Too Many Outrages, Too Little Space

My upcoming newspaper column:

This is hard. Try winnowing topics, when every day brings another outrage against truth, justice, and the American way. So much to say, so little space and time. Today’s column is catch-up and other condiments. 

Brazenly gifting the wealthy while leaving the needy behind, the health plan coughed up by our Republican Houseguests is as hypocritical and heartless as predicted. (Definitely not a bribe, health insurance execs get the greatest tax breaks of all. Not lottery winners, though, to whom nearly ten percent of its pages are devoted.) Assembled in secret, pieced from decades of desiccated Republican healthcare ideas, it’s been pitchforked from all sides. Viable or not, it demonstrates to whom that party is beholden, for whom they have the least concern, and over whose eyes they pulled the wool. Ryan wants a fast vote, before it’s scored by the CBO. Years in the making, still hiding from the light. 

Yet again, Ben Carson proved cognition isn’t required to separate brains, and not just by referring to slaves as immigrants. There’s his frontal-lobe-slapping claim about brain stimulation and memory. He definitely didn’t learn it in med school. Breitbart, maybe. He’ll be a fabulous leader at HUD. 

Trump was furious that J. Beauregard Sessions, straight-up liar to Congress about meeting with Russians, recused himself from hypothetical Justice Department investigations of the Trump/Russia nexus. No doubt he’d been counting on J-Bo to steer snoopage away from the crux. Were his tweets about Obama wiretaps manifestations of his paranoid and increasingly worrisome dissociative disorder, or a ploy to keep the media off the Sessions/perjury Trump/Russia scent? Either way, demanding an investigation seems capricious at best, especially if Congressional Republicans were to allow (unlikely) a deep dive by independent investigators. If they do, it might 1) discover there were indeed wiretaps of people near to Trump, b) confirm they were legally authorized by a FISA judge, not Obama, based on compelling evidence of illegal activities, and iii) help us understand Trump’s connections and deference to Putin. Bring it! 

Why so little concern among Trumpophiles over the network enmeshing Trump, his family, his henchmob, and Russians within or near to their government? Is it statistical happenstance that the number of Russian functionaries found dead since Election Day, including several directly connected to Gang Trump, is up to eight? Among them is a person involved in the allegation of a micturative video involving Donald in Russia. Nothing, Trump defenders? No worry that the Gold House has been sublet to the Kremlin? How would you be treating this if Obama were president? Ben Carson is wrong about the brain’s memory functions, but it sure has the power to rationalize. 

Reversing an Obama order, Republicans made it easier for companies to cheat and endanger employees.  

Do Trumpists still think Obama golfed too much? 

Trump lies with abandon. How do we know when he’s not? 

For Trump’s infrastructure plan, we’ll pay tolls. 

To finance its immigration crackdown, Chez Bannon is considering cutting FEMA, the Coast Guard, and airport and rail security. Only in Trumpworld is that rational. 

Trump deceived us about requiring American steel for pipelines, and Russia wins the gold. Rubles to a Putin pal.  

Speaking of corruption, here’s a fascinating exploration of Trump’s connection to Azerbaijani deplorables and Iranian terrorists. 

Are local Trump apologists okay with defunding Puget Sound cleanup? Great Lakes, too? Waste of money, was it? What’s more important, clean waters to support marine life (and, therefore, us) and to drink, or another aircraft carrier for Trump to strut around on, flight-jacketed? Might national security be better maintained by attending to our own neighborhood, especially since we already have the most powerful and sophisticated military in the solar system? It’s not enough, spending more than the next fourteen nations combined? They’re also cutting NOAA’s and NASA’s ability to study our home planet. That’s even worse for security. Madness is what it is. 

Squeezing those agencies, of course, and others, fits with Trump’s and Congress’ fear of inconvenient research that produces facts they’d rather ignore. Expect more suppression. 

And now, leaving the surface nearly unscratched, I’ve used up my space. This is impossible. 

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Repeal, Replace, Regress

My upcoming newspaper column:

Freedom’s just another word for no health left to lose. So says Doctor Republican Congressman Michael Burgess of Texas, regarding numbers of people with healthcare coverage: “If the numbers drop, I would say that’s a good thing, because we’ve restored personal liberty in this country.” Wow. And lest you think the Republican plan for replacing The Affordable Care Act is right around the corner, Trump has had an epiphany: “Nobody knew healthcare could be so complicated,” quoth he. 

The statements provide clarity regarding Congress and our occupant of the Gold House, the latter of whom has repeatedly, if without specifics, called the ACA a “disaster,” falsely promising to end it on “day one”; and the former of which spent the last seven years voting fifty-five times to repeal it. That they’re only now discovering Obamacare is the opposite of a disaster for many millions of Americans, and replacing is harder than repealing, reveals much about our Congressional majority and their ability to govern. Legislating, evidently, isn’t like riding a bicycle: when you spend eight years blocking instead of producing, you stop knowing how. 

