All posts by Kate Cox

Senate Plans Meaningless Hearing On Obamacare Repeal Bill

One of the reasons that the effort to repeal the Affordable Care Act met a dramatic late-night demise in July was the criticism that GOP lawmakers held no actual hearings on this matter that could directly impact many millions of Americans. As Republican senators look to make one last try at repeal before their clock runs out, legislators are finally holding their first, but ultimately pointless, public hearing on healthcare.

I’m just a bill…

Ordinarily a bill goes through an iterative process before it becomes law. The path goes something like this:
  • One or more Senators introduce it
  • The bill is then referred to relevant committee(s)
  • The committee(s) hold one or more hearings and markup sessions on bill, debating its merits and adding or subtracting language (amendments)
  • The final, amended bill passes committee by majority vote
  • The full Senate then votes on the bill after committees are done
That’s regular procedure. But when you go through the regular procedure, in the regular way, for a regular bill, you run the procedural risk of needing to have at least 60 Senators on your side in order to move forward. That’s clearly not going to happen with ACA repeal proposals, which are universally unpopular with the Senate’s 48 Democrats (and Democratic-caucusing independents). So all of the the ACA repeal efforts have been moving through a process called budget reconciliation. To put it briefly, budget reconciliation allows certain types of bills to be fast-tracked through the Senate with only a simple majority. Since Vice President Mike Pence holds the tie-breaker, the GOP need only get to 50 “yea” votes in order to pass the bill. At the same time, this all has to happen by Sept. 30, which is the end of the federal government’s fiscal year. Any bill passed after that would have to go through the normal channels and would need the 60 votes to end debate in the Senate.

Out of the ordinary

The failed July bill did not go through any committee hearings, which was one of Sen. John McCain’s (AZ) key objections when he voted it down. “We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of aisle, heed the recommendations of nation’s governors, and produce a bill that finally delivers affordable health care for the American people,” McCain said at the time. Other Senators also called for a return to “regular order” in the wake of the July mess. And so, a hearing. Sen. Ron Johnson (WI), one of the co-sponsors of the Graham-Cassidy bill, personally promised that the bill would get at least one proper committee hearing. He could bring it before his committee, he said: Homeland Security. “I’m chairman of Homeland Security,” Johnson said. “If either the Finance Committee or [Health, Education, Labor and Pensions] Committee won’t hold a hearing, I’ll notice one this afternoon. We’ll hold a hearing on this prior to September 30th.” And he did indeed put a hearing on the Homeland Security calendar for Sept. 26. If that sounds ridiculous to you, you’re right: The Homeland Security and Governmental Affairs Committee has nothing at all to do with healthcare or health insurance legislation. There’s no real overlap. But Johnson’s political dare paid off: Sen. Orrin Hatch (UT), chair of the Senate Finance Committee, agreed to hold a hearing on the proposal on Monday, Sept. 25. The relevant testimony and witness list are yet to be determined. “Senators have expressed a strong desire to examine the details of the Graham-Cassidy proposal through a public hearing,” Hatch said in a statement. “A hearing will allow members on both sides of the aisle to delve deeper into its policy and gain a better understanding of what the authors hope to achieve.” The hearing, however, is largely for show — to tick a box and say they did it. Aside from a few wild cards, Senators’ minds are already made up along partisan and ideological lines.

And what do they hope to achieve?

The one leg up that the Graham-Cassidy bill has over McConnell’s summer attempts is that it’s not being hidden or kept secret. But other than that, it’s a very similar pile of cuts, likely to have consequences every inch as dire… if not worse. The Congressional Budget Office, tasked with analyzing potential legislation to run the numbers on it likeliest outcomes, won’t have time to churn out a full, deep-diving report on the Graham-Cassidy proposal. However, it is expected to release a high-level, preliminary sketch early next week. READ MORE: Senate may vote on latest Obamacare repeal bill without knowing how many people it will affect Anyone with a pre-existing condition would be at risk for incessantly skyrocketing premiums under Graham-Cassidy, Vox reports. The non-partisan Center on Budget and Policy Priorities also finds that federal healthcare funding — to programs like Medicaid and individual subsidies — would be slashed by hundreds of billions of dollars over the next ten years. The American Medical Association sent a letter [PDF] to the offices of McConnell and Senate Minority Leader Chuck Schumer (NY) asking the Senate to reject Graham-Cassidy because it “would result in millions of Americans losing their health insurance coverage, destabilize health insurance markets, and decrease access to affordable coverage and care.” Other organizations voicing opposition include the AARP, the American Cancer Society, Cancer Action Network, the American Diabetes Association, the American Heart Association, the American Lung Association, the Arthritis Foundation, the National Health Council, and the March of Dimes, among others.

How’s that math?

