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One Year After Egypt's Rab'a Massacre, U.S. Still Funding Repression |
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Sunday, 17 August 2014 14:05 |
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Benjamin writes: "Since the massacre, Sisi has overseen a year of intense government repression that has included the arrests of tens of thousands of people, including Islamists and leftist political activists."
U.S. activist Medea Benjamin is arrested by women riot police during her participation in a march to Al Farook Junction in 2012. (photo: Hamad)
One Year After Egypt's Rab'a Massacre, U.S. Still Funding Repression
By Medea Benjamin, Common Dreams
17 August 14
 t has been one year since the August 14, 2013 Rab’a Square massacre in Egypt, when the Egyptian police and army opened fire on demonstrators opposed to the military’s July 3 ouster of President Mohamed Morsi. Using tanks, bulldozers, ground forces, helicopters and snipers, police and army personnel mercilessly attacked the makeshift protest encampment, where demonstrators, including women and children, had been camped out for over 45 days. The result was the worst mass killing in Egypt’s modern history.
The government’s systematic effort to obscure what took place, beginning with sealing off the square the next day, has made it difficult to come up with an accurate death toll. But a just-released Human Rights Watch report, based on a meticulous year-long investigation, found that at least 817 and likely well over 1,000 people were killed in Rab’a Square on August 14.
The report contains horrific first-hand accounts. One protester recalled carrying the dead, piles of them. “We found limbs that were totally crushed. There were dead people with no arms, obviously a tank ran over them. Imagine you are carrying piles of bodies, it is something you can’t imagine. Even the bodies that you are carrying, you carry an arm of a person, alongside the leg of another person.”
A student from Cairo University recounted that the ground was a “sea of blood” and how she watched the bleeding protesters in horror, “knowing that I was not able to do anything besides watch them die.”
A doctor described the scene at the mosque in the square: “I have never seen anything like what I saw when I stepped inside. The entire floor was covered in bodies. To slow down the decomposition, people had put ice around the bodies. But the ice had melted and mixed with the blood, leaving us wading in blood and water.”
Human Rights Watch’s executive director, Kenneth Roth, and the director of its Middle East and North Africa division, Sarah Leah Whitson, had planned to be in Cairo this week to release the report, but were held at the airport and denied entry into Egypt.
The systematic and intentional killing of unarmed protesters is a crime against humanity and those responsible should be investigated and held accountable. At the top of the chain of command during the Rab’a massacre was then-Defense Minister Abdel Fattah el-Sisi, who orchestrated the military overthrow of democratically-elected Morsi. But neither Sisi nor any government officials have been prosecuted for the killings. On the contrary; Sisi has managed to usurp even more power, becoming Egypt’s president via rigged elections.
Since the massacre, Sisi has overseen a year of intense government repression that has included the arrests of tens of thousands of people, including Islamists and leftist political activists. More than 65 journalists have been detained and some, like three Al Jazeera journalists, have been sentenced to 7-10 years in prison. Egypt’s criminal justice system has become a cruel joke; sentencing 1,247 people to death in trials makes a mockery of the word “justice”. In many cases defendants were not brought to their trials and lawyers have repeatedly been barred from presenting their defense or questioning witnesses.
Amnesty International has documented the sharp deterioration in human rights in Egypt in the past year, including the surge in arbitrary arrests, torture and deaths in police custody. Amnesty says torture is routinely carried out by the military and police, with members of the banned Muslim Brotherhood particularly targeted. Among the methods of torture employed are electric shocks, rape, handcuffing detainees and suspending them from open doors.
Gen. Abdel Fattah Osman, who heads the media department at the Interior Ministry, denied the accusations of torture and rape in prisons and declared that "prisons in Egypt have become like hotels.”
I had a minor taste of this regime’s “hospitality” when I attempted to enter Cairo on March 3, 2014 as part of a women’s peace delegation. I was stopped at the airport, detained for 17 hours, and then thrown to the ground and handcuffed so violently that my shoulder popped out of its socket. Instead of allowing me to go to the hospital to have my arm reset, as the doctors insisted, I had my scarf stuffed into my mouth, was dragged through the airport and deported to Turkey. I was never given any explanation as to why I was detained, attacked, arrested and deported. To this day, months later, the pain in my arm is a daily reminder of the thugs who run Egypt today.
