Tag: congressional republicans
Health Inflation Won't Stabilize Until Politicians Confront Monopoly Hospitals

Health Inflation Won't Stabilize Until Politicians Confront Monopoly Hospitals

Today’s inflation report is a wake-up call for wannabe-be health care reformers. It provides the perfect opening for injecting how to control hospital prices into this year’s political debate.

The overall inflation rate ratcheted up 4.2% last month, driven largely by fast-rising gasoline and diesel prices that are entirely due to Trump’s ill-conceived, undeclared and unwinnable war against Iran. If you take out food and energy, inflation was up “only” 2.9%. That’s still nearly a full percentage point above the Federal Reserve Board’s target level.

But dig a little deeper into the numbers and you find medical inflation, which many Americans consider their most pressing concern, rose 3.6% over a year ago, faster than the core inflation rate. Prices for hospital services were almost entirely responsible for the jump — up 5.7% year over year.

The second largest component of health care services — physician fees — grew at a much slower pace, up 2.8% or about the same rate as core inflation. Drug prices fell 2.1% over the past year.

The drug price component of the consumer price index is somewhat misleading since the Bureau of Labor Statistics measures the change in existing drugs and generics, not the price of new drugs coming to market. Big Pharma introductory prices for new drugs like the popular GLP-1s have reached sky-high levels, which often come down somewhat after launch to attract more customers.

Novo Nordisk’s Wegovy, for instance, came to market at $1,349 a month, but now can be purchased for as little as $350 a month. That shows up as a major price decline in the index, even though many consumers still can’t afford it because their insurance companies won’t pay for it.

Speaking of insurance companies, the New York Times reports their prices fell 6.4% over the past year, which is hard to understand given the rising prices for almost all of the services they finance with the premiums collected from employers and consumers. I also don’t know where the Times got that data since I couldn’t find it in either the Bureau of Labor Statistics press release or the agency’s detailed data tables.

I suspect at least some of the decline in health insurance prices reflects what individuals pay for plans sold on the exchanges, where millions of people are switching to bronze plans from pricier silver plans to lower their upfront premiums. Unfortunately, when they use their insurance, they will have much higher out-of-pocket costs.

This isn’t a price decline. It’s a cost-shift. I suspect some health care economists will insist cost-shifting doesn’t exist, claiming it reflects consumer preference for the cheaper item.

None of this is good news for the nation’s hospital leaders, who have launched a major media campaign to shift the blame for rising health care prices onto health care’s other special interests. The American Hospital Association’s March report “The Cost of Care” blamed the surging cost of drugs, labor and supplies for their price increases.

Some of that is true, but the document offers a classic inside-the-beltway manipulation of data to make its case. The AHA report used a consulting firm’s data to show that “advertised salaries for registered nurses have grown 26.6% faster than the rate of inflation over the past four years. These increases are essential to maintain staffing levels but also contribute to the overall financial challenges hospitals face.”

Let’s take a closer look at that claim. The cumulative inflation rate between May 2022 and May 2026 was 13.8%, an average of about 3% a year before compounding. A 26.6% increase brings that to 17.5% over four years, or an average of about 4% before compounding. If anything, the AHAs data shows nurse wages have gone up about a percentage point faster each year than underlying inflation, which is what you might expect from a sector of the economy with a large union membership. Hospital prices, on the other hand, have gone up about two to three percentage points faster than inflation.

Higher wages for nurses can actually be a good thing for hospitals, which frequently hire traveling nurses to staff unexpected surges in patient load or temporarily fill open positions. The staffing firms that provide those nurses (like publicly-traded AMN Healthcare) impose huge mark-ups on the underlying nurse salaries, which make their cost considerably higher than hiring permanent staff. The same is true for many of the support staff occupations inside hospitals. If hospitals paid adequate wages and provided decent working conditions for their permanent staff, perhaps they wouldn’t have to rely on high-priced staffing firms to keep their facilities running.