There are 52 Republican Senators and one Vice President — so to get to 51 votes, McConnell can only afford to lose three. An analysis by the numbers-minded folks at FiveThirtyEight concludes that 46 votes are a sure thing or a nearly sure thing right out of the gate. That leaves a couple of likely “no” votes and four “wild cards” to contend with. Sen. Rand Paul (KY) has already gone on the record in opposition, both in various Tweets and in an op-ed for Fox News. Paul’s opposition comes from the far conservative side: He believes that Graham-Cassidy does not go far enough to remove all traces of the ACA from the world. However, Paul also originally had stringent objections to the July bill at first, before changing his mind and voting for it anyway — so it’s anyone’s guess where his vote would actually fall. The same is true of Utah Sen. Mike Lee, who also initially opposed the July bill for being insufficiently conservative before then voting for it anyway. Sen. McCain has indicated that he might be amenable to voting “reluctantly” in favor, but said his approval was contingent on whether the governor of Arizona felt the Graham-Cassidy would help or hate the people of that state. Gov. Doug Ducey put out a statement endorsing Graham-Cassidy on Monday, and so now McCain is considered more likely to go for it. The other two holdouts in July were Sens. Susan Collins (ME) and Lisa Murkowski (AK). Both objected to deep cuts to Medicaid and other healthcare spending that would negatively affect the populations of their states — and since the new bill provides for cuts that are either equally as bad or worse, all eyes are on Collins and Murkowski to renew their objections once again. Neither, however, has yet gone on the record with either full opposition or support. The Portland Press-Herald reports that Collins has “concerns” with the Graham-Cassidy proposal, particularly with regards to Medicaid. Murkowski is also a long shot to bring on board, CNN reports, because the Graham-Cassidy proposal, as written, would likely be a losing proposition for Alaska overall. Alaska’s governor has come out against the bill. But as Axios reports, the Trump Administration has gone all-in on trying to sway every single Republican Senator to support the proposal — and so we are once again, as a nation, on tenterhooks, waiting to see which way the breeze blows up on Capitol Hill in the coming days.

California ISP Privacy Bill Stalls Out After Heavy Pushback From Industry

There is no federal-level law protecting your private web data from your internet-providing company anymore, and there likely won’t be a replacement anytime soon. So some states are trying to take matters into their own hands. But the latest, last-ditch effort in the tech capital of the U.S. has failed, after strong pushback from the very companies it would regulate.

The Federal rule

In late 2016, the Federal Communications Commission adopted a rule that would place some basic limitations on how your internet service provider can use your personal information. Basically, the FCC split up all your personal data into two big categories. One was opt-in only: Your ISP could only share certain highly personal data (like your web browsing history) if you explicitly opted in. Other data, however, was in the “opt-out” bucket: Your ISP would be permitted to use, sell, and share it until and unless you explicitly told them to stop. The rule would have applied to home providers like Comcast and Charter, as well as to wireless providers like Verizon and T-Mobile. But it never got the chance to see the light of day: Basically as soon as the new Congress began in January, the House and then the Senate voted to reverse and block the rule. President Trump signed the resolution killing the privacy rule in May, and so its absence has been law ever since. RELATED: Without internet privacy rules, how can I protect my data? But the U.S., of course, operates at the state and local level as well as at the federal one, and so other jurisdictions have been trying to come up with their own ways to protect residents’ privacy ever since the federal rule was dropped.

Enter California, stage right

In February, a member of the state Assembly proposed a bill to create an ISP privacy rule in California. The California Broadband Internet Privacy Act (AB-375) sought to limit ISPs ability to share your data in almost exactly the same way that the now-defunct FCC rule did — with the customer having the right to opt-out of some kinds of data usage, and the internet company being required to get affirmative customer opt-in for others. Because California is both the nation’s most populous state and also headquarters to most of our biggest tech conglomerates, its state laws have outsized influence. For example, California’s 2003 privacy protection law requires all websites accessible in the state to conspicuously post their privacy policies. Because of the way the Internet works, the list of websites accessible to California residents is functionally the same as a list of all websites, and so all of us everywhere get to benefit.

Not so fast…

The bill, from the start, faced long odds. It was moving through the state Senate in an unusual way, procedurally, needing approval from three different committees in order to move forward. Meanwhile, the same companies that objected to the federal government taking action to protect consumers’ privacy objected to the largest state doing it, too — and they had company from the Golden State’s own tech giants. A massive coalition of internet groups sent a letter of opposition to AB-375 [PDF] to the California Assembly after the bill was last amended on Sept. 12. That coalition had every major ISP you can think of, including Altice, AT&T, Charter, Comcast, Cox, Frontier, Sprint, T-Mobile, and Verizon signing on, along with their representative lobbying groups, as usual. But both Facebook and Google also joined in, along with Verizon’s Oath, the recently-renamed giant that used to be Yahoo and AOL. Digital-rights advocates began framing AB-375 as a classic consumers-vs-industry battle: AT&T and Comcast wanted to quash the bill; constituents began to rally support and try to make it happen. But California’s legislative deadline came and went on Friday night with no motion, and so the bill is toast until it can be raised again in 2018.  

