The Emperor's New Healthcare Plan
There's one thing you should know about President Donald Trump's new healthcare plan: it does not exist. It has never existed. Perhaps in some metaphysical sense it does exist, but only when you ponder the question: "Does a thought of something that does not exist actually exist?" That is the only realm in which Trump's magic healthcare plan might be said to have an existence; as a vague, ill-defined wish for a magic plan to cure all ills, both medical and political. Other than that, it exists precisely as much as the Emperor's new clothes exist, which is to say: "Not at all."
Not unlike those regal garments, though, Trump will soon demand that all his faithful sycophants praise his new yet-to-be-revealed healthcare plan to the skies as the best thing to come along since sliced bread. This is because his hand was forced at a recent town hall event by George Stephanopoulos, who asked Trump why he hadn't released his wondrous plan that he's been promising to the American public almost nonstop for the past four or five years. Stephanopoulos pointed out a few examples (among many) of Trump promising journalists that his healthcare plan was almost ready and would be announced within a matter of weeks -- only to have these deadlines repeatedly pass with no plan in sight. Trump was put on the spot, so he upped the ante. The magic new plan was not merely aspirational (a few weeks in the future), but actually existed right now. It was "all ready to go," Trump promised the country, and it would be better than anything George had seen in his entire lifetime. Since then, his aides have been echoing this rosy assessment of the plan (which does not, in fact, exist).
Once again, for those who have been in a multiyear coma, Trump has been making this promise for over four years now. He's promised an imminent plan over two dozen specific times as president, and it was a huge campaign promise when he ran in 2016. Trump's plan (he swore) was going to be "better and cheaper" than the dreaded Obamacare. He was a deal-making genius and had brilliantly come up with the answer to the problem, details of which he would be announcing any day now. During the 2016 campaign, he began by promising he'd release his plan before the election. This was back when he was also promising he'd publicly release his taxes, though. Neither promise was kept. He then shifted to the Nixonian strategy of saying he had a "secret plan" for healthcare that was so downright amazing that he couldn't release the details until after he got elected. He promised he'd do so immediately upon taking office.
Trump then got elected, took office, and no plan emerged. Trump then threw all his political weight behind the Republican "repeal and replace" movement, which failed by one vote in the Senate. Senator John McCain voted against it because, as he pointed out, there was no "replace" included in the repeal bill. This is because congressional Republicans had never managed to come up with their own Obamacare replacement plan on their own. They still haven't, by the way. They have now given up even trying, after the Senate repeal failure.
Throughout all the myriad attacks on Obamacare which Trump launched, he kept insisting that right after it was repealed, he would introduce his own spectacular plan to replace it. This became a bigger issue in the 2018 midterm elections, as Democrats pointed out that repealing Obamacare (or overturning it in the courts, which Trump is also actively trying to do) would mean removing all the good things people had come to love about Obamacare, including protections for people with pre-existing conditions. Trump was directly asked about this very subject in the ABC town hall, by a voter who told the president that she would be dead within 72 hours if Obamacare disappeared with no replacement. This was what prompted Stephanopoulos to pressure Trump on his non-existent plan, in fact.
Now that Trump upped the ante, the White House is left with the unenviable task of throwing something (anything!) together in a few days that might fool people into thinking Trump does have a plan (spoiler alert: he doesn't). Their basic problem, however, is the same one that has confounded Republicans all along -- Obamacare is actually a very conservative idea. It came from the Heritage Foundation and Mitt Romney, after all. So it's pretty much impossible to create a GOP alternative which is ideologically to the right of Obamacare which is anywhere near as good as Obamacare itself.
Every attempt Republicans make at throwing their own non-Obamacare plan together has had the exact same result. It can be cheaper, but not better. It could be better but not cheaper, too, but Republicans shy away from anything more expensive because of their own empty promises to come up with a cheaper plan. All the GOP plans would cover fewer people, have far fewer patient protections built into the law, be more expensive for consumers -- or all three at once.