While the global human rights community has watched in horror as the basic rights of Egyptians have been torn asunder, some regional governments, particularly Saudi Arabia and the Emirates, have embraced Sisi and are providing billions of dollars of support. Perhaps this is not surprising, given that they are autocratic regimes that want to stave off democratic change in their own countries.
But what about the Western nations that pride themselves on their democratic values? European Union foreign policy chief Catherine Ashton criticized the use of force by the military-backed government, but later assured Sisi that the EU would provide 90 million euros worth of financial assistance. And in December 2013, she even took her family on a Christmas holiday to Luxor, meeting with Egypt’s minister of tourism just a few weeks after dozens of peaceful protesters were killed.
The US case is similar. According to US law, a coup is supposed to have consequences. Senator Patrick Leahy of Vermont, who wrote the legislation, said, “Our law is clear: U.S. aid is cut off when a democratically elected government is deposed by military coup. This is a time to reaffirm our commitment to the principle that transfers of power should be by the ballot, not by force of arms.”
The US government refuses to even obey its own laws, which would entail cutting the $1.3 billion to the Egyptian military. Too much is at stake for powerful interests:
- The US wants Egypt to fulfill its commitment to the 1979 Camp David Accords, which ensures Egypt’s complicity in the Israeli occupation of Gaza. This complicity became clear during the latest Israeli attack, where Sisi helped squeeze the Palestinians by closing off the border between Egypt and Gaza.
- The US wants to ensure priority access for US Navy ships to the Suez Canal, as well as the flow of oil and gas through the canal.
- “Aid” to Egypt is really a subsidy for US weapons exporters. Most of the money never gets to Egypt but goes to powerful U.S. military contractors such as General Dynamics and Lockheed Martin that make the tanks and fighter jets that get sent to Egypt (whether or not the Egyptian military wants the equipment).
When Secretary of State John Kerry visited Sisi on June 22, he announced that the US would release $575 million of the $1.3 billion. He told Sisi, “I am confident that we will be able to ultimately get the full amount of aid.” And now Kerry is strengthening Sisi’s hand by making him a key player in the ceasefire talks between Israel and Gaza, despite the fact that Sisi has been an enemy of Hamas—a group he considers too closely linked with Egypt’s Muslim Brotherhood.
On this terrible anniversary of the Rab’a massacre, Egyptians are still mourning the dead, nursing the injured and crying out for help from the prisons and torture chambers. But the “Western democracies”, dancing with the dictator, have turned a deaf ear to their cries. That’s why activists the world over are marking the occasion by showing solidarity and by calling on their governments to break ties with Sisi’s regime.
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The Economics of Police Militarism |
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Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=32235"><span class="small">Sarah Stillman, The New Yorker</span></a>
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Sunday, 17 August 2014 14:00 |
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Stillman writes: "The crisis of criminal-justice debt is just one of the many tributaries feeding the river of deep rage in Ferguson. But it’s an important one—both because it’s so ubiquitous and because it’s easily overlooked in the spectacular shadow of tanks and turrets."
Ferguson, Missouri. (photo: Jeff Roberson/AP)
ALSO SEE: Six Days in Ferguson: Voices From the Protests
The Economics of Police Militarism
By Sarah Stillman, The New Yorker
17 August 14
 wo crucial battles broke out in Ferguson, Missouri, this week. The first began with the public airing of sorrow and rage after the death of the eighteen-year-old Michael Brown, who was shot by a police officer, on Canfield Court, in the St. Louis suburb, at 2:15 P.M. last Saturday. Then came the local law enforcement’s rejoinder to the early round of protests. Officers rolled in with a fleet of armored vehicles, sniper rifles, and tear-gas cannisters, reinserting the phrase “the militarization of policing” into the collective conscience. The tactical missteps by the town’s police leadership have been a thing to behold. (They’re also to be expected; anyone doubting as much should pick up Radley Balko’s “The Rise of the Warrior Cop.”)
One moment, we see a young man with a welt from a rubber bullet between his eyes; the next, three officers with big guns are charging at another black man who has his hands up. On Thursday, Jelani Cobb filed a powerful account from the sidewalks and homes of Ferguson. Cobb asks about “the intertwined economic and law-enforcement issues underlying the protests,” including, for instance, the court fees that many people in Ferguson face, which often begin with minor infractions and eventually become “their own, escalating, violations.” “We have people who have warrants because of traffic tickets and are effectively imprisoned in their homes,” Malik Ahmed, the C.E.O. of an organization called Better Family Life, told Cobb. “They can’t go outside because they’ll be arrested. In some cases, people actually have jobs but decide that the threat of arrest makes it not worth trying to commute outside their neighborhood.”
