Do It Right

Big things are happening in criminal justice, and Philadelphia, Pa. is not being left out.  On Wednesday, Slate's Leon Neyfakh wrote

President Obama just gave a major speech calling for criminal justice reform. The speech presented an expansive yet detailed argument not only for reducing the number of people serving time in prison, but for changing the way prison time is spent so that individuals return to society better-equipped to succeed.   

The speech, delivered in Philadelphia at the annual conference of the NAACP, comes one day after the president commuted the sentences of 46 nonviolent drug offenders serving time in federal prison, and one day before a scheduled visit to a federal prison in Oklahoma.

The speech was wide-ranging—Obam asaid he wanted to talk about proposals “in the community, in the courtroom, and in the cellblock”—but was built upon a basic thesis, that the American criminal justice system “is not as fair as it should be,” and that “while the people in our prisons have made some mistakes, and sometimes big mistakes, they are also Americans.”

“Mass incarceration makes our country worse off,” Obama said, “and we need to do something about it.”

Taking a hint from New York City, Philadelphia's presumptive incoming administration (photo of Democratic nominee and overwhelming general election favorite Jim Kenney from Jeff Fusco for The Philadephia Inquirer) also has decided mass incarceration- or, rather, mass detention- makes the community worse off.  The Philadelphia Inquirer reports

As New York City prepares to do away with cash bail for thousands of low-level offenders charged with nonviolent crimes, Jim Kenney is weighing a bail proposal for Philadelphia, part of a broader plan to address the city's overcrowded prisons in the event that he wins the mayor's office this fall.

Kenney's campaign spokeswoman, Lauren Hitt, declined to provide details on what he is considering. But she said Kenney, who in May won the Democratic nomination for mayor, is looking to reduce the city's prison population while ending what she called "the epidemic of nonviolent offenders being kept in prison because of their inability to make nominal bails."

As recently as Monday, Kenney's staff and stakeholders met to discuss options for bail reform. "It's clear that everyone shares that common goal," Hitt said.

Inmate advocates have long argued that bail unfairly burdens the poor, and their criticism has gained some traction in recent years in other quarters. Across the country, broader prison reform has increasingly drawn bipartisan support, as it addresses both humanitarian and fiscal concerns. New Jersey's legislature last year passed changes that allow judges, starting in 2017, to release certain inmates without bail before trial, a measure supported by Gov. Christie.

In Philadelphia, about 75 percent of the city prison system's approximately 8,000 inmates are awaiting trial. Advocates have said that on any given day, hundreds likely are detained on low-level offenses because they cannot pay relatively small bail amounts.

Advocates may say, but few would doubt, that there are several hundred individuals detained in Philadelphia on any given day because they cannot make bail on low-level offenses.  Depending on the definition of "low-level," the number may be in four figures.

The city recently received a $150,000 grant to study means of reducing its inmate population and officials are unsure of their eventual approach. However, the Inquirer continues

Under New York City's $18 million plan, announced last week, as many as 3,000 people will be placed in court supervision programs as an alternative to bail.

Providers will use a risk assessment tool to pick eligible candidates and determine the level of supervision, including regular check-ins or connection to services that address specific needs.

Separately, New York City Council last month said it was looking to create a $1.4 million fund that would be used to cover bails of $2,000 or less for defendants who cannot afford to pay.

The de Blasio Administration, as this New York Times article from April describes, is taking numerous steps to reduce its population of detainees. However, the primary principle which should guide any approach is understood by a former correction commissioner who is quoted as noting "Speedy disposition of justice is just an incredibly important moral obligation for a state. These are pretrial; they're not guilty of anything."

Actually, some of them are guilty. But they haven't been found guilty, at least not yet, and deserve some consideration.  However, whether in NYC. Philadelphia, or elsewhere, giving the individuals their just due- if done properly- will not come cheaply.

Releasing more inmates before their case is heard will endanger the city unless there is adequate supervision.  That will not be the case if- as in New York- monitoring of the defendants is outsourced to a private company.  Accountability will be greater, and standards applied more uniformly and consistently, if supervision remains in the public sector. Judges are not employed by a private company and neither are prosecutors. The same should apply to the professionals who will be ensuring (as much as possible) that the defendants remain arrest-free and returned to court as scheduled.

