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It's Time to Move Past Employer-Based Health Insurance Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=53219"><span class="small">Ezra Klein, Vox</span></a>   
Thursday, 09 April 2020 12:37

Klein writes: "According to a new analysis by the consulting firm Health Management Associates (HMA), the Covid-19 crisis could lead to between 12 million and 35 million people losing employer-sponsored health coverage due to job losses."

The coronavirus shows tying health insurance to jobs is a disaster. (photo: iStock)
The coronavirus shows tying health insurance to jobs is a disaster. (photo: iStock)


It's Time to Move Past Employer-Based Health Insurance

By Ezra Klein, Vox

09 April 20


The coronavirus shows tying health insurance to jobs is a disaster. Let’s fix it.

ccording to a new analysis by the consulting firm Health Management Associates (HMA), the Covid-19 crisis could lead to between 12 million and 35 million people losing employer-sponsored health coverage due to job losses. 

Not all of them will tumble into the ranks of the uninsured. Some will be caught by Medicaid, by Obamacare, or by other safety net programs. Some will find new jobs, with new insurance. But millions will fall through the cracks, particularly in states that have refused to expand Medicaid. In a scenario where unemployment hits 25 percent — calamitous, but plausible — HMA forecasts that as many as 11 million people could find themselves uninsured. That wipes out about half of Obamacare’s coverage gains, practically overnight.

Here, as elsewhere, Covid-19 is worsening a policy problem that long predates the virus. Tying health insurance to employment is now, and always has been, a disaster. It gives bosses too much power over workers, reduces entrepreneurship, saddles businesses with health costs they can’t control and insurance problems they don’t understand, makes the tax structure more regressive, reduces wages, bloats administrative spending, and drives up costs throughout the system. 

It has also, as Paul Starr writes in Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform, created a “policy trap” that has stymied health reformers over and over again: About 160 million Americans get insurance through their employers, and for all the system’s flaws, they are mostly pretty happy with that insurance, which makes them resistant to disruptive change. 

But disruptive change is here, whether anyone wants it or not. It won’t just be felt in the rising ranks of the uninsured, in the millions of people who lose the insurance provided by their workplace and have to scramble, desperately, for an alternative. It will also be felt by those who keep their job-based insurance, only to see it degrade as their employer rushes to cut costs. 

According to the Kaiser Family Foundation, average premiums for employer-based insurance have risen 54 percent over the past decade — far outpacing wages or inflation. Cost-sharing has increased, too: Average annual deductibles have doubled in the past decade. Employers have been shunting health costs onto employees in both good times and bad, and these are the worst times. Many of those who keep their employer-based insurance will see their premiums and deductibles rise, their networks narrow.

This is a crisis. But it is also, perhaps, an opportunity to solve the policy trap and finally move beyond employer-based insurance. 

The two poles of the Democratic health care debate

The Democratic primary was defined by the debate over Bernie Sanders’s Medicare-for-all plan, which, in its expansive and uncompromising ambition, rolled a number of health reform debates into one. But one of its best features, substantively, was that it ended employer-based insurance forever. 

The problem is that canceling 160 million insurance plans is likely to be a political catastrophe. When polled, it routinely turned people against Medicare-for-all. Most members of Congress — including some co-sponsors of Sanders’s bill — blanched at that level of disruption. House Speaker Nancy Pelosi dismissed it, as did the Senate Democrats who will lead the next health care push. The logic was straightforward: If the problem you’re trying to solve is that people hate losing the insurance their employer gives them, forcibly taking it away from them isn’t likely to go over well. 

Moreover, the tax increases necessary to move the entirety of the employer-based system onto the federal budget would be eye-popping. That’s what killed the statewide single-payer push in Sanders’s home state of Vermont, and Sanders never said how he’d solve it nationally. 

But if the political weakness of Sanders’s plan is that it upends too much of the current system, the substantive weakness of Biden’s plan is that it does too little to transform the current system. 

