Health care reform was supposed to relieve the financial strain on hospitals that have provided a lot of free charity care to poor and uninsured patients. The reform law, known as the Affordable Care Act, was expected to insure most of those patients either through expanded state Medicaid programs for the poor or through subsidized private insurance for middle-income patients, thereby funneling new revenues to hospitals that had previously absorbed the costs of uncompensated care.
In return for the new income streams, hospitals that treat large numbers of the poor and get special subsidies to defray the cost would have those subsidies reduced on the theory that they would no longer need as much help.
But after the Supreme Court ruled that the reform law could not force states to expand their Medicaid programs, 20 or more states declined to do so. That failure has hurt some big urban hospitals, because their charity care burden remains essentially the same even as their federal aid has been cut. Even in California, which has expanded its Medicaid program, public hospitals that serve the poorest patients could face a big funding shortfall in future years, according to a study just published by researchers at the University of California at Los Angeles.
There are three things we know about man-made global warming. First, the consequences will be terrible if we don’t take quick action to limit carbon emissions. Second, in pure economic terms the required action shouldn’t be hard to take: emission controls, done right, would probably slow economic growth, but not by much. Third, the politics of action are nonetheless very difficult.
I’ve been looking into that issue and have come to the somewhat surprising conclusion that it’s not mainly about the vested interests. They do, of course, exist and play an important role; funding from fossil-fuel interests has played a crucial role in sustaining the illusion that climate science is less settled than it is. But the monetary stakes aren’t nearly as big as you might think. What makes rational action on climate so hard is something else — a toxic mix of ideology and anti-intellectualism.
I’ve noted in earlier columns that every even halfway serious study of the economic impact of carbon reductions — including the recent study paid for by the anti-environmental U.S. Chamber of Commerce — finds at most modest costs. Practical experience points in the same direction. Back in the 1980s conservatives claimed that any attempt to limit acid rain would have devastating economic effects; in reality, the cap-and-trade system for sulfur dioxide was highly successful at minimal cost. The Northeastern states have had a cap-and-trade arrangement for carbon since 2009, and so far have seen emissions drop sharply while their economies grew faster than the rest of the country. Environmentalism is not the enemy of economic growth.
Charles Blow’s op-ed today is the perfect complement to Professor Krugman’s.
Because of the current make-up of our politics, the current tides in them, America’s historical relationship with religion and its place in all of our lives, we need to account for the current push-pull struggle between the theocrats and the plutocrats in their quest to establish supremacy.
What more perfect marriage is there than the obscene amounts of business money in our politics and the teachings of the theocrats in changing the way we view science and believe in scientific facts?
To read the rest of this op-ed and my comment, click here.
AMONG Americans age 40 and older, there’s a pastime more popular than football, Candy Crush or HBO.
It’s bashing millennials.
Oh, the hours of fun we have, marveling at their self-fascination and gaping at their sense of entitlement! It’s been an especially spirited romp lately, as a new batch of them graduate from college and gambol toward our cubicles, prompting us to wonder afresh about the havoc they’ll wreak on our world.
For decades they’ll be saddled with our effluvium: a monstrous debt, an epidemic of obesity, Adam Sandler movies. In their lifetimes the Atlantic will possibly swallow Miami Beach (I foresee a “Golden Girls” sequel with dinghies and life preservers) and the footwear for Anchorage in February may be flip-flops. At least everyone will be saving on heating bills.
The Obama administration did unveil a bold climate-change measure last week. Or, rather, it signaled its intent to act: We’ll have to wait and see whether Congress figures out a way to foil the president or the courts gum things up. The plan as it stands would cut carbon pollution from American power plants 30 percent from 2005 levels by 2030.