The Washington Post is covering the various incarnations of the GOP "Death to Obamacare Act" (I have lost track of what it's latest name is) on a minute-to-minute basis. Read quick here; it'll change in another half hour.
My question is this: What's driving the GOP to rush this?
I know that Trump ran on a promise to repeal/replace in 100 days. That deadline has passed, and the WaPo reports that Republican lawmakers aren't afraid of Trump. Most Americans don't like the GOP proposals. Trump's ratings are poor. So he's not driving this boat even if he is on a fake cover of Time.
The Senate GOP should settle down, make a case for Obamacare reform based on actual facts instead of characterizations like "death spiral," and level with the base: Health care is a complicated mess, no matter what our president says, and any effective legislation needs to address the causes of increasing health costs at the core. Here's Dr. Kenneth Davis, CEO, Mt. Sinai system, explaining this to Judy Woodruff. I bet Dr. Davis would be MORE than happy to share his expertise with Sen. McConnell and others.
The GOP has a chance to come out of this looking like heroes: We IMPROVED health care. Democrats followed our lead. We get stuff done. Vote for us in 2020. We promise we won't put a boob at the top of the ticket this time.
Are they really so stupid that they're going to fling legislation at a wall until something randomly sticks, scrape it onto a plate, and call it spaghetti?
What am I missing here?
They want to get the healthcare debacle over with so they can get on with what they're really passionate about, tax cuts! They never met a tax cut that they didn't get wet dreams about. In order to do the cuts, they have to come up with some spare cash. Guess where it's going to come from.
ReplyDeleteAlso they want to get rid of the ACA early rather than later and close to the midterm elections; figuring that people will be less likely to blame them for the fallout the more that time has elapsed. Got news for them, memories aren't that short. Unless people are part of the 37%, then nothing matters except loyalty to the tribe.
DeleteHmm. I guess. But if they can get to the heart of health care reform--real reform--then won't they have effected some savings?
ReplyDeleteSee, I am a prissy pants in many ways, and my basic propensity is to be a conservative. I like decorum, and rules, and spending prudently, and preserving culture and values, noblesse oblige and all that crap.
But the horror of today's conservatives is that they spend like drunken sailors on the military and tax loopholes for rich people. Both parties are profligates, but at least with the Democrats ordinary people are getting more of the pie.
I think what's driving McConnell and the more conservative of the Republicans is a deep belief, maybe not even always consciously acknowledged, that only productive and successful people deserve to survive, that Gos smiles on those who are good and that if your life is crap it must be your fault, that the winners in life should not be dragged down by those less fortunate. It's a Darwinian/Puritan religious/economic combo.
ReplyDeleteThat is why the Freedom Caucus guys want to completely get rid of MediCaid and give big tax cuts to the rich. That is why they want people who do get MediCaid to work for it. Here's a bit from an article in The New Yorker ...
"Why is the Republican Party so hostile toward Medicaid? It can’t simply be reflecting the wishes, and interests, of its voters, many of whom are now beneficiaries of the program. Donald Trump appeared to understand this when, from the beginning of his campaign, he promised not to cut Medicaid. (Of course, this pledge turned out to be worth about as much as a marketing flyer for Trump University.)
The two keys to the Republican attitude are money and ideology. If you view the modern G.O.P. as basically a mechanism to protect the wealthy, Medicaid is an obvious target for the Party. The program caters to low- and middle-income people, and its recent expansion was financed partly by an increase in taxes on the richest households in the country ....."
I think there is a small-government impetus, too. Some people really think the government doesn't belong in anything but very basic functions of defense and law enforcement. They really believe most functions are better carried out by private enterprise. Even though reality doesn't bear that out.
DeleteThe small government idea is really about that same Darwinian thing. Big government exists to help equalize benefits to citizens and to mitigate dangers to those who are most at risk. Conservatives want people to succeed or fail based on luck, personal power, or destiny.
DeleteI think that conservatives expect people to do things for others without being forced by the government. I know many good-hearted conservatives who do this. The problem is that some people are not in a position to volunteer time or share wealth because they don't have any. And they don't have any because conservatives have passed laws letting employers off the hook insofar as a livable wage and working conditions are concerned. If conservatives ran their businesses with the same generosity that they ran their personal lives, we wouldn't need big government.
Delete"....my basic propensity is to be a conservative. I like decorum, and rules, and spending prudently, and preserving culture and values..." Me too. But the meaning of "conservative" has changed. We can thank the Tea Party movement and the alt-right for that.