Trump has been promising the impossible, because he swears up and down that his plan will be much cheaper -- both for the government and for the consumer -- and far, far better than Obamacare. This simply is not possible -- just ask any of those congressional Republicans who have tried to square this circle. Replacing Obamacare with a better plan is possible, but more expensive (for either the government or the consumer, or both). Replacing Obamacare with a cheaper plan is also possible -- but it would be far worse, by any measurement.
President Barack Obama and the congressional Democrats who hammered together the Patient Protection and Affordable Care Act had to juggle a whole bunch of competing interests. They achieved some goals (such as protecting pre-existing conditions and banning lifetime benefit caps), but fell short on others (providing a public option to buy into Medicare). But they did so in consultation with the health insurance industry, drug companies, hospitals, and doctors. They balanced all the wants and needs of these groups and came up with Obamacare.
But you cannot separate the parts you like from the parts you don't like, because the overall deal doesn't allow for it. You cannot -- as both Trump and the Republicans have learned to their chagrin -- just dictate "protect pre-existing conditions" without the rest of the plan to back it up. Every attempt to do so has failed. Republicans' lack of an answer to this is one of the major reasons why they lost control of the House of Representatives two years ago, in fact.
Whether Republicans (and Trump) like it or not, Obamacare has set a bunch of healthcare standards. It protects consumers from all the worst excesses the health insurance industry used to be allowed to get away with. It expanded coverage and made it cheaper. The number of people with health insurance has gone up by the millions. Those are all now benchmarks that any replacement plan will have to meet. Obamacare is not perfect (far from it), but it did solve a whole bunch of very real problems for millions of people. Any replacement will have to do the same, or be widely rejected by the public.
Trump's White House now has this impossible task to accomplish, in a very short period of time. Trump just promised that his magic plan already existed, so he's now got two options, neither of them very appealing. He could quickly cobble together some half-baked ideas and call it a plan, or he could revisit his Nixonian "I've got a secret plan, which I will share with the public right after the election" strategy.
By the way, Joe Biden does have a plan to improve and build upon Obamacare. It may not be the best plan, but it does have the benefit of actually existing. Biden's plan is far more timid than the "Medicare For All" idea other Democrats ran on, but once again, it actually does exist.
Donald Trump does not have a plan at all. He never has had one. He is a con man, plain and simple, and he's been running this con for a long time now. All he's got to show for it is magical thinking -- that Obamacare can very easily be replaced, with a much better and far cheaper plan that covers as many people and offers the same protections. But after ten full years of Republicans trying to solve this conundrum, the clear conclusion has to be that such a plan is downright impossible. If it were possible, the Republicans would have stumbled upon it by now. Since they haven't, it isn't. The Republican plan has never existed. Neither has Trump's. Now that he's promised that his plan is already finished (something he hasn't done since the 2016 campaign, I believe), he's going to have to either put up or shut up. What will almost certainly happen is his White House staff will throw together some sort of executive order that comes nowhere near actually replacing Obamacare, but perhaps tinkers around an edge or two. Trump will then demand fealty from all other Republicans in the form of high praise for the stunning beauty of his wonderful new invisible clothes. No doubt he'll get at least some of this.
But no matter what the crowd of toadies is yelling, one thing will remain unalterably true -- Trump's "far better and far cheaper than Obamacare" healthcare plan simply does not exist. It never has, and it never will.
-- Chris Weigant
Follow Chris on Twitter: @ChrisWeigant
@don,
that is an image nobody needed. now kindly shut yer piehole. preferably with pie.
JL
Bweep! Bweep! Bweep!
Another killer Lincoln Project offering.
The fact that -- day after effing day -- The Lincoln Project is so much more devastating than anything I can ever recall the Democrats coming up with tells me the Democrats have pretended to be ineffective since Saint Ronnie because they're OWNED by Big Money.
