What a combination! I should probably be opining on the fate of the American Health Care Bill. However, it’s getting wall to wall coverage on every news channel and you’re probably sick of it already. Of course, my opinion is that its failure is the best result.
A Quinnipiac poll that came out a couple of days ago put the Bill’s approval at only 17%. The disapproval rating was a massive 56%. Whatever your opinion about Obamacare, it was never that unpopular. In fact in a CNN/ORC poll in January, the approval rating for Obamacare was 49% and the disapproval rating was 47%. People are realizing that Obamacare is actually not that bad and like President Trump, they’re understanding that healthcare is difficult to sort.
TRUMP: “Nobody knew that health care could be so complicated.” https://t.co/LFr422VHbq
— Bradd Jaffy (@BraddJaffy) February 27, 2017
Personally, I suspect Obamacare’s approval rating is even better now that voters have seen what they could get instead. The Congressional Budget Office (CBO) rating of the Bill was dismal. Republicans have to accept the Zeitgeist is changing. More and more USians see healthcare the way that the rest of us do: its provision is a collective responsibility. It’s something for which we should all pay taxes to ensure everyone is looked after. Results like this from the CBO report are unacceptable to the majority these days, not just those they affect:
The way the tax breaks in the Bill give so much to the wealthy is also unconscionable. Basically, elderly and poor people are being tossed on the trash heap to enable rich people to get tax breaks.
Anyway, enough about that. I may write more about the topic later if I feel up to it. In the meantime, on to more important things – Simon’s Cat!
Simon’s Cat: Camouflage Challenge
This is a real cutie!
Now wasn’t that better than politics?
I actually have rather a lot to say about the healthcare topic. However, I get so frustrated that Republicans, who are supposed to be all about the economy, are unable to see that universal healthcare is actually better for the economy than what they’re constantly trying to introduce. For many things, perhaps most, a market-driven solution is best. Healthcare is not one of them and that is NOT a nod to communism or socialism.
Simon’s Cat: Fly Guy
I’ve just undone all the good I did by posting a Simon’s Cat video, so here’s another one to finish on. An oldie (July 2009) but a goodie:
Trevor Noah on the American Health Care Act
I can’t help it. I have to add this:
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The cat is such a relief. I’m tired of thinking about Trump. Of course, he’d like us to forget about what he’s trying to do with the country. I feel it’s some kind of obligation, a duty, to keep and eye on him and stay informed on issues as they arise, even though there’s nothing I can do about them.
Heather, I’m not sure why you think the Reps are supposed to be all about the economy. That’s just spin, like calling Reagan a fiscal conservative despite running up the largest budget deficits ever. The modern Reps at least are all about the cult of personal responsibility (accept when it applies to themselves of course) and the economy and everything else can be damned.
Yeah, good point. It’s like saying they’re all about small government, then they want to legislate what happens in the bedroom, or they’re about personal freedom, except about drugs and abortion. I could go on of course.
Republicans at least pay lip service to limited government, while Democrats are relentless in seeking to empower politicians and bureaucrats at the expense of individuals, families and communities. Democrats demand mountains of regulations that stifle innovation, efficiency, competition, and growth, and that serve no purpose but to increase graft and other crimes.
Concerning drug policy, I believe you may be misinformed — it has been largely bipartisan, but much of the criticism over the years has come from libertarian-oriented Republicans. As for protecting the right to life, it is the first duty of any civilized society. If you’re not going to do that much, then there truly is no reason to have a civil authority at all.
I’m not sure why you would rely on any party to provide good government that wants to do away with it. They have no incentive to do a good job.
A lot of regulations are about making life better. Does anyone really want to go back to the Wild West of no consumer or employee protection, lack of financial regulations, air and water like China, and all the rest. The massive fraud you speak of is easier in those circumstances, not harder. The 2008 global financial crisis was caused by US banks able to do things enabled by Bush’s roll back of regulations. Now the Trump government wants to roll back the protections introduced by the Dems. Yes, that might allow rich people to get richer. It also puts everyone else at risk once again of losing everything.
