Michael Tomasky's Blog, page 41

The deficit commission reports | Michael Tomasky

Well, this is one of those days when I know I'm living a wonky life in a wonky town, because I and everyone I know is really excited about the release of a report on the deficit by a commission. Woot woot.

The draft report, a 50-page power-point document, came out this afternoon. It's not easy reading for the layperson because its recommendations all say we propose doing this, but they don't add the crucial information most people would need to know, which is, okay, compared to what status quo? You're just supposed to know the what. That's why it can be hard to divine what's really being said in these things until serious experts have had a few days to digest it.

But the chatter is that it's just about exactly what most people expected, which is to say, it's full of recommendations about spending cuts (including Social Security and Medicare) that most Democrats won't go for, and tax-revenue increases (modest politely bruited) that Republicans won't go for in 100 years; therefore, it is a dead letter already. That might be unfair. We'll see. But for now it's the latest chapter in the ever-growing book on why this town doesn't function anymore.

First some history. Two senators, Democrat Kent Conrad and Republican Judd Gregg, proposed a congressional deficit commission. Obama liked the idea. But once Obama liked the idea, Republicans didn't. They filibustered it. Seven GOP cosponors of the proposal voted against it.

That led to this commission, appointed by Obama and congressional leaders. It has 18 members, and 14 of them have to agree to recommendations for them to move forward. Everyone knew going in that the real catch here was going to be getting Republicans to agree to anything resembling a tax increase, otherwise they'd never get 14 votes. And so the recommendations are...well, surprise, via Jonathan Chait:

Anticipating this dynamic, the commissioners crafted a plan that's tilted, overwhelmingly, toward Republican priorities. About three-quarters of the savings come from spending cuts. And the one-quarter that comes from increased revenue comes through an overhauled tax code with lower marginal rates and corporate income tax rates--that is, something that is a fairly good deal for conservatives on its own terms.

But Republicans are unlikely to support even a hefty chunk of these proposed cuts, which come from the Pentagon. And anyway, Pentagon cuts always have bipartisan cover, because cutting a Pentagon program often means cutting jobs in somebody's district. Except that here, a lot of the proposed military cuts have to do with pay and benefits, which seems unlikely to go anywhere either.

I've read it, and I could take you through it, but that isn't really the point. The point is that this document is going nowhere, but also that these commission co-chairs, Erskine Bowles (Dem) and Alan Simpson (Rep), had an impossible job to begin with.

This is Congress's job. I mean, it's exactly what they're paid to do - sort out the nation's fiscal house. They punted.

We are in a permanent state of dysfunction that no one can fix. At least now the Republicans, who will control the House, will share some of the blame.

US politicsMichael Tomasky
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Compromise schmopromise

This does not count as a Tomasky quiz, because the question is way too easy, but: which party's members are far less inclined to support political compromise?

We have a new poll out from Gallup for USA Today showing the following:

Americans think it is generally more important for political leaders to compromise to get things done (47%) rather than sticking to their beliefs (27%), but Republicans and Democrats hold differing views on the matter. Republicans tilt more toward saying leaders should stick to their beliefs (41% to 32%), while Democrats more widely endorse compromise (by 59% to 18%).

Well, if anything, I'm shocked that it's as close as it is among Republicans. But notice the difference, which Gallup kind of oddly plays down in the way it describes this. By fully 40 points (the 31-point differential plus the nine-point differential), rank-and-file Democrats are more inclined to say compromise than rank-and-file Republicans.

We could offer a lot of different reasons why this is so. But I have just one reason, and it is that Democrats are much more likely to inhabit an evidence-stocked world in which problems and their solutions are complicated and maybe the other guy has a bit of a point, whereas Republicans increasingly inhabit a world in which their sources of "news" are telling them that liberals aren't merely wrong but evil and must be crushed. Yes yes yes, there's partisan caterwauling on the left too, but it doesn't compare in quantity or quality.

