Confusion has its cost

My wife and I were listening to a favorite CD on a day trip by Crosby, Stills, Nash and Young called “So far.” It is the first album recorded after Neil Young joined the band. One of the songs is called “Helplessly Hoping.”

The song title is an excellent metaphor for what many feel about the tenure of the US president. A key line of the song echoes a concern that I have – “Confusion has its cost.”

Going into this administration, I expected a heavy dose of untruthfulness, bullying and name calling from the president. I expected concerns over policy decisions he might make, pulling out of the Paris Climate Change Accord, being an example. Sadly, I have not been surprised on these fronts.

What has surprised me is the level of chaos and incompetence present in the White House. And, I am not alone in this assessment. Conservative pundit David Brooks uses the term “equal parts chaos and incompetence.” Together, they cause confusion.

There is confusion around inconsistent messaging, unstable decision-making, overshadowing or derailing emissaries, being swayed by biased or misinformed sources, and a disdain for study or receptivity to input counter the president’s set notions.

This confusion has a cost. Other leaders have lamented they do not know who speaks for America. Republican leaders feel the same, but can only grumble under their breath. Perhaps, the best metaphor for the Trump presidency is his communication people hiding in the bushes to discuss what to say about Jim Comey being fired. Not only did the regal-minded Trump not tell Comey he was fired, he failed to tell his communication staff.

Ron Christie, a former Bush communication official noted that well run White Houses have monthly, weekly and daily talking points. I think one reason the daily press briefings went away, is the lack of such.

Confusion has its cost. Our reputation, our word, our commitment, our governance require clarity. Another measuring rod is White House turnover, which is much higher than previous administrations.

Letter from a Republican candidate in 2000

In The Charlotte Observer today, a letter from a former Republican candidate for Lieutenant Governor in 2000 was printed. Andy Nillson wrote a letter entitled “Trump’s power must be checked by GOP.”

Nillson’s letter echoes what non-Republicans and a handful of Republicans are saying. Below is his letter, which speaks for itself:

“Lately, the truth that many Republicans like me are realizing is that the our president is not upholding the ideals of our party and our country.

His administration violates duties of office with callous indifference. And President Trump expects Republicans to fall in line behind him, regardless.

I have been most appalled by the president’s mishandling of foreign policy matters – especially the Ukraine situation – and his conduct during the Mueller investigation.

His power must be checked by other Republicans. Congress must do its duty to bring forth all of the evidence so the country can move forward. We cannot repeat Watergate. It will set Republicans back 50 years.”

These letters from courageous Republicans need to be highlighted. Please feel free to share this letter with Republican legislators and others.

I know Trump followers will dismiss Mr. Nillson as a RINO (Republican in Name Only), so his opinion can be discounted. Sadly, Trump’s party does not bear much resemblance to the Republican Party.

This is not Democrat witchhunt. I agree with Nillson’s comments. Republicans must remember their oaths to the US constition and think more of protecting it than the incumbent president. Nillson, like Nebraska GOP State Senator John McCollister, should be applauded for their political courage.

End of week wanderings

With multiple topics rolling around in this older brain, here are a few end of week wanderings (or wonderings as the case may be). In no particular order:

It still amazes me that people in leadership still don’t know people record things. Congressman Anthony Weiner sends pictures of his Johnson to a teen girl and then is surprised when it goes public. Justin Trudeau talks in public about “he who shall not be named” and it goes viral. Boris Johnson denies being in the conversation, when we can see him in the conversation. And, “he who shall not be named” makes the same mistake later. Let’s face it, people talk about dealing with Trump as he is like trying to hold mercury in your hands. Just don’t play your hand where we can see (or hear) the cards.

I feel sorry for my friends in the UK as they have a choice between the same Boris above and Jeremy Corbyn. Neither person is a day at the beach, but Johnson has a Trump like propensity to be untruthful. He is just more glib than the US president. Brexit will likely occur and it won’t be pretty. The UK will be in the doldrums for several years as a result. In some respects it will be poetic justice if the folks who misled the public are in charge when the you-know-what hits the fan. I fully understand the Brexiters point of view, but the financials will not be pretty as forecasted by smarter people than me.

