Affordability in politics is obviously a new concept for Republicans to understand

Echo opinion published in The New York Times by Jarod Bernstein:

Fixing Affordability

Today, the most important word in politics and economics is “affordability.” Americans want it, and political candidates attack incumbents for failing to provide it, but economists grumble that the government can’t deliver it. 

Political commentators warn that candidates who exploit Americans’ frustration with high costs risk quickly losing public support if they enter office and fail to help, as has happened to Donald Trump.

The naysaying economists and commentators are right, if “affordability” means cutting prices across the board. 

Only a long and deep recession can reduce prices on most goods and services. But,

 Americans still want prices to drop. They won’t be satisfied to hear that the rate at which prices are rising — inflation — is lower.

Fortunately, politicians can embrace a more realistic affordability agenda defined by two simple criteria: First, it is focused on a narrow set of essential, big-ticket items that define the affordability problem for many consumers — including child care, housing, health care and electricity. Second, it highlights how these essentials are unnecessarily expensive because the markets for them are flawed in some way.

For most of what we buy, markets work well, and government price setting would do more harm than good. Though food production could benefit from more competition, there is not much the government can do about grocery prices, for example (obviously, reversing Republicans’ recent cuts to food support would help low-income families).

The market for child care, however, doesn’t work well. In the most expensive counties, child care can cost more than $20,000 a year, a burden for even relatively high-income families. 

Those who need it most, young parents, often don’t earn enough to prompt the market to supply plentiful quality child care. 

Consequently, unless a young family is uniquely wealthy, the government must subsidize their child care purchases. 

Recent research reveals that robust public investment in the child care sector quickly elicits new supply, and new supply restrains price growth.

Housing is also essential but undersupplied. About a quarter of homeowners and half of renters spent more than 30 percent of their gross income on housing in 2023, according to the Congressional Research Service. Government policies have warped the market. Zoning rules and other regulatory sludge discourage developers from building affordable homes. Tariffs are raising the cost of building — adding, by one estimate, nearly $11,000 to the construction cost of the typical home. The government needs to boost the supply of affordable housing, fast.

A new plan from the Center for American Progress that I helped write argues that the federal government should use its leverage to encourage undersupplied communities to finance new affordable multifamily housing, expand the production of modular housing and scale up existing local programs that are eliminating barriers to affordable home building.

The emphasis on increasing the housing supply is crucial. If the government just gave money to people to buy or rent homes, the result of more money chasing the same number of units would be just higher prices.

Much of the same logic applies in our broken health care market. The government plays a huge role in this market through the Affordable Care Act (ACA), Medicare, Medicaid, the Children’s Health Insurance Program, drug negotiations and more. These programs enable millions of people to get health care they otherwise couldn’t afford. But people and the government still pay too much.

America's health system is twice as expensive as those of our international peers, suggesting that the government could spend less and consumers could pay less — though many with their hands in the U.S. health-care cookie jar would earn less. 

As the Stanford University economist Neale Mahoney and I recently argued, that would require loosening rules that restrict the supply of medical professionals, capping hospitals’ and doctors’ charges, lowering the Medicare eligibility age and allowing federal agencies to negotiate lower prices on many more drugs.

The market for electricity, too, is highly regulated and often fails to prioritize consumers. Electricity costs were essentially flat for the five years before the Covid-19 pandemic, then climbed about 40 percent between 2020 and 2025. Politicians are starting to run, successfully, on capping electricity rates and forcing energy-gobbling data centers to pay more of the costs of adding them to the grid. Reversing Mr. Trump’s drive to halt the building of renewable energy projects would also help. Despite his efforts to pull the plug, renewables are, by far, the fastest-growing and least expensive sources of increased supply.

Each of these ideas are realistic:

• providing young parents with the resources to afford quality child care, 
• increasing the supply of affordable housing, 
• capping health care costs, 
• expanding the supply of clean energy enough to lower electricity bills 

So, in summary, the political party that promises and delivers on this agenda would position itself at that all-too-rare intersection of good policy and good politics.

Maine Writer- Obviously, Donald Trump tries (but failes) to talk the talk but the word "affordability". Yet, the word itself is difficult for him to pronounce and he has no idea what "groceries" means because he never shopped for anything with that name.  He has failed to deliver on his campaign promise to lower prices "on day one". Trump lied about anything he could concoct to get elected, including, by the way, claiming that Mexico would pay for his big ugly immigration wall along the U.S. southern border.   

Too few nurses to hire: hospitals are maxed out and staffing ratios will harm access to care

Mandated staffing ratios may not solve the complex issues facing hospitals and nurses.  Echo editorial opinion:

As the Bangor Daily News Editorial Board talked to nurses who support legislation to mandate staffing ratios and a representative of hospitals, which oppose the bill, a system in crisis was agreed on.

As people have become sicker, and mental health and substance use disorder needs go untreated, hospitals — particularly emergency rooms — have become increasingly dangerous and unpleasant places to work.

Both groups agree that this crisis needs immediate attention. They also agree more nurses are needed in hospitals and other health care settings. They disagree on how best to accomplish this.

The Maine State Nurses Association supports LD 1639, which would mandate specific ratios of registered nurses to patients. For example, one-on-one care would be required in operating rooms and intensive care units. Nurses could care for four patients receiving pre-surgical and rehabilitative care.

The bill is sponsored by Senator Stacy Brenner, D-Scarborough, who worked as a nurse-midwife.

“The bill … accomplishes two primary goals: increasing patient safety and encouraging nurse retention,” she said in a press release.

“The care and touch of a knowledgeable and dedicated nurse in those times when you are feeling most vulnerable greatly increases patient satisfaction, dignity, and the overall perception of their hospital experience,” she added. “This is a bill for everyone. But, most especially, this is a bill for bedside nurses.”

Brenner (who was a midwife) and other nurses spoke about their increasing frustration with working long, and sometimes unpredictable hours, while worrying that their patients were not getting the care they need and deserve.

This stress is understandably wearing on nurses, prompting many to leave the profession.

This situation is unsustainable, Cokie Giles, who has worked as a nurse at Northern Light Eastern Maine Medical Center in Bangor for 34 years, told us. There is not a nurse shortage, Giles, who is the president of the Maine State Nurses Association, told us. Rather, there is a shortage of nurses willing to work under current conditions.

And here is the crux of the problem. While studies have found that patients have better health outcomes when nurses care for fewer patients, there are, unfortunately, economic and human resource realities to consider.

There are already 1,500 nursing vacancies, according to Jeff Austin of the Maine Hospital Association. The association estimates that another 1,000 nurses would be needed to meet the standards in Brenner’s bill.

We are skeptical that requiring fewer patients per nurse will solve the many reasons driving people to leave the nursing profession or choose not to work in hospitals. Many nurses now work as traveling nurses, which typically pays more than being on staff at a hospital, or work in medical offices that don’t have the stress and chaos of a hospital, which must take any patients that show up at their door.

At a time when Maine already has a nursing shortage, we are concerned this bill would make the situation worse without addressing the underlying causes of worsening conditions in hospitals in Maine, and across the country. This could mean that hospitals would have to close units and deny care if they couldn’t hire enough nurses to meet the mandates in LD 1639. This could be one reason that no state, except California, has adopted broad nurse staffing ratios like these. Massachusetts has mandated nurse staffing ratios for intensive care units.

Without more mental health beds, for example, too many patients are spending time — often weeks or even months — in hospital emergency rooms. This is horrible for the patients and the medical care caring for them. Solving problems like this requires a much larger commitment — namely funding — from the state to grow the availability of mental health services.

This is just one of the significant and complex issues facing hospitals. That is not to say that hospitals, and other medical practices, should not invest more in improving working conditions. They (hospitals) cannot, however, hire more workers if those workers don’t exist.

Donald Trump motivates his cult by fear - echo from Illinois

To the Editor of the Northwest Herald, an Illinois newspaper:

Donald Trump ran for president to bolster his business interests.

He never intended to win and actually be president. Once elected, Trump never intended to help people or promote democracy, as all of our previous presidents did. His only intention is to flatter his base into reelecting him. Tactically, that requires him to suck up headlines so that his base is not exposed to contradictory ideas or approaches.

