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At Least You Can’t Call It Trumpcare

The Senate’s Republicans unveiled their plan for America’s health care on Thursday, and although it’s an admirably short 142 pages there’s a lot consider about the policy and political implications. As President Donald Trump once infamously said, “Who knew health care could be so complicated?”
The policy implications alone will take weeks of debate among people who actually have some idea what they’re talking about to sort out, but the previously unannounced bill is currently scheduled for a vote early next week. So far as we can tell from the news reports that concern themselves with the boring policy stuff, the Senate Republicans’ repeal and replaces some elements of the existing unpopular Obamacare law, differs somewhat from the even more unpopular bill that was passed by the House of Representatives’ Republicans, and will predictably leave some people better off and others worse off. Calculating how likely it is that this all comes out according to the greatest good to the greatest number of people is pretty damned complicated, as even the most greenhorn politician by now knows, and it looks as if we’ll just have to wait until we’re old and sick and to see how all that turns out,
We like to think ourselves far more savvy about the political implications of any given policy, but in this case that’s also pretty darned complicated. That unpopular Obamacare law has been the metaphorical Moby Dick to the Republicans’ Captain Ahab ever since the Democrats took momentary advantage of Democratic majorities in the House and Senate and a Democratic president to force the hated legislation down the throats of a reluctant American populace without a single Republican vote. Now there’s a momentary majority of Republicans in the House and Senate and a Republican in the White, so that unpopular Obamacare should be right in the aim of the Republicans’ harpoon, but it’s unlikely they’ll join to pass and unpopular bill of their own.
So far as we can tell both the House and Senate bills allow people to choose a wider range of policy options from a more competitive insurance market, and after a couple of years they’ll let the rest of the country free from paying the subsidies to government-created high risk markets, which is fine with our free-market sensibilities. After that, though, hey’ll also cut loose the beneficiaries of those markets, some of whom voted a straight Republican ticket last time around, and we’re not sure hot they’ll take it.. Planned Parenthood won’t receive any funds for a year, which the right will love and the left will loathe, and certain insurance industry subsidies will continue for a while and a lot of spending will eventually be spent at the state level, and there’s something for every conservative Republican to hate and something that every liberal Democrat will have to admit could have been worse.
Which makes it a tough news cycle for the Republicans. As hated as the Obamacare still is, and well deserves to be, the Republican alternatives from both the House and Senate have even more unpopular. The House bill results in a tax break for wealthier Americans, which might make economic sense but is hard to explain in a headline, and there’s no getting around that some telegenically sympathetic Americans would wind up without health care and on national news as a result, so it will take a pretty noticeable decline in a lot of Americans’ insurance premiums to offset the Republicans’ public relations damage. Both the House and Senate bills retain the unsustainable rules about giving the same priced coverage to pre-existing conditions and for now provide the billions of dollars of subsidies that props that up, but no one on the left is going to give the Republicans credit for that nor acknowledge how unsustainable that will be over is the long run.
There’s a lot for an old-fashioned Republican to like in both the House and Senate bills, but there’s enough to hate that the House bill passed by despite numerous defections and the Senate bill might not get to a simple majority, and all the talk radio hosts were fuming that it wasn’t the full repeal and replacement of Obamacare that they’d been chasing after for eight long years. We’d have to see some district-level polling to decide how we’d vote if we were one of the entire House or that third of the Senate was up re-election. What with those Republican majorities in both the House and the Senate and a Republican in White House the Republicans should be able to ram anything they want down the American public’s throats in the same way the Democrats did with that damned Obamacare law, but of course that’s also complicated.
Trump ran for the president on a solemn pledge to repeal and a replacement that hated Obamacare law, but except for assurances that it would provide coverage for everyone at a far lower cost and be so great it would make your head spin he wasn’t very clear on what it would look. He spoke admiringly of Scotland’s fully nationalized health care system, seemed to endorse Canada’s slightly-less-socialized single payer system, and bragged that unlike every other Republican he wouldn’t make any cuts in in Medicaid or other entitlement programs. Unlike the previous scenario when Democratic majorities in the House and Senate and a president in the White House were ramming things down the American public’s throat, a sufficient number of traditionally conservative Republican senators are taking a principled stand and the president is going his populist ways.
Trump celebrated the passage of the House bill with a beer bash at the White House, even though he’s a tee-totaler himself and the House passing a bill isn’t even a halfway marker toward getting something done. After that budget-cutting bill was celebrated he “tweeted” that more federal money should be spent on health, and it was leaked from pretty much every traditional conservative that Trump had called the House bill “mean” in a tense meeting with the House Republicans, and it’s not yet clear how he’ll respond to a similar Republican bill,
On the night before the Senate Republicans unveiled their health care bill Trump was revving another enthusiastic campaign rally, some eight months after the campaign was supposed to have ended, Trump said he was hopeful would that it would have “heart.” A news cycle isn’t nearly long to discern Trump’s thinking, so for now we’ll have to see if the legislation as sufficient heart to satisfy Trump. All of Trump’s most strident defenders on talk radio and other outposts of the conservative media find it all too bleeding-heart, many of his voters find it potentially life-threatening, and we can only guess where Trump will wind up. We can’t imagine the Democrats seizing this golden opportunity to kiss up to Trump for that single payer system they’ve always dreamed of, or Trump abandoning that portion of the Republican party that’s all he’s got left at the moment, so we expect some desultory compromise on America’s health care.
We’ll hope that it somehow works out with that greatest good for the greatest number, and given how awful that Obamacare law was we wouldn’t be the least bit surprised if something better did somehow come to pass.

