Healthcare: The Defining Issue of our Day

Healthcare: The Defining Issue of our Day

The first American president to promote national health insurance was Republican President Theodore Roosevelt, who believed that no country could prosper if its people were sick and poor.

Today not everyone accepts that view.  Yet, a recent study by the conservative think tank, the Heritage Foundation, notes that the U.S. ranks 12th in the world in measures of economic freedom and 10 of the 11 nations ahead of us have achieved universal coverage.  This isn’t a coincidence—our lack of universal coverage is holding us back economically.

The fact is, universal healthcare is the best way – along with education - to ensure a level playing field for all Americans to fulfill their highest potential and live a productive life. Today, middle and low-income workers and their employers struggle to pay for healthcare, and millions more of our poor are shut out of the system altogether, saddling too many with staggering debt or forcing them to live with debilitating pain that keeps them from working or being the parent their children need.

And the sad fact is, many who lack coverage end up falling out of the middle class, due either to massive debt or untreated conditions. Health insurance costs, subsidies, and coverage are extremely uneven in America. Seventy-five percent of Americans receive some form of subsidized healthcare, but, according to the Kaiser Family Foundation, about 50,000 South Dakotans remain uninsured, or with very expensive, insurance, about half who are middle income employees and employers. These individuals get NO premium tax credit and also must pay the exorbitant premiums and high deductibles for insurance purchased on the ACA health insurance marketplaces.

The other half are low income individuals – often workers who do not qualify for Medicaid and who earn too little to qualify for premium tax credits under the ACA, so lack any access to coverage, because South Dakota state government elected not to expand Medicaid to include them.  Imagine the devastating effect of a major illness on those families making between $11,880-$24,300 with no insurance! Nearly all of us get healthcare eventually; it’s often neither timely, nor affordable.   To paraphrase what Almanzo told Laura about ice, as she later recounted in the Little House books: everyone gets their ice. It’s just that the rich get their ice in the summer, and the poor get theirs in the winter.

That is true of healthcare in America. The poor get their healthcare in our emergency rooms, our jails and our prisons, often erratically, at extremely high costs we all end up paying, and often, when it is too late to easily treat.   During my time as a judge, those who appeared before me in felony court and those I sent to prison often were beset by addiction and mental illness that led to crime, and nearly all lacked access to mental health and addiction treatment on the outside.

Our Native American neighbors and friends face a crisis of a different sort – people there are dying because their facilities are some of the worst in America, and no one in government seems to care. The high cost of healthcare also hinders our manufacturers’ ability to compete internationally; Warren Buffet calls it “the tapeworm of American competitiveness.”  And he’s right.

Let’s debate the best fit for us as South Dakotans, but to work, any plan must provide timely, affordable healthcare for all Americans.  Everyone who is able to work should pay for their care, but no one should pay too much. It’s the right thing, both morally and economically.  And while we address the best way to ensure affordable care for all, let’s allow those who currently lack access to employer or other coverage the option to enroll in Medicare. The conservative business magazine, Forbes, has shown that if we enact sensible universal healthcare we not only will save  money, we can actually balance our budget!  The reason is that we already pay for universal care, just not in obvious ways: in county care for the poor, jail inmate and prison care, and in higher healthcare costs and
increased crime.

We’re entitled to know how the candidates for our sole seat in Congress would have voted on the morally and economically disastrous bill the House passed six months ago; so far, none of the announced candidates have told us.  That’s not leadership. They owe it to South Dakotans to let us how they would have voted on this monumental legislation.

Access to healthcare is a solvable problem, and it’s one every other developed nation has already solved.  America is economically stronger and wealthier than them all.

We need  members of Congress willing to set aside partisan politics in order to reach a broad agreement and common sense plan that reflects who we are as Americans, and that covers everyone. That is the only way we will achieve what every other developed nation has already accomplished: affordable healthcare for each of our citizens.

Responsible, Fair Tax Law and the Republican-passed Legislation

Responsible, Fair Tax Law and the Republican-passed Legislation

Republican House leaders portray their $5.5 trillion tax cut as middle-class tax relief. Nonpartisan tax experts, including Congress’s own Joint Committee on Taxation, conclude though that the greatest share of the tax cuts go to corporations, the ultra-wealthy and their heirs, while many in the middle class will see taxes rise over time.

The majority party in Congress plans to pay for some of this by cutting hundreds of billions from Medicaid, which provides health care to poor children and their caretakers, as well as nursing home care for our elderly who have spent their resources, from Medicare, and by cuts to other domestic programs, including the USDA.

All this will heavily impact South Dakotans, leave millions nationally without health coverage, and shift costs the federal government now bears to state and local taxpayers.

But these painful measures still won’t be enough to pay for the massive tax cuts for corporations and the very well-off. So these cuts will also cause our national debt to soar another $1.5 trillion to $2.3 trillion and likely slow rather than spur economic growth.

This is trickle-down economics, which as one economist said “is like loading a horse with oats in order to feed the sparrows.”