He is so lacking in original ideas that his most recent tactic is to announce outlandish, fear-based actions, then back down before returning to the outlandish position. That way, he can consume an exponentially higher amount of air time over a longer period with only one issue.

Most importantly, he knows his supporters are motivated by fear. All of his propositions are based on fear, which necessitates misinformation and lies. His supporters do not know or seem unconcerned that their options for health care are disappearing (both in facilities and affordability); that consumer and employee rights are evaporating; that he is destroying the viability of family farms; that government benefits are decreasing; or that regulations concerning safe food, air, water and drugs are disappearing.

Unfortunately, the main job of the media has changed. It no longer can rely on reporting the daily happenings.

The electorate desperately needs the media to report what is not announced – the changes being made to the social safety net; environmental safety; workplace and worker safety; drug and food safety; and the fact that his new United States-Mexico-Canada Agreement forever bans consumer or government interference with drug prices, to name a few.

Cece Drazek in Marengo, IL

Conversations- open to being completely "wrong": an economist view

I'm a nurse, not an economist. Therefore, my opinion about Bill Kristol's video discussion about economics was written from my consumer's point of view. Indeed, I learned something.
Okay, I took the advice of respected conservative pundit Bill Kristol. In fact, I listened to the 90 minute video conversation with his expert economics friend Irwin Stelzer, who spoke eloquently about how economic theories impact on modern issues of the day. As a registered nurse, I appreciated their discussion about health care, although it was only a small segment of the conversation. Moreover, I learned about how one academic economist processes information. Here are my take aways from this interesting conversation:

Dr. Irwin Stelzer, an economist, in conversation with conservative pundit Bill Kristol

I was impressed by the concept of "being wrong".  Dr. Stelzer spoke about how the polarizing political arguments - particularly those embroiled with climate change - have the philosophical potential of being completely wrong.  He was not advocating in support of climate change theories or against those who deny the concepts.  In fact, he abhors the use of the word "climate change denial" because it conjures up the horrible images of Holocaust denial, a disgusting relationship albeit unintentional. 

Nevertheless, the presentation about the possibility that climate change denial might be "totally wrong", was an interesting discussion. In his economics argument, he said it's possible that those who fervently believe in climate change as absolutely true, could also be wrong.  In other words, if one side or the other are totally wrong, and in the philosophy of "all things are possible", this is highly probable, then how do these opposing factions reconcile their errors?  If I understood Stelzer, his concept about being totally wrong regarding climate change means that those who deny the theory must accept the fact that they might be wrong. In so doing, they must evaluate to what degree they are willing to accept any possibility that climate change is real? As I understand this argument, Stelzer might advocate for the denial group to at least acknowledge that ice caps are melting at an accelerated rate and this could be the result of human interference in the environment.  This doesn't mean they accept the advocates for climate change theories because, frankly the proponents of climate change don't have very much data to demonstrate their position is totally right, either. What is most probable in this economic conundrum (my word, not his) is that there are risks and opportunities in the acceptance of "climate change theory". For example, people in Canada might embrace the possibility of warmer temperatures while coastal communities must accept the risk of losing their generational ways of living, as sea levels rise.  (Although this seems too simplistic, especially coming from a learned economist, the acceptance of inevitable change and human capacity to adapt  are "evidenced based outcomes", a health care concept.) Stelzer recommended a carbon tax to accommodate the proponents of climate change and thereby relieve the responsibility for deniers about their opposition, in the event the advocates are totally right. (Hmmmm....An interesting theory....) In effect, the carbon tax would be a way to build an economic incentive to buffer the potentiality of climate change being real.

Dr. Stelzer spoke eloquently when he discussed economic inequality. He is worried about how compensation for working is losing it's correlation to the quality or integrity of the job.  He used the example of a T-shirt salesman who works hard, does all the right things, sells T shirts at a competitive price but then his competitor goes to China to buy the same design much cheaper and, thereby, takes all the business. Sadly, the hard working T-shirt salesman is not compensated for doing what was right and fairly competitive, while the person who undersold the costs used unfair trade policies to take his T-shirt rivals livelihood.