— Bud Norman

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Health Care is Complicated

A bill that significantly altered Obamacare passed the House of Representatives on Thursday by a margin of 217 to 213, but that close call doesn’t bode well for its chances of passage in the Senate, where the far slimmer Republican majority has its own political considerations to be made. Even if both Republican chambers do approve the bill and the Republican president signs that still won’t fulfill their promise of full repeal and replacement of Obamacare, with much of the socialist assumptions we’ve been railing against all the these years being officially stipulated to by the Republican party, and the consequences of what’s left remain to be seen.
There are credible enough sources saying millions of Americans will suddenly be left without health insurance that the Democratic press will make a great deal of it, and surely find plenty of undeniable sob stories to tell about it, and that will probably poll even worse than Obamacare does. There’s a credible argument to be made on the right that a free-market based system of health care delivery will incur a few sob stories but overall provide a greater good to a greater number of people, but the Republican president made campaign promises about health care for everyone and the government paying for it and the Republican establishment he ran against has given up on the idea of mandated coverage for pre-existing conditions, and even after a big Republican victory the argument seems to have shifted to the left.
Health care is complicated, though, as even President Donald Trump has humbly admitted, and lately even such longer-standing conservatives as ourselves are obliged to make the same admission. Our beloved and rock-ribbedly Republican father has lately had some back surgery at a seemingly brand-new spinal hospital which we’re much relieved to say seems to be going well, and has been paid for by some incomprehensible mix of that darned LBJ’s Medicare program and our dad’s diligent lifelong payments to insurance and supplemental insurance plans, and although he’s always done a remarkably good job of taking good care of himself theres no telling how it might have turned in a purely free-market system. He characteristically asked us from his hospital bed how the latest developments he’d been watching on Fox News might ultimately affect us, and we had to admit we had no idea.
We’ll keep following the latest developments, and Dad’s health, and our own poor decisions, and hope for the best.

— Bud Norman

The Second Hundred Days Begin

President Donald Trump’s most ardent admirers admire his blunt talk, so we’ll just go right ahead and say that his second hundred days are off a to a rocky start. He gave a couple of interviews that invited ridicule by his liberal critics, signed a spending bill that offered nothing his conservative supporters were hoping for, and had a “very friendly” phone call with the Philippines’ crazy-pants president that alarmed pretty much everybody but Trump’s most ardent admirers.
One of the interviews was aired Monday morning on CBS’ “This Morning” program, and featured host John Dickerson asking Trump about his relationship with preceding President Barack Obama. Trump said “He was very nice to me, but after that we’ve had our difficulties.” Pressed further, Trump said “You saw what happened with surveillance, and everybody saw what happened with surveillance.” Unsure what happened and everybody saw with surveillance, Dickerson asked for clarification. “You can figure that out yourself,” Trump replied. A seemingly befuddled Dickerson stammered about question about Trump “tweeting” that Obama was “sick and bad,” and Trump again replied that “Look, you can figure it out for yourself.”
At that point the interview was already going badly, except for those viewers who always revel in watching Trump be brusque with an interviewer, and then Dickerson had the impudence to ask “But you do stand by that claim about him?” Trump replied that “I don’t stand by anything,” and by then it was destined to go down in history as one of the most disastrous interviews ever. Even Trump’s most ardent admirers will have to admit that “I don’t stand by anything” isn’t something you can post on YouTube with the title “Trump absolutely destroys CBS reporter.”
Trump added that “I just — you can take it the way you want,” and something about how it’s all been proved and everybody’s talking about it and how it should be discussed, and “we should find out what the hell’s going on,” and some more short snippy answers to tuhalf-asked questions before terminating the interview with a polite “OK, it’s enough. Thank you. Thank you very much.” We doubt it did much good, though, and expect that only the line about “I don’t stand by anything” will wind up in future editions of Bartlett’s Familiar Quotations.
Trump also sat down in the Oval Office for an interview with the far friendlier Salena Zito of the far friendlier Washington Examiner, but even that friendly conservation went badly awry. As Zito was reading off a carefully chosen list of questions about current issues, all of which provided the president an opportunity to make the case for his policies, Trump suddenly interjected — “apropos of nothing,” as Zito would explain to one of her subsequent interviewers — a rambling soliloquy about his high regard for President Andrew Jackson, whose portrait was hanging nearby.
“They said my campaign and is most like, my campaign and win, was most like Andrew Jackson with his campaign. And I said, ‘When was Andrew Jackson?’ It was 1828. That’s a long time ago. That’s Andrew Jackson, and he had a very, very mean and nasty campaign, because they said this was the meanest and nastiest campaign yet.” Not content to confess his previous ignorance of 19th Century American history, Trump further speculated that “I mean, had Andrew Jackson been a little later, you wouldn’t have had the Civil War. He was a very tough person, but he had a big heart. He was really angry that he saw what was happening with regard to the the Civil War. He said ‘There’s no reason for this.’ People don’t realize, you know, the Civil War, you think about it, why? People don’t ask that question, but why was there the Civil War? Why could that not have been worked out?”
All of which, alas, was irresistible fodder for all the left-wing critics and late-night comics and more respectably leftist press pundits. They had Trump on tape once again veering off topic into some self-aggrandizing non sequitur, and once again into territory he didn’t know much about. Jackson did indeed run an historically nasty campaign against John Quincy Adams, but emulating that it not something that politicians should brag about. Adams did run an historically nasty campaign against Jackson, who plausibly blamed his scandalized wife’s death on the bad press, but Trump getting sentimental about how Jackson visited her grave every day almost writes its own own punch lines.
Jackson sure enough was a tough guy, with the evidence of a lifelong facial scar from the saber of a British officer inflicted on the sassy 13-year-old prisoner of the Revolutionary War — or one of those guys “who got caught,” as Trump put it in another disastrous interview — and a distinguished record in several conflicts with Indians and historic and folk-song worthy victory in the Battle of New Orleans. But given Trump’s military and tough guy record, which involved bone spurs and a “personal Vietnam” of dodging venereal disease on the New York City dating scene, he really shouldn’t be inviting any comparisons. As for Jackson’s “big heart,” Jackson was the guy ordered that the peaceable and productive Cherokee people be forced from their Carolina’s on a death march along the Trail of Tears, and even in his final, frail years he was using his cane against any impudent pressmen. All of that might play well with Trump and his most ardent admirers, but for everybody else it’s a disastrous interview.
Jackson was also an ardent defender of the peculiar institution of slavery, so a less friendlier interview might well have asked Trump how he thought Jackson might have averted a Civil War in a way that Americans of that time or this time would have found acceptable. Although Trump seems not have given it much thought until recently, the question of why the Civil War happened as been a matter of ongoing debate ever since, and most Americans who have passed a sixth grade history test or earned a doctorate in the field have reached the same conclusion President Abraham Lincoln did in his second inaugural address: “One-eighth of the whole population were colored slaves, not distributed generally over the union, but localized in the southern part of it. These slaves constituted a peculiar and powerful interest. All knew that this interest was somehow the cause of the war.”
There were also arguments between North and South over tariffs and taxes and all the immigrants pouring into the north, to be sure, but so far that’s not the sort of thing Americans have civil wars over. Trump is clearly speculating, apropos of nothing, that the pro-slavery guy would have settled the far more pressing, far more irresolvable question of slavery, and that such a savvy deal-maker and tough guy with a big heart would have done the same, and unless you’re an ardent admirer that’s a hard interview to defend.
Several of Trump’s usual defenders were too busy, though, grousing about that spending bill that got passed and signed and was hopefully overlooked in all the rest of the chatter.
We won’t recount all the gripes that the talk radio hosts had, but we’ll link you to the gloating of The Washington Post that headlined it “Eight ways Trump got rolled in his first budget negotiation.” They note that Trump not only didn’t get his one billion dollar request for a border wall, which sometime supporter called a “measly one billion,” but the bill includes explicit language against any spending on a border wall. Trump had vowed no increase in spending, but the bill includes no cuts and $4.6 billion for Trump’s Appalachian coal miners and $295 million for the Puerto Rican Medicaid recipients that Democratic House Minority Leader Rep. Nancy Pelosi insisted on, and the $61 million that Democratic Senate Minority Leader Chuck Schumer got for the New York City and Palm Beach, Florida, law enforcements that are paying for Trump’s frequent visits, which even the right wing talk radio hosts are starting to sour on.
Obama’s $1.2 billion funding for a “moonshot” cancer program was renewed, the Environmental Protection Agency’s budget was cut by 1 percent rather than the requested one-third, and Planned Parenthood was defunded at all. The defense budget was raised by less than half of what Trump insisted on, 160 Republican riders were dropped, and as early as last week the White House was agreeing to keep stringing along the Obamacare subsidies. There’s more, but The Washington Post ran out of column inches for its gloating. Lest you think it’s all “fake news” from “The Washington Compost,” all the talk radio hosts seemed to be grousing about the very same things.
It’s all temporary, with more battles vowed to be more vigorously fought, and there’s plenty of blame to go around to those establishment Republicans that Trump vowed to bring to heel, and as always the Democrats are nothing to brag about, but for now there’s no denying it makes for a bad news cycle. The headlines and the poll results would been even worse if a Republican president and Republican congress hadn’t come up with something to avert a government shutdown, but we doubt even Trump will tout that victory.
That’s enough to keep even such political junkies distracted, but we couldn’t help noticing that phone call between Trump and the Philippines’ Duterte. It’s a long story but we were born in the Philippines and have tried to keep abreast of the news there ever since, and we’re aware that the current leader is a foul-mouthed and boastfully murderous fellow who has lately been waging a “war on drugs” that has gunned thousands of people who might or might not have been involved in drugs, as no courts or evidence were involved, and has had the most profane words for American ambassadors and Roman Catholic Popes but a friendly relationship with the dictatorship in China. Trump has had only kind words for the man, though, and his own State Department’s synopsis of their most recent phone call described it as “friendly” and including an invitation to the White House, which Duterte has yet to accept.
That’s more fodder for the left, especially after his recent congratulatory phone call to Turkey’s President Raccip Erdogan after winning a clearly rigged election to give his Islamist government dictatorial powers, and anther move that the right is struggling to defend. There might well be some brilliant strategy at play here, and we surely hope so, but if Trump is just trying to drive a plot line he’s going to need some new writers.