Meanwhile, the House Energy and Commerce Committee today held a hearing on Capitol Hill to promote greater hospital and insurance company price transparency, an issue for which there is bipartisan support. The assumption is that greater transparency will promote competition and allow health care “consumers” to shop.

This ignores the economic realities of health care. First, only a small portion of health care services are shoppable. Second, there is little or no competition in most markets. Third, even where competition exists, most patients are locked into networks and hospital systems that offer a closed loop of primary care and specialty physician providers. More than half of all doctors in the country now work for either hospitals or insurance companies.

“The monopolization with regard to hospitals and so many health care interests exists and is getting worse,” Rep. Frank Pallone Jr. (D-NJ), the ranking member of the committee, said in his opening statement. “So, let’s not forget that … to use transparency more effectively …, we have to also look at the competitive environment to make sure it truly is competitive.”

I’m not holding my breath for Republicans to endorse greater antitrust enforcement. But it is disappointing that Democratic leaders are putting all their marbles on competition policy to bring down hospital prices, which under the best of circumstances will take years of court battles to bring results.

I didn’t get a chance to listen to the hearing today, but I bet not a word was said about putting hospitals on budgets, putting physicians on salaries and giving administrators the freedom to deploy their financial resources in ways that deliver better health outcomes. The American people are ready for meaningful change. So far, such proposals are missing from this year’s health care debate as we head into the mid-term election season.

Merrill Goozner, the former editor of Modern Healthcare, writes about health care and politics at GoozNews.substack.com, where this column first appeared. Please consider subscribing to support his work.

Reprinted with permission from Gooz News

How Trump's Immigration Crackdown And Growing Inequality Threaten Social Security

How Trump's Immigration Crackdown And Growing Inequality Threaten Social Security

On Tuesday the Social Security Trustees released their latest report on the system’s finances. The numbers didn’t change much: Unless something is done, the Old Age Survivors and Disability Insurance (OASDI) program, Social Security’s official name, will be unable to pay full benefits starting in either 2032 or 2034, depending on some technical issues. That’s not far away: If the Trustees are right, the prospect of a Social Security crisis will loom over the next presidential administration.

It’s important to understand, however, the nature of the looming crisis. It won’t be an economic crisis. It won’t even be a serious fiscal crisis. Whatever you may have heard, Social Security isn’t in danger of going bankrupt.

What we’re facing, instead, is potential political crisis. Congress and the White House could easily take action to sustain America’s retirement system. But given the current state of our politics, there’s no guarantee that they will.

There is a widespread misunderstanding of how Social Security works. While Social Security was designed to look like a pension fund, it isn’t. A pension fund pays benefits out of a stock of assets it has accumulated over time. In contrast, Social Security operates as a government transfer program, like food stamps or Medicaid.

Now, unlike food stamps — but like the highway trust fund — Social Security is on paper supported by a dedicated tax, the payroll tax, that is assigned to that program. But I say “on paper” because from an economic point of view assigning the payroll tax to Social Security is just an accounting convention. What matters for the U.S. economy is the overall balance between government spending and government revenue, not the difference between one type of spending and one source of revenue. So there’s no inherent economic significance to the fact that by 2034 payroll tax receipts will be insufficient to cover promised benefits.

There is, however, a legislative issue. As long as the Social Security Administration can pay benefits out of payroll taxes and its cash reserve, there’s no need for Congress to vote each year to authorize benefits — they just keep going out until further notice. However, once those resources become insufficient, benefits will fall —by 17 percent according to the Trustees — unless Congress passes new legislation that “tops up” Social Security’s finances.

Yet the current administration and Republican party are such extremists that there is a real risk that Social Security will be held hostage on behalf of their goals. If this should come to pass, the hostage-takers will claim that shoring up Social Security is unaffordable. Right on cue, Mike Johnson, the Trump-sycophant Speaker of the House, declared on Monday that “entitlement programs” like Social Security “have to be adjusted and fixed,” and that Republicans will introduce a plan to that effect next year.