Biden’s plan leaves the current system more or less intact, but adds a subsidized, Medicare-based public option available to individuals and small businesses. Under the Biden proposal, the employer-based system remains, but if you lose your job, or simply don’t like or can’t afford the insurance offered by your employer, you have another option. The plan would also serve low-income Americans in states that refused to expand Medicaid, giving them an option they desperately need. 

But the Biden team made a series of policy choices to limit the impact their public plan would have on employer-based health insurance. Large employers are not allowed to buy into the new public option. Individuals can’t use the money their employer is spending on private health insurance to buy into the public option. What they’ve built isn’t a glide path to Medicare-for-all, or even to a new hybrid system. Instead, they’ve created a backstop to reinforce the current system, with all its flaws. And over the next year, the coronavirus is going to make those flaws gruesomely apparent. 

The Biden team’s fear is that opening the public option to all employers would destabilize the employer-based system — companies with sicker, older workforces would rush into the public system, driving up its costs, or perhaps they would nudge their older, sicker employees to enter into it so they could offload their spending onto taxpayers. These concerns are reasonable, but they’re also manageable. Whether you choose to solve them reflects whether you think the American health care system is fundamentally broken or just needs to be patched up. 

Biden’s plan would require far less in new taxes than Sanders’s plan — the Committee for a Responsible Federal Budget estimated the 10-year cost of Biden’s proposal at $2.25 trillion while Sanders’s bill clocked in at $30.6 trillion — but even pre-coronavirus, CRFB estimated that it would still leave 10 million to 15 million people uninsured. Post-coronavirus, it will leave millions more uninsured, and it will have little to offer those who keep their employer-based plan but find themselves paying more and more for less and less. 

With Sanders’s exit from the race, Biden is a lock to win the Democratic nomination. But his win will leave many progressives disappointed. Biden needs a way to reach out to them. A good place to start would be a better health care plan — one that’s truly universal and that ends employer control over health insurance. 

Biden isn’t going to embrace Sanders’s Medicare-for-all plan. But he can do better than his current health care proposal, and he should. I can even suggest a place for him to start.

Medicare Extra is the middle ground Democrats need

Back in July, the Center for American Progress released its “Medicare Extra” proposal. As I wrote at the time, the plan was, and is, an intriguing synthesis of left and moderate ideas on health reform. It’s universal, it uses Medicare’s pricing power to hold down costs, it rebuilds the health system around public insurance — and it gives everyone, everywhere, a true choice between public and private options, no matter what their employer is offering. In all those ways, it goes much further than Bidencare.

At the same time, Medicare Extra retains private insurance options, allows employers to continue offering insurance to employees if they think they can provide something better than the public option, and it holds the total price tag to somewhere in the $2.8 trillion to $4.5 trillion range. Which is to say, it’s not nearly as disruptive as Sanders’s Medicare-for-all bill, and it only requires about a tenth of the tax increases. 

Here’s how it works:

  • Medicare Extra builds a new public insurance program called, well, Medicare Extra. The new plan shares Medicare’s name, but its benefits are much more expansive: It includes, for instance, vision, dental, and reproductive health coverage.

  • Everyone in the system, from individuals getting insurance from their employer to traditional Medicare enrollees, could choose to purchase Medicare Extra instead, and they’d be eligible for normal subsidies and employer cash-outs if they did so. So unlike in Biden’s plan, employers could buy Medicare Extra for their employees, and even if they didn’t, employees could take the money their employer is spending on private insurance and use it to buy Medicare Extra. 

  • Premiums are on a sliding scale, with Americans under 150 percent of the poverty line paying nothing and those making 500 percent of the poverty line or more seeing their total contribution capped at 9 percent of income. Cost-sharing, too, varies by income, with total out-of-pocket spending, even for the richest, capped at $5,000.

  • Newborns would automatically be enrolled in Medicare Extra, as would the uninsured and every legal resident upon turning 65. Medicaid and Obamacare would be folded into the new program, and anyone on traditional Medicare, Medicare Advantage, Tricare, Veterans Affairs coverage, the Federal Employee Health Benefits Program, the Indian Health Service, or employer-sponsored coverage could opt in. 