Goddamn. If only Don Harris was still alive!
Death Harris
2
The Deathocrats are just as naked as the Republikillers.
Said the perpetual parasite who obsesses over them both.
And so are the media that pretends the CMPs are not naked and provides cover for the CMPs by hiding the CMP's genitals in their mouths.
Yet here you are again.
Which is why the media literally sucks.
Said the whining perpetual mooching circle jerk who's been salivating near daily on this blog for multiple years for the media's lip service.
Wake up. Wise up. Rise up.
Pervert.
Your Red Card is long overdue.
nypoet22
3
that is an image nobody needed. now kindly shut yer piehole. preferably with pie.
This.
Kayleigh McEnany is already explaining that there IS a plan, but it's a secret. In 2016 it was absurd, but somehow workable, for Trump to say he had a secret plan when none of the other Republicans had much of anything to say at all.
This time round, I think it will be very difficult for either McEnany or Trump to convince anybody that their "secret" plan is better than the one that Biden openly provides.
MtnCaddy,
The Lincoln Project is so much more devastating than anything I can ever recall the Democrats coming up
That's what's known as an assertion. What's your evidence that these ads are devastating? The fact that you find them convincing? Ever heard of preaching to the choir?
If only Don Harris was still alive!
Yeah. If only there were more Russian tools like Death Harris out there to discourage people from voting so that the orange swamp thing can hang on!
Death Harris,
Do you currently have heath insurance? Who pays for it? Don't dodge.
I used to work for Blue Cross and Humana. I consistently voted for those who promised an end to my employers and job. On the other hand, a large percentage of Americans will not vote for an end to employer-based health insurance. It's bizarre, but Americans are not good at math.
Contrary to what Death Harris promotes, sitting out elections does not get you what you want. Until those who want real universal healthcare start voting, nothing will change.
Death Harris,
Isn't that like burning down the village to save it?
Are you afraid that somebody has stolen your plan?
Trump Claims Dog Ate His Health-Care Plan
By Andy Borowitz
September 17, 2020
Donald J. Trump’s promise to release a long-delayed health-care plan hit a snag when his dog ate the only existing copy of the plan, the President disclosed.
“I left the plan on my desk, and somehow the dog got up there and ate it,” he said. “It’s a bad dog, quite frankly.”
Trump’s explanation met with raised eyebrows from the White House press corps, none of whom had been previously aware that the President had a dog.
https://www.newyorker.com/humor/borowitz-report/trump-claims-dog-ate-his-health-care-plan
Speaking of Trump and Healthcare, one of the topics at the WHO health presser today came up when Jamey Keaten, Associated Press asked the panel about their thoughts on what the CDC director Redfield said about masks being better protection than a vaccine and on what Trump said about masks not being good and that a vaccine will be ready by next month and did any of them agree. Jamey always elicits great responses from the panel but they never take the Trump bait.
Here are the remarks by Dr. Ryan in response ...
"Consistent messaging is very important from all levels, between science and government and across all of the different topics. This is complicated stuff; data, information, evidence, guidance changes and so it isn't easy for everyone to be on message, all the time.
"But what is important is that governments and scientific institutions step back and review the evidence and give the most comprehensive and easy to understand and digest information so people can take appropriate action.
"We also need to take a look at the tools we have right now. We sincerely hope and we are working very hard at WHO, under the leadership of DG Dr. Tedros and with our partners, to drive the development of safe and effective vaccines. But, we don't have those vaccines now. What we do have are well-tested strategies that we know work.
"As Dr. Tedros always says, it's not about doing one thing. It's not just about masks; it's not just about physical distancing and avoiding crowed spaces; it's not just about hand hygiene and respiratory etiquette. DO IT ALL!
"Governments need to get that message across and continue to get that message across to communities and they need to empower communities to take action. There's nothing worse than being told what to do when you cannot do it because you don't have the resources or the education or the knowledge.
