Politics

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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.

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National Security or Politics?

Here’s a fun way to look at the current crisis surrounding the White House. Put it in the perspective of one of your favorite espionage novels. Is Trump a Russian spy? Or is he simply a Russian stooge?

We don’t know of course, but it sure looks like the Kremlin has him on a tight leash. He never says anything critical of Putin despite the latter’s obvious thuggishness and anti-democratic attitude. He keeps quiet on the current turmoil the Russians are instigating in the Ukraine. He avoids eye contact every time anyone raises his apparent infatuation with the strong man tactics that Putin deploys to suppress his opposition. And he makes all sorts of disruptive comments about both the EU and NATO both of which act as bulwarks against Russian influence in Europe.

To sum up: Trump, contrary to decades of prior policy, looks, sounds, and acts like a big buddy of the Russians.

Why?

Is he worried about his business interests in Russia?

Is his borrowing from Deutsche Bank underwritten by dark loans from Russian banks?

Is that infamous MI6 file accurate?

Did he collude with the well-known Russian attempts to interfere in the American election?

What, exactly, is the nature of his relationship with the Russians? Is it innocent? Or is it nefarious?

Why did he keep General Flynn in his office as the most senior US intelligence officer despite being told by the Justice Department that they were concerned Flynn was a possible blackmail target?

This is a long list. The circumstantial evidence is accumulating fast. The intelligence agencies are concerned enough that they consider Trump himself a possible security risk.

We are beset with floods of speculation and very little fact — the only facts are those surrounding Flynn, and the existence of very large and odd looking loans from Deutsche Bank. The MI6 file has a respectable source, but has not been fully verified — as far as we know.

Under the American system we need Congress to exert its right to oversee and investigate Trump’s relationship with Russia, but if they delve too deeply it will take up time and divert resources from their policy agenda. The dilemma is already unnerving many Republicans in Congress. Rand Paul, the libertarian Senator, blurted out that it makes no sense for “Republicans to investigate Republicans” which nicely sums up the problem. Whilst it represents an astonishing abandon of their constitutional responsibilities it fits neatly with their political goals.

So which is it? National security or politics?

That’s not an easy one to answer if you are a radical Republican bent on undoing the Obama era before you have to endure the midterm elections in 2018. This year is crucial to the Republicans, if Trump’s ineptitude is compounded by scandal and investigation their 2016 triumph will have been pyrrhic at best.

So which is it? National security or politics?

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Amateur Hour

I can’t resist. I have tried, but I can’t.

Trump is a total amateur. A complete child in a land of grown ups.

His organizational capacity is weak. His personnel selection ability is mixed. His leadership ability questionable. And his strong man image a total illusion.

We were promised, throughout the election, that a Trump presidency would be, amongst many amazing things, one of iron will and foreign policy grit. Gone would be those days of Obama searching for a more modern role for the world’s mightiest army. Gone would be those apologies for bygone mistakes. Gone would be the days of equivocation. No. Not at all. We were going straight back to the heady days of Teddy Roosevelt and the strong arm, red-blooded, all-American, tough guy, rapid response.

ISIS was doomed. Give it a few days at best.

North Korea was doomed. Give it a few days at best.

Europe falling apart? So what?

NATO? Let them defend themselves.

China? Bring it on. That’s a sure fire war in the making.

Trump was going to bring the swagger back to American foreign policy. The bully boy was back in town.

Well.

Not so much.

Russia, so we learn, rigged the election and has files that incriminate Trump and a few of his main men. So the latest Ukrainian unrest? Not a whisper from our fearless leader. Carry on Russia! We aren’t looking.

That defiance over the South China Sea? That radical phone call to Taiwan? That tough guy talk about Chinese trade? Evaporated in the first phone call with the Chinese president. The Chinese press now calls Trump a “paper tiger”. Toothless, belligerent, but a pussy cat nonetheless.

That North Korean missile launch? The silence is almost deafening. Trump punted the problem to the Chinese — it’s their issue.

Then there’s the complete chaos in the Trump administration itself.

General Flynn turns out to have been paid by the Russians. He spoke to them about foreign policy whilst being an advisor during the election. He thus broke the law twice over.

Trump himself knew about all this which means he broke the law too.

And he didn’t have the fortitude to fire Flynn. In a strange and eye-opening contradiction of his TV persona Trump didn’t fire Flynn peremptorily, he waited timidly for the resignation. Weak-man Trump rather than strongman Trump.

So much equivocation was there in the White House about Flynn and the threat to national security that he represented, that the Department of Justice (and other concerned agencies) where responsible folks had warned Trump about the possibility of leaks and breaches etc, had to resort to leaking their concerns to the press in order to engender sufficient energy to get a result. Trump, apparently, was frozen in inaction.

Then there was the absurdity of the reaction to that North Korean missile launch.

It came during a fancy outdoor dinner reception Trump was hosting in Florida. The subsequent scenes as Trump and his aides huddled in plain view of his guests in order to cobble together the American response was a textbook example of insecurity. Secret documents were strewn across the dinner table where guests could get good photos of them. Aides huddled within ear shot. It was all a great big show for the guests, many of whom immediately updated their social network pages with photos and updates oblivious to the national security risks, but drunk on the splendor of sharing the moment with their host. How fun it must have been for Buffy and Muffy to be there in the center of the action. It was almost like the movies. Now that’s worth another big donation to the Trump coffers. Real time immersion in the affairs of state. Good food too.