— Bud Norman

Tweeting and Twisting the GOP

The internecine Republican feuding has lately become more complicated. It’s still the same old story of the establishment versus the insurgents, the squishy moderates versus the principled conservatives, and the real Republicans versus the Republicans In Name Only, but the days it’s hard to tell who’s on which side. At this point in the plot President Donald Trump is “tweeting” threats against the House of Representative’s “Freedom Caucus,” so all the old labels of establishment and insurgent and principled and squishy no longer make any sense, and who the real Republicans are is very much up for debate.
As a relatively recent Republican Trump won the party’s nomination with a plurality of primary and caucus votes by running as an outsider and populist renegade hellbent on burning down the hated GOP establishment, as exemplified by party chairman Reince Priebus and House Speaker Paul Ryan and Senate Majority Mitch McConnell, but following his improbable win of the electoral vote he seem surprised to find that he suddenly was the establishment. After running on grandiose promises of repealing Obamacare within days of taking office and replacing it with coverage for everyone at and lower costs and so beautiful it would make your head spin, Trump made Priebus his White House Chief of Staff and turned to Ryan McConnell to make good on his word, then went off to golf at his fabulous Mar-a-Lago resort, as populists do.
That was fine with the plurality of the party that now defines Republicanism as obeisance to Trump, and when it all went down in flames many of them were eager to blame Priebus and Ryan and McConnell and the rest of the hated establishment who had hoodwinked the naive Trump, even if he had also been elected because of his boasts of being both anti-establishment and the savviest deal-maker ever, and there was plenty of blame to be spread around the whole party. Some of those squishy moderates who somehow survived the past six years of insurgent anti-establishment primary purges bucked the party line on the bill because they were cowed by its 17 percent approval rating and all the looming sob stories from the 24 million people expected to lose health care coverage the first three years of premium hikes that were also forecast. More votes were lost from the “Freedom Caucus,” the same insurgent populists who had gained office by running on the original “Tea Party” wave of dissatisfaction with the Republican establishment, as they objected to the bill because it didn’t fully repeal Obamacare and replaced it with something that retained too many of the taxes and regulations and outrageous infringements of free market principles and individual liberty that the entirety of the party had claimed to be against from the get-go.
Trump took to “Twitter” to blame the “Freedom Caucus” members and threaten them with primary challenges by more obeisant Republicans if they didn’t come around. “The Freedom Caucus will hurt the entire Republican agenda if they don’t get on the team, & fast,” Trump “tweeted,” adding with similar eloquence that “We must fight them, & Dems, in 2018!” Later “tweets” mentioned individual members by name, with similar political intimidation repeated, which leaves us wondering what the Republican establishment but not doubting that it’s likely to be burned down.
The “tweets” don’t seem likely to settle the matter, though, as the “Freedom Caucus” members defiantly “tweeted” back in Trump’s own blustery style. Kentucky Rep. Thomas Massie responded with a snarky “#Swampcare polls 17%. Sad!” Virginia Rep. Tom Garrett of Virginia “tweeted” a simple “Stockholm Syndrome?” to suggest that Trump was now stuck with the hated establishment label. None appeared to be at all intimidated, and we can’t see why they should be. It’s easy to resist a populist movement that’s polling 17 percent in the polls, which is truly is sad, Trump’s numbers are hovering around 40 at a time when a president should be getting a honeymoon bump, and most of those “Freedom Caucus” members won their districts by bigger margins than Trump. Some of them really believe what they ran on, too, and can more persuasively argue why they voted against the bill Trump backed than Trump can argue for it.
To the extent that they can’t “tweet” the argument, conservative media ranging from the rabble-rousing radio talkers to the old eggheaded and think-tanky ink-and-paper publications will make it for them. Given that Trump’s remaining support won’t listen to any media that isn’t explicitly conservative, that’s a problem. Some of the conservative media are by now obeisant to Trump, but given their past full-throated supported for the “Freedom Caucus” and its anti-establishment stand they’re going to have some tricky talking to do. There are still enough Democrats hanging around Congress that Trump will need pretty much Republican vote to “get on the team, & fast,” which will be hard to do with a party that prides itself on its rugged individualism and stubborn independence and despite a certain reverence for order and tradition has lately come to regard any sort of establishment as needing to be burned down.
All of which leaves the Republicans with a whole lot of soul-searching about what their party really stands for. Given the current state of the Democratic Party, the country desperately needs the Republicans to get on with it.

