Quotulatiousness

September 29, 2017

Judge Roy Moore as a sign that worse is coming

Filed under: Politics, USA — Tags: , , , , — Nicholas @ 03:00

ESR posted this to G+ yesterday:

Judge Roy Moore, a truly repellent creature who reifies every liberal’s fantasy of what fundamentalist conservatives are like (well, except for the racism – even Moore is not actually a racist), has won in Alabama against a candidate backed by the GOP establishment and Trump.

And I wonder if Democrats are too far gone to heed the warning.

You demonized the Tea Party, and you got Trump. If you neutralize or expel Trump as you dream of doing, worse is coming. Roy Moore is worse. Roy Moore is a sign. The conservative/populist revolt can no longer be contained even by Trump. The beast is loose.

Time to question your assumptions, Democrats (and establishment Republicans). The more painful and disruptive that self-questioning is, the more likely it is that your party might escape the destruction that is coming.

As the Instapundit often says, “Do you want more Trump? Because this is how you get more Trump.”

September 23, 2017

QotD: Political ideology

Filed under: Politics, Quotations, USA — Tags: , — Nicholas @ 01:00

Ideological principle is the lifesblood of a political party. The more a party focuses on “electability” and “pragmatism”, the more it cuts its own wrists and drains its own blood. Eventually, the point is reached that the party exists for no reason but to profit the party elite, which is understandably not of interest to anyone outside that elite.

What do the Republicans stand for today?

Pragmatism in politics is like cocaine. A little bit goes a long ways. You not only win, but you feel like an all-conquering tiger. But gradually, you start needing more and more to achieve the same affect, until finally, you overdose and your heart stops.

Vox Day, “The impracticality of pragmatism”, Vox Popoli, 2015-10-24.

August 21, 2017

Solar Eclipse: Republicans, Democrats, & Libertarians React!

Filed under: Humour, Politics, USA — Tags: , , — Nicholas @ 03:00

Published on 20 Aug 2017

How are Republicans and Democrats, conservatives and liberals, reacting to tomorrow’s solar eclipse?

With the mixture of denial and panic that they bring to virtually every issue, from regulations to crime to climate change.

Fortunately, there is a third way, one grounded in rational debate, respect for the limits and power of science, and sound policy.

For links and info, go to https://reason.com/reasontv/2017/08/20/solar-eclipse-denialism-and-alarmism

Script and editing by Sarah Rose Siskind.

Starring Andrew Heaton, Sarah Rose Siskind, and Jim Epstein.

Produced by Andrew Heaton and Sarah Rose Siskind.

July 28, 2017

Game of Thrones in the DC swamp, where nobody has read Sun Tzu’s Art of War

Filed under: Media, Politics, USA — Tags: , , , , , — Nicholas @ 03:00

Kurt Schlicter offers some strategic advice to President Trump, illustrated by some recent Game of Thrones narrative (dunno how accurate, as I’ve neither read the books nor watched any recent TV episodes):

President Trump has done remarkably well so far, considering the hatred, contempt, and subversion he faces from members of his own party – much less the garbage he endures from the astonishingly inept and newly Russophobic Democrats. These nimrods’ bright idea for appealing to the deplorable people we call “normal Americans” is to take the New Deal and replace the adjective with “Better.” It has yet to occur to them to try not calling us “Jesus-loving gun freak racists who aren’t afraid enough of the weather and don’t believe women can have penises too.”

But it’s bad strategy to rely upon the lameness of your opposition. Instead, the president should be focused on launching a disciplined and overwhelming attack against the establishment to force his agenda through. But he’s not doing that. He’s messing up by going off on emotional tangents, and it will catch up with him.

[…]

Spoilers follow, so stop reading if you care.

Here’s the problem. The president has some huge challenges. He has limited combat power – yeah, he has a lot, and while it is still superior to his enemies, it is not unlimited. There’s a basic military rule of thumb that you break at your own peril. You do not split a superior force.

When you split a superior force, the enemy can then move to defeat you piecemeal. A superior force nearly guarantees a win. Take the guaranteed win. Grind out the victories. Don’t split your army.

