Trump to rally: GOP senators who oppose health bill ‘will have a lot of problems’

Trump speaks for an hour at campaign-style rally in Youngstown, Ohio, and boasts of accomplishments while pledging once again to build that wall

Donald Trump warned that Republican senators who dont support legislation repealing and replacing Obamacare will have a lot of problems.

Speaking for an hour at a campaign-style rally in Youngstown, Ohio, Trump took a victory lap after the Senate voted to begin debate on legislation to repeal the Affordable Care Act. We are now one step closer to liberating our citizens from this Obamacare nightmare, he said.

Before a raucous crowd in the blue-collar city, Trump went on to warn that any senator who votes against repeal and replace tells America that they are fine with the Obamacare nightmare, and I predict theyll have a lot of problems.

However, Trump spent comparatively little time discussing healthcare. Instead, he returned to familiar themes from his freewheeling presidential campaign, deriding fake news and pledging once again to build that wall on the border between the United States and Mexico. He also returned to familiar boasts about how, with the exception of Abraham Lincoln, he can be more presidential than any president thats ever held this office and taunted protesters, saying about one: Hes going back home to mommy.

He spent much of the rally boasting about his accomplishments since taking office: I think, with few exceptions, no president has done anywhere near what we have done in his first six months.

In particular, Trump dwelled on his efforts to curb illegal immigration and deport undocumented migrants from the United States. Trump claimed that in doing so we are liberating our towns and cities and warned darkly of immigrants in gangs committing crimes.

They dont want to use guns because its too fast and its not painful enough, claimed Trump. So theyll take a young, beautiful girl, 16, 15 and others, and they slice them and dice them with a knife because they want them to go through excruciating pain before they die, and these are the animals that weve been protecting for so long.

Trump though did not address the investigations into Russian interference in the 2016 election or his growing displeasure with Jeff Sessions, the attorney general, for recusing himself from the justice departments investigation into the 2016 campaign.

Read more: https://www.theguardian.com/us-news/2017/jul/25/trump-republicans-healthcare-bill-rally-ohio

John McCain had the chance to do the right thing on healthcare. He failed | Lucia Graves

There are many reasons to respect the Arizona senator, but his remarkable stoicism and service cant excuse his yes vote in the Senate

John McCain often gets cast as a truth-teller to Donald Trump, but his voting record says otherwise. And nowhere was that more clear than on Tuesday when, despite his own ill health, when it came to the decision of whether to take other peoples healthcare away, he cast a decisive vote in the wrong direction.

Addressing his fellow lawmakers, McCain called passionately for a return to regular order, and for senators to work constructively across the aisle. Why dont we try the old way of legislating in the Senate, the way our rules and customs encourage us to act, he said in his Tuesday speech. If this process ends in failure, which seems likely, then lets return to regular order!

Though he has often railed against Trump as if he cant actually affect what he is complaining about, McCain isnt a helpless observer hes an influential senator. And on Tuesday, as the country draws closer than ever before to the death of the Affordable Care Act, he was a pivotal one.

Had McCain simply voted no to the question of whether the Senate should begin debate on a repeal or replacement of Obamacare, which squeaked by in the Senate with a vote of 51-50, the chambers leader Mitch McConnell might well have been forced to do the very thing McCain claimed to want: restore the chamber to order.

Instead, McCain, who was recently and tragically diagnosed with an aggressive form of brain cancer, and who returned to DC explicitly to help save the GOP healthcare bill, voted yes.

To put it another way, faced with a rare opportunity to make a real tangible difference, he risked traveling amid failing health to make possible the very thing he decried.

More damningly, he voted yes to take away healthcare from millions of Americans including an untold number of other cancer patients even as he continues to access benefits of the quality care afforded him as a senator, care subsidized by American taxpayers.

Never mind that at this point in time Republicans have little idea what the bill they would replace Obamacare with will contain. Never mind that we have arrived at this point through a secretive process devoid of public hearings, or even that Republicans would have the healthcare of millions of American women dreamed up entirely by men.

Politics appears to have triumphed over logic. Sadly, the politics that won out today are is not even a sort personally dear to John McCain that much was made clear in his floor speech. Its not even his own electoral politics that won out, either; after a tough re-election battle, he wont be up again until 2022, freeing him up as much as electorally possible to act solely with his moral compass as the guide.

Instead, McCain did the very thing he had just railed against, acting out of partisan loyalty.

There are many reasons to respect McCain, a former prisoner of war who endured torture in the five and a half years he spent captive in North Vietnam, and has campaigned against torture by the US. His 2008 campaign against Barack Obama now looks like the very model of civility in the wake of Trump.

But even his remarkable stoicism and service cant excuse what he just did.

The grim reality is that health insurance is of the utmost importance when it comes to surviving cancer, the second leading killer in America after heart disease. Put simply, the uninsured are much more likely to die than those with insurance and sooner.

A recent study in the journal Cancer found the uninsured were 88% more likely to die of testicular cancer than those with insurance. For patients with Medicaid, the number dropped to a 58% greater chance of dying than privately insured patients like McCain.