I would only entrust power to those who know and agree that the best government is the least government. Best and least are perfectly compatible goals.
To frame the choice as between either the status quo or Somalia is a false choice.
Bullshit. Either you’re quite happy with the Wild West that Heather describes, or you don’t know what “least” means.
Least means smallest; it doesn’t mean nil or null.
But really, must you make things so difficult for yourself? You get the point, which is inarguable: It’s not a binary choice.
You’re the that talks in false absolutes, not me.
Sorry, but no, this is not some triumph for the sinister forces of collectivism and socialism. A more straightforward repeal would have passed. Meanwhile, Americans’ love of liberty burns more intensely than ever, and the immutable laws of math and physics and economics still govern. The hated Obamacare will be gone sooner if repealed, or soon enough if left to destroy itself.
No politician ever can or will improve anyone’s material well-being. Only economic growth and opportunity can do that. Thank goodness we finally have political leadership that understands that unchanging fact of life.
Except Obamacare isn’t hated anymore, and universal coverage and single-payer would be good for economic growth. The Republicans think they are going to create growth via the debunked Trickle-Down Theory of economics. The best way to increase economic growth is by increasing economic equality. That means, among other things, financial support for the poor and tax cuts for the middle class. The kind of tax reform that’s needed is simplifying the tax code by doing things like removing all the tax breaks for the wealthy. The effective tax rate for the wealthy is not, as they complain about, the highest in the developed world. If they got rid of all the tax breaks the complaint would be fair. As things stand, it’s not. Only small businesses pay the highest rates which is stupid because it stops small businesses starting and makes them more likely to fail. They are the engine of real economic growth.
But Heather, reality doesn’t matter when you have blind religious and political dogmas on your side.
Speaking from experience? 😀
(You know I’m saying that with a cheeky grin!)
Why yes, far too much experience. I’ve been dealing with jam’s kind for forty years!
Certainly not all conservatives are blinded so:
Good article. Any reasonable person should be able to admit there are issues with Obamacare. Instead of dozens of votes to repeal it, which the Republicans only brought to the floor because they knew they would blocked, they should have worked with Democrats to fix it. They created a rod for their back with “Repeal and Replace”. They could have instead made it seem like a majority of the good that came from Obamacare was because of them and presented themselves as the adults who would cooperate (however inaccurate that is).
There are big issues with Obamacare – it was a conservative Heritage Foundation idea after all, as Frum points out – which is a big part of why Reps engaging with it would very unlikely have made it better. But they would have made it more palatable to themselves and I agree it would have been the politically astute thing to do.
But the tea party driven Republican party simply isn’t capable of that. If practical things like cost were the issue, we’d just expand Medicare to all, as it has been shown to be the most cost effective way to provide coverage. But the real issue for Reps is those dogmas, the ideological opposition to universal health care, driven by the ideological (and Calvinist) belief that people who can’t afford health care, or who otherwise get trampled by the system, are entirely at fault, and just get what they deserve.
I agree too. It’s a point historian Simon Schma made when doing a show about the influence of religion on the development of the US. It’s also a thing that’s always made me realize how much dogma drives these people – they look at poor people in their own country and think it’s all their own fault, but they never think that about poor people in Africa or Asia, for example.
That I think is also part of the habit of the American Exceptionalists of looking down on every other country. They can’t look at the things that work in other countries and apply them to their own because that would be admitting someone else might know better than they do. I think that’s part of the reason they won’t go for universal healthcare – it would be following the rest of the developed world and admitting they are the ones who are right on the issue. In fact they’ve got an ideal opportunity because all systems are different and none is perfect. They could take the best bits of them all and truly have the best system in the world for the rest of us to aspire to.
Good analysis Ken. I agree. I hadn’t thought of the Calvinist influence, but I think you’re right. It’s the only thing that makes sense of the resentful coldheartedness.
The Health-Care Debacle Was a Failure of Conservatism
“As a novice to the subject noted recently, health care is complicated. Too complicated for ad-hoc policymaking and simplistic conservative nostrums.”
