Milwaukee County Labor Council AFL-CIO

November 27, 2014

In The News

Walker turns his Tea Party into Mad Hatter

By Dominique Paul Noth
Editor, Milwaukee Labor Press
Posted November 30, 2012


No, I don’t think the entire Republican Party is bigoted or misogynist. But look at why so many Americans regarded them askance during the Nov. 6 election.

At a time when most Protestant denominations support contraception, the GOP nationally and in various states offered bills, talking points and platforms that so opposed abortion as to endanger all women’s reproductive rights.

At a time when Catholics preach a social justice that doesn’t stop at borders, the party offended Latinos and immigrants with insistence on electrified fences and self-deportation, costing them electoral support for the next decade.

At a time when business leaders would kill for a bargain that promised nine dollars in spending cuts for every new dollar of tax revenue, to a person their leaders turned down the idea in a primary debate, shocking hard thinkers in the financial community.

At a time when America celebrated its first African American president, GOP rallies were full of ugly slurs, caricatures of Obama as a painted Kenyan clown and rhetoric from party spokesmen labeling him lazy and, as one said recently, “catering to the underclass.”

As noted even by sometimes partisan hack and sometimes GOP statesman Sen. Lindsay Graham, if you’ve dug a hole, at least stop digging.

Some in his party have -- now that the election is over and they lost bigtime. And even some conservatives, moderates and liberals still want to think better of the Grand Old People who gave us Lincoln. The defenders now provide the excuse that the excesses were a plunge to the right to satisfy the Tea Party in the primaries. They didn’t really mean it, the argument goes. We’ll do better next time.

Oh yeah? The Tea Party contingent still rules too many statehouses, so after the election the first bills promulgated were more attacks on Planned Parenthood and voting rights, more ALEC social agenda bills, more incendiary garbage.

Stranger, many GOP governors turned from misogyny and racism into schizoid-land and a bipolar haze, announcing decisions that contradict the core Republican values of state rights and smaller federal government.

Chief among the turncoats was Wisconsin Gov. Scott Walker.

And it all centers on a law of the land, Obamacare, upheld by a conservative leaning US Supreme Court.

These governors have decided to turn wider control to the federal government and refuse any say in how their own citizens face up to their own health care costs, a violation of the purpose of state government. It’s a curious act of defiance, akin to holding your breath till your face turns blue. That’ll show them!

The big bad fed? Walker trusts them and Kathleen Sebelius to set up the crucial state health care exchange program.

Obamacare is not only legal -- it is growing in popularity. It is not government controlled but it sets priorities for providing private health companies with new customers (some 15 million at the very least and could be more depending on what happens in the Medicaid world). It speeds technological advances, increases standards of accountability and cost-cutting. It actually incorporates many ideas from Republican think tanks and emphasizes state rights. To do all this, the full law doesn’t go into effect until 2014 -- a plodding pace that may not have been wise for Obama politically but was assuredly honorable in fitting pieces smoothly. (The president still believes in a cooperative America, somewhat naively it seems.)

The GOP governors’ response? Schizo Incorporated. First, Walker turned down millions of dollars in planning money and told the feds to leave his government out, to develop the state’s Exchange program without his support.

This is the essential state lynchpin of health premium savings for the cheapest possible comprehensive health care. Now it’s up to the bureaucrats under Cabinet Secretary Kathleen Sebelius to develop the best deals for your neighbor.

Now progressives can be of mixed mind about that. Walker’s reason was ridiculous –that it would cost the state to get involved in Exchange though the US Department of Health and Human Services was mandated to offer millions of dollars in support and he was blowing off millions invested in the effort by his predecessor, Gov. Doyle.

His real reason was ego. When he said the state wouldn’t have control he meant HE wouldn’t have control. But local physicians, hospitals, legislators and health professionals had been regularly meeting for months on how to set up exchanges to save themselves money and provide better health care.

