"The central doctrine of Christianity, then, is not that God is a bastard. It is, in the words of the late Dominican theologian Herbert McCabe, that if you don’t love you’re dead, and if you do, they’ll kill you."--Terry Eagleton

"It is impossible for me to say in my book one word about all that music has meant in my life. How then can I hope to be understood?--Ludwig Wittgenstein

“The opposite of poverty is not wealth; the opposite of poverty is justice."--Bryan Stevenson

Thursday, November 17, 2016

I used to think it was the hubcaps....

There's a reason the GOP has never seriously put forward any effort to repeal Obamacare:  they don't want to.

"The exchanges are the first problem, they need to be repealed, the individual mandate needs to be repealed. There are a number of things that need to be repealed, but I think what we need to focus on first is what would we replace it with and what are the steps that it would take to do that?" he said. "Preexisting conditions will stay. There is no way the Congress is going to repeal preexisting conditions. it might take a different form, but people with preexisting conditions are going to be able to buy insurance in any replacement plan Republicans put forward."

There is no plan to replace Obamacare, which is why Paul Ryan couldn't tell Andrew Cuomo what would happen to coverage for birth control.  And you can't repeal the individual mandate without destroying the entire basis for universal health insurance coverage under the Affordable Care Act.  Indeed, the best way to lower insurance costs is to get even more people who don't need healthcare at the moment, to get insurance under the ACA:  that would increase the pool of money available, while diluting costs for the sickly, and so lower prices.  Remove the individual mandate, people jump out of the pool, the cost per person staying behind rises precipitously.

Of course, the real problem with the ACA is expecting those mysterious "market forces" to solve the problem in the first place.  For reasons too numerous to discuss, healthcare doesn't respond to supply and demand the way the international oil market does.  Then again, we are now awaiting the ascension of a President who doesn't understand that Japan pays 60-70% of the costs of the U.S. military bases on its territory, and so presumes Japan (and other countries similarly situated) pay nothing for the U.S. to be there.

We are guided by idiots, in other words.  Ignorant buffoons who think ignorance is a substitute for knowledge.  Clowns who think they can repeal the individual mandate to buy insurance, but still require insurance companies to overlook pre-existing conditions, and look to the market to continue to keep costs down; when the whole reason not to cover pre-existing conditions is to keep the costs of insurance down.  That's the way the market works; which is one of the many problems with relying on the market to take care of costs in healthcare. (You'll notice Sen. Alexander never says how the circle can be squared without just keeping the ACA as it is; but at the same time, he says that's what we have to do.)

And frankly, the Republicans understand this, which is why they don't have a plan to replace Obamacare.  They say they want to "reform" Medicare, too, and can do it through reconciliation.  But they know they can't; and eventually they'll blame the Democrats for their failure to do so.  The only alternative the GOP has is single-payer; because Obamacare is their program.  If they could just rename it, they'd be happy with it.

But they've made it the car they have to chase, and the GOP has one strategy: never, EVER, catch the car.  Every so often somebody needs to go out and say that they probably can't catch it as soon as they said they could so they can keep running and baying and finding another moving object to chase.

Watch the doughnut, not the hole.


Blogger June Butler said...

One way to move forward incrementally would be to open Medicare to anyone who wants in (aka the public option) and attract younger, healthier people, which would keep costs down. I expect if that happened, a number of employers might drop their health insurance plans, especially small businesses, which could eventually lead to something closer to single-payer.

Will this happen? Not soon. We'll probably limp along as we are for some time.

8:43 PM  

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