ReplyDeleteHere are a couple of links: here and here. The first is a single payer idea, the second is the conservative (as presently defined) vision of healthcare.
Just read Matthew Sitman's essay on why centrism is baloney. Thinking of canoeing whitewater as an analogy, centrism and compromise can plow you into a rock. The Commonweal writers I resonate most closely with are Sitman, McCarraher and Annett. I recalibrate on them.
ReplyDeleteSorry Stanley, I'm afraid I am an incurable centrist (you know, like a dead skunk in the middle of the road!)
DeleteIn a democracy like ours, what are the alternatives to centerism? The off-center now ruling in DC is hardly a flourishing enterprise. Would Bernie Sanders being doing any better? Count me skeptical.
DeleteI think he would have gotten the Obama treatment, and I don't know how much clout Bernie wields in Congress. Some Republicans said nice things about him during the campaign, but possibly only to pan Hillary, whom they expected to win the nomination.
DeleteI would say that Sanders represents the lost center. There was a day when the institution of Medicare and Medicaid hardly raised an eyebrow. Now it's communistic. My center is 1930s vintage center but I'm probably to the left of that.
ReplyDeleteMost days, I just want to get me a copy of the Anarchist's Cookbook and make everybody start over. But that's Exasperated Me talking. Not to be confused with outright sedition.
ReplyDeleteThere is nothing wrong with compromise, but, having been involved in union organizing and what not, I know that you don't start in the center. And it helps if they're a little scared of you.
I don't wear my prissy pants to those types of things.
Canoeing again, sorry. If everybody else is leaning over the right side of the canoe, having a nice upright centrist posture isn't going to keep you afloat.
ReplyDeleteI don't like centrism - it's like compromise - everyone gets to be unhappy :)
ReplyDeleteI'm a liberal on pretty much everything. I think liberalism is the moral high ground we all should aspire to. It's the gospels as politics.
Conservatives are examples of the worst in human nature and the Trump administration and its supporters show that so well in all their policies.
I believe there is a certain yin and yang between liberalism and conservatism (speaking of it in the classic sense, not alt-right). We need both in a healthy society.
DeleteImagine we are talking about torture. You think it;s morally wrong in all cases and that it's also ineffective at getting information.
DeleteThe other guy thinks torture is ok and a good way to get intel from terrorists.
Would you be happy with a compromise where we only tortured people on Monday, Wednesday, and Friday instead of 7 days a week?
If you feel strongly about something being right or wrong, I don't see how compromise can work.
No, there are times to draw a line in the sand. Bit you draw too many lines in the sand, you get yourself boxed in, and nothing happens.
DeleteHeadstart has been a program with wide bipartisan support (though perhaps right-wing support is dwindling). The issue isn't whether to fund the program, but for whom, at what levels, and whether to build in tracking to see what long-term gains kids make. Compromise is necessary to keep some programs going.
unagidon here.
ReplyDeleteI've been banging my head against thousands of Facebook comments and have been reading dozens of articles to try to figure out what the Republicans think they are doing. Several themes emerge. It is true that for many, Trumpcare is really a tax issue more than a health issue. But in almost all cases, the opponents of the ACA think that what they are doing is moral and that to support the ACA or even some kind of single payer is immoral.
I found a Right wing article (I don't call the Right "conservative" anymore) talking about why Paul Ryan opposes Medicaid. The article reports him saying that he had read a study that claimed that and expanded Medicaid would cause between 500,000 and 2,500,000 people to stop working by choice if they could get free insurance provided to them without having to work for it. He claims to want to prevent this and this part of how he frames his libertarian economic argument as an ethical one. We see echoes of this "philosophy" when we see someone say that they don't want to pay taxes to support lazy people who don't want to work.
It is also from this that the tax cut idea springs as a positive moral act. It's not exactly the case that workers and such on the Right want to give a big tax refund to the rich. It's that they think that the tax on the rich to support the ACA should not have been levied in the first place since it is an unjustified confiscation of money that the rich "earned" to support laze people. To me this cements their moral argument, because it casts both the taking and the giving as immoral and destructive acts.