There will be other costs, as New York City will learn. Mayor de Blasio wants all defendants to be scheduled within 45 days. Additional judges, prosecutors, public defenders, and probation officers (or whatever the City chooses to call them) will be needed to process the cases. In their absence, there will be irresistible pressure to issue 'get out of jail free' cards.

Once the  research is completed and a strategy implemented, Philadelphia officials very likely will succeed in their effort to prevent city jails from being cells for holding defendants because they are too poor to meet bail for a relatively minor offense.  But they will endanger the public  safety unless they are committed to spending a substantial amount of money on hiring real people to perform an important job.







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Not Enough

On Monday, Charlie Peters noted, Hillary Clinton "said some tough stuff about income inequality and took some well-wrought shots at both Scott Walker and Jeb (!) for their respective demonstrations of fealty to the plutocrats. And that bit about demythologizing the Uber economy was long overdue."

As reflected in the video below, the rhetoric was impressive as Mrs. Clinton, according to Reuters

toughened her stance against Wall Street on Monday, vowing to tighten oversight of the financial industry and warning of serious risks in the "shadow banking" industry.

In her first major economic speech of the 2016 election campaign, Clinton assailed financial institutions in detailed terms as she pledged to cut the income gap and spur wage growth for ordinary Americans.

Details were sparse. Further

The Democratic front-runner stopped short of calling for the break-up of big banks as some liberal Democrats have sought. Clinton has no plans to reinstate the Glass-Steagall Act to split commercial banks from their investment operations, Clinton economic adviser Alan Blinder told Reuters.

Hillary Clinton already has broken with Clinton 42 on at least two issues: the mass incarceration enabled in part by enactment of the Omnibus Crime Control Act of 1994 and the Defense of Marriage Act, which stood prior to being ruled unconstitutional as an obstacle to same-sex marriage.

However, Bill Clinton earlier this year had  disavowed his support for DOMA (and confirmed that he supports same-sex marriage).  And confronted about the anti-crime legislation he supported and signed, he acknowledged "The problem is the way it was written and implemented is we cast too wide a net and we had too many people in prison," which is as close as politically possible to screaming "I screwed up."

So those two issues are low-hanging fruit for a Democratic candidate.  In her remarks the other day, Mrs. Clinton

proposed encouraging firms to share profits with employees, and ensuring that stock buybacks are not used just for an immediate boost in share prices. She said she will announce a plan to reform capital gains taxes to reward longer-term investments and not just quick trades.

In the absence of corresponding legislation- which she did not advocate- the first is beyond the scope of the presidency.  The "plan to reform capital gains taxes" is- hopefully- forthcoming and should be viewed with skepticism.

The "speech was short on specific policy proposals" but presumably we are to be comforted because "Clinton put the fight for higher wages for working Americans at the heart of her economic agenda,"

With minimal effort and less risk, HRC could could have recommended reinstatement of the Glass-Steagall Act, repealed as part of Gramm-Leach-Bliley, signed as Bill Clinton was leaving the Oval Office.  Or she could have signaled doubts about the trade policies of Presidents Obama and Clinton- and Bush and Bush.

Admittedly, the latter was unlikely to come from an individual who on 45 occasions has promoted the Trans-Pacific Partnership, and who stood silent as Congress dealt a major blow to consumers, labor, and the environment with approval of fair trade. Yet, in what was reported to be "a major economic speech," something specific and significant about trade or financial services was the least that should have been demanded of a Democrat. Its absence from the front-runner for the Democratic presidential nomination should be a cause of concern- even a "red flag"- for progressives, including the 26+ members of the Congressional Progressive Caucus who already have endorsed the neo-liberal from Illinois/Arkansas/New York.

Charlie Peters concludes

The financial-services sector, and the even-bigger-than-they-were banks that are its cornerstone, remain perfectly capable of hauling the economy over the cliff one more time. And, as we are seeing in Europe, indiscreet economic royalism is all the rage. The Democratic candidate for president in 2016 has to be clearly in opposition to every aspect of this rising oligarchy. It's not the 1990's any more. Whoever gets elected is not going to have a real-estate bubble in one pocket, and a tech-bubble in the other. Whoever gets elected is going to have to deal with the serious repercussions to the economy that continue to bedevil us due to decisions made during the last Clinton presidency. This speech was a decent start, but that's all it was.