This is a classic nature v. nurture question, is it not, when you think about it? I mean, Republicans were not born less likely to accept compromise. It's taught.

This difference between the voters of the two parties explains many of the differences in the way the parties operate on Capitol Hill, as we are about to find out again, and as we have seen in the past. Bill Clinton had a 60% approval rating the entire time Tom DeLay's Republicans were impeaching him. That didn't matter. What mattered was a base that was screaming: Get the bastard. They're going to be screaming it over the next two years, even louder.

US politicsDemocratsRepublicansMichael Tomasky
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Beck on Soros | Michael Tomasky

I couldn't really watch very much of Glenn Beck's ballyhooed "expose" of George Soros on his show last night, and I don't really know whether this sort of thing should be taken seriously or simply dismissed and ignored. (No, I'm not linking to it.) But as one who doesn't watch Beck, I have to say that I was flabbergasted at his techniques.

The show is called The Puppet-Master. The sound stage is bedecked with a puppet-show theater and various other puppets strung up from the rafters at about the height of Beck's eyeballs. The visuals establish the theme. Beck starts in talking about puppet shows, segues to the master, mentions secret agendas and hidden motives. It is absolutely uncanny how in the first two or three minutes of his monologue he is unwittingly describing Fox News and himself.

Other blogs are highlighting the preposterousness of the presentation. Soros, says Beck darkly, helped finance coups and revolutions in Eastern Europe. Says Media Matters:

As examples, Beck cited Soros' purported roles in the Rose Revolution (Georgia), the Orange Revolution (Ukraine) and the Velvet Revolution (Czechoslovakia), as well as "coups" in Croatia and Yugoslavia. Author Richard Poe then connected Soros' previous work to Beck's accusation that Soros' "target" is the United States.

Unmentioned in Beck's program, but revealed in Shadow Party, the book Poe co-wrote and which appears to be the source material for a lot of the information being presented by Beck about Soros, is the fact that many of the governments Soros supposedly helped bring down were autocratic ones, often headed by former Communist leaders.

Shadow Party explains that "Soros helped bankroll the 'velvet revolution' that hastened the fall of a dying Communist regime and catapulted dissident playwright Vaclav Havel to the presidency of the Czech Republic." (Shadow Party, p. 231) The Velvet Revolution led to the establishment of Slovakia as an independent nation and eventual inclusion in NATO.

Shadow Party also goes on to note that Soros' support for the Otpor organization in Yugoslavia helped to bring about the end of Slobodan Milosevic's reign, and points out that the International Criminal Tribunal later charged Milosevic with crimes against humanity.

Similarly, the Orange Revolution in Ukraine was a non-violent response to a disputed election that involved poisonings and assassination attempts. And the Rose Revolution replaced Georgian President Eduard Shevardnadze, a former Soviet official, with Mikheil Saakashvili, who Beck himself has heavily praised.

Beck claims that Soros helped to engineer a "coup" in Croatia, but this seems to be a reference to Soros' opposition to Croatian President Franjo Tudjman, who died in office and was replaced by Stipe Mesic. The BBC explained Mesic's election this way: "He espoused a clean break from Mr Tudjman's authoritarianism, which had left the country internationally isolated and in economic recession."

Meanwhile, Beck disappears completely Soros' role funding anti-Communist dissidents like Poland's Solidarity movement, Charter 77 in Czechoslovakia and Andrei Sakharov in the Soviet Union.

One could go on and on. It really is shocking that something like this could be on American "news" television. I mean, not much is shocking these days, but this is just rancid propaganda, delivered (almost) openly as propaganda, with just enough of a patina of "information," a structure and rhythm similar enough to that of a standard news-magazine show, that it can just barely pass as one to those who want to believe it.