The crisis of criminal-justice debt is just one of the many tributaries feeding the river of deep rage in Ferguson. But it’s an important one—both because it’s so ubiquitous and because it’s easily overlooked in the spectacular shadow of tanks and turrets. Earlier this year, I spent six months reporting on the rise of profiteering in American courts, which happens by way of the proliferation of fees and fines for very minor offenses—part of a growing movement toward what’s known as offender-funded justice. Private companies play an aggressive role in collecting these fees in certain states. (Often, this tactic is aimed at the poor with unpaid traffic tickets.) The reports from Ferguson raise questions about how militarization and economic coercion feed a shared anger.
Missouri was one of the first states to allow private probation companies, in the late nineteen-eighties, and it has since followed the national trend of allowing court fees and fines to mount rapidly. Now, across much of America, what starts as a simple speeding ticket can, if you’re too poor to pay, mushroom into an insurmountable debt, padded by probation fees and, if you don’t appear in court, by warrant fees. (Often, poverty means transience—not everyone who is sent a court summons receives it.) “Across the country, impoverished people are routinely jailed for court costs they’re unable to pay,” Alec Karakatsanis, a cofounder of Equal Justice Under Law, a nonprofit civil-rights organization that has begun challenging this practice in municipal courts, said. These kinds of fines snowball when defendants’ cases are turned over to for-profit probation companies for collection, since the companies charge their own “supervision” fees. What happens when people fall behind on their payments? Often, police show up at their doorsteps and take them to jail.
From there, the snowball rolls. “Going to jail has huge impacts on people at the edge of poverty,” Sara Zampieren, of the Southern Poverty Law Center, told me. “They lose their job, they lose custody of their kids, they get behind on their home-foreclosure payments,” the sum total of which, she said, is “devastating.” While in prison, “user fees” often accumulate, so that, even after you leave, you’re not quite free. A recent state-by-state survey conducted by NPR showed that in at least forty-three states defendants can be billed for their own public defender, a service to which they have a Constitutional right; in at least forty-one states, inmates can be charged for room and board in jail and prison.
America’s militarized police forces now have some highly visible tools at their disposal, some of which have been in the spotlight this week: machine guns, night-vision equipment, military-style vehicles, and a seemingly endless amount of ammo. But the economic arm of police militarization is often far less visible, and offender-funded justice is part of this sub-arsenal. The fears that Cobb and Ahmed describe—court debts that lead to warrants and people who are afraid to leave their homes as a result—compound the force that can be wielded during raids or protests like those on the streets of Missouri. Debtors’ fears change their daily lives—can they go to the grocery story or drive a child to school without being detained? “It deters people who have legitimate problems from calling the police, and removes the police’s ability to do what they’re supposed to be doing—helping people in the community respond to emergencies,” Karakatsanis said. It erodes the community’s trust in and coöperation with law enforcement.
In Alabama, Equal Justice Under Law has filed a class-action lawsuit against the city of Montgomery on behalf of minor offenders who have been jailed for debt; their challenge is pending and the city refutes the allegations, but, Karakatsanis says, at least thirty-five people were released from jail for their court debts since the suit was filed. (A judge has issued a preliminary injunction that leans in favor of the debtors.) More often than not, though, plaintiffs who face overwhelming municipal-court debts never get a shot at a legal challenge. Instead, their problem often compounds their resentment and their disinvestment in authority.
Several years ago, I embedded with U.S. troops in Kandahar, Afghanistan, and spent time with a unit that was tasked with implementing the directives from a set of trainings known as “Commander’s Guide to Money as a Weapons System.” The trainings instruct troops in how to use economic tools to further military objectives, and there is a warning printed in the opening pages of
one such field manual: “Warfighters and their leaders must ensure their actions will stand up to a Congressional inquiry and must not cause embarrassment to the Department of Defense.” Here, “real” militarism has one advantage over its domestic counterpart, at least doctrinally—the principle is genuine investment in communities where the military hopes to earn trust and influence. Unsurprisingly, it has proved complicated to implement (and has often failed wildly), but, at least in theory, it is far more graceful than police officers or the military blasting their way across human terrain. Here at home, SWAT teams continue to tear down the proverbial power lines.
