« The Weeds

Medicare for Many More

2018-02-27

Dylan Scott joins Sarah and Matt to talk about a new universal health care plan — plus some exciting administrative data from the good-old USA!

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This is an unofficial transcript meant for reference. Accuracy is not guaranteed.
Play Weezer's going to be in Austin for South by southwest. If so, I'd love to invite you to join me for a live taping of Uso, Concho I'll, be at the deep end by VOX media. On Sunday March 11th at three hundred and thirty talk to Melinda Gates, CO, chair of the bill, Melinda Gates Foundation, we're going to be talking about the work they do about the state of public health worldwide, isn't, isn't getting better in the world excited of his conversation. That, though, the work they do is important and it is controversial and it is interesting and it is making a lot lives better and there's a around that. To begin to, so I think I think a very good episode and you should come see it the deep ended by vocs media. We are taken the Belmont Fray three day, event itself by South West again that, as from March nine March, eleven- and it isn't just made- can get life podcast for many vocs. Media podcast network favorites, including care switches, record decode the vote verge, cast. But again you can join me for live taken. These are concho on Sunday March, Eleventh three, thirty, conversation Melinda Gates to request an invitation code of oxen mediator, com, sash S,
as W dash twenty eighteen again. That is vocs immediate outcome, slow as Ex as W Das, twenty eighteen, I know that is super memorable, but again, ESA clicks W Das, twenty eighteen and I'm not forward to seeing you there. Maybe you just some of age or federal taxes, but still pay your California taxes, of which a loser that salted acts that that's another episode below welcome to deliver. So did the weeds and the Vocs media podcast network. I Matthew Ecclesiastes join as always by Sarah Cliff, as was out vacation this week as it were, joined by Dylan Scott policy reporter, focusing especially on health care here function, which means we're gonna talk, healthcare, we're gonna talk up. We ve got a good reason paper, it's about it.
in a state of data emanating from the United States of America or done with Scandinavia. It's amazing. U S administered, it is rare, but but powerful potent who did it. A couple healthcare things we want to talk about is starting with the new a new proposal and what I would consider a white paper Yes, I think this is a true white paper in our white paper. Verses working paper debate, so This is a paper from the centre for american Progress and proposes a program called Medicare Extra for all, which is a kind of clunky, but notable for two reasons. one is just where it is coming from the centre for american progress is I think of as a more centrist and very influential liberal, think tank here in D C, they tell the part of the established. so heartily establishment they tend to be. You know in the twenty. Sixteen you kind of think of them is the Clinton aligned, think tank ends What we're seeing here is big influential think tank,
is manned by a lot of people who go in and out of democratic white houses shifting much much closer to the Bernie Sanders Vision of healthcare. So I think one thing is Think about this report is to think about who who the authors our because to me it shows a very big shift in the Democratic Party and Democrat policy see that you have this Clinton, aligned think tank shifting towards the Sanders point of view on healthcare, which brings us to the plan itself. I would eat it technically knock call it a single payer plan, but it certainly is a universal coverage plan, so the idea of Medicare extra for all would be to shift lots and lots and lots of people into the matter your programme to beef up the benefits of medical care, and over the next. You know if you implement this plan over a decade or so you'd see the majority vast majority of Americans covered through government plan one of the things. as do a little bit differently
Then the plan proposed by Bernie Sanders, which would really be a single pair, would put all Americans into the Medicare programme. It does let people stay and employer sponsored insurance, it doesn't white that out doesn't say all of us are transitioning there. Policy and political reasons to do this. I think the political ones might be strong that you dont want to send out millions of cancellation? Nobody says, as we saw how people react to disrupt. And with Obamacare but Actually, this plan reminds me of a lot of european Healthcare systems, in that it includes multiple payers are multiple sources of health insurance government regulation of the prices they pay is ever really tightly regulated insurance market you, of people spending money on health insurance, one of the big differences between Medicare Extra and the Sanders Medicare for all, is that it does expect that higher income, Americans are going to make some pretty soon
live again contributions to their own healthcare people above five hundred per se, to the poverty line, which I think is about sixty five thousand so dollars for an individual are going to be expected to put Ten percent of their income towards premiums, which you know that's a pretty significant our people, the poverty line, are not going to pay premiums, and you would see the same kind of sky cost sharing for things like coal payments and deductibles so, It certainly envisions people, bending money on health care. So in that way, I think it might be a disappointing lands to plan to some fans of these Sanders approach to health care definitely is not going all the way to Canadian says but it is a really really big step to the last step towards European Healthcare systems. From where I've seen cap, covering the healthcare debate. For the past decade, or so, yeah
