knows if it will work over the long term, but the idea that we need to slash the hell out of our “entitlements” before all the data is in, is just daft. In fact, this whole discussion has been daft from the beginning. From the idea that austerity was a good idea in a downturn to the idea that we would make major changes to our health care system and then fail to see how they work before deciding that costs are too high, this rush to deficit cutting has been a disaster.

As Bernstein says, our leaders need to take a chill pill. We need to take a break from all the unnecessary Grand Bargaining and all the politicians need get out of this rut of thinking the world will end if they don’t cut spending. Obama’s legacy is going to be Obamacare. He doesn’t need the grand bargain, it was always stupid. And if Obamacare succeeds in reducing the deficit as Bernstein’s chart indicates may be happening, he can take credit for that too. That’s a lot. It’s enough.

Every American who cares about jobs and a healthy U.S. economy should pick up the phone right now, call your Congressperson’s office, and tell whoever answers, “I want my representative to vote this week for the Back to Work Budget introduced by the Congressional Progressive Caucus.”  [Note: The Congressional switchboard is 202 224-3121.]  Also click here to go on record as telling Democrats to vote against the job-killing Ryan budget and for the Back to Work budget.

But we can’t just stop after that.  Beyond this week’s vote, it is very important for progressives to keep building a movement to demand a plan for jobs – like the Back to Work Budget.

Republicans outnumber Democrats in the House, and they will vote almost in lock-step for Republican Rep. Paul Ryan’s job-killing budget.  And after that vote, most progressives will go back to trying to soften to impact of Washington’s bipartisan fixation on reducing deficits.  This is important work. We must stop Democrats from offering to cut Social Security benefits.  And we should demonstrate that cutting tax loopholes for the rich is a better deficit-reduction strategy than cutting programs for kids.

But reducing the deficit in a more humane way will not create more jobs for the 20 million Americans who desperately need jobs.  And Democrats shouldn’t delude themselves:  We are not going to win back the House in 2014 by campaigning as the guys who have a better plan for cutting the deficit than the Paul Ryan and the Republicans.  Not while the economy is barely growing or falling backwards.

In 2010, the last midterm Congressional election, Democrats lost the House because they didn’t run on a plan to create jobs.  And they didn’t use such a plan to expose Republican jobs proposals as giveaways to the rich.

President Obama and his team felt Democrats deserved credit for having passed the 2009 stimulus bill and for preventing the economy from falling into another Great Depression.  But rather than call for more action to create jobs (which they could have blamed Republicans for opposing), President Obama’s message in the run-up to that election was “Have patience, the jobs are coming.”  But voters were still not seeing new jobs or a robust recovery, and polls, like Stan Greenberg’s post-election survey for the Campaign for America’s Future, found that a crucial percentage of voters were disappointed in Obama and the Democrats because they “failed to get the economy growing or create jobs.”  And so we lost the House.

Today, despite a presidential campaign that revolved a lot on who had the better jobs plan, the political debate in Washington, driven by the party that lost the presidency, is once again dominated by the question of which party has the best plan to cut deficits.  But Democrats should not forget that voters still care most about jobs.  After the presidential election, 95 percent of Americans told Gallup job creation should be President Obama’s top priority for his second term.

Progressives need to listen to the American majority and build a movement to demand action on jobs.  Of course we should do everything we can to mitigate the damage from Republican austerity measures.  But our more important mission is to lay out an agenda to create jobs and growth.  We should take that agenda to the American people – and we should also demand that the Democrats, who claim to be the party of the middle class and the poor, embrace that agenda (something very much like the CPC Back to Work Budget) and take it into the 2014 elections.

We can and should keep the CPC Back to Work jobs plan alive – and we should build a movement around it.   At town meetings in every district, we should ask some big questions in a very public way:

Which House candidates support creating jobs through investing in infrastructure?  Which candidates understand that, at today’s low interest rates, these long term investments are practically free?  Which Democrats or Republicans are willing to take a tour (in their districts) of eroding bridges, roads, sewer lines or nonexistent rail projects, accompanied by unemployed workers and union members who might get those jobs, if we invest in the future?