In a sign of hope, the new commander in Ferguson, Captain Ron Johnson, of the Missouri State Highway Patrol (who grew up in Ferguson), immediately seemed to grasp this issue when he assumed leadership on Thursday. “We all want justice. We all want answers,” he told the Associated Press. “It means a lot to me personally that we break this cycle of violence.”
In reckoning with police militarization, the economic side of the phenomenon should be considered. The connection may not be obvious to those who’ve never had the gas or water or electricity in their homes shut off. But these forces operate in tandem—the tear gas and the tickets; the weaponry and the warrants—compromising a wide range of fundamental rights that seem, in Ferguson and beyond, to have gone up in smoke.
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Mercury in Our Seafood: When Is Fish No Longer Safe to Eat? |
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Sunday, 17 August 2014 13:53 |
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Palmer writes: "So what’s a toxic level of mercury in your diet? This has long been a concern, because many fish contain measurable levels of mercury, which can cause profound neurological disease and death if consumed in sufficient amounts."
(photo: Shutterstock.com)
Mercury in Our Seafood: When Is Fish No Longer Safe to Eat?
By Brian Palmer, OnEarth.org
17 August 14
A new study raises new alarms about mercury contamination in the ocean. What does that mean for your fish intake?
oxicologists have a saying: “The dose makes the poison.” In other words, there is no such thing as “toxic” or “non-toxic”—it always depends on how much of a substance you consume.
So what’s a toxic level of mercury in your diet? This has long been a concern, because many fish contain measurable levels of mercury, which can cause profound neurological disease and death if consumed in sufficient amounts. The issue gained new urgency last week when a study in the journal Nature showed that mercury concentration at the ocean surface has tripled since the beginning of the industrial era.
How does mercury get into fish, anyway?
In the 19th and 20th centuries, factories dumped massive amounts of methylmercury—the most dangerous form of mercury, bonded to carbon and hydrogen—directly into waterways. The most infamous example occurred in Japan in the 1950s and ’60s, when industrial mercury poisoned more than 2,000 people who ate fish from Minamata Bay. (The neurological syndrome caused by severe mercury poisoning is called “Minamata disease” after the tragedy.)
Mercury dumping has been a problem in the United States, too. I grew up a few miles from New York’s Onondaga Lake, where the Allied Chemical Company disposed of as much as 20 pounds of mercury per day in the mid-20th century. “America’s most polluted lake” is still recovering.
Mercury can also take a less direct route to the sea. Burning fossil fuels releases mercury into the air—around 160 tons per year in the United States. The mercury settles to the ground, where rains eventually wash it to the ocean. There, elemental mercury turns into methylmercury. Scientists aren’t quite sure how this conversion occurs, but it probably involves the metabolism of a small but abundant living creature. When that creature is eaten by bigger creatures, the methylmercury travels up the food chain, collecting in animal tissue in larger and larger amounts. That’s why predators like tuna have troubling levels of mercury—they eat a lot.
What are the effects of mercury exposure?
Cases of mercury poisoning go back thousands of years. Mercury probably killed the first Chinese emperor, Qin Shi Huang, in 210 B.C.E. at the age of 39. He believed mercury pills would grant him immortality (oops). But Mercury doesn’t just kill. It can first drive a victim to insanity. The phrase “as mad as a hatter” harkens back to Victorian England, where mercury was used in haberdasheries. (Mercury inhalation is still a problem in many workplaces.)
Mercury’s notoriety as a poison derives from these instances of acute exposure. Diagnosing these cases is clinical child’s play. The symptoms—like numbness in the extremities, weakness, and a narrowing of the field of vision—are well known, and they appear soon after exposure. The challenge for toxicologists is sussing out the more subtle effects of lower doses of mercury, like the ones you might get from eating fish.
Fetuses and small children, for example, are extremely sensitive to mercury. Exposure to mercury in the womb can affect cognitive development, impair memory and attention, and slow language acquisition, even when the doses are too low to cause any observable symptoms in the mother.