— Bud Norman

Trying to Turn a Defeat Into A Victory, Bigly

President Donald Trump’s so-loyal-he-could-shoot-someone supporters seem to like his penchant for blunt talk, so we’re sure they won’t object that we frankly he note lost “bigly” last week on his first important legislative attempt to make America great again. A hasty and ham-fisted attempt to pass a highly unpopular repeal-and-replacement of the unpopular Obamacare law was called off just before it was clearly about to go down in flames, Trump’s much-touted dealmaking prowess and much boasted-about knack for always winning couldn’t prevent it, and the mainstream media and the late night comics and the rest of the Trump-haters spent the weekend celebrating.
There were some bold efforts, of course, to explain how the failure of a bill that Trump had given his full-throated support to will ultimately prove another one of those victories that he always wins. One theory holds that the fault lies with House Speaker Paul Ryan, who clearly deserves and surely will be saddled with much of the blame for the debacle, and that his weakened position therefore strengthens that of the President who had handed Ryan the responsibility for the first big legislative fight of his administration, but it’s not clear how that pans out. Trump praised Ryan’s efforts, then “tweeted” for everyone to watch a Fox News show where the host happened to spew a diatribe calling for Ryan being removed from the speakership, and at this point it’s not clear who would replace Ryan or how he might have united a fractious Republican Party or otherwise handled the situation any better. Another theory offered by Trump holds that the Democrats are now responsible for the continued existence of Obamacare, which is still widely unpopular in its own rights and absolutely hated by every kind of Republican from Trump to Ryan to such old-fashioned rank-and-file sorts as ourselves, but the bill was also sunk by the more moderate and most conservative Republicans and party rank-and-filers who also found something to hate in its hasty and ham-fisted and form.
The guy who does the “Dilbert” cartoons became famous as a political pundit by predicting that Trump’s ingeniously persuasive rhetoric of schoolyard taunts and barnyard epithets and outrageous boasts and fourth-grade level discourse would win the presidency, and ever since that prediction proved true he’s been explaining how even the craziest things Trump says are part of “4-D chess game” he’s playing against the checkers-players of the political world. To explain how Trump failed to even get a vote on a bill he’d given his full-throated support that would have more or less kept one of his most frequent campaign promises, the guy who does the “Dilbert” cartoons notes that the press is no longer describing Trump as Hitler but is instead calling him an incompetent buffoon, which is supposed to be some sort of victory. Somewhere in the 4-D world of chess that Trump and the guy who does the “Dilbert” cartoons this might make sense, but in the three dimensional world that the rest of the inhabits Obamacare persists and the mainstream press and the late night comics and the rest of the Democrats are celebrating and such rank-and-file Republicans as ourselves are feeling yet another ass-kicking.
Obamacare is still an awful idea headed to an horrendous outcome, but waiting around for enough insurance companies and actual human beings to die for the Democrats to admit it seems a rather cruel political strategy, and the hasty and ham-fisted repeal-and-replace plan that was proposed last week went down despite the best efforts of both Trump and Ryan. Something better should still be possible, even if it doesn’t live up to Trump’s extravagant campaign promises of coverage for everybody and it’s gonna be a lot cheaper and better and you’re head will spin how great it is, and even if Ryan’s grimmer realities about winners and losers and the inevitable payoffs of freedom and equality are frankly admitted, but at this point it doesn’t seem likely. Those conservative Republicans who objected to the pulled bill for conservative Republicans seem suddenly marginalized by Trump, Ryan and and the slightly-less-conservative Republicanism he represents are clearly weakened as well, and if the Democrats ever do feel compelled to come asking for a deal we still worry that Trump the deal-maker will make one that keeps all his campaign promises of coverage for everyone and the government will pay for it and it will be a whole lot cheaper and make your head spin.