"There is a process for transferring knowledge to people and it's not just shouting at them. It's communicating with them; it's engaging them; it's understanding the confusion. It's understanding their concerns and apprehension and not laughing at it or turning it into a political football.
"It's about genuinely communicating with people and genuinely recognizing that this is confusing and upsetting - communication is something that all of us need to strive to be better at - politicians, scientists, doctors, nurses, parents, teachers - everyone needs to become better communicators and take that responsibility seriously."
In the environment envisioned by Dr. Ryan, it is easy to see what a competent response to this pandemic looks like.
Dr. Ryan also made some very important points about how we prioritize healthcare spending and how it needs to change. Hopefully, this pandemic and the gaps in healthcare that it has exposed will be impetus enough to make those changes.
Thursday was World Patient Safety Day and its motto was, ' Safe Health Workers, Safe Patients' and it all ties in with what needs to happen to strengthen healthcare systems globally.
Dr. Ryan's remarks:
"There are 3 things that haunt frontline health workers: (1) to stand there and watch people die because you can't help them; (2) to see a worker fall and be infected, your colleague and friend; (3) what really preys on health care workers in most of these situations is the chance that they could take an infectious disease home to their families, their children, their friends.
"So, frontline health workers are working under immense pressure and they are extremely courageous. The best we can do is give them the tools, the training and the environment in which they can do their work at the safest possible level. Because when you feel safe you do better and your performance increases. And, that's what we want - highly performing, highly skilled health workers operating in an environment where they can turn all of their knowledge into solutions for patients. If they are concerned about their safety, they won't perform as well.
"So, if we want to make this a cold, logical argument, a protected health worker is an effective health worker.
"We should truly celebrate frontline community nurses and public health nurses. Often the first medical person a child sees is a public health nurse and the last person is a public health nurse during end of life care.
"We should also, and we do, celebrate sophisticated hospital-based medicine. It's huge, it's cutting edge and it takes us to the next level of care. But, sometimes we forget the lives that are saved in communities by community care workers.
"We see that now in public health. We are doing better at saving lives in ICU's. But, we're not doing a whole lot better at doing public health surveillance and contact tracing and community education and outreach.
"We should always invest in our tertiary healthcare systems and in sophisticated medicine but sometimes we forget to make the small persistent and long-term investments in primary healthcare, in community health, in prevention and supporting our communities.
"When we get through the end of this pandemic, I hope we sit down and have a really tough conversation with ourselves around what is the right balance of investments in health. Because, some of the negative impacts of this pandemic have definitely been driven because we don't invest enough in frontline community health, public health and primary healthcare.
"Dr. Tedros says all the time that primary health care is the bedrock of universal health coverage. And, our public health nurses, doctors and midwives are the bedrock of primary healthcare."
The WHO presser yesterday was a wealth of other information, too!
I couldn't help but think how, if all goes well with your presidential election, the US will be in a great position to do the work of rebalancing where investments in healthcare and public health are made. Most countries need to massively invest in their public health architectures and these are just some of the opportunities that this pandemic could unleash!
OK, just answered a bunch of comments from all of this week. Go check them out...
:-)
-CW
Who would I like to see in a Biden cabinet?
I'd like Marie Yovanovitch as Secretary of State, I love your choice of John Kerry as Secretary of Defense! I was thinking Robert Reich as Treasurer. I'm torn on AG between Preet Bharara and Glenn Kirschner... leaning towards the latter but there's not much in it. Put Elizabeth Warren in charge of the Consumer Affairs and Proection Office. It's her baby so let her build it up. Give HUD back to Julián Castro.
Death Harris [19]
I am not telling people to sit out elections.
Yeah, you are. There are virtually no candidates at any level that meet your criteria.
Death Harris [20]
I'm assuming that you're not splitting hairs and pretending that Medicaid is not insurance.
