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Roy Blunt’s (tele) town-hall: What he said and what he didn’t say

25 Thursday May 2017

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Missouri GOP Senator Roy Blunt entertained about 5000 constituents today (5/23) at one of the tele-town hall events that have become de rigeur for GOPers who want to avoid the messy give-and-take with outraged constituents that unpopular Republican policies can generate. When asked why he hadn’t met with some of us in person during last week’s congressional recess, Blunt huffed and puffed and observed that he had held some 2000 town halls during his last term – more than just about anyone else, he said. Of course, that was in the BT (Before Trump) Era and back in the days when, thanks to a Democratic majority in the Senate and President Obama’s veto pen, the GOP never had to face the  worst consequences of their horrible policies.

My impression of the format? It worked. Blunt and his staff had total control; no matter what he said, there was no opportunity for pushback, no inconvenient follow-up questions. We often got to see hear him practice the fine art of political evasion. He did, to be honest, let us know where he stands on lots of issues – although, thanks to the controlled format, he was also able to leave lots unsaid. The highlights, as well as I can reconstruct them from my notes, including what was not said, follow below:

Trump Budget Proposal:

Biggest takeaway? Blunt really seems to want to distance himself from the Trump budget. When asked about specific cuts – in health care, jobs training programs and support for the new NGA headquarters slated for St. Louis – the latter two of which he promised to support vigorously – he noted that the budget was advisory only, and reminisced about the way GOPers had ignored Obama’s proposed budget. The implication was clear that they would do the same to Trump’s financial fiasco.

Veterans Administration:

Blunt did, without specifically pointing it out, endorse some key elements of the Trump Budget spending. He observed, for example, that he wanted to make it possible for veterans to get their treatment from private doctors by expanding the same “choice” option for which the Trump budget increases spending.

Left unsaid: Choice programs haven’t been an unequivocal success, partly because of hasty implementation, but also in terms of expense. They are opposed by some veterans groups that would prefer to see the funds used to bolster the VA hospital system instead.

Trumpcare: pre-existing conditions

When Blunt was asked about Trumpcare’s callous destruction of existing protections for pre-existing conditions, he first trotted out a somewhat garbled verson of the standard, but misleading GOP talking point about providing “access” to health care rather than insurance. He then, laudably, expressed sympathy for those who suffer from chronic illness. When, however, he said, and I paraphrase, that when one is healthy, one may have many problems, but when one is ill, there is only one problem and one focuses only on that illness, I got the impression that he wanted to suggest that pre-existing condition talk was somewhat beside the point. He then quickly shifted the emphasis to his past support for increased funds for medical research.

Left Unsaid: Blunt didn’t address how the six million chronically ill folks who may, under Trumpcare, be unable to afford insurance will get “access” to those new treatments that increased research funding may discover.

Obamacare

As part of what struck me as an implicit and awkward apology for Trumpcare, Blunt resorted to the GOP all-time go-to: Obamacare is failing. This is an attempt to deflect attention from Trumpcare that works only because it has become an article of faith for the GOP true believers, facts be damned. Insurers, Blunt claimed, are pulling out of the market, leaving a shambles where soon nobody will be able to get coverage.

Left Unsaid: Blunt did not point out that by refusing to either continue or deny CSRs (cost-sharing reductions), subsidies paid to insurers to help cover low-income individuals, President Trump is creating uncertainty that is causing insurers to consider leaving the Obamacare market and pushing them to steeply raise premiums . Insurer groups even wrote a letter to Trump imploring him to do something about the situation.

Trumpcare in the Senate

In response to a question about why Senate majority leader Mitch McConnell had said that he would not work with Democrats in fashioning the Senate Healthcare proposal, Blunt, after patting himself on the back for all his bipartisan initiatives, rather reasonably replied that Democrats weren’t willing to work with McConnell – which why would they? Obamacare is still superior to anything Republicans have proposed, after all.

Left Unsaid: Why is the Senate, all male, all Republican, working group so secretive about what they are planning – and why does it consist of some of the most rightwing, anti-Obamacare Senate members? Why aren’t Senators like Susan Collins (ME-R), who has proposed her own version of a replacement bill, included in the working group?

Student Debt

Blunt ignored the new Trump budget proposal as if it were really as irrelevant as he earlier indicated and boasted instead about current Pell grant funding increases and legislation that allowed students to use them year around. He said some nice words about how the federal government recognizes the desirability of creating a skilled citizenry, but, in so many words, said if you can’t pay back those huge educational loans, too bad, baby, you’re on your own.

Left Unsaid: What does he think of Education Secretary Betsy DeVos’ proposals to cut student loan funding, cut current debt forgiveness programs, cease government subsidies to pay student loan interest charges, and help students who fall behind in repayment?

Trump Russiagate scandal

Blunt is a member of the Senate Intelligence Committee and he was emphatic that Russian interference in U.S. elections needs to be investigated and all questions must be answered as a matter of national security. He stated, not surprisingly, that the best place for that to happen was the Intelligence Committee.

Left Unsaid: No mention was made of possible Trump campaign collusion with the Russians. Nor was any mention was made of the recently named Special Prosecutor, Robert Mueller, whose investigation, as far as Blunt’s presentation went, might not even exist.

Afternote

A gentleman asked about the “leakers” who so trouble Donald Trump. He observed that he could write a program himself and catch the miscreants, so why couldn’t the big-time government folks catch them and put them in jail where they belong? Blunt agreed that unsanctioned leaking was bad and might compromise security in some instances. To his credit, Blunt, unlike many of his GOP colleagues, did not minimize the RussiaGate scandal by suggesting that the real evil-doers were the whistleblowers.