The study found the same trend held true for patients with glioblastoma, the malignant brain cancer McCain was recently diagnosed with. Its a terribly disease with a median life expectancy with his type of just 15 months, and thats as true for McCain as anyone, but the uninsured still die faster than anyone.

Voting to subject any one of millions of Americans to go to meet such a fate without even the benefit of the best tools medicine has to fight it is cruel, given McCains new-found appreciation of the benefit.

The estimated cost of McCains recent surgery to remove the cancer above his eye is a sum that would bankrupt many Americans, using the Medicare rates for which McCain qualifies.

Theres a way to fix the fact that many Americans under the age of 65 dont have access to any such care: let everyone under it buy in, a scheme for which many on the left have argued. But on Tuesday, McCain helped move the country in precisely the opposite direction.

We still dont know which of several bills Republicans will bring up for a vote, but all of them involve millions of Americans losing the very sort of health insurance upon which McCain depends.

The only question is whether its a matter of 22, 32, or just 15 million people who will lose access. What we can say with confidence is whatever version moves forward, McCains lost more than his good health hes lost his decency.

Read more: https://www.theguardian.com/commentisfree/2017/jul/25/john-mccain-healthcare-senate-vote-republicans

John McCain has been diagnosed with brain cancer, spokesman says

Statement reveals brain tumor known as glioblastoma was removed along with blood clot above senators right eye during surgery last Friday

John McCain, the Arizona senator and former Republican presidential candidate, has been diagnosed with brain cancer.

A brain tumor known as a glioblastoma was removed from McCain along with a blood clot in a surgery at the Mayo Clinic on Friday, a spokesperson said on Wednesday.

McCains office had only previously announced that the blood clot had been removed from above the 80-year-olds left eye.

The Mayo Clinic said in a statement released by McCains office: The senator and his family are reviewing further treatment options with his Mayo Clinic care team. Treatment options may include a combination of chemotherapy and radiation. The senators doctors say he is recovering from his surgery amazingly well and his underlying health is excellent.

The surgery had forced McCain to stay in Arizona this week and miss votes in the Senate. It had led to a delay in the vote on the Senate Republican bill to repeal and replace the Affordable Care Act (ACA), which was originally scheduled for Monday. Since the delay was announced, a sufficient number of Republican senators came forward to express their opposition to the bill and forced the majority leader, Mitch McConnell, to shelve it and instead try to push a vote on a clean repeal of the ACA.

In a statement, the Arizona senators spokesperson said that in the aftermath of his diagnosis, further consultations with [the] Mayo Clinic care team will indicate when he will return to the United States Senate.

An extended absence would likely make it even more difficult for Republicans to repeal or replace the ACA, popularly known as Obamacare. Senate Republicans have a narrow 52-48 majority and, with the tie-breaking vote of Mike Pence, can only afford to lose two votes if McCain is present. His absence means that two Republican no votes would now sink any legislation if all 48 Democrats are unified in opposition.

McCain, who was re-elected to his sixth term in the Senate in 2016, was the Republican partys presidential nominee in 2008 and finished second to George W Bush in the 2000 GOP presidential primary. Prior to his career in politics, McCain served as an aviator in the US navy, and was held as prisoner of war for five and a half years during the Vietnam war. While being held captive by the north Vietnamese, McCain was repeatedly subjected to torture. He retired as a captain after earning a number of decorations including the Silver Star, the Bronze Star and the Distinguished Flying Cross.

The Arizona senators illness sparked an outpouring of support from both sides of the aisle.

In a statement, Donald Trump said: Senator John McCain has always been a fighter. Melania and I send our thoughts and prayers to Senator McCain, Cindy, and their entire family. Get well soon. Trump, who famously set off a political firestorm in 2015 by saying McCain was not a war hero, said earlier in the week of the Arizona senator: We hope John McCain gets better very soon because we miss him. Hes a crusty voice in Washington. Plus we need his vote. And hell be back.

Barack Obama, against whom McCain ran in the 2008 presidential election, tweeted: John McCain is an American hero & one of the bravest fighters Ive ever known. Cancer doesnt know what its up against. Give it hell, John.

Barack Obama (@BarackObama)

John McCain is an American hero & one of the bravest fighters I’ve ever known. Cancer doesn’t know what it’s up against. Give it hell, John.

July 20, 2017

A number of McCains colleagues in the Senate also expressed their well wishes. In a statement, Mitch McConnell said: John McCain is a hero to our Conference and a hero to our country. He has never shied from a fight and I know that he will face this challenge with the same extraordinary courage that has characterized his life. The entire Senate familys prayers are with John, Cindy and his family, his staff, and the people of Arizona he represents so well. We all look forward to seeing this American hero again soon.

Outside a meeting of Senate Republicans to discuss healthcare reform on Wednesday night, senator John Hoeven of North Dakota said they had learned of the diagnosis during the meeting.

It was very emotional almost kind of stunned disbelief, Hoeven told reporters. Senator James Lankford, of Oklahoma, then led them in prayer.

Hoeven said the senators had received a message from McCain via South Carolina senator Lindsay Graham, a close friend. The senator told them he was eager to get back and get to work, Hoeven added.

Graham was visibly emotional as he recalled his conversation with McCain when he learned of the diagnosis.