— Bud Norman

Health Care Remains, For Now, in the Waiting Room

President Donald Trump might yet grow bored with winning, but it probably won’t happen today. On Thursday the House of Representatives delayed a vote on the health care legislation Trump is backing, lest it go down to certain defeat, and even if they are swayed by his threat to drop the matter altogether if they don’t pass it by the end of this work day it won’t likely count as a win.
The vote was scheduled for Thursday because that was the seventh anniversary of the signing of the hated Obamacare law that the current legislation is intended to repeal and replace, as Republicans have been promising to do for the past seven years, and apparently the irony of the date was too much for the bill’s backers to resist. It came too soon for Trump and House Speaker Paul Ryan to round up all the Republican votes needed to overcome the predictably unanimous Democratic opposition, though, and so far it is not apparent why Trump has decided that the matter must be resolved today or not at all. Nor is it apparent that Trump’s threats will sway any reluctant Republican votes, or that it would be a good thing if they did.
Although Trump is careful not to call the proposed plan “Trumpcare,” despite his usual penchant for putting his name on everything, he has fully invested his rapidly diminishing political capital into the project, and he’s threatened any dissenting Republicans with political consequences if they defy him. He’s a president who’s polling in the high 30s and low 40s, however, and the bill he’s pushing was at 17 percent approval in the latest poll, and the Republican dissenters have plenty of perfectly Republican reasons to offer their constituents, and the Democrats in their districts surely won’t mind the nay vote, so the threats rang rather hollow on Thursday and might again today. If even the reluctant House Republicans are cowed by the prospects of presidential “tweets” there’s still a big fight ahead in the Senate, and even if Trump can win over all the Republicans he has slandered in that body the bill he signs won’t necessarily be scored a victory.
As it stands now, the bill has something for everyone but a diehard 17 percent or so of the country to hate. The Democrats can’t stand any alteration to their beloved Obamacare, no matter how obvious its many shortcomings have become over the last seven years, and all us Republicans who were Republicans long before Trump joined the party are disappointed that the repeal isn’t root-and-branch and the replacement retains too many of its most infuriating assaults on individual liberty and economic logic. Obamacare’s promise of coverage for pre-existing conditions makes as much sense as letting people buy fire insurance after their house has burned down, but it polls through the roof and is therefore protected by the bill. The new bill would end subsidies to millions of Americans who rely on them for health care coverage, many of whom who will have undeniably tear-jerking stories to tell the newspapers and broadcast networks, and although most of them are now inadequately covered and driving up costs for others and would happily opt out of a system that’s hurtling toward insolvency Trump and Ryan and the rest of the Republicans have done a poor job of making that case.
There’s bound to something in even the worst legislation to like, and we find favor with the fact that the proposal would eliminate a number of Obamacare’s more ridiculous requirements. For the past seven years we’ve been arguing that the Little Sisters of the Poor shouldn’t be forced to pay for contraception coverage, monogamous married couples shouldn’t be forced to pay for potential sexually-transmitted diseases, and healthy young people earning starting salaries shouldn’t be stuck with anything more than catastrophic coverage, but somehow the Republicans are mangling even that argument for the bill. Our own snarly Kansas Sen. Pat Roberts tried to make the point by sarcastically telling a female reporter that “I’d hate to lose my mammogram coverage,” which was quickly construed to mean that Republicans were against mammograms and their bill would eliminate that coverage for those who might choose it, even though that wasn’t the case at all, and not being a reality star he wound up apologizing via “tweet,” which is pretty typical of how the Republicans’ public relations campaign has been going thus far.
Although Trump is the leader of the Republican that has majorities in both chambers of Congress, he’s not had much luck lining them up behind the bill he’s careful not to call “Trumpcare.” Any concessions he makes to the hard-liners only makes it harder to woo the squishy moderates in purple districts who dread all those inevitable tear-jerking stories about people who lost their healthcare, his threats of political retribution for anyone who defies his will grow more ridiculous with each passing ridiculous pronouncement and every public opinion poll, and Speaker Ryan and Senate Majority Leader Mitch McConnell and the rest of the Republican establishment that Trump vowed to overthrow are looking equally inept. Now seems a good time for the party for stop and think through what it’s doing, but Trump has decided that it has to be done today, which is symbolic of nothing in particular, or that we’ll just have to put up with another four years of Obamacare.
Call us old-fashioned, but we don’t see why Trump and Congress and the rest of us can’t take a few more weeks or even a few more months to come up with something that both makes sense and scores more than 17 percent approval in the public opinion polls and might even get a Democratic vote or two from some purplish district. Back when Obamacare was passed we and everyone else who was a Republican at the time argued that the Democrats were hasty and reckless and obviously over-promising, and thanks to the anniversary-date vote that was planned for Thursday we’re reminded they took a full year to enact that stupid law, which passed without a single Republican vote and has haunted the Democratic Party ever since. We can’t help thinking that if the Republicans take just as much time, and come up with a sales pitch that avoids needless snark and doesn’t promise the coverage for everyone at much lower prices that Trump promised during their campaign, we might wind up with something that’s at least somewhat better. ┬áIf that’s not a next-news-cycle victory for Trump and his real estate negotiation style, so be it.

