NY Times:
G.O.P. Support of Senate Health Repeal Erodes During Break
A week that Senate Republicans had hoped would mobilize conservatives and shore up support for their measure to repeal the Affordable Care Act instead ended with eroding enthusiasm, as usually reliable Republican senators from red states blanched at its impact on rural communities.
I’m not going to insist it’s already failed, but it sure looks like the “it’s moderates that always fold” meme is wrong. Here’s why it might be so:
Philip Klein/WashExaminer:
Republicans, prominently with House Speaker Paul Ryan's "Better Way" proposal last year and with President Trump's boasts, chose to abandon their long-standing approach to pre-existing conditions and embrace Obamacare's approach instead. Once they did that, it effectively became impossible to truly repeal Obamacare. But Republicans are still dedicated to being able to claim that they passed something they can call repeal. So their solution has been a piecemeal approach — picking off parts of Obamacare, many of which were in place to offset the effects of denying bans on pre-existing conditions.
Keeping the pre-existing condition regulation complicated Republican efforts to repeal the individual mandate, which was put in place to coerce young and healthy individuals to purchase insurance. It meant a worse Congressional Budget Office score and the need to figure out alternative ways to prevent healthy individuals from leaving the market in greater numbers. It made it much harder to figure out a way to lower premiums, to offer individuals more choices and flexibility, and to stabilize the rocky Obamacare insurance markets — all of them the stated goals of Republican leaders in taking on the healthcare issue.
ACA repeal is politics. Their master plan is to issue junk insurance that doesn’t cover people, while cutting Medicaid and making voters buy junk policy if they buy anything at all, aka “freedom”. That makes their insurance (big) donors happy (they win either way, like stock brokers who make commission on both buy and sell), and may lower some premiums (that’s a visible thing and why they want it, but deductibles go up, so out of pocket expenses are overall higher, aka “pay more and get less”), but leaves way too many people without decent coverage. The voters know it and they do not approve.
But that’s a policy issue, and conservatives already think they’ve lost on policy. Keep that in mind, as we constantly keep blaming Democrats for “not winning”.
Republicans think coverage expansion didn’t matter, it’s all about premium prices and nothing else. They act like the public is clamoring for private insurance, and regard any government insurance as welfare. But the reality is that Obamacare/ACA does so much good for so many people that Republican Senators can’t quit it. They just can’t. The voters won’t let them.
Voters want the most glaring problems fixed. And that means cooperating with Democrats AND ceasing the sabotage that’s making current premiums rise. That’s what they are hearing at home.
Vox:
I shared my toddler's hospital bill on Twitter. First came supporters — then death threats.
I was offered a .22 bullet, although I’m still not sure whom he meant it for, me or my child. One man took me up on the challenge I’d posed in the thread and declared that my son just wasn’t worth keeping alive anymore. There was even a percentage of the comments dedicated to the belief that I was a foreigner or, worse, a terrorist, which is when I started asking news outlets to use my full name: Alison, not Ali, since people seemed unable to believe that I was, in fact, a white chick from New Jersey.
Jonathan Chait/New York:
If Republicans want to give up their long-standing boycott of any tinkering with the bill and instead pass some simple patches, they might anger some conservatives, but they will also steer clear of inflicting humanitarian disaster on their own constituents, who might not appreciate it.
Trumpcare isn’t dead until it’s dead. But the Senate Republicans look like a group of politicians who have decided they don’t care enough about health-care policy to absorb the political blowback that passing a law snatching insurance from millions of Americans would instigate.
Catherine Rampell/WaPo:
The reason Republican health-care plans are doomed to fail
The cost to a supermarket of selling you a yogurt is basically the same as the cost of selling me a yogurt. That’s not true for health insurance, where I might turn out to be a much more expensive customer than you are.
In a world where patients know more about their health status (e.g., a bum knee) or future health spending (e.g., pregnancy, long-delayed surgery) than insurers do, insurers try to attract only the cheapest, healthiest enrollees by offering the cheapest, stingiest plans. Cruz would eliminate quality minimums, remember.
When consumers have a choice of many plans, and insurers can tweak those plans to attract the healthiest patients, you get a death spiral.
Axios:
The most unpopular bill in three decades
This is why Senate Republicans are having so much trouble with the health care bill. The Republican health care effort is the most unpopular legislation in three decades — less popular than the Affordable Care Act when it was passed, the widely hated Troubled Asset Relief Program bank bailout bill in 2008, and even President Bill Clinton's failed health reform effort in the 1990s. That's the verdict from MIT's Chris Warshaw, who compiled polling data from the Roper Center on major legislation Congress has passed since 1990.