He says, Ive been through worse, Graham told reporters. Five minutes into the call, however, McCain wanted to talk the legislative priories, Graham said.
God knows how this ends, he said. But I do know this: This disease has never had a more worthy opponent.

In a statement, McCains daughter Meghan said: He is a warrior at dusk, one of the greatest Americans of our age, and the worthy heir to his fathers and grandfathers name. But to me, he is something more. He is my strength, my example, my refuge, my confidante, my teacher, my rock, my hero my Dad.

Meghan McCain (@MeghanMcCain)

Statement regarding my father @SenJohnMcCain: pic.twitter.com/SMte9Hkwkq

July 20, 2017

Lauren Gambino contributed to this report.

Read more: https://www.theguardian.com/us-news/2017/jul/19/john-mccain-brain-cancer

Journalist under fire for calling it ‘crazy’ not to be disgusted by homeless people

Prominent Mother Jones writer Kevin Drum says critics deliberately misreading his response to study on peoples reaction to seeing homelessness

A high-profile Mother Jones writer has suggested that it would be crazy not to have a reflexive disgust of homeless people, stirring the anger of those who say he is perpetuating the worst kinds of stereotypes.

Writing on Friday, Kevin Drum was responding to a study which found that some people with a propensity for feeling disgust might experience it when faced with someone living on the street.

Glenn Greenwald reacted by posting photographs of homeless people who have performed altruistic acts alongside a screen shot from Drums story. The two authors of the study, meanwhile, say Drum glossed over subtleties in their work.

outside in america

He seemed to just be endorsing the worst stereotypes without any nuance or without any humanization of these people, said Scott Clifford, one of the authors and an assistant professor of political science at the University of Houston.

Drum said his critics were guilty of deliberately misreading what I wrote.

The authors of the study which is admittedly eyebrow-raising owing to its lexicon set out to untangle a contradiction. Across the country, cities seek to aid homeless people by providing shelters and millions of dollars in funding, while also passing laws against sitting or lying on sidewalks, or restricting where RVs can park, which serve to exclude them.

They examined survey data and focused on a particular feeling that seemed to play a role in perpetuating this paradox: While most of the public wants to help homeless people, they write, sensitivity to disgust drives many of these same people to support policies that facilitate physical distance from homeless people.

Disgust, they propose, might help explain nimbyism in this casea desire among housed people to prevent camps or housing being built in the vicinity of their own homes. And they argue that the media exacerbates disgust with stories that mention disease and unsanitary conditions.

But they do not say that this kind of reaction of reaction is universal: while some people are prone to feeling disgust in the presence of homelessness, others are less likely to.

In his brief response to a summary that the authors published in the Washington Post, Drum said he found their results unsurprising. About half the homeless suffer from a mental illness and a third abuse either alcohol or drugs, he wrote, before commenting how crazy it would be not to not to be disgusted by a population like that.

He finished by suggesting that it was the work of a decent human being to overcome these reflexive feelings and find empathy.

It certainly is the work of of a good human being not to act fully based on immediate reactions, said Maria Foscarinis, executive director of the National Law Center on Homelessness & Poverty. She said the study seems to make sense, though she had some reservations. But she did not agree with Drum, calling the post really over the top and not true to what the paper is saying.

Its just a manifestation of the worst kinds of stereotypes. As a subscriber to this publication, Im really disappointed.

Pete White, head of the Los Angeles Community Action Network, said he thought Drums conclusions risked tarring an entire group of people, as if every houseless person is addicted to drugs and had a mental illness.

Both of the studys authors expressed displeasure. He appears to believe that everyone will in all circumstances feel disgust towards homeless people, said Spencer Piston, the other author and an assistant professor of political science at Boston University. Theres a clear irony here, which is that we argue that the connection between disgust and attitudes about the homeless depend in part on media coverage and the extent to which homeless people are portrayed as disgusting.

In an email, Drum said that he did not think his blogpost was unfaithful to the study. He also pushed back at those condemning him. Please note that I didnt say I was disgusted by the homeless, nor that they are inherently disgusting, he said. Only that, given the nature of the demographic, its not surprising that most people find them disgusting.

Clara Jeffery, the editor-in-chief of Mother Jones, said that the anger was fueled by the terms used in the study and not Drums writing itself. But it is one brief post about a study, she added in her email. Mother Jones has an extensive body of work on the homeless, the housing and mental health and opioid crisis fueling it.

Do you have an experience of homelessness to share with the Guardian? Get in touch

Read more: https://www.theguardian.com/us-news/2017/jul/17/homelessness-kevin-drum-mother-jones-disgust

Senate will vote to repeal Obamacare without replacement, after new healthcare bill stumbles

Republican Mitch McConnell calls for vote on clean repeal, after senators Mike Lee and Jerry Moran come out against latest effort to replace Obamacare

Senate majority leader Mitch McConnell has announced that the Senate will vote on a clean repeal of Obamacare without any replacement, after two Republican senators broke ranks to torpedo the current Senate healthcare bill.

Senators Mike Lee of Utah and Jerry Moran of Kansas came out on Monday night in opposition to McConnells Better Care Reconciliation Act (BCRA), the Senate version of the controversial healthcare reform bill that passed the House in May.

Senate Republicans hold a bare 52-48 majority in the Senate and two members of the GOP caucus, the moderate Susan Collins of Maine and the libertarian Rand Paul of Kentucky, already opposed the bill, along with all 48 Democrats. The announcement from Moran and Lee made it impossible for Republicans to muster the 50 votes needed to bring the BCRA bill to the floor.

Instead, McConnell announced late on Monday night that the Senate would vote on a bill to simply repeal Obamacare without any replacement in the coming days.

The Kentucky Republican said in a statement: Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful.

He added that in the coming days the Senate would vote on repealing the Affordable Care Act with a two-year-delay. The Senate passed a similar bill in 2015, which was promptly vetoed by Barack Obama.

McConnells plan echoes a statement made by Donald Trump in a tweet on Monday night, in which the president urged a repeal of Obamacare with any replacement to come in the future.

Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate. Dems will join in! Trump wrote.

The announcement from Lee and Moran came as Trump was having dinner at the White House with a number of senators who support the bill. Trump talked to several conservatives on the phone over the weekend, including Lee, in an attempt to win their support.

In a tweet, Lee noted that he could not support this version of the bill. Moran used the same language on Twitter. Both voted for a clean repeal of the Affordable Care Act in 2015, albeit with the expectation that it would be vetoed by Obama and not become law.

In an op-ed in The Resurgent, a conservative online publication, Lee cited the fact that the current bill did not incorporate an amendment that he introduced with Ted Cruz to allow insurance companies to offer bare-bones insurance plans. In Lees argument, the mandate that insurance companies cover pre-existing conditions resulted in a hidden tax which meant that middle-class families are being forced to pay billions in higher health insurance premiums to help those with pre-existing conditions.

In a statement, Moran took a slightly different tack. He said: There are serious problems with Obamacare, and my goal remains what it has been for a long time: to repeal and replace it. This closed-door process has yielded the BCRA, which fails to repeal the Affordable Care Act or address healthcares rising costs. The Kansas Republican also warned that the current legislation leave[s] the federal government in control of everyday healthcare decisions which Moran said made it more likely that our healthcare system will devolve into a single-payer system, which would require a massive federal spending increase.

The announcement came shortly after a Senate vote on the healthcare bill was delayed due to the hospitalization of John McCain. The Arizona senator had a blood clot removed from above his left eye on Friday night and was unable to fly to Washington as a result. On Saturday, McConnell said the Senate would defer consideration of the bill while McCain recovered. A number of other moderate Republican senators have yet to take positions on the bill, most notably Dean Heller of Nevada.

Although a repeal of Obamacare without providing for a immediate replacement has long been popular with conservatives, many other Republicans have been skeptical of this approach because of the potential political cost.

In contrast, McCain said in a statement that Republicans should start the process of passing a health care bill over. Congress must now return to regular order [and] hold hearings, said the Arizona Republican.

In a statement, the Senate Democratic leader, Chuck Schumer, said: This second failure of Trumpcare is proof positive that the core of this bill is unworkable.

He added: Rather than repeating the same failed, partisan process yet again, Republicans should start from scratch and work with Democrats on a bill that lowers premiums, provides long-term stability to the markets and improves our healthcare system.

Lauren Gambino contributed reporting

Read more: https://www.theguardian.com/us-news/2017/jul/17/republican-health-bill-senators-oppose-vote

How the middle class hoards wealth and opportunity for itself

American society is dominated by an elite 20% that ruthlessly protects its own interests

When I was growing up, my mother would sometimes threaten my brother and me with electrocution. Well, thats not quite right. In fact, the threat was of lessons in elocution, but we wittily, we thought renamed them.

Growing up in a very ordinary town just north of London and attending a very ordinary high school, one of our several linguistic atrocities was failing to pronounce the t in certain words. My mother, who was raised in rural north Wales and left school at 16, did not want us to find doors closed in a class-sensitive society simply because we didnt speak what is still called the Queens English. I will never forget the look on her face when I managed to say the word computer with neither a p nor a t.

Still, the lessons never materialised. Any lingering working-class traces in my own accent were wiped away by three disinfectant years at Oxford University. (My wife claims the adolescent accent resurfaces when I drink, but she doesnt know what shes talking about shes American.) We also had to learn how to waltz. My mother didnt want us to put a foot wrong there either.

In fact, we did just fine, in no small part because of the stable, loving home in which we were raised. But I have always been acutely sensitive to class distinctions and their role in perpetuating inequality. In fact, one of the reasons I came to the United States was to escape the cramped feeling of living in a nation still so dominated by class. I knew enough not to think I was moving to a socially mobile utopia: Id read some of the research. It has nonetheless come as something of a shock to discover that, in some important respects, the American class system is functioning more ruthlessly than the British one I escaped.

In the upper-middle-class America I now inhabit, I witness extraordinary efforts by parents to secure an elite future status for their children: tutors, coaches and weekend lessons in everything from French to fencing. But I have never heard any of my peers try to change the way their children speak. Perhaps this is simply because they know they are surrounded by other upper-middle-class kids, so there is nothing to worry about. Perhaps it is a regional thing.