— Bud Norman

The Boring Bureaucrats of the CBO Score

The Congressional Budget Office is back in the news, what with all this fuss about repealing Obamacare and replacing it something or another that in any case isn’t to be called Trumpcare, and we’re heartened to see their reassuring initials again. Back when political news was mostly a boring affair about arcane accounting questions the boring bureaucrats of the CBO were always in the lead or at least third paragraph of every story, but that was before the political news became more entertainingly about the latest “tweets” and the accusations of treason being flung from both sides, so lately we find ourselves missing the old days.
That good ol’ CBO finds itself back in the news because of its long-awaited “scoring” of the first of three promised phases of repeal of Obamacare and replacement with something that nobody is calling Trumpcare. The report contains plenty of argumentative ammunition for the Democrats who are unanimously opposed to the plan, possibly enough to scare some of the Republicans with whetted thumbs against the political winds, and a few big numbers that speak well for the first phase of the scheme but might embolden its conservative critics. All in all it was the desultory conclusion that you’d expect from a numbers-crunching bunch of boring bureaucrats, which is what the CBO is paid to be, and within a certain margin of error involved in all human undertakings we’re inclined to accept their findings.
One finding is that 24 million fewer Americans will have health insurance over the next decade if the current proposals of repeal and replace are enacted, which is a number hard for the most pro-reform media to spin, and which the anti-reform media gleefully headlined. The pro-reform forces therefore questioned the supposedly boring objectivity of the bureaucrats at the CBO, rightly noting its past errors in overstating the benefits and understating the costs of Obamacare, but they’ve conveniently forgotten how that happened. We were among the anti-Obamacare voices who noted that the CBO was diligently “scoring” those costs and benefits according to the pie-in-the-sky assumptions and spreadsheet legerdemain that the Democratic administration and Democratic majorities in Congress had described, and that the CBO had made that disclaimer quite clear, and when you take into account that the CBO’s forecasts couldn’t have taken into account subsequent Supreme Court decisions and other events they did about as well as anybody. If the current Republican administration and Republican administrations in Congress didn’t offer such helpful guidelines we can hardly blame those boring bureaucrats as the CBO.
Even without any helpful guidance from the Republicans the CBO has concluded that the first part of more or less Grand Old Party’s three-phase plan would lower federal deficits by a not insignificant $337 billion, given the nation’s poor fiscal health, and would eventually reduce the average American’s health insurance premiums by 10 percent, which by the now the average American would not consider an insignificant sum. The Republicans should be able make some political hay out of those numbers, but at the moment they’re busy discrediting everything the CBO says, and the eventual part will only play out long after the next election cycle and just before the president’s reelection race. The CBO’s past miscalculations were based on the garbage-in-garbage-out assumption of the Democrats who front-loaded their carefully planned Obamacare with early benefits and defrayed costs, while the CBO’s current calculations reflect the Republicans’ longstanding preference for paying up front, and although that makes for good policy we can’t fault the CBO if it makes for lousy politics. If the American public isn’t taking a longer range view of the situation, neither can we fault the CBO for that.
So far as we can tell from the CBO reports and everything else we read and hear and see this Obamacare thing has made things better for some people and worse for others and on the whole worse all around, and we’re quite sure this three-phased real and replacement with something that won’t be called Trumpcare might prove better but surely won’t be perfect. We’re holding out hope that nuns won’t be forced to pay for contraceptive coverage and monogamous married couples won’t have to fork out for sexually transmitted disease plans and teetotaling types aren’t hit up for alcoholism treatment, and that the the youngsters who only need catastrophic care can pay on the cheap, and that the daredevils can continue to defy the actuarial tables, but by now we have to admit that the benefits won’t come without costs, that those costs are actually figured in the long term that people rarely consider, and even those boring bureaucrats at the CBO can’t make any reliable predictions.
We always liked those old-fashined Republicans who used to acknowledge such uncertainties, but these days the party is represented by President Donald Trump and his campaign promises that everyone was going to be covered and the government would pay for it and premiums would go down and care would go up and everything would be great. He was never clear about the details, and being a big picture guy he seems to have left those details up to those Republican establishment guys he ran against, and they seem to have some old-fashioned ideas about paying up front and letting some number of Americans that might approach 24 million go without health insurance, and although there are philosophical arguments to made for that which the CBO can’t score he doesn’t seem able to make it, and this repeal and replace thing seems to be the very first time in his life that he doesn’t want his name on something.
As bad as Obamacare was we’ll still expect something better, but not matter what happens we won’t blame those boring boring bureaucrats at the CBO.

— Bud Norman

Who Knew Health Care Was Hard?

President Donald Trump was speaking to a meeting of the National Governors Association about health care reform a couple of weeks ago, and he offered up yet another one of those occasional quotes of his that cause us slap to our foreheads. “I have to tell you, it’s an unbelievably complex subject,” he said. “Nobody knew that health care could be so complicated.”
Every sentient American already knew that health care is darned tricky, and certainly each of those governors hearing the speech were especially well aware of it, so it’s a sobering thought that pretty much the only person in the country who thought it was easy is the president. Even the minimal amount of regulation that a free-market purist would agree to for the ever-evolving and increasingly high-tech medical sector that comprises a full sixth of the nation’s $17.4 trillion economy is bound to be tricky, managing every aspect of it is beyond the ambitions of even the most arrogant Democrats, and any compromise you might find somewhere in between is bound to be exponentially more complicated. The policy questions are daunting enough, but as Trump as surely figured out by now, the politics involved are even more convoluted.
Trump and the Republicans running the two chambers Congress rolled out the first of three promised phases of their plan to repeal and replace the current Obamacare system earlier this week, and if they thought that getting it passed into law was going to be easy they should now be wised up. There are still enough Democrats left in Congress to make trouble for for any changes in Obamacare, although the law is unpopular enough throughout the districts and states that it’s largely responsible for a Republican White House and an electoral victory for a Republican president, and there are still enough pre-Trump sorts of Republicans left in both chambers who won’t stand for any aspect of Obamacare, even those several provisions that poll extremely well with the general public, and what with politics making strange bedfellows they can cause all sorts of complications together.
Unless you’ve been too busy with your reality television show or branding negotiations to have been paying attention, for the past seven years or so the repeal and replacement of the hated Obamacare has been the metaphorical Moby Dick to the Republican’s Captain Ahab. Not one single Republican, even though squishy ones that you still find up way up northeast, voted for the damn thing, everyone last one of them has cast meaningless votes for its repeals on a regular basis ever since. From the most staid conservative publications to the most shrieking talk radio shows the entirety of the party was opposed to Obamacare, which was forced on a resistant public with some procedural legerdemain and a variety of lies about lowered costs and keeping your plan and your doctor that were eventually exposed, and conferred unprecedented powers on the federal government, and had monogamous couples paying for sexually-transmitted disease coverage and Catholic nuns paying for contraception and otherwise permanently altered its social contract with citizens, and generally offended every old-fashion Republican principle. As the false promises about lower costs and freedom of choice were exposed the Republican majorities in Congress grew, and with a Republican president who wouldn’t have gotten his party’s nomination without an unequivocal promise to repeal and replace Obamacare it should have been easily accomplished.
Politics is always complicated, though, and Trump’s apparent belief that it’s actually all quite simple adds another layer of complexity. The parts of Obamacare that allow young people to remain on their parents’ plan until age 26 and let people sign up for insurance at the usual rate after a pre-existing condition have been discovered poll well with the public, the subsidies that are being provided to a reported 20 million or so people are even more more popular with that reported 20 million or so people, and among them are some folks who will have tear-jerking stories to tell on the nightly news, and at this point it’s hard to tell how the unpopular Trump will fare against the unpopular Obamacare. All the Republicans are taking care not to call the new policies Trumpcare, even Trump, who usually loves to put his name on things, because at the moment both Trump and Obamacare seem equally unpopular.
As the pre-Trump sorts of Republicans, we were hoping for that most minimal sort of regulation no matter how complicated that might prove. If the insurance wants to sell policies that allow include children to any old age we’d be happy to let them, and expect that many would find it profitable to do so, but we wouldn’t force them do so no matter what the polls have to say about it. The preexisting conditions thing about Obamacare comes with all those heartbreaking stories, but you could just as easily interview people who couldn’t get flood insurance after their house was underwater, and no matter how heartbreaking it just doesn’t make economic sense. We have some red-in-tooth-and-claw solutions to the whole matter of rising health care costs, too, but we acknowledge they won’t poll well, and admit that the ever-changing high-tech world of medical marvels makes it very complicated.
Interstate health insurance plans and no mandated coverage of unnecessary producers and much of what else we were hoping for wasn’t included in the latest proposal but is promised to come in phases two and three of the great Republican health care reform roll-out, and for now we’ll take their word for it. Still, we can’t help wondering why they’re dishing it out like that. Something in phase one might make sense if it were done in conjunction with something in phase two or three, but not otherwise, these things being very interrelated, and the uncertainty of what’s to come only complicates matters further. Coming up with something better than the undeniably disastrous Obamacare system should have been a relatively simple matter, but of course Trump complicated matters by promising something “wonderful,” which of course is a whole lot harder to achieve.
Trump was all over the place on the issue during his improbably victorious campaign, wowing the Republicans with the usual repeal and replace rhetoric, but also promising the broader public some spectacular but unspecified plan where everyone would be covered and the government would pay for it and the costs would go down and quality of care would go up, and he really should have expected that would prove complicated. He’s already abandoned a campaign position in favor of that stupid individual mandate that requires poor people to pay a penalty for not having insurance, but endorsed a plan that would allow insurance companies to charge a 30 percent fee on people whose insurance have lapsed, and he’s no longer talking about the government paying to insure everybody, but he has abandoned enough longstanding Republican positions about the proper role of free markets and individual liberty and meddling bureaucracies in the nation’s health care to lose some Republican support. On the other hand he’s still retreating from the Democrats’ positions on those very vital questions, and won’t likely get any support from a single one of them.
We’re hopeful that at the end of all this complicated fuss that’s going to consume the next several months we’ll wind up with something that’s at least better than that dreadful Obamacare, but we don’t expect that it’s going to wind up being something as wonderful as what was promised. Obamacare wasn’t altogether bad, otherwise its repeal and replacement wouldn’t be so thorny, but it’s dreadfulness was made all the more apparent in contrast to the sales pitch, and what’s likely to known as Trumpcare surely won’t be altogether good, so its promises should be made accordingly. That’s not the Trump style, of course, and some painful but necessary procedures will probably be left out of the care, and we expect the fuss over it will outlast us all.
One of the few old-fashioned Republicans who has somehow enthusiastically embraced this newfangled Trumpist party is Arkansas Sen. Tom Cotton, who has been surprisingly outspoken in his opposition to what’s thus-far been rolled out. He “tweeted” that the Democrats were too hasty in passing that darned Obamacare when they enjoyed a Democratic White House and majorities in both chambers of Congress, and urged that his own party not repeat the mistake. We like Cotton’s old-fashioned Republicanism, and despite our disappointment with his enthusiasm for Trump’s newfangled party we think his advice to slow down and get it right is sound. The Republicans should take at least enough time to hear all three phases of what they’re doing, gauge just how free-market the party can get away given the current political climate, do what’s doable, and be satisfied if the results are somewhat better than Obamacare even if it so wonderful that nobody dies.