So, no job and no health insurance. Are you independently wealthy? Got a sugar daddy? Sponging off your mom? Homeless and using the computer at the public library? Or what?
Chris,
If people actually think rich=smart/smart=rich, then that particular obstacle in the effort to obliterate the Republican cult of economic failure can surely be overcome with effective communication and communicators.
But, I guess if you really believe that that kind of thinking is difficult to overcome, then you must believe that Democrats aren't up to that fight. And, sadly, I guess you're probably right. :(
As treasury secretary, Timothy Geithner was the best communicator, by far, when it came to obliterating the Republican cult of economic failure and, frankly on many other critical issues, too. Ironically, though, he is radioactive to most Americans on the rich folks thing and so he can't be the messenger on this. Whatever.
What's stopping Geithner from writing op-eds and making appearances on cable news programs right now? What's he waiting for?
Don't get me wrong. I have no interest in hearing from him.
I think you just answered your own question. ;)
Sometimes, JFC, you can be pretty funny. :)
Maybe Democrats could just dig up the many remarks he made on this issue from when he was Treasury secretary, especially the events he did at CAP and just use them verbatim, without attribution. Heh.
Actually, there is another great communicator and he was the one who actually coined the phrase, Republican cult of economic failure.
Here is David Fiderer's seminal piece from back in 2010 and updated in 2017. Just replace Bush with Trump as nothing has changed.
https://www.huffpost.com/entry/the-bush-tax-cuts-and-the_b_781419
[25]
I don't think so. I don't need to be convinced about the GOP. They have no redeeming qualities as far as I'm concerned.
I'd say he really doesn't care because he's OK or he'd get out there whether Biden asked him or not. The cable networks have time to fill.
Do you know what radioactive means in the context of politics?
Do you remember the venom that was thrown his way by average voting Democrats? It wasn't that long ago, you know.
Later, JFC, have to get to work ...
Now I'm confused about why you're promoting him. He doesn't have to convince Dems about GOP failure.
Now, I'm confused. So, why is Trump leading on the economy and why do Republicans generally lead on the economy?
I'm not promoting him. I understand why I can't.
I'm promoting the great messaging he had on the Republican cult of economic failure and his message on why Democrats are the better stewards of the economy.
Now, I really have to go!
[33] Elizabeth Miller wrote:
"Now, I'm confused. So, why is Trump leading on the economy and why do Republicans generally lead on the economy?"
Because all Republicans and a majority of Independents think that Republicans are better on the economy because they are seen as supporting businesses. Obviously Democrats would disagree. It's the Independents that you need to convince. Unfortunately anything in America that criticizes the Republican pro-wealthy position also is too easily characterized, wrongly, with that big old bad "socialism" label and is therefore automatically anathema to Independents.
[16] Chris Weigant wrote:
"OK, just answered a bunch of comments from all of this week. Go check them out..."
Where? Darn if I could find them! Am I missing something?
[36]
At the bottom of the comment thread for each of the last three columns.
[35]
The "independent" label also applies to Green Party members and those who truly do not lean one way or the other, but I do agree that a slim majority of them are probably just ashamed to identify as republicons due to culture war insanity.
CW-
"Does a thought of something that does not exist actually exist?"
I think you are putting Descartes before d' horse.
By Cartesian logic, If Trump thinks about a "health plan" than Trump knows he exists. The "health plan" can still be an illusion...like Trump University.
change than to then in 39. Dang!
JFC,
I don’t think you’ve gamed this out properly. If OD has legs (and underpants), then, sure, you’re losing on every transaction, but you’re making it up in volume.
Let’s say 10 million voters sign up and effectively create the I’m Not Voting for Any of You B**tard* Party. In the first election cycle, they execute their pledge by whatever means is legal in their state, resulting in something over 120 million actual active voters deciding the election. OK, but the momentum will be undeniable.