Proponents justify this by claiming that corporate tax rates are too high, but the truth is that corporate taxes have declined by half as a percentage of our economy over the past 50 years. While the sticker price is 35 percent, the average rate corporations pay is closer to 20 percent.

The best evidence that large corporations are prospering is that their profits and the stock market have been hitting all-time highs for years now.

And as for our highest income earners, they already enjoy relatively low taxes by historic measures and over time have gained a bevy of tax loopholes only they can access. This is why we routinely hear stories of billionaires who pay effective tax rates lower than secretaries or farmers.

Meanwhile, wages among the middle and lower middle class have stagnated despite massive worker productivity gains. These facts help explain why 1 percent percent of Americans control 90 percent of our wealth, and why one in three American children grows up poor.

The truth is that ultra-wealthy and giant corporations don’t need a tax break, and we can’t afford to give them one. America has a national debt of $20 trillion and counting. Just as a family cannot continue to spend more than it takes in, neither can a nation do so without finally reaching a day of reckoning.

So, how should we approach tax reform? First, we should enact revenue-neutral corporate tax reform that lowers rates and closes loopholes, allowing repatriation of money held overseas.

Second, we should close loopholes only the well-off can access and apply the savings to a tax cut for those who need it and will actually spend it to stimulate the economy: the middle class and small business families who create about two in three American jobs.

We can also help low- and middle-income families by converting the mortgage interest deduction to a credit, so a homeowner receives back 15 percent of mortgage interest paid, allowing those who don’t itemize to also benefit. And instead of eliminating the personal exemption for each family member, as the bills propose, we should restore the exemption to its former value by increasing it from the current $4,050 to $6,000, and we should help low-income working moms and dads by increasing the child-care credit. These are each pro-family measures that will help the middle class and spur the economy.

Finally, we can help small businesses and farmers level out their taxes by instituting my proposed “Rainy Day IRA” plan, which would allow them to set aside up to $50,000 annually from taxable income to be invested tax-deferred until needed in a low-income year.

This bill is less about sound policy than it is about giving the party in office and their major donors a legislative victory. The last tax overhaul — enacted during the Reagan administration — passed with bipartisan support. That kind of bipartisan approach is missing so far and it is sorely needed to enact the sort of sound tax policy that will stand the test of time.

Congressional Dues

Congressional Dues

Washington is broken. We wonder why, when we send decent people to Washington, nothing ever gets fixed, why our national debt keeps growing no matter which party is in the majority and why well-off people get lavish tax breaks and pay a smaller percentage of their income in taxes than a waitress, or a farmer, or a small business owner.

I believe the biggest problem is that Congress has fallen under the control of politicians beholden to the ultra-wealthy, large corporations and other special interests. Here’s one way it happens: we send people to Washington who promise to drain the swamp, but they soon find that it’s more like a comfortable hot tub.

During orientation for new House members, their party leaders see to it that they are pampered, wined and dined, but soon those party leaders explain a practice most of us know nothing about. Today, both parties’ leaders levy dues based on the congressman’s committee choice: the more lucrative the committee for fundraising, the higher the dues.

Yes, astoundingly, our representatives are expected to pay to do the work we elected them to do. Rep. Thomas Massie, R-Ky., likens the practice to extortion: “They told us right off the bat as soon as we [got] here, ‘These committees all have prices and don’t pick an expensive one if you can’t make the payments.’”

We aren’t talking about token sums. Rep. Ken Buck, R-Colo., explained in his recent book, “Drain the Swamp,” that to serve on a mid-level congressional committee, a first-term Republican congressman is expected to pay $220,000 in dues to the Republican National Congressional Committee – a second-termer – $450,000. The higher that one rises in party leadership, the higher the dues: a top Republican committee chair is expected to pay $1.2 million, higher-up party leaders from $2.5 million to $10 million, and the Speaker, a whopping $20 million, which was no problem for Speaker Paul Ryan, R-Wis., who, according to Buck, raised $50 million.

Who provides them these extraordinary amounts? Wealthy corporate and special interest donors, introduced to the new members by leadership. These donors are more than happy to give big contributions in exchange for the control they wield. This is how party leaders use our congressmen as conduits to funnel enormous sums of money to the parties against the people’s interests.

If you don’t pay your dues, you’ve got a big problem. The leadership can get nasty. Democratic leaders have maintained a wall of shame listing those who owe dues; they have also sent collection letters and even made phone calls to “delinquent” House members.

It gets worse. Leadership promises to route dues back into key races the incumbents are at risk of losing, but if the congressman opposes the party’s leadership on a key issue – say, the recent health care bill – the party may not just withhold campaign money in the next election; they may use the war chest to fund a primary challenger.

It takes a strong person to withstand such pressure, and many don’t.

I am convinced this system is not only morally corrupt, but that it also polarizes and serves the large corporate and special interests.

The only way to change a corrupt system is to fight against it.

I am willing to stand – alone if necessary – to oppose it. But I don’t believe I will be alone. There are others in both parties who bitterly oppose this system and hate how it shackles many from doing what is right. They need help to end it.