The real point, of course, is to chase Soros out of politics, to make his money somehow dirty to Democrats and progressive groups. Meanwhile, as Beck surely knows, top Republican operatives and money people are already at work plotting how their side's Soroses, and they have many of them (and as I've said it is of course their right every bit as much as it is George's to put their money behind their beliefs), are going to dump multiple millions into the defeat of Barack Obama and the Democrats in the Senate. So Beck is playing his part. It's overt Republican propaganda. And there's nothing to stop it.

Glenn BeckGeorge SorosMichael Tomasky
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More on Texas and Medicaid, this time from an expert | Michael Tomasky

Harold Pollack, the University of Chicago healthcare expert nonpareil, read my post yesterday on Texas and wrote me an email, which I asked him to gussy up a bit here and there and expand upon, and which I henceforth reproduce for your edification, here:

They're not ending Texas Medicaid.

Given Medicaid's enormous costs and the politically vulnerable constituencies the program visibly serves, it's not surprising that emboldened Texas conservatives speak of abolishing Medicaid in their state. Before anyone gets too deep into this, it's worth noting that the whole idea is financially, organizationally, and politically disastrous. Were it not for the serious human consequences that would ensue, liberals might ardently hope that Texas Tea Party-types seriously pursue this effort.

From an economic perspective, the federal government pays the lion's share of Texas's Medicaid costs.) Even in good times, Texas's federal matching rate exceeds 60 percent. The feds will pay virtually the entire tab for people made newly-eligible for Medicaid through health reform. Conservatives who favor abolishing Texas Medicaid claim to have found some way to make the budget numbers work. I don't believe them.

Even if I'm wrong, balancing budgets is only one issue in play. For reasons I can't describe in detail here, Medicaid is hard-wired within the payment systems and the business models of thousands of medical providers. It is also the conduit through which many services are provided in nonprofit agencies, schools, and other settings. No one can really say what removing billions of dollars from this ecosystem would actually do.

Perhaps the only predictable consequence would be to provoke a determined backlash from some of the most organized and well-funded constituencies in America: Nursing home operators, advocacy groups for the physically and intellectually disabled, and many more. The macroeconomic consequences for Texas of rejecting more than $10 billion per year in federal aid would be significant, too.

Then there is one final point. The owner of this space has noted the disjunction between Americans' professed belief in the general virtues of limited government and our actual support for particular costly programs that serve ourselves and others we want to help. That will matter here. Many people believe that Medicaid serves stereotypical poor people. Indeed, most Texas Medicaid recipients are low-income kids.

Yet the dollars tell a different story. Almost 60% of Texas Medicaid dollars cover services to the elderly or the disabled. Lawmakers may expect that slashing Medicaid will produce ardent but ineffective protests from traditional Democratic constituencies. But legislators may instead encounter surprising numbers of angry Good ol' Boys asking what the hell happened to the nursing homes and visiting nurse agencies that help their elderly parents, or why their cousin's autistic child suddenly can't get services through his local school.

You never know what's going to happen this political season. I'm still confident that blustering politicians who go this route will soon be seeking other work.

ME AGAIN: The readers and I thank you, Harold. This is another thing a lot of people don't understand, which I didn't get into yesterday just because the post was long as it was, but Medicaid, not Medicare, covers the bulk of nursing-home expenses in this country for people who qualify for assistance. Typically, as some of you may know from experience with mom or dad, Medicare pays only for strict short-term stays after a hospital visit.

So gutting Medicaid means..well, imagine those horror stories - throwing people out of nursing homes. Who'll be making those decisions? Unlike last year, this time, "death panels" might actually be not too far away from the truth.

US healthcareTexasMichael Tomasky
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Getting to know the roadmap | Michael Tomasky

So Jim De Mint, the nullification senator, was on Meet the Press Sunday, and he railed against debt and deficits and said we need to cut - but oh, no, of course, we don't need to cut Social Security or Medicare! Here's the relevant chunk of the exchange with David Gregory, via Jonathan Chait:

GREGORY: All right, well, let me ask you specifically about that. Where would-- do you think the American People have to be prepared for sacrifice? Which part of the budget, knowing that there's only 15 percent that's non-- discretionary-- or that's real-- that's real-- non-defense discretionary-- part of the budget. What are you gonna target-- for cuts?

