The Republican vision of health care

So, one of the freedom caucus yahoos let out what he really thinks about health care and why we shouldn’t have pre-existing conditions.  Chait’s take:

In a CNN interview, Representative Mo Brooks, an Alabama Republican, makes the case for Trumpcare in much starker terms: It will free healthy people from having to pay the cost of the sick. “It will allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool that helps offset all these costs, thereby reducing the cost to those people who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy,” explained Brooks. “And right now, those are the people who have done things the right way that are seeing their costs skyrocketing.” …

Of course, you can’t pay your own way if you’re too poor or sick to afford your own projected medical costs. Indeed, sometimes people who are healthy at the moment find one day they are not, or they have a sick child, or maybe they simply want to have a baby. (The cost of bearing children is another one Republicans want to be borne entirely by those doing it.) The Republican plan expresses one of the core beliefs shared by movement conservatives, and utterly alien to people across the globe, right and left: that people who can’t afford the cost of their own medical care have nobody to blame but themselves.

I saw some pretty good responses on twitter (the most recent are here).  My own would be along the lines of… shame on my 14-year old son for letting his genome undergo a random mutation in utero.  No health care for him!

Quasi-related, I did enjoy Jimmy Kimmel’s heartfelt story about his newborn son and the importance of health care for all.  But, in his need to be politically neutral and not Colbert, he definitely got the politics wrong.  Thus, really enjoyed this from Isaac Chotiner:

“If your baby is going to die, and it doesn’t have to,” Kimmel continued, starting to tear up again, “it shouldn’t matter how much money you make. I think that’s something that, whether you are a Republican or a Democrat or something else, we all agree on.” The crowd burst into applause. “We need to make sure the people who represent us, the people who are meeting about this right now in Washington, understand that very clearly. Let’s stop with the nonsense. This isn’t football. There are no teams. We are the team. It is the United States. Don’t let their partisan squabbles divide us on something every decent person wants.” [emphasie mine] Again, huge applause. “No parent should ever have to decide if they can afford to save their child’s life.” …

Note that Kimmel laid the blame for this “nonsense” at the feet of “partisan squabbles.” In his telling, the fault lies not with one of the “teams” but with the games they play in Washington, at the expense of the rest of us. But this is an untenable analysis of the political present.

Kimmel might have paused to ask exactly why the positive change in health care reform that he described occurred in 2014. If he had, he might have noticed that it was the result of another “partisan squabble”—i.e., a bill that the Democratic Party had pushed and passed and that the entire Republican Party had made it their singular mission to oppose.

Now, with a new House bill on the verge of possibly being voted on, the parties are once again divided, with the entire Democratic Party lining up against a bill that would very likely do great harm to people with pre-existing conditions, leaving them with coverage gaps and high premiums. About 85 percent of House Republicans support this bill, as does the Republican president. Despite his promise to care for people with pre-existing conditions, Trump quite clearly knows as much about the bill he backs as he does about the Andrew Jackson presidency, which is to say very little.

I’m glad Kimmel believes that all decent people want to cover pre-existing conditions. I’d like to believe that, too. But a good chunk of America just voted for a president and a party that do not care at all about providing health insurance for needy Americans, whether or not their medical problems are pre-existing. Those Americans chose that “team.” Kimmel seemed to briefly acknowledge this fact during another, better part of his monologue, when he rebuked President Trump, by name, for proposing a cut to the National Institutes of Health. On the issue of health care, however, Kimmel was determined to blame the system.

But the problem in Washington is not partisanship per se. It’s an ideologically deranged party and its know-nothing leader in the White House.

All that said, the good news is that the political ground has shifted tremendously in 8 years and it seems highly unlikely to get a bill through both the House and Senate that would gut the pre-existing conditions mandate and throw millions of health insurance.

The budget deal

I swear I read a half dozen stories/posts on the matter yesterday, but it was only Vox that managed to explain why Democrats had so much leverage to get such a good deal:

Republicans, despite controlling both houses of Congress and the White House, had a problem when it came to funding the government: They needed Democrats to sign on.

Unlike Trump’s Cabinet nominations, which only a need a simple majority of 51 votes in the Senate to pass, a spending bill needs 60 votes — meaning Republicans in the Senate need their entire party and at least eight Democrats to sign on to the omnibus.

If Republicans didn’t need Democrats to pass a bill, they could have hiked defense spending, appropriated money to start Trump’s border wall, and maybe even defunded Planned Parenthood (although Speaker Paul Ryan has said that belongs in the health care debate).

But from the beginning, Senate Minority Leader Chuck Schumer and House Minority Leader Nancy Pelosi warned Republicans that any attempt to fund the border wall, roll back environmental and consumers protections, or pull funding from Planned Parenthood would meet with unified Democratic opposition.

It appears as though Democrats got their way — and conservatives got almost nothing they wanted.

Because Republicans needed Democratic votes to fund the government, the result was a spending package that was a tough sell for conservatives. The more Republicans lost votes on the right flank, though, the more Democrats they needed to avoid a shutdown — so the spending bill kept moving ever-further left. As the chair of the Democratic Caucus, Rep. Joseph Crowley, said last week, the negotiations made it apparent that Republicans would need Democratic help to pass the bill in the House as well.

And, of course, what this means is that Democrats have gotten pretty smart about how to use their minority power.  As Republicans showed under Obama, the vast majority of the public doesn’t really get this 60 votes in the Senate thing.  They just expect the party in power to get things done and blame them if things don’t get done.  The reason Republicans so completely caved is because they were confident (and correct) that they would bear complete blame for the shutdown.

Nice summary of the deal and the winners and losers in another Vox piece:

It’s worth taking stock of just how far the agreement from is from what Trump initially demanded.

Trump wanted billions to build a wall on the Mexican border. He didn’t get a dime for it. He wanted staggering reductions to medical and scientific research. Democrats successfully won a $2 billion increase in funding for the NIH.

Trump proposed cutting the EPA’s budget by 31 percent. He wanted to gut the State Department with a 29 percent cut, and weaken the Labor Department by reducing its budget by 21 percent. All three of the agencies will keep essentially their entire funding streams.

Also, no cuts to Planned Parenthood.  and some help for Puerto Rico.  As for Trump’s vaunted dealmaker status?  Not so much.

%d bloggers like this: