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Socialized Medicine and the State of the Union

Self-described socialist Vermont Sen. Bernie Sanders has officially proposed a Medicare For All Act, which is basically a socialized single-payer insurance scheme, and although it’s not likely to become law in the near future it’s nonetheless an ominous development.
The bill already has 15 Democratic Senators signed on, including several who are considered contenders for the party’s next presidential nomination, and all the polls confirm our anecdotal evidence from conversations at the local hipster bars that the party’s increasingly leftward base is enthusiastic for the idea. For now they don’t comprise a majority of popular opinion, much less the needed congressional majorities, and there’s also a putatively Republican president to veto anything they might get passed, but the idea no longer seems so far-fetched.
Democrats have been chasing the white whale of socialized medicine for a century or so, and Republicans have been successfully fending off the bogeyman of their efforts for just as long, The left has long noted that America is alone among the industrialized nations in not offering some sort of universal health insurance, and the right has long been able to reply by noting how much longer people in those countries have to wait for a medical procedure, and how much they pay in taxes, how puny their militaries become to pay for it, how free markets are as always more efficient than the government-run variety, and all those arguments still stand.
Even the editorial board at The Washington Post acknowledges the budget-busting implications of Sander’s proposal, and such relatively centrist Democrats as recent Democratic presidential nominee Hillary Clinton are warning against Sanders’ influence on the party. The Democrats had a hard enough time getting the semi-socialized Obamacare passed with bigger majorities in congress and a more true-blue Democrat in the White House, they suffered huge electoral losses on the lower ticket right down to the city council levels as a result, and for now there are only 15 Democratic senators and the usual number of House members signed on.
That’s for now, though, and these days there’s no telling how long that will last. For four consecutive electoral cycles the Republicans gained everything but the presidency on a promise to repeal Obamacare, and on the fourth try a putatively Republican won the White House on the same promise, but so far it’s proved as impossible as ever to undo any entitlement program that has a couple of million telegenic beneficiaries. The Republicans are betting that when Obamacare inevitably fails with vast human consequences both public opinion and the Democrats will come crawling for some free market solution, and not notice they didn’t try to at least stave it off, but we wouldn’t make that bet.
Some Trump-wary Republican pundits we respect think the Democrats are lurching so far leftward with a socialized single-payer system that they’ll wind up with a ’72-style loss, but these days seem even weirder than that weird year. Once upon our young lifetimes the words “socialized medicine” were a career-ending slut, but that was before a self-described socialist won 45 percent or so of the Democratic votes. It’s not good to root for other party going to the extremes, whether you’re a Republican or a Democrat, because there’s always a good chance that your party will as well.
Those sound arguments about the inefficiencies and far-reaching costs of socialized medicine still persuade most Republicans and the more sane sorts of Democrats, but the vast majority of the country is as always susceptible to promises of coverage for everyone at a vastly lower price. We can easily believe that next time around those silly Democratic primary voters will buy it, as the last time around the Republican party nominated a candidate peddling the same snake oil. All indications are that after an illegal-immigrant-bashing campaign Trump is eager to sign the illegal-immigrant-friendly “DREAM Act” that Obama and those bigger Democratic majorities couldn’t get passed, and he’s also capitulated to the Democrats’ budget and debt ceiling proposals, so there’s no telling how he might come out on a deal to immortalize him as the man who brought universal health coverage to America.
For now, at least, there are clean-ups from the floods and “Russia” leaks and plenty of other things to worry about.

— Bud Norman

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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