I'll try to be brief. Your early days in Congress, you responded to constituent taunts about seven years of 'repeal and replace' rhetoric by pointing us to some sketchy talking points published by the Speaker's office. You now embrace the Freedom Caucus approach to health care, and have spoken publicly on their behalf. I'd like to impress on you a third way, the same way I expressed to Tom Perriello during the crafting and enactment of the ACA. Let me first state that I don't believe that the ACA has any insufficiencies that can't be attributed to GOP sabotage.
I've stated on Twitter to you and Rep Brat of Virginia's 7th district my objections to the anti-federalist erosion of the regulatory authority of the several states; the diversion of financial capital from investment to predation; and the frank refusal to legitimize and make provision for medical necessity as a public obligation of hospitality to others. All appear to be features of the Freedom Caucus approach. One that keeps coming up, for decades now, is the erosion of the sovereign capacity of the People as exercised by juries.
Prior to the ACA, medical emergencies large and small could be presented to certain hospital emergency rooms (and still can) with an assurance of appropriate treatment. This assurance is subsidized by providers, insurers, and governments, and ultimately by individuals in cost of services, premiums, and taxes.
I think we can agree that this last resort safety net of the emergency room is the least efficient place to effectuate a public guarantee of care. Despite crowd reaction to hypotheticals addressed in the 2012 Republican debates, turning people away is not an option. If you believe it is an option, just come out and say it. I assure you, the people of the Fifth district will take umbrage. The alternative is a system of care that promotes wellness, promotes relationships with providers, has multi-tiered service capacities appropriate to needs, and stops giving thousand dollar care to fifty dollar concerns.
What does all this, preserves the sovereignty of states and citizens, promotes responsible use of personal savings, and incentivizes cost containment and innovation? Look to Nelson County for some answers. I'm certain other localities in our Fifth district, in Virginia, and nationwide have similar exemplary public health providers. Embrace that service model. As far as where subsidies come from -- fellow patients, fellow policy holders, or fellow residents, such is a matter of political values and interests. We all want others to pay disproportionately. I don't much care how that allocation is made. I'll do my share. I do care when the result of those deliberations constrains juries, state and local governments, financial stability and justice, individuals in need of medical attention short of crisis, and competing models of care. I believe the Freedom Caucus formula threatens these and more fundamental American values.
I did try to be brief. Sorry. I'll close briefly by stating that subscription-style wellness services appear to me to be a service model by which state and local governments in partnership with the medical community can provide means-adjusted subsidized care and walk-in urgent care. Medical catastrophe remains a concern. Whose, I don't know, but wellness emphasis should lessen the instance of catastrophe and facilitate more efficient response. Think wellness. Legislate wellness. I've shared my views. I'm sure you will continue to share yours and hope several large venue town halls will be one means of sharing. The only personal response I'd request is your prepared constituent response to ACA related queries, by email or snail mail, as suits your operation.
Wednesday, March 15, 2017
Wednesday, March 1, 2017
Open letter to Rep Tom Garrett, re: Defense Budget
I look forward to bringing you a milkshake at your Charlottesville town hall meeting. I'm writing today about what I think is a shared concern about the debt burden our generation has placed upon generations to follow. Personally, I'm no opponent of debt incurred to obtain productive assets. I assail recurring and deepening debt incurred to live beyond ones means. Vague hopes of better days to come (unrealistic economic growth projections) defer today's assessment of what can be done without.
The Clinton presidency and Contract-With-America Congress brought an investment ethic to government functions. Money spent now on education and infrastructure, for instance, was expected to produce an ROI in reasonable (not fantastic) projections of consequent prosperity. Here, I decry the Tea Party/Freedom Caucus/Norquist ethic that Government has no right to reap what is sown. Sowing to the wind is as likely to squander itself in military boondoggle as in public sanitation, perhaps the archetypical function of good government. Trump seems to decry the denial of harvest of spoils (keep Iraq's oil) from the West Asian strife sown in the wake of the 9/11 attacks. All in all, it's been a bitter harvest there. Why? Posterity will ponder all that, as they imagine what more enlightened investments might have produced. Alternatively, posterity might imagine what worse might have come their way had our West Asian adventures not happened, while continuing to pay the bill.
