Kevin Drum

How Likely Is a Budget Deal Later This Year?

| Thu Oct. 17, 2013 9:39 AM PDT

My congressman, John Campbell, has been sending out daily emails during the budget showdown, and today's wrap-up shows an admirable grip on reality:

The mainstream media (MSM) would have you believe that this was a "bipartisan agreement". It was.....in the same way that Lee and Grant reached an agreement at the Appomattox Courthouse in 1865. It was a complete surrender on the part of Republicans. All that was "negotiated" were the terms of that surrender.

Yeah, pretty much. Except that, as I recall, Grant allowed Lee's men to keep their swords and horses, didn't he? I'm not sure the 2013 GOP even managed to get that much out of the deal.

In any case, Campbell's email is basically an effort to buck up the spirits of his fellow conservatives by taking shots at the media, Janet Yellen, Obamacare, and scurrilous Democrats. (No, I'm not sure what Yellen did to deserve being put into this company.) That's all fine. But I thought this was the interesting part:

The next "cliff" comes on January 15, 2014 when the government could potentially shut down again. That date was intentionally chosen because that is when the next round of Sequester cuts, that further reduce government spending, take effect. This round of cuts will disproportionately hit defense spending. Democrats are hoping that they can leverage increased funding for defense for all the IRS, EPA, ObamaCare and welfare spending that they want. I think that effort will fail. The greatest threats to America today are from within, not without. In my opinion, we must preserve the Sequester as the only force we currently have that is limiting the cost and scope of government to some degree. Between now and then, watch the White House spin machine spool up on how "devastating" these cuts are in order to soften the ground for this push. But, if they want to shut the government down again in order to increase spending, let them do it.

How should this be taken? In its most obvious sense, it's an assertion that Republicans won't budge on sequester levels of spending. If the greatest threats to America are "from within, not without," this means they're willing to sacrifice the Pentagon in order to keep domestic spending low.

On the other hand—and I freely admit that I'm just reading tea leaves here—when Campbell says only that "I think" increased funding will fail, that sure doesn't sound very adamant, does it? Even granted that Campbell isn't a table-pounding type of tea partier, that seems pretty lukewarm. Maybe there really is a minor deal to be made on the budget later this year.

Advertise on MotherJones.com

The Republican Defeat in the Budget Deal Was Complete and Total

| Thu Oct. 17, 2013 9:05 AM PDT

The budget deal passed by Congress yesterday did, in the end, include one concession to Republicans: a provision that tightens up income verification for Obamacare recipients. Since Democrats were insisting on principle that they wouldn't provide Republicans with any ransom in return for keeping the government open, this seems a little worrying at first. It may not be a big ransom, but it's not zero, either.

Today, though, Sarah Kliff reassures me. In fact, it really is zero:

The deal basically requires two submitted reports in the course of the next year. Health and Human Services Secretary Kathleen Sebelius is due to submit the first report by Jan. 1, which must detail "the procedures employed by American Health Benefit Exchanges to verify eligibility for credits and cost-sharing reductions described in subsection." Six months later, the HHS inspector general is required to submit a report "regarding the effectiveness of the procedures and safeguards provided under the Patient Protection and Affordable Care Act for preventing the submission of inaccurate or fraudulent information by applicants."

....There's nothing about the income verification measures that passed Wednesday night that will change Obamacare, aside from a few staff members at Health and Human Services devoting some hours to gathering the data and writing up these reports. And that probably explains why Democrats were okay with passing this language in the first place.

That's it? A couple of routine reports? I take it back: The Republican defeat in this debacle really was complete and total.

The Conservative Fundraising Racket, Part 674

| Thu Oct. 17, 2013 8:09 AM PDT

This morning in my inbox I have a "personal appeal from Rand Paul." Nothing unusual about that, but check out the subject:

Dear Concerned American:

"I owe these unions."

President Barack Obama couldn't have stated it any more clearly.

