Letter to Rodney Davis on the Affordable Care Act

Below is the letter I just sent to my congressman.

I undoubted spent way more time drafting this letter than it was worth. I have no illusions that my congressman will read it and be swayed by my logic. As a practical matter, the best I can hope for is that someone on his staff will look at it carefully enough to add one tick to the column for “constituents opposed to repealing Obamacare.”

And yet, I think it was worth the effort I put into writing it—partially for my own benefit, as a way to clarify what I thought the most important points were, and partially for any local folks who might read it and be moved to weigh in with their own thoughts on the matter.

The Honorable Rodney Davis
1740 Longworth House Office Building
Washington, DC 20515

Dear Congressman Davis:

I am writing to urge you to preserve three key elements of the Affordable Care Act, which Speaker Paul Ryan’s “A Better Way” agenda does not protect: that policies cover the full range of essential care, that coverage be available at standard rates regardless of preexisting conditions, and that credits be available to help lower-income people buy health insurance.

With the Affordable Care Act’s rules, it’s possible to buy an insurance police and know that a full range of important care is covered. The “more choices” supported by Speaker Ryan’s plan would mean that people could “chose” to buy insurance with incomplete coverage. I have first-hand experience with how much work it is to analyze and compare insurance policies, trying to read between the lines to see what essential coverage is missing. The result of the Speaker’s plan would be many people who thought they were getting a good deal on their insurance would face bankruptcy because of hidden gaps.

With the Affordable Care Act, the last four years have been wonderfully free of the anxiety that any illness could turn into the “preexisting condition” that would make health insurance unavailable. Speaker Ryan’s plan to condition this on “continuous coverage” is a poor substitute. Sometimes people suffer a financial catastrophe and are temporarily unable to afford to maintain their insurance. It is terribly cruel to compound such a catastrophe with the additional penalty that health insurance—once they can afford it again—be unavailable or unaffordable.

My wife and I have modest incomes, and make some use of the credits available through the Affordable Care Act, which have made my insurance much more affordable. Speaker Ryan’s plan would eliminate these credits and replace them with a single credit which would probably be much smaller—and if as large, would be enormously generous to people with high incomes who scarcely need help affording their health insurance. The current means-tested credits seem much more likely to advance to goal of making health insurance available to everyone.

I urge you preserve these key elements of the Affordable Care Act.

Yours sincerely,

Philip M. Brewer

There are plenty of other things I might have included as well. For example, under the Affordable Care Act an older person can only be charged 3 times as much as a younger person for the same policy, whereas the Speaker’s plan would increase the multiple to 5x. If enacted, that change would cost me a lot. But I thought these were the most essential points: That insurance actually be insurance, that it be available, and that it be affordable.

Progressive policies with conservative rhetoric?

I wonder whether it would be possible to advance a progressive policy agenda that was cloaked in conservative rhetoric.

For example, it is currently legal for police to use unlimited force to produce compliance with their orders, even illegal orders. Essentially, you are forced to stop going about your business, comply with whatever the police tell you to do, allow them to search you and whatever you’re carrying, tolerate an indefinite delay, even let them take you to the police station if they chose, all without offering any sort of resistance.

Any questioning of their actions or inquiry into its lawful basis can be interpreted as “resistance,” and any degree of resistance, no matter how minimal, is considered legal justification for the police to beat you up, taser you, pepper-spray you, or even shoot and kill you—and they will suffer no consequence beyond (perhaps) a brief period of paid leave.

People of color have borne the brunt of these sorts of police actions for a long time. With the advent of ubiquitous cameras we have now seen many people of color murdered while offering up either no resistance at all, or such minimal resistance that it should shock the conscience to see lethal force used. We have also seen many white people granted great deference by police under circumstances where a black person would have been killed.

This is the circumstance that led to the “black lives matter” slogan.

Many people—especially, I suspect, many Trump voters—object to this slogan, preferring to suggest that “all lives matter.”