They did in a recent Game of Thrones episode. The hot girl with the dragons met with the sort-of-hot woman with the three hard-six daughters, the bi-curious pirate chick, the sassy old lady who used to be Emma Peel, and the differently-abled person of shortness, and they came up with a war plan. It was a terrible war plan. They split their vastly superior force in two instead on focusing on the castle with the hot woman who was getting it on with her brother before she became a big enough star not to have to do nudity.

Terrible plan. Naturally, the enemy destroyed their fleet because they split their forces and ditched their dragon air cover like morons. I expect the producers thought it was super progressive to have the generals be all either women-identifying women or dwarves, but then they got thoroughly beaten by a cis-vertical phallo-person of pallor.

I’m not sure that’s the girl/midgetpower message they meant to convey, but whatev. The point is that when you lose focus and try to fight every battle, you risk losing every battle. The Sessions fight wasn’t strategically necessary – hell, “winning” would mean someone even worse because there’s no way the Senate will confirm anyone as AG that Trump actually wants.

Focus. Discipline. No one enemy can compete with the president, but a bunch of enemies can. Using the superior force at hand in a cunning, targeted way can bring back the winning. But uncoordinated, quixotic, emotion-driven lashing out? No, that’s what the Democrats and the Fredocons want from the president – mostly because they know from their own bitter experience how it leads to losing.

July 14, 2017

Brace yourself for the next round of Obamacare [repeal | reform | tweaking | posturing]

Filed under: Health, Politics, USA — Tags: , , , — Nicholas @ 03:00

Megan McArdle doesn’t view this latest attempt to “fix” Obamacare with any great optimism:

Mitch McConnell is once again announcing that the Senate is going to come out with a new health-care bill and try to hold a vote next week. That exhaustion you feel is the same despair that seeps over you when a pair of ill-matched friends announce for the 17th time that they’re getting back together.

As with those friends (we all have them, don’t we?) there seems to be no set of mutual goals upon which a durable partnership can be built. Many Republican legislators want Obamacare to die. Others would probably attend the funeral with ill-concealed delight, but they don’t want a reputation for having killed it. Still others would like to be able to tell voters that they “did something” about Obamacare, even though in reality they are loath to actually, you know, do something — because their states would lose money, or voters would lose insurance.

[Wearily] So what can be done here? Realistically.

As an exercise on paper, the answer is easy:

  1. Stop trying to make this a tax-cut bill, and focus on reforms that can pave the way to fiscal stability, and dismantling many of the perverse incentives that have so distorted our health-care system.
  2. Leave Obamacare’s taxes intact. (Yes, even the dumb ones, of which there are many.)
  3. Turn Medicaid into a fixed grant rather than an open-ended entitlement, either by making it a block grant, or switching to a flat per-beneficiary payout — but don’t try to make block grants a confusing cover for very deep cuts to the program.
  4. Provide generous funding to stabilize the individual health-insurance exchanges, but demand in return very wide latitude for states to decide how they stabilize their insurance markets — including jettisoning any of the Obamacare regulations they think are getting in the way.
  5. Meanwhile, move the system more aggressively toward health-savings accounts plus catastrophic insurance — and get Democrats on board by offering to have the government fund some portion of those health savings accounts for low-income citizens.

Is that my ideal health-care system? No. But it gives Republicans some of what they want (a more consumer-driven, pro-market program in the individual market, and a big start toward reforming the bloated and byzantine mess that is the Medicaid program). It gives Democrats some of what they want (money for people who don’t have very much of it, plus they don’t get splattered by the fallout of Obamacare exchanges melting down). In theory, it could pass.

And in theory, I could play third base for the Yankees, if Joe Girardi were willing to hire me. The truth is that after years of complaining about obstructionism, Democrats have developed a sudden taste for the stuff; there’s a substantial faction of both politicians and voters who want the Democrats to stand by and do nothing, nothing, that Republicans might like. And even among those who think they want bipartisan compromise — well, I spend a lot of time listening to those folks, and when you get down to it, frequently their idea of a “compromise” is that they get a huge government program that costs hundreds of billions of dollars, and Republicans get trivial increases in the size of health-savings accounts, and maybe to twiddle with a few of the outer decimal points on growth rates. In other words, what they think is a vision of compromise is too often actually a vision of America ca. 1992, when Republicans were a minority party who had to come begging for crumbs.

