After Trump's health care fiasco
For the past two days pundits have been sorting through the debris left by the implosion of the Republican attempt to "repeal and replace" Obamacare and are now looking around for someone to blame.
The most risible and illogical rationale is Trump's own, which blames the Democrats for standing solidly against the Republican attempt to obliterate, like it or not, one of the most significant pieces of legislation of the Obama administration.
Now, the morning after, it's worth considering what could still be done to improve America's rickety system of health care for those who can't afford it. But with Trump in charge—a man of little vision except his financial and personal aggrandizement—the prospects do not look good.
There were many missteps and bumbling actors in this debacle but the primarily responsibility falls on Trump, for selling his plan to undo Obamacare not next month or next year but immediately—as he deemed himself uniquely qualified to do—even though he didn't have much of a clue what Obamacare was about or what was wrong with it, let alone the intricate legislative machinations required to replace it or fix it.
"Nobody knew health care could be so complicated," Trump exclaimed a month ago, with a mixture of surprise and exasperation.
My cat Fifo could have figured the complexity of the problem and he's not the brightest feline in the cathouse.
Under Trump, bombast, hyperbole and plain lying took the place of analysis and tedious negotiations with the members of his own party, let alone the Democrats or the American public, to shape a consensus on this very thorny problem.
Obamacare is a DISS-ASS-TER, Trump kept saying, while holding the little index finger and little thumb of his smallish right hand in a circle for added emphasis. Polls showed Obamacare to be unpopular and Trump figured that knocking it was a political no-brainer.
During the final and frantic negotiations over the fate of the Republican health care bill, Trump reportedly told members of the ultra-orthodox House Freedom Caucus, "[f]orget the little shit and let's focus on the big picture here."
Not surprisingly, the recalcitrant conservative House members took umbrage at the president dismissing their concerns as "little shit" in favor the "big picture," i.e. scoring a big win for Trump by approving what had become a centerpiece of his litany of hot-air promises.
As if to underline the Trump's message, Stephen Bannon essentially told House Freedom Caucus members to put up and shut up: "Guys, look. This is not a discussion. This is not a debate. You have no choice but to vote for this bill."
In the end, of course, Trump's "little shit" congealed into a big, steaming loaf of the stuff, leaving him and the Republicans looking like it too.
The heart of the Republican plan to reform Obamacare was to reverse billions in taxes imposed on high-income folks in order to fund the program, while leaving America's health care coverage for the uninsured that much more tattered. That proposal seems to be dead for now.
Still, dreamers can dream that after the Obamacare fiasco, a bipartisan team could come together to try to fix the program's many admitted shortcomings rather that destroy it--even though in Washington's poisoned partisan atmosphere that is a long shot indeed.
More likely is that Trump, unable to admit defeat, will instead try to further weaken Obamacare through funding cuts and other forms of sabotage and then claim "I told you so" if it fails.
Sadly, scenario number two is more likely. After all, this is all about Trump and his outsized ego, not what's best for the vulnerable uninsured population in the U.S.
Late-breaking news: I finished this posting on Sunday afternoon and it ended on a down note, i.e. there was no likely way Democrats and Republicans would come together to find some common ground on health care.
I woke up Monday morning with news from the New York Times that after the GOP mishmash over "repeal-replace", there is now some talk of trying to find bipartisan solutions for reforming the nation's health care system.
Also in the Times there's a piece about The Weekly Standard, a publication trying to set itself as a conservative voice using "facts, logic and reason." Breitbart News and Alex Jones, and a good part of the Fox News team need not apply.
Imagine that.
The most risible and illogical rationale is Trump's own, which blames the Democrats for standing solidly against the Republican attempt to obliterate, like it or not, one of the most significant pieces of legislation of the Obama administration.
Now, the morning after, it's worth considering what could still be done to improve America's rickety system of health care for those who can't afford it. But with Trump in charge—a man of little vision except his financial and personal aggrandizement—the prospects do not look good.
 |
| Tiny fingers do the talking. |
"Nobody knew health care could be so complicated," Trump exclaimed a month ago, with a mixture of surprise and exasperation.
If he had given the issue even cursory attention—which of course would have involved considerable reading, not one Trump's favorite pastimes—he would have learned about Hillary Clinton's failed stab at health care reform, and the endless months of negotiations to get Obamacare enacted.
 |
| Fifo sez: Obamawhat? |
Obamacare is a DISS-ASS-TER, Trump kept saying, while holding the little index finger and little thumb of his smallish right hand in a circle for added emphasis. Polls showed Obamacare to be unpopular and Trump figured that knocking it was a political no-brainer.