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Stiffing Greece

The news from Europe isn't all bad, for The Wall Street Journal reports

Europe’s standoff with Greece has thrown German Chancellor Angela Merkel into one of the deepest domestic political crises of her 10-year tenure. This coming week, things may well get much worse.

The Social Democrats, the conservative chancellor’s left-of-center junior governing partners, are increasingly criticizing Ms. Merkel and her finance minister, Wolfgang Schäuble, for appearing to be prepared to kick Greece out of the euro at least temporarily. Her conservatives in parliament are demanding a hard line. Ms. Merkel herself has left her options open—a strategy that critics warn is increasingly untenable.

David Dayen explains

What has been happening in Greece has been a long exercise in sadism by European elites, who care only about keeping their political project alive, regardless of how those who must deal with the consequences are affected. Three governments ago, Greece rang up a series of debts that they have no practical ability to pay back. The structure of the eurozone, 19 countries sharing a common currency, encouraged this debt buildup, which manifested through capital flows from the wealthier north to the southern periphery. With a single currency, investors chased higher returns in countries where capital was scarcer; this was part of the core euro design. When the investors pulled out and the debts came due, the northern states, led by Germany, pretended this didn’t happen and demanded their money back.

Eduardo Porter of The New York Times recognizes "a general less about the nature of debt," that "major debt overhangs are only solved after deep write-downs of the debt's face value.  The longer it takes for the debt to be cut, the bigger the necessary write-down will turn out to be." He finds this is

a general lesson about the nature of debt. Yet from the World War I defaults of more than a dozen countries in the 1930s to the Brady write-downs of the early 1990s, which ended a decade of high debt and no growth in Latin America and other developing countries, it is a lesson that has to be relearned again and again.

Both of these episodes were preceded by a decade or more of negotiations and rescheduling plans that — not unlike Greece’s first bailout programs — extended the maturity of debts and lowered their interest rate. But crises ended and economies improved only after the debt was cut.

Germany itself refused to pay its external debt between the two world wars, from 1929 to 1931.  But that was 85 years ago and pre-dated the rise of the Third Reich, so its applicability to the present situation is extremely limited. However, as economist Thomas Piketty notes (photo from the AP, cutting post-WW II debt in half  in 1953)

after the war ended in 1945, Germany’s debt amounted to over 200% of its GDP. Ten years later, little of that remained: public debt was less than 20% of GDP. Around the same time, France managed a similarly artful turnaround. We never would have managed this unbelievably fast reduction in debt through the fiscal discipline that we today recommend to Greece… Think about the London Debt Agreement of 1953, where 60% of German foreign debt was cancelled and its internal debts were restructured.

There are eighteen nations other than Germany which belong to the European Union and use the euro (In map below from Wikipedia, nations in blue are in the European Union and use the Euro; in yellow or red are nations in EU but without Euro; in purple, nations not in EU but which use Euro.)  However, Germany is by virtue of geography, as well as economic and political dominance the leader of the pack.  Piketty argues, "Those who want to chase Greece out of the euro zone today will end up on the trash heap of history. " And at least for now, that's the government in Berlin and its chancellor, Angela Merkel.

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Free Speech Must Survive The Confederate Flag

The Oxford Dictionary defines hate as "feel intense or passionate dislike for (someone)," which could apply to a whole range of offenses, especially domestic violence; but never mind. More importantly, the website of the US Department of Justice describes a "hate crime" as "the violence of intolerance and bigotry, intended to hurt and intimidate someone because of their race, ethnicity, national origin, religious, sexual orientation, or disability. "

Fortunately, it adds "The purveyors of hate use explosives, arson, weapons, vandalism, physical violence and verbal threats of violence to instill fear in their victims, leaving them vulnerable to more attacks and feeling alienated, helpless, suspicious and fearful."

Or, if you are Nick Bromell of the University of Massachusetts, Amherst, the purveyors of hate may hold fast to a political position you find noxious. Bromell in Salon writes (with emphasis on "anywhere")

displaying the Confederate flag anywhere is, at bottom, an act of hate. It should be recognized as such, and punished as a hate crime.

Given the millions who suffered under the whip of slave masters, and all the families separated as slave traders sold sons and daughters away from their parents, and wives away from their husbands, All Americans should recoil from the Confederate flag with the same horror we feel for the Nazi swastika.