But I think there is a better explanation. Americans tend to think their children will be judged by their accomplishments rather than their accents. Class position is earned, rather than simply expressed. The way to secure a higher status in a market meritocracy is by acquiring lots of merit and ensuring that our kids do, too. What ones parents are like is entirely a matter of luck, points out the philosopher Adam Swift. But he adds: What ones children are like is not. Children raised in upper-middle-class families do well in life. As a result, there is a lot of intergenerational stickiness at the top of the American income distribution more, in fact, than at the bottom with upper-middle-class status passed from one generation to the next.

Drawing class distinctions feels almost un-American. The nations self-image is of a classless society, one in which every individual is of equal moral worth, regardless of his or her economic status. This has been how the world sees the United States, too. Historian Alexis de Tocqueville observed in the early 19th century that Americans were seen to be more equal in fortune and intelligence more equally strong, in other words than they were in any other country, or were at any other time in recorded history. So different to the countries of old Europe, still weighed down by the legacies of feudalism.

British politicians have often felt the need to urge the creation of a classless society, looking to America for inspiration as, what historian David Cannadine once called it, the pioneering and prototypical classless society. European progressives have long looked enviously at social relations in the New World. George Orwell noted the lack of servile tradition in America; the German socialist Werner Sombart noticed that the bowing and scraping before the upper classes, which produces such an unpleasant impression in Europe, is completely unknown.

This is one of many reasons socialist politics struggled to take root in the United States. A key attraction of socialist systems the main one, according to Orwell is the eradication of class distinctions. There were few to eradicate in America. I am sure that one reason Downton Abbey and The Crown so delight American audiences is their depictions of an alien world of class-based status. One reason class distinctions are less obvious in America is that pretty much everyone defines themselves as a member of the same class: the one in the middle. Nine in ten adults select the label middle class, exactly the same proportion as in 1939, according to the pollsters Gallup. No wonder that politicians have always fallen over each other to be on their side.

But in recent decades Americans at the top of the ladder have been entrenching their class position. The convenient fiction that the middle class can stretch up that far has become a difficult one to sustain. As a result, the modifications upper or lower to the general middle class category have become more important.

Class is not just about money, though it is about that. The class gap can be seen from every angle: education, security, family, health, you name it. There will also be inequalities on each of these dimensions, of course. But inequality becomes class division when all these varied elements money, education, wealth, occupation cluster together so tightly that, in practice, almost any one of them will suffice for the purposes of class definition. Class division becomes class stratification when these advantages and thus status endure across generations. In fact, upper-middle-class status is passed down to the next generation more effectively than in the past, and in the United States more than in other countries.

One benefit of the multidimensional nature of this separation is that it has reduced interdisciplinary bickering over how to define class. While economists typically focus on categorisation by income and wealth, and sociologists tend more towards occupational status and education, and anthropologists are typically more interested in culture and norms, right now it doesnt really matter, because all the trends are going the same way.

It is not just the top 1% pulling away, but the top 20%. In fact, only a very small proportion of US adults 1% to 2% define themselves as upper class. A significant minority about one in seven adopts the upper middle class description. This is quite similar to the estimates of class size generated by most sociologists, who tend to define the upper middle class as one composed of professionals and managers, or around 15% to 20% of the working-age population.

As David Azerrad of the Heritage Foundation writes: There is little appetite in America for policies that significantly restrict the ability of parents to do all they can, within the bounds of the law, to give their children every advantage in life. That is certainly true. But then Azerrad has also mis-stated the problem. No one sensible is in favour of new policies that block parents from doing the best they can for their children. Even in France the suggestion floated by the former president, Franois Hollande, to restore equality by banning homework, on the grounds that parents differ in their ability and willingness to help out, was laughed out of court. But we should want to get rid of policies that allow parents to give their children an unfair advantage and in the process restrict the opportunities of others.

Most of us want to do our best for our children. Wanting ones childrens life to go well is part of what it means to love them, write philosophers Harry Brighouse and Adam Swift in their 2014 book Family Values: The Ethics of Parent-Child Relationships. But our natural preference for the welfare and prospects of our own children does not automatically eclipse other moral claims. We would look kindly on a father who helps his son get picked as starting pitcher for his school baseball team by practising with him every day after work. But we would probably feel differently about a father who secures the slot for his son by bribing the coach. Why? After all, each father has sacrificed something, time in one case, money in the other, to advance his child. The difference is team selection should be based on merit, not money. A principle of fairness is at stake.

So, where is the line drawn? The best philosophical treatment of this question I have found is the one by Swift and Brighouse. Their suggestion is that, while parents have every right to act in ways that will help their childrens lives go well, they do not have the right to confer on them a competitive advantage in other words, to ensure not just that they do well but that they do better than others. This is because, in a society with finite rewards, improving the situation of one child necessarily worsens that of another, at least in relative terms: Whatever parents do to confer competitive advantage is not neutral in its effects on other children it does not leave untouched, but rather is detrimental to, those other childrens prospects in the competition for jobs and associated rewards.