  • The plan saves money by expanding Medicare’s pricing power throughout the system — including to employer-provided private insurance. It’s the first of the major Democratic proposals to rely on a version of all-payer rate setting

There are plenty of details and decisions in this plan worth debating. But something like Medicare Extra offers a middle ground that this moment demands. It eases the disruption of reform without reinforcing the dysfunctions of the status quo; it makes employer-provided health insurance one option people can freely choose, if they prefer it, rather than making it the only option most people have; and it creates a system that, while not single-payer, is far more integrated than anything we have now: a public system with private options, rather than a private system with fractured public options. 

So far, Biden has done a good job releasing plans and making statements about how he would manage the coronavirus crisis. What he hasn’t done is reveal a vision for rebuilding in its aftermath. He’s offering a candidacy to feel relieved about, rather than inspired by. But coronavirus, and the damage it will unleash on an already broken health care system, demands more than that. 

Finding a synthesis in the health reform debate, one that respects the moderate’s fear of disruption, the leftist critique of the status quo, and the post-coronavirus reality that now surrounds us, would be a good place to start. 

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RSN | Bernie's Decision: Retreat Should Not Be Confused With Surrender Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=48990"><span class="small">Norman Solomon, Reader Supported News</span></a>   
Thursday, 09 April 2020 11:48

Solomon writes: "Politics is ultimately about life and death, as the current pandemic horrors make clear. Policies that can seem abstract not only routinely harm quality of life; they also kill."

Presidential candidate Sen. Bernie Sanders speaks during a rally at Grant Park on March 7, 2020, in Chicago. (photo: John J. Kim/Chicago Tribune)
Presidential candidate Sen. Bernie Sanders speaks during a rally at Grant Park on March 7, 2020, in Chicago. (photo: John J. Kim/Chicago Tribune)


Bernie's Decision: Retreat Should Not Be Confused With Surrender

By Norman Solomon, Reader Supported News

09 April 20

 

olitics is ultimately about life and death, as the current pandemic horrors make clear. Policies that can seem abstract not only routinely harm quality of life; they also kill.

Both Bernie Sanders campaigns for president have brought a principled seriousness to the national discourse that no other candidate has come near matching. Now, we seem to be entering new terrain. Or are we?

You might not like “war” metaphors — but a vicious reality is that various types of warfare are constantly happening against billions of people on this planet. Humanity is under siege from structured injustice due to anti-democratic power.

We don’t have a choice of whether or not we’re in a class war. It’s going on perpetually — waged with enormous financial, political and media firepower. The firepower of class warfare against Bernie Sanders has been ferocious and unrelenting. The Bernie campaign is dissipating, but class war is sure to remain unrelenting.

Our choices revolve around whether and how to fight back against the centralized wealth and huge corporate interests waging that endless war. Now, as the era after the Bernie 2020 campaign gets underway, I’d like to tell you a little about one of the countless inspiring activists I’ve met — and why his outlook is so connected to the moment we’re in now.

Fifty years ago, Fred Branfman saw the human consequences of war in Laos — an airborne genocide that took place courtesy of U.S. taxpayers and the Orwellian-named Defense Department. Fred was a humanitarian-aid volunteer in Laos when he discovered that his country was taking the lives of peasants there by the thousands.

Fred assembled Voices from the Plain of Jars. Published in 1972, with the subtitle “Life Under an Air War,” the book included essays by Laotian people living under long-term U.S. bombardment as well drawings by children who depicted the horrors all around them. As one bookseller put it, “This is the story of the first society to be totally destroyed by aircraft.”

In 2006, when I talked with Fred, he said: “At the age of 27, a moral abyss suddenly opened before me. I was shocked to the core of my being as I found myself interviewing Laotian peasants, among the most decent, human and kind people on Earth, who described living underground for years on end, while they saw countless fellow villagers and family members burned alive by napalm, suffocated by 500-pound bombs, and shredded by antipersonnel bombs dropped by my country, the United States.”

Fred moved to Washington, where he worked with antiwar groups to lobby Congress and protest the inflicting of mass carnage on Indochina. He saw the urgent need to work inside and outside the political system to change policies and save lives.

