Hey, Suckers! You wuz Robbed!

6YbM

Trump Lauded Farmers, Medicare and AIDS Programs. Then He Unsheathed the Budget Knife.

Medicare-for-all v. Medicare-for-less: Trump’s proposed cuts put health care at center of 2020 race

So, here’s a message for all the I-hate-brown-people and all the fetus-people who think you have to cling to the low-tax people and the deregulation-people to keep from going down.

The message is, you may be right, but there is a price to pay for your brown people hatred and your love of fetuses.

Because the low-tax people and the deregulation people won’t just stop with low taxes and lots of deregulation.

They’re coming for your health care, too.

They really don’t care if you die.

 

Two Simple Questions about Health Care

When Ross Douthat sucks his thumb over Roman Catholic theological controversies, my eyes glaze over. Aardvark ain’t got no dog in THAT fight.

Other days—and today, I think, was such a day—he’s worth a read. In a column headlined The Health Care Cul-de-Sac, Douthat urges both political parties to “step back and think about our national priorities”—and then, having thunk deep thoughts, to conclude that it is not a national priority to replace Obamacare, nor is it a national priority to enact a single payer health care system. He writes,

If Obamacare repeal is really dead for the year 2017, both left and right have a chance to shake their minds free of the health care debate and ask themselves: What are the biggest threats to the American Dream right now, to our unity and prosperity, our happiness and civic health?

I would suggest that there are two big answers, both of which played crucial roles in getting a carnival showman who promised to Make America Great Again elected president. First, an economic stagnation that we are only just now, eight years into an economic recovery, beginning to escape — a stagnation that has left median incomes roughly flat for almost a generation, encouraged populism on the left and right, and made every kind of polarization that much worse.

Second, a social crisis that the opioid epidemic has thrown into horrifying relief, but that was apparent in other indicators for a while — in the decline of marriage, rising suicide rates, an upward lurch in mortality for poorer whites, a historically low birthrate, a large-scale male abandonment of the work force, a dissolving trend in religious and civic life, a crisis of patriotism, belonging, trust.

Having laid this predicate, Douthat goes on,

Now a follow-up question: Is the best way to address either of these crises to spend the next five years constantly uprooting and replanting health insurance systems, and letting health care consume every hour of debate?

The First Question

We come now to Aardvark’s first question, and it goes to my progressive friends.

And the question is,

Doesn’t Douthat actually have a pretty good point about priorities?

The Second Question

Here comes the second question, and it’s for you, Mr. Douthat. Ross, like many of your ilk, you speak of single payer health care systems as though only an insane person could even entertain the idea. In today’s column, for example, you refer, and I quote, to “outlandish single-payer expectations,” and you speak condescendingly of “single-payer dreams.”

So here’s the question:

We have all heard of “American exceptionalism.” But what, in your humble opinion, makes America so bloody exceptional that it is a pipe dream to have efficient socialized medicine in America, when all other advanced capitalist countries have some form of single payer systems?

In short, what is it about us that means we Americans can’t have nice things?

Enquiring minds want to know.

Fuck You, Democrats. And Please Work with Me on Health Care. Pretty Please with Sugar on Top

please

In his Oval Office remarks on the evening of March 24—the day Trumpcare bit the dust—master logician Donald Trump blamed his party’s failure to govern on … the Democrats!

Moving on from that elevated beginning, Trump went on predict the implosion of Obamacare and let us in on how much delight he will take in blaming said allegedly forthcoming implosion on—take three guesses—the Democrats!

These developments, he confidently predicted, will force the evil, cowardly Democrats to crawl into the Oval Office, praise his fine new suit of clothes, lick his feet, and beg to be allowed to cooperate in fixing the imploding Obamacare legislative project.

It was an odious invitation. If anyone is inclined to accept it, they will need to bear in mind that he who would sup with the devil should bring a long spoon.

Should Democrats give it a whirl anyway? And how do they answer the underlying questions: Is Obamacare “imploding” or isn’t it? (Much of the discussion of that question has a superficially partisan ‘tis/t’ain’t/’tis/t’ain’t quality about it; where does the truth really lie?) Insofar as there are real problems with Obamacare, not just partisan bullshit, how would reasonable people go about fixing the problems? And is there an icecube’s chance in hell that at least some Republicans could be persuaded to work with Democrats to find real solutions? (This would require, among other things, that Paul Ryan invite the “Freedom Caucus” to kiss is ass. After this evening, Ryan might welcome the opportunity to make such a declaration.)

I intend to inform myself better on these matters and, in future posts, to share the gist of what I think I have learned. My working hypotheses are that

  • Yes, the mandate was relatively weak to begin with; the Trump Administration has taken steps to make it even weaker; and that’s a problem.
  • Some people who buy insurance on the exchanges really do pay too much in premiums and, having made their unduly high payments, suffer from high deductible which they have trouble paying, if they become sick, because they paid too much for insurance to begin with. It’s a problem that could be addressed by increasing subsidies, taking steps to hold down payments to providers, and doing everything possible to make sure that insurance markets have enough competitors to make them “workably competitive,” as the microeconomists would say.

I tend to think the Democrats should make, and should be seen to be making, a good faith attempt to work with whoever is willing to work with them on these problems.