Which House candidates want to rehire teachers, police, and first responders?  Who would pledge to find federal revenue to share with the states and cities to reverse the terrible layoffs that have devastated education and public services – and worsened the economic crisis?  Let’s do a tour of school houses and fire stations that would benefit from infrastructure investments, too.

Which candidates will fight to make sure all jobs are good jobs – and all communities full-employment communities?   Candidates should not only go on record for raising the minimum wage and improving benefits like paid sick leave, but they should also be asked what they would do to put jobs into African-American and Hispanic communities.  And they should tell us where they stand on strengthening workers’ rights to bargain for better wages and better benefits.

And which House candidates would go to senior centers and nursing homes in their district?   The questions on the table:  would you force big drug companies to lower their prices – or would you rather cut Medicare and Medicaid benefits and turn Medicaid into a voucher, as Ryan proposes?

The CPC Back to Work jobs plan is just full of ideas that creative organizers could make the focus of the next election.  But in order to get that kind of organizing going, we have to force ourselves to think beyond the next horrendous budget vote in Washington (as important as that may be), and we have to think ahead.

If we frame the debate around the next election, we should be able to get the Democrats’ attention.

And if we frame the debate around the next 10 or 20 years of America’s future – and around whether the next generation (and tomorrow’s retirees) will be able to create a hopeful future of good jobs and opportunities for all – we will surely get the attention and involvement of Americans of all walks of life.  And if we do that, we can not only win back the House, we can rebuild our country.

It’s finally here. After a long week of teasing and hint-dropping that kept much of Washington wondering, Paul Ryan has released a new budget. Now, that we can finally see what’s in Ryan’s budget, it’s a bit of a let down. Ryan trots out most of the same old ideas, some of which have actually gotten worse with age. And what’s new is the same shallow shift in “tone” that Republicans apparently still believe will win over the voters they alienated in 2012. Beyond that, not much has changed.

Ryan’s 2012 “Path to Prosperity” was really a “Roadmap to Ruin.” This year’s “Path to Prosperity” takes a few unexpected turns that are probably intended to disorient Americans in hopes that we don’t notice Ryan’s “new” budget (soon to be the GOP’s “new” budget) arrives at the same destination.

Let’s start with what hasn’t changed.

Health Care Reform

Just like last year, Ryan’s budget calls for the repeal of the Affordable Care Act. After more than 30 failed attempts at repealing the law and a Supreme Court decision upholding it, this is such a non-starter that even fails the laugh test with Fox News anchors. Almost no one in hell gives this a snowball’s chance in hell of happening, nor is it popular with voters. Americans may be somewhat ambivalent about the health care reform law as  a whole, but only 33% support repealing the law.

So, why would Ryan even mention it in his budget? The simple answer is that it’s probably de rigiuer in the GOP at this point. If it wasn’t in the bill, the tea party Caucus of the House GOP would almost certainly insert it in the budget before House Republicans inevitably and overwhelmingly approve Ryan’s budget.

There’s another answer that I’ll get to in a bit.

Medicare

Once again, Ryan’s budget ends Medicare as we know it.

This year’s “Path to Prosperity” again proposes the creation of a Medicare “premium support” system starting in 2024, which ensures that no one 55 or older will be affected. Ryan reportedly toyed briefly with the idea of increasing the Medicare cut-off age to 56, but backed down when the idea infuriated Republicans in Congress, Never mind alienating the one the few remaining groups Republicans can still count on.

“Premium support” is called “competitive bidding” now, but future seniors would still be forced to choose between traditional Medicare-as-we-know-it, and the new voucherized version that would offer them a fixed amount to buy private health insurance. But that “fixed amount” would increase with the rate of inflation, not the rate of health care inflation. So, seniors will be left holding vouchers that are worth less and less each year.

Medicare

Paul Ryan and the GOP still want to gut Medicare.

Medicare comes in for the same block grant treatment it received in Ryan’s previous budget, giving the states more “flexibility” to administer their Medicaid programs, by slashing their Medicaid rolls. This amounts to the same kind of “catastrophic success” as “Welfare Reform” of the 1990′s, which Ryan cited as the model for his budget.