In 2009, 52% of bankruptcies in the US were because of healthcare costs. Many of those people actually had insurance but they were the junk policies that some Republicans want insurance companies to be able to sell again. That is an absolute disgrace imo, and an indictment of market responses to health care.
I’m a big fan of Schma. His History of Britain 15 yrs ago was great. Are you referring to The American Future, perhaps? I’ve read the book, but not seen the doco.
I can’t remember what it was called, but it wasn’t that long after the History of Britain. Within about 5 years anyway.
“Too complicated for ad-hoc policymaking and simplistic conservative nostrums.”
Better say, then, it’s too complicated for any sort of “policymaking” — indeed too complicated to let politicians anywhere near it.
Except that’s so untrue, firstly because doing nothing is also policymaking, but more importantly because decent healthcare policy exists in many countries whether it fits with your dogma or not.
@Ken: Doing nothing or doing little is indeed policy, and — notwithstanding your dogma — is by far the wisest policy in many circumstances, especially when the problem being addressed is complicated and can be made worse.
Notwithstanding your dogma, the experience of smaller less complicated countries may or may not be relevant.
(P.S. taking one’s values into account is not being dogmatic.)
Ah yes, after your bull is called out you hedge your absolutist claims with “in many circumstances” and “may or may not be”. But engaging in good faith means not spouting such shit in the first place.
Now I’m really starting to worry about you. By any chance, have you been drinking again?
“Drinking again?” That’s going too far j.a.m. Stick to disagreeing on the issues please.
Heather, you have the patience of a…what, kindergarden teacher? You’re hosting a mega-trollster if you ask me.
The system that you oddly think was “debunked” is, in reality, the most powerful economic engine the world has ever known, one that has drawn tens of millions of poor families from the ends of the earth — my family and that of every American you’ll ever meet, generation after generation — and made them wealthy beyond their imagination. Socialism had nothing to do with it. “Equality” had nothing to do with it, except for equality of opportunity and rights.
No one ever came to the USA in search of a generous welfare state. We came here yearning to breath free, seeking unlimited opportunity, eager to work and strive and prosper and fulfill our God-given potential, and determined to escape every form of political oppression including socialism.
That’s a rewriting of history if ever I heard one. Yes, people went to the US seeking freedom and opportunity, but not freedom from socialism. They were largely escaping systems that kept the poor downtrodden and unable to escape their station in life. Where a small number had most of the wealth and most others barely survived. That system was also one in which the Church taught people were born into a particular station in life and it was a sin to want to move out of it. Last century, a tiny proportion of immigrants were escapees of communist regimes, but that is not the dominant story of the US immigrant.
In my defense, I clearly referred to “every form of political oppression”, socialism being among them, but without any suggestion that it was dominant.
It’s not the case that “elderly and poor people are being tossed on the trash heap”. The bill has nothing to do with Medicare, and the massive expansion of Medicaid under Obama was to cover additional, by definition non-poor people.
Did you not read the graphic about the example of a 64 year old man on just over $26 thousand? I suppose he’s young and wealthy?
You mean the graphic by the guy who reads dumb jokes on a low-rated cable channel?
The same graphic appeared on multiple channels, including Fox News and CNN. (I know because I saw it there myself.)
Here’s an impressive interactive map that shows the differences down to county level of the differences in healthcare costs between the ACA and AHCA.
A quote from the accompanying article:
That out-of-context quote is absurdly misleading, since it’s only talking about AHCA subsidies, and not the other massive government healthcare programs that provide medical coverage to retired and low income persons — more than one in three Americans, before you even count the disabled, veterans, and Obamacare subsidies.
But those programmes were expanded to cover people they hadn’t covered before and that expansion was to be rolled back, so it’s completely relevant. They will either have to buy insurance, which they won’t be able to afford, or have nothing.