DEMINT: Well, I don't think the American People are gonna have to sacrifice as much as the government bureaucrats who get paid about twice what the American worker does. First of all, we just need to return to pre-Obama levels of spending in 2008. We need to cut earmarks so people will quit focusing on taking home the bacon. We need to defund Obamacare. And then we need to look at the entitlement programs, such as-- the way Paul Ryan has done in the House with his road map to America's future. To fix our tax code, to fix Social Security and Medicare, and to cut the cost over time. We've got the plans, David, to do this. We just-- we need to talk about 'em. We need to help the American people see where we're going.

(CROSSTALK)

DAVID GREGORY: I want to be very-- very-- very specific, because going back to 2008-- spending levels will not get anywhere close to balancing the budget. So, you're saying that everything has to be on the table. Cuts in defense. Cuts in Medicare. Cuts in Social Security. Is that right?

DEMINT: Well, no, we're not talking about cuts in Social Security. If we can just cut the administrative waste, we can cut hundreds of billions of dollars a year at the federal level. So-- before we start cutting-- I mean, we need to keep our promises to seniors, David. And cutting benefits to seniors is not on the table.
Excuse me –let me grab a sip of water.

GREGORY: But then-- but where do you make the cuts? I mean, if you're protecting everything for the-- the most potent political groups, like seniors, who go out and vote, where are you really gonna balance the budget?

DEMINT: Well, look at-- Paul Ryan's roadmap to the future. We see a clear path to moving back to a balanced budget over time. Again, the plans are on the table. We don't have to cut benefits for seniors. And we don't need to cut Medicare. Like-- like the Democrats did in this big Obamacare bill. We can restore sanity in Washington without cutting any benefits to seniors or veterans.

Ryan's roadmap. He is, as you may know, the only Republican in Washington who has actually done serious work on budget and entitlement issues, and by appearances the only one who actually has a grasp of the implications of actual policy. It also seems that his roadmap will be a kind of blueprint for what the Republicans want to do on these matters. So let's become familiar with Ryan's work.

Here, for your perusal, is last year's CBO analysis of Ryan's roadmap. You should look through it.

There are some good things about the roadmap. Its goal is budget balancing, and it accomplishes that. By 2080. But still. Let's give him the benefit of the doubt. It eliminates the the tax deduction for health-insurance costs, replacing them with tax credits. The tax credits look small to me, given the costs of actual insurance plans in the US, but CBO says it could result in fewer uninsured, and I'll take CBO's word for it.

But beyond that, the roadmap privatizes and shifts a lot of risk onto consumers, seniors especially. He wants to introduce private accounts to Social Security for those 55 and under. And he wants to control Medicare costs, and he does it in the most obvious way. Cut them. It's all much more complicated than that, in fairness, but basically, vouchers would replace the current Medicare system, and the amount of the vouchers would be pegged to an inflation index that in real life increases far less quickly than the actual costs of health care have.

Now, you may think private accounts and vouchers are good ideas. But just remember what a complete nonstarter privatization was in 2005, when the GOP had a president with political capital he intended to use. And I'd rate the private accounts second in the roadmap, in terms of political difficulty, to what Ryan wants to do with Medicare.

His proposed cuts to senior health care seem staggering; and remember how Republicans attacked Obama and the Democrats last year over the relatively modest Medicare cuts in HCR. It made them hypocrites, but they knew damn well it was winning politics. Democrats may be slow on the uptake sometimes, but they're not this slow.

Ryan has produced a reasonably honest document. He will end Social Security as we've known it and control healthcare costs for all and especially for seniors by vastly reducing their rate of increase, which will shift risk from the government to seniors, as Ezra noted.