Many liberals and leftists look to a willingness to say “black lives matter” as a marker that you’re on the right side of this issue.

My question is, could a political candidate who was on the right side of this issue (and many other issues, such as using the threat of jail to balance town budgets on the backs of indigent people) couch his objections in terms that would not offend Trump voters, while still pushing for good policies? And would such a politician be able to get support from both sides of the political divide?

For example, I’d like to see a policy that said that resistance to an unlawful order from a police officer was legal and that any force used by the officer to produce compliance was an illegal assault—the officer should be prosecuted. I’d like to see a policy that any monies extracted from an indigent person under threat of jail be considered the proceeds of an illegal extortion scheme—everyone involved in the extortion should be prosecuted, the money returned, and the original fine forgiven.

If a politician were to propose such ideas, but describe them with terms like “all lives matter,” or “protecting liberty and private property rights,” could such a politician draw support from both sides?

I’m doubtful. But I’d like to see it.

Rodney Davis questionnaire response

Congressman Rodney Davis has a questionnaire asking for constituent input on questions of the day.

I filled it out some weeks ago (in mid-December) and found some of the questions to be . . . . Well, here. This is what I sent to his office after I posted my questionnaire response:

Several of the questions on your recent survey were hard to answer, because an accurate answer might be taken as supporting a position that is the opposite from what I intend. These two in particular:

“Do you believe we need to shore up Medicare so it’s available to future generations?”

Of course I support preserving Medicare. However, I would  oppose any changes in the basic design of how Medicare makes healthcare available to seniors. In particular, I would strongly oppose turning it into some kind of voucher program.

My understanding is that, together with the cost savings provided by Obamacare, Medicare is very close to being fully funded. It seems quite possible that no changes are needed going forward. Depending on the details of health care costs and payrolls in the future, it may be that some additional funding will be required, but that is the question for the future.

“Do you believe Congress must provide proper oversight of the VA to ensure our veterans are receiving the care they deserve?”

Again, providing oversight is exactly what Congress should do. However, I would oppose giving the VA additional mandates—either in terms of the care they are to provide, or in terms of the reporting they are required to provide—unless those mandates are fully funded.

I have no sense that the VA is doing anything other than providing the best care they can with the resources provided. Congress’s deeper obligation, beyond oversight, is to provide the resources necessary to care for our veterans.

I expect to go on pestering Congressman Rodney Davis on a near-monthly basis for the next two years.

Rodney Davis: Please take a stand against Trump’s immigration order

I just sent the following to my representative in Congress via the web form on his page at the House website:

Based on media reports and what I can find on your website and twitter feed, it appears that you have not yet taken a stand against Trump’s illegal and unconstitutional executive order blocking entry by nationals from certain countries.

Can I count on you to do so in short order?

I didn’t mention in my note, but wanted to mention here, that Davis’s words for his constituents after the recent election invoked Lincoln’s phrase “With malice toward none, with charity for all,” so I’m a little concerned that he may be putting a dangerous strain on our nation’s limited supply of irony.

I also refrained from once again pointing out that the Republicans in Congress are straight-up cowards, afraid of widows and orphans.

What cell phones teach us about the power grid

Back in the day the telephone network was a regulated monopoly. As long as the phone company kept the regulator happy, they were permitted to earn rate of profit on their investment. This resulted in a couple of interesting effects.

First of all, the company was incentivized to invest more in infrastructure: The more they invested, the higher their profit (which was a regulated rate times the size of their investment). This is very different from an unregulated company, where investment is viewed as a cost.

Second, while keeping the regulator happy was always a complex dance, the regulator tended to focus on a few key metrics, one of which was network uptime. This incentivized the phone company to use that large infrastructure investment to produce a network of extreme reliability.

And that network was reliable. In my personal experience with wired phones in that era a wired phone always had service: For two decades as a youth I had literally 100% success picking up a phone and getting a dial tone. Likewise, calls did not drop. Service was rated in nines: 99.999% uptime was 5 nines, 99.9999% uptime was 6 nines.

