interviews
Labor and the White House
by Dave Weigel
March 31, 2021
This interview with Dave Weigel, national reporter covering politics for the Washington Post, was conducted and condensed by franknews and Payday Report.
DW | The White House's involvement in the Amazon union drive was a big surprise. I mean, we know where it could have originated, the union talked to the White House; they have kind of an open door with Biden that they didn't have with Trump. We know that Faiz Shakir, Bernie Sanders’ campaign chairman, and his group, Perfect Union, got involved. So, there was public pressure.
The fact that the White House and the president released that video was a big deal to people. And, he made this decision to get involved very early on in his presidency. It was within his first 50 days. He decided to do what hadn't been done before and give a message in support of the union. It was a very careful message. The new labor secretary, Marty Walsh, when asked specifically about Amazon, responded in more general tones.
But, no matter what happens, if you are in for a penny, you are in for a pound.
A lot of previous presidents, including Barack Obama, said a lot less about these union drives and, in doing so, limited their own exposure. If the drive didn't work, people didn't say that the president supported something that didn't work. The fact that Biden made a statement, early on, when it wasn't clear how this was going to go, is a real political statement of what they thought was important.
frank | How do you think his background plays a role in this?
He's always leaned in really hard and identified with workers in the same way he's tried to identify with different civil rights movements. Joe Biden has always wanted to be seen as the kind of person who is coming from Scranton, who has lived through the sixties, and who wants to jump to the front of the march if there is a struggle happening.
He frames everything in terms of fairness. He's not as natural as other members of the party in talking about this. When Bernie Sanders talks about this, for example, he talks about greed, he names CEOs, he says nobody deserves that much money, he talks about a maximum wage and how there should be no billionaires at all. Biden doesn't go that far. Biden has never gone after Jeff Bezos. He's never gone after individual heads of companies the way that Sanders does. He does this sort of a "Hey man, these guys are under assault, somebody needs to stick up for them."
That is something that he has always wanted to be part of his brand. Even when he was voting for trade deals like NAFTA as a Senator, he was never really comfortable. He had the same ideological mindset as a lot of the Democrats in the eighties and the nineties. He did it because he saw that that was the way things were moving and he voted strategically. But, the stuff that fired him up was when he could side with workers. It is the same thing with the projects he took on under Obama when he was Vice President.
During the Democratic primary, he didn't get the same amount of labor support that Hillary Clinton did, but, Sanders didn't get it either. There wasn't the same sort of a landslide of labor to get in early and say, this is our candidate. Instead, they were demanding more of the candidates.
I would cover presidential primary events with the Teamsters in Cedar Rapids or the Building Trades in DC and you would kind of look to the level of applause as an indicator. The interesting thing is that at those events Sanders would lay out the things he did and what he wanted to pass. Biden would go on at length about non-compete clauses and about wage theft and things like that. It was less, "I have studied all of the papers on this and I've decided this is my policy," and more of "this seems unfair and I'm against this thing."
I think the Democratic Party is increasingly understanding what labor can mean for them strategically.
Republicans have gotten kind of tangled up on labor. They have done better with union households, but they are basically the party of deregulation still. They've never really moved on the labor part of their messaging. That makes it easier for Biden to compete for these workers. When it comes down to it, Republicans want “right-to-work." Josh Hawley, who branded himself as a working-class candidate, for example, supports a national right-to-work.
Biden was very concerned with winning back more union households. Union workers were saying, “Democrats had the presidency for 16 years. What do they do for us?” Biden didn't have all the answers that labor wanted, but he was making a lot of specific promises about how he was going to act. He talked about infrastructure spending and about how he was going to run the NLRB and how he was going to approach employers. It was less than Sanders did, but that's way more than Democrats had done in the past.
I mean, the McCain/Romney era Republicans had no appeal to the sort of voters who voted for Obama twice and then voted for Trump. Biden only peeled back maybe 10% of them depending on where you're talking about, but it has made life easier for Democrats.
This fight has in large part been framed in the context of continuing a battle for civil rights. Do you see Biden lean into that messaging?