But the Republicans cannot be honest about these plans, because they know they're death politically. If you go to Ryan's web site, you'll see that he obfuscates all this, naturally, talking about "empowering" seniors to do this and that. And then, De Mint, Mr. Tea Party Budget Cutting Purity, goes on MTP and says a) we will attack the deficit but b) no no no no, not by cutting Social Security or Medicare!

In 1995-96, Gingrich tried to make Medicare cuts and changes that were nothing compared to the roadmap, and Clinton ate him for lunch. Just sayin. What the GOP wants to do is very hard, and it's very hard because, while far more Americans pin the label "conservative" on themselves, when it gets down to practice, most people don't like their ideas.

US CongressRepublicansMichael Tomasky
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Six lessons for schoolkids | Michael Tomasky

In today's Guardian, Simon Schama (government adviser? I did not know) lays out his idea about the six things from British history he thinks schoolkids should know: the Henry II-Thomas a Beckett nastiness, the black death, the execution of Charles I, the expansion into India, the Irish wars and the opium wars.

Set me thinking about the American equivalent. My list: The conquering of the hemisphere, in both its glory and gory details; the War of Independence, as we cheekily insist on calling it to this day, and the formation of the republic (one might call these 2a and 2b); the Civil War and history of slavery; the Great Depression and the New Deal; The 60s; The Age of Reagan.

I skip a lot, of course, but my concentration on the 20th century here is designed to give the little ones some grounding in the country in which they actually live and how it came to be what it is.

Since as you know I haven't yet had a child enter the pedagogical ranks but will sometime soon, I have no idea what they're teaching these days. I'm sure they teach all these things. But how they teach them is the question.

Take for example the Monroe Doctrine. Did I ever tell you my Monroe Doctrine story? I was in third grade, Miss Cook's class (yes, Miss! remember, it was 1967-68). Miss Cook was explaining to us that this was a truly important moment because it was the first time the US asserted itself as a world power, telling European nations that any meddling in the southern bits of the Western hemisphere would be regarded as acts of aggression against the US. And so, we said to Europe, that's our playpen, not yours.

I have a very clear memory of thinking to myself, in the vocabulary of a seven-year-old: well, that's all well and good vis a vis us and Europe, but didn't that sit rather oddly with the folks who lived down there? I very nearly raised my hand to ask this question, but I was sort of shy about speaking up in class anyway, and something was telling me that the question was impertinent and possibly subversive.

I would imagine that the Miss Cooks of today's America do in fact go into all that. Or at least today's non-Texas America. But we have horrible fights over these things here. I don't get the impression from reading Schama's piece that the history curriculum is quite the intense cultural battleground that it is over here.

What I wish all kids would leave high school with is a strong sense that being a good American requires only: that you believe in the Constitution and the Bill of Rights; that you understand that when it comes to thinking and acting about one's country, these civic obligations are more important than religious conviction or blood ties. When I was young, I feel that we had achieved a rough consensus around those notions.

It's out the window today. Both right and left share some blame for this, in my view. There's a point on the graph where southern regional chauvinism and dedicated multiculturalism meet, paradoxically enough, and it's the point where identity takes precedence over civic commonality. But I've been banging this drum for, gosh, 15 years now, and things have only gotten worse and worse, so maybe I'll just stop and take up the other side of the argument and see how that works out for awhile.

United StatesMichael Tomasky
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George W Bush's Decision Points towards rehabilitation | Michael Tomasky

Haunted by a ruined economy and unfinished wars, President Bush will need more than a memoir to rescue his reputation

The exit polls from last week's midterm elections – those venerated scrolls that tell us why Americans voted as they did and what they think of the state of the nation – contained continuing bad news for poor George W Bush, now out of office two years and, for the most part, impressively silent. One question asked voters whom they blamed for the economic collapse. While the No 1 answer was Wall Street at 35%, the second spot was occupied not by Barack Obama, but by Bush, at 29%. Obama was the culprit for 24%.