Senate Republicans Making One Last Effort To Take Down Obamacare

Yes, again: After spending the spring and summer trying and failing to repeal the Affordable Care Act, Republicans in the Senate have come up with one last Hail-Mary bill to take down the ACA and revamp American healthcare.

So what is it this time?

Senators Lindsey Graham (SC) and Bill Cassidy (LA), joined by Dean Heller (NV) and Ron Johnson (WI) on Wednesday released a new, last-ditch ACA repeal bill. Graham and Cassidy actually first pulled together their proposal in July, while the Senate was foundering on the McConnell bill that eventually failed. Most folks call this attempt the Graham-Cassidy bill, although the Senators’ offices are trying to make “GCHJ” happen. (It won’t.)

What does it do?

Although this bill [141-page PDF] takes a slightly different approach to repeal than the failed July bill, Graham-Cassidy still aims for several similar outcomes, including:
  • Repealing the individual mandate
  • Repealing the employer mandate
  • Permitting states to opt out of requiring insurers in their borders cover essential health benefits
  • Ends the Medicaid expansion
  • Replaces some Medicaid funding with block grants that states can use for whatever
An analysis from the non-partisan Center for Budget and Policy Priorities concludes that Graham-Cassidy would result in large cuts to federal funding for healthcare overall, without replacement. The bill would also hurt anyone with pre-existing conditions on the individual market, because of the way in which states would be able to opt out of benefits and coverage requirements. Graham-Cassidy would “cause many millions of people to lose coverage, radically restructure and deeply cut medicaid, and increase out-of-pocket costs for individual market consumers, the CBPP concludes. Our colleagues down the hall at Consumers Union agree. “Just like its predecessors, this plan would leave tens of millions uninsured, threaten key consumer protections and coverage requirements, and fundamentally alter Medicaid by drastically cutting funding and shifting billions of dollars of healthcare costs onto states and consumers,” CU’s Betsy Imholz said in a statement. In short: it’s basically a new skin on the same set of policy proposals we all saw circulating earlier this year.

Is it actually going to happen?

Hill-watchers and Washington media largely consider Graham-Cassidy an unlikely long shot at best — but if watching Congress in 2017 has taught us anything, it’s: ¯_(ツ)_/¯ The math in the Senate is the same now as it was in July: Senate Majority Leader Mitch McConnell needs 50 members to vote in favor of something in order to get it to pass. (Vice President Mike Pence can cast a tie-breaking 51st vote as needed.) That’s leading Republicans in favor of the bill to crow that they’re almost there, boasting that at least 47-49 members are already in line to vote for it. But as we saw this summer with Sen. John McCain’s (AZ) dramatic late-night thumbs down, it’s that 50th vote that you can’t get by without. There are 52 Republicans in the Senate, meaning that if three choose not to support the bill, it’s dead in the water. Sen. Rand Paul (KY) has already gone on the record as a “no.” Sens. Susan Collins (ME) and Lisa Murkowski (AK) were the other holdouts over the Senate’s July bill. At the time, both cited objections to cuts in coverage and in Medicaid funding. Consdiering Graham-Cassidy promises equally dire cuts, it seems unlikely that either would suddenly be swayed — but unlikely is not the same as impossible. That said, anything that did manage to get through the Senate would still have to get through the House before becoming law… and the clock is ticking. Because the procedural tactic Congress has been using to try and rewrite healthcare, budget reconciliation, has a deadline. Congress has to be completely done with any bill before the clock strikes midnight on Sept. 30.

Verizon Gives Up, Decides It Doesn’t Want To Buy Comcast Or Charter After All

Ever since an openly business-friendly administration stepped into the White House, analysts and investors have been pushing for Verizon to merge with a cable/internet giant like Comcast or Charter. And the telecom titan’s CEO has even indicated his interest in a corporate marriage of convenience with a massive cable or media company. But now the company says it has no immediate plans to wed. Verizon has “moved on” from trying to acquire or be acquired by one of the big cable companies, CEO Lowell McAdam told a crowd of investors and money-men at a confernece this week, Bloomberg reports. Despite already being the largest wireless carrier in the U.S., and having a massive, sprawling, critical copper and fiber network over giant swaths of the country, Verizon has been desperately flinging itself at cable suitors all year long. In April, McAdam made it clear that he wanted to talk merger, and he wasn’t picky, saying that he’d be happy to discuss terms with Comcast, Charter, or even a media-side company like Disney. A couple of months later, news dribbled out that Verizon had actually tried to make a play for Charter, but Charter said no. It wasn’t that Charter’s wholly uninterested — it, too, has been considering more mergers this year — but rather that Verizon’s $100 billion offer reportedly wasn’t nearly enough. Bloomberg also notes that merging with a cable company right now might be kind of pointless for a company as well-positioned in the wireless world as Verizon is. Comcast and Charter are both slowly trying to pivot away from strict pay-TV, and even home wired broadband, and instead are heading into the mobile space. Streaming TV is up, 5G is on the horizon — and while consumers, by and large, think their mobile carriers are okay, they still really hate their cable companies. So perhaps giving up on cable dreams is indeed the smarter thing for Verizon to do.