The trouble is that in the real world this seems like a distinction without a difference. What they call competitive advantage-conferring parental activities will almost always be also helping-your-kid-flourish parental activities. If I read bedtime stories to my son, he will develop a richer vocabulary and may learn to love reading and have a more interesting and fulfilling life. But it could also help him get better grades than his classmates, giving him a competitive advantage in college admissions. Swift and Brighouse suggest a parent should not even aim to give their child a competitive advantage: It would be a little odd, perhaps even a little creepy, if the ultimate aim of her endeavours were that her child is better off than others.

I think this is too harsh. In a society with a largely open, competitive labour market, it is not creepy to want your children to end up higher on the earnings ladder than others. Not only will this bring them a higher income, and all the accompanying choices and security, it is also likely to bring them safer and more interesting work. Relative position matters it is one reason, after all, that relative mobility is of such concern to policymakers. Although I think Brighouse and Swift go too far, they are on to something important with their distinction between the kind of parental behaviour that merely helps your own children and the kind that is detrimental to others. Thats what I call opportunity hoarding.

Opportunity hoarding does not result from the workings of a large machine but from the cumulative effect of individual choices and preferences. Taken in isolation, they may feel trivial: nudging your daughter into a better college with a legacy preference [giving applicants places on the basis of being related to alumni of the college]; helping the son of a professional contact to an internship; a single vote on a municipal council to retain low-density zoning restrictions. But, like many micro-preferences, to borrow a term from economist Thomas Schelling, they can have strong effects on overall culture and collective outcomes.

Over recent decades, institutions that once primarily served racist goals legacy admissions to keep out Jewish students, zoning laws to keep out black families have not been abandoned but have been softened, normalised and subtly re-purposed to help us sustain the upper-middle-class status. They remain, then, barriers to a more open, more genuinely competitive and fairer society. I wont insult your intelligence by pretending there are no costs here. By definition, reducing opportunity hoarding will mean some losses for the upper middle class.

But they will be small. Our neighbourhoods will be a little less upmarket but also less boring. Our kids will rub shoulders with some poorer kids in the school corridor. They might not squeak into an Ivy League college, and they may have to be content going to an excellent public university. But if we arent willing to entertain even these sacrifices, there is little hope. There will be some material costs, too. The big challenge is to equalise opportunities to acquire human capital and therefore increase the number of true competitors in the labour market. This will require, among other things, some increased public investment. Where will the money come from? It cant all come from the super-rich. Much of it will have to come from the upper middle class. From me andyou.

This is an extract from Dream Hoarders: How the American Upper Middle Class is Leaving Everyone Else in the Dust, Why That is a Problem, and What To Do About It by Richard V Reeves (Brookings Institution Press, 2017)

HOW TO STAY AHEAD – OR PLAY FAIR

As parents, we naturally want our children to flourish. But that laudable desire slides into opportunity hoarding when we use our money, power or position to give our own children exclusive access to certain goods or chances. The effect is to strengthen class barriers.

1. Fix an internship using our networks. Internships are becoming more important but are too often stitched up privately. Its worse if theyre unpaid. Instead: insist on paid internships, openly recruited.

2. Take our own kids to work for the day. Children learn what work is from adults. Instead: try bringing somebody elses kid to work, perhaps by partnering with local charities.

3. Be a Nimby. By shutting out low-income housing from our neighbourhoods with planning restrictions, we keep less affluent kids away from our local schools and communities. Instead: be a Yimby, vote and argue for more mixed housing in your area.

4. Write cheques to PTA funds. Many of us want to support the school our children attend. This tilts the playing field, however, since other schools cant do the same. Instead: get your PTA to give half the donations to a school in a poor area.

Read more: https://www.theguardian.com/inequality/2017/jul/15/how-us-middle-classes-hoard-opportunity-privilege

John McCain predicts Republican healthcare bill will fail

Unpopular bill further imperilled after senators returned to their states and faced constituents strongly opposed to it

A senior US Republican senator has predicted that the bill to roll back Obamacare would probably fail, adding to growing signs that the bill is in trouble.

My view is that its probably going to be dead, John McCain said on the CBS program Face the Nation.

The Senate bill, which faces unified Democratic opposition, has been further imperilled during a week-long recess where several Republican senators have had to return to their states and face constituents strongly opposed to it. Senators return to Washington on Monday.

The Senate bill keeps much of Obamacare intact but strips away most of its funding. It repeals most Obamacare taxes, overhauls the laws tax credits and ends its Medicaid expansion. It also goes beyond repealing Obamacare by cutting funding for the Medicaid program beginning in 2025.

The White House chief of staff, Reince Priebus, said on Sunday on Fox News that President Donald Trump expected Congress to pass a bill to repeal and replace Obamacare.

The Republican senator Ted Cruz on Sunday said failure to pass the bill was not an option and the Senate effort had to focus on lowering premiums. He pointed to an amendment he offered that is being scored by the nonpartisan Congressional Budget Office, which assesses the impact of legislation.

Cruzs amendment would allow insurers to offer plans that do not comply with Obamacares mandate that they charge sick and healthy people the same rates and that they cover a set of essential health benefits, such as maternity care and prescription drugs, as long as they also offer plans that do comply with the regulations.

The amendment has drawn the support of conservative senators and groups, who say the it will help lower premiums. But moderate Republicans and outside critics say it will erode protections for people with pre-existing conditions and make their insurance unaffordable.

