Friday, March 24, 2017

Put A Fork Into Trump Care (And Obamacare Repeal) - It's Dead

"Trump is no longer a CEO sitting at the head of a board table anymore, where he can just pound his fist on a desk and make a decree. He's learning that you've got a lot of different constituencies, and people who believe certain things. In this case the Freedom Caucus, who aren't willing to move off them. This will be a learning moment for Trump and we'll see if he moves on from it. There is no question he's been damaged by it." - Willie Geist, on ''Morning Joe' today.

After all the months of shouting, hoopla, hype and braggadocio, the 'fat lady' has finally sung and it appears Paul Ryan's and Trump's monstrous (AHCA) plan to make America sicker is dead.  Mothers and their sick and disabled kids can once more find succor and solace in the imminent defeat of this terrible bill and sleep the sleep of the just each night.  This will be in contrast to the restive nights that await Paul Ryan's cabal of extremist nincompoops who believed they could rip away health care for millions and not pay a price.

How could they not after the latest iteration (thanks to pressure from the Freedom Caucus)  included nixing ten essential health care benefits. These included: hospitalization, maternity care, prescription drugs and mental health services

As one pundit described the latest mutation of this hybrid monstrosity last night:

"What is so shocking is the White House does not care what the content of the bill is. But the bill isn't some abstraction. It's the entire health insurance market for a nation of 330 million people. You can't just negotiate it like you're doing a development deal in Atlantic City....If this bill does fail and they just drop it, the cost of substantively making people's health care worst is worse than the short term political cost of failing to live up to Trump's promises - as bad as that's going to be."

What was especially hilarious yesterday was reading Karl Rove's op-ed piece in the WSJ raking the Dems over the coals for their opposition to this foolishness and "lack of governance".  But last I checked, total resistance to an opposition's bill pays huge dividends. Look how it panned out for Mitch McConnell and his gang who vowed back in 2009 they'd block every and anything from Obama.

Most people who only casually read about this Ryan -Trump creature on offer are only vaguely aware of the damage it would do, if passed, especially now that the Freedom Caucus managed to insert a few of its concessions into it. For example, it would amount to a wholesale rollback of the most popular parts of the Affordable Care Act and a complete deregulation of the insurance industry coupled with massive subsidies which would be a recipe for essentially a million different 'Trump university' -style health care operations to spring up. These would offer people scam insurance even as they collected federal dollars.  That's what would transpire if this hybrid monster were to pass. But my bet is that it won't.

The beauty of the Reepos' predicament is that the seed of the Ryan-Trump health care plan's destruction was there all along. It was apparent to anyone with the eyes to see it, who understood the political dynamics at work. On the one hand a band of 24 or so extremists from the Tea Party calling themselves the "Freedom Caucus" who'd already sent Johnno Boehner back to his Ohio home with this earlier intransigence, and on the other hand the remaining Reepo moderates who inhabit states for which any level of repeal would be horrendous.

Hence, it is not amazing or astounding to see that as the concessions for the Freedom Caucus bunch have been added, the moderates have peeled away. Hence, Ryan and Trump can't keep the whole together moving toward approval. They are playing whackamole, with a moderate fleeing each time a Tea bagger comes on board.  No wonder Dems are delighting at the spectacle, as the people who would be adversely affected should be as well.

The 'pukes never understood, especially the Tea Bagger faction, that the Dems under Obama succeeded in getting their ACA through because they were willing to take very tough votes. After all, the Left was furious - as much or more so as the Freedom Caucus - when the public option got left off the table in committee., But they understood that getting 'half a loaf' was better than getting none. It was better more people would get access to health care than the number remained at the status quo. And so they sucked it up and moved on since as a party they believed in the project. The Freedom Caucus , despite all its rhetoric, has no such commitment and would rather there be zero loaves than that they abdicate their principles.

But this is why the Trump, Ryan plan has been doomed from the start.  First, because their whole project has never been affirmative, i.e. actually making the health care system better, but rather destructive, or mainly abolishing Obamacare. Second, they always harbored a band of extremists who had never been prone to compromise in the past and assuredly wouldn't do so now.  The way the WSJ editorial today (p. A14, 'The Freedom From Reality Caucus')  portrays these arch conservatives is telling:

"By insisting on the impossible over the achievable, these self-styled guardians of conservative purity could become the worst friends conservative ideas and free markets have had in decades."

Lastly, the "free market" baloney pushed as the basis of the plan was always codswallop. This is  because no one who knew free markets would be so daft as to believe they'd support affirmative health care for loads of sick people, e.g. frail elderly or those with pre-existing conditions. This isn't rocket science or astrophysics. For profit insurance companies exist - wait for it- FOR PROFIT!  That means they will not willingly insure people who are high risk, at least not without huge offsets.  That generally means a big pool including millions of healthy people to pay for the sick ones.

Hence, Mick Mulvaney's palaver this a.m.:

"We want to take Obamacare away and give people the control and options that they want, the quality they deserve, and the affordability that they need."

A snake oil salesman peddling a new brand of arsenic couldn't have done better in terms of the BS meter. But this twit did offer a "solution" to those who are worried: they can move to a different state that offers more benefits.

If that doesn't materialize the only alternative is what the Freedom Caucus zealots are offering: bare bones plans with ginormous deductibles, and not even providing basics like maternity care, cancer screening and prevention. Oh, and forget about extending coverage to kids (adult children) on a parent's plan or allowing for pre-existing conditions.

Here's the final takeaway: Even if this mutant of Trump's and Ryan's were to somehow pass the House today, it will be dead on arrival in the Senate. You can make book on it. So no Reepo or Trump lover ought to celebrate even if I am proven wrong today and this mishmash manages to get enough Reepo dopes to "walk the plank" - as Sen. Tom Cotton put it.

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