 See, there’s the problem with this is that the welfare reform of the late 1990s was not a success. Not unless you’re a conservative. And even then it was at best a “catastrophic success” — defined here as “success” that’s actually catastrophic for those it’s purported to help. That’s also what makes it a success. That is, if you’re a conservative.

What makes it a success? Well, in a sense, failure. It works if it doesn’t work, in other words, especially if it doesn’t work for the right people — because the right people are the wrong people. Follow me? No?

… In the unlikely event that Ryan’s budget proposal became actual policy, it’s going to have the same effect as the late 90s welfare reform that Ryan uses as his model. The primary measure of its success will be the declining numbers of people receiving services from the programs Ryan is targeting.

It’s highly unlikely that those people — the elderly, the disabled and children — will be better off. That goes for their families, too. As DailyKos’ Joan McCarter points out, a quarter of Medicaid spending pays for long term care for the elderly. Without Medicaid, families who are already taxed more under Ryan’s plan, have to pick up those costs. That’s an added burden for middle class families.

… But that’s why it will be a success. Making people better off, by reducing their need for assistance, isn’t the point of conservative welfare reform. The point of conservative welfare reform is reducing the fewer people receiving help, not the reducing the need for help. That’s why it’s so successful, if you’re a conservative like Paul Ryan. Because all you have to do is cut.

Ryan’s new budget has the same catastrophic results for American families where Medicaid is concerned.

The GOP’s cuts to Medicaid would have disastrous consequences for countless American families.

An overview of the likely impact gives a 10,000 foot view of the collateral damage that’s likely to be the result of the kind of cuts Republicans want to inflict on Medicaid.

• Up to 44 million could lose health coverage. Federal spending on Medicaid would fall by $1.4 trillion, or 34% by 2021. States would receive $243 billion less per year. Cuts would produce decreases in Medicaid enrollment, resulting in 31 million to 44 million to lose coverage.
• By 2013, 400,000 would lose vital health care services by 2013, according to the CBO.
• By 2016, 1.7 million children will lose health insurance. If the Republican plan becomes law the CBO estimates that 1.7 million children will lose health insurance by 2016, as half the states could eliminate their CHIP programs, and remaining states could roll back coverage.
• As many as 15 million could be forced off Medicaid rolls, according to state-by-state analysis.
• Cuts would seriously impact seniors and people with disabilities. Some 14 million seniors and people with disabilities depend on Medicaid to pay for nursing home care and assisted living — which costs about $72,000 a year, on average. In fact, 70% of nursing home patients are Medicaid recipients. Deep cuts would mean less coverage for nursing home residents, shifting more of the cost on to the elderly and disabled beneficiaries and their families. Sharp reduction in the quality of nursing home care is another likely result. Many elderly and disabled recipients would be unable to obtain coverage elsewhere because of pre-existing conditions.

 Economy, Safety Net, Etc.

The rest of Ryan’s new budget pretty much follows the same “Roadmap to Ruin.”

• Fannie Mae and Freddie Mac still get replaced by private secondary mortgage lenders. Ryan’s budget proposes “winding down” Fannie and Freddie’s key role in enabling millions of middle- and working-class Americans to become homeowners, and replacing them with private lenders who have played a key role in evicting middle- and working-class Americans from their homes.
• The Supplemental Nutrition Assistance Program, aka “food stamps,” still gets converted to a state block grant program in the model of 90s-style “welfare reform,” with the same catastrophic for American families.
• Pell Grants still get reduced, this time to what they were for the 2009-2010 school year, and targeted towards the “truly needy.”
• The wealthy and corporations still get huge tax cuts, costing the government $7 trillion revenues.

So what’s different this time around? Varying degrees of cynicism and sanity.

Ryan cynically adopts in his budget the same Obama policies he campaign against in 2012, including: the Medicare savings Ryan dishonestly denounced as “cuts”; the savings from ending the wars in Iraq and Afghanistan, which Ryan once called “phantom savings”; and the revenue from the fiscal cliff deal, which Ryan opposed.