The Senate majority leader, Mitch McConnell, aims to hold a vote on the legislation, which needs the support of at least 50 of the Senates 52 Republicans, before a six-week recess that begins on 29 July.

Yet even McConnell cast doubt on the bills prospects for passage last week.

Speaking at a luncheon in his home state of Kentucky, McConnell said if Congress failed to follow through on a seven-year pledge to repeal Obamacare then it must act to shore up private health insurance markets, comments seen as providing a pathway to a bipartisan deal to fix the health system.

Read more: https://www.theguardian.com/us-news/2017/jul/10/john-mccain-predicts-republican-healthcare-bill-will-fail

McConnell hints healthcare vote could fall short: ‘I’m a guy with a Rubik’s cube’

Senate majority leader spoke to impasse over key aspects of Republican bill at an event Thursday, but said no action was not an alternative

Senate majority leader Mitch McConnell on Thursday hinted that the Republican effort to repeal the Affordable Care Act (ACA) could fall short as conservatives and moderates in his conference remain at an impasse over key aspects of the bill.

Before leaving Washington for a week-long Fourth of July recess, McConnell delayed a vote on the Republican healthcare bill after it was clear there was not enough support for the plan, which would leave 22 million fewer people without health insurance over the next decade, according to an analysis by the Congressional Budget Office.

If my side is unable to agree on an adequate replacement, then some kind of action with regard to the private health insurance market must occur, McConnell told constituents at a Rotary Club lunch on Thursday, according to the Associated Press.

No action is not an alternative, he added. Weve got the insurance markets imploding all over the country, including in this state.

McConnells comments were quickly embraced by his Democratic counterpart, Senate minority leader Chuck Schumer.

Its encouraging that Sen McConnell today acknowledged that the issues with the exchanges are fixable, and opened the door to bipartisan solutions to improve our healthcare system, Schumer said in a statement.

As weve said time and time again, Democrats are eager to work with Republicans to stabilize the markets and improve the law. At the top of the list should be ensuring cost-sharing payments are permanent, which will protect healthcare for millions.

McConnell faces a daunting task as he works behind the scenes with senators to craft a bill that bridges the ideological divide within his conference. Moderates, especially those from states that opted to expand Medicaid under the ACA (also known as Obamacare) are wary of scaling back spending on the health insurance program for low-income Americans, and conservatives are irked the plan does not go further to repeal the law.

Im in the position of a guy with a Rubiks cube trying to twist the dial in such a way to get at least 50 members of my conference who can agree to a version of repealing and replacing Obamcare, McConnell told Kentucky voters at a town hall-style event on Thursday, according to NBC. That is a very timely subject that Im grappling with as we speak.

Senate
Senate minority leader Chuck Schumer holds up a photograph of constituents who would be adversely affected by the proposed Republican bill. Photograph: Andrew Harnik/AP

An initial draft of the Senate Republican healthcare plan mirrors the structure of the House bill, which passed in May. The measure would repeal key pieces of the ACA while extracting deep cuts to Medicaid compared to spending under current law.

McConnell has since made changes to the bill, including adding $45bn to combat the opioid epidemic, among other adjustments. The CBO is expected to release another analysis sometime next week, a likely indicator that Senate Republicans will not vote on the plan until later this month.

On Thursday, a handful of senate Republicans echoed McConnells skepticism about whether the party would be able to reach an agreement on health care.

It is precarious, senator Ted Cruz, a conservative of Texas, said on San Antonios KTSA Radio. The majority is so narrow, I dont know if we get it done or not.

Senate Republicans are using a special budget process known as reconciliation to avoid a Democratic filibuster of the repeal plan. To pass the bill, Republicans need support from at least 50 of their 52 members. No Democrats are expected to support a repeal measure. In the case of a tie, vice-president Mike Pence would cast the final vote.

Cruz has offered an amendment that would allow insurance companies to sell non-compliant plans as long as they also offer at least one plan that does meet Obamacare standards. Experts on both sides of the political debate said such an action could devastate insurance markets.

Senator Jerry Moran, a Republican from Kansas who surprised his party when he came out against the bill, told constituents in Palco that healthcare reform is almost impossible to try to solve when youre trying to do it with 51 votes in the United States Senate, in which there is not significant consensus on what the final result ought to be.

As the debate over healthcare rages, Senator Pat Toomey, a Republican of Pennsylvania who supports the bill, suggested during a televised town hall on Wednesday that McConnell was several weeks away from winning enough support for a vote. Asked why Republicans were struggling to fulfill a years-long campaign promise, Toomey offered a candid reply.

Look, I didnt expect Donald Trump to win, he said. I think most of my colleagues didnt, so we didnt expect to be in this situation.

Read more: https://www.theguardian.com/us-news/2017/jul/06/republican-healthcare-bill-mitch-mcconnell-vote-delay

Activists cry cowardice as Republican senators shut doors to healthcare town halls

Pat Toomeys closed-door talk saw him accused of not having the courage to speak to those affected, while Ted Cruz also faced dissent at his ticket-only event

At a town hall in Pennsylvania on Wednesday night, Republican senator Pat Toomey faced an angry protest over his role in the GOP healthcare bill, while Ted Cruz was heckled over his suggested amendment to the legislation at an event in Texas.