They will still turn up in emergency rooms, costing their state a huge amount when, if there was universal health care, their problem could often have been easily fixed by early intervention by a GP. They’d be back at work being productive, or even looking after grandchildren while their solo mum daughter worked her minimum wage job and paying tax, instead of taking up a hospital bed.
Since this discussion has a lot of rot about Americans’ supposed “resentful coldheartedness” and eagerness to toss the undeserving poor into the rubbish bin along with Grandma, and since some seem to love any set of junk statistics purporting to compare countries: Americans continue to lead the industrialized world in adhering to Jesus’s commandment to love their neighbor.
Atheistic China is last.
You’ll notice New Zealand with its at least 42% atheism is right up there too. I think last year or the year before we were second only to the US.
This is indeed an indice that the US always does extremely well in.
Chinese have much less disposable income, so I’m not sure they can be criticized too heavily. I’d like to see an index where disposable income was taken into account, though I am sure that the US would still do extremely well in such an index.
There is though the concept of the “deserving poor”. In northern Europe, for example, everyone pays higher taxes and everyone gets looked after equally. Some of those needing help in the US are required to be “deserving” in some way. They need to beg in some way, they have to belong to the same Curch etc. I’m not sure that’s fair or right.
I’m not trying to diminish the US achievement in doing well in this index though. You deserve to be praised for it.
I think you missed the bit about “and making a prfit at the same time. Without the profit motive in there, healthcare is considerably simpler.
But, as j.a.m. will no doubt point out, without he prospect of big fat juicy profits extracted by grinding poor people into fear of their lives, then healthcare mega-corporations won’t have an incentive to enter the industry. Which is fine, as the expansion of the UK NHS during the post-War economic slump demonstrates perfectly well. Without mega-corps making mega-profits (though the drug mega-corps did make sufficient profit to find the business profitable).
And let’s not forget the racism component to all this. The Southern states maintained a form of apartheid just a few decades ago. Many here have a deep hatred and fear of black America and feel compelled to undercut any gift to the “lazy”, “undeserving”. Many lower and middle class whites think any government give-away in any form at all is unjust because the biggest beneficiarie are, in their mind, blacks on drugs, unwilling to work. Health care serves to encourage and support the bottom class at the expense, they say, of the “hard working” white class. The blacks are freeloaders and Government support will erode the difference in status between blacks and whites. This difference in status keeps the white lower classes from feeling they are the bottom rung on the social ladder. Just having lived through a highly successful black presidency, the whites are feeling more threatened than ever. GOP strategy taps into this blatant racism by condemning Obamacare, which can sound a lot like O-black-care to the white working class. This is why, even though many working class whites realize they themselves will be hurt by Trump’s policies, their fear of having to pay taxes to support blacks overrides that anxiety. In America race has been and will remain the elephant in the room.
And you know this how, exactly? Seriously, can you substantiate any of it?
I live in the U.S. . I grew up here. I know my people. It’s a very racist society beneath the surface. I’m sure if you want to know more about racism in America, you could just Google it and come up with so much material it would keep you busy for a lifetime. I’ll leave the research to you.
If growing up here and knowing people is all it takes, I’ve got that covered. Frankly it sounds like just the kind of lazy malarkey that people tell themselves to flatter themselves and to save the trouble of changing their minds. Perhaps you think the same about my own modest contribution. So there we are.
You sell yourself short. Denying racism in the South is no modest contribution. I don’t think even the liar-in-chief has told one that big.
@Ken: Once again, friend, it’s not that hard: The question is not whether racism exists or whether it is bad; the question is whether rickflick’s concrete and specific — but emotional and unsubstantiated — claims are true or false.
Bullshit if you must, but don’t call me friend.
The insurance companies are just unnecessary middle men from the pov of those of us who get excellent health care paid for by the government via our taxes. They don’t do anything except make it more expensive and restrict access. While insurance companies in the US have been complaining about Obamacare, that doesn’t seem to have stopped their profits increasing. Call me a conspiracy theorist, but I suspect that premiums suddenly went up so much last year because it was election year.