And in the sanity dept., Ryan’s budget is as reality-challenged as anything else we’ve seen from the Republicans. The insanity becomes evident upon realizing that Ryan and the GOP actually hope voters will be taken in by a “bait and switch” strategy designed to incite fears the deficit and government spending, and draw attention away from what Ryan’s budget is really about: dismantling government.

As with his previous budget plans, this year’s “roadmap” is an elaborate justification for his vision of minimalistic government. His call to balance the budget has less to do with putting the federal government on a sustainable path—as Ross Douthat points out for The New York Times, “Modest deficits are perfectly compatible with fiscal responsibility”—and everything to do with his narrow ideological agenda. “The reality,” notes Ed Kilgore at the Washington Monthly, “is that he’d be promoting the same policies even if the budget were in balance.”

If there’s anything worth noting about this new budget, it’s the extent to which it shows a Republican Party unchastened by the 2012 elections. Nearly every Republican—from Mitt Romney down to Senate and House candidates—ran on ideas promulgated by Ryan. And while it’s hard to attribute a win or loss to any given policy, there’s no question these ideas are unpopular with the public. Despite this, and despite the fact of Republican losses at all levels of government, the party is roaring back with the same approach to spending and taxes, with little in the way of adjustment.

Americans are unlikely to be fooled.

It’s true that when asked in the broadest sense if they would prefer to reduce the deficit mostly by cutting government programs instead of mostly by raising taxes, Americans chose cutting 53-37 percent.

But when asked about specific kinds of government programs, respondents chose raising taxes over cutting Medicare, Medicaid, Social Security, education and transportation. They said they would rather cut spending only when it comes to energy, the military and unemployment benefits.

Do you hear that, Mr. Ryan? A lot of Congressional Republicans want to cut jobless benefits, but they don’t want to balance the budget at the expense of military contractors or the oil companies.

Paul Ryan’s “new” budget sports some notable changes on the surface, shifting focus from denouncing the president’s policies to shrieking about the deficit. But, the more Paul Ryan’s budget changes the more it stays the same. It’s still about shrinking government, cutting taxes of for the 1 percent, making the elderly pay more for health care, and taking health care coverage for more than 30 million Americans.

Paul Ryan has presented, and Republicans will almost certainly embrace, another budget that no one wants. That much hasn’t changed.

-In his extraordinarily well-documented expose on the medical-industrial complex for Time magazine, “Bitter Pill: Why Medical Bills Are Killing Us,” Steven Brill explains thoroughly and repeatedly what serious pundits, policy experts and policymakers have failed to see or have feared to say: There is no free market in health care.

Though Brill doesn’t say it, the logical implication is that only Congress can rein in the cost of health care. No private entity, be it insurers or employers, let alone consumers, has the countervailing power to bring down prices.

In fact, Congress has permitted the pharmaceutical industry, lab companies, device and equipment manufacturers, hospitals, nursing homes and others to hide behind a veil of secrecy about the prices they charge, effectively sanctioning massive gouging of patients, businesses, states and taxpayers.

Brill brilliantly puts to rest the notion that “competition” can fix the unsustainable rise in health care prices. There simply is no meaningful competition. Few people understand what virtually any medical product or service actually costs, let alone its value. Hospitals do not have the leverage to secure better prices with suppliers. But, as Brill shows, hospitals have increasing power to set prices well in excess of their costs. Consumers are clueless as to what’s a fair price. The market is broken, and the growth in health care costs is unsustainable.

This explains why every other developed country in which the government limits health care prices has per capita health care costs that are so much lower. What many people do not realize, however, is that administered pricing has not stifled supply. Nursing homes and hospitals in America are hungry for Medicare patients. And outside the United States, these same health care corporations are still making sizable profits. Brill reveals that profit margins in other countries that secure far lower prices for drugs are significant enough that drug companies sell a substantial portion of their drugs outside the U.S.

Brill underscores the value of Medicare, to the extent Congress allows it to administer doctor and hospital rates and protect older and disabled Americans from out-of-control prices. And he highlights Medicare’s efficiencies, including its low administrative costs, illustrating why it is more cost-effective than private insurance and how seamlessly it works. Those of us fortunate enough to have Medicare can stop worrying about whether we could afford a heart transplant or a knee replacement. It’s enough that we must bear the emotional and physical toll of the operation itself.

