3D Chess with Health Care

[Michael Stuart Kelly]

3D Chess with Health Care

People know of my enthusiastic support of President Trump. Some might wonder why I haven't talked about the repeal of Obamacare.

Frankly, I haven't known what to think until now. The way it was unfolding was soooooooo ulike the way Trump does things, I've been scratching my head. But after the Republican plan was withdrawn, it became clear to me.

It's another 3D chess move by the president.

I haven't seen anyone recently discuss the original intention of Obamacare. It was designed to fail.

This was widely discussed before it passed, then this angle went down the memory hole as it started to be implemented. The idea was that once the insurance companies left the exchanges and the thing was falling apart, Obama (or other progressive, say, Clinton had she been elected) would help ramp up the public clamor of pain, then blame it all on the greedy insurance companies. At that point, they would ram through a single payer health plan without serious opposition and slay the insurance company villains in one fell swoop.

I think President Trump just took over Obama's designed to fail plan and is using it for his own ends. 

Think of the benefits to him once Obamacare becomes unbearable. 

1. He breaks the Democrat alliance against him since many Democrats will come on board to help negotiate a way out of the mess they now own 100%.

2. He breaks the back of all-or-nothing entrenched Republican sides since he will have Democrats on board.

3. He will be able to engineer a plan he believes in based on popular support rather than a big fat compromise with special interests. 

4. He gets the Koch brothers to finance the midterm campaigns of folks who will vote for the plan he ultimately wants because they have committed a half a trillion dollars or so to this end, saying anybody who voted for Ryancare would not get any money.

And on and on...

All he has to do is weather the gloating and snark from the clueless mainstream press (which is business as normal for him) and make sure the "evil greedy insurance companies" are not set up as the villains for the collapse--in practice--of Obamacare. Now, with the Republican plan flop, that will be easy.

When the kaboom starts to hit, he can say the Republicans tried, but Obamacare was too much of a mess to do it the traditional way. So not only are Obama and the Democrats to blame for the mess (they, not the insurance companies become the villains in the public mind), there needs to be a radical solution... etc., etc., etc.

Like he said to the press today, he was elected to repeal and replace Obamacare, but he made no promise to do it in 60 days.

I stand in awe.

 

Michael

[william.scherk]

26 minutes ago, Michael Stuart Kelly said:

He will be able to engineer a plan he believes in

What plan does he believe in? Presumably he believed in yesterday's plan, if only as 'good enough' to fulfill a promise. 

Where do we start exploring the 'plan he believes in'?  I mean, what are the principles and priorities?  What kind of systematic fix does he want on the other side of tomorrow?

[BaalChatzaf]

2 hours ago, william.scherk said:

What plan does he believe in? Presumably he believed in yesterday's plan, if only as 'good enough' to fulfill a promise. 

Where do we start exploring the 'plan he believes in'?  I mean, what are the principles and priorities?  What kind of systematic fix does he want on the other side of tomorrow?

I think Trump has/had  only one idea.  Repeal ACA.  I don't think he has gotten much beyond that.  Do you think Trump can actually conceptualize a plan without working out all the minute details?

[jts]

36 minutes ago, BaalChatzaf said:

I think Trump has/had  only one idea.  Repeal ACA.  I don't think he has gotten much beyond that.  Do you think Trump can actually conceptualize a plan without working out all the minute details?

As long as it is normal for doctors to not be in the business of putting themselves out of business, no so-called health care plan devised by any politician will be satisfactory.

In a free market (which we don't have), every doctor would be in competition with other doctors to get people well and to keep them well. In other words, the only way a doctor would be able to stay in business would be by doing his best to put himself out of business and to do it at a lower price, in competition with other doctors who are doing the same.

Then and only then you will have a satisfactory health card system.

 

[Michael Stuart Kelly]

3 hours ago, william.scherk said:

Where do we start exploring the 'plan he believes in'?

William,

That's perfect! Who could possibly resist?

So here goes.

Since you were fine with passing Obamacare first so you could see what's in it, why not keep that standard?

 

(I'll give a better answer tomorrow. I'm tired, but I had to make that comment. The setup was just too perfect.)

Michael

 

 

 

[william.scherk]

2 hours ago, Michael Stuart Kelly said:

Since you were fine with passing Obamacare

Obamacare is a monstrosity. The GOP has been selling its noose, shroud, and coffin for 7 long years.

This was an opportunity to de-bone a grotesquely complicated and intrusive law. I am sure opportunity will return and that Trump will champion a replacement -- given time and design. What the hell the GOP did with seven years ...

In the end, the monster ACA became law because it 'fixed a problem' that other Western industrialized nations 'fixed' further back in time. In other words, universal access made manifest through various national schemes, while the USA remained an outlier, with a significant minority unable or unwilling or unprompted to get basic health coverage.  

I think that the ACA will stand until there is consensus that a better ACAnstein can be designed. From north of the border, it all seems so bizarre. We 'solved' the problem in the 1960s by federal imposition, after a fruitless strike by doctors in Saskatchewan.  It took only a few years for a Saskatchewan solution to be imposed on all provinces, and a remarkably short time for the new regime to come on line: universal, portable, accessible.

What you call Medicaid is basically all that Canadians get, universally. Meaning that there is lower overhead. No extra layers of administration, no middlemen HMOs, no thousands of differing insurance accepted at which thousands of facilities. It is all integrated and smooth as a socialist candy apple.

Just kidding. But while the 'solution' forced on provinces and doctors and insurance companies and public service is probably much more monstrous than a 'mixed' Obamacare could be (from an O'vish POV), it yet did not grow over the years. Administration is no more costly now than it was then. There hasn't been an inflation of associated costs as in the US systems, or middlemen and adjusters. So the bizarre nature of ACAnstein comes from its huge, ungainly, stitched-together lumbering mass. 

The bill headed for failure under Paul Ryan was a hack on a hack, with costs and benefits chopped out and sewn back on. Behold AHCAnstein!

More seriously, the polls show the bill on offer stank up the house.   Acanstein is still more popular than Ahcanstein, so what are you gonna do. Get your own people to put together a bill that does exactly what you think Replacenstein would do.  Then fight like hell to give it life.

But obviously, take the time necessary to perfect the plan.

 

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Edited March 25, 2017 by william.scherk
Abominatrix.