Biden did not really lean to the racial justice aspect or the civil rights legacy aspect of this labor fight. When the congressional delegation here came down a couple of weeks before the vote, they were much more explicit. Someone like Jamal Bowman or Cori Bush is much more comfortable saying that than Biden. That is the thing about Biden. He basically sets boundaries. He says what his position is and backs off and lets the action happen without his constant commentary. It's very different than Trump in that way too. And that's different than the Sanders position. And it's different than what Warren said her position would be as president.
Can you give us context on how or why you started covering this story?
I started covering the Amazon drive because of the president and members of Congress intervening. I mean, labor decided to get involved months before, but the fact that Democrats were getting involved was new. It has been interesting to monitor their investment in this over other Democratic Party causes.
There's a little bit of intervention from the Democrats, but not, I'd say equal to what Amazon is doing. They are not the advertisements on TV. We all know the Democratic party is kind of involved, but it is not the same political project that I've seen in other places.
There are two stories that kind of were happening at the same time; they have merged, but not completely. One is this labor drive, which is smaller than most drives that have succeeded. It is not overwhelming. You don't see labor signs everywhere you go. But, on the other hand, the level of national involvement is kind of new.
Had Biden said nothing, there would have been a story, but it wouldn't involve the White House, it wouldn't involve the Democratic Party, and it might not involve the PRO Act.
And I think that's going to change because of this.
New interview w/ @daveweigel @PaydayReport
— frank news (@FrankNewsUS) April 6, 2021
"The White House's involvement with the Amazon drive was a big surprise ... Previous presidents, Obama comes to mind, said a lot less. The fact that Biden did that early on is a political statement of what they thought was important." pic.twitter.com/MwYlmqE4xQ
That was a big decision Biden made to be a part of this.
Right. And that political story is interesting. The story here is much more independent. A lot of the people who've come in to help canvas are from smaller groups. You have Black Lives Matter and DSA groups from the area, but you don't have the Democratic Party getting involved in a huge way. I think that is something that people will revisit after the vote.
Should the Democratic Party, like most left parties in the world, be very involved with labor? Should they always take the side of labor?
Most social democratic parties are labor parties and they build up from there. Their coalition includes labor unions. In the British Labour Party, for example, labor has a role in electing the leadership. That is not the case here. That's the conversation I think they're going to start having when this votes over. For example, if there are, and the union says there are, hundreds of people around the country calling them saying, "Hey, I have some questions about what I can do at my fulfillment center in my town," that will be a question for Democrats.
And if Amazon wins, do you get spooked? Amazon has been very punchy in their PR. They might say that a bunch of elite Democrats stood with the union and the workers stood with Amazon. That is very comfortable turf for Amazon to be on, and that leaves a big question open for Democrats. If the union succeeds, throw all of that out the window. I think the lesson that everyone would take in that case would be that if it takes less than a three-minute video from the president to get momentum for something like this, then we should keep doing that. As we talk, I don't know the answer to that question. I think that is something that is going to be answered when the votes are in.
interviews
Insurance Coverage Design
by Naomi Zewde
September 24, 2020
This interview with Naomi Zewde, an Assistant Professor in the Graduate School of Public Health & Health Policy at the City University of New York, and a research fellow at the Roosevelt Institute, was conducted and condensed by franknews.
Naomi | I focus on health insurance coverage and the economic and financial implications of insurance coverage design. I look at how these things affect household financial wellbeing.
franknews | We know that medical debt is rising. What is happening in the healthcare system that explains the increase?
The issue of consumer debt in general in America is almost like a slow fire.
In healthcare, people’s deductibles are growing at incredibly fast rates; deductibles are growing much faster than premiums, and certainly much faster than wages over the past decade. People are left exposed to a greater share of their medical expenses, and exposed to huge medical bills — typically more than what most people have in their savings. That creates a lot of stress and fear, and often the threat of that financial burden deters people from seeking care.
What drives the prices of care up?
We don’t know.
We have a lower life expectancy. We have fewer physician visits per capita. We have a higher rate of chronic conditions. Those who provide healthcare - physicians, nurses - are not necessarily reaping the benefits either. We know that the utilization rate of the healthcare system is not unique to the United States. So why are the prices so high? That is up for debate.
