For those of you who were really expecting John McCain to come through and vote for the “skinny repeal” senate GOP healthcare bill…
Otter’s wise words ring true. But it’s not like McCain didn’t warn you. He stated he opposed the bill when he voted to allow it to go up for debate. So I’m not mad at McCain. He did exactly what I expected him to do, preen for the cameras, virtual signal for his media friends, and toss a big FU to the Republican Party. It’s the same thing he’s been doing for years. So why the surprise?
In fact, I think McCain did the GOP, and Trump, a favor. The various GOP “repeal and replace” bills were all terrible anyway as I recounted here. None of them fixed the real problems with the individual insurance market or the exchanges. So why should Republicans get their hands dirty in a rush to get anything passed when they will own the results? And since none of their bills fixed the problem, the results will be pretty bad.
And of course, as time goes on, I’m less and less sure that the House and Senate leadership really wanted any bill to pass. It seems like it would have been fairly easy to buy off most of the dissenting senators by simply allowing the people on the Medicaid Expansion to keep their plans, as I suggested back in June. Did Mitch McConnell really think Lisa Murkowski was going to vote get rid of Medicaid expansion and reduce the federal contribution to Medicaid, when half of her state is on some version of Medicaid? How did he think she and the other senators who are from states that have a large dependency on Medicaid would vote? But if your real goal is to deliver Trump a failure, what better way than provide a sure fire failure of a bill that’s doomed to fail? Admittedly I don’t have any evidence that they sunk the bill on purpose, but if not, they truly are incompetents.
So what now? I think at this point, Trump should recognize that of the many enemies he has in DC, the Republican led Congress is definitely part of them. And to that end, he should remove the healthcare issue from their hands. And how to do this? Form a Presidential commission to put together a health care plan, a “terrific” one which meets Trump’s criteria for a healthcare replacement bill. Nothing of Trump was reflected in the Congressional bills but this is being viewed as Trump’s failure. Taking the issue from Congress and giving it a Presidential commission removes the issue for this year, and allows both Trump and the Congress to move onto other issues. What happens when the commission finishes a Trump approved health care plan is another story, but it moves the issue from the failed column to “pending.”
My general thoughts and feelings on Trump’s constant attacking of Jeff Sessions is that it’s disgraceful and shows poor leadership to be attacking a loyal subordinate in such a passive aggressive (and sometimes not so passive) and very public way. Sessions isn’t in some random cabinet post; he’s the Attorney General, and almost everything that Trump wants in domestic policy depends on Sessions. That’s doubly true when you’re talking about issues like immigration. Sessions is really the only “Trumpist” in the cabinet. Everyone else could care less about Trump’s ideas. So without Sessions; there is no logical replacement (or at least one that the Senate would confirm-Sorry Kris Kobach) to carry on Trump’s policies. Regardless of what happened to the rest of Trump’s Presidency, Trumpism would be over.
So why would Trump be acting in such a crazy way? CNN has beclowned itself trying to puzzle that one out, but going through the interwebs, I’ve seen 4 theories that might explain Trump’s attack on his only ally, Jeff Sessions.
One. Trump’s a madman.
In this case, Trump is just as he appears to be. He’s gone into a rage because of the Mueller investigation, and can’t stop himself from sniping at Sessions because he doesn’t really want to fire him but wants him gone and hopes if he is humiliated publicly often enough, Sessions will just resign. Who Trump gets to replace him and how that takes care of his Mueller issue are just problems for another day. The main thing is to get rid of someone who Trump feels failed him. That this will damage him with a large section of the conservative base doesn’t matter. Trump angry now!
Two. Trump is Mr. Magoo.
This is the theory of the Lion of the Blogosphere. According to the Lion, Trump is just bouncing around from situation to situation, but through sheer luck and happenstance; he winds up smelling like a rose. Trump’s speech in which he mentioned the effects of immigration in Sweden is a good example. After making a comment about the problems being caused in Sweden by immigrants, Trump was roundly mocked on social media and the weekend political shows, only to have immigrant riots break out in Sweden days later. Was Trump a prescient social scientist, or did he get lucky on counting on Muslims being Muslim? My magic 8 ball says “signs point to yes.” In any case, Trump one; Media smart-asses zero.