Destroying the ACA, on the other hand, is ethical to them. Their arguments are a bit more complex, because the Right does see that many people have benefited from the ACA. We may even assume that even ideologues like Ryan see it, because if he's concerned about 2,500,000 "lazy" people slip streaming on Obamacare, he must be away for the 21 million people who are not according to his own definition. But it's here that we see the nastiest side of Right wing political manipulation. A thing that has struck me in reading all the Facebook comments is that so many people don't know how the ACA works or even how our healthcare system works. Having been in the business for a couple of decades, I don't blame them. I think I have even written in Commonweal about how the whole system is actually set up to hide its own inner workings. But in reading lots of opinions, I feel as though the misleading of the Right is systematic. The Right has taken people's general problems with healthcare, problems that have spawned the need for the ACA or for single payer, and have made these attempts at a solution the cause of the problems. The Right blames everything; everyone's problems with healthcare, on the ACA, even if the ACA has eliminated some of the problems. There is this strange ahistorical thinking out there where people want to hearken back to the "good old days" before Obamacare. It's frustrating for me if I try to address this and tell people that they are simply wrong (in a nice way). And I find here something else that's going one.
The strength of the Right's assault on the ACA and the thing that makes that assault immune to any systematic criticism is that the Right has linked the attack to people's personal experiences. One can't attack the Right's narrative without also attacking the actual experiences of the people who support the narrative. If I tell someone that their narrow network was not created by the ACA, which nowhere discusses networks at all, I'm flat out told that I am lying, because I am discounting their bad experience with narrow networks that they themselves never had before the ACA was passed.
I have tended on Commonweal to argue that it won't really work for us to attack the Right by promoting a moral argument, say like the Right ignores the poor. The Right believes that the Left creates the poor by tying up capitalism with regulations and by making people dependent on government support. While there is a battle going on about the definition of "good", I think that this battle really needs to be fought at the level of making people look at whether what they propose actually works or not. This way of looking at things is more technical than moral. In other words, accepting that the Right might be reasonable in their desire to make people more self sufficient and to make the earning and distribution of goods more equitable (in their case via the market), a better question might be "does this really work"?
DeleteAs for Trumpcare, I have been surprised that it has not been attacked where it is most vulnerable. Trumpcare will eliminate Medicaid for millions. But Trump ran on a platform that claims that many millions of American workers have lost their well paying jobs to foreign countries. He made a point of saying that these people were unemployed or underemployed and in bad shape. It follows that these are the very people who need at least the temporary support of an expanded Medicaid. On of the most successful arguments I have used on Facebook is this one; that the coal miners in W Virginia are not in fact lazy freeloaders. That in fact they have been screwed and now Trump's own supporter are tying to kill the support that the supporters claim was needed in the first place. I have even challenged some people to go to West Virginia and tell people there that they are simply lazy people who refuse to get a job. And I think that this argument is the kind of argument that would turn Trump's own head; that would allow him to kill Trumpcare in the name of the people who voted for him.
Forgive me, by the way, it this looks disjointed. It was a sort of stream of consciousness thing.
Delete"The article reports [Paul Ryan] saying that he had read a study that claimed that and expanded Medicaid would cause between 500,000 and 2,500,000 people to stop working by choice if they could get free insurance provided to them without having to work for it."
DeleteSomeone should explain to Rep. Ryan that millions of workers HAVE NO EMPLOYER PROVIDED HEALTH INSURANCE and that number is growing all the time as employers look for ways to eliminate the health insurance benefit because of its exhorbitant costs.
So young, healthy working poor cannot afford to quit work if they get Medicaid because they have rent, utilities, transport, child care, groceries, and the rest of it to pay.
For older, sicker Americans, he may not be far off. Our strategy before Obamacare was for one of us to quit work so we would qualify for Medicaid until Medicare kicked in. I don't expect to live much past 70, so I started drawing Social Security at 62 so we could afford the Obamacare premiums and in reading deductibles I have to pay as a result of my health problems.
Low-income people have to play the system because the system is rigged against us. If the Republicans could get that through their Ayn-Rand-addled brains, they might actually get somewhere.
in reading = attendant. yeesh
DeleteTrump still says he thinks, maybe, the Senate will come up with something we all will love, which will be cheaper and cover more people. Of course, he is not part of the negotiations; he is too busy with his re-election campaign.
ReplyDeleteAs for the Rs, they have always wanted to eliminate Medicaid, and this is how they will do it. If they succeed, they will take aim at their next target, Medicare, and then Social Security to prove they have been right since 1934 about it being a bad idea. They have never been about people's health; they have always been about shrinking gummint and the taxes that support it.
I'm sure that the corporations and billionaires pay those lobbyists just to keep things fair. Notice the one "civilian" on the republican baseball team, the one who got shot, was a lobbyist for Tyson, a giant corporation. No Joe Sixpack there though a lot of them can play.
ReplyDelete