I sort of disagree with your analysis that the AHCA’s defeat was a good thing. Some analyses show that the three states most negatively affected would have been West Virginia, Kentucky, and Arkansas, three states that went for The Sociopath in a big way. So maybe, had it become law, the pain that it would have inflicted among “The Stupid” would have been massive and would in turn have done irreparable damage to the Rethuglican brand. And that could only have been a good thing, although so much suffering would have been a shame. Ezra Klein made that point on Charlie Rose earlier in the week.
Yeah, it was clear that those who would suffer most were Trump supporters. However, the really low approval rating of the Bill means that many, maybe even most, of them realized this. Only 60 days in I think there’s now a significant tear in the Emperor clothing of Trump. It’s been impossible to open their eyes previously, but this might have actually had an affect.
Wait, I thought their “fear of having to pay taxes to support blacks” would override any concern about adverse effects for themselves.
Anyway, you’re conflating support for repeal with support for a particular bill. The same poll you cite says that support for full or partial repeal is 70%.
JAM, you can start here. But don’t expect me to be responsible for you education. Now you’re on your own.
This article talks about why conservatives are often hostile to groups lower on the socio-economic ladder such as blacks and Latinos in America. As a matter of fact, it wouldn’t surprise me if you recognized yourself here:
Rick, this link has been hacked by someone, at least it’s sending me somewhere else. Can you provide it again?
It’s a PDF file. Not sure how it plays there. Here I took off the HTML and added some spaces.
http: //www. sulloway.org/ PoliticalConservatism(2003).
Thanks Rick. That works better. 🙂
What I recognize is confirmation bias:
We both have lots to learn. I was hoping we could learn together.
Best of luck.
I wonder if the U.S.would be that close to the top if you took away religious donations? Sorta like covering your a$$ for the hereafter.
I didn’t want to mention that, though I did wonder. However, if they genuinely believe that giving money to the Church makes things better for everybody we should probably give them their due.
However, I have to say it does annoy me in particular when people go on about the generosity of those who only contribute to a church that demands a tithe. I’m not sure how much generosity is involved there.
Trumpcare certainly wasn’t the answer, but let’s not forget that Obamacare falls well short of what is needed.
A sober and lucid discussion of the sheer irrationality of denying that medical care is a business like any other business:
Needless to say, ceding still more power to politicians and bureaucrats would constitute a “cure” far worse than the supposed disease.
The problem with this article is that it presents single-payer healthcare as reciprocal healthcare. It’s not. It’s a form of insurance. However, because there’s only one company (the government, Medicare, whatever) costs are much reduced. There’s no advertising, no need to make a profit. One company negotiates on behalf of all citizens and they can get excellent rates on behalf of their “customers”. I don’t know where the author is coming from with the idea that cost isn’t part of it. Of course it is.
As for the decision-makers that the GOP labelled “death panels”, that was absolutely ridiculous. Of course someone has to make a decision as to what gets funded and what doesn’t, and insurance companies do this too. In fact, insurance companies do it a lot more because they refuse to cover people, have lifetime limits, and all sorts of other things. Or people just die, or die earlier than they otherwise would, because they can’t afford treatment. That doesn’t happen in NZ, Australia, Canada, Great Britain etc.
She is misrepresenting what our health systems are like.
And it is not ceding power to politicians either. Governments in NZ lose power if they fail to maintain the health system in as good a condition as the people expect. They have to perform in this area or they’re out on their ear.
It’s ok, Heather, it’s just the undeserving poor that die, not virtuous well off folks. Makes the system more efficient in delivering on the real goal – getting rich!
As the article discusses, it feels good to get all sanctimonious, but it’s delusional. Resources are going to get allocated one way or the other. Favoring the politically advantaged is no better (or different) than favoring the economically advantaged.
Indeed, “someone” is going to decide, and that’s the point of the article. Resources get allocated one way or the other. Either way, as you say, some people are going to be denied treatment, and die, or die early, or suffer needlessly. If this happens to you, does it really matter whether it’s due to economic circumstances rather than political circumstances?