Chronic, low-dose exposure in adults could also be a concern. Some doctors believe that trace levels of mercury contribute to heart disease and high blood pressure, though the evidence for this is currently inconclusive. These claims are based on a small number of studies conducted on discrete populations living in remote areas. In addition, the precise mechanism that would link low-dose mercury to heart disease isn’t fully understood.
So how much is too much?
The Environmental Protection Agency recommends consuming a daily maximum of0.1 micrograms of mercury for each kilogram of your body weight. That would limit a 176-pound adult (the national average) to 8 micrograms of mercury each day.
What does that mean in terms of cans of tuna or pieces of sashimi? Well, you’ll need a species-by-species chart of mercury concentration to figure that out. The amount of mercury in certain types of fish varies greatly. For instance, the average adult could eat 13 ounces of fresh salmon per day while staying under the EPA recommended maximum. You should avoid swordfish, though—eating just 0.14 ounces, a mere forkful, would put you over the limit.
| Species | FDA Average | Atlantic, Pacific Catch | | Domestic Samples | | | | Anchovies | 0.04 | ND, 0.04 | | Cod | 0.10 | 0.06, 0.11 | | Crab | 0.06 | 0.26, 0.15 | | Flounder | 0.05 | 0.08, 0.07 | | Halibut | 0.25 | 0.25, 0.28 | | Herring | 0.04 | 0.04, 0.14 | | Lobster | 0.17 | 0.28, 0.17 | | Mackerel | 0.15 | 0.22, 0.09 | | Mussels | ND | 0.08, 0.03 | | Oysters | ND | 0.07, 0.06 | | Perch (ocean) | ND | 0.08, 0.08 | | Pollock | 0.06 | 0.02, 0.06 | | Salmon (fresh) | 0.01 | 0.13, 0.04 | | Salmon (canned) | 0.05 | ND, 0.04 | | Scallops | 0.05 | 0.01, 0.04 | | Shark | 0.99 | 0.75, 0.80 | | Shrimp | ND | 0.04, 0.03 | | Snapper | 0.19 | 0.28, 0.25 | | Swordfish | 0.98 | 0.98, 0.98 | | Tilefish | 1.45 | 1.45, ND | | Tuna (fresh/frozen) | 0.38 | 0.28, 0.24 | | Tuna/albacore (all forms) | ND-0.76 | 0.47, 0.17 | | Tuna/yellowfin (all forms) | ND-0.76 | 0.31, 0.06 | | | | Data Source: Sunderland EM. (2007)
If you don’t want to break out your calculator and metric system conversion charts, use this handy seafood calculator from NRDC (which publishes OnEarth) for an estimate of your weekly mercury consumption.
These calculations can be helpful, but there are caveats. Not all scientists agree with the EPA’s mercury limits, and many more would add the proviso that they represent an extremely rough guess at what constitutes a safe level. In addition, the recent Nature study shows that oceanic mercury levels are on the rise, and existing research suggests that trend may continue for centuries. As increasing mercury concentrations travel up the food chain, the amount of fish you’ll be able to can consume while staying within the EPA’s “safe zone” will decrease over time.
The federal government (and the fishing industry, naturally) don’t recommend avoiding fish altogether. Almost immediately after I received notification of theNature study, the FDA Twitter account recommended increased fish consumption for pregnant women. (My colleague Jason Bittel has more details about the new federal fish-eating guidelines.) It’s tough, with all the conflicting advice, to know for sure what to do.
Promising developments?
But there’s hope! Last November, the United States joined the Minamata Convention on mercury. If enacted, this international agreement would prohibit new mercury mines, regulate the industrial use of mercury, and reduce mercury emissions from coal-fired power plants.
Now for the bad news. Although 100 countries have signed on, the United States is the only nation that has gone through the official legal processes required to accept the convention. It will take 49 others before the agreement goes into force. So after budgeting a few years for that, plus a century or two before ocean mercury levels actually begin to drop, maybe you should leave the swordfish to your distant descendants.
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FOCUS | The Five Biggest Lies About Obamacare |
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Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=5903"><span class="small">Michael Tomasky, The Daily Beast</span></a>
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Sunday, 17 August 2014 12:11 |
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Tomasky writes: "The reality is this: On the evidence available to us so far, nearly everything that the more vocal conservative critics have said about the ACA has been wrong."