Medicare’s weakness is that Congress has forbidden it from using its leverage to achieve fair rates for drugs, devices and durable medical equipment. Congress has also prevented Medicare from determining which health care goods deliver value and encouraging enrollees to use those products.

Deficit hawks within and outside Congress, who control the debate, support regulations that protect the medical industrial complex, help Wall Street and squeeze consumers. Perhaps the best examples are rules that give drug companies long-term patents and the power to set prices and the law that forbids Medicare from negotiating drug prices. Their concerns about the deficit and Medicare’s rising costs, coupled with their opposition to government regulation and misplaced faith in the free market to bring down health care costs, conceal their true agenda—protecting and increasing corporate profits.

Squeezing Medicare enrollees further by shifting additional health care costs to them, as the deficit hawks propose, does nothing to control spiraling costs. Neither does continuing to countenance the pharmaceutical industry’s practice of setting prices that have no relationship to their actual costs or to what they charge other countries for the same products. The market is broken, and it’s under the control of monopolistic players protecting their economic turf.

“Lopsided pricing,” as Brill describes the problem, really can only be addressed in one way: balanced regulation. Rather than preserving the health care industry’s power to set prices that bear no relation to the actual cost of production, Congress could sanction government-administered pricing to ensure health care companies a reasonable profit in a regime of balanced regulation. This would transform the marketplace for drugs, devices and equipment and bring the U.S. in line with all other governments in the wealthiest nations.

Likely fearing reproach from Wall Street and marginalization of his reporting by conservatives, Brill fails to call for administered pricing. Instead, without the advantage of rigorous research on the solution side of the high-medical bills equation, he throws out ideas like breaking up provider monopolies and reforming medical malpractice laws that may help a little at the margins but have no chance of solving the bigger problem. But Brill deserves credit for exposing the next great challenge in the evolution of the U.S. health care system. In closing, quoting Johns Hopkins health economist Gerard Anderson, he leaves no doubt that “all the prices are too damn high.”

A report in The Hill newspaper last night suggested that Sen. Charles Schumer (D-N.Y.) may be floating a proposal that includes cuts to Social Security and Medicare. If Sen. Schumer’s proposal was accurately reported, the senator could not be more wrong.

Just as President Obama declared in his inauguration speech that America does not have to cut Social Security or Medicare, Sen. Schumer reportedly offers up cuts to those crucial programs in vain hope of getting Republican support for tax increases.

Sen. Charles Schumer (N.Y.), the Senate Democrats’ chief political strategist, sees a joint budget resolution between the Senate and House as the key to raising another $600 billion in new tax revenues. …

Just as Republican leaders have been forced to back away from threatening to crash the economy to force Democrats to accept cuts to Social Security and Medicare, Sen. Schumer capitulates to the hostage taking that Republicans appear to be abandoning.

I hope the news reports are wrong because Sen. Schumer has previously been a strong opponent of cuts to Social Security. The Campaign for America’s Future reminds him and all Democrats that the chained CPI would mean an immediate cut to current Social Security benefits. These cuts are very unpopular with all Americans, and Democrats should be leading the fight to protect Social Security and Medicare, not helping Republicans accomplish their harmful goals.

It’s possible to feel sorry for Mitt Romney, as one human being to another. Apparently he really didn’t believe he could possibly lose and now he’s “shell-shocked.” Guess he didn’t listen to all the experts who said he was going to lose. Forget Nate Silver: Bob Dylan said Obama would win in a landslide.

But Romney’s loss is the nation’s gain. In case anybody had any lingering doubts about that, here’s a reminder. It’s the transcript of an interview I did with Mike Papantonio on Ring of Fire radio about Romney’s business practices in the health care field. The discussion was based on a piece called “Sick Money,” which covered Romney’s and Bain’s investment in health care companies that went on to commit fraud and patient abuse.