Trump is in way over his head. He cannot, yet, discern the difference between being a business honcho throwing a big bash for buddies, and being the President of the United States. He acts as if the nation is just an extension of his business. This is all just a great big money making opportunity. There are deals to be made. Just don’t stare at him or else he’ll quiver in fear.

The ship of state is riddled with security breaches, lapses, and weaknesses that make anyone with a sense of propriety cringe.

The man has no respect for his office.

He is an amateur.

This is amateur hour.

And the Republican leadership min Congress? Are they cranking up the ancient protections that the constitution provides? Are they wheeling out all their best outrage over our foreign policy missteps? Are they bravely stepping up to defend the rule of law? Are they taking on their assigned role as overseers of government? Do they give a damn?

Of course not.

Amateur hour indeed.

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Obamacare Replacement News

Well, there isn’t any.

Replacement is clearly a little more difficult than the Republican party thought it was going to be. In fact it is beginning to look a lot like being impossible. Whatever turns up, whenever it turns up, and however it is presented could be a monumental fudge.

Jason Linkins has a detailed history of how the Republicans have stuttered to where they now are. Which is basically where they were four years ago, if not more.

At this rate I think the GOP would be best advised to announce they have already replaced Obamacare with something called the Affordable Care Act and hope that no one notices that the two are the same thing. After all well over 50% of Republican voters apparently don’t know that the ACA is the proper title of Obamacare and, when asked, say that much prefer the former over the latter.

Slick marketing people have done this kind of thing for years. It’s called re-branding.

In any case all we hear or see from Republican leaders and various party experts is either total silence or a shuffling uncertainty leading nowhere. Apparently the latest efforts to get some sort of consensus has broken down and we are back to being told that they are working hard on developing a plan that will be announced soon. Or sometime. We also are being told that the replacement process is in disarray as people steadily learn that Obamacare represents the only solid way to accomplish its goal of making care more affordable and thus increasing coverage. Stepping away from any part of it means starting all over.

Even more awkward fro Republicans is that they are now realizing that fixing the parts of Obamacare they don’t like is relatively easy. They could do that quite quickly.

But they promised to get rid of it.

Oops.

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Not Friedman!

While I was checking the inner debates the Republicans are having about health care I came across this quote [in an article written by Tierney Sneed in TPM] from Representative David Brat, an extreme right winger:

“When it comes to how much you want to park in the HSAs for providing catastrophic care, that, when it comes, to the safety net, we have to find the Milton Friedman way of doing that,” Brat said. “The Price bill would do tax credits. I am not a fan of those because it keeps the federal government in the center of that.”

My heart sank.

Milton Friedman? Really.

His version of economics is simply an ideology cloaked in clever language. And it is profoundly anti-democratic.

Friedman’s stalwart libertarianism led him to develop an economics that started, unscientifically, with a built-in bias against communal action. This meant that anything the government did was, a priori, damaging to the magic that Friedman was desperate to ascribe to the workings of something he, and most economists, call markets.

Markets, you see, are wonderlands that always and inevitably lead to efficient outcomes. And it is no good any starry eyed liberal tinkering with those outcomes. They are magically correct. By correct we mean that they cannot be improved upon. Economists have this vice like attachment to certain core beliefs. One of those is that, if left unfettered, markets will zero in on an allocation of stuff that can never be improved, especially by meddlesome governments.

The way you get to this particular promised land is by letting the great forces of supply and demand batter away at individual preferences and budgets until all the trading and so on ends with no one able to make another trade without such a trade making someone else worse off. It sounds wonderful. Now to make this all work we have to believe in magic. We have to suspend our intelligence and imagine a world where everyone knows exactly what everyone else is doing, where no one cheats, where everyone is marvelously rational, where they don’t suddenly change their minds, where they can calculate at the speed of light, absorb vast amounts of data, and always — yes always — arrive at precisely that combination of stuff they wanted. Within the constraints of their budget of course.

The distribution of stuff in this fantasy world is not an issue to libertarians like Friedman. It is always deserved. It is always morally right. This leads the libertarians to have to argue that the distribution of original privilege and opportunity is equally deserved. They don’t care about egalitarian opportunity: what they are concerned with is the rationality of what people do with what they begin with — no matter how poor they are. Poverty is the individual’s fault.

Poverty, some of them argue, is relative anyway. Aren’t we all better off than our forbears? Yes of course we are. So, they argue, we ought not quibble about the distribution of wealth. Yes, we have poor people, but so what? They have lots of stuff our ancestors didn’t have. So quiet down and stop whining about redistribution.

Anyway, as Friedman argues, markets are never ever wrong. And markets can always fix any temporary problems: all those clever and rational consumers will punish bad companies and reward good ones, so we don’t need to regulate.

And so on.

It’s fantasy stuff. It’s patently absurd as a description of the real world. It is plainly ridiculous when you examine the contortions necessary to make it all work out the way Friedman says it does — he famously argued that we ought worry about the absurdity of the inputs to his reasoning we ought only focus on the veracity of the outputs. Naturally those outputs “proved” the efficacy of markets.

So, with this all swirling in my head I hope you can understand why my heart sank when I read that a member of Congress actually wants to build the real world in the image of the Friedman fantasy. It’s all simply ideology. It is an attempt to provide intellectual rigor to an anti-social policy outcome.

Beware of Friedman! He was an ideologue first and foremost.  His so-called economics were, in truth, a political agenda. Quoting him approvingly marks you as anti-democratic because he valued market efficiency over and above any other social outcome no matter how repressive the political process needed to be to arrive at that efficiency.

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