think that point about employer base coverage is almost like the essential feature of the plan right. The fundamental challenge for moving to a universal single pair programme is that half of Americans get their coverage their work and sir and I found when we did some focus groups around single pair last fall most people who have employer base coverage or more or less satisfied. And so the disruption that would come to enrolling, Every single American into a government run programme is sort of like that's that's the biggest challenge that single pair advocates going to face. So I read, the cat plan is almost entirely structured around. How do we sort of alive that problem, while still creating a universal coverage system We find this to be a little, maybe over over dwell on a bigger
on one level right. I mean this plan it. It reduces disruption in the sense that box media, like might not drop our coverage and put us into the Medicare Extra forever and risk, but, on the other hand, like all of these, like strong public option these by UN and traditional mechanisms, the anticipate Shin is that, in fact, many employers would opt in to this stem and its individual opt in right. I mean what you would for Molly appear poet, extend. Why would you want to do is create this. I knew better programme, but let people who don't think it's gonna be better, not an role in it, and then it just I win, win win for everybody this is done at the level of like the corporate HR department, so to the exit
The political opponents want alike spread, like fear, uncertainty in doubt. It still the case that passing this bill could cause your employer to cancel your plan and in rural you in that every government run alternative and so to sell the programme to people. You can have to make the case that the government run alternative is actually not that scary so I see reasons for doing it this way, but I don't think it's like that. Much of it game changer. Exactly and then in policy terms its also not that big of a diamond particles, politics, but it end of the day. If we're talking about you know a one year versus a ten year transition to a system in which everyone is enrolled. Ultimate,
in a government system. It's you know. It's kind of similar and you gotta make the deal's you gotta make to get it through to me. I do think it's interesting that they were t and I would say, of fundamental disagreement with Sanders about, but the end where am, I should look like that. There is one world in which the idea is that you know there is a public service. Provided on a common basis to everyone. The way like the park, his or high school is or the bus, is, and a system in which there is subsidy based me it, which this retains that, like a Mamma care type, l and fundamentally do not get the mainstream faction of the democratic parties. Like intransigence on this
point which seems like across the board right like when it came to college there, like scandalised by the thought of like sting tuition. Subsidy is an affluent upper middle class families. But also like not at all saying we should have means tested tax credits for access to parks, its wits areas are the real picture understand you are you're confused by the Sanders focus on free for all or the other knows. I hereby onto my weapons by the Mainstream Democrats, insistence on Means testing, Not I mean testing everything but like sclusively means testing anything, that's new. Even while they completely accept the logic of non means, tested, public services for everything we harness, where other things at a great yeah liquids like what's the problem here, will to your point about creating a more attractive alternative. Like me,
This plan lays out. You know you can pay up to ten percent of their income and premiums yoga eager and I'm out of pocket cap. That's that adjust based on your income and yet it seems like a much harder to sell to be like we're. Gonna move you out of this one: administrative bureaucracy with all these sort of various levels and and self payment that You are required to make an into this other one that has just as much complexity. Verses like us Anders plan where it just be like here's, your free health, insurance, blankets. Actually I mean it's the same as a progressive income tax right, I mean to say, like ok, there's gonna be a sliding scale, subsidy level, because I can't get the philosophy right that it's like. Ok, the government should be helping the people who need them most hell, but, like the tax code already has that feature, so I guess the c b o will score it differently. If you say like, I have a benefits phase verses. I have a higher increase in my peril, tack, size but like in the economics at least, I think it's the exact same thing
It just seems hard to explain so I dont and it s hard to explain that the green you look at International healthcare systems. More countries have made the choice. to do some kinds of means testing and what people pay for health care, usually the ones I am familiar with, mostly European healthcare systems, blossom a child where, below this threshold, you don't pay anything you're, consider its considered. You know that or someone who needs a service and can't afford it and above the thrush you, been contribute something each time you go to the doktor usually small mad, an IRA? Looking at some scandinavian cost? Sharing before coming in here in places Sweden and Norway. You're talking about like fifteen or so dollar co payments with an Sweden. The caution airing limit is like less than two hundred dollars. You, a hundred a year. This is a few years ago was about a hundred and fifty zero, maybe he's up to two hundred per as much so I think it is actually a pretty common
feature of health care, but I put buses actually like this category. Two leg we'd charge people to use buses because we think it's a limited good, there's only so many seats on on the bus. if the page time you mean what one, the bus noodle daylight, but you ll pay a little bit to get but if your low income, usually most city, is a grand some kind of programme, its free, it's discount, Jed, the idle ideological underpinnings, are what similar that we have this resource, that is always going to be limited, and we actually extended a little more if we ask higher income people to kick in some amount of money. we remind them like with a nudge each time like hey. This does cos It's fine! If you go to the doctor, We want to remind you like with a five or ten dollar payment. I do, one thing that is surprising to me: I think they have nine modeled out the cap plan. Yet the folks I talk to at the think tank say there