Three. Trump is pulling a professional wrestling “work.” Having worked with professional wrestling before, Trump is well aware how wrestling is much more like a soap opera for dudes than an athletic contest. There is a lot of drama in the wrestling story lines and sometimes a heel can get into a feud and then it turns out he has a secret alliance with the babyface! Yeah! The day is saved! In this scenario, Trump and Sessions are working together to draw out and crystallize support for Sessions by having Trump attacking him. Suddenly, every media person and Democrat (I know, same thing) who hated Sessions suddenly rush to his support. This gives Sessions freedom of action for things that will be unpopular to the Democrats/Media because if Trump is mad at Sessions, that must be good.
Four. 5D Chess. In the Scott Adams version, Trump is like Spock, if Spock were a New York real estate developer and hotel and casino owner. Actually, that’s not a bad idea for a Star Trek spin off: Star Trek: Las Vulcan. Where pleasure is logical… In this scenario, Trump is running all of the various media scenarios through his mind palace, war gaming the responses of the various media networks and politicians to insulate Sessions from future criticism similar to theory three; set a public distance between Sessions and Trump to give Sessions a free hand.
Which do I think is the mostly likely? Well I think we’ve seen signs of all four over the course of the Trump campaign and Presidency, although there could well be a lot of overlap. When Trump tweeted the punching CNN gif, did he know what the media reaction would be and that it ultimately would make the media look extremely stupid, or did he Mr Magoo his way into that situation? It’s hard to say. There is a lot of overlap between theories one and two and theories three and four. But when it comes to Sessions, I hope it’s a theory three & four scenario, but I fear it may be a theory one & two.
The end of “Game of Thrones” is on the horizon, but creators David Benioff and D.B. Weiss have already mapped out their next plan at HBO for when they officially depart Westeros.
HBO has given a series order to “Confederate,” a new drama that hails from Benioff and Weiss, Variety has learned. The show has no ties to “Game of Thrones” and is not one of the many potential prequels in development at the network.
“Confederate” chronicles the events leading to the Third American Civil War. The series takes place in an alternate timeline, where the southern states have successfully seceded from the Union, giving rise to a nation in which slavery remains legal and has evolved into a modern institution. The story follows a broad swath of characters on both sides of the Mason-Dixon Demilitarized Zone – freedom fighters, slave hunters, politicians, abolitionists, journalists, the executives of a slave-holding conglomerate and the families of people in their thrall.
Production on “Confederate” will begin after the final season of “Game of Thrones.”
One the one hand, as a big fan of alternate history literature, I would like to see a show that takes on the South winning the Civil War. It’s an issue that’s been done many times in books. Writer and historian Harry Turtledove has written an entire series of books, the “Southern Victory” series that goes from the end of a southern victory in the Civil War to the end of an alternate World War II. So it could be fascinating.
But on the other hand…
There has been an incredible backlash on social media.
Game of Thrones creators David Benioff and D.B. Weiss say they were prepared for the backlash that greeted Wednesday’s announcement of their next TV project, HBO’s alternate-timeline drama Confederate, which imagines slavery as a modern-day institution.
I don’t believe that for a second. I think they were genuinely caught by surprise. Because of course, no matter how good a Social Justice Warrior you are, there is always someone further to the left who will be more than happy to institute a pogrom. After all, we live in the era of #Dunkirksowhite.
So I don’t think the same premium network that took a medieval fantasy like Game of Thrones and made it into a girl power story of breaking the dragonglass ceiling and thinks Lena Dunham nudity is empowering is going to push ahead with a show that their peers oppose as a concept. Sure, if the Duck Dynasty guys came out in opposition to this show, that might turn things around, but I think the desire to stay on the left side of the twitterverse will strangle this show in the cradle.