More than three decades after his experiences in Laos, Fred wrote about “the effect on the biosphere of the interaction between global warming, biodiversity loss, water aquifer depletion, chemical contamination, and a wide variety of other new threats to the biospheric systems upon which human life depends.” He was far from optimistic. And that’s where, in April 2020, Fred has much to convey to us with a spirit that remains powerful several years after his death.

Many people who pay attention to national and global realities are in despair, and the loss of the Bernie campaign now adds to the weight of pessimism. Fred would have understood. Looking toward the future, he said, “I find it hard to have much ‘hope’ that the species will better itself in coming decades.”

But, Fred went on, “I have also reached a point in my self-inquiries where I came to dislike the whole notion of ‘hope.’ If I need to have ‘hope’ to motivate me, what will I do when I see no rational reason for hope? If I can be ‘hopeful,’ then I can also be ‘hopeless,’ and I do not like feeling hopeless.”

He added: “When I looked more deeply at my own life, I noticed that my life was not now and never had been built around ‘hope.’ Laos was an example. I went there, I learned to love the peasants, the bombing shocked my psyche and soul to the core, and I responded — not because I was hopeful or hopeless, but because I was alive.”

And human.

That should be reason enough for solidarity and determination. We will often lose. We will not give up. We must not give up.



Norman Solomon is co-founder and national coordinator of RootsAction.org. He was a Bernie Sanders delegate from California to the 2016 Democratic National Convention. Solomon is the author of a dozen books, including War Made Easy: How Presidents and Pundits Keep Spinning Us to Death.

Reader Supported News is the Publication of Origin for this work. Permission to republish is freely granted with credit and a link back to Reader Supported News.

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FOCUS: What Bernie Accomplished Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=36361"><span class="small">Robert Reich, Robert Reich's Facebook Page</span></a>   
Thursday, 09 April 2020 10:49

"Dear Bernie, I'm sorry you will not be president, but the country is far better off because of your unrelenting courage and commitment to the progressive change we so desperately need in a country riddled with inequality and division."

Robert Reich. (photo: Getty)
Robert Reich. (photo: Getty)


What Bernie Accomplished

By Robert Reich, Robert Reich's Facebook Page

09 April 20

 

ear Bernie,

I'm sorry you will not be president, but the country is far better off because of your unrelenting courage and commitment to the progressive change we so desperately need in a country riddled with inequality and division.

Four years ago, in the 2016 Democratic primaries, you made it respectable to talk about Medicare for All, free public higher education, and raising taxes on the wealthy. You alerted America to the vast and growing gap in income, wealth, and political power, and its dangers for our economy and democracy.

This time, you've not only made it respectable to talk about these and other issues, such as a Green New Deal, but you've persuaded a majority of Americans that these problems must be addressed. You've given voice to the poor, working class, the undocumented, indigenous people -- all those who have been bullied and abandoned throughout our history.

You have inspired and galvanized a new generation of young Americans. You have made it possible for America to live up to its ideals. Your courage and determination have made me and countless others proud.

May your voice, your indignation, and your moral clarity ring out for years to come.

Fondly,
Bob

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We Cannot Rely on Trump. Congress Must Lead the Way in This Unprecedented Crisis Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=24193"><span class="small">Bernie Sanders, Guardian UK</span></a>   
Thursday, 09 April 2020 08:20

Sanders writes: "President Trump is incapable of providing leadership, and instead continues to mislead the public and act out of political self-interest. So it is Congress that must lead, and it must do so now."

Bernie Sanders: 'The American people deserve and require leadership from Washington that acts aggressively.' (photo: Caleb Kenna/Reuters)
Bernie Sanders: 'The American people deserve and require leadership from Washington that acts aggressively.' (photo: Caleb Kenna/Reuters)


We Cannot Rely on Trump. Congress Must Lead the Way in This Unprecedented Crisis

By Bernie Sanders, Guardian UK

09 April 20


The American people deserve and require leadership from Washington amid this horrific pandemic and economic meltdown

n this unprecedented moment in American history, we need an unprecedented legislative response. President Trump is incapable of providing leadership, and instead continues to mislead the public and act out of political self-interest. So it is Congress that must lead, and it must do so now.