Romney’s investments encouraged precisely the kind of predatory capitalism that’s ruining our health care system and driving our costs so much higher than those of other industrialized nations, even though we offer less coverage to fewer people. All the conservatives who claim to be concerned about our national deficit should focus their energy on driving Bain-style investment out of the health care sector.

Here’s a transcript of the interview, courtesy of Ring of Fire radio (which is an excellent program). There may be a few typos, but they’ve gone to the effort to transcribe the talk and we appreciate it:

Mike: We’re talking about the very crazy, very dangerous Mitt Romney. Every day it’s more evident. It’s a man not in control of his brain or his mouth and unfortunately, we don’t want to put in control of a bomb.

There’s more. Parts of the Mitt Romney story come out every day. Mitt Romney spent a lot of time trying to run away from his record, for example, at Bain Capital. That was a good move for him. It seems likely every week that there’s a new story about corruption, incompetence, greed. It shows us the real character of this guy who wants to be involved with international policy in places like the Middle East on days like today. Really?

This week is no exception. Stories emerge telling us how Bain Capital’s been hustling the healthcare industry, driving up costs for everybody in America. Richard Eskow is a senior fellow, campaigned for America’s future. He’s the host of weekly radio show The Breakdown. Richard, tell me this story. It’s a fascinating story because we miss parts of stories like this all the time, don’t we?

Richard: We do and it gets overlooked. While we’ve got politicians out there like Mitt Romney and Paul Ryan telling us that we can’t afford to continue providing Medicare to seniors or Medicaid to poor people, Bain Capital actually has a very consistent record of being pioneers in a greed-driven for-profit healthcare system that really adds to those costs exponentially.

Mike: Let me set up just a little bit for time purposes. When you leverage buy-out, when you go into a company and you leverage the company, what you do, what Bain did, is they’d go in; they get more loans than the company could ever handle–$607 million worth of loans. They would pay their percentage of being that capital investor but they wouldn’t pay the other investors but they would pay the management team. They’d pay the Bain team. Then they would leave that corporation in such bad shape they had to something to raise money. What would they do?

Richard: What they do is that so much money was borrowed to deal with the Bain people that it really put them under incredible pressure to jack-up their revenues which they would do by, for example, tricking doctors into ordering unnecessary Medicare procedures, which one of the CEOs that Romney and his team picked wound up being convicted for doing, being convicted of Medicare fraud. Another team that, from all we can tell, Romney picked to run a drug store chain, they were convicted of investor fraud, and also for fraud in the State of New Jersey for selling things like out-of-date baby formula, out-of-date medications or prescriptions. When you put people under that kind of financial pressure they get desperate to cheat, bend the rules, do whatever they have to do to make their numbers. That’s the real Romney Care.

Mike: R.J., I can’t disclose too much what I want to tell you. I want tell you how accurate you are, how you hit this. Bobby Kennedy and I have been involved in a campaign; it’s an anti-fraud campaign with the Whistle Blower Statute. What we found is we started an ad campaign all over America saying if you want to report fraud, call us. We’re doing stories, we’re doing follow-up on them. You know where most of the stories are coming from? They’re coming from the healthcare industry.

Richard: I’m not surprised.

Mike: We see bundling, we see unbundling, we see … as you point out in your story, it’s very interesting. We’ve seen very similar things. You talk about where they take a red piece of cellophane and put it over the end of a flashlight and then they say this is some kind of special equipment, ultra-ray equipment, and they charge $3,000 for the flashlight. That’s the kind of stuff we’re seeing right now. This is what you’ve been talking about for a long time R.J..

Richard: I’ve worked in this area. I’ve helped track down some of this fraud. When you have a guy running for President whose entire career is based on pushing people to do the wrong thing, giving them the incentive to do the wrong thing, and then looking shocked when they turn around and do the wrong thing … look, these are people that he hired. These are people that he put into place. These are deals that he set up. He’s just a representative of a whole broken system. I’m not at all surprised you’re finding it right and left because Romney Care, for-profit healthcare is the reason why we have much more expensive health system than any other developed country and cover far fewer people and offer them far less. It’s a broken system.