July 10, 2017

QotD: The illusion of freedom in America

Filed under: Government, Liberty, Politics, Quotations, USA — Tags: , , , — Nicholas @ 01:00

Being a citizen in the American corporate state is much like playing against a stacked deck: you’re always going to lose.

The game is rigged, and “we the people” keep getting dealt the same losing hand. Even so, most stay in the game, against all odds, trusting that their luck will change.

The problem, of course, is that luck will not save us. As I make clear in my book, Battlefield America: The War on the American People, the people dealing the cards — the politicians, the corporations, the judges, the prosecutors, the police, the bureaucrats, the military, the media, etc. — have only one prevailing concern, and that is to maintain their power and control over the citizenry, while milking us of our money and possessions.

It really doesn’t matter what you call them — Republicans, Democrats, the 1%, the elite, the controllers, the masterminds, the shadow government, the police state, the surveillance state, the military industrial complex — so long as you understand that while they are dealing the cards, the deck will always be stacked in their favor.

Incredibly, no matter how many times we see this played out, Americans continue to naively buy into the idea that politics matter, as if there really were a difference between the Republicans and Democrats (there’s not).

As if Barack Obama proved to be any different from George W. Bush (he has not). As if Hillary Clinton’s values are any different from Donald Trump’s (with both of them, money talks). As if when we elect a president, we’re getting someone who truly represents “we the people” rather than the corporate state (in fact, in the oligarchy that is the American police state, an elite group of wealthy donors is calling the shots).

Politics is a game, a joke, a hustle, a con, a distraction, a spectacle, a sport, and for many devout Americans, a religion.

In other words, it’s a sophisticated ruse aimed at keeping us divided and fighting over two parties whose priorities are exactly the same. It’s no secret that both parties support endless war, engage in out-of-control spending, ignore the citizenry’s basic rights, have no respect for the rule of law, are bought and paid for by Big Business, care most about their own power, and have a long record of expanding government and shrinking liberty.

Most of all, both parties enjoy an intimate, incestuous history with each other and with the moneyed elite that rule this country. Don’t be fooled by the smear campaigns and name-calling. They’re just useful tactics of the psychology of hate that has been proven to engage voters and increase voter turnout while keeping us at each other’s throats.

John W. Whitehead, “Don’t Be Fooled by the Political Game: The Illusion of Freedom in America”, Huffington Post, 2015-08-12.

June 12, 2017

QotD: The reality of political limitations

Filed under: Government, Politics, Quotations, USA — Tags: , — Nicholas @ 01:00

The main obstacle to getting what [the Republicans] want is not the lack of leaders who are willing to fight; the main obstacle to getting what they want is that what they want is well outside the ZOPA [zone of possible agreement]. I’m not saying this to taunt my conservative friends; I agree with many of the things they want. But I recognize that there is a wide gap between what I (we) want, and what can be foisted upon the American public by its elected representatives. If I want outcomes closer to my preferences, then the primary problem is not the folks in office, but the preferences of the average American voter. Focusing your attention on politicians, instead of the hearts and minds of your fellow citizens, is like attempting to fix a faulty car engine by swapping out the dashboard gauges.

Megan McArdle, “Let’s See What Republicans Learn From Losing Boehner”, Bloomberg View, 2015-09-25.

May 26, 2017

A Brief History of Politicians Body-Slamming Journalists

Filed under: Media, Politics, USA — Tags: , , , , , — Nicholas @ 06:00

Published on 25 May 2017

In the twilight hours of a special election to replace Montana’s lone congressman, Republican hopeful Greg Gianforte reportedly “body slammed” and punched a Guardian reporter after the journalist tried to ferret out an answer about GOP health care plans. In this video Reason TV imagines a world in which other, high profile politicians give into violent impulses when confronted by the press.