With anxiety growing, everyone in our country needs to know that, in the midst of this horrific pandemic and economic meltdown, their government is doing everything possible to keep them healthy and financially secure.

In other words, we need to build upon and expand the recent stimulus package with new and bolder emergency legislation which must be passed as soon as possible. Here are a few core principles that must be included in that legislation.

First, Congress must explicitly authorize that the Defense Production Act is fully utilized to demand that the private sector start delivering the equipment and products that our medical personnel desperately need in order to treat their patients. We cannot rely on Trump to do it.

Recent reporting has revealed that the Trump administration did not start ordering crucial equipment like masks until March. It is beyond comprehension that, in the wealthiest nation on Earth, doctors and nurses throughout the country are putting their lives on the line because they lack an adequate supply of surgical masks, gloves and gowns. We must also produce the ventilators as well as the various kinds of testing kits that we need now and will need in the future, as well as the dwindling supply of certain prescription drugs that are essential to treat the virus. States and hospitals should not have to compete against each other. The federal government must take the lead in coordinating efforts.

Further, during this crisis, every American must be able to receive all of the healthcare they need regardless of income. Before the pandemic, 87 million people were uninsured or underinsured. That number is rapidly escalating as millions of workers are not only losing their jobs but are also losing their employer-based health insurance.

The cost of hospital treatment for the coronavirus amounts to tens of thousands of dollars. Tragically, we have already seen people who have delayed treatment due to concerns about cost. In this pandemic, lack of insurance will lead to more deaths and more Covid-19 transmissions.

As long as this pandemic continues, Medicare must be empowered to pay all of the deductibles, co-payments and out-of-pocket healthcare expenses for the uninsured and the underinsured. No one in America who is sick, regardless of immigration status, should be afraid to seek the medical treatment they need during this national crisis.

Obviously, Congress must not only address the pandemic crisis, it must also act with a fierce sense of urgency to effectively deal with the economic crisis as well.

In the last two weeks, a record-breaking 10 million people filed unemployment claims – more than during the entire 2008 Great Recession. Frighteningly, the St Louis Federal Reserve projects that 47 million more people may become unemployed by the end of June, with unemployment reaching 32%. While such estimates may be a worst-case scenario, the reality of the pandemic has taught us that worst-case scenarios are what we must plan for. For the sake of working families all over this country, we must be prepared for all contingencies.

We cannot wait before taking the bold action that is necessary. In my view, it makes a lot more sense to prevent the collapse of our economy than figuring out how we put it back together after it crumbles. Simply stated, that means that every worker must keep receiving his or her paycheck and benefits during the crisis. In the recent emergency relief bill, Congress appropriated over $25bn in grants to the airline companies so that 2 million workers in that industry will continue to receive their full paycheck and benefits through 30 September. And that is exactly what we must do for every worker in America. This is not a radical idea. It is similar to what France, Norway, Denmark, the UK and other countries are doing.

Further, as quickly as possible, we must get money into the hands of people by immediately providing a $2,000 monthly emergency payment to every person in the country until the crisis has passed.

In addition, we must guarantee paid medical and sick leave to all workers. It has been estimated that only 12% of workers in businesses that are likely to stay open during this crisis are receiving paid sick leave benefits as a result of the second coronavirus relief package. We have got to increase this figure to 100%.

Moreover, workers who are on the frontlines of this crisis including those who work in grocery stores, warehouses, paramedics, nurses, pharmacies, domestic workers, postal workers, farm workers, public transit, truck drivers and janitors must receive $500 a week hazard pay, childcare and a safe and secure workplace.

Finally, we must put an immediate moratorium on evictions, foreclosures and utility shut-offs, and suspend payments on rent and mortgage loans for primary residences during this crisis.

This is a frightening and devastating time for our country, and the world. Never before in our lifetimes have we had to deal with both a public health pandemic and an economic meltdown.

The American people deserve and require leadership from Washington that acts aggressively, puts working people first, and provides peace-of-mind to the most vulnerable people in our country. Now more than any point in recent history, we are in this together. We must act with love, compassion and urgency.