But this is a ploy, because while the cost of maintaining Social Security benefits at their promised level isn’t trivial, it is in fact affordable. According to the Trustees’ report, the actuarial balance of OASDI up through 2050 — the amount of additional funds it would need to keep paying full benefits for the next 25 years — is 1.06 percent of GDP. To put that number in perspective, the Trump administration proposes increasing military spending next year by $420 billion, equivalent to about 1.4 percent of GDP – without any discussion of whether that’s affordable

Yet how did we get to the point where Social Security will need to be topped up? The main answer is that we have an aging population, with a growing ratio of retirees collecting benefits to workers paying into the system:

Trump’s anti-immigration policies are making this problem worse. According to the Trustees’ report, lower immigration will deepen Social Security’s financial hole because many immigrants are working-age adults who will pay into the system for decades before they collect benefits. In fact, this problem may be much bigger than the report acknowledges: The report’s baseline assumption is that we’ll have net immigration of almost 1.2 million people a year, and even the pessimistic case assumes 750,000 a year. Meanwhile actual net immigration has already been cut far below that — and may now be negative.

Moreover, Social Security is being financially damaged by growing income inequality in America. Payroll taxes are levied only on wages up to $184,500, and they don’t touch capital income. With the distribution of income increasingly shifting from labor to capital, as well as becoming more unequal among wage-earners, revenue from the Social Security payroll tax has been falling as a share of national income. From 1990 to 2024, it fell from 5.02 percent of gross domestic income to 4.46 percent.

Which brings me to the question that, these days, we ask about everything: How might Social Security be affected by the advent of AI?

A short answer: If, as many of us fear, AI accelerates rising income inequality, it will further reduce the payroll tax receipts that currently pay for Social Security and further endanger its finances.

On the other hand, if AI, as its advocates promise, leads to faster economic growth, it will increase the potential tax base that could and should be used to support Social Security and other social insurance programs. But to take advantage of that larger base, we’ll have to get serious about taxing wealth and capital income.

Is Social Security in trouble? Yes, but only because of the way its financing is currently structured — a structure that no longer works well because our society and economy have become so unequal. Moreover, Trump’s immigration policies are further endangering its already deteriorating financial condition.

So don’t believe Republicans’ gaslighting that it will be necessary to cut Social Security benefits. All that is necessary to preserve Social Security is political will to raise taxes on the wealthy and a sensible immigration policy.

Rising Gas Prices Enraged Republicans Under Biden, But Not Any More

Rising Gas Prices Enraged Republicans Under Biden, But Not Any More

When the price of gas skyrocketed in 2022 after Russia invaded Ukraine, Republicans fell over themselves to blame then-President Joe Biden in hope of hurting his reelection bid as well as Democrats in the midterms—even though Biden was not at fault for the spike.

But now, with President Donald Trump squarely responsible for the exponential increase in oil and gas prices after he launched an ill-conceived war on Iran, Republicans have completely reversed course, claiming that high gas prices are a cost that they're willing to pay.

It’s a message taken directly from Dear Leader, who had the gall to argue this week that higher oil prices are actually good for Americans.

Get a load of Rep. Jim Jordan of Ohio, who said Thursday that he’s totally fine with higher gas prices in order to let Trump wage war in Iran.

"If that means prices go up for a short time, I think Americans understand we can live with that," Jordan said on CNN.

But in 2022, Jordan was one of the loudest voices criticizing rising gas prices.

"Real America doesn’t care about the January 6th Committee,” he wrote on X at the time. “Gas is over $5 per gallon!”

And he was still on a tear about gas prices in 2023.

"Gas prices are up 63 cents this year. Groceries prices are still at record highs. Good luck affording a house with 7% interest rates. Bidenomics!" Jordan wrote on X at the time.

But Jordan is not singing the same tune today, with gas prices up 69 cents over the last month, grocery prices rising, and mortgage rates at more than six percent—all directly thanks to Trump’s war and illegal tariffs wreaking havoc on the economy.