Polls opened in Montana less than twenty-four hours after Gianforte’s confrontation with Guardian reporter Ben Jacobs, and his subsequent assault charge. In the event that Mr. Gianforte is elected to Congress there is a reasonable chance he will interact with more journalists in the future, and possibly even have to formulate responses to Republican legislation at some point.

Written by Andrew Heaton, Austin Bragg, and Meredith Bragg
Performed by Andrew Heaton and Austin Bragg
Produced by Meredith Bragg and Austin Bragg

May 20, 2017

“Trump has always said the kinds of things that most of us learn to think the better of around our freshman year of high school”

Filed under: Media, Politics, USA — Tags: , , , — Nicholas @ 03:00

Megan McArdle on the calls to impeach or otherwise depose Il Donalduce (soft coup, anyone?):

Trump has always said the kinds of things that most of us learn to think the better of around our freshman year of high school — not just the tragic wailing about how hard everyone is on him, but also the needy self-flattery: When he isn’t claiming that he knows more about Islamic State than our nation’s generals do, he is putting similarly laudatory words in the mouths of the brilliant and impressive people who apparently constantly ring him up so they can gush like tween fangirls at a Justin Bieber concert. Does he expect people to believe these utterances? I have no idea. But the reason most people don’t say such things is that whether you expect them to or not, no one ever does.

As for the rest … the twitter rants? Check. The lack of respect for longstanding political and institutional norms? Check. The outrageous, uncalled-for attacks on anyone who gets in his way? Check-plus. All quite evident before the American public went to the polls in November. And that is the rub.

It’s one thing to remove a president who is clearly no longer the man (or woman) we elected to the office. But this is what Americans, in aggregate, pulled the lever for. Do his staffers and Congress have the right to step in and essentially undo that choice?

Even as a thought experiment, that’s a tough question. It becomes much tougher still when we are not in a tidy textbook, but in a messy real world where his followers, having voted for this behavior, do not recognize it as a sign of impairment. If Trump is removed now, they will see the removal not as a safeguard, but as a soft coup. And they won’t be entirely unjustified. The damage to our political culture, and its institutions, would be immeasurably grave.

I think there’s a case for removing Trump on the grounds that he is clearly not competent to execute the office — not that he has committed “high crimes and misdemeanors,” but that he simply lacks the emotional and mental capacity to do the job. But preserving the very norms he’s destroying requires that removal not be undertaken until things have reached such a state that most of his followers recognize his problems. So those of us who believe that the competence of the executive matters — that there are things worse in a president than “more of the same,” and that what we are now seeing is one of them — will simply have to hope like heck that his supporters come to the same conclusion we have before he damages much more than his own reputation, and the hopes of the people who elected him.

May 19, 2017

“Everything is a potentially impeachable offence or an indication that Trump is mentally unbalanced or both”

Filed under: Media, Politics, USA — Tags: , , , — Nicholas @ 05:00

Jay Currie says that the ongoing epidemic of Trump Derangement Syndrome is worse than the 2001-2009 Bush Derangement Syndrome outbreak or even the 1969-1974 media demonization of Richard Nixon:

There was a fair bit of anti-Bush sentiment, and Reagan was often attacked, and, of course, Nixon was vilified long before Watergate; but for sheer, sustained, noise, anti-Trump campaigning by the Democrats and the mainstream media is an order of magnitude or two greater. Everything is a potentially impeachable offence or an indication that Trump is mentally unbalanced or both. The never-Trumpers in the RINO section of the Republican party are having a great time suggesting that Trump is a threat and a menace and needs a good impeaching.

In the hysteria virtually any bit of information, regardless of source, so long as it is anti-Trump, is a page one story. Anonymous sources say Trump revealed super secret stuff to the Russians? Perfect, Wapo is on the job and he’s a traitor or an incompetent or both. Doesn’t matter that the people in the room heard nothing of the sort. Impeach him! Guy phones the NYT with a pull quote from a memo that former FBI Director Comey wrote to file on a meeting with Trump? Quote says Trump said, ““I hope you can see your way clear to letting this go, to letting Flynn go,” Trump allegedly told Comey, according to the memo. “He is a good guy. I hope you can let this go.”” which is clearly the biggest obstruction of justice since Nixon wanted Archibald Cox fired.