And that’s a shame, because this show could have, as they say, started a conversation. Not a good one maybe, but since plenty on the left want to kick the South out of the union right now, it might be interesting to see what the world would have looked like if they had gotten their wish.
Breaking news from the who-the-hell-cares department, but MSNBC token Republican Joe Scarborough, of the Morning Joe show, has left the Republican Party. . . I’m shocked, shocked I say!
Actually I really was shocked. I thought Scarborough left the Republicans years ago. He didn’t vote for the Republican nominee not just last year, in 2016, but the last go around, in 2012. If you never vote for Republicans, on what basis do you call yourself one? Well maybe he was an “MSNBC Republican.” If someone’s primary political issue is gun control and their most hated senator is Texas Senator Ted Cruz, you are either Senator Diane Feinstein or… “Conservative” MSNBC host Joe Scarborough. But Joe’s left leaning positions aren’t new. I used to think Joe was trying to just keep his job. MSNBC did fire Pat Buchanan for driving while conservative, so I figured, if you like those nice paychecks, you have to sing their tune.
When the network takes an editorial position, they can count on Joe to follow along loyally. The key to that is to join, or as is often the case, lead, the mob. Joe is the first one to pick up the torch and pitchfork and begin to emote, throwing logic and reason to the wind and justfeel. He did it with Newtown, with Joe calling for tight gun control regulations (they did this daily on the show for almost 6 months after the shooting). If there is any incident that generates a purely emotional mob response Joe is there for it.
The Gabby Giffords shooting? He was there to warn the right to stop targeting innocent lefty politicians. He joined in blaming Palin and the Tea Party for the shooting.
Trayvon Martin? He joined the network in emoting about tea and skittles over and over again, even while his network was editing 911 calls from the shooting.
Ground Zero Mosque? He demanded that be built too.
So the reason why Joe Scarborough can make it on MSNBC as a Republican is because he has been a faithful team player. But now that he’s come out of the closet, he doesn’t need that. It turns out that he can now to be free to be himself: A confused guy undergoing a mid-life crisis. How else to explain first the affair, then divorce, and now engagement to co-host Mika Brzezinski? And now a ridiculous “music” career, including Manhattan gigs and music videos. Videos mind you, that he, without the least bit of shame, airs on his show.
As for Joe’s affair and divorce, each marriage is a mystery, so maybe I shouldn’t judge that, but I feel perfectly free to judge falling into the arms of Brzezinski. Without claiming any psychic powers, I can tell you that on his deathbed he’ll regard his affair and engagement to Brzezinski as his biggest mistake (assuming he didn’t kill that intern in his office in Pensacola).
And yet I’ve been a long time viewer to Morning Joe. For all the flaws of its hosts, it’s been different than any other dull and dumbed down morning show. It’s provided some drama, such as when Mika and Joe got into a fight when she called him a chauvinist (I didn’t know at the time it was flirtation), and Yuval Levin discussing the Burkean and Paine traditions of American political thought. You can’t get that on the Today Show. And Joe Scarborough did great work in eviscerating Paul Krugman on a debate on the Charlie Rose Show. It’s always entertaining when a University of Alabama grad, ex-Politician, and TV host, gets the better of a New York Times columnist and Professor of Economics in his own field.
So while I’ve enjoyed the longer conversational style aspects of Morning Joe; the show’s #nevertrump descent into pure snarkfest had ruined what was formerly a useful show, and turned it into a 3 hour morning long Cobert Show, only without the attempts at humor, all the while the main host acts out his mid-life crisis on live TV.
But as Joe pursues establishment approval that will never come, no matter how much he debases himself, he won’t be missed on the right, even if he takes all 12 or “Joe Scarborough Republicans” with him.
So bye Joe.
