Tuesday, July 18, 2017


At Reason, Peter Suderman says what killed repeal-and-whatever was the incompatibility of the "moderate" and "conservative" Republican viewpoints and the leadership's feckless disregard for the principles at stake:
The confusion over the single risk pool was the Republican confusion over health care in distilled form: Conservatives proposed an idea intended to loosen the grip of insurance regulations, but that might have ended up more expensive in the long run. Leadership used that idea, but modified it in a way intended to appease moderates. That modification would have made the provision work at cross-purposes to its original intent, or maybe not at all. It was a compromise that ended up providing nothing for anyone...

The disagreement over the single pools regulation may seem wonky or obscure, but it represents the whole of GOP disagreement over health care in miniature. Moderates want one thing; conservatives want another; leadership just wants to pass something and doesn't care much what it is—and the result is legislation that doesn't make any sense, as policy or as politics.
But this could describe any legislation, defeated or successful -- the reconciliation of opposing principles, under the guidance of leadership, to produce a bill.

What really doomed the bill was something Suderman won't mention: The seething anger the plan in all its forms provoked among the public. By the end it was on its way to single digit support -- with its supporters in all but the most benighted GOP districts shortly to follow. Obamacare is a Rube Goldberg machine for dispensing health care and everyone has good reason to hate it, but it doesn't necessarily follow that people would be happy to replace it with Pay or Die II; if your boiler goes out every morning, the way to better heat yourself and your family is not by setting the house on fire.

Also, unlike the saps who work at wingnut publications, Republican politicians know that they're not really beloved of the public -- they just vote for them because they hate Democrats, gays, women, Mooslims etc. For validating their contempt, they'll reward Republicans with office, and even applaud their stupid bathroom bills and whatnot. But they're not going to die for them, nor let unforeseeable illness send them to the poorhouse so Paul Ryan can fall to his knees in his St. Ayn chapel blubbering "We did it, Ms. Rand."

Trump's instinct to blame the Democrats, while nuts, is about the best strategy they've got now. You can see the brethren working on it already: At USA Today, Texas Public Policy Foundation analyst Chris Jacobs blames "Liberal Medicaid alarmism.... The liberals who claimed this year’s Republican health bills would 'cut' Medicaid" -- interesting choice of scare quote, that -- "are the same ones who endorsed Obamacare’s reductions in Medicare spending." Yeah, but 1.) The voters are still getting their Medicare benefits, so what do they care, 2.) they at least dimly intuit that the Medicare money went to another health care program, Obamacare, whereas anyone, even the dimmest gomer in Gomer Gulch, knows that whenever a Republican defunds a program, the money goes straight to Montgomery Burns and the guy in the top hat from the Monopoly game.

Jacobs ends by claiming the left "did the American people a disservice by detracting from the debate on health care that our country deserves." But there never was a debate; merely a round of Who Do You Trust. Voters may hate the Democrats for their association with people they've been trained to hate, but they don't think Democrats are going to kill them. About Republicans, really, what sentient American would say the same?

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