I am not sure if the Democrats will help or harm themselves by impeaching the president in the House. It is probably both. But, they still must do it. The US president is a national security risk with his modus operandi that has become apparent on Ukraine. Using shadow diplomacy to exploit a country for personal gain, not briefing the real diplomats on all the issues, covering-up a phone call and other key emails and obstructing justice (as also evident in the Mueller Report) and the US has a president that can be used for nefarious purposes. He would detest this word, but I feel he is a “stooge” for Vladimir Putin. The question is he an active participant in that role or is so uninformed, he will believe Putin if he gives Trump perceived victories. Yet, the other key reason for the impeachment is the president thinks he is a “king.”

By the way, the US president wants Adam Schiff, Nancy Pelosi and the Bidens to testify in the Senate. OK. If they do, I want Donald J. Trump, John Bolton, Mike Pompeo, Mick Mulvaney and Mike Pence to testify. I would like also to hear from Dan Coates and Sue Gordon as to why they were asked to leave the National Intelligence leadership. Trump will never testify as he has so much difficulty with the truth.

The Global Climate Summit is going on in Madrid. Progress must be made. Several US states and business are likely present, making up for the Trump stance. Good things are happening, they just need to happen faster and with the US leadership a part of the equation rather than what they are getting now.

Puzzlement

I am puzzled. I have been concerned for a long time about actions and behavior of the current occupant in the White House. Why am I puzzled?

We have a national security risk in the White House and his actions are being explained away by his sycophants as just Trump being Trump. That may be true as he has been an untruthful bully who strong armed people for many years. He now thinks he is a king, when he is only president.

While three expert witnesses said the president committed an impeachable offense, we have a one expert witness say he needs to see more evidence to confirm impeachment. I respect his opinion, so the president needs to stop obstructing justice and let people who heard him abuse power to testify. More on the cover-up would be nice, as well.

It apparently is not enough for a higher up to order you to work with the president’s attorney to exploit Ukraine. Who else would have that authority, that attorney relationship and something to gain from the exploitation?

This abuse of power fits into a larger narrative of a president who is taking a wrecking ball to our global reputation and relationships, while cozying up to autocratic leaders. There is a reason so many leaders talk about ways to deal with this impetuous person as do US GOP leaders.

The NATO meeting is yet one more example of the chaos he is causing. While asking for NATO countries to pay their share is a fair request, denigrating people does not serve us well. Seemingly every issue he involves himself in is contentious.

I am puzzled why this is not more obvious to his followers. Part of the reason is they are asked to look the other way with a sophistry by talking heads on a favored news station. What I see is abuse of power, corrupt behavior, obstruction of justice, and an active cover up.

It is a puzzlement, but here is one more. You know the sycophants are worried about other shoes that will drop. That has to keep them up at night. It should.

Former Arkansas surgeon general brags on Medicaid expansion

I have written often about the Affordable Care Act not being fully implemented since 15 states have not expanded Medicaid. Rather than repeat my arguments, let me reference the attached editorial written by Dr. Joe Thompson, the former Surgeon General of Arkansas, which I read in Friday’s The Charlotte Observer. The reason for their interest is North Carolina has a Democrat governor working with a Republican majority General Assembly and the issue of Medicaid expansion is of importance. The editorial is entitled “Medicaid expansion works in deep red Arkansas. It would work in North Carolina too.”

“My home state of Arkansas is unusual among Southern states in having adopted Medicaid expansion early and in our own fashion.

I was Arkansas’ surgeon general in 2013 when the state first faced the question of whether to expand Medicaid. Like North Carolina now, Arkansas then had a Democratic governor and a Republican-controlled legislature. Fortunately, we avoided an impasse; lawmakers on both sides of the aisle came together to approve an innovative alternative to traditional Medicaid expansion that provides private health insurance coverage to about 250,000 people earning up to 138% of the federal poverty level.

The effect on Arkansas’ uninsured rate was swift and dramatic. A 2015 Gallup report showed that since Arkansas’ Medicaid expansion program took effect in January 2014, the state’s uninsured rate had been cut roughly in half, dropping from 22.5% to 11.4% ― the biggest reduction in the nation.

According to the U.S. Census Bureau, Arkansas’ uninsured rate was 8.2% in 2018. North Carolina’s was 10.7%, the ninth-highest rate in the nation. Arkansas’ reduced uninsured rate led to a 55% reduction in uncompensated-care losses at hospitals. This has been especially important for rural hospitals, which treat many low-income patients.