with third party economic model is to think figure out things like. How much would this costs people are different income levels, what would the crushing be? It sounds really hi to me at this point, but maybe I'm wrong, don't know yet. But it sounds like four people who are in a higher earners who score welfare cuz cause you're gonna, have them kicking in a decent amount, as premiums as their cost sharing, but I think would be different from a european system in that sense that it would be much higher cost sharing, for more more affluent by me, like you could argue the Europeans comparing to have like a more even more progressive tax system, so wire and can people are contributing thou I, but I want to draw a distinction between. Why do you have co payments in the public system, and why do you have income based premium? Why? So, I think you have co payments. I think we're The reason workers that no country can provide healthcare services in unlimited quantities sway
so you need, if you have a universal system, some mixture of administrative rationing and, like consumer disincentives to consume. health care, so most systems implies some of that. Right- and we were looking at the Nordic Systems- Davies, Wade, low co payments, but they're not zero ride, so I think The idea is to like get you to at least think about before. Before you go see the doctor them so a lot of sense and then to say: ok, look for eighty. Ninety percent of the population. These are low, very reasonable, co payments, but we're gonna, u know, kicking a little extra money, so the poorest of the poor or or children. You know some select categories of vulnerable people get extra financial helps, so they can go see that free. I totally get that and if America needs higher co payments, because we're coming from a different status quo point like that also makes little sense to me. It
some a premium side. We're like. I don't. I don't actually understand what like work. It's doing as I understand it, like administratively, there's no escape from this system, right if I'm bouncing along at whatever it's weird to talk about everything in terms of money both of the poverty line and have mentioned in Europe like five hundred percent. But you have you heard about twice the national median income, which you know many most people obviously aren't by definition, but but many people are who are paying, which is how much like but a hundred thousand acres household income you're paying ten percent of your income in premiums right? So that's like that's like a tax but not Attacks but there are gonna, be tax, increases any Egypt like it just seems odd to me like it, it seems like why
not say that by there's, no premiums but we're gonna have to have higher taxes, paper this system, since clearly you're gonna have to have high taxes to pay for this system. Why think? Because retain the unclear sponsored feature, so I mean call it a premium tax on people who don't keep employers. Punter insurance. I think that's why you do it as a premium versus attacks like one of the things I am. I did more have to call than some other observers that about how much a plan like Medicare, draw what a road employer sponsor for, I think one of the things the ac roll out taught me is that employers funds are coverage. It's really sticky eat of people dont like change, they don't like disruption and there was, expectation. I talked a lot of health economists taken twenty times you're, so young people exogamy annual John Gruber, who would say by twenty twenty by twenty twenty five. The employer market won't exist,
the more it is just so much cheaper for companies to put their people Mama carer and pay panel. He's instead of providing health insurance and that just totally has not been true. We haven't seen not even and the employer market, but any sort of erosion of the employer mark. And I think part of that has to do with the launch of health I think I think that scared and players off at first it that you know the plans that people who get employer sponsor average at work would get on the market place. Are Fifthly, not nearly as generous, and we think of like higher earners like You know like big accounting firms, banker, something transitioning their employer is to Medicare extra. They may have people paying significant money towards their premium? It is one of my assumptions that Asia Rollout really revised. Was this idea that companies are they want to get rid of, the burden of providing insurance, but I don't think there actually that enthusiastic and pretty
worried about what their workers would do if they, if they went in that direction, and so on this point I'm am curious. What you guys think I read the plan is actually kind of suddenly can a working really hard to preserve a lot of employer insurance because there are different ways that that implies It could act under Medicare extra in as background like one of the defining features of the american insurance system is that the benefits that employers, the health benefits them employers give to their workers or tax free rein, and so under the Medicare extra plan, employers either either continue to just provide private insurance, and there be some standard sets for how much they have to provide their workers, but they would more. less function as it does now, and they would keep that unlimited taxpayer more or less, but I know
that if employers sent their workers or if their workers went to Medicare Extra, the employers would be provide to pay money into Medicare extra. That money would not have the same tax benefits that it currently does, and so I wondered if you think about that behaviorally. Does that mean that there is a lot of incentive for employers to continue offering their own coverage and sort of a subtle way to keep standing up the system. I didn't, I didn't not catch that that it switches that suits you lose the tax reduction. If you pay the Medicare extra right more or less year and so would think right? Doesn't that That was cap about that. I talked to her Spiro one of the authors he, I hope, that's right and if I don't suppose some think the biggest were group my understanding was they they, so they saw giving attack exemption to companies that are transitioning to Medicare extra almost as a double son,
