Category: Injustice Anywhere is a Threat to Justice Everywhere, MLK jr

The New York Times – Opinion

Wonking Out: Inequality, Mortality, Medicare and Social Security

Paul Krugman – November 4, 2022

My Thursday column is about the assault on Medicare and Social Security that is almost certain to follow if Republicans prevail on Tuesday. If the G.O.P. wins control of Congress, we can expect it to hold the economy hostage, most obviously by weaponizing the debt ceiling, in an attempt to force big cuts in Medicare and Social Security.

This isn’t an outlandish scenario. It already happened once. In 2011, after taking control of the House, Republicans sought to extort major cuts in the social safety net from the Obama administration — and they almost succeeded. In fact, President Barack Obama agreed to a rise in the age of Medicare eligibility, from 65 to 67. The deal fell through only because Republicans were unwilling to accept even modest tax increases as their part of the bargain.

This time around, the demands are likely to be even bigger. A report from the Republican Study Committee, which probably gives a good idea of where the G.O.P. will go, calls for upping the retirement age and the age of Medicare eligibility to 70.

The report justifies such a rise by pointing to the long-term increase in the number of years Americans can expect to live after age 65, which it calls a “miracle.”

What the report doesn’t note are two probably related caveats for this miracle. First, the increase in seniors’ life expectancy has actually been much smaller here than in other wealthy nations. Second, progress has been very uneven within America, with much bigger gains for groups with high socioeconomic status — precisely the people who need Medicare and Social Security the least — than for the less fortunate.

Let’s talk first about America’s lagging performance.

In the 2000s, as Democrats were nerving themselves up for another push on health care reform — a push that culminated in the Affordable Care Act — I would frequently encounter people who asserted, not having checked the numbers, that the United States had the world’s highest life expectancy. Not by a long shot. I don’t know how many people still believe that, but my sense is that relatively few Americans are aware just how badly we’ve fallen behind.

Much of America’s shortfall in life expectancy reflects factors that apply only or mainly to the nonelderly: high infant mortality, high rates of shootings and deaths in traffic accidents. Even among seniors, however, we have lagged ever further. Here’s a comparison of life expectancy at age 65 in the United States and France since 1980.

What explains older Americans’ tendency to die younger than their counterparts abroad? It’s not, for the most part, their inability to pay for health care in their later years. For now, at least, all Americans 65 or older are covered by Medicare, a universal, single-payer system, although it doesn’t cover everything, and many seniors still have trouble paying for medical necessities.

So what’s the problem? Inadequate health care earlier in life surely takes a toll, but more broadly, our high mortality probably reflects our society’s extreme inequality — not just in income but also in status, perceived economic opportunity and more. Americans on the losing side of high inequality have trouble affording health care and adequate nutrition; they are also, all too often, demoralized by their position, leading to deaths of despair and unhealthy lifestyles that take a toll over time.

That Republican report calling for Medicare and Social Security cuts mentions “inequality” just twice — both times in footnotes citing articles claiming that government antipoverty programs make poverty worse. That’s only to be expected: Conservatives tend to bristle at any mention of inequality and class, often denouncing anyone who even raises the issue as Marxist.

Yet progress in raising life expectancy has been extremely unequal among income groups. Here are widely cited estimates from Dana P. Goldman and Peter R. Orszag of likely life expectancy at 65 for American men born in 1928, 1960 and 1990, broken out by wage quartile — that is, which quarter of the wage distribution they were in while working. (The numbers for women are similar.)

Life expectancy has been rising much more for relatively affluent Americans than for the less well off.

It’s not necessarily income per se that is driving these disparities. To some extent, it could reflect other factors that are correlated with income, especially education. Anne Case and Angus Deaton, who famously pointed out the rise of deaths of despair, have shown that mortality for adults — surely including adults over 65 — has been rising for Americans without a college degree but not for those with one.

And there’s also a strong regional element. Woolf and Schoomaker show that overall life expectancy, probably reflected among seniors, too, has diverged between lagging heartland states and coastal states, part of a trend of rising regional disparities as the knowledge economy has favored large metropolitan areas with highly educated work forces.

Here are estimates of life expectancy at birth — again, most likely closely correlated with life expectancy at 65 — for some selected states:

The numbers in parentheses are each state’s rank in 1959, 1990 and 2016. The rise of New York is striking; so is the relative decline of Oklahoma and Kansas, both of which had higher life expectancy than New York as recently as 1990.