But, do we get anything in trade? If we’re trading Joe to the left, does the left have anything to offer us? Well as a matter of fact…
You may not have heard of Laci Green, particularly if you’re over thirty and don’t follow Social Justice Warrior intersectional feminism (and who does?) but in the world of YouTube, she’s a big star. Her feminist blogger YouTube channel has a million and a half subscribers and 146 million views. That’s a big audience for a lot of feminist yammering about Planned Parenthood and pansexuality. But then something weird happened earlier this year…
Suddenly Laci was talking about meeting some anti-feminist video bloggers and listening to different perspectives. “Listening to different perspectives” is exactly the opposite of what’s typical on the left these days, and particularly among the SJW set. Why oh why would she suddenly be interested in “different perspectives” that run counter to not just her world view and politics, but her business model?
You guessed it, she met a guy. And the guy she met is an anti-feminist you tuber who goes by the name of Chris Ray Gun. If you were a publicist, you could hardly craft a better Romeo & Juliet storyline. The MTV movie practically writes itself. In the world of you tube, Chris Ray Gun is a much smaller commodity than Laci Green is, but at almost half a million subscribers, he’s still a pretty big deal. But Chris shows no signs of reconsidering intersectional feminism, Laci is the one with her worldview shattered.
But that shattering is a long term process and as Laci struggles to deal with other perspectives on feminism than the ones she picked up at Berkeley, she’s dealing with the blowback of rethinking her worldview. One can’t predict where that will lead. With Joe Scarborough, once he began the process of status seeking among the establishment, the conversion was only going to go one way. But a move to the right is a different story. That’s usually with the understanding that, as Whitaker Chambers thought, that it’s a defection to a losing side. And you lose everything else as well, your old friends and your old, respected position. In Laci Green’s case, it could cost her a business. So the process of conversion isn’t assured. On the other hand, trading Joe Scarborough; for even a feminist who is willing to have a conversation; is more than a fair trade in my opinion.
Senators Mike Lee and Ted Cruz have thrown out their fix to pull the Senate Health Bill across the finish line, the “Consumer Choice Amendment.” As described by the Daily Caller:
The amendment, known as “Consumer Choice,” allows insurers to sell plans that do not follow regulations created under Obamacare for patients with pre-existing conditions, with the caveat that insurers have to sell at least one plan that adheres to Obamacare’s mandates. The proposal would allow insurers to sell cheaper plans with fewer benefits.
That’s all well and good, but it sounds like a ploy to simply get the Senate health bill passed, not to actually fix the wreckage in the independent health care market caused by Obamacare. One doesn’t have to be a medical policy analyst to see that an insurance market with one Obamacare compliant plan and all the others free of such restraints will cause a flow of premium dollars away from the one Obamacare compliant plan, making it unaffordable. Unless you have a pre-existing condition, why would you want such a plan?
So this plan doesn’t actually fix the independent insurance market, it ghettoizes the Obamacare plans. I’m unclear if the Obamacare plans become so expensive that the insurance companies have to subsidize them increasing the premiums and out of pocket expenses on every other plan they offer in the state, or if they just give up and continue the current process of bailing out of state exchanges as each state becomes unprofitable; the current “death spiral” trend. In any case, the health care market gets worse and death spirals the Republicans right out of office, leaving the Democrats to craft their own gimme-free-healthcare bill.
So what to do? Is healthcare really so intractable that there is no solution? I don’t think so, and Republicans used to understand the issue much better than they apparently do now. Republicans used to have all kinds of health reform plans, none of which look anything like the current Better Reconciliation Act.
So here are a couple suggestions that together I think would make a pretty good GOP replacement bill, but first, Republicans are going to have to come to terms with two fantasies that dominate the health care debate:
The health bill can’t be a tax cutting bill. Republicans want to get rid of a lot of the Obamacare tax increases, and it’s true that many of them were pretty poorly thought out, but we’re not going back in time to 2009, we’re stuck with the conditions that Obamacare left in the health care market and the expectations that people have from their healthcare plans. The taxes can be rejiggered any way you want, but it should remain revenue neutral.