(image: The Daily Beast/Elena Scotti)
ALSO SEE: Have Insurers Found New Ways to Avoid the Sick?
The Five Biggest Lies About Obamacare
By Michael Tomasky, The Daily Beast
17 August 14
Despite its continued unpopularity, the Affordable Care Act has been a success, and conservative predictions of “death spirals” and huge premium spikes just haven’t come true.
 ooked at one way, it’s been another rocky summer for Obamacare. First, the Halbig v. Burwell decision by D.C. Circuit Court of Appeals, in which two conservative judges used an error in the act’s language to leap to the ludicrous conclusion that a law passed for the very purpose of helping all Americans get health insurance was in fact intended to allow only certain Americans to do so, was a potential body blow. The full D.C. Circuit is widely expected to reverse the two conservative judges en banc sometime this fall, but it could still wind up at the Supreme Court, and with this Supreme Court, you just never know.
Second, the law isn’t getting any more popular. It’s true that some polls, which ask respondents whether to “keep and fix” the Affordable Care Act or repeal it, generally produce majorities saying the former. But that doesn’t mean people have warmed to it, and in early August, a Kaiser Family Foundation tracking poll generated some inexplicably bad numbers. The basic favorable-unfavorable rating was 37 to 53 percent. That 53 percent represented a staggering eight-point negative spike since June.
The spike is odd and vexing, since the news of actual substance since June has mostly been very positive. Most obviously, there are the several million—somewhere between 6 million and 12 million, depending on which source you believe—more Americans with health insurance. Those who pay closer attention to such things might have noticed developments like one that happened at the end of July, when the Medicare trustees’ report said that the program’s solvency could extend for an additional four years, to 2030, because of savings achieved through the ACA. But of course, the percentage of Americans who know that is infinitesimal.
So, yes—jury still out and all that. Perceptions remain terrible. But it’s worth stepping back and looking at reality. And the reality is this: On the evidence available to us so far, nearly everything that the more vocal conservative critics have said about the ACA has been wrong. No. “Wrong” implies a statement made in good faith. These charges were often made in the worst possible faith. And they were lies.
And—here’s a crazy thought—maybe it’s not just dumb luck that the law seems to be working, especially in the states that took the Medicaid money and set up well-run exchanges. Maybe it’s working because bureaucrats (!) anticipated all the potential problems and planned for them in the writing of the law. Nancy-Ann DeParle, one of the administration’s chief architects of Obamacare, put it this way: “When President Obama took office, there were 42 million uninsured Americans, premiums that were unaffordable for families and businesses, a delivery system with the wrong incentives, and unsustainable cost growth. The Affordable Care Act was the product of nearly two decades of bipartisan analysis and discussions among health policy experts and economists to address these problems, and most--indeed, virtually all--of the policies in the law had widespread agreement from these experts.” In other words, writing this law wasn’t guesswork.
Herewith, the five biggest whoppers, with special emphasis on the fifth (and most current one), and how they’re turning out to be so fantastically wrong.
1. Healthy People Won’t Sign Up
Or call this “Death Spiral Part I.” The idea here, spread lustily by many conservatives since 2010 but especially during last fall’s disastrous roll out, was that healthy people simply wouldn’t buy insurance. Senator Orrin Hatch said last November that “at this pace, the Obama administration will never be able to meet their enrollment goals.” Speaker John Boehner at the time groused that “the idea that the federal government should come in and create a one size fits all for the entire country never was going to work.”
Their hope was that only really sick people would sign up, which would lead rates to spike—the much-feared death spiral (more on that later). But lo and behold it turned out that millions of healthy people did want health insurance. As noted above, the precise numbers are hard to come by. But Gallup’s estimate is that the country has roughly 10 million newly insured citizens under Obamacare. And insurance companies report that around 80 to 85 percent of them are paying their premiums (this was another canard spread on the right, that people would sign up but never pay).
In sum, the law’s advocates were right, and its critics wrong, that health insurance was something normal Americans did in fact want. “There never was any realistic prospect of a death spiral,” says Jon Gruber of MIT, one of the country’s top health-care economists.
2. You Won’t Be Able to Choose/Keep Your Doctor/Plan
It’s true that this happened in a limited number of cases—maybe six or seven million people who bought policies on the individual market got cancellation letters from insurers telling them that their plans didn’t meet the minimum requirements under the new law, as NBC News explosively reported last fall.
