AHCA Supplement

  1. WSJ whiffs
  2. David Brooks on fire
  3. Pascal-Emmanuel Gobry, Freedom Caucus ally
  4. [Michael Brendan Dougherty: GOP lies]
  5. Zero tolerance?

1

The Wall Street Journal editorializes in full oblivion in the AHCA context:

The President’s status as a deal-maker is being mocked in the media, but he has played a constructive consensus-making role. As he’s asked the Freedom Caucus holdouts—we’ll paraphrase—you’ve won multiple elections on repealing and replacing ObamaCare, and then voted more than 90 times for symbolic repeal you knew Mr. Obama would veto. Now I’m prepared to sign the genuine article—and you’ll sink this over details?

Their answer is apparently yes.

No, it’s not details. The AHCA, presented as a repeal of Obamacare, is a fraud — and I say that as one who isn’t invested in repeal.

The Freedom Caucus, as I understand it, wants repeal to be followed by a free market replacement of some sort. This is what Republicans ran on and for which they voted repeatedly when their votes were just symbolic.

Trump, in contrast, promised universal coverage and yadda yadda yadda B.S. The Freedom Caucus and Trump have never been on the same page.

I could be wrong, but not wronger than the WSJ, I think.

2

David Brooks is on fire with similar themes in greater depth:

Legislation can be crafted bottom up or top down. In bottom up you ask, What problems do voters have and how can they be addressed. In top down, you ask, What problems do elite politicians have and how can they be addressed?

The House Republican health care bill is a pure top-down document…

First, the new Republican establishment leaders needed something they could call Obamacare repeal — anything that they could call Obamacare repeal.

It became clear as the legislative process rushed forward that there was no overarching vision in this legislation on how to reform health care or even an organizing thought about how to improve the lives of voters. There was no core health care priority that Republicans identified and were trying to solve.

There were just some politicians who wanted a press release called Repeal.

Second, Donald Trump needed a win. The national effects of that win seemed immaterial to him.

His lobbying efforts for the legislation were substance-free. It was all about Donald Trump — providing Trump with a pelt, polishing a credential for Trump. His lobbying revealed the vapidity of his narcissism. He didn’t mind caving to the Freedom Caucus Wednesday night on policy because he doesn’t care about policy, just the publicity win.

Third, the bill was crafted by people who were insular and nearsighted, who could see only a Washington logic and couldn’t see any national or real-life logic.

(The Trump Elite. Like the Old Elite, but Worse!)

Overall, I’m a fairly neutral bystander — except for the part where Donald Trump gets denied an utterly unprincipled “win.” Hurray for that.

3

Pascal-Emmanuel Gobry:

[T]oday, the GOP, as the party that holds the White House and both houses of Congress, owns health care. Which means that anything bad that happens will be blamed on them.

And under the AHCA, bad things would have happened. It was just a mess of a bill. Millions of people, especially Trump voters, would have lost coverage. Regulations that keep health-care costs high would have largely stayed in place because the Republican Party decided to pass the bill through a process known as reconciliation, which requires only 51 votes in the Senate but can only affect the parts of ObamaCare that directly affect the budget. The structure of the bill’s tax credits, favoring older voters at the expense of the young, and the rich at the expense of the poor, was akin to a Democrat caricature of what a Republican health-care bill would look like. The attack ads just write themselves.

If the AHCA became law, it would have made a mess similar to the mess created by ObamaCare (and probably worse, suggests the CBO), except this time Republicans would own the mess.

This is a quandary where two conservative priorities are put in tension. Conservatives want to deregulate health care. And conservatives want the government to spend less money on health care. The problem is that they can’t do both. If they repeal bad ObamaCare provisions (and they are bad), such as guaranteed issue (which forces insurers to provide coverage to anyone), or community rating (which prevents insurers to price based on the customer’s actual risk), many people will suddenly find coverage unaffordable. If these people don’t get money to compensate for those short-term fluctuations and keep getting covered, there will be millions of pissed-off Americans. By the same logic, if conservatives want the government to spend less money on health care, the only way to do it in the short term is through regulations that force insurers, and maybe providers, to provide services at essentially below cost, which means regulation. The AHCA tries to thread that needle by doing a little of both, but it won’t work. It won’t work politically, because it gives every stripe of conservative a reason to be angry; and it won’t work on the policy merits, because lots of people will lose coverage and because it won’t fundamentally inject consumer dynamics into the health-care system.

One of the deep and time-honored insights of conservatism is, quite simply, that you don’t always get everything you want, because the world is tough. Conservatives are going to have to choose. And they should choose the approach that gets rid of the regulations.

 The goal for conservatives in health care is to have a system where prices go down over time through consumer choice and innovation. That requires active consumers and a deregulated marketplace. In the short term, because of the way ObamaCare was designed, the only way to accomplish this without committing political suicide where 15 million sick people are suddenly dropped is to write some checks.

Slash regulations. And then subsidize health care. That has to be the conservative answer.

Obviously, that’s just my point of view. But at least I have a point of view, something the Republican leadership has conspicuously failed to have.

4

Don’t forget Michael Brendan Dougherty‘s calling out the Republicans for healthcare lies, featured here yesterday, I think.

5

A four-year old has been suspended from school for a week for bringing a shell casing he got from his policeman grandfather.

Trump’s hard power contempt for soft virtues strikes close to home.

The two stories seem connected by a zero-tolerance idiocy on steroids.

* * * * *

“Liberal education is concerned with the souls of men, and therefore has little or no use for machines … [it] consists in learning to listen to still and small voices and therefore in becoming deaf to loudspeakers.” (Leo Strauss)

Some succinct standing advice on recurring themes.