Then there’s Rep. Mark Alford of Missouri, who told CNN this week that “there may be sacrifices to be made at the pump on a temporary basis."

"I think the people in my district are [willing to pay higher prices at the pump],” Alford said. "I'm willing to pay 30 percent or 30 cents more at the pump to make sure Iran doesn't have a nuclear weapon that's going to hit the U.S."

ALFORD: There may be sacrifices to be made at the pump on a temporary basisRAJU: Do you think Americans are willing to make it?A: I think the people in my district are. I'm willing to pay 30%, or 30 cents more at the pump to make sure Iran doesn't have a nuclear weapon that's going to hit the US

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— Aaron Rupar (@atrupar.com) March 11, 2026 at 2:50 PM

Just a few weeks ago, Alford was praising Trump for lowering gas prices.

"President Trump and House Republican’s [sic] America-First energy agenda is working—and it’s working so well that even networks usually quick to criticize are reporting the relief with a smile. When gas prices go down, American families go forward,” he wrote on X.

So then does Alford think that skyrocketing gas prices thanks to trigger-happy Trump make Americans go backward?

Sen. Rick Scott of Florida also said that Americans just have to get over surging gas prices because Trump's war is more important.

“We’d love to get gas prices back down, but the most important thing is [to] destroy Iran’s ability to produce a nuclear weapon, destroy their military, their ballistic missile capability," Scott told CNN. “We all want gas prices to come down. Nobody wants gas prices higher. This president doesn’t want gas prices higher. But we have to be realistic."

Of course, Trump said in June that the United States “obliterated” Iran’s nuclear capabilities, so it’s unclear how in just a few months the country became such a massive threat that war was necessary.

Given that a majority of Americans don't support Trump’s war and only wanted to see prices in the United States come down, it's hard to imagine that being a winning message for the GOP.

But that didn’t stop Sen. Roger Marshall of Kansas from pushing the same message.

"Freedom is not free. Americans are gonna have to make some sacrifices," Marshall said, even though the war in Iran has nothing to do with freedom in the United States.

However, there is one Republican sounding the alarm on Trump's war.

“If we are still bombing Iran with kinetic action—people don’t want to call it war—if there’s still kinetic action that causes oil to be over $100, I think you’re going to see a disastrous election [for Republicans],” Sen. Rand Paul of Kentucky told Fox Business.

Rand Paul: "The 2026 elections, already we are behind the 8 ball. If you add in high gas prices, high oil prices, and if we're still bombing Iran with kinetic action -- people don't want to call it war -- I think you're gonna see a disastrous election."

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— Aaron Rupar (@atrupar.com) March 10, 2026 at 9:00 AM

Paul’s right: Rising gas prices are Trump's fault, and voters will punish the GOP for it come November.

Reprinted with permission from Daily Kos

Why The Save America Act Could Be Political Suicide For Republicans

Why The Save America Act Could Be Political Suicide For Republicans

It's common sense, Republicans say. You have to show ID to buy a beer, board a plane, or land a job as a snow shoveler. Why not require proof of identity from those who seek to exercise our most sacred civic right, casting a vote?

According to the polls, the GOP has won the argument. Most Americans favor a voter ID law.

What Republicans are currently pressing for, the SAVE America Act, however, is not a voter ID law, a requirement that registered voters prove who they are when they go to the polls. SAVE is a "prove you're a citizen" law.

Why is the GOP pushing SAVE America? Republican voters will be hit hardest. Clearly, neither President Donald Trump nor the Republican Party knows what's good for them.

A voter ID law — something most states, especially red ones, currently have — passes the common-sense test for most Americans because it requires a form of identity nine out of 10 people have, or can obtain fairly easily, like a driver's license or non-driver's state identification card. Some states even take non-photo IDs. Voter ID laws have been promoted by Republicans primarily because they limit or eliminate mail-in voting, which they wrongly assume benefits Democrats.