it is often a company like moves people to Medicare extra those we are going to get their government subsidy. The company go in and say, like hey, we're, gonna help you pay your premium. That's over for you and so he did not. So this was how I read the plan originally when I talked it over about it. His view was, if we kept the tax exemption for what they're paying on the premium, there's actually getting few subsidies, the ring the subsidy that their people get better in part of medical extra and they're. Getting the tax subsidy were happy to give them wine, but and I guess you could like supercharged writing in them. The two subsidies to really at the moment is genetic enterprises which are trying to deal with large right, and I think I like I think these are also the questions I would really be hashed out of this ended up as a legislative, debate as well, because of goods is goes valuable. We're safe before the amount of subsidy than an individual gets depends strongly on that individuals. Ink
right. So this sounds like if you are a large, employ a fairly low wage workers right I mean, if you're Walmart, why measures as well provide insurance. Video files happened. They do, but so be very attractive, in that case, to send people off into a world where they're gonna get prowling. Most of those people would get fairly heavily subsidize premium rate verses like if you're Goldman Sachs and your staff for now be getting heavy subsidies as individuals in the thing, but your tax write off is quite valuable that the tax exclusion more valuable, the more highly compensated. You work forces and the Medicare extra subsidy is more valuable. The lower subsidize you work for
says so. It seems like you, your hr department, but have to like really look at like the income profile of your staff can make a big deal. The idea of a highly compensated workforce you're, giving up a big tax subsidy in order to get a very small direct. banning subsidy, but we have a low wage workforce. Its exact opposite three The break in gonna talk about the larger context into its medical extra falls. These aims What business is powered by great people and define great people would be great to have a great way to find people, and just posting your job online and kind of praying that somebody good sees your add implies. That's that's not good enough anymore. It's is twenty. Eighteen, there should be a better way. There is a better way better ways called zip recruiter, zip recruiters found
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move on from right. I think the cat plan sets this up pretty explicitly right, like they ve been, they ve laid out that there are under the Trump Administration under a republican Congress. There have been a lot of threats to the affordable care act and its new status quo, and so that four necessitates that we need to set up and even more of a bigger universal programme that would sort of be on a sale. or from some of those outside threats- and I mean we ve seen that come to fruition here in the last couple of weeks, there has been too thin, was that we ve we ve written about that. The Trump administration and the Republican led states have been doing to try to unravel the fordable, correct as much they can, even though Republicans in Congress failed to repeal it. So, on the one hand, the Trump Administration is trying to expand the you
of short term limited duration, insurance plants, and these are insurance plans that are currently limited. You can only buy them for three months there more or less designed for people who are maybe in between jobs and just need some kind of coverage to get them through. till they have more robust insurance, again under those plant. Those plans are not subject to all of the rules that we associate with the affordable care act. You know they can deny people coverage based on their medical status. They can charge people higher premiums based on their health status. They don't have to cover all the essential health benefits that Obama care mandated, and so it's kind of a return to a pre asia world. The reason right now that those pants plans are necessarily very attractive as they only last for three months. What the Trump administration wants to do is extend them to three hundred and sixty four days, so that's more or less than a real insurance plan and they're, even looking at they haven't decided about this yet, but they have Dave
four comments on whether they should make these plans renewable and so these plans last year and if their renewable, it's more or less just this alternative pre, oh boy, my care markets that would because there is healthy, there's medical underwriting because there might be fewer benefits covered its probably going attract younger and healthier people away The Obamacare markets into these short term plans which, as we Gus or and am sure, as you guys, this dusk all the time on this podcast cast? That's gonna drive up premiums because you're gonna have an older and sicker Obamacare market left behind, and the other piece of this that's variants more or less the same thing. It's just a state doing it, and so the Trump Administration Idaho, has proposed that Non a plans should be allowed to be sold in the state kind of in total defiance of federal law, they aren't even asking for like a federal waiver to do it. They're the same work allow plans there, medical underwriting and that don't have to cover all these essential health benefits back onto the market, and you would expect more or less the same phenomenon