At this point, Trump supporters usually say, “but the White House could have handled this better.” I don’t. I don’t say that because there is no “handling” the mainstream media, rabid Democrats and charging RINOs.

Trump and his people have to make a choice between conforming to the norms of a Washington Presidency or simply saying that was what Trump was elected to fix.

[…]

I don’t have any sense that Trump or the White House staff know much about “damage control”; however, they have a good deal of capacity to, in the words of a former President, punch back twice as hard. To do that they need to ignore the storm and fury of the Washington establishment and the legacy media and go for kill shots with live ammunition. The Comey memo archive is a great place to start.

Earlier, Nick Gillespie had pointed out that the people who are screaming for an impeachment bill now are the same people who wanted Il Donalduce impeached even before he was elected:

But let’s get real: At this point in the game, all the explainers about how impeachment works (the 1990s called, they want their sex scandals back!) and adapting the 25th Amendment’s ability to remove the president from decision-making during colonoscopies to the current crisis are evidence-free exercises in ideological masturbation. If we are going to survive not just the Trump years but eventually get around to kick-starting the 21st century, we’re going to have become smarter media consumers and demand more from both our politicians and the press. “The New York Times has not viewed a copy of the memo,” explains the Paper of Record, “but one of Mr. Comey’s associates read parts of it to a Times reporter.” As Reason‘s Scott Shackford has noted, that’s what Joe Biden would call a “big fucking deal” if it turns out to exist and to be accurate. It’s also a pretty big if at this point.

But even before Comey’s possible “paper trail” documenting President Trump’s demands (which may or may not actually rise to the level of impeachable offense) came to light, his enemies were out in force. For god’s sake, they wanted him impeached even before he was the Republican nominee.

[…]

Needless to say, none of this absolves Donald Trump of any wrongdoing. But impeachment talk this soon and this thick is coming not from a place of seriousness but pure partisanship and ideology masquerading as disinterested belief in the public good. When the Republicans moved to impeach Bill Clinton back in the 1990s, it was the same thing and it didn’t exactly work out that well for many of the main conspirators, or for the country at large. Among other things, the impeachment push indirectly led to the ouster of Newt Gingrich as Speaker of the House, which eventuated in an actual child molester being way high up in the presidential line of succession.

The impeachment of Bill Clinton was one of the major mileposts in the long, ongoing shift of America from a high-trust to a low-trust country, one in which faith, trust, and confidence in most of our major public, private, and civic institutions have taken a massive beating for decades now. Maybe it was the Warren Commission Report that got the ball rolling, or Lyndon Johnson’s infamous “credibility gap.” All the secret wars in Cambodia and Watergate sure didn’t help and the mind-boggling revelations of the Church Commission might have the final nail in the coffin of trust. The Pinto disaster sure didn’t help, nor did other revelations of private-sector fakery. You throw in freakazoid oddness such as the People’s Temple, United Way scandals, and rampant Catholic Church buggery, and, well, what do you expect? Across the board, fewer and fewer of us trust the government, the media, labor, corporations, etc. to do the right thing given the option of doing the wrong thing.

But if you’re still in the “impeach now, impeach often” camp, here’s your game plan:

Published on 18 May 2017

Want to get rid of the president?

There are two ways, basically.

First, find an impeachable offense. According to the Constitution an impeachable offense: treason, bribery, or “Other High Crimes and Misdemeanors.” What counts for that last part? Nobody knows. Some people say it means bad things only people in high office can do—like misusing public assets, dereliction of duty, or having sex and then lying about it. Others say it’s any crime or misdemeanor at all, even if it has nothing to do with a president’s position or power. Did you steal a pen from work? Petty theft is a misdemeanor. You should no longer be president.