Yes, the conversation between Kristol and Stelzer was laced with not too subtle references about their mutual opinion regarding Donald Trump's leadership.

Although this conversation with Bill Kristol and Dr. Stelzer was educational, my summary of the discussion was this:  America will survive climate change theory and, by extension, endure the leadership of Donald Trump.  It's just a shame we must all suffer the philosophical agony of this era, before reaching this conclusion.

Some quotes from this discussion:

Stelzer: "...think about...healthcare...We are going to get it wrong. When you are trying to guess how many millions of people are going to respond to what kind of policy, we’re going to get it wrong. So the question is, which is the least costly error we can make?"

Kristol asks:  "you are a very strong advocate for a carbon tax, which is a favorite of a lot of the environmentalists. People sort of say, 'Well how could he be both? I thought he – he seems like a climate skeptic and then he is for this carbon tax'."

Stelzer responds:  "(If we)..don’t agree with them 100 percent, you are a 'denier'. And I hate that term, because it comes out of the Holocaust. It’s a terrible term. And I have told them that and they keep using it. So, you say, okay, I don’t like these people. But nevertheless, I've got to look at what they say."

"And it doesn’t look to me like what they are saying is plausible – that the world is going to come to an end – especially since that’s an invitation for more government. So the people who are doing it have an incentive. You have always got to look at what the incentive is of the person who is making the position. And so his incentive is to expand government, and naturally...regulation."

"So then you say to yourself, well, but I could be wrong. Now let me see, if I’m wrong and the globe heats up, that’s not a reversible error. That is an error. You can’t buy a fan and cool the globe down – you’re done. So, maybe I am wrong. They think they’re right, they know they’re right. I think I am right, but I am not sure I am right."

So then the question is, what policy is appropriate that will do the least damage if I am wrong? Well, we should do something as costless as we can to reduce emissions, in case they are being generated by human behavior. Well, what is the most efficient way to do that? Now, there, an economist can be helpful..."  

Check out this entire transcript at the link here.

Maine health care providers standing behind affordable coverage

A long and growing list of health care providers are going public with our support for the coverage provided to our patients through the Affordable Care Act (ACA) or Obamacare.  We support public health policy initiatives to expand access to health care for everyone.

In spite of repeated and expensive efforts by Republicans in Congress to repeal this insurance coverage, the beneficiaries continue to enroll regardless of how many obstructions have been thrust in the way of access to the insurance.  

Nevertheless, like ghouls consumed in a cauldron of "repeal mania", the Congress continues to work towards repeal of the Affordable Care Act as well as privatization of Medicare and Medicaid. These regressive harmful health care initiatives are obstructing access to quality care, denying providers compensation but being debated without the consent of benefices who pay for the coverage. In Maine, a coalition of Maine Providers Sanding Up for Healthcare published an open letter to Senator Susan Collins and MaineWriter was among the signers.

Here is the response from our coalition leaders:
To all the signers of the ACA letter to Senator Collins

(Maine Providers Standing up for Healthcare)
Thank you so much, all of you, who signed on to the ad/message to Senator Collins. We got a lot of acknowledgement and coverage for our stand. We have to hope that the momentum toward quick repeal is slowing as folks realize how difficult developing a replacement for the ACA would be.

Thank you, too, for those who were able to contribute to the cost of the ads. We had impressive half page ads in the papers in Portland, Augusta, Waterville and Bangor. All together that cost slightly over $7000. With donations that came in Friday, we have recouped all of that and gone just a little over. So those of you who have not sent in donations, save it for the next issue.

The question is what next??? (We are asking...) but don’t know how to create a platform/ Blog/list serve that we could use to communicate and discuss if and when and how to use our voices again to influence decisions made that affect our patients. If one of you can do this, it would be great.

Upcoming challenges to our patients’ health include:- ACA repeal -no coverage for preexisting conditions, throwing 32 million people off individual policies purchased on exchanges, etc.