— Bud Norman

Overselling Obamacare and Trumpcare

From our birth up until the Indiana primary of last year or so we were as steadfastly Republican a soul as you’re likely to find even here in deep-red Kansas, so of course we’ve been anxiously awaiting the repeal of Obamacare for coming up on eight long years now, but president-elect Donald Trump’s latest statements to The Washington Post on the subject are not reassuring. He’s long promised repeal, and by now we don’t doubt him a bit about that, but he’s also promising a replacement that would provide “lower numbers, much lower deductibles” and “insurance for everybody.” Which sounds great, especially when he insists we believe him, because that he can tell us, OK?, but we can’t help suspecting it sounds a bit too great.
Being street-savvy and wised-up sorts of erstwhile Republicans we were never fooled by President Barack Obama’s assurances that his eponymous Obamacare would save the average American family $2,500 a year and insure everybody and not add a single dime to the national debt, or any of that blather about how if you like your plan you can keep your plan and if you like your doctor you can keep your doctor, and along with every last Republican Senator and Representative in Congress, even the ones from those wimpy northeastern states and districts, we were against it all along. It sounded so convincing, what with those well-crafted phrases delivered in that smooth baritone voice, but the numbers never did add up. Given all the same ongoing laws of probability and supply and demand and the rest of darned reality, we’re doubtful that Trump will be any more able to deliver on a promise of both lower deductibles and universal coverage. Liberals more honest than Obama have always acknowledged that universal coverage will entail greater universal costs, more honest conservatives than Trump have always countered that leaving free people to pursue their self-interests will results in the greatest good for the greatest number of people even if there are some costs entailed, but the more demagogic types on both ends of the spectrum will always promise that no such hard choices need be made.
Feel free to disagree, as there are arguments aplenty to be made, but our prairie Republican instincts incline us to side with free people pursuing their own self-interests and the government having as little to do with it as possible. We don’t want people dying in the street, and are quite willing to limp along with a health care system that pays for indigent emergency care through whatever convoluted and no doubt costly means the pre- and post-Obamacare systems provided, bit if you’re claiming to have come up with something so ingenious that it can simultaneously cover everyone and lower everyone’s costs we’re going to be skeptical no matter what party you’re claiming to represent.
As usual with Trump’s triumphant claims, there was a follow-up interview with a more well-spoken spokesman who reassured all us conservatives, as the term was formerly defined, that Trump was actually talking about such free-market reforms as eliminating interstate competition in the insurance market. That does seem a good idea to us, as do some other of those free-market reforms he mentioned, but even that more well-spoken spokesman didn’t attempt to explain how they’d wind up with both lower deductibles and universal coverage. Presumably he meant to imply that such free-market reforms would lower health insurance premiums and other costs to point there was “universal access,” which is what the the Republicans have always called their best effort at the greatest good for the greatest number of people, but we wish he’d just gone with that persuasively honest term, which at least won’t wind up seeming so ridiculous as all that nonsense about Obamacare’s big savings and debt-neutrality and keeping your plan and doctor.
Hating Obamacare is such a longstanding habit by now that almost any other national health care policy will seem a welcome relief, however, and we’ll hold out hope that the mostly pre-Trumpian Republicans in Congress will continue hating it for the some doctrinaire reasons and be suspicious of any newly peddled snake oil claims about everything working out well for everyone.