Equifax Says Site Vulnerability Behind Massive Breach; FTC Confirms Investigation

It’s been a week since credit reporting agency Equifax admitted it had lost sensitive personal data for 143 million American consumers — one of the worst data breaches yet. Now, the company says it knows how the intruders got in… and it’s through a bug that was first identified six months ago.

The Problem

Equifax updated its breach information page this week to identify the vulnerability malicious actors were able to use to get access to all that juicy private data. The issue was in the Apache Struts framework, code used to develop and run Java-based apps for web servers. Loads of companies, including other banks and credit reporting agencies, rely on versions of Apache Struts to work. Ars Technica reported on the vulnerability in early March. Means of exploiting the vulnerability were “trivial, reliable, and publicly available,” Ars noted at the time, making the flaw high-impact, high-visibility, and leaving major sites vulnerable to an increasing wave of attacks. By the time Ars ran that story on March 9, Apache had already issued a patch. And yet by the time the big breach began two months later, in mid-May, Equifax had apparently still not updated, since its systems were vulnerable to that flaw. Ars notes that applying this particular patch is “labor intensive and difficult,” due to the way the software works. But clearly the worse-case outcome of not doing it has proven to have massive consequences for not only nearly half the entire U.S. population, but tens of millions of people around the world as well.

The Investigation

In an extremely unusual move, the Federal Trade Commission has confirmed that it has opened an investigation into the circumstances of the Equifax breach. “The FTC typically does not comment on ongoing investigations. However, in light of the intense public interest and the potential impact of this matter, I can confirm that FTC staff is investigating the Equifax data breach,” an agency spokesman told media. MORE: How much control do you have over your private data? The FTC is responsible for overseeing business compliance with laws that require credit reporting agencies to keep non-public personal information, well, non-public. So although it’s exceedingly rare for the Commission to confirm an investigation has been opened, it’s also unsurprising they would do so in this case. Virginia Senator Mark Warner on Wednesday sent a letter [PDF] to the FTC requesting it launch an investigation into the massive data breach. “Aspects of this breach raise questions about the data security practices of Equifax that implicate the FTC’s existing authority,” Warner wrote. The Senator also called out several of “Equifax’s post-breach actions,” including poor site management of the breach notification portal, weak user PINs for credit freezes, and confusing notification to consumers who just wanted to know if they were hit. “Taken as a whole, and given past breaches by other major credit bureaus, these lapses may potentially represent a systemic failure by firms currently incentivized to collect and store highly sensitive identification and financial data for Americans,” Warner said. “I fear that firms like Equifax may illustrate a set of institutions whose activities, left unchecked, can significantly threaten the economic security of Americans.” In the wake of consumer complaints and media coverage, Equifax says this week it has updated call center support, added clarification about mandatory binding arbitration, and revamped the way it issues PIN codes to consumers placing freezes on their credit. We’ve asked Equifax for a comment and will update if we hear back.

Homeland Security Officially Bans All Federal Use Of Kaspersky Products

The federal government needs antivirus and malware protection at least as much as any other large organization, if not more. But now, after first stopping new purchases, and then asking private business to cut ties, the feds are officially blocking any government use of Kaspersky Lab products, citing security concerns over the company’s reported ties to the Kremlin. The Department of Homeland Security today issued a binding operational directive — that’s an order, to most of us — requiring all federal agencies to excise Kaspersky software from their systems. Agencies have 30 days to identify if they’re using any Kaspersky products, 60 days to come up with a detailed plan how to stop and switch if they are, and 90 days to begin implementing the plan to give Kaspersky the boot. “This action is based on the information security risks presented by the use of Kaspersky products on federal information systems,” DHS writes. “The risk that the Russian government, whether acting on its own or in collaboration with Kaspersky, could capitalize on access provided by Kaspersky products to compromise federal information and information systems directly implicates U.S. national security.”

Russia, Russia, Russia

Kaspersky isn’t some new startup. The company has been offering its suite of antivirus and security products in the U.S. for nearly 20 years. They’re generally well-regarded, considered to be at least as good as the competition when it comes to features and price. But there’s one big factor that’s become a big problem, in this deeply weird modern era we’re all living through: The company and its founder, Eugene Kaspersky, are Russian, and the company and its products have recently come under scrutiny as a result. Since 2015, several reports have surfaced that Eugene Kaspersky has ties to Russian military intelligence. Any potential vulnerabilities related to using the software stemming from those ties were by and large minimized or ignored, though… until recently.

Another brick in the wall

It’s been a rough summer for Kaspersky. In May, the Senate Intelligence Committee held a hearing at which the heads of several intelligence agencies told Senators they were monitoring Kaspersky Lab and had concerns about the security of its products. Then in July, on the heels of a report from Bloomberg Businessweek claiming that Kaspersky — both the company and the man — still had ties to Russian intelligence, the feds removed Kaspersky products from the approved list government agencies can buy from. In August, that was followed by a report that the FBI was asking private-sector companies to stop buying and using Kaspersky products. Then earlier this week, Best Buy became the first major retailer to pull Kaspersky software from its shelves.