Keep those calls coming. This week is the Big Push.
Michael Gerson/WaPo:
Most psychiatrists are (understandably) uncomfortable with diagnosing from a distance. And the particular diagnosis of narcissistic personality disorder requires significant impairment — which is a hard case to make of a figure at the pinnacle of American politics.
And yet. There are judgments that must be made about the fitness of leaders. Citizens are under no ethical obligation to be silent when they see serious dysfunction. The challenge here is not merely the trashing of political norms. The main problem is the possibility that America has an unbalanced president during a period of high-stakes global testing. This is not a clinical diagnosis. It is a civic and political judgment, made necessary by the president’s own words and acts. Trump holds a job that requires, above all else, the ability to unite and steady the nation in a time of crisis. There is no reason to believe he can play that role.
Long, superb read from the Guardian:
There is no such thing as western civilisation
The values of liberty, tolerance and rational inquiry are not the birthright of a single culture. In fact, the very notion of something called ‘western culture’ is a modern invention
Someone asked Mahatma Gandhi what he thought of western civilisation, and he replied: “I think it would be a very good idea.” Like many of the best stories, alas, this one is probably apocryphal; but also like many of the best stories, it has survived because it has the flavour of truth. But my own response would have been very different: I think you should give up the very idea of western civilisation. It is at best the source of a great deal of confusion, at worst an obstacle to facing some of the great political challenges of our time. I hesitate to disagree with even the Gandhi of legend, but I believe western civilisation is not at all a good idea, and western culture is no improvement.
Eugene Robinson/WaPo:
“A little learning is a dangerous thing,” wrote the poet Alexander Pope. Three centuries later, Pope’s aphorism perfectly — and dangerously — describes President Trump’s understanding of history as a zero-sum clash of civilizations in which “the West” can triumph by imposing its will.
The speech Trump delivered Thursday in Warsaw’s Krasinski Square might have been appropriate when Britannia ruled the waves and Europe’s great powers held dominion over “lesser” peoples around the globe. It had nothing useful to say about today’s interconnected world in which goods, people and ideas have contempt for borders.
Susan J. Demas:
The Quiet Rise of Pro-Trump Media
Of course, the convenient way to dismiss facts you don’t like nowadays is to scream out “#Fake News!” at the top of your lungs like a toddler. Go ahead. I’ll wait. Critical thinking is, indeed, a burden.
But this debate is actually far less interesting than new developments in the media marketplace that haven’t garnered much attention. And this is all taking place as Trump enjoys what Dartmouth political scientist Brendan Nyhan calls “state media” level coverage from Fox News. The echo chamber extends to other right-wing outlets like Breitbart, Rush Limbaugh and Newsmax (now on the DirectTV lineup), not to mention conspiracy theory wonderland Infowars, which is run by Trump confidante Alex Jones.
Robert H. Frank/NY Times:
Lingering uncertainty about the fate of the Affordable Care Act has spurred the California legislature to consider adoption of a statewide single-payer health care system.
Sometimes described as Medicare for all, single-payer is a system in which a public agency handles health care financing while the delivery of care remains largely in private hands.
Discussions of the California measure have stalled, however, in the wake of preliminary estimates pegging the cost of the program as greater than the entire state government budget. Similar cost concerns derailed single-payer proposals in Colorado and Vermont.
Voters need to understand that this cost objection is specious. That’s because, as experience in many countries has demonstrated, the total cost of providing health coverage under the single-payer approach is actually substantially lower than under the current system in the United States. It is a bedrock economic principle that if we can find a way to do something more efficiently, it’s possible for everyone to come out ahead.
Kaiser:
While a slim majority favors the idea of a national health plan at the outset, a prolonged national debate over making such a dramatic change to the U.S. health care system would likely result in the public being exposed to multiple messages for and against such a plan. The poll finds the public’s attitudes on single-payer are quite malleable, and some people could be convinced to change their position after hearing typical pro and con arguments that might come up in a national debate. For example, when those who initially say they favor a single-payer or Medicare-for-all plan are asked how they would feel if they heard that such a plan would give the government too much control over health care, about four in ten (21 percent of the public overall) say they would change their mind and would now oppose the plan, pushing total opposition up to 62 percent. Similarly, when this group is told such a plan would require many Americans to pay more in taxes or that it would eliminate or replace the Affordable Care Act, total opposition increases to 60 percent and 53 percent, respectively.
I prefer single payer but it will need to be an evolution over a long period of time, with a great deal of education, to get the US public to accept it. In other words, you have to do the work. If all you got is a slogan, you fail.