Mike: What Bain would do, they would find a company, they would say, “We want to do a hostile takeover”, basically. Leverage buy-out, it was always a hostile setting. They’d go in. They would fire everybody they needed to fire. They would sell off everything they could sell off, whether machines, cars, copper out of the wall, whatever it was. Then they would go to the bank and say, “Look, give us $700 million. Leverage us $700 million”. They would go to their friends. They would leverage $700 million, then they would pay themselves. It might be $20 million, $30 million, $40 million right up front. They would leave the company in a position to where bankruptcy was inevitable, had to take place, there was no way you could pull it out. Taxpayers would then come in and have to pay for that. One of their big focuses was healthcare, wasn’t it?

Richard: Yes. Mike, it’s not just that the taxpayers have to rescue the bailed out company, your health plan and mine, Medicare, Medicaid … these are only the cases we know about. This overbilling goes on every day; this cheating goes on every day. They’re creating part of the system that almost guarantees it’s going to take place because that’s what desperate people do when they’re trying to beat the numbers the next guy’s getting.

Mike: Right now what we have … there’s another part to it and you picked it up in your story just like we had, just like Ed has so many times. Every time Ed talks about this story, the idea of, “Well, I left Bain Capital in 1999.” When you follow these stories that you’re talking about, clearly, he didn’t. He was making money. He was listing himself as a CEO. He was saying he was the sole shareholder for three years after 1999. Now, as we’ve said so many times, he was either lying to the Feds with his SEC 10K, which is fraud. People go to prison for that Mitt.

Richard: Exactly.

Mike: Mr. Mitt, if you’re listening or any of your pals are listening, people go to prison for that. He was either lying there or he’s lying to the American public right now because he’s so embarrassed about stories like the one you’re telling where he goes into a company like CRC. Tell us the CRC massive debt story so we can understand how he takes money from all of us and puts it in his pocket.

Richard: CRC is a horror story because there you’re talking about an organization that was supposed to be, among other things, treating kids. You’re talking about leveraging a lot of money for the treatment of kids with problems. Horrible things happened because they were really trying to leverage as much money out of it as they could.

Mike: By the way, I can’t even count the number of times they’ve been sued. CRCs been sued …

Richard: They’ve been sued over and over again for torturing kids. I mean, the details are horrifying.

Mike: Yes, they are.

Richard: Kids forced to wear clothes soaked in their own urine as punishment because they weren’t allowed to change their clothes or go to the bathroom, and just torture and graphic … children 14, 15-years-old committing suicide and this company going out and convincing parents that they could solve their son’s or daughter’s problem.

Mike: R.J., Mitt knows exactly what goes on there. He knows about the lawsuits. Even though the lawsuits have been hidden from the public, they’ve been hidden, literally. You have … the lawyers that settle the cases are not allowed to talk about it. The judges seal the records to where we don’t see but we know what’s happened. They’ve leveraged the company. They’ve de-staffed, understaffed, undertrained, they’ve put any bumpkin in there that’ll fill a warm body and they have them taking care of kids that are in such critical, emotional … having such critically, emotional problems that the kids are committing suicide. They’re doing the things that you’re talking about right now, right as we speak. CRC is alive and well, isn’t it?

Richard: Yes. It was put ….

Mike: I don’t know if it’s well. It’s alive.

Richard: They’ll hire some minimum wage, untrained person. There was a case where they didn’t see the warning signs of impending death in a teenager because they were just minimum wage kids themselves. Then that child died. Again, settled out … details not available. It’s a horror story. They’ll do what they have to do to make a buRichard: ck, to cut corners because that’s the system they represent.

Mike: R.J. Eskow, great work. I mean great work.

Richard: Thanks, man.

Mike: I’m just really impressed with this story because I see it firsthand. We handle Whistleblower cases. We handle people who tell these stories. They call our offices from all over the country. They tell us these stories. You know what? Your story nailed it. Your story is one of the most accurate … it just unfolds exactly like the stories we’re told all the time, mostly from the healthcare industry where these ‘whistleblowers’ come forth and they say, “Look, this is a company that’s stealing from the government and so … very important. Keep this work up, okay?