younger and older people are going to Non Obamacare plans, which makes the Obamacare market costlier sicker older. The Idaho issue it's a suit of racism are fundamental questions which I mean there's a war. you can't just dot, I mean what, but can you can you not just because, like what, if Congress, ass, the law to utter no ban assault weapons. and Idaho pass a different law was like sorry. This is a really interesting thing like delay, and I have become obsessed with IDA. How, if you subscribe to our newsletter, vocs care much. You certainly start if you're interested in health care you realize It's basically become in Idaho newsletter at this point vacant. So does he know like states, do not have the authority to ignore federal law like that is a fact, but how
Will you compel a state to follow federal law when they decide to ignore it? That puts a lot trickier That part is, he is something of that were watching play out in real time. So one of the things that come up a lot when I have discussed this with people, usually the back, I would be the federal government Idaho's as we're not gonna. Do Obama care the federal government says: that's our law. You have implemented. We are going to take whatever steps. You know we need to take to get to do so. You even saw this in early Obamacare days. There is some concern her protections that states were supposed to implement for states. Did it and the federal government said: ok, fine, we're just going to step in and be the regulators in this case, because you guys aren't doing less. So you the federal government would be the backstop, but in this case they trim. Administration, I'm not behaving as chain We have known about this. I don't plan since June, since late January Adrian
secretary. Alex's hours gun questions about it. I believe Europe event where he said it wasn't really his place too. We are sitting couldn't comment on media reports. He needed urgently needed to see if it so it's the people running the executive branch of the federal about it. Dont believe that the federal law should asked right, so they are choosing to not yet in force. in a way this is actually kind of similar to what the Obama administration did on marijuana. When Washington Colorado's are passing laws, that's a marrow, as legal our state. They do. You know cited not to not to Forest budget law there. I think it is quite different size, I think is very say: there's some similar is evil. in second term pro marijuana Obama, marijuana. Because it was illegal under federal law. Marijuana businesses could not claim federal business tax benefits and they cannot access the american banking system.
fairly confident that red, if this was a different situation right, what a woman who was, he withdrew the d, a right for enforcing marijuana laws in states that that had adopted legalised marijuana. I dont think Obama would necessarily like sand. I don't know what, like This isn't have an enforcement arm like that, like your goons, like not going to stores in Boise, but if you said, look the SEC and other bank regulators and you're not operating a legal insurance company like they would they would stop. That's, the distinction of a great Nicholas Bagley at the University of Michigan, made that point that you know it cost millions of dollars and hundreds of hours of manpower to enforce federal Drug prohibition, but to just to stop at the Blue Cross of Idaho from selling not Obamacare plans should be as simple as sending a letter or may be doing something kind of through the back door at the Essen scourges. Stepping in yourself like that is what the federal government did Andrew Obama. They said ok later tweets,
no, like you. If the state is not going to regulate this federal law like we will take over you guys are big negligent and I think one of the interesting questions about Idaho. So when this plan first came out, adopts them healthcare experts who were like this is just grandstanding. No, insurance company is going to be done, to sell non Obama, plans has the fines for selling not Obamacare plants are incredibly high. You, be charged up to a hundred dollars per person per day stay. Someone is enrolled in one of these, so you know- try Idaho, but this isn't going anywhere. Then the just health insurance company and I dont know I do hope we cross loose shields, as we would like to sell these plans and we would like to do so beginning. April am we're gonna call them. Freedom, lands and we're gonna put them on the market, and then came very very real that, a states could actually of these on Obamacare plans on the market and it's not totally clear
two of the federal government is not going to step in the next place is likely goes. Is the courts in some kind of challenge to the insurance cover? the itself, who is selling a non compliant plan, probably not a challenge to the state. of Idaho, there's an interesting questions about standing who can actually bring this law suit. Like all of this to step back to where we started is you know, cunt for why you're seeing a plan called Medicare Extra show up right now, Peter I think, back to twenty ten, the Democrats, they were building a law that did and worked around challenge. They thought they'd have getting industry to comply with the affordable care, actually made sure they had farmer, they insurance companies. They doctors on board They felt like this log just couldn't work if they didn't have, those big business actors on board. I think it's they did not feel the same way about Republicans. I certainly try to get them on board and I don't think they enough. There was like anything else they
could have done to do so, but they felt like what still going to pass this law and you at once, it like rules out of people's health insurance republican. Will become friendly implementers at this law, that there was an egg partition. For example, every state would set up their own marketplace because, like why would you turn that over the federal government of Europe you been lobbying for state control and lay lobbying for more state power, and I think Democrat built a law that was not resilience. To these kind of implementation, challenges to It's just deciding what we don't want to implement debt and Obamacare gave states a lot afflicts flexibility. It gave the regulators a lot of flexibility around things like the short term plans that Dylan talked about, but I'd have to the folks at key they are kind of realising that this law worked so hard on is not specially resilient to these challenges that they did not expect act, and I think that is enough. Large way what is driving like? Why do another healthcare push because