Given merely what the Nazis did to European Jews- killing approximately two-thirds of them before the war ended- any comparison to their reign of genocidal terror is odious. Additionally, as noted on the US Holocaust Memorial Museum website,

While it classified Jews as the priority “enemy,” the Nazi ideological concept of race targeted other groups for persecution, imprisonment, and annihilation, including Roma (Gypsies), people with disabilities, Poles, Soviet prisoners of war, and Afro-Germans. The Nazis also identified political dissidents, Jehovah’s Witnesses,homosexuals, and so-called asocials as enemies and security risks either because they consciously opposed the Nazi regime or some aspect of their behavior did not fit Nazi perceptions of social norms. They sought to eliminate domestic non-conformists and so-called racial threats through a perpetual self-purge of German society.

The battle flag of the Confederacy should not be honored in any way by any government in the USA (nothing special about the video below- except the accent). But that's a far cry from punishing private display of it as a hate crime.

It is logically, and it is constitutionally.  Prohibiting display even of the swastika, the symbol of Nazism, has been found violative of the U.S. Constitution.  The best known and most relevant case began when

In 1977 Frank Collin, the leader of National Socialist Party of America, announced the party's intention to march through Skokie, Illinois. In the predominantly Jewish community, one in six residents was a Holocaust survivor. Originally, the NSPA had planned a political rally in Marquette Park in Chicago; however the Chicago authorities blocked these plans by requiring the NSPA to post a public safety insurance bond and by banning political demonstrations in Marquette Park.

On behalf of the NSPA, the ACLU challenged the injunction issued by the Circuit Court ofCook County, Illinois that prohibited marchers at the proposed Skokie rally from wearing Nazi uniforms or displaying swastikas. The ACLU was represented by civil rights attorneyBurton Joseph. The challengers argued that the injunction violated the First Amendment rights of the marchers to express themselves.

Both the Illinois Appellate Court and the Illinois Supreme Court refused to stay the injunction. The case was sent to the Supreme Court of the United States.

On June 14, 1977, the Supreme Court ordered Illinois to hold a hearing on their ruling against the National Socialist Party of America, emphasizing that "if a State seeks to impose a restraint on First Amendment rights, it must provide strict procedural safeguards, including immediate appellate review... Absent such review, the State must instead allow a stay. The order of the Illinois Supreme Court constituted a denial of that right." On remand, the Illinois Appellate Court eliminated the injunction against everything but the swastika. The Illinois Supreme Court heard the case again, focusing on the First Amendment implications of display of the swastika. Skokie attorneys argued that for Holocaust survivors, seeing the swastika was like being physically attacked.

The Illinois Supreme Court ruled that the use of the swastika is a symbolic form of free speech entitled to First Amendment protections and determined that the swastika itself did not constitute "fighting words." Its ruling allowed the National Socialist Party of America to march.

The repugnant demonstration was ruled acceptable in Skokie, Illinois. Skokie was then home to an estimated 6,000 to 7,000 Holocaust survivors, approximately one in six residents, and was described (by a guy named Reich; ironies abound) as "a kind of ground zero for Holocaust survivors in America."

Fourteen years later, in a case not primarily involving religious bias but racial bias (as with the Confederate flag), the US Supreme Court was asked to rule on the constitutionality of a local bias-motivated criminal ordinance in St. Paul, Minnesota which was used to charge "several teenagers (who) allegedly burned a crudely fashioned cross on a black family's lawn." The Justices ruled unanimously that the ordinance "prohibits otherwise permitted speech solely on the basis of the subjects the speech addresses."

The cross, a symbol of  racial prejudice and hate, was burned on the lawn of the family in an obvious (and frightening) effort to intimidate its black residents- and could not be prohibited on that basis.

The Court found that an ordinance criminalizing the action violates the First Amendment- and Nick Bromell wants to criminalize display of the  flags because they (emphasis his) "send a clear, painful, and frightening message:You don’t belong here. By being here, you are in danger. This nation is not for you. "

The flags do, indeed, shout "you don't belong here" because "this nation is not for you." However, a march by American Nazis, a mere 32 years after the end of WWII, in a neighborhood characterized by Holocaust survivors says more than "you don't belong here." It shouts "Adolf Hitler didn't finish the job."  And a cross burned on the lawn of a  black family is intended to glorify lynching and instill fear of it.