The Medicaid cuts can’t be part of the bill. I get what the House and Senate are trying to do, and I have to raise a glass to their under cover of darkness attempt to do something about one leg of our multi legged stool of entitlements that are crushing our long term budgetary outlook. I’ve seen barely a mention in the media (too busy chasing Russian ghosts I guess) of the fact that the Republicans are trying to remove Medicaid as an entitlement program by limiting its federal contribution, pushing ever greater costs, as well as the freedom to design their own programs, to the states. But that has sabotaged doing anything else with healthcare. If that’s something that can be put down in a reconciliation bill then it’s something the Democrats can easily change the next time they’re in power, so why waste political capital on a plan that can (and will) be totally reversed with 51 Democratic votes?
Now on to the suggestions! Many of these I’ve made previously but not under a single list and probably requires a full repeal of Obamacare, but anyway…
A. Tax Credits available for purchasers of independent health insurance plans that are actually equivalent as a consumer to the employer health plans being covered by private companies. And that would be pricy, something along the lines of a $5000.00 tax credit for individuals and $10,000.00 for families. This would come close to paying about two thirds of the premium cost of the average group plan.
B. But wait you ask, that doesn’t do anything about medical inflation, that encourages people to seek out the most expensive plans they can afford with their tax credit. Not so fast… Any leftover amount from their tax credit would be rolled into a Health Savings Account (HSA). So say you find a family plan that only costs $8,000.00 per year, and then $2,000.00, the balance of your unspent tax credit, can be rolled into an HSA account to be used to pay co-pays, and deductibles. That’s a big incentive to be a smart consumer.
C. Of all of the Obamacare Mandates, the one on Preexisting Conditions is the most popular, and the one that is most likely to survive in any future health bill. I’ve already described in detail how to have pre-existing conditions paid as a secondary payer via Medicaid.
D. The other Obamacare mandates are mostly idiotic. Pediatric dental care? Come on! But none are probably more idiotic the requirement to cover “children” up through age 26. Of all the mandates, that probably had more to do with the collapse of the Obamacare exchanges than any of the others since they took the young and healthiest group out of the exchanges and put them mostly under their parent’s employee group plans. That should simply be reduced to 21 or 22. Otherwise it mainly benefits upper class kids in graduate school. However I recognize that there are constituencies for all kinds of nonsense, so to borrow from Cruz and Lee’s amendment, require that each state have one plan that has one of those mandates. Let there be one plan that really does have pediatric dental care, and if you really want that, that’s the plan you get. I think the market would provide those options anyway, but one mandate per plan, rather than all of the mandates in one plan, like the Consumer Choice Amendment has, should be affordable. Of course the priciest mandate, for Pre-existing conditions, would be applicable to all plans but wouldn’t affect the price because they would be covered by the secondary payer.
E. Of course the media and CBO crying jag over people losing their health coverage due to the elimination of the Medicaid Expansion can be avoided by simply allowing those currently under Medicaid Expansion to keep their plans. I elaborated on this back in June, but if the 14.5 million people currently covered by Medicaid Expansion know they won’t lose their plans (even if no new people are added to the program) that takes a lot of wind out of the sails of the opposition, and as I noted last month, those numbers will only decline over time.
F. There are other smaller fixes that will help things, many of which I’ve mentioned before, but are not by themselves game changers, such as:
A federal cap on non-economic malpractice damages.
Allow purchasing pools of small employers and nonprofit associations and clubs (think the Elks Club).
Allow consumer purchase of health insurance across state lines. There is some question on whether this will actually increase competition and reduce prices but hey, we allow it for employer health plans, so why not?
Allow doctors and other health providers take a tax deduction for indigent care. For some doctors, taking a deduction on the cost of service based on Medicare rates might be a better value than simply being paid for the service with Medicaid rates.
It’s not a fully realized health bill, but I think it’s a good outline that most of the right could agree with. If not this, it has to be something, and I mean something that won’t continue to wreck the health care market like the current House and Senate versions will. The clock is ticking.
Mike Street Station 