Historians will look back at this time to see how we dealt with this unprecedented crisis. I hope they will observe that we responded with the courage and boldness that the moment required.

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Why Is Trump's Inspector General Purge Not a National Scandal? Print
Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=49944"><span class="small">Benjamin Wittes, Lawfare Blog</span></a>   
Thursday, 09 April 2020 08:20

Wittes writes: "If, three years ago, President Trump had removed two inspectors general from their posts within a week of each other for overtly self-interested reasons-as he has done over the past few days-it would have been a big scandal."

Former intelligence community inspector general Michael Atkinson. (photo: Getty)
Former intelligence community inspector general Michael Atkinson. (photo: Getty)


Why Is Trump's Inspector General Purge Not a National Scandal?

By Benjamin Wittes, Lawfare

09 April 20

 

f, three years ago, President Trump had removed two inspectors general from their posts within a week of each other for overtly self-interested reasons—as he has done over the past few days—it would have been a big scandal. Presidents don’t just fire inspectors general for doing their jobs, after all. And presidents who agree to have an oversight board composed of inspectors general don’t typically sack one of them to prevent him from leading the board’s monitoring of trillions of dollars of congressionally appropriated money.

Yet last week, the president announced the firing of Intelligence Community Inspector General Michael Atkinson for overtly retaliatory reasons. Atkinson had been the inspector general who notified Congress, as he was legally bound to do, of a whistleblower complaint that raised a matter of “urgent concern”—the event triggered the Ukraine scandal and the president’s resulting impeachment.

Trump, in explaining Atkinson’s removal, made no secret that it came in response to Atkinson’s having gotten Trump in trouble.

“I thought he did a terrible job. Absolutely terrible,” Trump said over the weekend. “He took a whistleblower report, which turned out to be a fake report—it was fake. It was totally wrong. It was about my conversation with the President of Ukraine. He took a fake report and he brought it to Congress, with an emergency. Okay? Not a big Trump fan—that, I can tell you.”

Nor did Atkinson himself doubt that the move was retaliatory. In a statement, he said that “[i]t is hard not to think that the President’s loss of confidence in me derives from my having faithfully discharged my legal obligations as an independent and impartial Inspector General, and from my commitment to continue to do so.”

Then, on Monday, Trump ousted Glenn Fine, the acting inspector general of the Pentagon, from his new role as the chair of the Pandemic Response Accountability Committee, which has an $80 million budget to monitor government spending under the new $2 trillion relief bill. Fine had been chosen for the new role by the other inspectors general on the committee. But Trump removed Fine as acting inspector general, thereby also removing him from the committee—and from his role as its chair, since only currently-serving inspectors general can be part of the committee. He then installed the inspector general of the Environmental Protection Agency as acting inspector general at the Defense Department in Fine’s place.

Before his role at the Pentagon, Fine had been the longtime inspector general at the Justice Department, where he had a reputation as a bulldog investigator. While Trump has not yet confessed, as he did with Atkinson, the reason for Fine’s removal, it isn’t subtle: Fine is the kind of guy who will make trouble.

Time was, and it was not so long ago, that presidents couldn’t just remove unwanted oversight mechanisms with impunity, much less do so as retaliatory gestures for people doing their jobs or because aggressive oversight of two trillion dollars of emergency spending might be inconvenient. The impediment wasn’t legal. It was political—the fear of response by some other actor in the governmental system.

Had Trump taken an action like this towards the beginning of his presidency, there would have been at least some response. When Trump fired FBI Director James Comey, after all, there was outrage. There were hearings. And it was the fear of blowback from Senate Republicans that prevented Trump for many months from firing Jeff Sessions as attorney general. That fear emanated from a tangible reality. Such an action would have once been a big deal that necessitated congressional reaction.

But the firing of a couple of inspectors general for transparently—and, in one case, admittedly—self-interested reasons is no longer that big a deal. Part of the reason is that the coronavirus has sucked all the air out of the room. Trump is counting on public distraction to give himself political space for activity that would have been much more scandalous only a few weeks ago. There’s nothing quite like a global cataclysm to distract the public from mere presidential abuse and corruption.