Is That Sardine-Style Coach Class Seating So Tight It’s Unsafe?

Everyone who flies, but who doesn’t have deep enough pockets to travel exclusively in first class, knows it: Airplanes are increasingly crowded and unpleasant. But is that frustrating lack of legroom actually endangering your life when you fly? The Daily Beast reports today that based on more than 900 pages of Department of Transportation and FAA documents it reviewed, that coach may simply be so crowded that it’s no longer safe in the event of an emergency.

Smaller and Smaller

It’s no secret that coach has steadily been getting more crowded for years. Seat pitch in particular — the distance between your seat and the seat in front of you — has been putting the squeeze on consumers for decades. In 1985, that depth measured between 31 and 36 inches on the major airlines; by 2014, it was down to the 30-33 inch range. Budget carrier Sprint crams their seats in even more shallowly, with a seat pitch of 28 inches, while American recently abandoned a plan to drop their economy seat pitch to 29 inches. Seats are also significantly narrower. Thirty years ago, they measured an average of 19 to 20 inches across; these days, they’re as low as 16.5 inches and average 17-18 inches wide. In Aug. 2015, an organization called Flyers Rights called on the Federal Aviation Administration to start making rules about seat pitch. Flyers Rights claimed that it wasn’t just a matter of convenience and comfort, but literally one of health and safety: Decreased space could make evacuations more difficult, they argued, as well as increase the risk of blood clots forming in the legs of passengers trapped in tiny seats for long-duration flights. After a lengthy legal back-and-forth, the D.C. Circuit Court of Appeals ruled earlier this year that the FAA needs to at least give serious consideration to the Flyers’ Rights petition, even if ultimately declines to make a rule about minimum allowable seat pitch.

The dangers of squeezing in

The Daily Beast reports that one of the reasons the FAA may have tried to dismiss Flyers Rights’ claims out of hand is because none of the safety testing actually lines up with the current configuration of planes and passengers. “All of the tests designed to achieve the fastest possible evacuations were devised decades before” density began to skyrocket and seat size began to shrink, the Daily Beast writes. As a result, it’s impossible to know if everyone really can evacuate a fully-packed jet under current seating conditions based on the tests that are currently done — especially as many tests are kept proprietary and internal by the airlines and manufacturers that conduct them. Of particular concern are the individual seat-back TV screens that airlines increasingly use. Sure, they’re convenient for catching an in-flight film or ordering a snack, but the combination of “TV” and “head” is not a healthy one. Department of Transportation documents the Daily Beast examined revealed that testing seat-back screens for blunt trauma impact destroyed so many screens that the FAA started allowing manufacturers to test with cheaper replicas, instead. Why? Because dummies’ heads were whamming into them with alarming frequency. For your safety, in a crash or otherwise problematic landing, you’re supposed to put yourself in the brace position to protect your head. But DOT diagrams show that simple geometry means that with low seat pitch, you literally don’t have enough space to do so.

Does it matter?

The FAA has until Dec. 28 to respond to the Flyers Rights’ petition with “a properly reasoned disposition of the petition’s safety concerns about the adverse impact of decreased seat dimensions and increased passenger size on aircraft emergency egress.” In English, that means the agency has to explain why it’s fine for them not to make rules about seat size or pitch, and ignore how densely packed airplanes are getting to be.

What The Heck Is Single-Payer Healthcare, Anyway?

Health coverage has been in the news in a big way this year, thanks to Republican-led efforts in Congress to repeal the Affordable Care Act (ACA) throughout the spring and summer. That plan ultimately failed, but both sides of the political aisle do agree on one thing: There’s a lot of room to go on improving health care access and containing medical costs. A new rallying cry has risen up among Democrats: Time for single-payer! But what does that actually mean — and what could it look like?

What does “single-payer” actually mean?

At its most basic, single-payer healthcare is the idea that one single entity — generally a government body or agency — receives and handles everyone’s healthcare bills. All treatment is paid for from a single body, which in turn is financed by taxes. Basically, there’s one insurer, everyone can use it, and it covers most or all preventative and medically necessary treatments. That’s in contrast to the multi-payer system we currently have in the U.S., where you and one or more insurance companies split up the bills for any services you receive. For example, if a physician bills you $1,000 for a procedure, you might be expected to pay anywhere from 10% to 50% of the cost, with your insurer picking up the remaining tab. It gets even more complicated depending what kind of treatment you’re seeking, what the specific terms of your annual deductible and out-of-pocket cap are, and how many entities are involved in providing your care, but the general principle holds. Related: How surprise medical bills knock consumers down

Are “single-payer” and “universal coverage” the same thing?