Once you get an impeachable offense, get a majority of House members to vote in favor of the motion and then go to trial in the Senate, with the chief justice of the Supreme Court presiding. After the highest-rated programming in C-SPAN history, the senators vote. If 67 senators find the president guilty, he’s gone.

There is another way, however, without all that messy legal stuff. But it involves the 25th Amendment, which is used to transfer power to the vice president whenever the president is getting a colonscopy. Seriously. It’s not pretty.

About 2 minutes. Produced by Austin Bragg.

May 16, 2017

Freaky Friday Politics: Republicans And Democrats Keep Switching Positions

Filed under: Humour, Politics, USA — Tags: , , , — Nicholas @ 06:00

Published on 15 May 2017

Democrats and Republicans are pivoting on issues faster than a bipolar swing dancer on a merry-go-round. Republicans are now big government protectionists. Democrats support free trade and states’ rights. It’s like the two parties switched bodies! It’s almost as if… they were FREAKY-FRIDAYED!

May 1, 2017

QotD: How to negotiate badly (unless you’re in a movie)

Filed under: Europe, Government, Media, Politics, Quotations, USA — Tags: , , — Nicholas @ 01:00

Does the [Republican congressional] caucus nominate a leader who will be itching for more such fights? This would be bad for America’s already dilapidated political institutions and civil society. It would also, I must point out, be bad for the Republican Party, which still shows lingering signs of infection by the dreaded “Ask for the Stars, You’ll Get the Moon” bargaining strategy. (Ever notice that’s so beloved by Hollywood, and by almost no one who actually has to negotiate deals for a living?)

The idea behind this is that you will eventually settle for something about halfway between your initial demands, and what the other side is asking for. The winning strategy is therefore to ask for enormous concessions, include unrealistic demands as bargaining chips, and convince the other side that you’re just crazy enough to walk away if they won’t make a deal.

As it happens, we have just had a demonstration of this technique — a live drama, no Hollywood effects: Greek Prime Minister Alexis Tsipras tried it with the EU. This strategy worked so well that he ended up with a worse deal than the original offer, plus a banking crisis that is still unspooling. Somehow, this never happens in Hollywood movies.

It’s easy to see why Hollywood loves this strategy: It’s really easy to explain without chewing up screen time, and it’s dramatic. Why don’t real-world negotiators more often do this?

Megan McArdle, “Let’s See What Republicans Learn From Losing Boehner”, Bloomberg View, 2015-09-25.

April 20, 2017

Words & Numbers: Hypocritical Partisans Pass Political Power

Filed under: Politics, USA — Tags: , , — Nicholas @ 03:00

Published on 19 Apr 2017

This week, Antony and James are equal-opportunity offenders, discussing the way power not only changes hands from one party to another, but support for political ideas flips back and forth as well. Neither the right nor the left is immune to this kind of hypocrisy.

Learn more:
https://fee.org/articles/hypocritical-partisans-pass-political-power/

March 14, 2017

“Most policy ideas are bad” (especially in US healthcare)

Filed under: Government, Health, Politics, USA — Tags: , , , , , — Nicholas @ 03:00

Megan McArdle says that the best plan the Republicans could come up with to deal with Obamacare is to do nothing, at least in the short-term:

For a policy columnist, “Don’t do that” is the easiest column to write. Most policy ideas are bad. If you simply blindly oppose everything that anyone ever puts forward, you’ll end up being right most of the time.

However, that’s not very useful for politicians. If they just sit around Congress playing tiddlywinks all day, voters will get cranky. Congress is supposed to do things. So, having spent a few days saying unkind things about the Republican health-care plan, it probably behooves me to state what I think they should do.

Well, boy, that’s a hard question. Here’s the thing: For all the unkind words I’ve said, I get the forces that have brought Republicans to this point. As I wrote Thursday, Democrats built a shoddy and unworkable structure out of the political equivalent of concrete: nearly impossible to repair or renovate, and darned expensive to demolish. The task is made even harder by the fact that Democrats currently control just enough votes in the Senate to keep Republicans from passing any sort of clean, comprehensive bill.