Scores of people gathered outside the ABC27 studio in Harrisburg, Pennsylvania, where Toomey was holding what had been billed as a town hall meeting.

But in reality just eight audience members were allowed into the invite-only event, and their questions had been pre-screened by the news channel.

The closed-door approach did not endear Toomey to the sign-waving protesters outside, who accused the senator of not having courage to speak to people who would be personally affected by the Senate healthcare legislation he helped to write.

Cruz, meanwhile, was heckled at what in theory should have been a safe event; a ticket-only town hall veterans discussion hosted by Concerned Veterans for America a rightwing advocacy group financed by the Koch brothers.

Audience questions for Cruz at the event in McKinney, north of Dallas, had been screened in advance by the CVA, but two audience members went rogue to quiz and interrupt the Texas senator over his proposed tweak to the Senate bill.

The Better Care Reconciliation act, which the Congressional Budget Office says would leave an additional 22m people without healthcare, is currently stuck in the Senate without enough votes to pass. Cruzs amendment would allow insurance companies to sell plans that do not include the Affordable Care Act (ACA)-mandated essential health benefits, in a move he claims would reduce costs.

At the town hall, however, Cruzs adversaries repeatedly shouted him down as he attempted to defend his measure.

When you mandate what every policy has to cover you drive up the cost of insurance, Cruz said, which means fewer people can afford healthcare. The essential health benefits also made people pay for coverage that they dont necessarily want, he said.

Its all fine and good to mandate that everybody get coverage for everything at all times, but what happens in practice is the prices go so high that people are left out in the cold.

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Ted Cruz also faced heckling at a ticket-only town hall event in Texas. Photograph: ddp USA/REX/Shutterstock

Some 1,300 miles to the north east, Toomey was being given a much easier ride from the eight attendees at his town hall. The majority of the questions from that crowd, as well as from small groups of people invited into the studios of three other ABC affiliates in Pennsylvania, focussed on healthcare, but there was no heckling and no follow-up questioning.

Asked about the damaging CBO score, Toomey accused the organization of bias and said that its calculations were based on wildly speculative assumptions that I think are extremely likely to come to pass.

Toomey denied that the process of drafting the bill which has no public hearings had been overly secretive, but was non-committal over whether he supported repealing the ACA without a replacement.

The senator was asked the question twice, both times saying that he believed the scenario was unlikely.

I just dont think there are enough votes in the senate to pass that, Toomey said. I just dont think its going to come to pass.

Meanwhile, outside the studio about a hundred people noisily protested both the senators role in the unpopular healthcare bill and his refusal to hold a truly public event.

We want Toomey to come home on his recess and actually speak with constituents, instead of doing telephone town halls or televised town halls where he doesnt have to interact with the people hes supposed to be representing, said Katey Dyck in a phone interview, who travelled two hours from her home in Fort Washington, just north of Philadelphia, to attend the protest.

Hes dismantling our healthcare system without having the courage to speak to people who would be personally affected.

Dyck travelled to Harrisburg with her two children and two friends, one of whom, Alison Fraser, was arrested after staging a sit-in at Toomeys Washington DC office last week.

There are issues with the ACA. There are things they can do to bring down costs, Fraser said.

But they cant just dismantle this bill that has really done so much to protect people, and make sure people arent discriminated against because of pre-existing conditions.

Also among the protesters was Josh Burkholder, a Democrat who ran unsuccessfully for US congress in Pennsylvanias fourth district last November.

Theyre giving a huge tax break to the 1% here, Burkholder said, also by phone, of the Senate legislation.

Its just awful. Making a giant tax break for the ultra rich while simultaneously pulling the rug out from under the poor of the country is just disgusting.

The majority of Senate Republicans have so far ducked interactions with the public during recess week supposedly a time for elected officials to return to their districts and meet with constituents.

The Washington Post reported that just four GOP senators planned to attend Fourth of July parades, while only three Cruz, Bill Cassidy from Louisiana and Jerry Moran from Kansas are scheduled to hold public town halls.

Cruz and Moran are openly opposed to the Senate bill while Cassidy has said he is concerned and has put forward an alternative to the plan.

Read more: https://www.theguardian.com/us-news/2017/jul/05/pat-toomey-ted-cruz-healthcare-bill-protest

North Korea: US and its allies face shortage of good options

Pyongyangs latest missile test has revived calls to deal with Kim Jong-un. But all possible strategies carry huge risks

North Koreas successful launch of an intercontinental ballistic missile that could one day carry nuclear warheads to the United States has revived talk of military intervention in the reclusive state.

Pyongyangs nuclear ambitions, once a somewhat abstract strategic concern for bureaucrats in Washington, have suddenly become more pressing. The secretary of state, Rex Tillerson, said earlier this year that all options are on the table for blocking its nuclear weapons programme.

Talk of a surgical strike often surfaces when politicians are contemplating military intervention in conflicts or troubled areas around the globe, perhaps because it carries connotations of a focused, efficient attack, with minimal collateral damage, like a clean surgical incision. That is a distracting illusion.

Read more: https://www.theguardian.com/world/2017/jul/06/north-korea-us-and-its-allies-face-shortage-of-good-options