The term “single-payer” often gets interchanged with “universal healthcare,” but no, the two are not the same. A national single-payer plan would almost certainly be universal (although the law could, for whatever reason, choose to exclude certain groups — limiting coverage to documented citizens, for example), but there are alternative ways to produce universal or near-universal coverage as well. Germany, for example, has universal coverage through a multi-payer system that operates in a complex public/private partnership. Health care is provided by private doctors and is paid for by “sickness funds” — one of a couple hundred insurance carriers, basically — that get their funding not from taxes but from employer and employee premiums. Conceptually, it’s not unlike the system the U.S. has been heading towards since the ACA took effect in 2014. But Germany’s plan differs from the United States in that the statutory insurance doesn’t come with enormous, ever-growing co-pays, deductibles, and co-insurance like most private American plans do. When you’re covered, you’re covered, with nominal extra fees. That’s different from something like the UK’s National Health Service (NHS). In Britain, you can receive care in NHS hospitals with NHS doctors and nurses working directly there, as government employees. Other practitioners may own private practices, but contract with the NHS to receive payment for services rendered. Canada has something in between: Anyone in the country can apply for public health insurance. Each province has its own insurance plan, which then reimburses providers in private practice for most services they provide. In the U.S., we do have limited public insurance for qualified groups, through Medicare and Medicaid. One way that some single-payer advocates suggest the U.S. achieve single-payer coverage would be through expanding those programs universally; the rallying cry is “Medicare for all.”

Is “Medicare for all” single payer?

In a broad sense, yes, it’s currently the most popular proposal for implementing single-payer care in the United States. As always, though, the devil is in the details. Medicare, New York Magazine notes, is not exactly easy to expand. It probably won’t scale very well, and it’s fairly confusing even for the millions who rely on it. Medicare recipients also still often owe significant co-pays and other out-of-pocket costs, NY Mag adds, which pretty much defeats the goal most of those who rally around single-payer care hope to achieve. What’s more, many critical aspects of care — dental and vision care, among them — aren’t included, and many participants (seniors) supplement their Medicare with private insurance. Realistically, then, many single-payer proposals being bandied about come closer to being a universal Medicaid expansion rather than a universal Medicare one. However, the phrase, “Medicare for all” tends to perform better in opinion polls than alternate phrasing, the Kaiser Family Foundation has found. Democrats (the party more likely to act in favor of some kind of universal care) in particular feel negatively about terms like “socialized medicine,” where majorities feel much more warmly about “Medicare-for-all.”

Who’s in favor of single-payer?

A rapidly-growing slice of the American public, for one thing. Data from the Pew Research Center, in June of this year, found that overall, 58% of respondents to a national survey felt that providing health care to all Americans is something the government should be responsible for. 33% of respondents overall felt that there should be a single national program, and 25% felt that it should be through a mix of public and private programs. Among self-identified Democrats, however, the skew now leans toward universal public coverage. By June 2017, a majority — 52% — responded that they favor a single, national government program for healthcare. That’s a marked increase from just one-third of Democrats agreeing with that statement in March, 2014. Physicians, overall, also seem to be moving in the same direction as the general public. A survey of doctors released in August found that a majority — 56% — supported the idea of moving to a single-payer healthcare system in the U.S. (In 2008, the same organization found that 58% of doctors opposed the idea.) Doctors largely want to be in the position to do medicine, not paperwork. And the more complicated the health insurance structure is, the more time physicians have to spend on the bureaucratic things they don’t care for — not just billing, but also spending time and energy making sure the tests or medications they prescribe will actually be covered by a patient’s insurance. “Physicians long for the relative clarity and simplicity of single-payer. In their minds, it would create less distractions, taking care of patients — not reimbursement,” an executive for the firm conducting the survey said in a statement.

Who’s opposed?

Opposition basically falls into two very broad categories: the ideological and the practical. Many, particularly but not solely on the political right or in the Republican party, oppose single-payer care on philosophical grounds. That same Pew survey that found 33% in favor of a national single-payer health plan also found plenty of respondents who want no part of it. Overall, 38% of those surveyed said that making sure Americans can access health care isn’t the government’s job. Most still favor keeping Medicare and Medicaid, since those already exist, but 5% of respondents said that government should not be involved in healthcare in any way — a figure that leaps to 9-10% among self-identified Republicans. Vox reports that Republican lawmakers are already gearing up counter-attacks to Democrats’ recent embrace of single-player bills, saying that implementing expanding Medicare or Medicaid any further would endanger the Department of Veterans Affairs and the health care veterans receive. Meanwhile, there’s the business angle to consider. The health insurance industry is massive. In the Fortune 500, UnitedHealth Group ranks sixth, Aetna 43rd, Humana 53rd, and Cigna 70th — to say nothing of the dozens of other small, medium, and large providers in the country. You would expect insurers to be opposed to the idea of full, federal single-payer coverage that would cut them out of the loop entirely. But insurers may be less hostile to the idea of some kind of compromise approach to universal coverage than you’d think. Back in May, Aetna CEO Mark Bertolini said that, “we should have that debate [about single-payer] as a nation.” He added, “instead of shouting back and forth across the stage, let’s discuss what single-payer means,” and posited (rightly) that there are many, many different ways to approach that goal, if it’s the policy goal the country wants.