And after spending an estimated BILLION dollars to re-elect Barack Obama and maintain control of the U.S. Senate, the union bosses couldn't agree more.

They're wasting no time demanding PAYBACK.

Top AFL-CIO union boss Richard Trumka has already made clear that he expects Big Labor's Card Check Forced Unionism Bill to be a top priority in Obama's second term.

....Since Barack Obama doesn't have to face the voters again for re-election, the union bosses understand this may be their last -- and best -- opportunity to make Card Check Forced Unionism the law of the land.

That's why it's vital you act today!

Vital indeed. And "VERY expensive," of course. So please make a generous contribution to the National Right to Work Committee.

The fact that Rand Paul opposes unions—and supports the NRWC—is no surprise, but this pitch is a sign of just how much of a racket conservative fundraising has become. There's no question that card check is something that both unions and Democrats support, but it couldn't even pass in 2009, when Democrats controlled the House and had a supermajority in the Senate. It has zero chance of passing now, and everyone knows it. Rand Paul certainly knows it, and the National Right to Work Committee knows it.

But there are frightened legions of Fox News viewers out there who don't know it, and Rand Paul wants a chunk of their Social Security checks. Right now. For a campaign against a nonexistent bill that he knows perfectly well isn't going to take place. Nice work.

Top Ten Winners of the Budget Showdown Debacle

| Wed Oct. 16, 2013 9:50 PM PDT

Conventional wisdom has it that President Obama was a winner in the budget showdown, John Boehner was a loser, everyone hates Ted Cruz, blah blah blah. But that stuff will all blow over within days. Here's a top ten list of the real winners:

Wall Street: They didn't panic because they figured Congress would do the right thing at the last second, just like always. They were right.

Kathleen Sebelius: If not for the shutdown, the media would have focused its attention 24/7 on the disastrous rollout of Obamacare. By now, Sebelius would be in about the same mental shape as the House stenographer if Republicans hadn't helpfully covered for her.

Pandas: For two weeks, anyway, they got to grow up without millions of prying eyes following their every move and cooing about how cute they are.

Netflix: Furloughed federal workers had plenty of free time on their hands, and a lot of them turned to Netflix to fill all those empty hours.

Robert Costa: He was everyone's go-to reporter for the inside scoop on what Republicans were thinking at each step along the way. A new job and a big raise can't be too far off.

Iran: Benjamin Netanyahu wants everyone to be outraged over Iran's peace overtures, but no one is listening. For the moment, anyway, Obamacare is the only existential threat that American conservatives have time for.

China: They want to see a "de-Americanized world." After watching the know-nothing takeover of the American government by the tea party, horrified leaders across the globe are inclined to think that's not such a bad idea.

Random House: Following Ted Cruz's epic filibuster, Green Eggs and Ham is all set to become the Christmas present of choice for millions of devoted tea partiers this holiday season.

The World War II Memorial: I've been there, and it's really not a very good memorial. But now it's the infamous site of the Barrycade! Attendance should skyrocket.

Democrats: They actually stuck together! Can you believe it? Republican overreach was so egregious that it accomplished in two weeks what no one in history had managed to accomplish in over two centuries. Will Rogers is spinning in his grave.

Today I Fired a Gun For the First Time in my Life

| Wed Oct. 16, 2013 6:27 PM PDT

Since I write periodically about gun issues, I've long had a vague feeling that I should learn how to shoot a gun someday. Not to become an expert or anything, but just so I have some idea of what's involved in a tactile, rather than an academic, sense.

So today I did. A friend of mine hauled out his gun collection and showed it to me, and then we headed out to a small indoor range and shot a few rounds each. So how did I do? The first gun on our list was a .40 caliber Beretta semiautomatic. On my first try loading the clip, I put the rounds in backward, which didn't work so well. So I reloaded, popped the clip in, flipped off the safety, and did my best to hold the gun the way I had been told to. As you can see below, none of my seven rounds managed to hit inside the target area, but five of them did hit the paper. Not bad for a city boy!