How does all this bear on Republican proposals to raise the retirement and Medicare eligibility ages? Because seniors’ life expectancy varies so much by class, an increase in the age of eligibility for major programs will take a much bigger bite out of retirement for Americans with low socioeconomic status, and correspondingly fewer years to collect benefits, than it will on those higher on the ladder.

And because disparities have been rising over time, the disproportionality of that effect has been rising, too.

Look back at the figure on life expectancies by quartile. According to these estimates, American men in the bottom quartile born in 1960 can expect to live only 1.9 more years after 65 than their counterparts born in 1928. That’s slightly less than the increase in the retirement age that has already taken place. And even men in that quartile born in 1990 are expected to have only 3.5 years more time after 65 than those born in 1928; meanwhile, Republicans are proposing a rise in the retirement age to 70, a five-year total increase, and an equal rise in the Medicare age.

One way to think about all of this, which is only a slight caricature, is that Republicans are telling janitors in Oklahoma that they can’t get benefits in their 60s — even though their life expectancy hasn’t gone up by much — because lawyers in New York are living longer.

It’s quite a position to take, and it would surely provoke a huge backlash — if voters knew about it, which most of them seem not to.

Paul Krugman has been an Opinion columnist since 2000 and is also a distinguished professor at the City University of New York Graduate Center. He won the 2008 Nobel Memorial Prize in Economic Sciences for his work on international trade and economic geography.

The New York Times

This Is What Happens When Republicans Tear Off Their Masks

Opinion – Jamelle Bouie – November 4, 2022

Even by the degraded standards of 2022, it has been shocking to watch Republican politicians and conservative media personalities respond to the brutal attack on Paul Pelosi — Speaker Nancy Pelosi’s husband — with lies, conspiracymongering and gleeful disregard for the victim.

Glenn Youngkin, the Republican governor of Virginia, made light of the assault — which left the 82-year-old Pelosi hospitalized with serious injuries — while campaigning for Yesli Vega, the Republican running to unseat Abigail Spanberger, the Democratic representative in Virginia’s Seventh District.

“Speaker Pelosi’s husband, they had a break-in last night in their house, and he was assaulted. There’s no room for violence anywhere,” Youngkin said, in what appeared to be a straightforward condemnation of the attack until he added, to the cheers of the crowd, that “we’re going to send her back to be with him in California.”

“That’s what we’re going to go do,” he continued. “That’s what we’re going to go do.”

Kari Lake, the Republican nominee for governor of Arizona, used the attack on Pelosi — who underwent surgery to repair a skull fracture after he was struck on the head with a hammer by his assailant — as fodder for a joke.

“Nancy Pelosi, well, she’s got protection when she’s in D.C. — apparently her house doesn’t have a lot of protection.” According to Kate Sullivan, a CNN reporter, the joke landed: “The crowd burst into laughter, and the interviewer was laughing so hard, he covered his face with his notes.”

The crucial midterm elections

Republicans seem to be surging heading into November, with Democrats struggling to break through, as voters turn their focus from abortion to crime and inflation. Even if the polls are as off, as pollsters fear, all signs seem to be pointing toward a strong showing for the G.O.P.

For months now, Times Opinion has been covering how we got here. Chloe Maxmin and Canyon Woodward argued that Democrats abandoned rural America. Alec MacGillis traced how the party ignored the economic decline of the Midwest. And Michelle Cottle described the innovative Republican ground game in South Texas.

Opinion has also been identifying the candidates who could define the future of their party. Sam Adler-Bell captured the bleak nationalism of Blake Masters, the Arizona Republican challenging Senator Mark Kelly. Christopher Caldwell described the transformation of J.D. Vance, the venture capitalist from Ohio who went from Trump critic to proud member of the MAGA faithful. Michelle Goldberg traveled to Washington state to profile Joe Kent, a burgeoning star on the right.

And throughout this election cycle, Opinion has held discussions with groups of experts – hosted by Frank Bruni, Ross Douthat and others – that have followed the season’s twists and turns, from reviewing the primary landscape to a Democratic backlash against the Dobbs decision which gave way to a Republican surge in the fall. And we paused to consider the mysteries of polls and the politically homeless along the way.

In a now-deleted post on Instagram, where he has more than six million followers, Donald Trump Jr. shared a photograph of a hammer and a pair of men’s underwear with the caption “Got my Paul Pelosi Halloween costume ready.”