Left unsaid: Blunt did not offer the questioner a job writing that program to catch the leakers. Wonder why.

*Typos corrected and format edited slightly (12.56 pm, 5/25/2017)

Ann Wagner toes the GOP privatization line on VA hospital scandal

18 Wednesday Jun 2014

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The most recent email newsletter that I got from my Congresswoman, Rep. Ann Wagner (R-2), Ann’s Weekly Roundup, focused on the scandal attendant on the long waits that many veterans have to endure in order to get care at VA hospitals. Wagner, needless to say, wants us to know she’s utterly, utterly aghast – even though she had little or nothing to say in February when her GOP compatriots in the Senate blocked Bernie Sander’s bill, S. 1982, that would have not only expanded the range of care available to veterans, but would have helped to alleviate the situation at notably overtaxed VA hospitals by providing for 27 new medical faciliities, facilities that, in the wake of the Iraq and Afghanistan wars are desperately needed.

Instead of addressing the real issue and acknowledging its genesis, Wagner prefers to troll veterans looking for more horror stories to back up her spurious claim that “the American people cannot trust the VA to correctly identify and address all deficiencies plaguing this agency.”  In fact, as Danny Vinik cogently argues in TNR, it’s more likely that only the VA itself can address the real problems – provided the funds to do so are made available.

Of course Wagner, in line with the notably dishonest GOP thrust toward privatization, doesn’t want us to believe we can trust the VA so she notably fails to mention the great job it does once folks get past door, or  the fact that “the VA healthcare system has consistently out-performed the non-VA/private sector in quality of care and patient safety.” Not a word from Wagner that the waiting period to see a doctor is, in many cases as long in the private sector as it is at most VA hospitals.

No, Wagner wants to send veterans into the private sector. For Wagner, who shows every sign of wanting to climb the GOP’s leadership ladder, the important thing is that there’s a problem at the VA that can be exploited by the pro-privatization fanatics in the GOP. Consequently, Wagner’s touting her role as a co-sponsor of the Veterans Access to Care Act, “which would allow any Veteran forced to wait more than thirty days for an appointment, the option to receive private-sector care.” Like most in the GOP, she ignores the spectular failures of the private sector in delivering health care in our free enterprise Wild, Wild West. Nor does Wagner, again in common with the rest of her GOP cohorts,  seem to be aware that this solution lacks the support of many veteran service organizations that ” long have feared such moves as a step toward dismantling their prized, fully integrated VA health system.”

But there’s still another dimension to the VA scandal that is truly scandalous serious.  It seems that staff in the Phoenix VA falsified patient wait-time records. It’s likely they did so because the VA was not only under pressure to cut wait times to 14 days, an interval that, given the myriad pressures on the system, was totally unrealistic, but because financial incentives were offered for achieving this wait time. This serious lapse has, of course, gotten everyone justifiably worked up; but only Republicans have tried to exploit it to favor their anti-government ideology:

“(The) VA’s sordid bonus culture is a symptom of a much bigger organizational problem: The department’s extreme reluctance to hold employees and executives accountable for mismanagement that harms veterans,” said House Veterans’ Affairs Committee Chairman Jeff Miller, R-Fla.

Which leads me to point out that the use of financial incentives is not unique to the public sector, It is a motivational mechanism that the VA along with other nonprofits has borrowed from that GOP icon, the private sector, where it has an equally spotty record. Take for instance, the issue of bonuses paid out to business executives. The Economist reports on a study that concludes that, “of the largest companies in America (those in the S&P 100), CEO pay has no correlation with either performance or market capitalisation.” Does this bother those GOPers like Wagner who champion the supposedly greater efficiencies of the marketplace? It certainly didn’t in 2009 when the GOP came out swinging to protect the bonuses “owed” to the CEOs of bailed out banks.

The issue in both the public and private sector is not the use of incentives per se, but the degree to which they are tied to realistic, easily verifiable goals. Cheating at the VA is akin to that in the education field where we find schools where merit pay as well as the survival of the school itself depends on students’ test scores while, at the same time, the school district is without the wherewithal to enable it to address the complex issues that lead to low test performance. Since the stakes are high and there’s no way to succeed, sometimes they cheat. Same at the VA.  

It’s not surprising that people who have to meet unrealistic goals to avoid censure as well as to supplement their income will cheat when they think they can get away with it. It’s a sad fact, but it happens. It happens in the private and the public sector and the conditions that give rise to such cheating need to be addressed. And in the case of the VA, putting veterans into the private health care system does nothing to address the issues – although it will up the costs for the American taxpayer. According to Danny Vinik:

… the Congressional Budget Office reported that allowing certain veterans to seek care at non-VA facilities would cost $35 billion over the two-year program, as The New Republic’s Brian Beutler predicted. If made permanent, CBO estimates it could cost $50 billion a year. For comparison, the VA currently spends $44 billion a year on its health care system. CBO notes that its estimate is preliminary, but it still is much higher than the expected cost. And this is only for the partial privatization part of the bill.

While the potential for a new $50 billion a year program is worrisome, the bill would not even address the underlying problems at the VA.

It’s not surprising that Rep. Wagner is touting a bill that opens the VA door slightly to privatization, but it is tragic that so many Democrats have allowed themselves to be stampeded through that door by the media circus that folks like Wagner have ramped up. Do we really want to pay more to give our soldiers so-so care? Or do we want to fix the real problems at the VA where doctors specialize in the specific issues that affect those in the military? Two Republicans voted against the bill because of its cost – and for once they were right to do so, given the dubious nature of its main provision. Why, though, were there no Democrats willing to stand against what Vinik identifies as a privatization “trojan horse.”