Will all that work go to waste? Not if Rep. Jon Richards has anything to say about it. Reports are that he and others are working on HHS Secretary Sebelius to incorporate all the good local work into a federal Wisconsin Exchange despite Walker’s attitude. But that depends on her generosity.

Not giving up despite Walker's bizarre obstinance, Rep. Jon Richards and others who wowrked for months on a more individualized Wisconsin Exchange are reportedly pressing HHS to incorporate their local efforts.

Basically the Exchange requires comprehensive coverage, sets reasonable income limits on who must have insurance and mainly offers comparison shopping – online and otherwise -- to find the best value that fits family needs and income. And it is portable.

At least Walker is admitting that the federal government is more efficient at this stuff than his cohorts – five of whom have now been convicted from his time as a Milwaukee county exec campaigning for governor -- as proven by how inexpensively the feds continue to run Medicare. But by refusing to partner he will cost citizens a lot of flexibility as well as financial support unless HHS goes an extra mile in innovation.

Unlike some other states where only two health providers dominate the market, Wisconsin has some 16 and prides itself on regional distinctions and personalized health services in communities. That's a lot of finesse and savings Walker will leave on the table – and it’s a flat myth that he can take the winnings back a few years from now after the feds have done the heavy lifting.

Why would they? If anything he has opened the door wider for those who want a single-payer system and a public option – another reality that must confound his Tea Party supporters.
Note how his ideological ego continues to trump good management, taxpayer savings and the cooperation government relies on.

But it is only the tip of the bipolar iceberg the GOP is engaging in. Another portion of the health initiative, and an area of important savings for state taxpayers, is Medicaid – and Walker is still threatening to hurt that.

This has long been a federal-state financial cooperation, though the state is miffed that the feds only pick up 53% of the costs and hospitals and physicians want higher payments from the whole system. So to sweeten the Affordable Health Care Act (ACA) and promote state involvement, Obama offered to expand Medicaid to some 20 million new uninsured that the states now face enormous cost burdens with, since they wind up in emergency rooms or relying on public safety nets because of lack of insurability.

Obama expanded coverage at a great bargain that states would be financially foolish to turn down (which is why most aren’t). The feds would pick up 93% of the cost. The US Supreme Court in upholding Obamacare said the states can’t be forced to take this Medicaid expansion but could so choose. So why wouldn’t you grab at such a deal? If you were told you’d get a dollar if you paid seven cents, wouldn’t you? Especially if otherwise you would have to spend the whole dollar?

These incidentally are not the poor, since many of the poor work. These are the poor plus – with a disability, an illness, a situation that prevents employment. Many on Medicaid are elderly who never qualified for Social Security/Medicare but depend on Medicaid and nursing home help to survive.

Listen to the respected Kaiser report: “Combined with greater private coverage, Medicaid expansion would result in a large reduction in the number of uninsured people, and fewer unpaid medical bills that raise costs for taxpayers."

If you look at a map of the US, the states turning down this expanded help smack of re-fighting the Civil War. It’s mainly a few states in the deep South. Will Walker make us Mississippians? He is balking, and may balk until February, though he knows that refusal leaves the state taxpayer on the hook to pay the full freight through the most expensive, least efficient means.

Here’s a further whammy. The business community wanted the state to get involved in the Exchange and definitely in the Medicaid expansion. The new Obamacare rules actually mean the money goes to the people not the institutions, to the best programs hospitals and providers develop for expanded Medicaid. Smart hospitals know this is a game-changer. It not only avoids bankruptcy but opens the door to flourishing with fresh clients. Companies can use the new health rules to more effectively cover employees.

So they pushed Walker behind the scenes for cooperation, from the WMC to the MMAC to the hospital and health insurance lobbies. They are still quietly pushing for the Medicaid expansion though they lost on Exchange.

It seems if he disappoints them there, they will gulp and just go along. After all, he is their golden boy, or golden retriever.

Clearly it is not only the GOP that is suffering Mad Hatter dysfunction.

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