Bush left office with fewer Americans supporting his job performance (around 25%) than still blame him now for the wrecked economy. These days, he is a retired multimillionaire – he received a $7m advance for this book (exactly the same, interestingly, as Keith Richards) – who doesn't need to do anything else as long as he lives. But surely, he doesn't want to go down in American history as one of the worst presidents ever.

Enter Decision Points, his new book, which can be read as the starting point of a rehabilitation process.

The Bush of Decision Points is a humbler and more measured man than the actual president many Americans remember. That would be the man who, when asked at one 2004 press conference (as mayhem raged in Iraq) if he'd made any mistakes or regretted any decisions, couldn't come up with one. But today, in his first major interview for the book, Bush told a top American television presenter that he was "a dissenting voice" on war with Iraq.

What he actually meant by that, he added, was that "I gave diplomacy every chance to work." He most assuredly did not, and the US strongarmed Mexico and other member nations of the UN security council to green light the war. We have it on the authority of others that Bush, bowing to the fervid demands of Dick Cheney and Donald Rumsfeld and others, started setting his sights on Saddam Hussein on 12 September 2001. But there are certain dark truths that men such as presidents must carry to their graves.

There is a personal decency to Bush and always has been. He is, for example, unusually gracious towards Barack Obama in the book, considering that Bush was writing Decision Points while Obama was out giving speeches reminding anyone who would listen that he wasn't the guy who drove the economic car into the ditch. Bush always said that Jimmy Carter's acidic criticisms of him stung him and violated his notion that presidents and ex-presidents should show one another a certain baseline respect. He does that here, and there is no reason to doubt that it is sincere.

The book in and of itself is merely "competent, readable and flat", in the words of the Washington Post's Jonathan Yardley. What is of more interest is thinking about the kind of post-presidency Bush will fashion. The other two media-age presidents to leave office with basement ratings were Carter and Richard Nixon. Nixon wrote a series of "deep-think" books attempting to salvage his shame. Carter did good deeds, building homes for the poor and overseeing election after election (although his increasingly strident rhetoric towards Israel has begun to cost him public-opinion points in the US).

Neither of those seems very Bushian to me. But as the exit poll shows, he's got a big renovation project on his hands, so he'd better do something. Something unexpected. An institute to help poor youths, perhaps. Or maybe a nonpartisan thinktank to help struggling small-"d" democrats the world over, even liberal ones.

The most partisan president in modern American history can't just tell us that's not really who he is and not who he meant to be. He needs to show it.

George BushPoliticsUS politicsUnited StatesBarack ObamaJimmy CarterRichard NixonFinancial crisisUS economyMichael Tomasky
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Watch the committees | Michael Tomasky

One of the most important things that happens when a chamber of Congress changes control is of course that the committees get new chairs. Former Democratic chairmen next January will become "ranking members," and former GOP ranking members will be Mr., or Madame, Chairman. Or woman.

More than that happens. Staff allotments change. Democrats will reduce committee staffs, Republicans will expand committee staffs. Most committees have investigative units and budgets. Starting next Jan. 3, the new chairs will set the new priorities of the committees, and the resources will be devoted to those priorities.

Nancy Pelosi created something called the Select Committee on Energy Independence and Global Warming. It has been chaired by Ed Markey, one of the leading enviro-greenies of Congress. Next year it will be chaired by James Sensenbrenner, one of the leading enviro-meanies. Hope that's not too cutesy. You get the idea.

Republicans have been saying that they were just going to get rid of the SCEIGW. But today comes word that Sensenbrenner wants to keep it running. Good. Wow. Has he had a change of heart?

Uh...not likely. What he wants to do, reports Politico, is have the committee focus not on the need for climate change legislation, but on the manifold ways in which the EPA costs corporate America money:

"The threat of the EPA's reach into the economy is so great that it deserves special attention this Congress, and no panel has developed more experience on these topics than the Select Committee on Energy Independence and Global Warming," Sensenbrenner said in a statement. "These regulations are moving quickly, but the oversight and subpoena power wielded by the Select Committee would put a tall hurdle in the path and would further expose the economic destruction these policies would bring."