— Bud Norman

A Not So Fond Farewell

President Barack Obama gave his farewell address on Tuesday night, so at least we’ve got that going for us.
President-elect Donald Trump once again grabbed all the attention, of course, with his indignantly “tweeted” denial of some juicy new allegations that were reportedly included in the intelligence community’s much-debated reports to Congress and other officials concerning Russia’s alleged meddling in the past election. A maybe true and maybe not true dossier of allegations was compiled by a reportedly respected ex-British intelligence official, and is now splashed all over the internet, and it mentions Russian prostitutes and some very kinky sex acts, as well as several presumably more hygienic but no less newsworthy contacts that Trump’s business and campaign officials had with Russian officials, and it’s undeniably more irresistible conversation fodder than another one of Obama’s orations.
All that cloak and dagger and kinky sex stuff will play out over the next several days or weeks or months, though, if not much longer than that, and in the meantime we feel obliged to take note of Obama’s speech.
For the past nine years or so we’ve been hearing about what a wonderfully eloquent orator Obama is, but we were once again unimpressed. The language is well-crafted enough by comparison to his successor’s schoolyard taunts and constant interjections of “believe me” and “OK?” and “that I can tell you,” but that’s damning by faint praise, and up against an Abraham Lincoln or Winston Churchill or Martin Luther King or any other first rate rhetorician it’s not at all memorable. Even his most awe-struck admirers are hard-pressed to remember any line he ever uttered quite so iconic as Dwight Eisenhower’s farewell address coinage of “military-industrial complex” or John Kennedy’s “bear any burden” shtick or even George W. Bush’s pithy “soft bigotry of low expectations,” and what they do come up with about “no red states or blues states” and “hope and change” and “yes we can” and that one about the sea levels falling now sounds faintly ridiculous after eight long years of his tiresome speeches.
Which left poor Obama, just 10 short days away from the seemingly inevitable inauguration of Trump, with the difficult job of making the case that all that hope had not been misplaced. He had a friendly audience in his adopted hometown of Chicago, all revved up by a soulful rendition of the the National Anthem, and he bounded on the stage with a rock star’s roar and a rock star’s rote greeting to a certain local neighborhood and a whole of thank you thank you very much, followed by some lame self-deprecating humor about being a lame duck, then he started waxing eloquent. He did so well enough that his still-ardent admirers who still feel that hope were probably tugging at their eyes, but any eyes that have been keeping a more unblinking watch on the past eight years were rolling.
There was some nostalgic talk about his young and idealistic days as a community organizer on the south side of Chicago, and how he learned that “Change only happens when ordinary people get involved, and they get engaged, and they come together to demand it.” That same south side of Chicago is presently so disorganized that it has a murder rate that would shock the denizens of your average third world hellhole, but so far the survivors haven’t gotten involved and engaged and demand change from Obama’s associates at City Hall, and somehow we got the sense that he wasn’t urging them to start now.
He followed that up with some rousing stuff about the wisdom of the founding fathers and their belief that we are “endowed by our creator with certain inalienable rights, among them life, liberty, and the pursuit of happiness.” At any rate it would have been rousing if he hadn’t spent the past eight years giving speeches about the country’s racist and sexist and classist origins, and steadfastly defending abortion rights, and restricting the citizens’ liberty in numerous ways, and generally making life miserable for anyone who was just trying to live it. There was some more rousing-for-the-faithful stuff about onward and upward to the more perfect union, along with a list of liberal goals that have been achieved over the years.
Even Obama had to admit that “Yes, our progress has been uneven,” and sometimes even “contentious,” and there was no talk about ocean levels falling or a new era of hope and change or any of the other stuff so many people were swooning for starting back about nine years ago. Instead, Obama tried to argue that things had worked out even better than promised. He touted the end of a Great Recession and “reboot” of America’s automotive industry and eight straight years of job growth, the shutdown of Iran’s nuclear weapons program and new relations with Cuba and of course the oft-cited death of Osama Bin Laden, along with a health care plan that insured another 20 million Americans, and boasted that “If I had told you that, you might have said our sights were set a little too high.
Even if that were all true it’s still setting the sights a little bit lower than during the messianic ’08 campaign, as far as we’re concerned, but without looking anything up and despite the florid language we were ready to dispute almost all of it. The Great Recession of ’08 did indeed come to an end, but recessions have always come to an end and usually with more robust employment gains than during the past below post-World War II averages, and who’s to say that whoever bought out General Motors would haven’t hired more workers? Iran’s nuclear weapons program is still on schedule and has a few billion dollar extra in its coffers thanks to Obama’s largesse, our new relations with Cuba are far too chummy with a communist regime for our tastes, and Obama saying he succeeded in killing Bin Laden where Bush had failed is like Nixon claiming credit for getting to the moon where Johnson and Kennedy had failed. That 20 million insured figure is by almost all other accounts vastly overstated, and includes a lot of people stuck on Medicaid and forced by buy overpriced insurance they don’t need, and it’s clearly one reason job growth has been so sluggish, and so many more people are stuck paying exorbitant rate increases and swelling budget deficits to pay for it that the guy who promised to repeal Obama’s signature piece of legislation wound up winning.
At that point Obama had to chide the crowd for booing the guy who did wind up winning, and we’ll give him credit for doing that, and he pledged a peaceful transfer of power and gave some props to George W. Bush for doing him the same solid. That was followed by a lot of talk exhorting Democrats to continuing be Democrats, and racism and climate change being very bad, and peace being better than war, along with some bragging about the oil boom he did everything he could to thwart, and a whole lot of blather that will be little noted and soon forgotten, to borrow a phrase from a more memorable orator. It didn’t convince us that we’d been wrong all along, and that Obama really was the Messiah we’d been told, but we suppose the true believers liked it, even if they can’t remember a single line of it today.
At this point we’re quite agnostic on the question of whether Trump really did pay those Russian prostitutes to perform those kinky sex acts while on a Moscow business trip, or whether any of those other dealings actually occurred, but we’re quite convinced he’s also no Messiah. All we can say at this point is that we can’t say we’re looking forward to four or eight more years of schoolyard taunts and constant interjections of “believe me” and “OK?” and “that I can tell you,” but at least the rest of Obama’s ponderous speeches will be more easily ignored as the forgettable asides of an ex-president.

— Bud Norman