How realistic is it?

Single-payer or universal coverage are certainly not in the cards as a serious policy proposal for 2017 or 2018, with the current Congress and White House we have. But the seeds of potential are being planted. Vermont Sen. Bernie Sanders, who retains much of the popularity he gained with his unsuccessful presidential run in 2016, plans to introduce a Medicare-for-all bill on Wednesday, Sept. 13. Sanders told NPR in early August that he had no expectation that the bill would go anywhere at all. “You’re not going to see it. That’s obvious,” he told NPR. Instead, he wants to use the bill to force a discussion about the merits and potential of single-payer healthcare going forward. Reports say Sen. Brian Schatz (HI) also plans to introduce a bill this fall that would expand Medicaid (not Medicare), allowing states to let anyone — not just low-income Americans — buy in. Basically, it would be similar to the Medicaid expansion that many states participate in under the ACA, effectively using Medicaid as a “public option” for anyone uninsured who wants it. Schatz and Sanders each plan to co-sponsor each other’s bills, Vox reports, part of a broader plan to move the conversation forward. Over the summer, several other high-profile Democratic Senators have joined the choir of voices singing the praises of “Medicare for all,”. Sanders’ bill now reportedly has 10 other Democratic Senators signed on as co-sponsors, including: Tammy Baldwin (WI), Cory Booker (NJ), Kirsten Gillibrand (NY), Kamala Harris (CA), Pat Leahy (VT), Ed Markey (MA), Jeff Merkley (OR), Brian Schatz (HI), Elizabeth Warren (MA), and Sheldon Whitehouse (RI). It’s also becoming a tenet of some 2018 House campaigns. As Rolling Stone and the Washington Post report, challengers for seats in California, Nevada, and Wisconsin — including House Speaker Paul Ryan’s seat — have already started campaigning with an explicit platform of single-payer, universal health care. There’s a single-player proposal currently afoot in the House, too. Rep. John Conyers (MI) introduced a bill that so far 117 of his fellow Democrats in the House support. The Conyers bill basically doesn’t just create a public option, but expands Medicare and Medicaid into one massive public option that would basically become mandatory — and fast. But that bill Vox notes, is skeletal at best — a sign that it stands absolutely zero chance of ever moving forward in the current Congress. It’s only 30 pages (the ACA, by comparison, famously clocked in at more than 900 pages of detail), most of which say merely that changes should be made, without specifying how.

What are the challenges?

Setting aside political and ideological obstacles to changing healthcare law at all, transitioning the U.S. from its current system to a single-payer system would come with significant logistical and practical challenges to work through. The U.S. population is currently more than 320 million people, and changing anything for all of us at once is hard work. Our policy steers more like a stack of boulders than a sports car, with every stakeholder wanting to make their own adjustments. Major changes to federal law and regulation usually require a long, slow phasing-in process, and healthcare is one that touches literally everybody in some way. But the biggest obstacle facing any single-payer plan is money. Lots and lots of money. Healthcare, to be blunt, is super duper expensive. It’s not that the costs themselves would go up in a transition to a single-payer system, Vox explains — it’s that the costs are high already. About 16% of our overall economy is related to healthcare, but right now all the spending is scattered. The government pays some, states pay some, private insurers pay some, employers pay some, and end-users — all of us who seek medical care — pay some. It’s hard to get a solid feel for just how high the spending is when it’s broken up all over. To make all of it come from a single, federal source, you’d need funding… and funding means taxes, which are yet another political land mine in the U.S., unlikely to be quickly or easily resolved any time soon.

Here’s The Stuff You Really Want To Know About Apple’s New iPhones

It’s been rumored for months, and recently leaked in detail but finally, confirmation day has come: Apple announced new iPhones and a slew of other stuff today at an event in Cupertino. [We will be updating this post throughout and after the Apple event.] CEO Tim Cook began by honoring late apple CEO Steve Jobs, for whom the company’s new theater on Apple’s new campus (the praises of which Cook sang at length) was named, and asking everyone to consider donating to relief efforts for those affected by Hurricanes Harvey and Irma before getting into the meat of his presentation.