In addition, Spencer Bachus of Alabama, who will probably chair the Banking Committee, spoke out last week against "expansive" interpretation of the Volcker rule, which curbs proprietary trading by banks and limits their involvements with private equity firms.

Most of what government does never even makes the newspapers, because most of it is fairly unremarkable. But when power changes hands like this, you get a reminder of just what that change entails in virtually every aspect of government, not just the things that make headlines.

And about the Environmental Protection Agency specifically, it's in the GOP's gunsights. Any attempt by the agency to regulate greenhouse gas emissions will get nowhere with a Republican House.

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Medicaid: the assault begins | Michael Tomasky

The most important article I read over the weekend was this one, in Saturday's New York Times, about some new goings-on in Texas:

Some Republican lawmakers — still reveling in Tuesday's statewide election sweep — are proposing an unprecedented solution to the state's estimated $25 billion budget shortfall: dropping out of the federal Medicaid program.

Far-right conservatives are offering that possibility in impassioned news conferences. Moderate Republicans are studying it behind closed doors. And the party's advisers on health care policy say it is being discussed more seriously than ever, though they admit it may be as much a huge in-your-face to Washington as anything else.

"With Obamacare mandates coming down, we have a situation where we cannot reduce benefits or change eligibility" to cut costs, said State Representative Warren Chisum, Republican of Pampa, the veteran conservative lawmaker who recently entered the race for speaker of the House. "This system is bankrupting our state," he said. "We need to get out of it. And with the budget shortfall we're anticipating, we may have to act this year."

So we are now talking about the dismantling of the welfare state in very specific and concrete ways. This is new, and it foretells a fundamental fight that's coming and perhaps soon. First, some background.

Medicaid provides basic healthcare to poor people. It was passed in 1965 along with Medicare, which provides healthcare to seniors. Medicare is a federal-only program. Medicaid is a joint federal-state effort, meaning states contribute a percentage (usually maybe 20 to 40% or so, varying from state to state) of the costs.

Medicaid was designed this way in part because Wilbur Mills, the moderate/conservative Democrat who chaired the House Ways and Means Committee at the time, thought that (and let's face it, not unreasonably) if the feds picked up the full costs of care for both groups, it wouldn't be long until we had an NHS. This was at a time, remember, when far more legislators (and Americans generally) would have been inclined to back such a thing).

The states' share of Medicaid costs has been an immense burden for two decades, there's no denying it. I remember Mario Cuomo complaining about it when he was governor, when I first started covering politics in New York. Cost have risen and risen. States set their own reimbursement rates to doc and hospitals, which vary wildly. And yet, Medicaid generally pays primary care physicians only about two-thirds as much as Medicare does.

Now, we bring in the new healthcare bill. It will expand Medicaid vastly and rapidly, by offering subsidies for the purchase of coverage for everyone up to 133% of the poverty line. The feds are going to cover all of these costs through 2019, and 90% thereafter for a bit. But states fear, and again not unreasonably, that over time their Medicaid commitments will expand.

Remember the Cornhusker kickback? This is what it was about: Nebraska's Ben Nelson wanted an amendment ensuring that Nebraska would not be responsible for covering future Medicaid increases. Right now, states spend on average about 20-25% of their entire budgets on Medicaid - obviously, higher in states with larger poor populations.

Liberals have been aware of these problems, which is why liberals and Democrats have proposed that the feds fully pick up the cost of Medicaid. In the context of the federal budget, it's not as much money as you might think: Tim Noah of Slate in this article says $25-$30 billion. That's not nothing, but it could be a findable amount of money in the context of a nearly $4 trillion budget.

Now, there's another proposal squarely on the table. Just stop doing Medicaid. Stop providing coverage for poor people. Nearly 60 million Americans get their care through Medicaid; this includes roughly one-quarter of the nation's children.