It harmed the administration’s credibility, and rightly so. But it didn’t represent much of a change from the past — the “churn-rate” in the individual market has always been high. More importantly, no one seems to have followed up with this population to try to figure out what percentage did, in fact, lose coverage and/or have to pay considerably more for a new plan, so we don’t actually know how many of those six or seven million walked away satisfied or dissatisfied.
But more broadly, in a country where some 260 million people have health insurance, no one has adduced any proof that the ACA has resulted in anything remotely like the cataclysm opponents predicted. In fact, last fall, Factcheck.org rated such claims as outright falsehoods. And Gruber noted to me that if some people are “losing” their doctors, it’s often by their own choice, because now that they have so many different coverage options, many are choosing less expensive or so-called “limited network” plans. “No one is making people buy these plans,” Gruber says. “They’re cheaper alternatives. This is capitalism at its finest. For the right to criticize that is just ludicrous.”
3. Obamacare Will Explode the Federal Deficit
You heard this one a jillion times back when the law was being debated. Still today, Republicans and conservatives are deft at cherry-picking numbers out of official reports that can convey the misleading impression that fiscal watchdogs think the law will be a disaster.
The truth is that the Congressional Budget Office said in 2010 and reaffirmed this summer that the Affordable Care Act’s budget impact would be positive. The 2010 estimate was that the ACA would cut deficits by $124 billion over its first decade. And in June, CBO head Douglas Elmendorf reported that his experts “have no reason to think that their initial assessment that the ACA would reduce budget deficits was incorrect.”
Now, he throws in a number of caveats, as any bureaucrat should, having to do with the fact that many provisions of the act will kick in later. But Elmendorf sees no hard evidence to suggest that initial estimates were wrong. In fact, says Paul Van de Water of the Center on Budget and Policy Priorities, “The CBO has estimated that the law will especially reduce the deficit in its second decade, and there’s every reason to believe that those estimates are on course.”
4. Okay, Then, It Will Bust States’ Budgets
Texas’ Rick Perry, Florida’s Rick Scott, and numerous other Republican governors have said that Obamacare will bust their budgets. They’re basing that on the fact that the federal government will pay 100 percent of the costs of Medicaid expansion through 2016, but a little less than that thereafter (although never less than 90 percent). So states are going to have to start shelling out (that is, states that take the money in the first place, which Texas and Florida did not).
That’s true as far as it goes. But here’s the part Perry and Scott leave out. All states have, of course, an existing relationship with the Medicaid program in which states pay for some portion of the program’s implementation. And a number of studies estimate that in that pool of funds, states will save significant amounts of money that will offset most of the new expenses incurred under Obamacare. For example, Massachusetts found that after implementation of Romneycare, its costs for “uncompensated care”—charity work, basically—decreased considerably. And one study released in June found that uncompensated care costs are already dropping dramatically under the ACA—but only in the states that have taken the Medicaid money.
Thus, Perry, Scott, et alia are perhaps agents of a self-fulfilling prophecy: Yes, the ACA might bust the budgets of their states—the states trying to kill off Obamacare. But in the states trying to make it work, the budgetary impact, say most nonpartisan experts, will be a little bit negative, but pretty small.
5. Premium Rates Will Shoot Through the Roof
This is the big enchilada, and the culmination of the alleged death spiral. The charge here is that the lack of healthy enrollees will force insurers to jack rates up to the heavens, because they’ll have all these sick and dying people on their hands. Premium hikes for this year were all over the map, because they were based on guesswork by the insurance companies about who was enrolled. But now, the companies have hard data. So just watch, critics say, as the rates go boom.
To be sure, you can go to your Google machine and enter “insurance premium increases 2015” and find a lot of scary headlines from earlier this year. But you can ignore them all, because no one really knows yet.
Here’s how it works. By roughly this past Memorial Day, insurance companies submitted their 2015 rate requests to the states. These could range from tiny to huge—but they’re just requests. State insurance commissioners are now reviewing the requests. Final, approved rates will be made public in November (before November 15, when Obamacare’s second enrollment period begins). By the way, the ACA, for the first time ever, rationalized this “rate season,” so that everything happens in almost every state at the same time and in more or less the same way. Before, there was no national logic to the process at all.