Yes, there are new phones

After a decade, it’s definitely no secret: New year, new iPhone. Apple’s shaking things up a little bit this year, though. They’re skipping the 7S generation that we might ordinarily expect a year after the 7, and going straight to the iPhone 8 and 8 Plus. The iPhone 8 and 8 Plus promise to use fancy new A11 “Bionic” high-speed chips and provide spectacular color displays, as usual, and alas, the headphone jack does not come back. This time, however, the aluminum in the phone is covered in glass both on the front and back for extra breakability, although Apple claims it is the “most durable ever in a smartphone.” What that glass does buy you, however, is wireless charging. “Words can’t describe how much nicer it is to just pick it up and put it down” rather than having to plug it in, Apple execs Phil Schiller said, explaining that Apple is working with other companies worldwide to standardize the tech it’s using, Qi, so wireless charging works in cars, restaurants, and with your furniture.
Apple
Apple
The phone comes in three colors: Silver, “space grey,” and gold, and Apple touts increased “splash” resistance. So maybe don’t jump into the pool with your iPhone in your pocket, but it might survive if it’s on the table when your beverage of choice takes a tumble. Apple also praised the updated cameras in the iPhone 8, displaying a wide array of images taken to highlight the camera’s perception of color and texture. Apple also touted the 4K capabilities of the iPhone 8’s video camera, as well as deep-diving on features designed to make augmented reality a thing people will want to use more than we largely do right now. Apple is eliminating the lower-storage-capacity versions of the iPhones. The 64 GB iPhone 8 will cost $699, and the 64 GB iPhone 8 Plus will run $799. You can pre-order both on Friday Sept. 15 and buy on Friday, Sept. 22.

There’s other stuff, too!

iPhones are Apple’s headlining product, but far from their only one. Apple Watch
Cook proudly informed viewers that the Apple Watch is now the number one smart-watch in the world by some undisclosed metric, before finally introducing the newest iteration of the software, WatchOS 4, and the new device, the Apple Watch Series 3. Apple pushed hard on all of the features in the new version of the Watch OS that apply to folks who like to stay active: biometric monitoring, especially with relation to heart rate and heart rhythm, and the ability to track resting heart rate in order to potentially give early warning of undiagnosed health conditions.
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The Series 3 Apple Watch, meanwhile, has integrated cellular communication capabilities — meaning you no longer need to have it connected with your phone in the next pocket, or in fact even near you at all. The new Watch also responds to Siri voice commands and boasts water resistance, plus full integration to some messaging apps. The benefits Apple touts are on-the-go connectivity when you don’t want your phone nearby — like, say, at the beach, or while going for a run. Because you can stream Apple Music directly to the watch, and negate the need to have your giant phone strapped to your arm while careening through city streets. WatchOS 4 is coming to all existing Apple Watches on Sept. 19, and the new watch will be available to pre-order beginning Sept. 15, and actually to buy on Sept. 22. The version without cell connectivity will cost $329, the version with will cost $399, and Apple promises you can still get a full 18-hour day of battery life from either one. AppleTV
Apple, like everyone else, wants to get in on 4K right at the beginning of its era. And the product is, oh-so-creatively, called AppleTV 4K. The new device will support both 4K and HDR color, in case you have a TV that can actually display those things already. Movies purchased on iTunes in 4K version will cost the same price as HD films, Apple added, and HD movies you’ve already purchased will get a free 4K upgrade. Apple also touted content to watch on the new device, particularly live sports and the addition of Amazon Prime Video to Apple TV (finally) later this year, then brought out game developer Jenova Chen to showcase Sky for iPlatforms, including the Apple TV, later this year. The cheapest version of the new AppleTV 4K starts at $149, will be available to pre-order on Sept. 15, and starts shipping Sept. 22.

Best Buy Pulls Controversial Kaspersky Security Products

In the modern era, it’s always worthwhile to consider how to protect your systems from unwanted, malicious actors. Kaspersky Labs’ software has been a popular option for doing just that for close to two decades now — but after increasing scrutiny of their founder’s potential ties to the Kremlin, one major retailer has decided to stop selling their security suite. Best Buy has decided this week to pull Kaspersky products from their real and virtual shelves for now, the Minneapolis Star Tribune reports. Speaking with the ever-popular person “familiar with the decision,” the Star Tribune reports that although Best Buy has not conducted its own investigation into Kaspersky, the company felt there were too many “unanswered questions” about Kaspersky’s reliability to keep its product on the shelves. Kaspersky has been offering its suite of antivirus and security products in the U.S. for nearly 20 years. They’re generally well-regarded, considered to be at least as good as the competition when it comes to features and price. But there’s one big factor that’s become a big problem, in this strange 2017 we all inhabit: The company and its founder, Eugene Kaspersky, are Russian, and the company and its products have recently come under scrutiny as a result. Since 2015, several reports have surfaced that Eugene Kaspersky has ties to Russian military intelligence. Any potential vulnerabilities related to using the software stemming from those ties were by and large minimized or ignored, though… until recently. The Trump administration removed Kaspersky Lab from the list of approved vendors for government contracts back in July, citing increasing security concerns. Since then, federal, state, and local government agencies have been considering if or how to phase out their own usage. In August, the FBI reportedly asked private sector corporations to consider phasing out Kaspersky products as well. In a statement to the Star Tribune, Kaspersky reiterated its position that it’s been “caught in the middle of a geopolitical fight” and is being treated unfairly while Russia and the U.S. engage in a whole mess of posturing this year. The company also added that it has had a “good relationship” with Best Buy, and that the suspension may be reconsidered in the future.