they see a lot of these problems and folding with that, but the last healthcare push all its worth. Noting that it's not it's me, I can almost gonna make a joke out of look at this weird thing Idaho is doing, but it's not just going to be Idaho, especially if they get away with it. I saw yesterday that Iowa legislators are already talking about introducing an Idaho, like plan into their stay? I think the expectation is of Asia just doesn't intervene and if it, if its proven, that the key Its can't really override this either than you know. You're gonna have half of the states that are controlled by republicans introducing their own freedom, where they have sustained rate, and the other piece of this is too, and I I took note of this in the cap plan is the other tracked worthy Trump Administration is kind of undermining progressive healthcare goals, as in Medicaid, and the Trump Administration has signalled to states that they can institute
requirements for medicate recipients and that sort of that's an idea. When you talk to people on the progressive side who work on Medicaid, they find sort of just fundamentally objectionable and that that its runs entirely counter to the purpose of medicate in the first place, and so I noticed that the cap plan more or less said that Medicaid would be subsumed into the federal program right now. It's a federal and state partnership and states have a lot of administering discretion about how to implement the plan in their states Dwayne how planned describes is more or less Medicaid would become generally run that what kind of remove all of this state discretion about how to how to run it, and I think that is again reflective to Sarah's point of like the progressive side of things, realizing the mistakes that they made and how they sit on the road to peace. Recently about this focus groups who dealt with democratic voter, as you seem to be like having the same mindset chief to it's kind of like the flip side of this. If you give too much power to the federal government,
right, like this envisions like a benevolent implementers of Medicare extra yeah, but it seems like their own, oh yeah, that that peace is kind of relevant to discuss. Yes, something we ran into a lot with the Clinton voters. We talk to people who said that they were early sort of receptive to the idea of single pair healthcare is they were worried that the federal government could conduct radically shift after four years, and I think it's a reflection on how they feel about Trump Trump has really shape up. Their ideas of the kind of people who could be in charge of the federal government and what they might be willing to do? And so, when you are talking about, a government run healthcare programme the idea that it could one year be run by Barack Obama, which I'm sure all these voters were we're fine with and the next year it could be run by Donald Trump. That's kind of debts, a jarring for them, and I think it's a it's. A you'll challenge in terms of just the political conversation, because people's faith in in institutions and governments even sort of the most
institutionally minded people like Clinton, voters who live around the Washington DC area, suddenly sort of unmoored and so yeah. Maybe those kind of bottom line to all this is that you can necessarily escape given just our political situation. You can't escape that volatility in and any sort of system that relies on the government. Bureaucracy is gonna, be see I mean I do think this is like a more profound, challenge we on the scope of like a single white paper right. But if you look it I mean not just as healthcare staff, but like these, dismembering of the consumer Financial Protection Bureau, the seeming redirection of the entire EPA budget to Skype, poets first class airfare, like Democrats either need to like make Republicans pay a political power eggs? That is so happy that, like they do not govern this way. The next time they govern or they need
entirely state based strategy for building a progressive but first I guess it's not just like. Ok, Donald Trump dazzling we're right, but it's like if they were public administration, backed by almost every congressional Republican, backed by most republican governors, therefore backed by most republican judges. Just as like a party consensus about how things should work. This is nothing you can do about that Rightly we haven't historically had there's lots of things were a trump says, something weird and then, like like from the other day, was I'd. Maybe we should raise the age for buying assault weapons, but many national Republicans disagreed with that, and it's like by no means clear that it will happen and if he'd tried to just through administrative Viana. Do something like that. You know he he get pushed back but if the Republican Party can hold this. Fairly extreme views and like wind, most elections, then
I don't think. You're gonna, like just like through some clever line of text. That's like no actually have to keep the benefits good. You know out out, ox them like that. I mean Trump ran right by Saint, really explicitly like that. He is different from other begins that he was gonna, provide health insurance and, like he's not done that at all, all and is also not clear, that he's paid like a real political price for it, That's I mean all these stupid from country stories keep confirming its Alec. The typical trump voter is like holy shit. He was lying about Medicaid. Now now I hate Trump, but you know people can just lie about like the major aspects of their policy views. That's like there's trouble