Again, to echo back to what DeParle said: The people writing the law knew all this was coming, and understood very well that rate shock would be a risk. As a result there are numerous provisions in the law designed to guard against it. The most notable one carries an obvious name: “rate review.” Under rate review, any request for an increase of 10 percent or more has to be approved by a board, to which the insurer has to offer copious documentation proving that such a hike is necessary. Prior to the ACA, there was no such review.
Before we go any further, let’s step back. What’s a typical, pre-ACA rate increase? Good question. In 2008 it was 9.9 percent; 2009, 10.8 percent; 2010, 11.7 percent. Within those broad averages, numbers were all over the map: In 2010, rates went up in Kentucky by just 5.5 percent, but in Nebraska by 21.8 percent.
The numbers released in November will similarly be all over the map. There are just too many variables to say otherwise—how much competition there is among insurers in any given state (in general, it’s increased); what the risk pool looks like in a state (how old, how sick); and other factors. So undoubtedly, there will be some isolated hair-raising increases.
We don’t know, but we do have some early indications and studies, and they are pretty hopeful. The Health Research Institute at PricewaterhouseCoopers looked at rate requests from insurers that have been filed across 29 states and the District of Columbia and found that the average increase is 8.2 percent, which is impressively low and definitely not “sticker shock.” And remember, these are mostly just requests (in Rhode Island and Oregon, the rates are final), which aggressive state insurance commissioners might seek to make still lower. "So far, the filings suggest modest increases for 2015, well below the double digit hikes many feared,” says Ceci Connolly, the managing director of the institute.
All the above is about the individual market—people buying insurance on their own, either through state exchanges or the federal marketplace. For a host of reasons, that’s the best barometer by which to measure the law’s success. But there are other markets, too, notably the small-business market, where employers with fewer than 50 employees buy for their workers. There has been some grumbling among conservatives that this “small-group” market will take an especially hard hit, but that seems not to be the case either.
Again, there will be great variance in the small-group market, according to Jon Kingsdale, of the Wakely Consulting Group in Boston. He says the biggest impact will be that, because of some technical changes made by the law, employers with older employees and larger families will likely see rates increase, while employers with younger workers and smaller families may see rates decrease. But overall, says Kingsdale, “I do not believe there will be a significant jump in rate in the small-group market, because the underlying body of people being insured is not so different from the prior year.”
One last point on rates: This is another area where Republican saboteurs of the law can, if they choose to, make it not work. That is, Republican state insurance commissioners can approve big premium hikes just to make the law look bad. Says Sally McCarty, the former Indiana state insurance commissioner, now at the Georgetown Center on Health Insurance Reforms: “States that are in earnest about implementing the law will likely see lower increases, and states not so concerned about seeing the law succeed will see higher increases.”
So there we have it. Yes, it’s too early for firm conclusions. But certainly the preponderance of the evidence so far is that the apocalyptic predictions just aren’t coming true at all. Granted, there’s a lot of other news going on lately, but this is the real reason why Obamacare has kind of dropped out of the news cycle: Republicans aren’t bashing it quite so much anymore, because even they see it’s kind of working.
The damage they’ve already done is considerable. “Health care is a topic that people feel particularly close to as it involves the most important decisions people make; it is also a topic people can feel incredibly anxious about for the same reason,” says Neera Tanden, president of the Center for American Progress and a former administration health-care official. “The right wing has preyed upon those anxieties by manufacturing one lie after another to create a veil of opposition against a bill that has so far been pretty effective at covering people and lowering costs. It is an indictment of our policy deliberations as a country that these lies have been so effective.” Slowly, the truth is catching up.
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s a new 72-hour ceasefire takes hold in Gaza, we turn to part two of our interview with world-renowned dissident and linguist, MIT Professor Noam Chomsky. Criticizing U.S. media coverage of the Israeli assault on Gaza, Chomsky says: "It’s a shameful moment for U.S. media when it insists on being subservient to the grotesque propaganda agencies of a violent, aggressive state." Chomsky also discusses his long-standing view that popular pressure at home is critical to ending the U.S. government’s backing for Israel’s occupation of the West Bank and Gaza. "The United States continues to provide the critical, decisive support for the atrocities," he says. "Sooner or later, it’s possible—and that’s really up to us—that domestic pressure will compel the U.S. government to join the world on this issue. That will be a decisive change."