[…]

What would I do in this situation? Well, the first thing I’d do is accept, deep in my heart, that there are no great outcomes possible at this point. The second thing I’d do is remember that nothing is always a policy option: If you can’t do something better than the status quo, don’t do anything. It’s what I said to Democrats in 2009, and it’s what I’m saying to Republicans now.

So what would I do to minimize the damage, within the constraints of political reality? Well, I foresee two potential futures for the current status quo. One, the exchanges where individuals buy policies could fail, leaving people unable to buy insurance. Or two, the exchanges don’t fail, and we’re left with an unsatisfactory but still operational system.

In either case, the Republicans’ best option is to wait. Why? Because what they can do now — hastily, without touching the underlying regulations that have destabilized the individual market — is worse than either of those outcomes. The partial-reform structure they think they’ll be able to get through the Senate is likely to make the problems in the individual market worse, not better. And the fact that they’ve tinkered with the program means that Republicans will take 100 percent of the blame.

She also re-iterates her own ideal solution (which she admits wouldn’t fly with the American public):

Longtime readers of my column know that my pet proposal is a radical overhaul of the whole system in which we zero out all the existing subsidies and just have the government pick up 100 percent of the tab for medical expenses that exceed 15 or 20 percent of a family’s adjusted gross income: basically, a single-payer catastrophic-care system for expenses that no one can realistically save for. Let people buy insurance for expenses below that, or, if it’s not too expensive taxwise, let people set aside more money tax-free in Health Savings Accounts. And make some more generous provisions for people closer to the poverty line, such as prefunding Health Savings Accounts for them. That’s the whole program. It fits on a postcard, though the finer details — like which cancer treatments we’re actually willing to pay for — obviously aren’t.

However, this is completely politically infeasible, because voters don’t want genuine insurance, by which I mean a pool that provides financial assistance for genuinely unforeseeable and unmanageable expenses. Voters want comprehensive coverage that kicks in at close to the first dollar of spending, no restrictions on treatments or their ability to see a doctor, nice American-style facilities, and so forth. They are also fond of their health-care professionals and do not wish to see provider incomes slashed and hospitals closed, nor do they want their taxes to go up, or to pay 10 percent of their annual income in premiums. This conflicting set of deeply held views is one major reason that Obamacare — and American health-care policy more generally — has the problems it does.

March 13, 2017

“It’s not really a debate over Obamacare, it’s a debate over Medicaid”

Filed under: Government, Health, Politics, USA — Tags: , , , — Nicholas @ 04:00

Robert Tracinski explains why the Republicans are having such a hard time with their oft-promised “repeal” of Obamacare:

House Republicans have released their proposed measure to “repeal and replace” Obamacare, and the whole enterprise is already losing steam right out of the gate. The measure is too small and incremental, less a repeal of Obamacare and more of a repair of it, keeping numerous basic features intact.

If you want to know why Republicans have bogged down, notice one peculiar thing about the Obamacare debate so far. It’s not really a debate over Obamacare, it’s a debate over Medicaid. That’s because Obamacare mostly turned out to be a big expansion of Medicaid. The health insurance exchanges that were supposed to provide affordable private health insurance (under a government aegis) never really delivered. They were launched in a state of chaos and incompetence, and ended up mostly offering plans that are expensive yet still have high deductibles. Rather than massively expanding the number of people with private insurance, a lot of the effect of Obamacare was to wreck people’s existing health care plans and push them into new exchange plans.

Ah, but what about all those people the Democrats are claiming were newly covered under Obamacare? A lot of them — up to two-thirds, by some estimates — are people who were made newly eligible for a government health-care entitlement, Medicaid. But shoving people onto Medicaid is not exactly a great achievement, since it is widely acknowledged to be a lousy program.

Conservative health care wonk Avik Roy explains why: “[T]he program’s dysfunctional 1965 design makes it impossible for states to manage their Medicaid budgets without ratcheting down what they pay doctors to care for Medicaid enrollees. That, in turn, has led many doctors to stop accepting Medicaid patients, such that Medicaid enrollees don’t get the care they need.” Partly as a result, a test in Oregon found no difference in health outcomes between those with access to Medicaid and those without.

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