The US Supreme Court, notwithstanding however wise or unwise these decisions may have been, decided the First Amendment is nothing to be trifled with.   That applies to the speech clause, as it should apply to the Establishment clause.  We cannot allow outrage over the Confederate flag to blind us to our nation's values.













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At No Cost

When Donald Trump announced on Tuesday, June 16 that he was seeking the GOP nomination for President, he declared

When Mexico sends its people, they're not sending their best. They're not sending you. They're not sending you. They're sending people that have lots of problems, and they're bringing those problems with us. They're bringing drugs. They're bringing crime. They're rapists. And some, I assume, are good people.

Trump was roundly and soundly criticized for the hostility he exhibited in characterizing Mexican immigrants as drug mules and criminals, even rapists.  A second, related, criticism focused on the stereotyping: "some, I assume, are good people," a concession meant to emphasize that he is unconvinced any are good. He's merely, generously, assuming they are.

In his interview Wednesday with NBC News, he told Katy Tur much the same thing:

I`m talking about the Mexican government forces many bad people into our country because they`re smart. They`re smarter than our leaders and their negotiators are far better than what we have, to a degree that you wouldn`t believe. They`re forcing people into our country.

This guy that killed the wonderful young woman from San Francisco, he went back to Mexico, they forced him out. They forced people into our country. And they are drug dealers and they are criminals of all kinds.

Trump again took heat for a decidely anti-immigrant stance, though he deserves some credit for consistency. He could have mimicked the party's leading presidential contender,  "the goggle-eyed homunculus hired by Koch Industries to manage their midwest subsidiary formerly known as the state of Wisconsin," who was in favor of comprehensive reform before he was against it before he was in favor of it before he was against it.  (And now for it again. Maybe.)

Virtually everyone, however, disregarded the vow made by Trump at his announcement when he vowed

I would build a great wall, and nobody builds walls better than me, believe me, and I'll build them very inexpensively, I will build a great, great wall on our southern border. And I will have Mexico pay for that wall.

He similarly told Kur (and CNN's Anderson Cooper previous to that, below) "I will make that wall impenetrable. OK? Impenetrable. You don't have to worry about how high it will be. And Mexico will pay for that  wall."

Mr. Trump, that is a cowardly statement. OK? Cowardly. You don't have to worry about how effective it will be. Because it won't be built.

It wouldn't be built, and Trump knows it. He himself told us  "They're not sending you. They're not sending you. They're sending people that have lots of problems, and they're bringing those problems with us."  The following month he told us "They`re forcing people into our country."

It would be lovely if someone had asked Trump who "they" is, but presumably he means the Mexican government, the same "Mexico" he says will "pay for that wall."  They are, in the candidate's view, sending us all manner of human waste- but they will spend their money to build a wall to keep from emigrating the people they're kicking out.

Perfect- no, really perfect.  This may be an unexplored reason Trump is gaining popularity among the Repub masses. He is selling them what they've been sold since the days of Ronald(6) Wilson(6) Reagan(6): all gain, no pain.  Cut the deficit, even the debt- and not only do it without a tax increase, do it with a tax cut.  It's all dessert and no vegetables, trimming down without exercise or change in diet, a pony under every Christmas tree.  It's secure the border with no sweat, no price to pay. Even better, we get a wall paid for by Mexicans, symbolically repenting for their sins.

The mainstream media and the Republican Party want us to believe Donald Trump is an outlier, the loud, drunken uncle at the Thanksgiving table. But he is now a Republican through and through. He is what the GOP has wrought.













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It Should Kill His Campaign. It Won't.

For a couple of months last winter, the top political question was: will he or won't he? will Willard Mitt Romney make a third run for the presidency/

Eventually, the former Massachusetts governor announced that he would not be a candidate. Evidently, however, the man who made elitism his running mate with his 47% remark has now under an assumed name, "John Ellis Bush," stated

My aspiration for the country and I believe we can achieve it, is 4 percent growth as far as the eye can see. Which means we have to be a lot more productive, workforce participation has to rise from its all-time modern lows. It means that people need to work longer hours and, through their productivity, gain more income for their families. That's the only way we're going to get out of this rut that we're in.