So that's that: my first time ever firing a gun. I loaded another clip, and on my second try I started to get the hang of lining up the sight and adjusting for the recoil, and did a little better. One round even went into the black. Next, my friend got out a .22 caliber rifle, and we plinked away with that for a while. Those .22 clips are cute little things, aren't they? Here's a couple of clips worth in my next target:

The first set all landed to the left. Then I overcompensated and got the cluster on the right. Then I apparently got it about right, and the next five rounds all went into the black.

Finally, we fired a 1 ounce slug from a shotgun. That puppy has a bit of a kick, doesn't it? Oddly enough, though, I managed to fire it fairly straight anyway. We were using a silhouette target at that point, and my single round hit it in the shoulder.

So now I know what a gun feels like and how to handle one. That's about all I know, but I figure any day in which I learn something new is a pretty good day.

The Obamacare Website Might Finally Be Getting Better

| Wed Oct. 16, 2013 11:38 AM PDT

My timing, as always, is perfect. Last night I wrote a post wondering just how bad the problems with the Obamacare website really are. Today, Sarah Kliff reports that things are finally getting better. The site remains slow, but she was able to complete an application that included financial assistance in about 30 minutes. Her application is now "in progress," so she hasn't begun the actual process of choosing a plan, but this is still better than it was before. Kliff also reports that shopping for plans is fairly smooth and easy.

So....maybe the problems are more resolvable than we thought, and are in fact finally getting resolved. Stay tuned.

Advertise on MotherJones.com

Reminder of the Day: When It Comes to Long-Term Spending, It's All Health Care, Baby

| Wed Oct. 16, 2013 11:22 AM PDT

With the budget crisis now on its way to resolution, it's worth reminding everyone that, in fact, the federal budget isn't really in bad shape. As Ryan Cooper of the Washington Monthly notes this morning, long-term predictions of doom are essentially based on one thing: the rising cost of health care:

The CBO's model has a factor which assumes that health care costs will continue to grow much faster than the economy forever—which means that if we get health care cost growth under control, our deficit "problem" will vanish entirely.

The conservative reply is that the way to get health care costs under control is to simply have less health care. We must "reform" entitlements; meaning raise the Medicare retirement age, cut Medicaid, etc. We can't afford to be generous, and some people are just going to have to go endure hardship or we're going to bankrupt the state.

But as the Monthly has long shown, this is nonsense. In fact, the United States' world-record health care costs are driven by a combination of policy factors, both on the private and the government side...."Centrist" elites don't seem to think that something counts as reform unless it's punishing a poor person somewhere, but the real action is in the policy design. Health care is expensive because of inefficiency, monopoly politics, lack of research, and interest group lobbying, not because Medicare is too generous. In fact, health care cost growth has slowed considerably since the passage of Obamacare, so if the administration manages to fix its IT disaster we could be in good shape already.

Yep. The chart below shows federal spending through 2008 in order to illustrate historical trends clearly without the spike of the Great Recession. As you can see, domestic spending ("Other") is declining; interest expense is declining; defense spending is declining; and Social Security spending is flat. It will increase a bit over the next few decades, but only by a point or two of GDP.

And then there's Medicare, which is increasing. But Medicare is increasing because (a) the population is aging, and (b) overall health care costs are rising. We can't do anything about aging, which means that essentially our entire long-term budget problem is caused by rising health care costs. That's it. If you're actually serious about this stuff, you'll spend essentially 100 percent of your time on policy proposals designed to reduce America's insanely high health care costs. Obamacare is a start, but there's still a lot more to be done.

Here's Why Your Asthma Inhaler Costs So Damn Much

| Wed Oct. 16, 2013 9:58 AM PDT

Dr. Russell Saunders is pissed off:

As I’m sure comes as no surprise, I prescribe a lot of medications....One medication I prescribe with great frequency is albuterol, a bronchodilator. Asthma is a very common childhood illness, and one that primary care providers can often manage without consulting subspecialists.