The SAVE America Act goes much further than voter ID. In an attempt to improve Republican candidates' chances under the guise of protecting voting integrity, it tries to disenfranchise Democratic voters.

Ironically, it will have the opposite effect.

Voter ID attempts to verify who you are. SAVE America requires you to show proof of citizenship in the form of a passport or a birth certificate with your current name on it. (Noncitizens can get a driver's license.) Far more Democrats have proof of citizenship than Republicans.

Fewer than half of U.S. citizens hold a passport. For these elites, the SAVE America Act would be a breeze. Sixty-four percent of Americans with a household income above $100,000 have a passport, while only 21 percent of those earning under $50,000 do. Upper-middle-class white voters lean Democratic; poorer whites lean Republican.

Roughly half of 2024 Trump voters have passports, compared to two-thirds of Kamala Harris voters. The 13 states with the lowest passport rates all voted Republican in 2024. Congressional districts with low passport ownership are overwhelmingly GOP-held, rural and/or Southern. Rural voters (a GOP stronghold) face longer drives to election offices for in-person verification. Older voters, military personnel, tribal citizens and working-class Americans — Republican-leaning demographic groups — are less likely to have the required documents.

A substantial number of voters don't have a physical copy of their birth certificate. Research by the Brennan Center "indicates that more than nine percent of American citizens of voting age, or 21.3 million people, don't have proof of citizenship readily available. There are myriad reasons for this — the documents might be in the home of another family member or in a safety deposit box. And at least 3.8 million don't have these documents at all, often because they were lost, destroyed, or stolen."

Poor voters — who tend to vote Republican — live more disorganized, mobile lives. They're less likely to know where their birth certificate is or how to obtain a new one, or be motivated to find out America would effectively repeal women's suffrage. "84 percent of women who marry change their surname, meaning as many as 69 million American women do not have a birth certificate with their legal name on it and thereby could not use their birth certificate to prove citizenship," notes the Center for American Progress. "The SAVE Act makes no mention of being able to show a marriage certificate or change-of-name documentation."

Women who change their names — twice as likely to be Republican — would have to present themselves at their county board of elections office, which is only open during business hours, when most people work.

There, local election workers — overwhelmed by a sudden surge of applicants — would have to sort through each individual's marriage and divorce decrees and other miscellany to determine whether Mrs. Jane Doe, née Jane Smith, is eligible to vote. Given that SAVE America mandates a fine and prison time for an election official who wrongly allows someone to vote, even someone who is a citizen but without the right documents, the path of least resistance for a beleaguered, poorly paid local election clerk would be to reject rather than approve name-change voters, including trans people.

After decades of easing voting with same-day registration, automatic registration with driver's license renewals, early and mail-in voting, SAVE America would make voting much harder. Many people will choose not to vote rather than jump through so many bureaucratic hoops for the right to choose between a center-left and center-right party, neither of which delivers for them. Here is the purpose of SAVE America — to radically reduce the number of voters.

Most of whom, hilariously, are Republican.

It's bizarre that the right is fighting for SAVE America. Democratic worries about discouraging working-class voters are sweet but run counter to their interests. As the 2024 election proved, poor and lower-middle-class voters are no longer theirs to lose. If Democrats were smart, they'd be the party pushing the SAVE America Act — or getting out of its way.

The GOP wants SAVE America because they haven't internalized the class shifts in the American electorate. Republicans have become the party of the working poor (even if they don't care about them), while Democrats are now the party of coastal elites (though they pretend to champion Joe and Jane Sixpack).

If passed, and signed into law, the SAVE America Act is likely to backfire for its Republican sponsors in the same way that Trump's advice to MAGA followers not to use write-in ballots contributed to his loss in 2020.

Ted Rall, the political cartoonist, columnist ,and graphic novelist, is the author of the brand-new What's Left: Radical Solutions for Radical Problems. He co-hosts the left-vs-right DMZ America podcast with fellow cartoonist Scott Stantis and The TMI Show with political analyst Manila Chan. Subscribe: tedrall.Substack.com.

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