I think it's time to to shift from our white paper tore working paper, but only after after you take a break, take a break. Are you going to sell myself last? If you are, I use really consider joining Ezra for alive taping. The is replying show he's gonna, be talking to two Melinda gates, such as a co chair of the Gates Foundation, Commerce, it about the power and importance if the land for peace, this one of the most influential should important people in the philanthropic world. So me talking with Azra where's, it happening it's happening at the deep end by vocs, meaning the vocs me taking over the Belmont. It's about a ten minute, walk from the US, prevention centre nicely Strong Ezra show is, can be happening Sunday March, eleventh three thirty p M, whose invited everyone is invited habit. We want to get your ticket request. An invitation to come. It's box he had not Tom Slash s acts as w hyphen, twenty eighteen, that's like the blocks Mediaset by South West site. Go there
check it out by no more information with pleasant invitation, vocs, media dot com, Slash S, tax s, w hyphen, eighteen, I'm so that the whole should bang. Here. The deepened by vocs media is taking over the Belmont for three event set by southwest ones. From March nine March, eleven features lifetime ass from a whole bunch of vocs media Podsnap, favorites care, swish, there's gonna, be there with her Rico Decode show the Virgin be there with the verge cast an answer. Gonna be talking, Melinda Gates for a special live taping of the is show, so please check it out this one's a doozy. We, political alignment attitude, swords government and tax evasion by Julie, Bury Cullen, Nicholas Turner and Banja L, Washington, I says the great group as read two economists at about you see, said Diego and Yale workmen Nicholas Turner from the Federal Reserve Board of critically. Previously he was at the Treasury Department and the Treasury Department economist he helped the team get access to irish data
Administrative Data, administrative data and say what they do. Is they look at what tax payments from different counties based on whether that county voted for the winning president trades like our? U aligned with the incumbent administration, are you opposed to the incoming administration and what they and is that when you shift from being aligned to diesel lined you're counties, reported income suffers dislike, mysterious rob and the drop is counts, traded in categories of income that is known to be harder for the IRS to verify, and they see also that phony looking to see claims also go up in counties that go into miss alignment, and IRA's odd? It's also go up into counties that go into Miss alignment, of which seems to be suggesting that when a president who you dont like is in office-
the sort of conscience and norms, slip away and people become more aggressive, tax evasion, and I will say it's not like all the sudden- nobody in these places is paying or taxes we're talking about, like some kind of smaller noticeable. But smaller share of so just I don't know, we already numbers gaming emulates than you magnitude of it, but just to give peoples in contact will they said something in there just to set the context that like percent or eighty five percent of people to pay their taxes cause like that's what they should do oh yeah, two serious point: it seems like a lot of this was at the margins, even if it was still no, I mean it's a into its about a one point, two percent change and reporting by means of huge to be clear- It's hard to get away with cheating on your taxes, mostly mostly your employer, also reports your income, you know so there looking at the sort of like what's get away with the ball, which is a fairly small share of the overall income and within that the magnitude is Maude
in part, because even a county ride so like Maricopa County in Arizona like voted for Donald Trump, but a huge number of the people live there did not vote? For you know, counties aren't people so like it's. It's not like. This is like devastating short, call in tax revenue results from this. It's more a curious window into human psychology and I think it's interesting but think through it doesn't seem to me to suggest a scale. Will people are like well fuck that, like trouble as an offer of offers an office, I'm just not paying my access any more but like movies sceptics. As of you know, what are my tax dollars going for? Is it actually that employ in that I pay there's some of the research they save in the conclusion of this paper the pre item. Where the confusion about what tax dollars go to. It said some other research. Finding that p
or who are more sceptical of government spending are more likely to overestimate into their own tax rates. So I think, is like an interesting window into Nicole psychology, unlike one way, we really do with our money as we enter this taxis and comments Little bit on how legitimate we think the governments is. You know, their whether remain to or not to that point what I thought was interesting to us. How, in that conclusion, was how malleable people's opinions could be. There was an interesting thing. It was from the Kaiser Family Foundation of finding that you know eighty per cent of people thought you know, we were spending too much on foreign aid, but then, when you told him what the actual amount was like one per cent of the federal budget that number opt in half and most people were actually find what I was curious, what you guys that we should do, this information. The one thing that the researchers point to a sort of better education about. What's your tax dollars are spent on, because to that guy
are finding. It seemed like people are mostly okay with how we spend our federal money if they know it, but they have a sort of these warped perceptions that may be founded in their political outlook. But I don't know it was like an interest one thing that was sort of intuitive but also like it was fascinating to see it put down with data. But then I was like what what what should we do with this? Exactly it's always interesting to remind itself, how little typical p, even people who voice strident opinions about politics does actually have a lot of like deep, but would you consider like an earnest level of concern with politics where you would like look stuff up? Am I try to check and an understanding going on you don't give. You were gonna like renovate your deck right, and so you took an interest in the past process and you would have to like find out how it works, and subsequently people dont relate to national politics in that kind of way they can become very cranky.