- Medicaid block grants and other Medicaid cuts, including CHIP

- Women’s health threats – loss of parity in insurance (no coverage for contraception or maternity care), unfunding of Title X and elimination of all family planning programs, eliminating Medicaid payments to providers who also perform abortions (Maine Family Planning and Planned Parenthood), and, of course, reversal of Roe v Wade

- Decreased coverage for Behavioral Health and Addiction

- Very high deductible plans which will essentially preclude the poor from coverage for chemotherapy, chronic care, etc.

- The threat of turning Medicare into a voucher system. With Price (in the dead of night) approved for HHS Secretary, we’re in for a real fight!

- And more!  (Let's include the privatization proposed for Veterans Health Care!)

Maine Writer is proud to be among this esteemed health care coalition and in support of their worthy causes to protect health care for all.

So let’s keep the conversation going. There’s so much to do. And, in the words of Barack Obama (remember when we wanted to quote a President?) “…we can afford neither complacency nor despair”.  (From Connie and Peter) Thank You!

Progressive versus Regressive Politics - Expressive Names Describe Political Divisions

Americans, indeed, most of the world's citizens, are familiar with the polarizing divide between our United States political parties. Democrats are perceived as being "liberal" (whatever that means) and as being different from Republicans, who are perceived as being conservative (whatever that means).  Same old same old.

A newly oriented political observer would need a dictionary and thesaurus to figure out what each party label means.

That's why I'm suggesting we modify the names of political affiliations to either Progressive or Regressive, rather than Democrat or Republican.  One way moves us forward, while the other is a retrofit to policies that have been tried before.

But, nevertheless, a person can be progressive about taxation, for example, while regressive about funding women's access to contraception, for example. These and other unrelated political topics (why women's health is political is beyond me, but, for many, this is the case) could then be sorted out by individuals, rather than party affiliations. 

In fact, the Pro-Reg labels might even have the value added of being educational for people who might be conflicted about where they fall on the political "left" (liberal) to "right" (conservative) spectrum. At the end of this exercise, we can each evaluate where we want to fall on this spectrum.

Let's make two columns:

Progressive 
favoring or advocating progress, change, improvement, or reform, as opposed to wishing to maintain things as they are,especially in political matters: a progressive mayor

Regressive
 obtained from or characterized by backward reasoning

Progressive                                         Regressive                    
Taxation

Supports revenue sharing                       Supports tax cuts for rich
Supports graduated tax system               Hall-Rabushka flat tax   

Women's Health

Supports women's access to health         Contraception should not
care including right to contraception       be government funded

Access to Health Care

Supports universal coverage for              Supports free market
preventative and illness care                   who  pays gets the care

Immigration

Supports path to citizenship                     Severely restricts path to 
for all immigrants                                     citizenship for illegal
                                                                 immigrants

Second Amendment Rights- a Constitutional amendment ratified in 1789

Supports some regulations for the right    Supports everyone
to own military assault multiple                including immigrants
ammunition clip weapons                         owning any guns, of any
                                                                  kind for any purpose

Voting Rights

Every American citizens must                   American citizens
have the right to vote,                                must prove they
one person : one vote                                 have the right to vote
and the opportunity to                                based upon 
execute this                                                inconsistent state
inalienable right in                                      promulgated criteria
an efficient and timely
manner

This is an abbreviated list of the Progressive-Regressive spectrum issues, but you can easily get the gist.

In summary, it will be difficult for people of intellect to submit to being Regressive when the Progressive point of view is clearly the position of enlightenment.  

If America is to progress in the enlightenment set forth by our esteemed Founding Fathers, we must block the Regressive movement.  A two party system needs Progressives on both sides of the political spectrum, especially when the Regressives are clearly obstructing our advancement as a civilized nation.

So, let's now describe Democrats and Republicans as both being progressives if we can focus on:

•  a future where equal opportunity is available to everyone, regardless of citizenship status; 
• where voting rights are respected for all American citizens ages 18 and older; 
• where the tax policy is benevolent to the poor and fair to the middle class; 
• where quality and affordable health care is available to all;
• and the Second Amendment is amended to protect innocent people from preventable gun violence.

Let's remove party labels and, instead, subscribe to all of the above.

That's progress!