If Texas followed through and opted out of Medicaid, I doubt it would mean that no poor person in Texas could get treatment. What it would mean is that without the state's contributions, reimbursement rates would fall even lower, and presumably many more doctors and hospitals would stop treating poor people for all but the most basic-maintenance conditions.

I see little reason to think Texas won't do this eventually. It saves billions; it's a way to confront Obamacare; and after all, poor people vote Democratic, when they vote, and Texas is run by Republicans. And I see little reason to think that other states, especially in the south but potentially all over as long as Republicans have enough control, won't follow suit. Southern states, unsurprisingly, have higher percentages of Medicaid enrollees, since they're poorer on average.

It is certainly true that Congress over the years has expanded Medicaid eligibility. Conservatives see that as drunken-sailor spending. I would say that Congress has stepped in to fill gaps discovered in the private-insurance system, as costs began to go through the roof and private insurers began tightening eligibility requirements and saying no more often. Medicaid is also designed to cover more people during economic downturns.

So a very fundamental fight is coming here. The odds, especially after last Tuesday's results, are that the conservatives will win. We've been reading for years that, of Medicare, Social Security, and Medicaid, it was likely that Medicaid would fall first, because the other two programs aren't means-tested; they serve middle- and upper-income people, so they'll probably survive. But Medicaid...

No solution is easy here, and I won't pretend that just lecturing you about millions of sick children can make the money appear. But what Texas is looking into is a solution to other problems, political and fiscal ones, not the problem of public health, of which it's apparently just washing it hands, if this comes to pass.

US politicsTexasMichael Tomasky
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Olbermann, plus a little more on Pelosi | Michael Tomasky

Some of you brought up Keith Olbermann on the last thread. I guess I'm just in a sour mood as this week winds down about the various people on my side of the row boat, but I think he was foolish to make those donations, unless he told some superior about them first.

Ngavc asked what my policy was. I donated to one statewide candidate who is a friend and whose race I knew I would have no remote chance of writing about. Other than something like that, I won't make donations. True, it's quite obvious what side I'm on, and I don't have to be like that WashPost editor who didn't even vote. In fact I already told you all that I voted, and how pleased I was to be able to pull the lever in Maryland for utterly unthreatened Democrats up and down the line.

But I draw the line at donations. Money...does things. It changes the nature of one's rooting interest. I feel funny about it. Others of my type, clearly affiliated opinion journalists, don't. That's up to them, and I wouldn't judge them, but this is just how I feel.

Indefinite suspension seems a bit harsh. If indefinite ends up meaning a week, that's okay, I guess. But we still need to know more. Did Olbermann run his three donations by any brass? And did Joe Scarborough run his donations (both to one person, a personal friend) by any brass? How do we know Olbermann's benefactees weren't personal friends? It isn't clear how NBC differentiates between these two. They're both opinionators.

Interesting comments re Pelosi, with many of you scattered across the board and defying partisan expectations. As I am, I guess. I just don't think it passes the average-Joe-Jane-common-sense test: what, they got hammered to death, and they're not changing coaches? Just doesn't track.

Final note: A friend just this instant sent me this, from Slate. Evidently - get this, now - Mick Jagger was ticked at Keith Richards' remarks about him in the latter's new book, so Mick wrote a several-thousand word letter to Bill Wyman complaining. Problem: There are two Bill Wymans. One's the bassist, the other is a rock journalist. Apparently, if this is for real, Mick sent his missive to the wrong Wyman. So now all of us get to read what Mick intended for Bill's eyes only. And I think I'll leave you in peace with that. Enjoy your weekend.

UPDATE, A LITTLE BIT LATER: The comment thread suggests that this is a hoax. Got me. Well played. It read awfully true, except that Mick seemed to be writing to bassist Bill as if he were a stranger. Anyway, it was still a fun thing to read. Funny Wenner dig.

US politicsMichael Tomasky
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