We do know a few things. One, we know that a lot of this money goes towards the vast administrative bureaucracy — something that is unique to the United States. We also know that the government in other countries set prices: they either operate as the sole purchaser and thus dictate prices or they dictate prices through legislation. In the United States, Medicaid has price controls, but private insurers can charge whatever they want. There is no real way for anyone to fight back. There's no designated person to say no, you're charging too much.
Based on your research, what effect does this have on households’ finances?
I have done work around housing evictions and medical debt. We found that Medicaid expansion reduces the rate of home eviction. Going into the research it was not necessarily clear what relationship the two would have, if any. It sounded plausible — people with chronic conditions, for example, end up having to choose between rent and care. But it is astounding to think about the fact that the design of our healthcare system can have these ramifications.
I also found, in a paper that came out last month, that for 25 percent of people who were uninsured before ACA, it's cheaper to file for bankruptcy than to reach a deductible of the subsidized ACA private insurance policy.
Wow.
It’s surprising right! But it makes sense and might explain why there is such low participation in ACA private insurance policies. The congressional budget office projected that 10 million more people would enroll in these plans than actually did; only 8 million people got these. They were way off. The paper investigates why.
And what did you find?
I suspected from the beginning that it was because the deductibles are so high. The median deductible for the silver tier coverage is $4,000. There is a sweet spot in terms of the subsidies that substantially lower your deductible and premium. If you make between $12,000 and $18,000 a year, subsidies will bring down the deductible to around $200. But once you make $24,000 a year as a single adult, you're facing between a deductible between $3,000 and $4,000. So in designing the policy, it was kind of like, we will give extra subsidies to lower-income households, but not in a way that reflects what it is actually it's like to live with these medical bills. It feels divorced from reality.
Our findings don’t necessarily mean the people have to declare bankruptcy. Bankruptcy sucks and hospitals also know that when you file for bankruptcy, they typically do not get anything out of it. So, they look to work with you. Neil Mahoney has a paper, Bankruptcy as Implicit Insurance, that essentially shows that hospitals tend to settle with consumers at their cost of filing for bankruptcy. Hospitals essentially say, whatever you were going to lose if you were to file for bankruptcy, just give that money to us instead.
That reminds me of what Deborah Thorne said in our interview with her: "As Americans, we often rely on credit cards to be our social safety net. And when that falls apart, we are left with bankruptcy.” What is your understanding of how we got to this place?
It's tied up with a social-political larger trend. I have been watching this show called the Black Journal from 1968 to 1977 with a bunch of progressive Black scholars.
I watched one that was right after Nixon got elected, and everyone was saying, "America is taking a turn towards facism. All of American’s white guilt money is gone.” I think that really well foretold this mass acculturation that happened under Nixon.
How do we return protections?
There is this famous paper - It’s the Prices, Stupid. I think there needs to be some kind of direct effect on price.
You mentioned the government can do so by either acting as the sole buyer of care or passing legislation. What do you think is the best way to achieve fair prices?
Right. One way of doing so is through a single-payer system. I am actually working on a study now that is going to be published to the Roosevelt Institute that compares single-payer with a public option.
There are two things to know about single-payer that are useful in this context.
One, it would get rid of most of the bureaucracy involved in negotiating prices — the different insurance companies, the different kinds of billing, and different plans. Right now, every doctor's office has multiple people whose full-time job is to understand how to interact with every single different plan of every different insurance company. There are many people employed on the side of the insurance company as well. Under a single-payer system, that would be gone. There wouldn't be multiple different rules to understand, and that reduces the aggregate resource use that is allocated towards healthcare.
Two, a single-payer system is tax-financed. That is important in terms of equity. You get to decide what percentage of household income should be allocated towards healthcare. Basically, the way our healthcare system is designed now means that the more money you make, the smaller percentage of it you have to put towards healthcare.
If we structure it as a tax-financed healthcare system, the way we fund most of our infrastructure, you just get to decide what percentage of household income you are going to take from each household along the income distribution.