The article’s author, Megan McArdle, is an astute and knowledgeable analyst. I’d be curious to know in what way she has misrepresented any substantive facts. McArdle cites a second article by Virginia Postrel, who presents a vivid case study in how politics dictates who lives or dies in a system like New Zealand’s.
The question McArdle’s article addresses is why we’re so desperate to delude ourselves with the fiction that medical services somehow are magically exempt from the laws of economics. But hey, why stop there? Why not a single-payer food system with no choice and no profits? Fortunately most rational people grasp that market competition lowers prices and increases innovation, productivity, and choice, while monopolies do the opposite. And in health care, as in every other business, profits are what make possible the miraculous advances that we have come to take for granted. As Postrel puts it, “if every place were like New Zealand, far fewer complex new drugs [to say nothing of technology] would get developed in the first place.”
Your argument about elections might hold water if you were talking about single-issue up-or-down referenda. But a general election outcome, by contrast, is usually a tangled knot of motives, interests, and issues. In any event, if I as an individual vote for the losing side, then I’m flat out of luck. I have indeed ceded my right of self-determination.
There are more resources available to allocate to helping people in a single-payer system. It is better for everybody if more people get good healthcare. It is better for managers if their staff are healthy. They stay healthier if they are looked after well from conception, and they have less days off work due to illness, and can work better too. Therefore they are more productive. A healthier workforce is also happier and more secure. It also means employers have more scope on how they reward good employees because they don’t have to factor in the cost of health, which often means they can’t afford to offer higher wages or some other incentive.
There are so many reasons why it’s actually economically better to have a single-payer system it’s clear that the GOP are only opposing it for partisan reasons. It was in fact originally a right-wing idea.
Partisan, yes, ideological even more so. One might even say delusional, like believing the “politically advantaged” and “economically advantaged” are different groups of people.
Yep. So much for compassionate conservatism.
@K: Interesting. So, if there’s no difference between the politically advantaged and the economically advantaged, it makes you wonder what some people think will be accomplished by making politics the end-all and be-all.
And do we really want to get into which viewpoint is more burdened by ideology?
@H: There is no compassionate ideology. Compassion is a personal virtue. People are compassionate, not isms or regimes. As the two cited articles make plain, socialized medicine is at least as ruthless as any other scheme, with added cruelty of impeding the very medical breakthroughs that give hope to many sufferers.
I’m glad to hear you admit that the Reagan doctrine of compassionate conservatism is a myth. I do not see how single-payer impedes medical breakthroughs. I understand that putting the word “socialized” in front of something denotes it as evil in your social circle, but that doesn’t work with those of us who understand how single-payer actually works and who know the difference between socialism and communism.
Re the burden of ideology, on the one hand we have Heather talking about the real practicalities of single payer systems that exist in almost every Western country, along with why the great majority of people strongly support such systems regardless of where they fall on the political spectrum, not to mention that the idea has a history not just on the left, but on the right as a means of increasing economic growth. On the other hand, we have you, seemingly in a corner with your hands over your ears, crying that it just can’t be true. So you win the dogma derby hands down, which I suppose helps explain how you can think that politics could be unimportant to people severely disadvantaged by the current corrupt system.
@H: It happens that I do know the difference between socialism and communism: Socialism is communism for kids (note that they share a category on Amazon):
@K: Nope. I offered two incisive analyses by two well-respected analysts, and they stand unchallenged but for a vague assertion that they “misrepresent” the facts in some unspecified way. The argument about the economic benefits of widely available care has nothing to do with whether a government monopoly is necessary or preferable to achieve that end. The assertion that a government monopoly is efficient contradicts historical experience and the laws of economics. The issue of innovation is not addressed: What happens if/when American consumers stop subsidizing medical progress for the whole planet? Then there is outright denial, as described in the articles, of the dreadful consequences of giving politicians power over who lives, who dies and when, and who suffers.
I make no bones about cherishing the values that have made the American republic one of mankind’s noblest achievements. That ain’t ideology, friend, it’s history.