Since January 2010, only one rural Arkansas hospital has closed for financial reasons. In the five neighboring states that have not expanded Medicaid, more than 50 rural hospitals have closed, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill.

Expanding Medicaid also has helped stabilize Arkansas’ health insurance market, improve competition and control premiums. Since 2014, at least three insurers have offered plans through the Health Insurance Marketplace in each county in the state. The competition encourages low rates: In 2014, 38 states had marketplace premiums lower than Arkansas’; today, only six states have lower premiums.Medicaid expansion has brought billions of new federal dollars into Arkansas’ economy: $1.7 billion between January 2014 and June 2015 alone, according to the Kaiser Family Foundation. Arkansas also is saving money because some individuals previously covered under traditional Medicaid, which in Arkansas is 30% state and 70% federally funded, are now covered under Medicaid expansion.

The federal government currently is paying 93% of Medicaid expansion costs and will pay 90% in 2020 and thereafter. A consultant told a legislative task force in 2016 that Medicaid expansion would save Arkansas $757 million between 2017 and 2021.Thirty-six states have now decided to accept Medicaid expansion.

Arkansas has become a firmly red state, but it has reauthorized its Medicaid expansion program with a supermajority vote every year because of the demonstrated benefits to the working poor, the economy and the health care infrastructure. Last year, Arkansas added a work and community engagement requirement that currently is blocked by a federal judge’s order, but however that issue ultimately is resolved, it is clear that Medicaid expansion has had tangible, positive results. There’s a reason the number of states rejecting it continues to shrink each year.

Joe Thompson, MD, MPH, is president and CEO of the Arkansas Center for Health Improvement. He was Arkansas’ surgeon general under Republican Gov. Mike Huckabee and Democratic Gov. Mike Beebe.”

In spite of efforts to naysay it, hobble it and kill it, the Affordable Care Act is stabilizing some. It needs more stability and Medicaid expansion would help in the remaining 15 states. I have also advocated the US government paying back the money they withheld from insurers causing some to leave the market, inviting those companies back to the market. I have also advocated the reduction of the Medicare eligibility age from 65 to age 62 or even 60. And, where options don’t exist, Medicare could be offered as an option for younger adults.

What frustrates this retired benefits manager, consultant and actuary is the fact people getting harmed by decisions to harm the ACA is not a major factor. There is too much focus on winning an argument that people getting screwed does not seem to matter. Please help make it matter. Even as we speak, the eating away at the edges of the ACA could lead the Supreme Court to rule it unconstitutional. If this occurs it would be a damn shame.

Letter to editor – as a Republican, I won’t follow blindly

A letter to the editor in my paper today was entitled “As a Republican, I won’t follow blindly.” The following are his first two paragraphs:

“Why are American citizens turning a deaf ear to the obvious wrongdoings of the president of the United States.

As a registered Republican, I am appalled that my fellow American citizens aren’t ashamed of the total disregard for the truth that is being emitted from Washington.”

This emperor has no clothes. He is also a national security risk as he belittles and embarasses an ally in need of our help for personal gain.

We must ask more why questions

We have a national security issue which is right in front of us. I sent the following to my Congressman and select Senstors. Please feel free to use and adapt.

We are not asking enough why questions.
– why is the president running a shadow diplomacy with Rudy Guiliani, who has not been vetted by the Senate?
– why does the president ignore the seasoned diplomats and intelligence officials to chase conspiracy theories postulated by editorialists on Fox?
– why are diligent, experienced, courageous and honorable public servants focusing on helping Ukraine gain better footing, when the president is so focused on his campaign?
– why is there obstruction of documents and witnesses? The president cries foul, but he is blocking witnesses. He can’t have it both ways.

As an independent and former Republican voter, I am deeply concerned by what has transpired in the White House with Ukraine. I am also concerned by an over zealous protection of someone who needs greater scrutiny, not less. I fully support the impeachment hearings. What witnesses are testifying under oath at great risk is very troubling.

It is also troubling that Devin Nunes is leading the GOP efforts. He cited on Thursday a partisan report that GOP Senator Richard Burr asked Nunes and Speaker Paul Ryan not to release as his Senate committee did not agree with its conclusions. Plus, we cannot forget that he had to step down as Chair of this committee as he informed the White House what they were investigating. So, I must confess I feel he lacks credibility and that is unfortunate.

Help us Americans get to the bottom of this.