The distraction is actually legitimate. In this moment, the public, like public officials, needs to prioritize. It is more important right now for reporters, television networks, commentators, and the public at large to absorb news about the pandemic than it is for people to absorb news about the president’s ongoing spree of abuses. One involves a fast-moving story of literally life-and-death stakes wherein each news consumer has a critical role to play by observing social distancing and other public health guidances. The other involves the latest iteration of a long-established presidential pattern of narcissistically-motivated abuses of the presidential appointment power. It’s a classic virus-infects-man story, whereas the pandemic—paradoxically—is a man-infects-virus story.

But there’s another reason the serial dismissal of independent inspectors general causes only a ripple, not a political wave. And that is that we’ve gotten so used to this sort of thing that we don’t see it as all that scandalous any more. We see it just as Trump being Trump.

Yes, when Trump removed Comey for overtly political reasons, it was a scandal. When he threatened to fire Special Counsel Robert Mueller and menaced Deputy Attorney General Rod Rosenstein, that was a looming scandal. And when he threatened to fire Sessions, Senate Republicans made clear they wouldn’t sit still for it—at least at first.

But by the time Trump actually fired Sessions, those same senators had gotten used to the idea. And by the time Trump got rid of National Security Council staffer Lt. Colonel Alex Vindman—along with his brother, for good measure—some of them were ready to defend it. Likewise, there’s been nary a peep about the wave of firings that has recently crashed over the Office of the Director of National Intelligence, which has included replacement of a DNI, an acting DNI, a deputy DNI, and a head of the National Counterterrorism Center. Simple repetition of the abusive behavior has caused us to integrate it into our list of things that presidents get away with doing—because he has gotten away with it. This is what we mean when we use the somewhat hackneyed term “normalize” in relation to Trump and his deviant behaviors. Trump has normalized the hiring and removal of investigative and intelligence officials on the basis of whether or not they will deliver the goods the president wants and whether or not they pose a political threat to him.

If Congress were under unified Democratic control, or if a handful of Republican senators cared enough to push back, there would be a lot that lawmakers could do. And there may still be. The administration keeps coming to Congress to ask for major relief packages, and House Speaker Nancy Pelosi and Senate Minority Leader Chuck Schumer have shown themselves adept at getting a great deal of what they want in the course of negotiating those packages. Holding some of the administration’s priorities hostage to the president’s behaving himself with respect to oversight is an aggressive approach—but, under the circumstances, a reasonable one. In the end, however, a Congress divided between Democratic and Republican control is going to have a hard time taking on the president on a matter about which the president feels as strongly as Trump does about his power to vindictively fire investigators and staffers who don’t “protect” him. Pelosi and Schumer should push, but they’re likely to lose.

There is, however, a major political actor who can make a difference here. His name is Joe Biden. If Trump has normalized this sort of abuse of his appointment powers, Biden—as the all-but-certain Democratic nominee for president—should be speaking regularly to abnormalize it. Biden has spoken regularly about Trump’s deviance from the norms and expectations of the traditional presidency. He has also sought to remind Americans what normal, competent and decent presidential leadership would look like in this coronavirus crisis. One component of that should be reminding Americans that normal leadership would not include pausing to settle political scores with officials who tell the truth. It would not involve taking action to avoid aggressive oversight of trillions of dollars in spending. And it would not involve demanding that an inspector general be a “fan” of the president.

Ultimately, the only way to reestablish the norm that presidents submit to internal oversight mechanisms, that they don’t seek to control them for personal benefit, and that they allow the law enforcement and intelligence agencies to do their jobs without political interference is to insist on it in the political arena. That’s what political campaigns are for. Biden is now in the stage of his campaign in which he needs to begin drawing contrasts between himself and the incumbent. He is no longer competing with others for the attention of Democratic primary voters, whatever Bernie Sanders might think. His challenge is to break through to the public and present an alternative to Trump.

This should be a key part of that alternative. In his efforts to draw contrasts with Trump, it is an area that warrants his very public and consistent attention. It is about what—and whom—the presidency is for.

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