about like all the money? That's a wasted on x without ever checking like how much money is wasted on eggs or is it wasted? Doesn't that hard to look things up It's just like not the level on which normal people engage with politics or with the power legal system because it doesn't actually matter. I mean it's like an important thing: recognize right. It's like whether you vote for Donald Trump or vote for Gay Johnson or stay home or welfare, Hillary Clinton or say Bernie what a wine it. It's nothing, he's gonna change, so you sort of engage in this like freebie position taking without needing to inform yourself in any kind of real way, and I think that's like incredibly fundamental too politics right and in Amerika we have such a lack of consensus between the parties righted
it was like a broad elite agreement that foreign aid is really good. Then you could imagine, the public and it doesn't seem like it would be that hard. It's only people like refuse to process information, but we have to like come from credible sources. This profound disagreement among the elected officials. So you hear a lot of people arguing and it's like that's on a good way to learn, What are things I think is notable is that data source they're, using obviously we really have data for under present trump, but we, they're using the two dozen Elections- oh George, w they're using the year before and after George W Bush was elected office, and then the year after, and Obama was elected to office and I think it's notable? This is something you're saying on both sides Not one of those trends that seems to be polarized towards republicans are Democrats in June That is certainly an era when politics were free
polarized, but even less so than they are right. now. So what the things I would wonder is if you repeat this study, you know in the year before now President Trump was elected. If you're going to see the man intuitive this amplify even more, if as people become more for partisan, and you know that action on the left to President Trump has been so incredibly strong, if, if this becomes even more of an issue, and then it gets to like this question of like this does become a significant issue woody. you about it. This is not just like funny fake money. It's This is the money that like runs the government, that funds the things that we do, like we're out like crisis territory yet, but I'm curious I have a trend like this one might develop in tandem with an increasingly partisan type of politics yet
the one thing. The study pry just Didn'T- have the resources to get to a sort of like how long like this, or is this just like a fundamental truth of american politics? Or is it something that's a more real phenomenon that reflects kind of party polarization I knew more time that tax receipts and saying that, I think, is just interesting. I remember from coming tax bill is its fiddle really long time. Since the budget deficit was a significant like macro economic problem in America, its it's got kind of hot and cold as a political topic, but it's been Probably this is a definite started, far away under Bill Clinton. In the mid nineties, it's so it became not a big problem. Is it went up the macro economic conditions when Bush was present again, one Obama was president were benign We're going on like twenty plus years now, since he's been like a concrete problem in which
the head of the Federal Reserve is like following up the treasury secretary and is like growth is gonna tank unless you can get the deficit download twenty five years, probably sense since Alan Greenspan and Bill Clinton had to have that conversation. so everything about like is like tax administration working is just like. had a total fantasy land and I give them crash is colonel, I believe on principle that you should make which people pay taxes and we're Providence kind of. Don't you can cannot let it go that way in some other regime and which had actually matters. You could imagine some of this stuff changing right I mean you, till a happy story in which, like faced with objective challenges, America's political elites feel that they need to like come together and like bolster public faith in institutions to make things work, I guess you could you can imagine going the other way and we just like typically disaster right. Well, that's too Sarah's point about arena see an even bigger effect
from Obama Trump. Yet this seems like an away a sort of a proxy for just deteriorating faith and in government institutions, and so if it keeps up than yet maybe we get to to crisis points. What did I feel like the liberal psychological Rio? to Bush in Trump has been different go on, I should like to me alone. The people I knew by democratic friends filled alienated from America by Georgia, be bushes elevation. Whereas they feel in some ways like a renewed sense of like patriotism. In response. Oh, I see today I don't know, there's still still the very strong, not my president, like I get. They do feel like this renewed sense of protecting America, but I don't have that like we're. Talking,
giving money to the governor of the state run. No, no, I mean that's true. That's true. I mean that we actually are. Tromp is maybe more similar to the conservative action to Obama, like the insistence that, like the true soul of America's now in exile, but that still makes you not one pay taxes. Ok, thanks for listening, I think so much too too. Don't scarred for coming on and joining us filling in thanks to Bridget Armstrong for producing this episode check out the weeds Facebook group for more exciting discussion of these and other subjects check out today explained our new daily podcast. That is really really awesome. We, Fans will especially like the immigration episode produce recently death as those who, like Health and Andorra, and so you know it's it's like all. You are your favorite friends, but with an even better team.
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Transcript generated on 2021-09-12.