Wednesday, July 19, 2017

GOP Congress just can't do health care.

The House snuck through a bill that nobody had time to read and sent it to the Senate.   Now, after working behind closed doors, the third Senate attempt has just got shot down -- by their own people.

Yes, it's partly because they can't reconcile the Paul Rand conservative wing with the Susan Collins moderates.   But it's more than that.  It's the Republican ideology that I wrote about on Sunday, July 14th to explain why they can't craft a health care plan that works.   It's incompatible with their ideology.

Now, Mitch McConnell's latest plan took just a few hours to be blackballed by three women senators:   Collins, Murkowski, and Caputo.

Writing for latest New York magazine's "Daily Intelligenser," Jonathan Chait begins with a quote from a conservative discussing the 2009 financial crisis, who said:  "Maybe it was a good thing we weren't in power then -- because our principles don't allow us to respond to a crisis like this."

Well, now let's add health care as another thing their principles don't allow them to do.   Did they know that?     All these eight years they've been promising to "repeal Obamacare" as though it was the devil incarnate?   No wonder all that bluster was not backed up by any semblance of a workable plan.

Chait continues:  "The cohesion Republicans possessed in opposition disintegrated once they had power, because their ideology left them unable to pass legislation that was not cruel, horrific, and repugnant to their own constituents."

In promising "great health care at a tiny fraction of the cost," candidate Trump, Chait says, was merely sounding the "more carefully hedged promises his party had made for years.

"In truth, it was never possible to reconcile public standards for a humane health-care system with conservative ideology.  In a pure market system, access to medical care will be unaffordable for a huge share of the public.   Giving them access to quality care means mobilizing government power to redistribute resources, either through direct tax and transfers or through regulations that raise costs for the healthy and lower them for the sick.  Obamacare uses both methods, and both are utterly repugnant and unacceptable to movement conservatives. .. .

"In no other country would a conservative party develop a plan for health care that every major industry stakeholder calls completely unworkable.  [i.e. Cruz's amendment to eliminate minimum coverage and pre-existing conditions requirements].  Any attempt to resolve the contradiction between public demands and conservative ideology has led the party to finesse it instead. . . .

"The Trump administration might lash out at Obamacare by continuing to sabotage its functioning markets.  They will find, however, that sabotaging the insurance exchanges will create millions of victims right away, as opposed to the luxury of delaying the pain until after the elections."

And Chait concludes with this:  "The power to destroy remains within the Republican party's capacity.  The power to translate its ideological principles into practical government is utterly beyond its reach,"

So much wisdom and understanding emerging -- just the conversation we should have had during the 2016 campaign.   Instead, we had Trump mania.


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