That’s why I call on the other House candidates in South Dakota and House candidates across America to state on the record that, if elected, they will refuse to support the dues system and will vote against any party leader who does not repudiate it. And to every voter in both parties: if you really want meaningful change in Washington, vote against any candidate who declines to publicly reject the dues system.

Ending this practice won’t eliminate corporate influence in Washington, but it’s an important step. This is about a simple question: whose interests are being served in Washington? How we choose to answer it will determine the kind of America we leave for our children and grandchildren.

Published in the Argus Leader:

Net Neutrality

Net Neutrality

The Loss of Net Neutrality is Devastating for Rural South Dakota.

I spent time in December meeting with the CEO of a South Dakota telecommunications cooperative, discussing our shared vision for how rural broadband can lead the way to enhanced economic development in rural South Dakota. Broadband holds incredible potential for rural South Dakota development, allowing local entrepreneurs to market worldwide, creating new opportunities for rural South Dakota communities to serve as the sites of businesses that transact around the world, enhancing telemedicine, and allowing telecommuting in all sorts of industries as never before.

But there is at least one emerging roadblock. I have spoken at length about how Washington seems to be conducting, intentionally or otherwise, what amounts to a War on Rural America. Another chilling example of this is its efforts to eliminate Net Neutrality, the principle that internet service providers treat all content equally and not give preference to internet giants which provide digital content. Under this principle, a user can load every web site or video equally, regardless of where the content is hosted.

In December, the Federal Communications Commission [FCC] voted 3-2 to dismantle the Net Neutrality rules that were established in 2015 after widespread organizing and protests by those who advocate for a free internet. These rules required internet service providers to treat all web content equally and neither block nor prioritize some content over other content in exchange for payment. The FCC decision to repeal that rule means that the federal government will no longer regulate high-speed internet as a public utility, like phone service. The effort to eliminate net neutrality, sadly supported by our congressional delegation, is a blow to rural South Dakota, particularly because rural residents have fewer choices of internet service providers. Less competition equals higher prices.

The FCC decision was widely unpopular - more than 20 million Americans had submitted comments to the FCC opposing the change. The reason there are so few service providers is that government has essentially granted those that exist monopolies in exchange for providing universal service. But the FCC vote removes their duty to provide universal service. It treats a provider like an information provider rather than a communications provider, a characterization that inaccurately captures how we think about and treat the internet today.

Dismantling Net Neutrality will have far-reaching impacts across America, but the FCC action is a particularly powerful blow to rural America. After a decade of public investment in broadband – as rural America stands on the brink of unleashing the potential of the digital age for its citizens – this action threatens to undermine that investment. It is another example of Washington – and our own congressional delegation – turning their backs to us.

Places like South Dakota already face tough challenges concerning broadband infrastructure. Unlike urban areas, which have, because of population density seen robust investment in infrastructure and growth, the opposite has been true in states like ours. In 2016, 39 percent of rural communities lacked access to true broadband — defined as a minimum download speed of 25 Mbps — even though it is present throughout urban America. In fact, nearly 11 million American households lack any access at all to broadband, and over 45 million non-urban households have a single provider offering wired 25 Mbps speeds.

South Dakota has not shared the economic growth so much of the rest of America has experienced over the past eight years. The data shows that poor broadband equals lower population growth, weaker economic development, fewer education opportunities, lower property values, and declining home sales. Good broadband, on the other hand, is a conduit to the rest of the American economy and a shield against economic isolation that too often comes with geographic isolation.

With good broadband, people can telecommute; they can practice telemedicine, connecting patients with specialists across the nation; they can develop micro companies on the Dakota plains, use the best technological resources in agribusiness, and generally compete on a much more level playing field with the rest of the international market in a host of innovative ways. Not surprisingly, entrepreneurship soars with it. Fast broadband removes much of the impediment of geographical remoteness in rural areas.

Broadband’s potential is limitless. Except for this: ending net neutrality will also likely end the promise of rural South Dakota overcoming  its geographic and economic isolation and destroy the hope of the economic promise  broadband technology holds.

This issue is not over. Congress has the power to undo what the FCC just did under the Congressional Review Act. It should exercise that authority to pass what’s known as a “resolution of disapproval” to overturn the FCC’s regulatory vote. You can be heard by calling our congressional delegation and urge them to reverse the FCC’s Net Neutrality-killing vote. While new legislation statutorily imposing Net Neutrality is also a possibility, the likelihood is that any new legislation fail to include the favorable rules of the Net Neutrality policy the FCC just repealed.

We need an advocate for South Dakota. I will fight in Washington to restore the principles of Net Neutrality.

The Dreamer’s Act

The Dreamer’s Act

I support federal legislation to place into statutory law Deferred Action for Childhood Arrivals [DACA]. Congress needs to lead by reaching a common sense and humanitarian solution for DACA.

There are several bills to choose from. The right thing to do is to provide these children the stability all children long for and deserve. Let’s protect the children!