Of course, that sort of reliability is impossible with cell phones. They move around. Worse yet, they go places where radio signals simply can’t reach.

Cell phone reliability is pretty darned good—let’s call it 98%, as long as you’re not trying to get service in places where nobody else cares if there’s service (the middle of the desert, the middle of the ocean, etc.). But people are not surprised when they find a spot where there’s no service, nor are they surprised if a call drops when elevator doors close or they drive into a tunnel.

This is not to say that cell phone service is bad. My point is simply this: To get the advantages of cell phones, people have accepted a drop in telephone service reliability from six nines down to less than two.

I think this is particularly of interest because I see a potential parallel with the power grid.

The big problem with solar and wind power is that they’re crappy at providing baseline power, for obvious reasons: nighttime, cloudy days, calm days, etc.

If you want a power grid to provide five or six nines of availability, you really need to have enough fossil fuel (or nuclear) generation capacity to provide a large fraction of your total power needs—at least 80%, probably more if you don’t have considerable diversity in your renewable sources (both diverse sources: solar and wind, and geographic diversity: the wind is always blowing somewhere and the sun shines different hours different places).

But just as people learned to get by with less than two nines of phone network reliability, people could certainly learn get by with a less reliable power grid as well.

Thinking of household use, there are certain things that really need fairly reliable power (refrigerator, freezer, furnace), but beyond those few things, we only require a high-availability grid because we’ve set things up with the expectation that it would be there.

Just two or three modest changes to the way we use power could easily accommodate a less-reliable grid.

The easiest one would be for each household to have a guaranteed level of power—enough to keep your food fresh, your pipes unfrozen, and a couple of lights turned on—and then make additional power available on an as-available basis. Alternatively, you could go with a market-based measure where power was cheap when it was plentiful and expensive when it was scarce. A third option would be to distribute the resiliency, with each household providing its own backup power storage or generation capability.

My point here is not to solve the issues for a smart grid, but just to make this point: For a big enough payoff—like the payoff of a internet-connected supercomputer that you can carry in your pocket—we would accept a considerable downgrade in reliability from our power grid.

The payoffs from renewable energy arguably are that big. (In particular, not rendering the planet uninhabitable for humans. But that’s a payoff that’s uncertain and diffuse, with the gains—especially the early gains—going to people other than the ones who need to make the sacrifices.) But there are payoffs to everybody: less particulates in the air, fewer pipeline and tanker spills, fewer truck and rail accidents hauling coal and oil through towns and cities, fewer worker deaths in the coal-mining and oil-drilling industries. And then there are the cost savings: Renewable power has the potential to be very cheap and very reliable in the out-years, once the infrastructure has earned out its initial capital costs.

It might well be worth getting past the idea that the power grid should provide near-perfect reliability, given the payoffs involved in accepting a bit less.

Second passports for expensive

This sort of thing was a fantasy of mine, back in the 1980s. I could see things getting worse in the US, and the idea that a foreign passport and foreign residency could provide an escape if things got too bad was pretty appealing.

Nowadays not so much. It’s not that things have gotten better in the US; it’s that things have gotten worse other places at least as quickly. More to the point, things getting worse in the US seems to make things worse other places, so the conditions that make the idea appealing are the same conditions that make it pointless.

One book that substantially influenced my thinking in this area is Emergency: This book will save your life by Neil Strauss. I recommend it highly. In entertaining and informative prose, he documents his transformation from just the sort of kook I was in the 1980s into somebody with a much more practical perspective.

Still, an EU passport might have its upsides. Anybody got a spare quarter million euros and an interest in learning Greek? (If money is no object, a half million euros will let you buy in to Ireland, and I expect learning Gaelic is optional.)

Graphic from Citizenship for Sale on the International Monetary Fund’s IMFDirect blog.