In contrast to Norquist, whose pledge I hope you did not sign, Laffer (high priest of Voodoo economics) believed in the legitimacy, indeed the centrality, of government seeking to maximize (and wisely employ) revenue. I'm of the opinion that most revenue sources are to the left side of the Laffer Curve, though some economic activity and consequent revenue might respond favorably to tax reduction. In contrast I fear that Norquist and perhaps you either regard tax reductions to either universally enhance revenues or to be an intrinsic good that government be starved of revenue, despite diminished well being of the body politic. Nihilists, anarchists, objectivists, or whatever you call them believe the worthy will rise above the American carnage in an insolvent government's wake. That kind of ethic counts Escobar and Aidid among the worthy, not so much John Galt and Howard Roark of fairy tale fiction.
If Virgil Goode and Robert Hurt recall any of my emails to them, I thing of these long prefaces as a common feature. I eventually get to the point. The very point I expressed in a recent Tweet. Consider the effects of your budgetary decisions upon the well being of our grandchildren's grandchildren. Consider outlays as either a frivolity that does not justify the debt we pass on, as an investment in a more safe and prosperous future, as an obligation incurred by past sacrifice, or as a recurring activity of current net benefit to the body politic.
I'm not writing with specific instructions, except that defense expenditures appear to be of more political than productive value, with dubious, even negative expectations of beneficial outcomes. I believe that the Constitution calls not for quadrennial defense review, but explicitly for biennial review, and that such a review, with explicit consideration of the recurring value of such things as readiness and deterrence against credible threats and of the investment value of innovations and expeditions, is necessary for a proper defense authorization and associated budget. I believe that a properly considered military budget would be a considerable reduction from historic level, but don't expect that you would agree. I do expect that you agree to the need for proper consideration as a basis, and not the demagoguery of an impulsive Executive. Insist on the Constitutionally mandated biennial defense review prior to any authorization of programs or allocation of funds. I expect a response from you sharing upon what basis you are guided in considering outlays for National and Homeland Security.
The Clinton presidency and Contract-With-America Congress brought an investment ethic to government functions. Money spent now on education and infrastructure, for instance, was expected to produce an ROI in reasonable (not fantastic) projections of consequent prosperity. Here, I decry the Tea Party/Freedom Caucus/Norquist ethic that Government has no right to reap what is sown. Sowing to the wind is as likely to squander itself in military boondoggle as in public sanitation, perhaps the archetypical function of good government. Trump seems to decry the denial of harvest of spoils (keep Iraq's oil) from the West Asian strife sown in the wake of the 9/11 attacks. All in all, it's been a bitter harvest there. Why? Posterity will ponder all that, as they imagine what more enlightened investments might have produced. Alternatively, posterity might imagine what worse might have come their way had our West Asian adventures not happened, while continuing to pay the bill.
In contrast to Norquist, whose pledge I hope you did not sign, Laffer (high priest of Voodoo economics) believed in the legitimacy, indeed the centrality, of government seeking to maximize (and wisely employ) revenue. I'm of the opinion that most revenue sources are to the left side of the Laffer Curve, though some economic activity and consequent revenue might respond favorably to tax reduction. In contrast I fear that Norquist and perhaps you either regard tax reductions to either universally enhance revenues or to be an intrinsic good that government be starved of revenue, despite diminished well being of the body politic. Nihilists, anarchists, objectivists, or whatever you call them believe the worthy will rise above the American carnage in an insolvent government's wake. That kind of ethic counts Escobar and Aidid among the worthy, not so much John Galt and Howard Roark of fairy tale fiction.
If Virgil Goode and Robert Hurt recall any of my emails to them, I thing of these long prefaces as a common feature. I eventually get to the point. The very point I expressed in a recent Tweet. Consider the effects of your budgetary decisions upon the well being of our grandchildren's grandchildren. Consider outlays as either a frivolity that does not justify the debt we pass on, as an investment in a more safe and prosperous future, as an obligation incurred by past sacrifice, or as a recurring activity of current net benefit to the body politic.
I'm not writing with specific instructions, except that defense expenditures appear to be of more political than productive value, with dubious, even negative expectations of beneficial outcomes. I believe that the Constitution calls not for quadrennial defense review, but explicitly for biennial review, and that such a review, with explicit consideration of the recurring value of such things as readiness and deterrence against credible threats and of the investment value of innovations and expeditions, is necessary for a proper defense authorization and associated budget. I believe that a properly considered military budget would be a considerable reduction from historic level, but don't expect that you would agree. I do expect that you agree to the need for proper consideration as a basis, and not the demagoguery of an impulsive Executive. Insist on the Constitutionally mandated biennial defense review prior to any authorization of programs or allocation of funds. I expect a response from you sharing upon what basis you are guided in considering outlays for National and Homeland Security.
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