The "rut" we're in, Jeb, is that

From the end of WWII until the 1970s productivity in the U.S. and median wages grew in lockstep. But from the late 1970s until today we've seen a divergence, with productivity growing faster than wages. The divergence indicates that companies and the people who own and run them are doing much better than the people who work at the companies.

"We have to be a lot more productive," says John Ellis Bush, of workers whose productivity has grown 240% since 1970 and have seen their average wages grow by approximately a third of that (graph from Mother Jones, below).  "People need to work longer hours," says the fellow who made at least $1.85 million each year, from when he left the Florida statehouse in 2007 through 2013. Most of that came from speeches, in which he presumably bemoaned Americans not so lucky as to be born to the family Bush.

Employed Americans have been working longer hours. What they need, as the maps below (also from MoJo) indicate, is the assurance of time off each week, which all but 15 other nations give their workers; paid annual leave, denied in only eight other nations; and paid maternity leave, lacking in only five other countries.

Perhaps a Bush, believing the USA began to fall apart on January 20, 2009 might not notice

Wage stagnation is a decades-long phenomenon. Between 1979 and 2014, while the gross domestic product grew 150 percent and productivity grew 75 percent, the inflation-adjusted hourly wage of the median worker rose just 5.6 percent — less than 0.2 percent a year. And since 2002, the bottom 80 percent of wage earners, including both male and female college graduates, have actually seen their wages stagnate or fall.

Charles Pierce is outraged at the media's favorite candidate as only he can be, writing

Holy Jesus H. Christ on a furlough, there's your "47 percent" moment for this cycle. What is it with this guy and with that other Florida Man, Marco Rubio? Is the sun so bright that neither of them sees the rakes until it's too late? Every legitimate survey demonstrates that Americans are working longer hours for wages that pretty much have remained flat for 30 years while most of the country's wealth was being shoved up to that level of the economy wherein reside Jeb (!) and his family of entitled layabouts. This is pure Romneyism in action. This one statement should kill his campaign. It should be hung around his neck like a dead raccoon until the last ballot of the 2016 election is cast. If it's not, it's only because some people will do anything to keep this guy viable because he allegedly is more "serious" than many of the other presidential candidates. Those people are wrong.

John Ellis Bush may be more "serious" as in having a much better chance of being nominated than Carly Fiorina, Bobby Jindal, and a couple of others who believe the same things but couldn't get away with saying them.   He is no more moderate than they are; he merely looks reasonable, as any Bush must, and is confident of his entitlement.  This is one of your three Repub front-runners, a guy who thinks the economy is ready to take off once Americans get off their rear end and start working.






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Mend It

(The imperial) "we" return to Ben Schreckinger and Jonathan Topaz, who on Monday claimed in Politico

Still, many of his most important positions today fall well outside the traditional parameters that have bounded American political discourse in recent decades. He wants to raise the marginal tax rate for top earners to more than 50 percent — which would be the highest rate in 30 years and is more than 10 points higher than Barack Obama proposed as a candidate in 2007. He says he would replace the Affordable Care Act — perhaps Obama’s signature accomplishment in office and a prized victory for Democrats — with a Medicare-for-all, single-payer system, a position that was too liberal for Dean when he was governor of Vermont. (Sanders’ standard Obamacare line is to quickly laud its “modest gains” but quickly say it isn’t enough.)

The Affordable Care Act is President Obama's signature accomplishment. And it would be "a prized victory for Democrats" if more than a few Democratic congressional candidates, incumbent or challengers, ever had run on it.  They would have, if only most voters believed that "signature accomplishment" were synonymous with positive signature accomplishment.

The Affordable Care Act has achieved the "modest gains" noted by Senator Sanders, who has stated "We have got to grapple with the fact that we remain the only country, major country, without a national health care program."   Among other problems wrought by the ACA, many doctors are dropping out of exchanges, as illustrated by Stacey Burling of The Philadelphia Inquirer when she wrote

When economist Dan Polsky set out to study how many doctors were in the health-insurance networks available to Obamacare customers, he found out it was hard - even for him.

How hard?

"Nine out of 10," said Polsky, executive director of the University of Pennsylvania's Leonard Davis Institute of Health Economics.