During the final and frantic negotiations over the fate of the Republican health care bill, Trump reportedly told members of the ultra-orthodox House Freedom Caucus, "[f]orget the little shit and let's focus on the big picture here."
Not surprisingly, the recalcitrant conservative House members took umbrage at the president dismissing their concerns as "little shit" in favor the "big picture," i.e. scoring a big win for Trump by approving what had become a centerpiece of his litany of hot-air promises.
As if to underline the Trump's message, Stephen Bannon essentially told House Freedom Caucus members to put up and shut up: "Guys, look. This is not a discussion. This is not a debate. You have no choice but to vote for this bill."
In the end, of course, Trump's "little shit" congealed into a big, steaming loaf of the stuff, leaving him and the Republicans looking like it too.
The heart of the Republican plan to reform Obamacare was to reverse billions in taxes imposed on high-income folks in order to fund the program, while leaving America's health care coverage for the uninsured that much more tattered. That proposal seems to be dead for now.
Still, dreamers can dream that after the Obamacare fiasco, a bipartisan team could come together to try to fix the program's many admitted shortcomings rather that destroy it--even though in Washington's poisoned partisan atmosphere that is a long shot indeed.
More likely is that Trump, unable to admit defeat, will instead try to further weaken Obamacare through funding cuts and other forms of sabotage and then claim "I told you so" if it fails.
Sadly, scenario number two is more likely. After all, this is all about Trump and his outsized ego, not what's best for the vulnerable uninsured population in the U.S.
****
Late-breaking news: I finished this posting on Sunday afternoon and it ended on a down note, i.e. there was no likely way Democrats and Republicans would come together to find some common ground on health care.
 |
| Time to stop laughing, Barry. |
Also in the Times there's a piece about The Weekly Standard, a publication trying to set itself as a conservative voice using "facts, logic and reason." Breitbart News and Alex Jones, and a good part of the Fox News team need not apply.
Imagine that.
Trump went along with Paul Ryan's pulling an old GOP plan off the shelf. It was a dumb idea. Dumping ObamaCare and replacing it with a workable system will take time. It will happen. Gotta happen because ObamaCare is imploding. Perhaps the U.S. should take a look at how we do it in Mexico. Government system for the poor that is far from ideal but much better than nothing. And a parallel private system for people who have the resources to use it, like me and you. And no one is strong-armed to participate in anything.
ReplyDeleteI agree that a two-tier system is inevitable because some people will always have more money. Everybody can't go to the Mayo Clinic, including you and me. Medicaid was supposed to provide for the medically indigent, but you have to be flat-out-busted poor to qualify. Even the working poor with marginal McJobs are too wealthy to qualify, leaving a gap in coverage. And some Republicans wanted to gut Medicaid too.
DeleteNot "strong-arming" people who don't want to participate is OK with me, like people who refuse to wear motorcycle helmets because it impinges on their freedom. All well and good, as long as they sign a piece of paper saying they will pay all expenses when they take a spill and crack their head.
Some people in Congress are talking about finding some bipartisan way out of this mess. Don't lose hope.
Don Alfredo
Instead of trying to reinvent the wheel, why isn't a group sent to the countries who have coverage for all and have those systems examined to find the best of the best?
ReplyDeleteYour brilliance and vision comes through again, Babs. In fact, the government of South Korea several years ago sent a delegation to different countries to study different approaches to health care insurance, though I don't know what they came up with. Must have been good. You don't read about South Koreans bitching about their health care system, at least not as much as Americans.
DeleteCertainly Fifo, with that glorious accounting name, should be able to figure out how to unwind that ball of yarn.
ReplyDeleteHe was at it yesterday, and after breakfast, a visit to the litter box and an 18-hour nap he'll be working on it again.
DeleteThe problem with all of the various efforts to fix healthcare (including "O" care is that they are focused on the wrong problem. Yes, we need access that's not tied to having an employer-sponsored group plan. But ultimately the problem is that US healthcare simply costs too much. We spend 17% of GDP on healthcare vs an OECD average of 10% and single-digit percentages in some advanced countries. This is the true problem, and if gov't would focus on reducing the cost of healthcare, "O"care would work fine, as would any number of other insurance schemes.
ReplyDeleteHowever, focusing on insurance schemes and then letting lobbyists write the bills will always result in failure, as we've seen.
Honestly, escaping the US healthcare racket is one of the better reasons to move to Mexico.
Saludos,
Kim G
Redding, CA
Where we are getting too much exposure to this system for our taste.