Not to be outdone, Representative Clay Higgins, a Louisiana Republican poised to chair a congressional subcommittee if his party wins the House, echoed a conservative conspiracy theory about the attack when he tweeted a picture of Nancy Pelosi with the comment “That moment you realize the nudist hippie male prostitute LSD guy was the reason your husband didn’t make it to your fund-raiser.”

The American political landscape has never been a particularly virtuous place, but nonetheless an important part of our politics has been the pretense that our leaders care about appearances, even as they fight to gain and hold power by any means necessary. Abraham Lincoln was both a bare-knuckled partisan brawler and a sagacious, broad-spirited political leader. So were many of our most revered and respected presidents, from Thomas Jefferson to Franklin Roosevelt and beyond.

From the beginning, Americans saw virtue — whether real or feigned, sincere or performed — as a key ingredient in the practice of republican self-government. Yes, the American system was built on the insight that institutions shape behavior and structure incentives. And yes, the main players at the Philadelphia convention tried to build a government that would harness self-interest and vice rather than rely on the better angels of our nature. But they still devoted a good deal of thought and attention to the role of virtue in their new order.

James Madison hoped that “the people will have virtue and intelligence to select men of virtue and wisdom” to lead their republic. And if not? If there was “no virtue among us,” then Americans were in a “wretched situation.” The reason, he explained, was that there were “no theoretical checks” that could render the nation secure in the absence of virtue: “To suppose that any form of government will secure liberty or happiness without any virtue in the people, is a chimerical idea.”

James Wilson, who helped produce the first draft of the Constitution and served as one of the first six justices on the Supreme Court, did not think that republican government could survive among a citizenry that could not or would not sacrifice its personal interest for the public good. “By the will and by the interest of the community, every private will and every private interest must be bound and overruled. Unless this maxim be established and observed; it is impossible that civil government could be formed or supported.”

Writing in a somewhat different vein, John Dickinson, who served as a delegate from Delaware to the constitutional convention, asked skeptics of the Constitution to ask how, exactly, a virtuous people would undermine their government. “Will a virtuous and sensible people choose villains or fools for their officers? Or, if they should choose men of wisdom and integrity, will these lose both or either, by taking their seats? If they should, will not their places be quickly supplied by another choice? Is the like derangement again, and again, and again to be expected? Can any man believe, that such astonishing phenomena are to be looked for?”

In all of this, the framers and founding fathers were interpreting the classical republican theorists, who emphasized, in one way or another, the vital importance of civic virtue. The Americans’ vision of virtue was different from that of many of their interlocutors — “Virtue became less the harsh and martial self-sacrifice of antiquity,” the historian Gordon Wood notes, “and more the modern willingness to get along with others for the sake of peace and prosperity” — but it was still critical to the maintenance and preservation of republican liberty.

As George Washington said in his first inaugural address, “There is no truth more thoroughly established, than that there exists in the economy and course of nature, an indissoluble union between virtue and happiness, between duty and advantage, between the genuine maxims of an honest and magnanimous policy, and the solid rewards of public prosperity and felicity.”

I used to scoff at much of this, thoroughly convinced that institutions mattered more than virtue. It was more important, in my view, to provide the right incentives than it was to try to cultivate values of honesty, decency, forbearance and public spiritedness.

But the example of the past seven years, from Donald Trump’s infamous ride down the escalator in June of 2015 to the present, has pushed me in the opposite direction. Institutions matter, but so does virtue, especially among the nation’s leaders. Even if it is insincere, the performance of virtue helps inculcate those values in the public at large. It says, in essence, that this is how we behave, even as we fight for power and political influence.

When politicians and other political leaders refuse to play this game — when they drop the pretense of virtue and embrace a politics of cruelty and malice, in which nothing matters but the will to power — voters act accordingly. Some may recoil, but just as many will embrace the chance to live vicariously through leaders who celebrate vice and hold virtue in contempt.

In a 1941 essay on socialism and British democracy, George Orwell observed, “An illusion can become a half-truth, a mask can alter the expression of a face.” In Britain, he wrote, “such concepts as justice, liberty and objective truth are still believed in. They may be illusions, but they are very powerful illusions. The belief in them influences conduct, national life is different because of them.”

“Even hypocrisy,” Orwell continued, “is a powerful safeguard.”

It is no small thing to have a public and political culture in which people feel the need to perform virtue, even if they don’t actually practice it. The mask alters the expression of the face; the performance becomes real.

And when would-be leaders and the people who follow them no longer want to wear the mask? When they no longer want to perform virtue in any sense or in any form? Then the face underneath can turn out to be very ugly indeed.