In the next cycle, when 40% of active voters are signed up as B**tard*, just 60% of the active voters will decide an election. Think of it, by the time 80% of active voters, who are, in fact, single-issue voters despite what you may think, remain true to their pledge, then, by golly, the Underpants Gnomes will have collected all the underpants they need and … profit!
I hope that helps.
From the Grateful Dead column,
[19] Elizabeth Miller wrote:
MtnCaddy,
I'm a Bernie Bro and while I'm sure Joe will be a good President Bernie woulda beaten Trump in 2016 and this election too if he won the nomination.
Really? How so?
Here's how so: Trump won nomination over all the Establishment Repugs in 2016. Sure, there was The Apprentice and $2 billions in free press but the major reason Trump won both the nomination and thence the Presidency was his promise to take care of the little guy. He wouldn't have won dink without that promise.
Let's say it's Bernie instead of Establishment Hillary. Yeah, the Establishment Hillary who offered more of the same economics as the Establishment Repugs vanquished by Trump.
Bernie addressed the same Populist dissatisfaction with the current state of the American Dream as did Trump in 2016. But Bernie's was for real and had been pushing this for decades. Plus Bernie didn't want to shove his religious beliefs down anybody's throat (read: anti-abortionist) and had been demonstratededly every bit the Pacifist as Trump.
Bernie would have unleashed us Progressives along with all of the other Democrats (like they'd vote for Trump?) and have beaten the idiot like a drum.
That's how.
Next question.
Elizabeth Miller did most decidedly NOT write any of the following ... be more careful next time, MtnCaddy!
[19] Elizabeth Miller wrote:
MtnCaddy,
I'm a Bernie Bro and while I'm sure Joe will be a good President Bernie woulda beaten Trump in 2016 and this election too if he won the nomination.
MtnCaddy,
Talk to me when Bernie wins the nomination.
John,
Because all Republicans and a majority of Independents think that Republicans are better on the economy because they are seen as supporting businesses. Obviously Democrats would disagree. It's the Independents that you need to convince. Unfortunately anything in America that criticizes the Republican pro-wealthy position also is too easily characterized, wrongly, with that big old bad "socialism" label and is therefore automatically anathema to Independents.
Are Independents really that obtuse?
In any event, Democrats could do a much better job at obliterating that kind of thinking. I mean, they only have logic, the truth, and decades worth of evidence on their side. ;)
And, if Democrats actually did do a better job of obliterating the thinking coming out of the Republican cult of economic failure, then they might get the votes of many who don't normally vote. Stranger things have already happened.
And, last time I checked, John and JFC, Democrats alone aren't enough to beat Trump, assuming many of them still won't vote this year. That last bit always astounds me. Maybe Trump has been enough to encourage them to make the effort this time around ...
Ruth Bader Ginsburg has passed! RIP RBG!
https://apple.news/ARMT2lSZ9T-2HuKO09WmEjw
From above
RIP RBG
I wish I was kidding this time.
I'll miss her very much. I loved reading her work. What a phenomenal woman she was. So sad.
When will there be enough women on the Court? When there are nine. Love you RBG!
Love you, Notorious RBG!
A critical election just more critical, by several orders of magnitude.
A critical election just got more critical, by several orders of magnitude.
She wrote a letter to her grand-daughter saying, in part, that she did not want Trump to pick her replacement. If that happens, then there is no justice in this world of ours.
Just days before her death, she dictated this statement to her granddaughter:
Elizabeth Miller
55
She wrote a letter to her grand-daughter saying, in part, that she did not want Trump to pick her replacement.
If he wins reelection, Trump should pick her replacement. If he doesn't win reelection, Biden should pick her replacement.
If that happens, then there is no justice in this world of ours.
Oh, I do hope McConnell insists they're going to replace RBG and attempts to do it. I don't believe that is in their best interests in the long run... so please do it, GOP hypocrites. It won't end well for you. :)
The Supreme Court has always been one of Biden's strengths. He will lead this fight and it's not just about a seat on the Supreme Court!