“Nobody knew.” Well, it’s undeniably true of Trump and those with whom he’s surrounded himself, and of the legislative bodies over which he holds apparently unlimited sway. Applied to those who wrote the original bill, though, and to the president who oversaw the process, it’s demonstrably false. Seven years ago, in fact, President Obama said, “The truth of the matter is that health care is very complicated.” That unstartling insight is shared by most people capable of thoughts of more than one-hundred-forty characters, and by anyone who’s addressed the subject seriously. 

Trump once promised, “We’re going to have insurance for everybody.” Everybody, it turns out, but those most dependent upon it, assuming the plans now being bandied by the band of bandits in Congress see the light of day. Tax credits and health savings accounts, the bedrock of Republican healthcare reform ideas, are a welcome tax dodge for the prosperous but of no use to people of modest means or less. Surely they recognize something so obvious. Don’t they care? Why their urgency to repeal? 

Simple: unlike Bush’s Medicare Part D, which, being unpaid-for, added to the budget deficit, the Affordable Care Act had built-in funding mechanisms, and has, in fact, lowered the deficit. But it did so by raising taxes on those most able to afford them; namely, Republican donors. Depending on income, the wealthiest stand to save tens (or, in some cases, hundreds) of thousand dollars with repeal. So let’s not concern ourselves with the millions who’ve gained coverage; or people saved from bankruptcy by lifted lifetime limits; or those having pre-existing conditions. (Or, as Rick Santorum calls such people, cheaters.) And forget about young people who had no access to coverage until allowed, under the ACA, to stay on parents’ plans till age twenty-six. There are donors to tend to. 

But let’s NOT forget reality. President Obama disappointed liberals by going with conservative-born health care reform. Naively thinking he’d get some Republican votes by doing so, he rejected the single-payer “public option” desired by the many people to his left. Predictable to everyone but Obama, that reaching out garnered exactly zero votes. Nevertheless, the reportedly liberty-crushing ACA has improved the lot of millions of Americans. 

And, yes, it’s far from perfect, because, as we’ve been reminded, healthcare is complicated. Compared to that of other Western countries, the American system is an expensive, unmanageable mess on many levels, the worst of which is keeping insurance companies between patients and providers of care, sucking money out like a failed Trump casino. (After promising otherwise, the tough dealmaker caved to drug companies on negotiating drug prices, another part of the mess.)  

Having done it for decades, I know stuff about health care. I know that insurance companies, given their business plan of collecting your money and trying not to give it back, are worse than unnecessary. I’m pretty sure any Republican ACA replacement, if they ever produce one, will leave the neediest worse off and won’t lower costs. And I know for certain that unless we get around to “Medicare for all” pretty darn soon, the system will fail.

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I Think This Is Important

Henry Aaron, the brains behind the R plan for Medicare (ie, the Paul Ryan plan which Rominee also loves), has changed his mind. Maybe he got tired after hitting all those home runs. In any case, he no longer thinks the plan will work. This, of course, means Rs will love it even more, since things that haven't ever worked or mathematically won't work are what they cleave to most; but I think it's important to listen to what he says. It cuts both ways:

The basic idea is simple: let people pick their health insurers in the private market, subsidize the premiums, and competition will drive down costs...

[...]

"In the years since Bob Reischauer and I put this Idea forward, I've changed my mind," Aaron said at a hearing of the House Ways and Means Committee last week.

[...]

The big reason is that Aaron has seen no evidence since the two men came up with the idea that their assumptions have been borne out. A key assumption was that the insurance industry or government would figure out how better to adjust risk among companies so that if one insurer suddenly was saddled with an unusually expensive population, it would share the costs with other insurers or the government. That would keep costs down because it removes some of the incentive to cherry-pick healthier customers or shun sicker ones.

[...]

"The evidence to date is not encouraging," Aaron said...

Aaron has not abandoned the idea of premium support for Medicare, if it can be figured out. He argued that rather than trying to do it right away, as Ryan and other proponents insist, policymakers should first see how it works for younger people -- as it is beginning to be applied in the health care reform law.

"The passage of the Affordable Care Act means we have put in place a key element of the premium support idea for the rest of the population, namely health insurance exchanges," Aaron said. "... We should prove that the health insurance exchanges work, get them up and running before we take seriously, in my view, calls to put the Medicare population through a similar system."

[...]

Aaron also argued that there's another problem with trying to ensure a premium support model works -- it requires stringent regulation to make sure companies don't game the system. Aaron said he can't see that happening with a Congress fired by anti-regulatory zeal.

I take a couple of points from this: first, the ACA is creating some innovations that need time to be assessed, good or bad. Second, the very idea of "premium support" has been suspect from the beginning, which is among the reasons I've never much liked the ACA.

Since this isn't just some guy on the street who's changed his mind, but the one behind the whole damn thing, you'd think it'd be given a certain amount of credence by Ryanites, give them pause, send them back to the drawing board.

You'd think.