....So I prescribe a lot of albuterol [inhalers]. Or rather, I would if they existed. Unfortunately, albuterol inhalers per se are not currently on the market. What my patients really get are prescriptions for Proventil or Ventolin or Proair. There are, at this time, precisely zero generic albuterol [inhalers] on the market.

The reason why there are none on the market and thus patients (or their insurance companies, if they are blessed with good coverage) are forced to pay for the name brands is contained in this horrifying and infuriating article about pharmaceutical pricing in the New York Times. If it does not make your blood boil, then I congratulate you for having a more even temperament than I.

I'm pretty sure that I don't have a more even temperament than Saunders, but I do have one advantage over him: I already knew what was going on with asthma inhalers even before Elisabeth Rosenthal's piece—the latest in her series about the high cost of American health care—appeared a few days ago.

Here's the short version of the story: as Saunders says, albuterol is a cheap medication because it went off patent long ago. Then, a few years ago, as part of the campaign to eliminate CFCs and save the ozone layer, CFC-based inhalers were set to be banned. Pharmaceutical companies took advantage of this to design new delivery systems and surround them with a thicket of patents. As a result, even though albuterol itself might be off patent, only name-brand asthma inhalers are available—and since there's now no generic competition the big pharmaceutical companies are free to jack up prices to their heart's content. And they have. After all, as Rosenthal points out, this isn't like acne medicine that you can do without if it costs too much. If you have asthma, you need an inhaler, period.

Is your blood boiling? Well, wait a bit. The story is actually even worse than this. You're probably thinking that what happened here is (a) overzealous environmentalists insisted on banning CFC inhalers even though they don't really have much impact on the ozone layer, and (b) pharmaceutical companies cleverly took advantage of this to suck some extra money out of asthma sufferers.

Well, the ozone layer was the initial cause of all this, so feel free to place some of the blame on environmentalists if you like. But as it turns out, scientists raised some early concerns about the inhaler ban because the replacement for CFCs was a powerful greenhouse gas. So they suggested that maybe it was better just to make an exception for asthma inhalers and let well enough alone. At that point, the pharmaceutical companies that had been eagerly waiting for the old inhalers to be banned went on the offensive. Nick Baumann picks up the story from there:

The pharma consortium transformed from primarily an R&D outfit searching for substitutes for CFC-based inhalers into a lobbying group intent on eliminating the old inhalers. It set up shop in the K Street offices of Drinker Biddle, a major DC law firm. Between 2005 and 2010, it spent $520,000 on lobbying. (It probably spent even more; as a trade group, it's not required to disclose all of its advocacy spending.) Meanwhile, IPAC lobbied for other countries to enact similar bans, arguing that CFC-based inhalers should be eliminated for environmental reasons and replaced with the new, HFC-based inhalers.

The lobbying paid off. In 2005, the Food and Drug Administration (FDA) approved an outright ban on many CFC-based inhalers starting in 2009. This June, the agency's ban on Aerobid, an inhaler used for acute asthma, took effect. Combivent, another popular treatment, will be phased out by the end of 2013.

In other words, pharmaceutical companies didn't just take advantage of this situation, they actively worked to create this situation. Given the minuscule impact of CFC-based inhalers on the ozone layer, it's likely that an exception could have been agreed to if pharmaceutical companies hadn't lobbied so hard to get rid of them. The result is lower-quality inhalers and fantastically higher profits for Big Pharma.

Rosenthal has a lot more detail in her piece about how the vagaries of patent law make this all even worse, and it's worth reading. But she misses the biggest story of all: none of this would matter if drug companies hadn't worked hard to make sure the old, cheap inhalers were banned. How's your blood doing now, Dr. Saunders?

