Healthcare continued …
Nothing could possibly give us more insight into the ineptitude and unpreparedness of Trump for high office than his comment yesterday:
“It’s an unbelievably complex subject. Nobody knew health care could be so complicated.”
Really?
Everyone knew. Everyone.
Except for Trump who has blithely been assuming that his bully-boy attitude could translate easily from his real estate business into the White House. He, like a lot of others in recent years, reacted to the gridlock in Washington by arguing we needed a bold business like period of “action” to solve our national issues. We did not need anymore “talk”. All talk and no action is a criticism Trump levels glibly at anyone who appears to want to reflect before doing or saying anything.
So it is with health care.
During the presidential campaign Trump promised the earth. According to his many statements on the topic no one was going to lose coverage, prices would fall, people could keep their own doctors, and all this would delivered by a private rather than public mechanism. He said he was going to eliminate the dreaded mandate aspect of the Affordable Care Act [aka Obamacare]. This was the crucial part of the three legged stool approach in the ACA that lowered average insurance premium costs. Unfortunately it raised them for healthy people and lowered them for the sick, and it was the subsequent uprising amongst the healthy that so motivated the Republicans. This was, of course, over and above their ideological objection to anything smacking of governmental intrusion into the purity of the free market.
The Republicans have been calling for the destruction of the ACA ever since it was voted into being. They have been passing legislation calling for its repeal with regularity — all the time knowing that Obama would veto any such attempt.
But here we are: since they control all branches of government the Republicans can now carry through with their threat. Their leadership promised urgent and early repeal to their rabid base of supporters. It was, we were led to believe, their number one priority ranking even higher than their promise to reduce taxes for the rich.
That sound you hear is the silence surround their efforts.
It now transpires that Trump had no idea what he was talking about, and is only just getting an inkling of the difficulties surrounding a health insurance program based on private market delivery. Any such program is riven through with contradictions unless, and this is the pivotal point, legislators are prepared to cut millions of people adrift from health care coverage. If the Republicans were willing to roll back the triumph of the ACA and its extension of coverage to the well over 20 million people who previously had not been covered, they could easily forge ahead. It would be an act of enormous callousness but not wood be consistent with their anti-social pro-individual ideological stance. Under that stance anyone without health care coverage is to blame for their own inadequacy and it is not the proper role of the state to compensate for that inadequacy.
The Republican mantra is, in this sense, straight out of the Hayek and Friedman playbook: “everyone gets what they deserve”; and if you have failed to get health care coverage you must, by definition, deserve not to be covered.
The social democratic mantra is, in contrast: “everyone gets what they deserve” implying a socially cohesive policy stance allowing for the public provision of health care because all citizens deserve it. They are, after all, equally citizens.
The problem currently undermining the Republicans is that their ideology prevents them from caring about their fellow citizens and so providing coverage to everyone. The idea of full coverage is contradicted by the need to prevent state coercion. Since the latter is needed to ensure the former the whole idea of full coverage through a private market collapses. It cannot be done.
Apparently neither Trump nor his key advisors had thought this through. Hence his ridiculous claim that nobody realized how complex health care policy making is.
Everyone knew.
Except Trump: What an amateur.