He concluded that many of the 10.2 million people who have bought insurance through the Affordable Care Act marketplace probably don't realize they are giving up access to many physicians and hospitals in order to get lower premiums.

He and colleague Janet Weiner learned that 41 percent of health plans at the midrange "silver" level included fewere than 25 percent of physicians in their  area, making them "narrow networks."

Cancer patients in particular often want to see topflight doctors, but in oncology, 59 percent of networks were classified as narrow.

Polsky said insurers need to do more to help shoppers determine who is in the network they are considering. Otherwise, he predicted, lawmakers may set specific limits on how narrow networks can be. The Affordable Care Act says only that networks must be large enough that "all services will be accessible without unreasonable delay."

Kathy Hempstead, who directs work on health-insurance coverage for the Robert Wood Johnson Foundation, said consumers using the exchanges deserve better information. "They don't have the information they need to support their decisions," she said. "You're only able to see the trees and not the forest." The foundation funded the Penn research.

Antoinette Kraus, director of the Pennsylvania Health Access Network (PHAN), said her organization, which helped people sign up for Obamacare insurance, is "definitely concerned" about small networks and is keeping a close eye on problems customers are encountering.

"It's great to get people health insurance coverage, but we want to make sure people can use that coverage," she said.

To most laypeople, ease of using the service is critical. But it's not so obvious to journalists, politicians, and others who believe that a major piece of legislation is valuable as "a signature accomplishment in office" apart from its actual value to actual individuals and families.

Between Democrats who celebrate Obama's health care reform and Republicans who gin up opposition by misleadingly claiming it has ushered in government control, typically lost is the reality that the Affordable Care Act would have done Rube Goldberg proud.  Burling continues

So far, patients have been most confused by tiered plans. These plans may have relatively large networks, but there are extra co-pays and deductibles when customers go to certain doctors and hospitals.

Patrick Keenan, PHAN's director of navigation, said plans with smaller networks were introduced before the most recent enrollment period. Subscribers were optimistic that they could get the doctors they needed, but Keenan said subscribers sometimes struggle with getting a physician with convenient hours in their neighborhood.

Transparent reform it is not. It is needed reform for, among its accomplishments, it has "bent the cost curve" and delivered health care to Americans previously without it.  A government website, obamacarefacts.org, lists many of its accomplishments, among which are

8 million enrolled in the Marketplaces during 2014 open enrollment (Oct 2013 to April 2014).

11.7 million are estimated to have enrolled in the Marketplaces during 2015 open enrollment (Nov 2014 to Feb 2015). This includes 4.5 million who re-enrolled from 2014.

As of March 2015 HHS reported a total of 16.4 covered due to the ACA between the Marketplace, Medicaid expansion, young adults staying on their parents plan, and other coverage provisions. According to Gallup that translates to an uninsured rate of 11.9% down from a high of 18% in 2013.

According to the US Census Bureau, before the ACA in 2009 about 48.6 million or15.7% of the population was uninsured.

The improvement is graphically demonstrated below, from that site.  In 2009, before the Act was passed, 14.6% of individuals at least 18 years of age were uninsured, and by 2015 the percentage was down to 11.9%. That is, in the timeworn phrase, nothing to sneeze at.

Nonetheless,it is far less of a drop than was inferred, implied, and occasionally even promised by supporters.  Democrats won't tell you that for obvious reasons; Republicans won't tell you that because it would draw attention to the millions of Americans who have obtained health care they otherwise wouldn't have. (And a bunch of conservatives probably are happy, for ideological or strategic reasons, that the number of insured isn't higher.)

Much of the blame goes to Repub governors who have not taken advantage of the opportunity to expand Medicaid, buttressed by the Supreme Court's decision which blocked the federal government from eliminating program subsidies to states which refused to expand eligibility.  Evidently, the intransigence was unexpected by the Administration, understandable given the harm which came to the poor when a state government  found its 10% contribution would be burdensome. (It may be too generous to assume that cost was the primary factor.)

It may be unfair to argue that the Administration was responsible for being caught unprepared.  Still, whatever the motivation, it stands as a failure of the legislation, though insufficient to conclude that the Affordable Care Act wasn't a success overall. It's an improvement and, technically, the President's signature achievement. However, most individuals- and Bernie Sanders- know that it is  simply Tnot good enough.






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