Word of the Day: Brinkmanship

| Wed Oct. 16, 2013 9:01 AM PDT

Yesterday my copy editor objected to my use of the word brinksmanship, recommending that I replace it with brinkmanship. I prefer the version with the S, but I usually take his advice unless I have a pretty good reason not to. Since my dictionary lists both variants as acceptable, I did what I usually do next: I powered up the Google Ngram Viewer to see which version is in more common use. Here's the result:

The version without an S is plainly the most common by a wide margin, so I went ahead and made the change. But I was intrigued that the word apparently first appears in 1955 and then shoots up the charts quickly, suggesting that it's a child of the nuclear age. Sure enough, dictionary.com confirms that this is when it first appeared, coined by Adlai Stevenson during the 1956 presidential campaign:

Associated with the policies advocated by John Foster Dulles (1888-1959), U.S. Secretary of State 1953-1959. The word springs from Dulles' philosophy as outlined in a magazine interview with Time-Life Washington bureau chief James Shepley early 1956:

"The ability to get to the verge without getting into the war is the necessary art. If you cannot master it, you inevitably get into war. If you try to run away from it, if you are scared to go to the brink, you are lost."

The quote was widely criticized by the Eisenhower Administration's opponents, and the first attested use of brinkmanship seems to have been in such a context, a few weeks after the magazine appeared, by Democratic presidential candidate Adlai Stevenson criticizing Dulles for "boasting of his brinkmanship, ... the art of bringing us to the edge of the nuclear abyss."

This is news to me, and since we've been playing budget brinkmanship for the past few months, I thought a brief refresher on the nuclear origins of the word might be in order.

Also (according to dictionary.com once again), the S in the alternate spelling is a "parasitic S." What the heck is that? Can any linguists help out here?

Senate Budget Deal Close to Finished

| Wed Oct. 16, 2013 8:07 AM PDT

After last night's collapse of John Boehner's 87th attempt to forge some kind of plan to end the budget/debt ceiling crisis, the Senate is back in the driver's seat. And oddly enough, today's Senate plan is identical to yesterday's Senate plan except for one thing: the sole provision that Democrats wanted has been jettisoned. So now the deal is that Republicans get a small bone in return for extending the CR and the debt limit a couple of months. Matt Yglesias figures this is bad news:

I think there's a very strong chance we just do this all over again in the New Year. The conference committee will be at loggerheads over the question of tax increases. Hard-core conservatives will remain unreconciled to the idea of abandoning the struggle. Mainstream conservatives will continue to be loath to split the party. And the reality will be that the strategy of sticking with the majority-of-the-majority principle until the 11th hour and then passing bills with mostly Democratic votes is securing policy concessions from Democrats. So why not do it all over again?

I don't really disagree, especially given the fact that apparently no one in the Senate can really think of a good reason that they'll be able to meet their self-imposed December 13 deadline to come up with a permanent budget deal. But there is one reason to hold out a tiny ray of hope: midterm elections. The closer we get, the more likely it is that Republicans will be punished if they shut down the government yet again. Right now, the Senate deal extends the debt ceiling through February, and if you tack on another four or five months of "extraordinary measures," it means the next debt ceiling crisis will start to heat up in July. Do Republicans really want to go through yet another hostage-taking scenario that close to Election Day? Or would they rather spend the summer telling horror stories about the rollout of Obamacare?

I'd say the latter. They may be insane, but they're not stupid. So that leaves only the CR, and the odds are good that Republicans will basically win the CR battle by keeping sequester levels of spending in place. They won't be able to win agreement on a bigger plan, but they'll probably win the sequester battle—which, let's face it, is a pretty big win. And with that, they'll declare victory and go home.

Then, after next year's election, maybe it will be grand bargain time again. Or maybe it will be yet more gridlock as we begin the death march toward the 2016 primaries. I really have no idea.

BY THE WAY: Remember all those people who have been chastising Wall Street for not taking the threat of a debt ceiling breach seriously enough? Well, guess what? The financial folks were assuming that Congress, yet again, would make a deal, but not until the very last second. And right now, it looks like they were exactly right. Maybe they're not so out of touch after all.